patrick.net

"Therefore Obama is right in a strange way: private enterprise has triumphed and government service is terrible. Everyone knows this."

These "town meetings" are really nothing but propaganda sessions run by members of Congress who are trying to burnish their fraudulent credentials as public servants, and trying to perpetrate a huge fraud of a health care bill that purports to be a progressive "reform" of the US health care system, but that actually further entrenches the control of that system by the insurance industry, and to a lesser extent, the hospital and drug industry.

http://obamboozled.blogspot.com/2009/08/why-arent-progressives-disrupting.html

How Obama's Deal With Big Pharma Undermines Democracy

http://obamboozled.blogspot.com/2009/08/how-obamas-deal-with-big-pharma.html

Lew Rockwell states: private enterprise has triumphed and government service is terrible. Everyone knows this.

Again, I wonder if State Senators share in this over generalization, including the insurance coverage they enjoy.

"Everyone" knows that government service is terrible, except for all of those VA and Medicare recipients who continually say that they like their service.

Why is it an issue that Obama chose the superior coverage offered by his wife's employer (given that it was a medical organization, it's no surprise that it was good coverage) to that of his employer? I certainly hope there isn't anyone stupid enough to think that a "public option" automatically means "the best insurance possible, and cheaper than anything else". As long as it's INSURANCE, it is highly unlikely to be "better" than the top-tier private plans (which are obscenely expensive for the employer, and in most years more expensive than the actual cost of medical care!).

This really misses the point. Obama isn't really pushing for single payer at this time (though he has voiced support for it). Instead his primary objectives are:

#1 Lowering overall costs, particularly for entitlements like medicare
#2 Covering everyone.

Nowhere in there is there a goal of creating a public insurer that is superior to the best private insurance. Nowhere.

Will it be better than most crappy insurance? Absolutely! Will many employer-provided plans be better? Of course.

If the plan was truly better than the employer plans, it would become a defacto single payer system and everyone would join it.

I don't think it's constructive to call someone a racist because they disagree with you. That can go both ways, like when people called Obama a racist for calling the Cambridge Police stupid, and he was called a racist. By the way, I was involved in a very similar episode with the Cambridge Police about 10-15 years ago. I was at the Hong Kong Chinese Restaurant(across from Harvard Square) after a night of drinking with some friends. We were at the restaurant, had just ordered, and gotten our food and were about to eat when the waiter told us that they were closing and that we had to take our stuff to go. We were quite, not causing any trouble at the time. A friend of mine, who is Asian, went up to the cashier and told him that it's unfair for them to kick us out like that, and asked if we can just eat for 20-30 minutes. The cashier said no, we have to clear out. My friend said to the cashier, "Why didn't you tell us that we'd have to take our stuff out before we ordered? We were seated at the table? I'm a Harvard Business student and we come here every weekend, we never cause trouble, and it's unfair that you kick us out like that." Next to the cashier was a group of Cambridge cops. One, who happened to be African American, stood up and told my friend, "Why don't you take your Harvard Ass out of here!" And my friend responded, "Am I doing something wrong? I'm not shouting. I'm not bothering anyone. If I'm doing anything wrong, why don't you arrest me?" The cop then grabbed my friends hands, spun him around, and put hand cuffs on him and arrested him. I didn't read the police report, but my friend said that the report was a complete lie. He had to hire a lawyer, which cost him a couple of thousand dollars, to get the case thrown out.

So my take on the Cowley Gates incident is that police lie, that the Cambridge cops have something against Harvard students and professors(in fact, there is a very antagonistic relationship between Harvard and Cambridge), that the Harvard community looks down on the locals(they derisively call them "Townies"), but I highly doubt that Cowley is racist. He's just a liar like many cops. I'm not saying all cops are liars, but they're human just like you and me.

Kevin,

I mostly agree with your points above. Some insurance is better than no insurance. Medicare and the VA insurance is better than even crappier insurance. There are some policies that cover everything and cost nothing(except for your employer who likely is paying you less because he/she's paying $20K a year to pay for that policy).

