patrick.net

tatupu70 says

That is a good one. So, are you then implying that liberals are Supermen?

I'm sure you've offended elliemae with your politically incorrect use of "superMEN." Was this just a slip or were you attempting to offend? I don't know. I think "Superpersons" would have been much more appropriate.

AdHominem says

So we are seeing that socialism is pushing up prices, because no one is accountable for the true cost of their own care and therefore there is little or no incentive to keep costs down, live a healthy lifestyle etc…
Socialism is failing us again.

The origin of the "moral hazard" term everyone loves so much? It comes from the 19th century fire insurance industry where the worry was too much fire insurance led to carelessness about fires. The phenomenon you describe is more correctly attributed to any sort of INSURANCE but particularly comprehensive with low deduductibles. So it's not at all an aspect of socialism and is present in capitalist insurance as well. The term has spread to be used in pop culture now for just about anything.

Ellie,elliemae says

AdHominem says

elliemae says

The reason that it doesn’t work in reality is that you can’t afford your own medical care. You will be bankrupted overnight and become completely dependent on the state…

Lets assume you are correct. Why can’t I afford my own health care?

This topic has been beaten to death - yet here we go again:
http://www.washingtonpost.com/wp-srv/politics/documents/american_journal_of_medicine_09.pdf
http://www.wowowow.com/politics/got-serious-illness-you-may-go-bankrupt-your-medical-bills-312694
In fact, in 2007, of those who filed for bankruptcy, about 80 percent had insurance. Consider these numbers: In 2007, medical problems contributed to 62.1 percent of all bankruptcies, and during the six years prior, the proportion of all medical-related bankruptcies rose by about 50 percent. Many others had to file because they lost much of their income due to illness, or mortgaged a home to pay their doctor’s bills. And these people aren’t poor — most, in fact, were well-educated, middle-class homeowners.
The Washington Post has the full study here. The New York Times notes that the health problems that left patients with the most out-of-pocket expenses were:
Neurologic (i.e., multiple sclerosis): $34,167

Diabetes: $26,971

Injuries: $25,096

Stroke: $23,380

Mental illnesses: $23,178

Heart disease: $21,955
The amounts are out-of-pocket expenses, not total expenses. Diabetes can cost as much as $1,000 per month, not counting the misc extras.

Yes Elli, disease treatment is expensive. Why is it so expensive?

AdHominem says

Why is it so expensive?

How much is your health worth to you? In a free market, service providers will attempt to set that price level, to varying degrees of success.

Nomograph says

Do you actually expect us to believe that your hobby is looking at old photographs of crowds from 1920 to 1950, RayRay?

I didn't say it was my "hobby" NomoNomo. Try to comprehend what you are reading.

Nomograph says

Personally, I’m more concerned about the 99% of Americans who DO deserve health care. I don’t spend much time worrying about the other 1%, but if that is what you want to spend your life on, be my guest. I’m sure it will work out wonderfully for you.

There you go again with your imagination. I don't "worry" about anything. You claim 99% of Americans "deserve" health care. What are you basing that assertion on? Please be specific. LOL

Ad homo:

You asked wAdHominem says

Lets assume you are correct. Why can’t I afford my own health care?

...and I answered. As I mentioned, this topic is a dead cat on the road of life. The more you run it over the flatter it gets - but people still run it over and then apparently expect it to jump up and run away or something. Maybe this topic has 9,000 lives?

Yet you ask why healthcare is so expensive. You are fully capable of finding out the answer - feel free to search Patnet for answers. Or go online to find out this info. You will believe what you want, and will make personal attacks on those who disagree with your point of view. But it doesn't change the system.

Healthcare should never be an option. EVER. Not for the poor, not for the rich. Not for the illegals, not for the pillars of the community. People who choose to work in the field should be paid; and those who devote years of their lives honing their skills should be paid accordingly. We spend an awful lot of money on people whose responsibility it is to deny benefits and commissions to people who call an 800# to sign up for a certain type of insurance - this is money that could be used to pay for actual care.

RayAmerica says

I didn’t say it was my “hobby” NomoNomo. Try to comprehend what you are reading.

Seriously, "comprehend?" I'd say that he does. I love the english language. You might want to try learning it.

elliemae says

I love the english language. You might want to try learning it.

