The Glade 4.0

No, we come into being quite independently of our own effort. Our lives are thrust upon us, when you think about it. Should an infant not have healthcare because their parents can't afford it? Why punish the child for the sins of the parent? Do you oppose public health care for children? Why or why not?




I believe that it is best if people can work to provide these things for themselves, but if circumstances conspire to put people in a place where they cannot, that we have an obligation to make sure their basic needs are met. That's why I support social safety nets like welfare, medicaid, medicare, social security, SCHIP, the US Military, Public Police Departments, Schools, and a public insurance option.

I would prefer a single payer plan, but it's not going to happen. I'll trust a government plan any day over a private health insurance plan. I've worked for those bastards and I am fully aware of how little they give a **** about their insured. At least the government has to worry about my vote.

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It feels like all the people who want limited government really just want government limited to Republicans.
---The Daily Show

Why punish anyone else to pay for the child's healthcare who are even less connected to the action of the parents?

If its wrong to punish the child becuase they had no say in it - its equally wrong to punish others who had no say.

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"...but there exists also in the human heart a depraved taste for equality, which impels the weak to attempt to lower the powerful to their own level and reduces men to prefer equality in slavery to inequality with freedom." - De Tocqueville

Okay, so now that we have agreed that health care may be a nebulous concept but is at least comprised of some disparate manner of goods and services, and you have previously indicated that you find Medicare to be a perfectly fine starting point, I have to ask which Part(s) of Medicare are you speaking of? There are four parts. They are referred to as (and I know this will come as no surprise to you, as you have done your research):
Part A - Hospital Insurance
Part B - Medical Insurance
Part C - Medicare Advantage Plans
Part D - Prescription Drug Plans

As I am sure you know, Parts A + B are what are generally known as the Original Medicare Plan. When you refer to Medicare, is this what you are speaking of? Or are you meaning Original Medicare + some Part C or Part D? Further, wherever your starting point happens to be, what further do you require as a covered good or service?

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No matter his answer Shuy, he will waffle like John Kerry at IHoP. He's like a rat, and when you corner him into the cage of his own answers, he will just attack.

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A man who has nothing for which he is willing to fight, nothing which is more important than his own personal safety, is a miserable creature and has no chance of being free unless made and kept so by the exertions of better men than himself. ~ John Stuart Mill

It's not punishment. Life isn't fair. Some are born with illnesses. Others are not. Those born with illnesses aren't punished, they just start out disadvantaged. This is where charity comes in. Nobody deserves anything in this life. You have the rights guaranteed by the Constitution, but you have to provide for everything else. I oppose tax-payer paid health care for infants because I believe charity should make up the needs wherever possible. And as I've already stated, EMTALA will already provide health care on an emergency basis for said infant regardless of the parents' ability to pay.


If you feel you have an obligation to provide, that's great. Shell out your own cash and time and do so. Don't force others. Just as I give of my own time and money to help others and don't expect other people to do what I'm doing.


I honestly don't get this. The government has a proven track record of pillaging funds for entitlements. The government poorly mismanages things at just about every level. "Big Insurance" had like, what? A 3 % average profit margin last year? Yet you ascribe the most insidious of motives to the people providing the insurance and somehow think it will be better managed in the hands of a government that will never have to care about providing quality service to its customers and will degrade medical care to the quality of the local DMV. If you really want to watch costs come down, then unshackle insurance companies and let them compete over state lines. Even my basic Economics 201 book says more firms competing will invariably drive the price down.

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The Dude abides.

Because that's what they're born to. They, or their parents can work to change it, but it's ot anyone else's job. No one else forced that particular person to be born to those circumstances. "Punishing the child" has nothing to do with it. Punishment is something negative that is specifically applied to a person in response to some unacceptale action. Unfavorable circumstances and events in life are not punishment, so the question is irrelevant.



Why do we have such an obligation?

The military is NOT a social safety net, nor are the police or schools.