As for the high rates of satisfaction for patients on Medicare and VA, read my take on the VA from yesterday. Seniors(most) and veterans tend to be VERY appreciative of the care they get. I worked at a VA and if not for the VERY VERY low pay for doctors compare to a private group and the VERY VERY poor ancillary services, I would love working at a VA. In terms of following evidence medicine, they are probably the best. But... If you took a group of Stanford Professors, dot.com professionals, etc. and made them get their care at a VA, I guarantee that satisfaction rates would drop to zero. In fact, this is an interaction I had with one of these individuals. A patient of mine had dropped by unexpectedly because she was just diagnosed with terminal liver cancer. I consoled her and spent some time with her as we both cried. This made me about 10 minutes late in seeing my next patient, a VP at a major dot.com. As soon as I got in the exam room and apologized for being late, the VP picked up her cell phone and started to make a call and told me, you wasted a half an hour of my time, now I'm going to waste yours. So I waited as she talked to her friend on her cell phone. She was on the phone for about 5 minutes but I waited patiently, but seeing that she was not going to get off the cell phone(by the way, there is a sign in the exam room and the waiting room asking patients to turn off their cell phones)I had to check on another patient in another exam room undergoing a procedure. I was not in the other room for more then a couple of minutes when I hear shouting from the VP with F bombs at my medical assistant demanding to know where I was and that I was making her late. So I hurry out of the other room, apologize to the VP, calm her down and treat her. I wonder how she'll be happy going to a VA type system.

My favorite patients are migrant workers, seniors, veterans, blue collar workers, etc. No funny business, no demands to treat them "holistically"(not that I have anything against "holistic medicine" but if you want to be treated holistically, go to a alternative care physician), no bringing in endless internet articles, etc. They just want to get treated so that they can go back to living their lives.

i just wanted the 200th post

>>>2ndClassCitizen,

I understand your point about the government's role in inflating healthcare costs. Clearly we agree that many government interventions have created a wildly uneven and inequitable system. But the analogy to the housing bubble isn't a perfect one.

While the government did play a role in inflating U.S. healthcare costs, it did so most glaringly by refusing to intervene rather than by any sort of intervention. I've mentioned that the Canadian Medicare system pays approximately 60% of what we pay per person. U.S. Medicare costs have similarly gone up at 1/3 less rapidly than private healthcare costs in the U.S. since the plan's inception in the 1960s. In other words, if, hypothetically, we had all been able to buy into the medicare plan, our premiums would be 2/3 what they are today. Despite all rhetoric to the contrary, Medicare is simply far more efficient than private insurance, with only about 3% of expenses going to administration (as opposed to over 15% for private insurers).

In the housing bubble, it could be argued the the Fed also erred by failing to intervene, most specifically, as Dean Baker has pointed out many times, by denying the bubble rather than using the Fed's bully pulpit to warn of the bubble's existence, and, hopefully, by so doing, ending the frenzy.

However, unlike with the housing market, I don't believe that the healthcare landscape would be appreciably better if the government had never intervened at all. In fact, it has been the privatization and corporatization of healthcare that, more than anything, has driven up costs in my lifetime. When I was born, most hospitals were run by charitable organizations, either religious groups or philanthropic groups. Profit wasn't the primary driver, helping people was. The same held for the major insurers. Blue Cross and Blue Shield used to be non-profits. Yet since 1990, in many areas, they converted to for-profit corporations that were then bought up by larger healthcare conglomerates. Here in CA, Anthem, the parent company of Blue Cross of CA, pulled 10 billion dollars in cash out of the local company in 2008. That's money that would have gone to reducing premiums in the past.

The reason standard market rules don't apply in healthcare is that people approach meidcal care far differently than they do buying a car or a house. They place complete trust in their doctors - in fact, they trust them with their lives. It is all but impossible to shop for prices for heart surgery or many similar treatments. The system is not set up for it, and people are simply not psychologically able to approach healthcare with the same attitude as they would shopping for a computer. And really, can you blame them? Paul Krugman made an excellent analogy when he said you wouldn't want to comparison shop for firemen. People approach healthcare in much the same way as they do other public services. Sure, when forced to, they will comparison shop in India, but this is mainly out of desperation. It is not optimal.

