patrick.net

Nomograph says

MCM says

Sorry, still don’t see the crisis. So you couldn’t get INSURANCE! The horror! Are you dead?

And these folks wonder why they don’t get a seat at the table where the decisions are made.

Yeah because the AMA, Big pharma etc.. are not at all special interest groups looking out for their own bottom line. J6P doesn't deserve a voice because???????

AdHominem says

Yeah because the AMA, Big pharma etc.. are not at all special interest groups looking out for their own bottom line. J6P doesn’t deserve a voice because???????

J6P is welcome, MCM is not. Anyone who doesn't care if their fellow man dies or not doesn't get to help make decisions about the future of America

Here is what will likely happen:

1. Cost overruns
2. Fraud
3. Additional coverage extended to groups
4. Rising deficits in the program
5. Lower payments to physicians
6. Lower payments to hospitals
7. Delays in payments
8. Rising taxes on the rich
9. Rationing by doctors, hospitals, government
10. Delays in treatment
11. More HMO care: assembly line medicine
12. A search for scapegoats

Obamacare will lead to an expansion of these forms of
medicine:

1. Concierge
2. Wal-Mart
3. ER
4. HMO
5. Mexican

CONCIERGE. The rich and very rich hire their own
physicians. They pay top dollar. The physicians do not take
third-party payments, either from the government or insurance
companies. They are independent practitioners. They make
house calls. The houses they call on are very large.

For the upper middle class, there are fee-for-service
physicians. They take no third-party payments. They do not
make house calls.

WAL-MART. These are the walk-in clinics. They are
price competitive. They treat minor ailments. They sell
services on a one-time basis. They take credit cards. They
may or may not cater to the Medicare crowd. They are
assembly-line clinics. There are no major surgeries or other
high-cost, high-risk services.

ER. Large hospital emergency rooms are mandated by law.
The poor get treated there. In a life-and-death emergency,
they work. People who would otherwise die in a couple of
hours are saved. For walk-in patients, the ERs ration by
time. Patients demonstrate their patience.

HMO. This style of medicine is efficient. It cuts
costs by cutting services and cutting time. You see the
physician on duty. You may not have seen him before. His
job is to get you in and out as fast as possible. Time is
monitored by the company. Computers make this easy.

MEXICAN. This is off-shore medicine. In Canada, when
you can't get treated for months or years, you come to the
United States and pay. This will not be possible for
Canadians much longer, except for rich ones. Mexico will
serve upper middle-class Americans as the USA has served
Canadians.

It is possible to get very good surgical care in Asia
and Latin America. You have to know who the good
practitioners are. Asian hospitals sell for 25% the same
level of services. There is less regulation there. Place
fares are cheap. A stay in a hotel is cheap.

There will be entrepreneurs who set up Websites off-
shore that direct Americans to practitioners abroad. The Web
allows this sort of advertising.

Physicians who practice alone or in small limited
liability corporations will find that they cannot compete
under the new payment system. Assembly-line medicine will
replace the traditional doctor-patient relationship.

The stupid thing is that the only criticisms that carry any weight are those from the left, not the right.

ObamaCare's mandate-with-subsidies (what is causing the most sand-in-the-vag reaction here) is basically what the f---ing Heritage Foundation was proposing not too long ago:

http://krugman.blogs.nytimes.com/2010/03/25/david-frum-aei-heritage-and-health-care/

And of course it's a lot like RomneyCare.

Most of this song and dance has been by the establishment to avoid any actual radical reform (single payer or the public option that would lead to single payer). The public has in fact been mau mau'd to accept something less than what we could have gotten with all three policy elements in Democratic hands.

Economics - some people understand some of it, and most people do not.

Unfortunately, when making economic forecasts one is always working with only partial and imperfect information.

Troy says
What we need are actual cost controls, to take the immense profits out of medicine, but HillaryCare got shot down 15+ years ago now. ObamaCare is hopefully just the first step. As a first step it is what it is — not too different from RomneyCare. It is indeed a victory for the existing for-profit medical establishment and further improvements will require more fighting against the forces of got-mine-screw-you conservatism.

