whitehouse: RT @katesantiago: Reality Check: If you like your #healthcare insurance you can keep it. Period. VIDEO: http://bit.ly/GpL3I #hcr #hir-rc
Do they think we're idiots? According the the guy who designed the public option plan, it will destroy small insurers before the big ones. This is typical of detailed bureaucratic programs. Only large companies have the resources to lobby and to process the regulatory information needed to survive. All those "no-bid contracts" to which people used to object were often justified in one sense, because there was only one company big enough to deal with the necessary regulations. In this case, smaller insurance companies will be less likely to be able to lobby for positions as quasi "public utilities". What happens to their capital funds when they can no longer offer insurance? GE is on the government's side. Why would that be? They have insurance holdings. I thought big, bad insurance companies were the villains which were against these changes. An example of the "crony capitalism" which typifies governments moving toward statism. Much of the corruption inherent in big government comes directly from the scope of the responsibilities it takes on. But back to our main subject . . .
All the mandates planned for insurance policies will make them different from the policies available now. And most policies will be much more expensive. They will not be able to compete with the public option which can borrow money from future generations (or from the Chinese).
The public option can only lead to a single-payer system, like in Canada. Or single-payer with a totally separate private option for the elite, like in Britain. This seems to be the way the Democrats are currently heading. There's also the more successful (in a smaller country than ours) French system of single payer with private supplements which most people buy. Though their system is running into serious financial problems now. But the Democrats are trying to cut out options for Medicare Advantage, so that doesn't seem to be where they're going. Captain Ed (whose wife is blind and has had a kidney transplant) comments:
In fact, Medicare Advantage is a Godsend for those trapped within the Medicare system. Recipients pay substantial monthly premiums, but the plan allows for better provider payments, which keep providers from locking patients out of their clinics. The extended insurance provides coverage for services which Medicare ignores, and some create a co-payment system rather than the 60/40 system Medicare gives seniors and the disabled in practice.Folding Medicare into a single-payer system and rationing care is the only way the Democrats can keep their promise to cut 500 billion dollars (less now, in at least one proposed bill) from Medicare spending to help pay for universal coverage. Decisions about which medical treatments will be covered are made by an unaccountable "panel of experts".
How do I know this? The First Mate has Medicare Advantage, and we saw what Medicare did before we got the supplemental coverage. It’s a disaster for anyone needing anything more than just maintenance care.
Profit vs. Non-profit organizations: Which are more ethical?
Ezekiel Emanuel, the head bioethicist at the NIH and brother of the president’s chief of staff:
. . . services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia.Read the whole thing.
Fatalism isn’t helpful; humility before the inevitable and pride in our ability to create - these can go hand in hand. As Helen points out, historians don’t learn from history when they deny it. One would think we’d remember where the roads diverged in the sixties, and which was the path to nowhere and which the path to life: Paul Ehrlich’s Population Bomb, which began “the battle to feed all of humanity is over. . . . hundreds of millions of people are going to starve to death.” But, then, instead of the ‘Great Die-Off”, Borlaug (and people like him) combined sympathy and ingenuity to pull off the Green Revolution.Emphasis mine. Future progress and medical choices are important considerations. Why does the Left feel the need to demonize the productive for-profit sector? Not to suggest that things can't go wrong in a for-profit system or that non-profit organizations cannot be productive - they have a significant, positive role to play. And in fact, there is nothing stopping private non-profit organizations (like the Mayo Clinic) from providing health care or even health insurance.
I am grateful to the kind of medicine that Obama repeatedly describes as a failure and the people - doctors, pharmacists, even insurers - as morally inferior to those who don’t make profits. , , ,
Every time someone goes to M.D. Anderson, down the road from us, they come back with stories of new treatments, new procedures, new medicines. And we are all heartened. America, despite the tragedy of the youth of those who suffered, did not have a disproportionate number of AIDS victims; we did invent a disproportionate number of AIDS medicines, which we gave with an open hand. I am sure the system needs some overhauling; I doubt that we need to spend as much on medicine as we do. But I suspect the medical Nobel Prize Winners are more worthy than Paul Krugman - and that group, heavily weighted to Americans, has benefited our economy - and the world’s. On the other hand, Rachel Carson, non-profit oriented altruist that she may have been, has done more to destroy happiness and productivity in Africa than can be easily repaired by the Borlaugs and Salks of the world.