I'm all for introducing innovations into the marketplace that work and that drive down costs. But we must also be realistic and realize that healthcare is different than other markets. It is for this very reason that all the fear mongering works so well - people are terrified of being left to suffer on their own. And it's on these fears that the right and "centrist" politicians are currently playing.

Can you imagine a world where the government does not interfere with the doctor patient relationship at all? It would be great, doctors wouldn't have to fill out endless piles of paperwork and instead could spend more time talking and working with patients. Medications would be less expensive because Medicare would not be driving up the costs. The insurance industry would either not exist or be a minor player because government did not give them subsidies in the form of tax exemptions to businesses.

It would not be perfect, because no human endeavor is.

For that matter why do we have health insurance in the present form anyway? I can't buy comprehensive car insurance that will pay for a new starter when mine wears out or a new set of tires.

That is because these are routine and predictable expenses associated with owning a car. Why does insurance have to get involved in routine maintenance such as physical exams, blood pressure medication, etc.. Shouldn't insurance be for catastrophic illnesses like cancer, and motor vehicle accidents?

Insurance (no matter if it is private or public) drives up costs, piles on red tape and limits choice. And make no mistake about it: during the Nixon years government backed the insurance industry and has been doing it ever since. Bush gave us the biggest expansion of government in history with Medicare Part D (a public private partnership where government foots the bill and industry reaps the rewards). Government blew this bubble and the powers that be want to keep blowing.

srla,

I agree that too much $ that goes into private insurance companies go to line the pockets of sharholders and the CEOs who make $10M a year.

But I don't think that arguments against reform are just "fear mongering". Already, those with Medicare in some counties have trouble finding a primary care physician. Since the rates that Medicare pays is below what is required to run a medical practice in the Bay Area, (in some parts of the country, it is enough, or some organizations with large private donations like the Mayo Clinic can thrive on Medicare rates) many providers won't accept Medicare anymore. In some of the current plans, there are plans to cut 10-30% from Medicare to offset some of the costs of covering more individuals. If this happens, there will be even less providers accepting Medicare, unless we go to a single payer system and all physicians are forced to accept these rates(which will bankrupt most large groups immediately). Sure there are plans to make providers improve quality to lower cost, etc. but no one seems to discuss any specifics.

Some Guy says

2ndClassCitizen says

Some Guy,

The government is SUBSIDIZING health insurance companies by giving tax exemptions to companies who purchase health insurance for their employees. Citizens can’t get this subsidy only businesses. Government is blowing this health care bubble by its tax policies and fee for service plans like Medicare.

You didn’t address my point at all. You simply repeated what you said before. I already refuted that.

I didn't know you had a point, but if you can't understand what I am saying I can't help you. My posts are pretty clear. The government (which is part and parcel with corporate America who funds the campaigns of the most influential leaders in government) blew the health care bubble by offering tax exemptions to employers that are not available to individuals, and by creating and expanding fee for service programs like medicare.

Also, Canada is fee for service, and if they have a bubble, it's only 60% as big as ours.

The administration economic adviser who appeared on the Daily Show Tuesday put it well when he said that, due to the conglomeration and monopolization of health insurance companies, they are now competing to find new ways to exclude sick people from coverage rather than fostering true competition that leads to lower prices and improved service.

We need a real dialogue comparing all available options. Instead we are getting a legislative process warped by a monied healthcare lobby, a lobby hell bent on preserving profit margins through any means necessary. This means "supporting" a variety of watered down options and also supporting fear mongering amongst the legislative opponents of the very same plans they are supposedly supporting. The manipulation of the legislative process is breathtaking in its complexity and duplicity. No wonder your average citizen is reacting on a purely visceral level, often one driven by fear.

SRLA,

Maybe Canada's bubble is smaller because they have 40% less red tape.

>>>2ndClassCitizen "Medications would be less expensive because Medicare would not be driving up the costs." Um... what? Medicare, while handcuffed by the Republicans when they created part B and thus unable to negotiate better rates, does NOT drive up any costs. In fact, it has been quite effective in containing costs. As I said, its expenses have gone up 1/3 less than private care over the past 4 decades.

