Monday, March 22, 2010

Health care "reform": Revisiting the questions 

More than two years ago, and a full year before the election of Barack Obama, I wrote a post that posed rather fundamental questions to would-be health care reformers. I respectfully submit that they are as germane today as they were then. My question for you, our esteemed and obviously brilliant readers: Did the just-enacted legislation and the public explanations thereof answer any of them to your satisfaction?


By Anonymous Robert Arvanitis, at Mon Mar 22, 09:19:00 PM:

The just-enacted legislation fails.

Historically,government intervention has distorted both demand (no pain so no deterrents overconsumption) and supply (artificial constraints on price but not cost!), a double-whammy.

The left now faces the consequences of those bad decisions (bankruptcy of Social security, Medicare and Medicaid). Rther than remove the distortions, the left decides to double-down with FURTHER intrusions. This is FAIL writ large.

The only answer is auction-because we are rational, tempered by charity, because we are humane.

Let prices determine, but make sure the least well-off 10% are protected. This is a safety net to protect the few, NOT a spider's web to snare us all.  

By Blogger JPMcT, at Mon Mar 22, 10:02:00 PM:

The sad thing about this is that we had a fully functional system with high quality physicians and hospitals that offered prompt care with world class technology. With 80% of the health care consumers insured, all we really needed was insurance reform and expansion of catastropic coverage for the poor.

Pretty much what the Republicans were suggesting. You know...the guys who had "no plan".

Well, what we got was:

1. Massive reorganization of the insurance business model...pretty much to the brink of making it unprofitable.

2. Massive regulation of physician and hospital income, again pretty much to the point of making people who want to enter medical school certifiably insane.

3. Bleeding the half dead Medicare program of half a billion dollars.

4. Relying on higher taxes in a recession to create income for the program. Can anybody give me an example of when that has worked?

5. NO provision for tort reform. This means no reduction in malpractice insurance along wihth the huge reduction in income. This means you will MAKE money by retiring if you are a physician.

6. NO provision for training the thousands of extra surgeons and general practitioners who will be needed to treat the exponentially increasing patient load. Get ready to go to Canada for your hip and heart surgery...the six month wait will look like a breeze.

7. Excise taxes on Pharmaceutical companies based on their market share. Heh..."Sir...take HALF an Aspirin and call me in a month!"

8. 1700 new bureaus!!! Need I say more about that??!!

The power and scope of this savage attack on American medicine is so blatant that I can reach no conclusion other than it is designed to fail....and create unrest...and wherever that will lead.  

By Blogger JPMcT, at Mon Mar 22, 10:06:00 PM:

Sorry...point three is half a TRILLION dollars.

...half a billion is chump change to these guys.  

By Blogger PolticalJunkie2008, at Tue Mar 23, 01:04:00 AM:

So This is How Liberty Dies…With Thunderous Applause: http://mittromneycentral.com/2010/03/21/this-is-how-liberty-dies-to-thunderous-applause/

The post I just linked to is the best post I have read in months. I know it's easy to get down after last night, but this post really picked me up and I hope it picks you up as well.  

By Blogger Don Cox, at Tue Mar 23, 04:36:00 AM:

"expansion of catastropic coverage for the poor"

Why should poor people get only "catastrophic coverage"?  

By Blogger Buku, at Tue Mar 23, 07:56:00 AM:

My opinion: You can quickly determine if a bill is actually a good thing for the people by noting whether congress exempts themseleves. Since they had to pass it to find out whats in it... maybe today someone can tell me if there are exemptions for our benevolent rulers.

So to answer your question... no not really.  

By Anonymous Edward Lunny, at Tue Mar 23, 08:13:00 AM:

Good grief, it's a fail, of typical governmental monumental scope. What government social program, or non-social program, is as efficient ,effective or true to it's stated goal as the healthcare extortion plan has been promised to be ?
But, I think that this mind set "Why should poor people get only "catastrophic coverage"? " goes right to the root of the problem. Why should poor people be given anything from the government ? Unstated ,in Don's question, but implied is the lack of any query or requirement of personal responsibility on the part of the poor. This bill, as with many of the other social assistance programs do not require any responsibilty on the part of the recipient. Shouldn't assistance require some participation on the part of the assistee ? Will they get life long aid ? Isn't there some point at which one can be reasonbly expected to care for oneself ? When fully 50% of the population effectively pay no federal taxes, or significant state taxes, why should the other 50% be expected to carry them in perpetuity ? How much extorted "charity" can one segment of the population be expected to pay without some benefit in return ? Particularly when the recipients of such largesse make little ,if any, effort to extricate themselves from a largely self inflicted predicament.  

By Blogger Don Cox, at Tue Mar 23, 02:43:00 PM:

"Why should poor people be given anything from the government ?"

In the case of health, because it is the interest of all citizens that all other citizens should be in good health, and able to work and contribute to the general prosperity of the economy. Also, because many diseases such as TB, measles and AIDS are infectious, and a taxpayer can catch them from a non-taxpayer.