Obviously, you've been sitting by the phone all this time and Brad Pitt hasn't called. It has made you very, very bitter. Give it up and move on dot org.

elliemae says

This is a constructive criticism, not a verbal attack such as you use (”very, very bitter”).

A fine example of a very sincere leftist that is offering "constructive criticism" out of the goodness of a caring, sharing, leftist warm and fuzzy heart. LOL

Aw, you like me!

elliemae says

I love the english language. You might want to try learning it.

How, may I ask, do you know whether or not I'm of Hispanic origin? Your challenge to learn English would be a highly offensive, politically incorrect, xonophobic, downright mean and nasty comment ... that is of course if I were Hispanic. Intente por favor ser un poco más sensative.

RayAmerica says

elliemae says

I love the english language. You might want to try learning it.

How, may I ask, do you know whether or not I’m of Hispanic origin? Your challenge to learn English would be a highly offensive, politically incorrect, xonophobic, downright mean and nasty comment … that is of course if I were Hispanic. Intente por favor ser un poco más sensative.

Really?

I could ask you to show where, in any of my posts, I assume what your nationality might be. But that would be too easy.

"xonophobic?" elliemae says

your message, if you have one, is lost in your lack of command of the english language and sentence structure.

I could do this for hours - but fortunately, I have a pressing engagement.

elliemae says

“xonophobic?”

So sorry elliemae .... I needed an "e" there instead of that "o." Looks like you've won again!

Yea that happens alot. I'll be gone for awhile - hope you'll be okay without me. Seems like you need someone to fight against to validate your existence.

elliemae says

This is a constructive criticism, not a verbal attack such as you use

elliemae says

Seems like you need someone to fight against to validate your existence.

Case closed. NEXT.

elliemae says

alot

uhhhh, it's a lot as in two words, not one word Little Miss Spelling Bee Champion. LOL !!

Oops. You are correct. I left out a space.

So - you were right once. Congrats! Mark this date on your calendar, as it doesn't happen often. RayAmerica says

elliemae says

This is a constructive criticism, not a verbal attack such as you use

elliemae says

Seems like you need someone to fight against to validate your existence.

Case closed. NEXT.

Exactly what case did you close? And why does it matter? Or should I ask, to whom does it matter? Certainly not to me - and it's obvious that you really want to matter to me. Otherwise, why do you post ridiculous statements on the interweb? Judging from the underwhelming response you receive, it doesn't impress many of us.

But I do enjoy discussing your sentence structure with you. Hopefully you will learn something - perhaps how to use the interweb to access help with your writing - that will enable you to further your professional career. Knowing that I'm a positive influence on you makes me warm & fuzzy inside.

elliemae says

Yet you ask why healthcare is so expensive. You are fully capable of finding out the answer -

Yes, But I want to know why YOU think health care is too expensive? Because YOU want to solve a problem with government interference. But in order to solve the problem we first need to understand it. So again I ask why is health care so expensive?

Top 10 reasons health care is expensive:

1. Medical School Tuition (Higher education tuition is in a lending bubble)
2. Medical Mal Practice Insurance (Thank you John Edwards)
3. Inflation
4. The Medical Establishment is the most protected and restrictive establishment in this country
5. Insurance Companies acting as criminal enterprises refusing to pay doctors.
6. Doctors price gouging to recover the cost off treating those who don't pay
7. The FDA regulates the industry to death
8. Medicare/Medicaid pay doctors next to nothing for services
9. The Elderly
10. The American Diet

You forgot one Oak. There is no real substitute for health care. If you get sick, you HAVE to use the health care system. They have monopoly power.

tatupu70 says

You forgot one Oak. There is no real substitute for health care. If you get sick, you HAVE to use the health care system. They have monopoly power.

Yeah, and don't forget the food service system. They have a monopoly on food!! If you get hungry there is no real substitute. When you are hungry you HAVE to buy food from a food retailer. We really should regulate those restaurants and grocery stores because they have monopoly power.

So again I ask why is health care so expensive?

Why wouldn't it be? Is there nothing not as important as your health or the health of a loved one?

While a new filling might only cost $50 in materials and labour, its utility is worth many tens of thousands to me. And that's a relatively minor health ailment.

Demand is completely inelastic and supply is relatively limited!

Basic economics tells us we're lucky to have the prices we do now, LOL.

