Democrats Seek Middle Ground on Healthcare

[Pangloss]

Hillary Clinton introduced her new healthcare plan this week, which would cost $110 billion/yr and be funded by the removal of Bush tax cuts. While this does represent a huge increase in spending, it would cover the main part of the gap that currently exists for Americans, helping with situations that aren't covered by CORBA (when departing a company) and offering government healthcare programs to those not currently able to afford coverage.

 

The program is similar to that used in Massachusetts, which was brought in under governor Mitt Romney. But Romney calls the new Clinton plan "socialized medicine" and his people are saying that what's right for Massachusetts is not right for America. Hmm.

 

What I think is most interesting about this is that it's Democrats who are seeking middle ground on this. Stepping back from the socialized medicine that the Michael Moore types want and allowing people to keep their current, employer-based plans.

 

What do you all think?

 

A relevent article:

http://abcnews.go.com/Politics/Decision2008/wireStory?id=3610855

[bascule]

An aside: universal single-payer healthcare is not socialized medicine. The latter owns the hospital systems, rather than just funding them. The former represents a government-run pooled risk system.

[ParanoiA]

Hillary Clinton: I have passed a law, solving the problem of americans not covered by health insurance...it says "all you mother@&$!ers got to have health insurance...HaHaHa!!! - gotcha' bitches! Told you I'd fix it!"

 

Mandatory coverage...what an obvious insult...

 

Actually, I thought the massachusettes idea got tossed out in the supreme court. I'll have to go dig into that I guess.

[Pangloss]

An aside: universal single-payer healthcare is not socialized medicine. The latter owns the hospital systems, rather than just funding them. The former represents a government-run pooled risk system.

Well you're right to point out that none of the major Democratic candidates have ever advocated an outright socialized system, I agree.

 

I'm wondering if you've noticed that your wunderkind Obama is taking a pretty moderate position here as well. Poor Jesse, what will he think of the prodigal son!

 

It's notable that the far left isn't attacking the major Democratic candidates over this, at least to the degree that they're harassing them over Iraq.

[bascule]

I'm wondering if you've noticed that your wunderkind Obama is taking a pretty moderate position here as well.

 

If I were backing a candidate based solely on the issues I'd be a Kucinich supporter. Unfortunately Kucinich is unelectable. I think Hillary is unelectable too, although sadly she may win the primary... Obama actually stands a chance of garnering nationwide support, precisely because he's a moderate (at least compared to Kucinich)

[ecoli]

Hillary Clinton introduced her new healthcare plan this week, which would cost $110 billion/yr and be funded by the removal of Bush tax cuts. While this does represent a huge increase in spending, it would cover the main part of the gap that currently exists for Americans, helping with situations that aren't covered by CORBA (when departing a company) and offering government healthcare programs to those not currently able to afford coverage.

 

The program is similar to that used in Massachusetts, which was brought in under governor Mitt Romney. But Romney calls the new Clinton plan "socialized medicine" and his people are saying that what's right for Massachusetts is not right for America. Hmm.

 

What I think is most interesting about this is that it's Democrats who are seeking middle ground on this. Stepping back from the socialized medicine that the Michael Moore types want and allowing people to keep their current, employer-based plans.

 

What do you all think?

 

A relevent article:

http://abcnews.go.com/Politics/Decision2008/wireStory?id=3610855

 

I'm not sure about this, but I don't think she's taking middle ground, really... it sounds to me like she's hiding behind rhetoric, and offering the same socialized health care as always.

[bascule]

...funded by the removal of Bush tax cuts.

 

Obama is proposing further tax cuts for the lower and middle class and a reinstantiating some of pre-Bush soak-the-rich policies. I would definitely like to see some of the wealthiest Americans taxed more, particularly by reforming the alternative minimum tax, and that's not just a bleeding heart liberal position: Warren Buffet wants it too.

 

Of course, all that aside: why raise taxes to fund new programs? Why not reduce funding to the military, DHS, and the executive, all of which have been money squandering wastes under Bush?

 

Or here's an even crazier idea: That which you can't account for comes out of next year's budget. That might help solve the ridiculous accounting snafus which have plagued the Defense Department for the past several years.

[Pangloss]

Obama is proposing further tax cuts for the lower and middle class and a reinstantiating some of pre-Bush soak-the-rich policies. I would definitely like to see some of the wealthiest Americans taxed more, particularly by reforming the alternative minimum tax, and that's not just a bleeding heart liberal position: Warren Buffet wants it too.

 

Ben Stein too. It's an acceptable position to many wealthy Americans, and it doesn't seem to be born out of guilt complex either -- it's just sound reasoning from sound minds. Nobody likes paying taxes, of course, but the idea seems to be that they can afford it and -- and this is critical for selling it to this group of people -- it's a sound investment.

 

I like the idea and I like that so many smart moderate fiscal conservatives are out in front on this.

 

 

Of course, all that aside: why raise taxes to fund new programs? Why not reduce funding to the military, DHS, and the executive, all of which have been money squandering wastes under Bush?