Hi Troy, I totally agree. We desperately need to reign in the costs of health care - that is where the reform needs to happen. The current HCR may be a first step, however, there is too much unpleasant baggage associated with this first step. Just my opinion. Doesn't mean I'm right and your wrong, and vice versa.

MCM says

Troy says
What we need are actual cost controls, to take the immense profits out of medicine, but HillaryCare got shot down 15+ years ago now. ObamaCare is hopefully just the first step. As a first step it is what it is — not too different from RomneyCare. It is indeed a victory for the existing for-profit medical establishment and further improvements will require more fighting against the forces of got-mine-screw-you conservatism.

Hi Troy, I totally agree. We desperately need to reign in the costs of health care - that is where the reform needs to happen. The current HCR may be a first step, however, there is too much unpleasant baggage associated with this first step. Just my opinion. Doesn’t mean I’m right and your wrong, and vice versa.

Everyone agrees that costs are too high. The disagreement in policy is in regards to the scapegoating half of that thought.

The democrats blame the evil corporations, libertarians blame the corrupt government, and republicans blame gay people.

Nomograph says

MCM says

Sorry, still don’t see the crisis. So you couldn’t get INSURANCE! The horror! Are you dead?

And these folks wonder why they don’t get a seat at the table where the decisions are made.

Hey Nomo, please clarify. Exactly who is it you are referring to not getting a seat at the decision table? I voiced my opinion, and since it doesn't agree with yours, I (and anybody that agrees with my opinion) automatically lose our seat at the decision table?

A rather feeble analysis at best...

tatupu70 says

AdHominem says

Yeah because the AMA, Big pharma etc.. are not at all special interest groups looking out for their own bottom line. J6P doesn’t deserve a voice because???????

J6P is welcome, MCM is not. Anyone who doesn’t care if their fellow man dies or not doesn’t get to help make decisions about the future of America

And the second board bully weighs in! I just need Vincente to jump in, and I score a trifecta!

Please go back a read my posts. I never stated I don't care about people dying. I was trying to make a point about insurance. Silly sheep, not having insurance does not guarantee that you are going to die.

Also, you and Nomo have a rather myopic view of who is making the decisions about the future of America - I am very certain that a large number of very uncaring individuals are sitting at the table.

tatupu70 says

MCM says

Sorry, still don’t see the crisis. So you couldn’t get INSURANCE! The horror! Are you dead? Are streets lined with dead people because they didn’t have INSURANCE?

Oh, I see. It’s OK if some people die because they didn’t have insurance–as long as it’s not a whole lot. And if they are buried quickly so you don’t really have to see them.
So, how many deaths before it becomes a “crisis” in your book? 1000? 10,000?

How many people have actually died because they didn't have health insurance? Serious question - I don't know the answer, so I wish someone would jump in with some verifiable statistics. I suspect it is a very, very small number.

If hundreds of people a day were dying, it might be considered a crisis. Or a pandemic.

The real crisis is the underlying cost of health care. And since big business controls congress, and the politicians are masters at keeping shallow thinkers spun up on hot button issues (ie crisis!), I really don't see things changing.

CBOEtrader says

Everyone agrees that costs are too high. The disagreement in policy is in regards to the scapegoating half of that thought.

The democrats blame the evil corporations, libertarians blame the corrupt government, and republicans blame gay people.

Nah, I don't think that's quite accurate. I'm ostensibly a "Democrat" since I usually vote that way, but I think it's just the incentives that are structured all wrong, not that anybody is evil.

I actually agree with former Republican Senate Majority Leader Bill Frisk, who had this to say a few days ago:

Medicare 45 years ago and the current health care legislation are historic in that they are both huge coverage bills, focused primarily on distributive justice: a country as prosperous as ours should ensure affordable access to health care for every American. But Medicare was a reform bill, and today’s Congressional bill is not. Without substantive reform that includes purposeful alignment of incentives throughout the care delivery value chain, spending will skyrocket, deficits will definitely increase, and the country’s recovery from recession will be slowed. With passage, we should immediately unite and commit to a true reform initiative that is patient-centered, provider friendly and consumer driven, fueled by 21st-century information and choice.

