23 Comments

1. Distraught:

We not only have come up with a solution to health care, but prevent its destruction at the some time. Apologies for a repost.

Speaking generally about the issue…I wonder if the “problem” is largely that the problem is just not well-defined. These plans all contain a plethora of agenda items, each of which is apparently dispensible, yet also necessary (to prevent thousands from dieing every day). Seems just as likely its a juggling act trying to satisfy some additional constraint, it is politics after all, and thats the real problem.

So many new questions have been swept by us already: health care is a now a right, insurance (alas) mandatory, the euthanization ‘bending the curve’, and what about a federal medical record system with your life, digitized and searchable as well as open to distribution by whichever civil employee cares to ‘misplace’ a laptop… now that itself is a nightmare.

This issue can seem very complicated at times. But I wonder if thats not the name of the game and so I don’t how useful it is try to find ’solutions’ to this moving, and possibly fake, target. Clearly, it would be great if health care was cheaper and less people used the FREE health care we already agree to offer in the emergency room, but I don’t feel this is likely with this congress, and am mostly concerned with averting disaster and the irreversible seeds they are trying so hard to sow.

Could the situation not be made clearer with a definate goal? After 911, having a dollar cost in billions, we formed an independent commision, yet for a trillion dollar institutional change that will directly affect everyone, this is apparently not the prudent thing to do.

The conclusion I draw so far is this: they do not want to find the right solution to a particular problem, but rather find the right ‘problem’ for a particular solution.

I will propose to you that insurance itself is just a game. Here is my definition:

In-sur-ance (noun): A form of betting in which the LOSER wins.

Just remember that. In fact, I have sometimes wondered if a global risk pool might make the most sense financially. Since it is all a scam, we might as well ensure equal screwing so no one can complain; however, there is zero chance the government could run this without debilatating overhead and gross incompetance. Furthermore, I think the financial issue should be secondary.

Oh, and what about the question of pre-existing conditions? how is that a rational idea. Its like forcing someone to bet on a crippled horse. Im not saying it might not work, nor that its not popular. I will say that I do recall hearing that its not so much a probablem of the condition, but moreso whether the person had been paying insurance up to that point; they all share costs at some level. Anyone, its moot really. My point here is just that we DO want these businesses to succede… don’t we?.

Nov 5, 2009 - 12:44 am 2. Anonymous:

Healthcare reform: Pay more, get less, be good socialists.

Nov 5, 2009 - 4:45 am 3. HoosierHawk:

Distraught:
The conclusion I draw so far is this: they do not want to find the right solution to a particular problem, but rather find the right ‘problem’ for a particular solution.

Bingo! We have a winner.

This article discusses the actual merits of “reform” propopals, and completely misses what’s real happening. In other words, it falls for the premise or excuse the are using.

I have heard three different justifications for this push for reform:
1. Millions of uninsured Americans
2. Rising cost of health care threatens our properity.
3. Longer life expectancy in countries with socialized medicine.

Which is it really? You can’t effectively solve a problem until you have clearly defined it. How can you evaluate the merits of any proposal until you have an objective goal to measure against. You can’t.

Justification 3 isn’t worthy of consideration, there is no illness that is better treated anywhere but the US. Life expectancy is no measure of the quality of health care – successful cure rates are and nobody beats the US.

Justifications 1 and 2 are contradictary – if you want to give millions of nonpaying people more access to health care, it’s going to cost a lot of money, and require more health care professionals. If you want to bring down costs, you can’t expand coverage and you will likely compromise quality of care.

There must be a clear goal in mind, but there doesn’t seem to be. If that’s the case, then why is reform being pushed so hard? As Distraught points out, it’s a preconceived solution is search of a problem.

The actual goals – more central government control over the masses, and perhaps the fact that medicare/medicaid is failing and it is politically dangerous to attempt a direct fix. Rather than addressing that problem head on, a health care reform allows the government to cover up the failure of this pet program, and bury it in an even bigger program that will eventually suffer the same fate, but long after the present ruling class is retired from Congress.

Nov 5, 2009 - 5:41 am 4. HoosierHawk:

I heard Congresswoman Bachman describe the health care reform bills as Congress inventing Chocolate cake with no calories. I guess some people would beleive that too.

Nov 5, 2009 - 5:47 am 5. Laura:

Hi,

I am an outreach coordinator for the health videos website.

I wanted to add to the discussion by offering up some videos for those of you looking for more information on health care reform. We have three topics pages about health care, one is specifically about policy, one is about the current reform efforts and finally, one features videos discussing the politics of it all.

http://www.icyou.com/topics/politics-policy/healthcare-policy

http://www.icyou.com/topics/politics-policy/healthcare-politics

http://www.icyou.com/topics/politics-policy/healthcare-reform

Check out these videos for answers to your questions, and check back daily for updates and new information!