There's only two options. Rigorous extra-market (ie GOVERNMENT) cost controls, optionally coupled with insurance mandates, or complete deregulation a la the deregulation of the mortgage market accomplished by the Republicans 1998-2003 in the hopes that new service providers will drive down profit margins.

Libertarians gravitate toward the latter because they are ideologues with their heads in cloud-cuckooland and therefore unable to learn from the real-world policy successes of the socialized systems -- from Japan to [er, I was going to say Ireland but their public system isn't that good] Norway.

Prices aren't high because of tuition (that's mistaking the cart for the horse), malpractice (less than 0.5% of costs go to malpractice), inflation (costs are rising many multiples of CPI), the FDA (the FDA is run by the industry). [Though I have to agree with Oakman that elderly + obesity is a big combo. The Medicare trust fund is going to be blown through later this decade, right when the baby boomers are entering their 60s.]

Disease itself isn't necessarily costly, as long as it kills quickly. Obesity adds a variety of syndromes that increase demand for care over longer periods of time and thus greatly increases health care costs.

You want to fix our system, study other systems and learn from them.

AdHominem says

We really should regulate those restaurants and grocery stores because they have monopoly power.

Jesus Christ you are a f---ing retard. This country is overflowing in food and productive farmland. The shit literally grows on trees.

The barriers to entry as a farmer or food preparer are minimal. Labor involves common household operations like turning on a stove and carrying a plate. We as a nation import millions of unskilled farmworkers to harvest the shit. We individually purchase food many times a day and can judge quality and value for our money trivially. Hunger is a trivially cured ailment.

Food service and medical service are two different planets, anybody who confuses the two has NO F---ING clue of the real world or economics.

Let's get this straight. Government passes laws that restrict the supply of medical services and medical practitioners (license requirements, education requirements, strict regulations on everything about the process etc..). The resulting shortage of "care" causes prices to go up.

Government caused the problem. Now we think government can fix the problem?

It's like asking Al Capone to take over law enforcement.

AdHominem is so right! We should be letting copy clerks do surgery using things they find around the office! There is no need for those pesky laws requiring that medical practitioners provide evidence that they have studied and now know things about medication and surgery and anatomy. Let's open up the field and see what the free market does with it! I myself make a patented heal-all tonic, I would tell you what's in it but it's a family secret, you understand, perhaps you would like to buy some?

AdHominem says

Government caused the problem. Now we think government can fix the problem?

There will never be an unlicensed medical service sector on this planet. Libertarians got 0.4% of the vote last time and that may or may not prove to be the highwater mark, depending on what rightwing nutjobs run in 2012.

Drink your collodial silver and turn blue for all I care.

Troy says

There will never be an unlicensed medical service sector on this planet.

that is just plain ignorant. If you need an organ transplant, are willing to pay, and don't mind using the black market.... where there is a will there is a way (or so I saw on vhs)

AdHominem says

where there is a will there is a way (or so I saw on vhs)

Why, is your eight-track broken?

elliemae says

AdHominem says

where there is a will there is a way (or so I saw on vhs)

Why, is your eight-track broken?

They make Eight-Tracks with video now? The reel to reel projector will SOON be obsolete!

Just curious, if you could afford an organ on the black market (and needed one for yourself or someone you love), would you go the non-licensed route? Why/why not?

Food service and medical service are two different planets, anybody who confuses the two has NO F—ING clue of the real world or economics.

And yet, a sweepingly general tautology that the health care industry has a monopoly on the health care system shows a "F—ING clue of the real world or economics...." LOL! I'm pretty sure that the analogy to the food industry was simply an attempt to show the stupidity of the original argument, but then again, conservatives don't think and they use 8-track tapes, and liberals think and use DVDs....

right you are Paralithodes, if there are monopolies in health care they are created/enabled by government legislation.

But by and large there is still a market (albiet an unfree/regulated market) in health care and alternative medicine. The left-libs want to argue that: "medicine is a right and since when you need medicine ("there is no elasticity in the market" they say) it needs to be provided by the state."
Well when you need food there is no elasticity in the market either. So I think the state should feed us too! 1984 here we come!

AdHominem says

Just curious, if you could afford an organ on the black market (and needed one for yourself or someone you love), would you go the non-licensed route? Why/why not?