"For that matter why do we have health insurance in the present form anyway? I can’t buy comprehensive car insurance that will pay for a new starter when mine wears out or a new set of tires." -- Okay, no offense, but now you're just not thinking things through. Most of us can pay for new tires or a new transmission out of pocket (or at least on manageable credit). We might also be able to pay for a basic medical exam out of pocket. However, IF we happen to need heart surgery, the vast majority of us could never afford to pay for it, even if we dedicated every cent we made for years. THIS is why we have medical insurance. It's the same reason we have car insurance, to protect us in the instance that we have a major accident.

There are many very real issues to be discussed and argued when it comes to healthcare reform. But we need to think things through and be informed, rather than subscribing to arguments that simply don't make sense.

srla,

I believe you just made my point. Health insurance, if it is to exist, should only be for catastrophic needs like open heart surgery.

By the way, if you don't know Medicare Part D is driving up costs, you probably don't work in a pharmacy.

If my posts don't make sense you are free to ignore me thank you.

2ndClassCitizen - Um, less red tape, yes. That is the nature of a single payer system. They have no forms to fill out. But unless you are envisioning a healthcare system where doctors do little more than treat sinus infections and sprained ankles, the high cost of many procedures would neccesitate lots of forms, whether to insurance companies or creditors. And have you ever tried taking out an unsecured loan for 100,000?

Yes, Medicare's drug coverage is a disaster in that it intentionally stopped the government from negotiating the same group discounts that the V.A., Canada, and every other country get. But is this not an argument for government intervention with drug pricing? How else do you contend that part D drove up drug costs?

No, the nature of a single payer system is wealth redistribution on a national scale. Add to that single payer will force me and millions of Americans to fund yet another government program the majority of us do not want. Like I said in my first post, how about ya'll who want the program put your money together and run it. Just let the rest of us opt out.

Wow free will, what a concept.

Patrick,
I applaud your fierceness on your health reform forum. Let me just
say, I had to deal with the medical system and my HMO insurance
company in depth due to my illness, and they suck.

Of course, I never realized they s.... until I had problems. I, like
most working people, were basically healthy, and got satisfactory
services for the kind of minor illness I have.

But when I needed something slightly different, the medical group was
against me, Blue Shield at all levels was against me for no good
reason. They made me wait and wait and went though rejection after
rejection. Do not think it will not happen to you readers. It just may
happen if these health insurance companies have no competition to
make the system better.

We need to fight hard for a better system with reasonable and
"predictable" cost/premium. Right now, we are "slave" of he medical
and insurance systems here. We have to work just to have insurance.

I hope our President and Legislative Bodies learn from Taiwan, a small
country with s pretty successful mandatory national health insurance.

http://blog.lib.umn.edu/schwitz/healthnews/2008/01/humbled-by-taiw.html

Part D costs tax payers in the fact that it exists and is expensive, very expensive. Part D costs seniors in that insurers are constantly changing their formularys to maximize profits and seniors can't keep up with the changes. Part D forces seniors to subscribe even if they don't need any medications by forcing up premiums for every month they don't join the plan. Part D encourages beneficiaries to utilize their benefits because they are already paying for them (they might as well get something even if they know they don't really need it). Part D might suppress drug prices for some beneficiaries but the other consumers are paying for the difference in higher costs and co-pays. Pharmacies generally charge much higher rates for people who have no insurance because they have to just to make up for the losses they incur due to unreasonable reimbursements by insurance companies (especially part D). Part D drives up costs by refusing to give patients a 90 days supply of medication, and instead forcing them to visit the pharmacy each month. Should I go on......

srla,

It seems like you're the one that isn't thinking things through and you're arguments are just rehash from liberal websites.

2ndClassCitizen said:
"That is because these are routine and predictable expenses associated with owning a car. Why does insurance have to get involved in routine maintenance such as physical exams, blood pressure medication, etc.. Shouldn’t insurance be for catastrophic illnesses like cancer, and motor vehicle accidents?"

It may not be a bad idea to have everyone(regardless of if it's a government plan or a private plan) to have an insurance plan that covers any major procedures or if out of pocket expenses over $5000.

I took my less than $10K car for a routine maintenance checkup and it cost me $1300 (labor plus expense to replace a few worn out parts) and and extra $200 to fix the antenna(which had broken at the base).