 

Or here's an even crazier idea: That which you can't account for comes out of next year's budget. That might help solve the ridiculous accounting snafus which have plagued the Defense Department for the past several years.

 

I'm all for cutting defense spending (intelligently). The real problem I have in Obama's case is that he's not about to cut spending on social programs. Entitlements are far greater an expenditure than defense, and correspondingly more wasteful.

[Severian]

I personally think Hilary's scheme sounds good. It is the best of both worlds. It allows people who are happy with their current health care arrangements to continue, but ensures that everyone should have some basic healthcare plan.

 

I wish that the UK would abandon the NHS and adopt this scheme instead. At the moment I am paying over the odds because I am paying compulsory National Insurance to entitle me to NHS care, but since the NHS is completely useless i am also paying for private healthcare.

[ParanoiA]

Nobody likes paying taxes' date=' of course, but the idea seems to be that they can afford it and -- and this is critical for selling it to this group of people -- it's a sound investment.

 

I like the idea and I like that so many smart moderate fiscal conservatives are out in front on this. [/quote']

 

Sound investment? I must have missed something important here. Are we still talking about taxes? Seriously, I don't understand.

 

I personally think Hilary's scheme sounds good. It is the best of both worlds. It allows people who are happy with their current health care arrangements to continue, but ensures that everyone should have some basic healthcare plan.

 

I don't see how it improves everything. It's a massive profit dump to insurance companies. Compulsory insurance is guaranteed business, and it's flat out wrong. This is not the way to fix healthcare. It's not fixing any of the problems, just addresses some symptoms. But everybody's all happy about it because it's close enough to socialized medicine that incrementalism will finish the job in a few decades.

 

Meanwhile, we fix nothing. Still stuck with an insurance dictated scheme. And after everyone's content that "everyone is covered", it will continue to be the corporate owned and twisted mess of crap it is today.

[Severian]

Let me ask, do you think it is right that some people shouldn't have health insurance? If so, what would you do with these people if they are in an accident? Would you give them emergency medical care? If so, who pays?

 

I would have no problem with someone (over the age of 18) refusing medical insurance, but then they should be treated as if they have refused medical attention.

[ParanoiA]

Let me ask, do you think it is right that some people shouldn't have health insurance? If so, what would you do with these people if they are in an accident? Would you give them emergency medical care? If so, who pays?

 

I would have no problem with someone (over the age of 18) refusing medical insurance, but then they should be treated as if they have refused medical attention.

 

Yes, it's right that some people don't have health insurance. Insurance is only needed because the cost of medical treatment is freaking ridiculous - which is what drives the feedback argument about lack of insurance equals lack of payment which causes prices to increase to make up for it.

 

No one ever talks about the regulations and tax penalties/incentives - and the legal structure that undermines the whole market concept. This is a large part of the source of the cost issue. Like I've said before, it's a socialist bubble within a capitalist framework. Insurance companies have all the power - and they should only be needed for emergencies.

 

You don't file a claim on your car insurance everytime you have a problem. You file a claim when you have a bad accident - an emergency. But medical insurance is tapped every single time you see a doctor for the sniffles or go into the ER for a severed limb. This is a big problem to me, and it's quite obvious why it's being ignored and instead our attention is directed to a "everybody deserves insurance coverage" mentallity. Watch the left hand so you don't see what the right hand is doing.

 

We have a leaky roof and people just want to add bigger buckets. Let's fix the leak, then we'll talk about buckets. If we address the problems that add the insane cost, insurance coverage could be competitive again since it would only be used for serious medical problems.

 

To answer your other question, the medical facilities should be free to make up their own minds to treat someone. After all, with or without insurance, I don't believe you have a right to someone else's labor - no matter how heartless it may seem.

[Pangloss]

I agree there's an awful feedback loop between insurance coverage and rising healthcare costs -- you'd have to be an idiot not to see it.

 

But I also think we've reached a period in human development where the interconnectedness caused by globalization and economy of scale have produced a situation whereby it benefits every individual to see that every other individual reaches a certain level of intellectual (educational) development and medical care. After all, it's not like I can run my factory all by myself, and somebody has to buy my goods.

 

The market's saturated, my friend -- there are no more new ones to tame. The future is greater efficiency with the ones we got.

[ecoli]

How will Hillary's plan affect those with health insurance but are denied coverage by their providers? I think this is the most important problem with the current system of insurance, but I have yet to heard it be addressed.

[ParanoiA]

So don't we have a duty to fix the actual problem so that every other individual can get the medical care they need? Maybe I'm missing your point, but I'm not seeing how any period of human development would benefit from faulty systems layered with band-aids. Seems to be a more intelligent society would want to fix problems at their source - even if that source isn't what I think it is.

 

We can still be an intellectual, compassionate and healthy society with free market care. I mean, think about some of the problems everyone brings up related to healthcare. Obesity, smoking, and etc - as long as we're all paying basically the same thing, we keep making bad decisions. But when your choices start costing you money, when you're being held accountable for your choices in life, then you have a tendency to make better choices. Today, we're all paying basically the same thing. There's no one running around bragging about only spending 500 bucks last year on medical stuff, while I spent 3,000 bucks. We're all paying 300 a month.