I don't know. Unless I was faced with the actual problem, I honestly don't know. But I'm leaning toward hell yes. The problem is that the origin of the organ would be suspect; was someone killed for it? is it diseased? But when you're grasping at straws, you grab the one closest to you in the hopes that it works.

I was once asked if I could vote for the death penalty. My answer was that I would have to feel strongly enough about the issue to take personal responsibility for that person's death, because I feel that my vote would be the same thing. I have also amazed myself by advocating the death penalty in a few local cases, most notably:

http://en.wikipedia.org/wiki/Beau_Maestas

...except his sister should fry, too. But first they should torture them in cruel, cruel ways.

http://www.fox5vegas.com/news/19602218/detail.html

140 years? not long enough. He should be allowed in general population wearing a shirt declaring his crimes, then he should fry.

Back to the current topic, which has (again) morphed into healthcare. I'm fortunate enough to have a serious, yet treatable disease. Without health insurance, I would remain in excruciating pain and die. I support a change to our current system, because I've experienced it from both the provider's and the patient's point of view.

Paralithodes--

Perhaps the monopoly analogy was a bit simplistic, but do you disagree that health care in general presents some unique problems for a free market? Do you think free markets can function effectively in health care?

tatupu70 says

Paralithodes–
Perhaps the monopoly analogy was a bit simplistic, but do you disagree that health care in general presents some unique problems for a free market? Do you think free markets can function effectively in health care?

Ask anyone that received laser eye surgery. It's probably the only area of health care that the market is allowed to function.

tatupu70 says

Paralithodes–
Perhaps the monopoly analogy was a bit simplistic, but do you disagree that health care in general presents some unique problems for a free market? Do you think free markets can function effectively in health care?

Tatpupu, Good, valid questions, but I am not sure I can answer your questions to your satisfaction based on what I assume is their underlying premise: that health care operates in a free market today. I am not sure that I agree that health care, or health insurance in particular, is operating in a "free market" in the first place.

First, one of the main positions of conservatives is that the Commerce Clause can be used to increase competition across state lines: something that does not exist now. Second, it seems to me that the consumer is way too disconnected from the cost of health care service for it to be considered as operating properly as a "free market."

The first problem may be caused by inaction at the Federal level. Whether the second problem was actually caused by the free market itself, by itself or in response to government intervention, I can't answer: I just don't know enough of the background of how this situation came to be.

So maybe I should answer: health care *may* present some unique challenges in a generally "free market." But I don't know for sure because I don't believe that it is operating in such a market, and I don't believe that blaming the generally very low-profit margin middle man as the primary cause of the problem is going to lead to the solution.

Paralithodes says

First, one of the main positions of conservatives is that the Commerce Clause can be used to increase competition across state lines: something that does not exist now. Second, it seems to me that the consumer is way too disconnected from the cost of health care service for it to be considered as operating properly as a “free market.”

Forgive my lack of knowledge, but I've never understood this argument. I've lived in several states and have enjoyed health care benefits from the same companies. Cigna, United Healthcare, etc. support plans in all states, don't they? What exactly would this "increased competition" do? How would it lower costs? Further, most companies with sites in multiple states have the same exact plan for everyone. Again--don't see how it would increase competition.

The disconnect between behavior and cost is interesting. I'm laughing thinking of peoples' reaction to a sliding scale of premiums based on body mass index or # of donuts eaten/month. I think it's an interesting idea, but it might be a problem politically.

tatupu70 says

Forgive my lack of knowledge, but I’ve never understood this argument. I’ve lived in several states and have enjoyed health care benefits from the same companies. Cigna, United Healthcare, etc. support plans in all states, don’t they? What exactly would this “increased competition” do? How would it lower costs? Further, most companies with sites in multiple states have the same exact plan for everyone. Again–don’t see how it would increase competition.
The disconnect between behavior and cost is interesting. I’m laughing thinking of peoples’ reaction to a sliding scale of premiums based on body mass index or # of donuts eaten/month. I think it’s an interesting idea, but it might be a problem politically.