Some of the people mentioned in the quoted section above as agents of positive change received taxpayer money. But the private sector is generally more efficient at disseminating advanced products and treatments to people. The parts of medical care in America which are not routinely covered under insurance (i.e., vision correction) have often seen dramatic advances which rapidly become less costly (i.e., Lasik). This is where arguments for Medical Savings Accounts come in. Perversely, enlightened self-interest often leads to more people-friendly results than altruistic motivations.
Why the rush to control everything about healthcare out of Washington right now? It has to put a damper on medical advances.
Why the Democrats MUST aim for a single-payer system through a Public Option
It takes a more words that a poll-generated talking point to get to the nitty gritty of what the Democrats are trying to do. Remember that the massive changes in health care (now "health insurance") which they proposed were originally pushed as the only way to SAVE THE ECONOMY. (Until the CBO's reports came out).
At the end of the day there is STILL no way to have all three simultaneously of: (1) universal guaranteed coverage; (2) comprehensive quality and choice; (3) cost control....cannot be done...you get two out of three at most. Clearly the Obamacrats intend on sacrificing (2) since they are massively constrained by deficits "....so the only choice is limiting choice and quality....and that in turn requires a de facto single payer accomplished through the subterfuge of dictating the terms of "private" insurance, turning them into all but public utilities, engineering the transfer to the "public option" over a relatively short period of time, and then dictating payment terms to providers through rate setting, service bundling and, most important in this context, the MedPAC council which will determine "quality-adjusted effective" treatment protocols. The net effect is that an elderly person won't get a hip replacement or a coronary bypass....and will have nowhere --- in the US --- to turn.Note: They can't have it both ways. Quoting Dorothy Rabinowitz: "The president shouldn’t worry about the protesters disrupting town hall meetings. He should worry about the Americans who have been sitting at home listening to him."
The disingenuousness of the left on this point is breathtaking. ....but the issue is NOT euthanasia, living wills etc....that's a pure straw man however insidious the proposal is and however dishonest they have been in covering it up or describing it. The real issue is the MedPAC council....there won't be any actual "death panel" adjudicating case-by-case....there won';t need to be!....the MedPac council will set up criteria and rules, more or less in secrecy....rules determined by "experts" and by design removed from Congress to prevent pressure to approve expensive protocols at the end of life....or for "life unworthy of life"....a faceless bureaucracy with a maze of rules will simply be built into the system....diffused responsibility, nobody accountable, just the way it will be, no one can do anything about it.
That's why they MUST control all provision through a de facto single payer...and effectively outlaw private provision....otherwise it will be seen that treatments are available and that some are "unfairly" grabbing medical "resources"...and they will not be able to control cost with a global budget.
This issue is a turning point. Read as much as you can. Follow the links. Read reasoned information from the liberal side, too. Not just from politicians. See what makes sense to you. Try to determine how the Democrat's bills are evolving. Think about which of their proposals would be irreversible as a practical matter, and about whether it would not be better to try out these proposals on a state level first. There's lots of detailed information out there to help you make a decision about which parts of the Democrat's (or Republican's) plans for changing the American health care system you want to support.
A couple of years ago, I read a very good argument for income-adjusted medical savings accounts along with a choice of (private) catastrophic insurance policies as a way to reduce costs and improve quality of care EVEN FOR MEDICAID PATIENTS IN CASH-STRAPPED CALIFORNIA. It was written by a surgeon, Dr. Linda Halderman, who treated low-income breast cancer patients and included financial break-downs. She had to close her business near here, in rural Central California, because of the bureaucratic rules for Medicaid in California. She gave Botox injections to affluent patients to subsidize her regular practice for a while, but it wasn't enough. And I lean toward Mark Steyn's thinking that if lawmakers can't read their own bills, control should be turned over to less over-reaching authorities. If California bureaucrats can be as counter-productive as they were in Dr. Halderman's case, federal bureaucrats with responsibility for a whole nation can make even bigger mistakes.
There are no perfect answers. And sometimes answers which seem good in the short run don't work out real well in the long run. The United States Post Office was a good idea. The Post Office was not always known for unreliable service, union members who treat fellow employees as their personal serfs, workplace violence, high prices, etc. In fact, mail carriers once had quite a heroic reputation. But when things start to go wrong in government-run organizations, they're hard to fix.
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