Though I would add that "consumer driven" is not sufficient. "science driven" is also needed. There is too much testing/treatment that is not scientifically proven to be of substantial clinical benefit, or has very high cost/benefit, but medical care "consumers" are all for it.

Funny how politicians can be perfectly reasonable once they're not in politics any more. Compare that to the McCains hissy fit "There will be no cooperation for the rest of the year"

BTW, CBOTrader, you mostly convinced me that the high level of infant mortality in the US is largely due to teen pregnancy. I did a bit of poking around, and your conclusion appears sound.

I think it is hard to argue that access to prenatal care and counseling would not be a great benefit these mothers and their children though, and probably at good cost/benefit to society as a whole too.

MCM says

The real crisis is the underlying cost of health care.

The US healthcare system is arguably the most highly regulated healthcare system in the world. We have been throwing increasing amounts of government resources at our healthcare system for the last 40 years. Currently, the US government alone spends more per capita on healthcare than any other government in the world. Yet our healthcare inefficiencies persist.

How befuddling.

Conclusion: the tea partiers (did you hear they are RACISTS??!!), Fox news pundits, and our retarded republican step-brother must be to blame. All we have to do now is increase government spending on healthcare, compliment each other for being brave/charitable, then join hands whilst singing kumbaya.

Oh, and anyone who disagrees with us hates poor people, likes to spit on minorities, steals from the elderly, and has sex with their cousins.

MarkInSF says

BTW, CBOTrader, you mostly convinced me that the high level of infant mortality in the US is largely due to teen pregnancy. I did a bit of poking around, and your conclusion appears sound.
I think it is hard to argue that access to prenatal care and counseling would not be a great benefit these mothers and their children though, and probably at good cost/benefit to society as a whole too.

I agree.

The point I was trying to emphasize though is that there is no real evidence to suggest that these mothers don't have access to prenatal care...especially the super poor, pregnant teens. Their healthcare at the very least is covered. At a minimum the poorest of US mothers have EXCELLENT post natal care.

The treatment for preventing premature birth is to live a healthy lifestyle. After the first 2 prenatal visits, the statistical benefit of preventing premature births via prenatal care is nonexistent.

tatupu70 says

My lord, you have really beaten this into the ground. WH just repeated exactly what Wellpoint had reported as their earnings. How is that a “lie”?? I would argue that it was Wellpoint that was deceiving in its earnings report. Blaming the WH is a stretch.

And oddly enough, I'm not the one to first bring up Wellpoint in these forums. It was brought up by someone arguing your side, with exactly the same false argument that the WH claims. Your over-simplication of what the White House did, as well as your assumptions of Wellpoint, are dishonest. It is obvious that you didn't even read the short press release that Wellpoint put out with its quarterly report (the type of release that nearly ALL companies do). You should at least do the very basic research.

If you believe that insurance companies are "hiding profits," then put your evidence on the table. It's clear that you didn't even read Wellpoint's releases, so now go through their statements and point out the specific areas that you believe they are "hiding" profits by burrying it in overhead, etc. While you are at it, ask the SEC to investigate them on these charges, as well as obvious violations of Sarbaines-Oxley. Otherwise your argument comes down to a mere witchhunt, which is of course exactly what the WH wants you and other followers to do: These companies have "huge" and "massive profits." It's not reflected in their financial statements? Oh, that is because they are hiding them elsewhere. Government is completely transparent and objective, private industry is dishonest.

Eliza says

This seems logical to me. I don’t see why people are getting so upset about it, or why it is a partisan issue.

It's a partisan issue because the Administration specifically targetted Wellpoint with a partisan point, specifically misrepresented their profits to make it seem as if their "one quarter" profit was not an anomaly based on things other than premiums, and to also make it seem that this "one quarter" profit was related to their premium increase. For people who like to parrot how conservatives don't understand "nuance," many liberals here seem to either not recognize or just simply feign ignorance of the same.