For a routine follow up with with a primary care doctor, Medicare pays the doctor about $30. $100 if the problem is more complex. If you don't have Medicare and no insurance(or a high deductable plan) it would probably cost you $100 for a routine visit or $250 if the problem is very complex. Of course if you need an MRI, it will cost you $4,000.

This way, no one is bankrupt by poor health(if you can't afford $5000, then the government should subsidize it).

Insurance should insure you against major loss. It should not be used to go to the emergency room everytime you have a cold.

altos,

I deal with Blue Shield all the time and they have been reasonable. Can you give some examples of thing they denied? Was what you were seeking experimental? Was it supported by the medical literature? Was it based on evidence medicine? If so, did your physician try to submit an authorization so that you can get it?

Everyone needs to understand that with a single payer system, it's not going to be a license to get every single procedure or medicine you want. In fact, unnecessary, experimental, marginal, procedures are exactly the things that will be cut out. It needs to be. Otherwise, it will be just as expensive and wasteful as the current system. It may even be worse if they don't regulate these things.

"No, the nature of a single payer system is wealth redistribution on a national scale." Um... well, since we already fund 60-65% of healthcare, would it really be that much worse? Especially when you throw in the massive amount of money wasted on the employer tax credit we both dislike. Add that in, and we are already paying for upwards of 70-75% of healthcare costs.

There might be a free market alternative to our system, but I have never heard one proposed that has a chance of working. On the other hand, every other major nation has some form of national health care for all citizens, so we know they can be effective.

Look, we're paying trillions for wars many of us opposed on the grounds they would not benefit us. Sometimes we pay for things we don't like. As a currently single person, I pay far, far higher taxes than married people with kids, like it or not. In fact, I find it amusing when many older married people complain about their "tax burden", only to find out they pay a few thousand bucks a year on a six figure salary. I compared figures with somebody I know who is married with kids and made the same as I did one year. He paid $6,000 and I paid $32,000. I might not like paying being taxed five times as much, but that's the way our society works, so I grin and bear it.

We need to change the system, or we will all go broke. If you know of a free market plan that will actually work, I would love to hear the details. But if we as a society were to decide to opt for single payer like everyone else has, then I guess those who don't like it will have to live with it. And I'm sure in any case, I'll pay quite a bit more for it than many others will.

srla,

Are you trying to scare us with threats like "change the system, or we will all go broke?" I can't think of any society in history where everyone went broke because they couldn't pay for health care. This bubble will pop if we get government and its insurance industry pimps out of the picture.

DT: "It seems like you’re the one that isn’t thinking things through and you’re arguments are just rehash from liberal websites."

If you have any specific evidence to support that, I'm all ears. I happen to side with the single-payer people on this one issue. I hardly agree with liberal websites on many issues. But simply because liberal people make certain statements does not make them untrue.

You said, "It may not be a bad idea to have everyone(regardless of if it’s a government plan or a private plan) to have an insurance plan that covers any major procedures or if out of pocket expenses over $5000." There is some logic to this approach, to be sure. There is a high degree of waste in no-deductible plans, and people do make dumb decisions when they have no financial investment. But if the deductible is too high, many will make equally bad decisions and put off seeing a doctor, thus leading to even higher decisions down the line.

This problem could be rectified in any system by simply having some sort of co-payment, especially for ER visits, and potentially income-based so as to disincentivize everyone equally from abusing the system. Canada is dealing with this very issue too. But a balance needs to be struck.

2ndClassCitizen, that is not a scare tactic, but a fact, based on cost projections from the CBO and other sources. You can disagree about what needs to be done, sure. But it's impossible to deny that if costs keep going up at the current rate of 17% a year, we will indeed go broke. It seems you want something to be done, but you prefer a free market approach. Fair enough. But are do you really believe that if we keep the present system as is, costs will not be prohibitive?

Some guy,

Yes, people are rioting in the streets for health care. No wait, they are accused of rioting against it. My mistake.

If you don't want single payer, that's fine. Of course, nothing close to single payer is on the table. At this point, the most that could change is that a government plan could be added to cover maybe 10% of the population and use its size to drive bargains and force badly needed competition. Due to intensive lobbying, it seems doubtful this will end up happening in any meaningful form.