 

This is the problem with "pooling" approaches - it undermines the natural self responsibility check. Anytime you remove the individual accountability component in a given system - you introduce corruption and waste among other things. Seems far more intelligent to take advantage of human's innate, natural "cure" of self accountability.

[Pangloss]

How will Hillary's plan affect those with health insurance but are denied coverage by their providers? I think this is the most important problem with the current system of insurance, but I have yet to heard it be addressed.

 

That either is, or should become (depending on the specifics), a legal matter, under the heading of contractual obligations and fraud. So I don't think her plan necessarily needs to address it, but it would be nice, I agree.

 

------------

 

So don't we have a duty to fix the actual problem so that every other individual can get the medical care they need?

 

Sure we do.

 

I'm not seeing how any period of human development would benefit from faulty systems layered with band-aids.

 

I am. Look at it this way: The system will never be perfect, but people need medical treatment right now, and every single day.

 

We can still be an intellectual, compassionate and healthy society with free market care.

 

Apparently we cannot. Even if all inhibitions were removed from the system, the coverage problem would still exist for the most basic of economic reasons. (shrug)

 

Obesity, smoking, and etc - as long as we're all paying basically the same thing, we keep making bad decisions. But when your choices start costing you money, when you're being held accountable for your choices in life, then you have a tendency to make better choices.

 

I think you're on the wrong track here. The cost to an individual for smoking or eating fatty foods is far greater than economic. But perhaps even more to the point, the result of those behaviors doesn't occur at the time, it occurs much later, after the damage has already been done. There's no way to learn from the mistake, and no way for the individual to repair the damage to MY business from having to replace/retrain HIS effort.

 

So it's worth it for me, as a member of the larger society, to invest in that infrastructure, especially if that effort includes education about fatty foods and smoking (which WOULD produce a "learning" effect). It's not a matter of ideological preference, ParanoiA. It's an intelligent investment in our future.

 

I'm not saying this is the ONLY intelligent way to pursue it, but it's not an unreasonable thing to do, and it's what people want, so I think it's the way to go. Just my two bits, of course.

[bascule]

The problem with a free market healthcare system is that it's in the system's best interest to keep costs on the rise, hence America's healthcare system being the most expensive in the world as a percentage of GDP. This doesn't improve the quality of care but it certainly improves how much money health insurance CEOs get to pocket.

[ecoli]

The problem with a free market healthcare system is that it's in the system's best interest to keep costs on the rise, hence America's healthcare system being the most expensive in the world as a percentage of GDP. This doesn't improve the quality of care but it certainly improves how much money health insurance CEOs get to pocket.

 

Should'nt competition offset this princible, however?

[ParanoiA]

The problem with a free market healthcare system is that it's in the system's best interest to keep costs on the rise, hence America's healthcare system being the most expensive in the world as a percentage of GDP. This doesn't improve the quality of care but it certainly improves how much money health insurance CEOs get to pocket.

 

Hence nothing, this is not a free market healthcare system. Competition is practically non-existent, hence American's ridiculously expensive healthcare system.

[bascule]

Should'nt competition offset this princible, however?

 

No, because most of the time there is no consumer choice. Most Americans are saddled with the insurance their employer provides and see only in-network care providers and specialists. Either that or they're on the way to the emergency room, at which point they usually don't pick the hospital who will give them care.

[Pangloss]

I concur with Bascule's points above. I've felt for a while now that employer-sponsored healthcare was a nasty trap. And that's a trap that's getting worse -- I saw a story the other day about employer-sponsored mandatory psychiatric healthcare! Not happy filling out TPS reports in your cubicle? Get thee to mandatory psychiatric retraining, or else! And good luck getting healthcare from your next employer once they find out what happened at your last one. Of course the gushing news reporter missed the Matrix/Brazil/Clockwork Orange angle completely.

 

(I knew I shoulda taken the red pill....)

[ParanoiA]

Found an interesting research report by Christopher J. Conover published back in October of 2004. He's an assistant research professor at Duke University specializing, apparently, in health care related issues. Maybe you all have already seen this...

 

http://www.cato.org/pubs/pas/pa527.pdf

 

This report estimates the cost of health services regulation at 339.2 billion with benefits at 170.1 billion - leaving a net loss of 169.1 billion. The cost of regulations outweigh benefits by two to one.

 

Another interesting number crunch in the report was a comparison of deaths related to lack of insurance to regulations. Per this document, he estimates 22,000 people die each year from costs associated with regulations, while 18,000 people die each year from lack of health insurance. That implies 4,000 more people die each year from regulation than from lack of insurance.

 

Yet we're up in arms about lack of insurance, and no one is even remotely bothered by regulation.

 

Seems to me, reforming regulation would help two problems (cost and death) whereas promoting insurance coverage only helps one (death).

[bascule]

There's more to take into account than just death. There's also debilitating injuries and chronic illness, i.e. suffering.