Nomograph says

And these folks wonder why they don’t get a seat at the table where the decisions are made.

All this time the conventional wisdom is that the Republicans simply didn't cooperate/participate or present any ideas, and their claims that they were shut out of the process was bunk. It's good to see someone on the other side finally admitting that they were in fact shut out. Thanks!

Troy says

the point is to move the status quo to the Canada, Japan, Swiss, Dutch, Danish, German, Italian, etc. systems.

So, the point IS in fact to go to a "single payer" system? So all of the arguments that many of the liberals here made, that this bill is not a step towards a government run system, all of the vitriolic push-back against those who claimed that this was socialist in nature - was all just posturing and feigned indignation, because in fact, its intent is in fact to go towards that goal? Thanks for finally admitting it.

MarkInSF says

BTW, CBOTrader, you mostly convinced me that the high level of infant mortality in the US is largely due to teen pregnancy. I did a bit of poking around, and your conclusion appears sound.
I think it is hard to argue that access to prenatal care and counseling would not be a great benefit these mothers and their children though, and probably at good cost/benefit to society as a whole too.

Mark, I sincerely suggest that you keep CBOEtrader's example, and your own research, in mind when you hear of such things as that the US "ranks 37th," or otherwise on some poll or another. The devil is in the details as to whether their components are really comparing apples to apples, or accounting for numerous confounding variables. The WHO includes within their rankings a metric that is essentially about the degree of nationalization of the health care system, and therefore the most "socialized" systems will rank higher in that component - affecting their overall rank - regardless of the actual hands-on care system in the country. This is no surprise: The WHO is specifically anti-free market with health care and has "social justice," "gender" issues, and "global warming" as some of its major issues - not very different than many other left-leaning advocacy groups.

MCM says

Nomograph says

MCM says

Sorry, still don’t see the crisis. So you couldn’t get INSURANCE! The horror! Are you dead?

And these folks wonder why they don’t get a seat at the table where the decisions are made.

Hey Nomo, please clarify. Exactly who is it you are referring to not getting a seat at the decision table? I voiced my opinion, and since it doesn’t agree with yours, I (and anybody that agrees with my opinion) automatically lose our seat at the decision table?
A rather feeble analysis at best…

You & I will never actually sit at the decision table. We can see it on teevee, but that's as close as we'll ever get. You can't lose what you never had - even feeble ol' Nomo knows that.

Paralithodes says

If you believe that insurance companies are “hiding profits,” then put your evidence on the table. It’s clear that you didn’t even read Wellpoint’s releases, so now go through their statements and point out the specific areas that you believe they are “hiding” profits by burrying it in overhead, etc. While you are at it, ask the SEC to investigate them on these charges, as well as obvious violations of Sarbaines-Oxley. Otherwise your argument comes down to a mere witchhunt, which is of course exactly what the WH wants you and other followers to do: These companies have “huge” and “massive profits.” It’s not reflected in their financial statements? Oh, that is because they are hiding them elsewhere. Government is completely transparent and objective, private industry is dishonest.

Well, it's very difficult for a layman to determine if Wellpoint is hiding profits as I can only see their public statements--if it was in there, it wouldn't really be hidden now would it? And give me a break with the SEC and Sarbanes Oxley BS--you don't think there are ways to move around numbers to make you appear less profitable?

But... here's what is freely available in their year end results:

Wellpoint free cash flow "exceeded $3 billion for 2009" Hmmm--that sounds like some serious money to me.

Wellpoint's SG&A was 16% for 2009. That equals another $9 billion. So, we're up to $12 Billion now just from one company covers 1/9th of the insured public. So, multiply that by 9 and we're at $108 Billion/year potential savings. Seems like real money to me.

Granted, there will be some administrative costs under any program, but I'd like to think that we could trim a LOT there... So, there you go. $100 billion/year.