It does seem most of us agree we are suffering from healthcare industry manipulation of the legislative process. Unfortunately, that seems the least likely thing to change.

I will add that since single payer, at its most expensive in other countries, costs less that 2/3 what our healthcare system costs per patient, and since the government already pays almost 2/3 of our national healthcare costs, then the redistribution would not be very large (and trust me, as one who gets redistributed FROM, that does matter to me). In fact, the only major redistribution under a single payer (or German-style multiple payer) system would be from healthcare interests to the rest of the economy.

I can understand why people are scared of change, especially given all the lies being promoted out there. But if you object to single payer, it would be helpful if you stated the specific reasons and why you object and give data to support them, rather than just relying on generalizations. That way we could respond to specifics.

srla,

Yes, if the government continues to subsidize health care the government will go broke. If it quits we all may yet have a chance.

chrisborden says

Yea, it ain’t no good news for people like me who never go to the doctor because we keep ourselves healthy (I don’t have insurance now because I earn a whopping $400 a week, but if I’m forced to buy it, of course I will, unless the penalty is small enough). I don’t like the idea of being forced to pay a “tax” that will FORCE me to spend money I don’t have, for care I don’t and might not ever need. I’d be willing to bet that it’ll cost me at least $300 a month, and that’s money DOWN THE TOILET unless I get sick, and that makes me sick. A heavy tax just to “insure” my health, and of course, if I have to buy it, you can bet I’m going to make up every condition in the book to get my money’s worth, rather than have the money go to waste, and that is what it is, waste. If it’s under $200 a month, I might bite, but beyond that, it’ll suck about 12% of my yearly income, and for frickin’ what? To make corporate profiteers richer. So that’s where this American comes from.

That's exactly I was thinking too. In fact I was so confident of my good health that even when my friend said that he had fever and cough, I still agreed to take him in my car to a business meeting. It never occurred to me that I could catch it from him. And what happened next is just scary to say the least. In fact someone who always hated doctors and believed in good health ended up going to emergency room, because I could not sleep 2 nights because of sever cough and fever. I tried postponing going to hospital thinking it will recover. I did not have insurance at the time as I had quit my job for a long vacation last year. My thought process was very similar to yours. Why buy health insurance when I never go to the doctor anyways.

To cut the long story short I ended up paying (in fact some of it is still not paid) 1200 bucks for my misadventure and that was after a 75 % discount. The hospital (El Camino in MT view) wanted to make me feel indebted to them for that 75 % discount. Doctors took 1 hour and did some unnecessary tests and wrote few prescriptions. But I was in such a terrible state that had they asked me to pay 5K for my illness I would have paid....

When you are healthy and doing well...Its hard to imagine what it feels like having bronchitis or pneumonia or malaria or Tuberculosis or cancer or 100s of other such diseases....

I don't mind paying to a govt system 100 or 200 dollars per month as part of my taxes, if I can be sure I will have a hospital to go to if I fall sick...

People are so frigging brainwashed in this country by big corporations that they have lost their power to think independently.

Well we agree that the current state of government interventions is a disaster. We pay far too much, that we can agree on. A big reason I support single payer is that it has a proven track record in many other countries. No such track record exists for a modern healthcare system totally free of government intervention. It is hard to see how that would address all our problems.

I also don't agree that healthcare is in a "bubble" in the sense that real estate was or tech stocks were. Bubbles are driven by speculative frenzy. People buy in out of fear they will be priced out, and they buy in out of a desire to make a killing. The government helped inflate the housing bubble by making credit far too cheap for far too long. They could have aborted it by simply admitting there was a bubble, or by not manipulating markets in the first place.