Do you really deny poor people the benefit of the law, the roads, the police, the National Parks, or the defense forces?

The kind of state you want is one like Zimbabwe, where a few very rich people are surrounded by millions of starving peasants. Why not be a bit more civilised than that?  

By Blogger Don Cox, at Tue Mar 23, 02:51:00 PM:

"When fully 50% of the population effectively pay no federal taxes, or significant state taxes,"

VAT takes care of that. Everyone who buys any goods or services (except exempt items such as books) pays some VAT. At least, they do here. So the only people paying no tax at all are those who never buy anything.

If you rely entirely on income tax, then that 50% may be true.

In the UK, we have a tax called "National Insurance" which is basically an employment tax. This was originally meant specifically to replace commercial health insurance, but it now goes into the general pot. This does mean that everyone in employment pays at least some tax.

I don't know the details of tax in other states of Europe.  

By Blogger JPMcT, at Tue Mar 23, 06:39:00 PM:

@ Don Cox:

The poor should only have catastrophic coverage because they already get first dollar coverage of everthing else thru existing Medicaid programs.

Personally, I think that the concept of "first dollar" coverage is a program killer. If people had to pay SOMETHING..even 5-15 bucks, to see a doctor before the other coverage kicks in, then we would not have the current abuse of emergency rooms and people going to the doctors office for things that could be cured with home remedies.

The absence of good coverage of truly serious illnesses for the poor not only creates hardship for their families, but also for hospitals (usually teaching hospitals) whose budgets take a collosal hit with charity coverage.

My current routine in billing the truly poor is like many docs...I don't bill them and absorb the cost.

If the Feds, in their largesse, would allow docs to "write off" the fair cost of such care on their corporate tax returns, that would also be a major help.

Needless to say, none of us are looking for any major help from the Obama administration. Most of us will be lucky to emerge solvent from this latest "Hope and Change" enema.  

By Anonymous Edward Lunny, at Tue Mar 23, 07:10:00 PM:

" In the case of health, because it is the interest of all citizens that all other citizens should be in good health, and able to work and contribute to the general prosperity of the economy." Except that they don't work and they don't contribute to the general prosperity. And therein lies the problem, assistance implies that there is participation on the part of the recipient. Unfortunately, participation is not considered or included as a requirement of receipt of assistance. When one receives something, healthcare, welfare et al, without having contributed to the system that provides such benefits,there is no perceived value in the support of that system. There is no sense,or concern, for the sacrifice made by others to provide the support that is the lifeblood of such a system. The mindset becomes, I want more, I'm entitled to more, so give it to me. There is no understanding or concern that other people have to work and earn and sacrifice to provide the means for a mechanism, an agency, to provide the assistance. So the assistance becomes to be treated without gratitude, without thought.
" Do you really deny poor people the benefit of the law, the roads, the police, the National Parks, or the defense forces? " Is it really so extraordinary to think that those whom benefit, all of those whom benefit, shouldn't contribute at some level ? Is it unreasonable to think that those whom can work and earn and participate ,should ? Do you really justify predatory taxation on those whom strive and succeed, those whom sweat and toil daily, so that some significant portion of the population can sit on their fat asses and benefit for no reason other than their lazy ? Admittedly, there are those whom have need of daily lifelong assistance and to those it should be provided. Those people do not make up the majority of those whom receive assistance, nor will they be the beneficieries of this healthcare extortion. Excluding those whom are truely in need, why are poor people poor ? What do they do for themselves ? Why haven't they extricated themselves from poverty ? Why haven't the existing programs helped them, or does their lifestyle preclude them ever being out of poverty ?
" everyone in employment " And those not employed ? Who pays their share ? What do those whom pay that share get in return ? This is the reason tax dollars should not be given in "charity" assistance programs. What causes are deserving ? Whom decides ? How much should be spent ? Whom decides ? Too often poverty is an excuse, not a reason. Using such an excuse to penalize and punish my family and myself, using such an excuse to rape and pillage my earnings and efforts isn't charity it's tyranny and extortion and it is despicable.  

By Blogger JPMcT, at Tue Mar 23, 10:02:00 PM:

Above noted.

Is it not clear...as in CRYSTAL clear...that the motivating force in Democratic legislation is to acquire voting blocs to maintain their power until the Constitution is castrated by thir President.

Health Care: Freebies for pretty much anybody without a job.

Immigration reform: Yo, bro Julio...we will give you a "fine"...you have your whole life to pay it...but in the meantine, here's your celebrity gift pack full of citizen goodies.

Teachers: if you suck as a teacher, worry not! Your job is safe with us. Hell, we don't want an "edgumacated" population anyway.

Cap & Trade: Hey, you all think Gore is an idiot, right? But we need to be a "Global Member" of the world community...so let's just "do this thang". Sheeeaat, you can afford the higher energy bells. We "CARE"...and so should you.

The more I think about this, the more I think I need to head back to Ireland.

At least the government doesn't seem to encourage civil

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