MCM says

How many people have actually died because they didn’t have health insurance? Serious question - I don’t know the answer, so I wish someone would jump in with some verifiable statistics. I suspect it is a very, very small number.
If hundreds of people a day were dying, it might be considered a crisis. Or a pandemic.

http://www.cnn.com/2009/HEALTH/09/18/deaths.health.insurance/index.html

It took about 3 seconds to google this article. 45K/365 = 123/day. I guess that qualifies as a crisis then.

tatupu70 says

MCM says

How many people have actually died because they didn’t have health insurance? Serious question - I don’t know the answer, so I wish someone would jump in with some verifiable statistics. I suspect it is a very, very small number.
If hundreds of people a day were dying, it might be considered a crisis. Or a pandemic.

http://www.cnn.com/2009/HEALTH/09/18/deaths.health.insurance/index.html
It took about 3 seconds to google this article. 45K/365 = 123/day. I guess that qualifies as a crisis then.

From the article:
"The researchers examined government health surveys from more than 9,000 people aged 17 to 64, taken from 1986-1994, and then followed up through 2000. They determined that the uninsured have a 40 percent higher risk of death than those with private health insurance as a result of being unable to obtain necessary medical care. The researchers then extrapolated the results to census data from 2005 and calculated there were 44,789 deaths associated with lack of health insurance."

Seems like just another spin on numbers with a pie in the sky conclusion. And nevermind the underlying agenda of the American Public Health Association (APHA).
Also, key word in the conclusion was "associated". No one dies because they don't have health insurance. Health insurance may be a contributing factor, but was not main cause. Insurance does not fix a ruptured appendix. Folks die because of lack of healthcare.

I really, really want to help people understand the difference between INSURANCE and healthcare.

MCM says

Folks die because of lack of healthcare.

Yes, and they don't get healthcare without insurance. Are you having a problem making that connnection?

CBOE--
I might agree with you if there were ANY examples of efficient, market driven healthcare solutions. They don't exist. Every other civilized country has universal health care. At significantly lower costs.
If I'm wrong and there is a good example to follow, please show me.

tatupu70 says

MCM says

Folks die because of lack of healthcare.

Yes, and they don’t get healthcare without insurance. Are you having a problem making that connnection?

Do you intentionally ignore those pesky little facts that contradict your predetermined political view of the healthcare industry, or does that happen subconsiously?

CBOEtrader says

Do you intentionally ignore those pesky little facts that contradict your predetermined political view of the healthcare industry, or does that happen subconsiously?

lol--could be either. Tell me which "facts" I'm missing and I'll let you know.

tatupu70 says

Well, it’s very difficult for a layman to determine if Wellpoint is hiding profits as I can only see their public statements–if it was in there, it wouldn’t really be hidden now would it? And give me a break with the SEC and Sarbanes Oxley BS–you don’t think there are ways to move around numbers to make you appear less profitable?

So in other words, since you have no evidence at all, you are just going to assume that they are hiding profits, simply because you distrust private enterprise and trust government (what government says). Like a witch hunt... Claim they make too much profit... They show you the numbers showing otherwise, and the only possible answer, with no evidence, is that they must be hiding something....

tatupu70 says

Wellpoint free cash flow “exceeded $3 billion for 2009″ Hmmm–that sounds like some serious money to me.

Clearly you don't understand what this is. But if your point were valid, then why did the WH need to engage in misleading propaganda and not just use this instead? I appreciate you trying to turn the argument into it being about Wellpoint itself - how else to divert the example ABOUT THE WHITE HOUSE towards something else in order to pretend the WH isn't lying?

tatupu70 says

Granted, there will be some administrative costs under any program, but I’d like to think that we could trim a LOT there… So, there you go. $100 billion/year.

Once again, after all of the machinations in this forum, and name calling of conservatives because this *ISN'T* about nationalizing the whole system under "single payer," you are at least the 2nd person today to directly or indirectly admit that the conservatives are right: That is exactly what this is about, and that is exactly why this bill was put into place - as a first step. Thanks for finally coming clean.

Paralithodes says

They show you the numbers showing otherwise, and the only possible answer, with no evidence, is that they must be hiding something….

Huh? They showed me numbers showing exactly what I expected. Not otherwise.

Paralithodes says

Clearly you don’t understand what this is.