What you don't get is that making it a government plan isn't going to help. The government plan is going to cut costs? How? Are they going to force drug companies to take less? Hospitals? Doctors? What happens when those people and organizations can't afford to do their buisness or just don't want to? Are you going to make drug manufacturing a government industry? Are you going to force people to be doctors and nurses when they don't want to because of the massive pay cut?

The problem with healthcare isn't private insurance. IT's the fact that people don't take care of themselves, and have this idea that the are entitled to someone else's dime to pay for a cure for every ailment. Obesity, smoking, alcoholism, and drugs are massive health-care cost increasers. What's the plan to reduce these problems?

Oh, that's right there isn't one. That would mean recognizing that people are responsible to some degree for their own care, and once that door gets open, the entitlement to public healthcare comes into question. Can't have that, can we? That might mean less poor people voting yur way because they've been bought with public largesse.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

An infant certainly cannot work to change their health care. They are born into a situation in which they have no control.

My lady faire and I were talking about this just the other day. She works at an inner city school, and the vast majority of the kids in that school lack good health care. So, the majority of them spend about 4 times as much time in pain as someone from a middle class family. That pain has a serious impact on their ability to learn, and the development done at that early age is key.

So these kids, who have no say in what situation they were born to, are now severely disadvantaged by a situation they have no ability to control. I just don't see how it's a moral idea to allow that to continue.



/scratchhead

Huh? I mean, you didn't get a choice as to who your parents were. You were born into the situation you were born in.



Well, that entirely depends. If the society we live in today is capable of providing good health care to children, I just don't think it's a moral or even rational act to deny it to them based on some vague philosophy about rugged independence. We are the only western industrialized nation that does not guarantee health care to all of it's citizens. Perhaps some might think that's a badge of honor, but I think it's a mark of shame.

You are basically arguing, if I read you correctly, that a child is guilty of a parent's lack of success.



Because we are all in this together. Because these things affect all of us. And frankly, because it's the right thing to do. You may disagree on that, and that's probably as far as that argument can go.



I strongly disagree. The Military *is* a social safety net, so are schools, and so are the police. We could have an entirely privitzed army that contracted to the various states and the country overall. However, we know that an army accountable to the public and to civilians is significantly less likely to become a threat to our liberty.

Police, fire, parks, H1N1 vaccines, dissaster response - all of these things are social safety nets. Should the people of New Orleans have been left to die because they could not afford a helicopter evacuation? I certainly don't think so.



Actually, in a way I agree with you. A simple public option will not drive costs down enough. The only thing that will truly drive down costs is a single payer system - essentially getting rid of all private insurance companies and having a single health care insurer that covers every citizen. Medicare for all, essentially. That, or an NHS style system where the government runs all health care in the country.

Both of those options have proved to be significantly more cost effective and better at delivering care than our own. Unfortunately, it's a very difficult pill to swallow for some of the most powerful lobbies in Washington.

I do think that a public insurance option will help keep doctors, hospitals, and insurance companies honest. It will have a great deal of bargaining clout, and will be able to negotiate good, fair costs for the people covered by the plan.



But that isn't what's being proposed, DE. What's being proposed is a public plan that exists alongside the current public plans, funded by premiums and deficit neutral.



Well, that isn' exactly true. Regulation of tobacco is already moving in a direction that is much more powerful. I agree that there are health issues that won't be solved by a public insurance plan. However, what it will help to solve is the financial devastation that comes when hard working people encounter a sudden illness or injury that ruins them, among many other things.



I'll ignore the somewhat venomous tone at the end here and respond to your first point -

People are responsible for their own care, and people all over the country take good care of themselves. And they can still get cancer. And their private insurance company can still just drop them because they don't want to pay for that cancer. So then their lives are ruined, despite doing everything right.

The poor are already able to access health care via medicaid. This effort is largely directed at people who work hard but still can't afford the frighteningly high (and ever increasing) cost of health care coverage.

One of the main things driving that coverage is the lack of competition. In some states, insurance companies control upwards of 90 percent of the market. I doubt you would argue that such a lack of competition has no effect on the price.

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It feels like all the people who want limited government really just want government limited to Republicans.
---The Daily Show

I call hooey. Provide data for even one such state.

CMS pays for around 50% of all medical care in the US.