Thanks,
Laura

Nov 5, 2009 - 6:36 am 6. Now and Then:

According to the CBO, the Republican bill, which has no chance of passage, would extend insurance coverage to about 3 million people by 2019, and would leave about 52 million people uninsured, the budget office said, meaning the proportion of non-elderly Americans with coverage would remain about the same as now, at roughly 83 percent.

The budget office has said that the Democrats’ health care proposal would extend coverage to 36 million people, meaning that 96 percent of legal residents would have health benefits. (DAVID M. HERSZENHORN)

Good work! Maybe 27 pages would have been better.

Nov 5, 2009 - 6:53 am 7. BobNY:

N&T, your facts are backwards, the CBO states that HR3962, the Democrats bill would leave those 52 million non-edlerly uninsured and cover 3 million.

http://cbo.gov/doc.cfm?index=10705&type=1

Nov 5, 2009 - 7:13 am 8. Paul Hsieh:

Thank you for this great analysis! The sectors of medicine which are most free-market (such as LASIK eye surgery) show the typical pattern of falling prices and rising quality that we take for granted with cell phones and computers.

This can and should be the norm in all of health care.

Nov 5, 2009 - 7:27 am 9. jb:

I’ve called my Congressman,,, have you?

Most of us have free long distance with our phone service, there is no excuse not to share your objections with your man in Washington.

Nov 5, 2009 - 7:43 am 10. goy:

GREAT article!

Here are some inconvenient truths we need to beat into the heads of Congress (some of which are already alluded to above):

1. Insurance is a tool for mitigating financial risk; it is NOT a viable mechanism for funding a routine cost of living.

2. Insurance is not health care. “Coverage” is not health care.

3. Group insurance is just a way to spread the wealth around – by spreading the costs around. Not only will it never perform this socialist function fairly, but its use encourages prices to increase.

4. Tort liability forces overtreatment.

5. Comprehensive coverage encourages over-consumption.

6. Health care costs increases correlate exactly with the federal government’s meddling in the health care market – first with Medicare, then with HMO’s, then with tax incentives that push group comprehensive, employer-paid benefit policies, next with conversion of those benefits to statutorally mandated entitlements.

7. Increasing quasi-competition between insurance provideres will NOT bring down health care prices – see #2. Only by reinstating the direct relationship between health care provider and consumer will we ever bring health care prices down.

Extra-constitutional government meddling in the free market for health care is the cause of skyrocketing health care costs. MORE extra-constitutional government meddling in health care will NOT reverse that trend.

Nov 5, 2009 - 8:40 am 11. TomF:

I guess the idea is that if it is somewhat broke, we need to finish it off. In the Soviet Union, they called it Peristroyka. “Destroy it to the foundation and then rebuild it.” They are still trying to recover. At least they were moving away from what we are moving towards.

Nov 5, 2009 - 10:56 am 12. Hotpatch6:

This whole thing defies logic. We are going to upend the health insurance system that the vast majority of citizens are satisfied with to do what? Create an unsustainable debt to provide insurance to about 12 million people who don’t have it? Why? Can’t they fill out MEDICAID applications, or find their way to the local ER? (The ER is free to them, you know). I am really not concerned with health insurance for millions of non-citizens, or for the millions of healthy young citizens who can afford medical insurance but choose not to buy it. Don’t destroy the whole imperfect system in the futile pursuit of perfection – you won’t find it.

Nov 5, 2009 - 2:20 pm 13. NeverforObamaCare:

Hotpatch6. You succintly summed up the whole issue.

Nov 5, 2009 - 7:18 pm 14. goy:

@12. Hotpatch6: – The ER is free to them, you know …

This is categorically false. ER services are never ‘free’.

First of all SOMEONE has to absorb the expense of unpaid ER treatment. This unpaid expense drives up the cost of routine health care for the rest of us who DO pay for the services we receive.

Second, EMTALA statutes only require treatment regardless of ability to pay when the illness or injury is life-threatening. And even then, the only services that must be rendered are those necessary to stabilize the patient. Simply going to an ER doesn’t qualify the patient for ‘free’ care. In fact, ERs nationwide are overrun with non-emergency cases precisely BECAUSE people keep repeating the lie that ER services are “free” if you just claim you can’t pay for them.

This is a big part of the national mindset that has to change if we’re ever going to get routine health care costs back down into line with the rest of our routine costs of living.