Clearly I don't understand what free cash flow is? It is the best gauge for how much money a company is actually making. Most of the accounting shenanigans are stripped away...

Paralithodes says

Once again, after all of the machinations in this forum, and name calling of conservatives because this *ISN’T* about nationalizing the whole system under “single payer,” you are at least the 2nd person today to directly or indirectly admit that the conservatives are right: That is exactly what this is about, and that is exactly why this bill was put into place - as a first step. Thanks for finally coming clean.

If you remember, I've been pretty consistent with my view that we need universal health care and that I wasn't thrilled with the current bill. I hope it is the first step. I'm not sure who called you a name, but it almost certainly wasn't because you said this bill was a first step towards nationalization of health care. Every other civilized country has nationalized health care and the results speak for themselves--lower health care cost per capita and better results.

tatupu70 says

CBOE–
I might agree with you if there were ANY examples of efficient, market driven healthcare solutions. They don’t exist. Every other civilized country has universal health care. At significantly lower costs.
If I’m wrong and there is a good example to follow, please show me.

This is a good point. I've been unable to find any system that even resembles a free market?

Communism breaks down because of human nature, though it sounds nice on paper. I am open enough to admit that the Libertarian free-market ideal (whatever that is) may a similar, unrealistic ideal. In practice though, since the Libertarian ideal will never happen, it is a moot point.

Our current system lacks any consumerism pricing mechanism, is riddled with anti-competitive monopolies/oligopolies, and is drowning in contradictory/confusing/politically driven command and control regulations. Every one of these issues is by government design.

So, now we have the democrats (plus some indies), who are deep in the emotional throws of a honey-moon phase with this current bill. These people ignore the natural laws of scarcity. They base their entire support on a fantasy of how much better the France/Canada/Germany systems work compared to ours. Though the republicans are nothing more than political noisemakers right now, the democrats are happy to use the massive amount of crap the republicans spew as a distraction to what the dems are doing. To top it off the propoganda machine uses the lie that our "free-market" system is the problem. Then, even after using extreme propoganda and distraction tactics, the democrats have to use every legislative trick available to get this bill passed.

How in the world can anyone justify any of this?

CBOEtrader says

......drowning in contradictory/confusing/politically driven command and control regulations. Every one of these issues is by government design.

Is government an alien entity like those amoeba things on Spock's back in season 1 episode "Operation Annihilate"? No, it's a product of a basic impulse to take care of our own. I'm sure in Homo Neanderthalensis tribes there were those who preferred turning the aged & sick out to die, and those who argued for using tribe manhours and food to heal and care for them. IMO this is not about "government" this is about what society wants to do, as these outcomes are driven by large numbers of individuals wanting it to happen. It's a common tactic to blame "government" because this tactic avoids civil war dividing lines with your neighbors. Do you go to neighborhood cocktail parties and start cornering all the the "progressives" and castigating them for how wrong they are? If so you won't get invited to many.

I’m sure in Homo Neanderthalensis tribes there were those who preferred turning the aged & sick out to die, and those who argued for using tribe manhours and food to heal and care for them.

In the lacota tradition, the tribe shared every commodity equally. Every member was expected to work for the greater good of the tribe. To ration the life-supporting resources, the old men of the tribe would leave the tribe to die when they personally determined they were no longer capable of prividing more to their community than they consumed. This was not forced upon them, but was rather done out of a sense of honor and natures balance.

Vicente says

No, [government] is a product of a basic impulse to take care of our own.

No, big government is the default. Freedom is the product of a basic impulse to take care of our own. Freedom requires a vigilant citizenry to keep the "necessary evil" of government from continually grabbing more power. As Murray Rothbard stated in Capitalism vs Statism ,

"Throughout history, states have existed as instruments for organized predation and exploitation. It doesn't much matter which group of people happen to gain control of the State at any given time, whether it be oriental despots, kings, landlords, privileged merchants, army officers, or Communist parties. The result is everywhere and always the coercive mulcting of the mass of the producers — in most centuries, of course, largely the peasantry — by a ruling class of dominant rulers and their hired professional bureaucracy. Generally, the State has its inception in naked banditry and conquest, after which the conquerors settle down among the subject population to exact permanent and continuing tribute in the form of "taxation" and to parcel out the land of the peasants in huge tracts to the conquering warlords, who then proceed to extract "rent." "