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“The duty of a patriot is to protect his country from its government.” - Thomas Paine

In North Dakota, BC/BS controls 90 percent of the market share. Here is a WSJ article that goes into some detail about the consolidation of the industry, and the decreasing amount of competition.

link




health reform dot gov has some information relating to North Dakota specifically.

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It feels like all the people who want limited government really just want government limited to Republicans.
---The Daily Show

While interesting, that's extremely misleading for you to post.




Emphasis added.

While BC/BS may have a 90% market share in small-group insurance that does not indicate a state-wide market share that big. Now, while I personally find a market share that large a bit high for my anti-trust sensibilities, to say that BC/BS has a market share of 90% in North Dakota without the "small-group insurance" context is misleading.

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“The duty of a patriot is to protect his country from its government.” - Thomas Paine

I agree that life is not fair. However, just because life is not fair does not mean we should do nothing to help create opportunity that overcomes that lack of fairness.



This is a fundamental tenent of conservatism, and so you're probably not surprised that I disagree with you. I believe everyone deserves a good education, quality health care, security, peace, and the opportunity to prosper. I believe that no one deserves to go hungry, or without shelter. I seriously doubt we can come to any kind of agreement on that particular notion.



And our concept of what those rights include has evolved over the years to include many things not originally put there. The right to vote, for example.



But emergency care does nothing for the health and well being of the child. If the child spends a week in pain before they finally get to the ER, that's a week of stymied development. How can you reasonably expect a child that spends the majority of their rime in some form of pain or illness to compete effectively?



I believe that we as a society have as much an obligation to provide all of us with health care as we have an obligation to provide all of us with the security a military brings. I see these as equal.



Yes, it's true that some politicians use government to pilfer money from "entitlements". Our previous president did that to Social Security very early in his presidency, an act often forgotten since it happened before 9-11. I don't see that as an indictment of entitlements, I see it as an indictment of those politicians. Thank goodness we have a democratic process to be rid of them.




Medicare is significantly more efficient than any of the private insurance companies out there. It's operating expenses are about 3%.



Well, it's a pretty simple formula -

The Private market has as it's goal profit. Not people's health. In fact, if they pay for people's health care, they negatively impact their profit. That's how insurance companies work. Therefore, the incentive for the insurance company is to avoid paying claims and to collect as much in premiums as possible, and to transfer as much of the cost of health care on to their policy holders as they can get away with. We see this reality in practice every day.

The public market has as it's goal satisfaction of the insured and public health. If I am unhappy with the way my plan treats me, I am not going to support the people managing it, and they can be out of a job. This will not happen in the private market because health insurance is a necessity for your life, well being, and financial security. We *must* buy their product or we risk the very real possibility of total financial ruin.

In this way, insurance companies are a lot more like a racket and a lot less like a benign private corporation.

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It feels like all the people who want limited government really just want government limited to Republicans.
---The Daily Show

...

Presuming this fact as true: That's because they have a monopoly. They're also nearly insolvent.



If this were the formula, you'd be right and I'd go stand with you. It isn't, and you're wrong.



1) That isn't the goal of CMS
2) You cannot remove them from their job as easily as a private entity.

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“The duty of a patriot is to protect his country from its government.” - Thomas Paine

Ok, but what portion of the overall market in North Dakota is small group? By the way, I didn't intend to be misleading, I simply did not see the difference, really. Small group insurance insures small businesses, etc, and a lot of people work in small businesses. It doesn't change the fundamental point I was trying to make - insurance companies are choking out competition and are raising prices at a pretty crazy rate.

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It feels like all the people who want limited government really just want government limited to Republicans.
---The Daily Show

So, it's cheaper to run, more efficient to run, and it keeps prices down. That's a ringing endorsement to me. If they are having financial difficulties, then like our Military, they should be shored up.




I'm sorry, but please show your work.

Insurance companies make money through what essentially amounts to a highly theory-crafted gamble, for lack of a better term. They make money by taking in more in premiums than they pay out in claims. They do not profit when they pay out more in claims than they take in in premiums.