Nov 6, 2009 - 8:08 am 15. Phillip:

Health is not a deliverable commodity and the more government involves itself in the patient physician relationship the more things will get screwed up and cruel. On a related note there is a posting on the Skeptics Health Journal Club pointing out that a highly credentialed scientist has found that people with high cholesterol live longer on average. If you are interested you can read more here.

http://healthjournalclub.blogspot.com/

Nov 6, 2009 - 10:45 am 16. JED:

The “Bizarro World” list is too long. Confusion and distraction are the stage magician’s way of making your purse and freedom dissappear.
Fundamental to the pro-universal health care hustlers is the (variable number)millions of uninsured. The sell point is that somehow we should be compassionate to the millions of less fortunate. The thrust of that forced charity is the mandatory betting pool; pay in or be speared by government approved guilt. Bizarro Word includes regulation by Idiotcracy and Thugocracy.

One would like to think that one’s own health is a matter of personal choice and responsibility, not the machinations of a bureaucracy.
The problem with being healthy is that one lives longer and that will cost more. Better health care is self-defeating if financial reconing is the gain. The cost of health care in the U.S. would be a load less if the feds issued vodka and cigarettes to lower longevity.
Keep up the good work Goy and all. . .
There is still room for good reason.

Nov 6, 2009 - 12:04 pm 17. Roark:

This news ought to scare everyone:

http://republicans.waysandmeans.house.gov/News/DocumentSingle.aspx?DocumentID=153583

Nov 6, 2009 - 6:18 pm 18. jellyneen:

the distortion of our food supply with government subsidies that stuff us and the animals we eat full of unhealthy corn and soy is why americans are sicker than the other countries they are compared to. sweden doesn’t have a population full of people stuffed with corn syrup– needless to say, they are much healthier.

americans who were born and came into adulthood before the Big Ag takeover after WW2 are of longer or the same life expectancy than comparable canadians/brits/etc.

american health is damaged by a food supply full of processed crap that is government funded. the solution is of course not more government funding for poor-quality health insurance (never actual CARE).

but whatever, this was all a power grab. we’ll never go back to a healthier food supply and we might just get stuck with another massive entitlement.

Nov 9, 2009 - 6:51 pm 19. Distraught:

Bad food. It’s what the people want. So be it. The fix to this is to have an educated and informed public. In the interest of time, I would suggest you focus on the informing part.

On that note, I still haven’t figured out how you grant one’s health as a right, and not their nourishment… or is that somewhere buried in the founding docs too.

Nov 10, 2009 - 6:35 pm 20. Distraught:

The other part of the fix would be to tie the cost of insurance to the severity (cost) of their life-choice induced conditions (diabetes? – flame me if wrong). I didn’t think to mention that, as the idea does not exist in the public consciousness as being acceptable, for some reason. But again, so be it.

Nov 10, 2009 - 7:06 pm 21. Distraught:

[Pajamas: partially off topic, but going in the trash. You may want to put it in yours.]

Apologies again, I previously referred to an attempt to post on another site regarding solar panels and “freakonomics” where the word “hypotheticals” was used profusely, which was not accepted… I think rightfully so. But it is a general rant on the climate and health care issues:

- begin post -

Great article. I too would like to say what a relief it is to hear a reasonable and entertaining voice on the topic.

I can’t help but notice however that the conclusion here too, consists of a lot of hypotheticals. So I would like to pose a different question, that being the two paragraphs below, and I apologize to the author and the new visitors of what seems to be an old post for the inappropriately long nonsense that came forthwith.

Why are we even considering taxing – so heavily – based on hypotheticals? And by hypothetical, I mean you couldn’t get 50 people in a room to agree on any of this, that had a reputation, could pass a lie detector, and a psych screen.

If this is an honest debate, should we not also consider the following hypothetical: Assuming there is a problem, it is perfectly possible that the solution could arise from Research and Development that would otherwise NOT occur under the proposed, imposed, economic slowdown.

I don’t think this type of speculation has any place in peace time legislation (or but – is it peacetime huh?). Leave the what if’s, should I sign it/press it, for the executive and a real emergency. This place can only survive on rational policy, obviously… unless we are just super lucky, or had a great foundation?

No wait. I simply can not believe that this danger is so immense and catastrophic, yet we cannot even measure it coming? What happened to conclusions based upon repeatable measurements? what is it, a 10th order effect? This planet has been around for ~4,5 billion years and for the last ~2.5 billion, amidst much larger changes in atmospheric concentrations, it has been doing ‘its thing’ just fine. This includes an ice age every now and then, smashing continental plates, magnetic pole shifts, and so on. Is it not a little pretentious to default to the idea that we can turn this place on its head in a blink of its eye?… without nukes.

And somehow, in what, 10-20 years, some fluctuation is going to appear without warning and not subside? The climate system will start darting off (some discontinuity I suppose? whats the physical model for this again? and why has mother nature been hiding it?) to some far off stasis, never to return while we will burn up, having had no prior measurable indication (none found yet: check) and no recourse but to pay to the gods? For crying out loud, its getting colder. While we do know something about the long CO2 lifetime, is it not reasonable to come to some agreement as to what effect must be observed before we bring the wheels of industry and productivity to a screeching halt. Can we at least see a cute animation or two before we fork over the trillions?