An much like our current moral and intellectual justifications of bigger government,

"To make their rule permanent, the State rulers need to induce their subject masses to acquiesce in at least the legitimacy of their rule. For this purpose the State has always taken a corps of intellectuals to spin apologia for the wisdom and the necessity of the existing system. The apologia differ over the centuries; sometimes it is the priestcraft using mystery and ritual to tell the subjects that the king is divine and must be obeyed; sometimes it is Keynesian liberals using their own form of mystery to tell the public that government spending, however seemingly unproductive, helps everyone by raising the GNP and energizing the Keynesian "multiplier." But everywhere the purpose is the same — to justify the existing system of rule and exploitation to the subject population; and everywhere the means are the same — the State rulers sharing their rule and a portion of their booty with their intellectuals."

Vicente says

Do you go to neighborhood cocktail parties and start cornering all the the “progressives” and castigating them for how wrong they are? If so you won’t get invited to many.

I try not to discuss politics or religion with people in my life...particularly the inlaws.

CBOEtrader says

So, now we have the democrats (plus some indies), who are deep in the emotional throws of a honey-moon phase with this current bill. These people ignore the natural laws of scarcity. They base their entire support on a fantasy of how much better the France/Canada/Germany systems work compared to ours. Though the republicans are nothing more than political noisemakers right now, the democrats are happy to use the massive amount of crap the republicans spew as a distraction to what the dems are doing. To top it off the propoganda machine uses the lie that our “free-market” system is the problem. Then, even after using extreme propoganda and distraction tactics, the democrats have to use every legislative trick available to get this bill passed.

Any time someone tries to tell me how Democrats (and some indies) feel, I can pretty much guarantee that it will be a misrepresentation. Your post was no exception...

It sounds like you have some economics background. As such, I would think that you would understand that there are certain conditions which must be present in order for a free market to produce an optimal result. Things like available substitutes, good informational flow, etc. Things that are unlikely to be present in a healthcare market.

There are obvious reasons why healthcare does not work as a free market. Further, universal coverage is good from an economic point of view as well. When people are sick and die young, it hurts the country. The most productive years of people's lives are wasted...

I agree with everything you have said, even including:

tatupu70 says

Further, universal coverage is good from an economic point of view as well.

Unfortunately, you are describing the bill you want, instead of the current bill.

This post is riddled with delusional utopian assumptions:

MYTH: Americans will be forced to change insurance even if they don’t want to.

REALITY: You can keep your current plan if you’re satisfied with it. Some insurance plans that offer an inferior product may disappear from the market, “but that’s a good thing for consumers, because better products will be offered,” McGlynn said.

Existing plans don’t have to meet the higher benefit standards of new policies but will face tighter regulations, such as eliminating a ban on pre-existing conditions that would apply to all policies come 2014.

The health care bill simultaneously dictates what must be covered in each health care policy, while keeping non-compliance penalties at a ridiculous level. If an employer can pay a penalty of only $750 per employee per each year while saving $9000+/year per employee in not having to buy insurance, that's one helluva incentive for companies to drop their current insurance coverage in order to maximize profits, thereby driving their employees to seek their own federally subsidized insurance. In other words, taxpayers will be footing the bill while employers pocket savings.. all thanks to the perverse incentives in this healthcare reform legislation

And dictating that insurance companies MUST accept pre-existing conditions?.. why in the hell then should ANYONE then buy insurance until they're already seriously ill? It makes no economic sense to do otherwise. It's no different than the government forcing auto insurance companies to sell insurance to an uninsured driver after the fact to cover a wreck that's already happened.

Those are just the tip of the iceberg of the unintended consequences that this legislation will incentivize.