They assess risk in order to hedge their bets, but they also do very underhanded things to keep their profit margins in place. Recently, in California, it was discovered that fully 21% of all claims were denied by the insurance companies there. There is no reasonable way to argue that it's all fraud.



I disagree entirely. It is much easier to elect different politicians than it is to get rid of a corporate board and infrastructure. Private entities are not accountable to the general public, they are accountable to their share holders. And in practice, they aren't all that accountable to the share holders.

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It feels like all the people who want limited government really just want government limited to Republicans.
---The Daily Show

It's not cheaper to run, nor is it more efficient (because it would have be more efficient to be cheaper). It operates with a government subsidy which means it doesn't have to be cost effective. Quite the opposite in fact.

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"It's real, grew up in trife life, the times of white lines
The hype vice, murderous nighttimes and knife fights invite crimes" - Nasir Jones

I don't know the answer to your first question. Again though, CMS controls about 50% of overall health spending in the US, so on average small-group would be a subset of the other 50% of ND's market.



Presuming your statements "cheaper to run and more efficient" as correct (even though I don't believe they are): in this paragraph you're supporting monopoly while opposing it in the preceding paragraph?





All of this is correct.

And yet none of this indicates anything underhanded by default, despite the accusations that have been sent towards private insurance companies.

Failing to pay on claims loses an insurance company business. As such, your portrayal of the formula is incomplete in saying (or implying) that all insurance companies essentially deny everything they can. That isn't true on its face because they want to attract and retain customers. Doing so in the US means attracting employers to pay for it. Doing that means promising speedy, cheap, and friendly service (not necessarily in that order) to the customers (the employees).

So, while true that some claims, or hell even many claims get denied at some time or another, making that SOP is sure grounds for business failure.




1) How many of those claims were denied with cause?
2) How many of those claims were paid on appeal?

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“The duty of a patriot is to protect his country from its government.” - Thomas Paine

It's administrative costs are a tiny portion of it's over all budget. In other words, three cents on the dollar goes towards administrative costs, where in a private insurance company it's more like 30 cents on the dollar. In fact, only a tiny portion of every premium dollar spent on a private plan actually gets paid out as a claim.

We can see this play out in the real world when we look at every other country in the western world who's public insurance or health system operates at a cheaper cost than ours, with better delivery and satisfaction than ours.

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It feels like all the people who want limited government really just want government limited to Republicans.
---The Daily Show

Prove those numbers.

I was content not to dispute the 3%, even though I disagree with it, until you put forth the 30%.

Since I know the 30% isn't correct, I'll now dispute both



Define "better delivery" and "better satisfaction."

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“The duty of a patriot is to protect his country from its government.” - Thomas Paine

It'll have to be tomorrow some time, it's getting a bit late to do number collection for the interwebs.

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It feels like all the people who want limited government really just want government limited to Republicans.
---The Daily Show

Yep.

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“The duty of a patriot is to protect his country from its government.” - Thomas Paine

Because in order to change it involves forcing other people to pay for a remedy for a problem they are not repsonsible for. Just because a person is in a situation they can't control doesn't morally obligate someone else to remedy it, unless there's a specific duty between those two inidividuals based on some other relationship they bear to each other. An infant can eventually work to improve its situation when it is old enough.



No one else chose that for you either, so it is equally valid to say they cannot be held responsible for changing it.



Rugged independance has nothing to do with it, nor does any vague philosophy. It has to do with simple human motivation.
If you fix people's problems for them, they stop trying to do it themselves, and if you take away the results of someone's success, they stop trying to succeed.

Guilt has nothing to do with it any more than punishment does. Guilt is a result of wrongdoing. The fact that people in poor circumstances aren't guilty doesn't somehow obligate anyone else to them.



All in what together? If something affects mew, why shouldn't it be my choice whether to do something about it? WHY is it the right thing to do? Soemthing better than "We're all human beings" or some other tautology would be nice.



That has nothing to do with it being a social safety net. The military exists to fight and defeat our enemies, not to solve social problems or provide jobs to the poor. The fact that it does so is a side benefit, not a purpose of it.