With healthcare, no such frenzied buying occurs. The cost goes up for completely different reasons - most prominently because of massive waste, over-testing, drug patent monopolies, insurance company inefficiencies, and malpractice issues. Therefore, the fix is far more complicated that it would be with financial markets. If the government were to withdraw altogether from involvement in healthcare, insurance companies would drop the vast majority over a certain age and everyone with health conditions. It's hard to see how that wouldn't be a disaster. Back before medicare, only 40% of seniors had coverage. If you want to see actual riots, talk about ending Medicare.

commonman2003 - man, sad to say, but you got off cheap. My insurance agent broke his little toe, waited 5 hours, switched emergency rooms, waited another 5 hours, then was treated in what he described as a supply closet by a doctor that popped his toe back into position in about 3 minutes. For that, he was billed $3,500 by UCLA. And that was after the hospital "discounted" his fees - conveniently down to the exact amount of his copay.

2ndClassCitizen says

No, the nature of a single payer system is wealth redistribution on a national scale. Add to that single payer will force me and millions of Americans to fund yet another government program the majority of us do not want. Like I said in my first post, how about ya’ll who want the program put your money together and run it. Just let the rest of us opt out.
Wow free will, what a concept.

Wealth redistribution ? You are so frigging afraid of wealth redistribution ? You think you made your fucking money in some island without anyone's help ?..What about all the people in the food chain who indirectly helped you. You think gardeners and janitors and other poor people are basically a nuisance ? God forbid if your millions somehow make it to help other people....

This extreme self centeredness has fucked this country...Everybody wants to slave away their life for a big fucking corporations and send hourly status report to their boss...Look at the life in Silicon valley..people do not have time to even chat freely for few minutes...Everybody is busy accumulating wealth...and making sure their frigging wealth is secure in some heavy locker....:-)

Fundamentally speaking, how is it not at least a little bit perverse that the insurance companies and big pharma are able to turn such massive profits from the inevitable breakdown of our biodegradable designs, a built-in feature for which no individual can be held liable? Outside of smokers, alchys and skydivers.

If you are a citizen of a nation who in some way contributes to that nation's GDP, why is it not then in the nation's best interest to insure it's own productivity? This is probably at least partially the thinking behind mass inoculations; beyond eradicating deadly/debilitating diseases, it keeps the population strong and generating the taxable incomes needed to keep the Senators and Congressmen employed and insured, among other things.

Yes, if the government continues to subsidize health care the government will go broke. If it quits we all may yet have a chance.

Chance? At what? That ship has sailed. Again, WHERE was all this outrage and debate during the bailouts of the banking industry? There wasn't one tenth of one percent of this level of concern (or rage) over the national debt and future tax burdens to lower and middle-class families in the coming decades.

commonman2003 - hahah But like I said, the really weird part is, we're already paying roughly the same amount just for Medicare that we would pay in a true single payer system, give or take 5-10%. Hard to believe, but it's true. A lot of us do pay a pretty decent amount in taxes already, especially here in CA. The trouble is, if we don't cut out all the pork in the system and just force everyone to get insured privately, either private people will go broke from premiums or the government will from subsidizing those premiums.

We need some sort of overhaul to cut prices from their current trajectory.

Wealth redistribution ? You are so frigging afraid of wealth redistribution ? You think you made your fucking money in some island without anyone’s help ?..What about all the people in the food chain who indirectly helped you. You think gardeners and janitors and other poor people are basically a nuisance ? God forbid if your millions somehow make it to help other people….

Find me one millionaire who doesn't think he *earned* his fortune.

Austinhousingbubble - I think most people here were pretty outraged by the bank bailouts. And I'd add the war debt to that total too, since I thought it was a huge waste of money.

I don't see any alternative myself to eventual single payer in the long run. I can't help but have mixed feelings about that, given the immigration situation and the costs related to that. But I also can't see denying anyone access to healthcare. It's just not a remotely humane option in a country this well off.

commonman2003,

I wish it was so, most of us are just struggling to pay off our loans. Is it too much to ask that I get to choose where the fruits of my labor go? Or should I just send the fruits of my labor to you? Clearly you have better sense of where it should be spent than a 2ndClassCitizen like me. What is the address for my payments? You'll be the first to get paid after the bank is finished with me.

Come to think of it, I would have been better off doing what I guy I met a couple of months ago said he is doing. He was a school teacher in Chicago, but moved to Hawaii to live off welfare, he is "letting the system work for him." (his own words). I should have just not gone to college, not taken out any loans and let the system work for me. What was I thinking? Man am I dumb!