ZippyDDoodah says

The health care bill simultaneously dictates what must be covered in each health care policy, while keeping non-compliance penalties at a ridiculous level. If an employer can pay a penalty of only $750 per employee per each year while saving $9000+/year per employee in not having to buy insurance, that’s one helluva incentive for companies to drop their current insurance coverage in order to maximize profits, thereby driving their employees to seek their own federally subsidized insurance.

Huh? Before the bill, they could drop insurance without paying any penalty. Why would having to pay a penalty encourage companies to drop insurance?

Huh? Before the bill, they could drop insurance without paying any penalty. Why would having to pay a penalty encourage companies to drop insurance?

Does the answer really need to be spelled out for you? Any employer who offered insurance before, did so for a reason - to attract and retain quality employees in order to prevent them from jumping ship to a competitor who offered insurance. Now with federally subsidized insurance, those incentives have been obliterated. Workers and chronically unemployed individuals not covered by an employer plan are incentived not to purchase insurance at all, waiting years until they need it to "buy" it, facing a penalty of only $95/year for not being covered. Perverse incentives to the extreme. But in utopia-world, those added costs from changes in behavior are never considered

Employers of low skilled and part-time workers often didn't provide insurance. Those workers, many of whom are young, often didn't need insurance other than high-deductible catestrophic insurance

ZippyDDoodah says

Does the answer really need to be spelled out for you? Any employer who offered insurance before, did so for a reason - to attract and retain quality employees in order to prevent them from jumping ship to a competitor who offered insurance. Now with federally subsidized insurance, those incentives have been obliterated. Workers and chronically unemployed individuals not covered by an employer plan are incentived not to purchase insurance at all, waiting years until they need it to “buy” it, facing a penalty of only $95/year for not being covered. Perverse incentives to the extreme. But in utopia-world, those added costs from changes in behavior are never considered

If you would spell it out correctly, perhaps. That's not at all how it works. Think it all the way through. Wouldn't an employee want a higher salary if their employer didn't offer insurance? Employer offered insurance will remain an incentive for employees. Don't you think families will want insurance for their kids? Or if they get pregnant?

And I'm not 100% familar with the way the penalties will work, but my guess is that it is considered and you just don't understand it.

Think it all the way through. Wouldn’t an employee want a higher salary if their employer didn’t offer insurance? Employer offered insurance will remain an incentive for employees. Don’t you think families will want insurance for their kids? Or if they get pregnant?

Employee offered insurance used to be a valued benefit, something that would cost the employee on average, about $10k/year if he had to purchase similar insurance coverage out-of-pocket. Now that the govt is offering federally subsidized insurance in which pre-existing conditions cannot be denied, individuals and families can pay a token amount $95 penalty (rising to $695/yr by 2016 with exceptions for hardship cases) and then "buy" (many won't have to pay) insurance only when they need it and still be covered, not substantively different than if they had an employer plan. Not much different than paying for auto insurance only for the month when you've had an accident, since individuals only have to pay for insurance when they're receiving treatment. Employer provided insurance will no longer be such a valued incentive for that reason. Worse, there are perverse unintended consequences in play to incentivize employers to drop insurance coverage.. $750 or $3,000 annual penalty per employee for dropping insurance with penalty exemptions for small businesses with under 30 employees (flood of new business created by breaking into 30 employee legal subsidiaries to get that loophole?), a significant savings from what they would have to pay in annual insurance for their employees.

As for your "guess" that I don't understand the penalties, please tell me where I'm mistaken http://www.usatoday.com/news/washington/2010-03-18-health-bill-table_n.htm

First off, I'm not sure I trust USA today to break down a 2000 page bill into a one page chart, but even so it appears to me that you've misread parts of that chart. It's the greater of the fees you listed and 2% of income. Still not a large amount, but in most cases more than $95.

But I still maintain that the vast majority of families want to have health insurance all the time. At least in my family, the kids get sick pretty regularly. It would be ridiculous to continually drop, then reapply, then drop, then reapply for insurance.

We'll see--if there are obvious unintended consequences, I'm guessing that they will get fixed. I'm not ready to throw out the baby with the bath water as it were. The bill is not perfect--I agree 100%. But it's a step in the right direction.