They aren't social safety nets a all. They provide protection against events which are not social in nature. Viruses and Hurricanes occur without regard to social conditions.



How do you know this is going to drive the costs down, and what about the problems of smoking, obesity, etc?



They may have proven cheaper, but cheaper is not the same thing as cost effective, Moreover, working differently in countries that are smaller in both geography and population, as well as different socially and economically does not mean they will work here.



Or it will simply drive these pplaces out of buisness. I have a feeling your idea of a "fair cost" for a service would be below what's realistic to pay for it, and what about when someone can't afford the "Fair cost"? That's right, you wnt it to be free, whih means other people have to pay MORE than the fair cost.



I said notihng about another proposal. I said costs come mainly from poor personal health behaiors such as obesity and smoking. Nothing about the plan being proposed alters that.



We've already tried taxing the hell out of tobacco to little effect. All we're going to do by regulating it is increase the attractivness of bootlegging it.



No, they can't just drop them because they don't want to pay for something after they have it. If that were the case, no one's cancer would EVER be paid for, and no one would buy insurance in the first place.



Which is a problem. Not because they can't get access to health care (which they can) but because we're paying for people to get something they don't need to have. We don't have any obligation as a society to provide people with these things. You're making a great case for more private charity though.

It's really just a program to buy the votes of the poor. Don't tell me people aren't going to vote for the guy promising them free stuff.



I would, except that who are insurance companies supposed to compete with, if not each other?

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."

And that is the question we will never come to an agreement on, and furthermore, the question that is at the very core of this debate. I believe we as a society have an obligation to ensure that every American has access to quality, affordable health care. You may disagree, and that's certainly your right, but that is the key component of this debate. It is, as the President said, ultimately a moral issue.

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It feels like all the people who want limited government really just want government limited to Republicans.
---The Daily Show

Yes, that certainly is opinion. I've linked story after story after story of the abysmal care people get in other countries that have government run health care.

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"It is true that democracy undermines freedom when voters believe they can live off of others' productivity, when they modify the commandment: 'Thou shalt not steal, except by majority vote.' The politics of plunder is no doubt destructive of both morality and the division of labor."

And sadly, for every horror story we find in the nooks and crannies of the internet, there are that many more success stories.

Recently, the Republican party tried to attack the NHS of Britain using similar horror stories, but Steven Hawkings came out very clearly in it's defense. Such arguments also presume that such horror stories don't happen in a private insurance system.

However, we know that private insurance companies do choose who lives and who dies, and they do so based on a profit calculation. DE makes the point that those private entities wouldn't have any customers if they denied every cancer claim, but that's a bit of a straw man. I never argued that they do it to everyone, or even the majority of patients. I argued that they *do* do it when they can get away with it.

To restate a previous example - a patient was dropped from their insurance after submitting claims for cancer treatment because of a previous diagnosis of kidney stones he never knew he had, and was never treated for. He died, because he could not afford the treatment he needed. In this way, his private health insurance company acted in exactly the way that conservatives allege that the government would behave. A bureaucrat in a private corporation chose who lived, who died, and why, and that individual did so on the basis of profit and loss.

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It feels like all the people who want limited government really just want government limited to Republicans.
---The Daily Show

And there's the problem. You want to claim it's a moral issue, but you can give me no good reason WHY providing publicly funded helthcare is the most moral solution given the costs it will inflict on other people. The poor and downtrodden are not more morally valuable or worthy than those with greater means. Morally speaking, the option of making people take greater responsibility for healthy living and relying on private charity to handle most of the burden appears best to me, in part because it has the immense moral advantage of allowing people to choose whether to help or not. Morally, charity provided freely is praiseworthy while that given because it is required by law is far less so.

Providing for medical needs is not some moral imperative that must be accomplished regardless of cost to other areas of society. The effects on everyone must be considered, as must the cost-effectiveness, not only in providing the actual care but in how it affects other facets of life. I'm not opposed to public healthcare because it's public; I'm opposed to it because my observations of government programs is that they are ineffective and wasteful. You seem to forget, I'm about the realpolitik, not the ideology.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."