This is a very good question! Of course there is no federal prohibition against an insurance company selling insurance in more than one state, and we all know that if we stop to think about it for a minute. In fact, the McCarren-Ferguson act of 1945 pretty much prevents the federal government from regulating insurance (this is why they are exempt from antitrust laws): http://en.wikipedia.org/wiki/McCarran%E2%80%93Ferguson_Act.
Health insurance is regulated at the state level for the same reason that almost everything else is regulated at the state level; namely that the United States is a federal republic! There probably are some inefficiencies caused by this, but it isn't the result of a federal ban nor is it any different than countless other industries which are regulated by the states (that is, everything from liquor to lawyers).
So this is just business in the United States - every industry would like the US Congress to pass laws about how they should operate and say that these laws trump state regulations. (well, lobbying state governments is cheaper than congress, but never mind for now.) This isn't even because they think that they could get congress to pass overly-business friendly laws (though that certainly would be nice from their perspective), it's simply that having one set of regulations to follow, one legislative and regulatory process to track, would simplify their business and reduce their administrative overhead. All businesses that operate across state lines want this. But they don't all get it because in our governmental system we generally see the concept of local regulation as valuable enough to trump the inefficiencies it introduces.
So another way of saying 'allow consumers to purchase insurance across state lines' would be 'get rid of the rights of states to regulate insurance', which is a bit ironic because the Republicans are supposed to favor states rights. Rhetorically this is brilliant because, while not actually a lie, it creates the false impression that there is a federal law which forbids companies from operating across state lines and once we get rid of that law there will be all this choice and competition. Really it is a red herring designed to make reform more difficult because:
1) It would require a large legislative effort for Congress to come up with comprehensive regulation to replace what states do now, and
2) It would create more conflict because the regulations necessarily would differ from some states existing regulations (stricter than some, more lenient than others, etc.) which would make an already difficult representative-by-representative negotiation even harder.
So in sum, I think this really is a talking point disguised as policy.

bdrasin says

Of course there is no federal prohibition against an insurance company selling insurance in more than one state, and we all know that if we stop to think about it for a minute.

And also of course, no conservative has argued that there is such a federal prohibition.... Therefore, your representation of the conservative argument with this statement is completely invalid.

bdrasin says

So another way of saying ‘allow consumers to purchase insurance across state lines’ would be ‘get rid of the rights of states to regulate insurance’, which is a bit ironic because the Republicans are supposed to favor states rights.

You seem to be simplifying things quite a bit to make your point, but the irony is that you seem to not consider the Commerce Clause... Isn't that what the Democrats are basing their argument on that intervention in the health care industry to this degree is Constitutional? The further irony is that one could assume that you are saying that Democrats do not support this approach *because* of respect for state rights...

bdrasin says

Rhetorically this is brilliant because, while not actually a lie, it creates the false impression that there is a federal law which forbids companies from operating across state lines and once we get rid of that law there will be all this choice and competition.

Rhetorically, your assertion is simply a strawman because you are basing it on a false impression of the argument, which you are creating, since the argument is for use of a "law" (the Commerce Clause) not the removal of some non-existent law.

bdrasin says

So in sum, I think this really is a talking point disguised as policy.

Of course. Is there a conservative argument or position that is not a "talking point?"

Again--you didn't answer my question. How would it lower costs?

tatupu70 says

The disconnect between behavior and cost is interesting. I’m laughing thinking of peoples’ reaction to a sliding scale of premiums based on body mass index or # of donuts eaten/month. I think it’s an interesting idea, but it might be a problem politically.

You've unfortunately done this several times ... swap a word in someone's description of a position in order to change the meaning of that position to something other than what was intended.... I never said the word "behavior." That is your word, which, while is broadly accurate, you have narrowly applied... My actual statemement was: "Second, it seems to me that the consumer is way too disconnected from the cost of health care service for it to be considered as operating properly as a “free market.”

People with medical insurance are generally insulated from either the true or the inflated costs of medical services because all they generally see are premium payments and relatively small co-payments. This may result in many more trips to doctors for minor things that do not require it, or numerous "second" opinions for the same thing, or simple unquestioning of the treatments, medications, etc., required. I know of no person, liberal or conservative, who thinks before going to the doctor: "What is going to be my burden on the whole system? If I incur more medical cost to the system than my premiums cover, for routine/non-emergency treatments, how will that affect the costs of everyone?" The general rule seems to be, if there is any question, go to the doctor: you are already paying the insurance and it costs very little to just get the consulation and peace of mind.