I wonder if this is not just a new form of sacrifice, for people lacking a core substance in their lives or something. But it doesn’t matter; I don’t think we should buy in yet. A hypothetical is not science, not a truth, not a principle, and when I hear talk of potentially sinking trillions for one, I get sick to my stomach; what is going on. Its not even in the same ballpark as CFC’s and the O^3 holes (I’m not implying they have anything to do with Al’s missing ice). The best science yet is still the thermometer “in my backyard”, and not some prized, massaged model or appropriately weighted data set.

It was magically colder this year – and last and last – and I hear it might have an interesting correlation with the sun cycle, or not; unfortunately I have not managed to catch any of the media, I mean experts, coming to any conclusion on that either; see lots of “what if’s” though. Heck, here is a real bonehead one: what about the trees, where is the silly little study showing the max capacity of trees, that they will not flourish under increased CO2, and that their restoring contribution will most likely be negligible. And what if the excursion was bounded? I am a lazy citizen and google sucks now. But seriously, what if it would rise at most 2 degrees?… 2 trillion for 2 degrees?… could be a boom… modicum of certainty, anyone?

– Trillions people… Its cold… seriously, what is going on in this country.

PS: I like to think the solution to this and most other things is education. That simple really. — Side note: We don’t know the ‘Green Age’ is prophesied right? We understand in this universe and on earth, nuclear power may end up being our best option, right? I’m only stating a hypothetical here — Nonetheless, Invest in education, I don’t think I need to argue that the long term survival of a democracy lies in the people. Its like your #4 hitter in baseball stars, just beef him up, it always pays. So, if you are not sure about voting on that big state project, place a vote for the future instead, and sleep better; for it will be that much less likely they will attempt something later on, like trying to swipe half your medicare budget while proclaiming it will be recovered from waste.

In reality, the recoverability of the $5 x 10^11 of said fraudulent activity has not even been addressed, as if it’s as good as in the bank. Doesn’t matter that this is being used to fund half of the deficit neutral behemoth bill right? or that nothing even approaching this amount has EVER been recovered from waste in any program anywhere, ever. And you can throw up as many hockey stick plots you want, for it is getting colder, unfortunately I know. But, seriously my fellow educated Americans, what is a thinking man suppose to do? Where does it end?.

But alas, choosing education over public expansion projects is not the easiest thing to do. There is no immediate return. Its not cheap. Its not for YOU and not for today, but for your children, and Tomorrow’s society, who will have to subsidize them otherwise. And that means you, if you are lucky enough to be there. Now that’s a bonafide sacrifice and comes with high probability payout. And for all you know, your child or possibly one in Madagascar, will change the world with his creativity.

And to bring this home, I am reminded why this whole ‘bending the curve’ baloney is just crazy. Wise is he who bets on, not against, the human spirit. Stephen Hawking was only supposed to live how long? and did what? I don’t know of any exam or questionnaire that could measure his lion-sized heart or potential at any stage in his life. And, since all people are equal, we must extend this to all. Ask yourself what the lowering of the upper end of the cost curve means. It means paying less for medical services for people in their later years than is paid out now.

Now they have a nice “Truth” made up hear for ya, if you want, you can believe that this will work because of increased efficiency. Their obscure idea is to ‘improve’ the system by paying only for an outcome (plus more waste elimination!) thus reducing those pesky unnecessary procedures. Of course, Ill believe that when I see it. Inevitably, they will be unable to provide the same amount of care. Funny thing here is, both manifestations seem to agree that you, the lucky in medicare, WILL have less procedures; one just claims those particular procedures will be ones which you don’t, or I guess ‘won’t', really need; which, again, I’ll believe when I see it.

I can’t help but sometimes see the proposed Health Care and Climate Crack as two heads of the same beast. Neither involves science or reasoning, only the proliferation of an unchallenged set of “Truths”. The only reasonable function of a 2000 page bill is to be intractable, so that no real debate on it could ever take place, and another set of more convenient “Truths” can be messaged, as needed.

Remember this problem is supposed to be about temperature change. I hope that the science of temperature change is not neglected in the pursuit of the science of CO2 change and proprietary computer modeling, not that they are not intimately related. I mean that these models should perform fair in predicting NON-catastrophic events, and have stability NOT requiring magic parameters. A crucial property here is continuity, meaning that the same program that predicts disaster in a hypothetical world, to be at all believable, should predict to some approximation, what we know to be correct in ours.

And for those who did NOT get the news flash, cause you probably won’t hear it elsewhere:

[Solar panels are NOT green] —- they may only be greenER, than something else, technically.

They may have zero carbon footprint, if we neglect fabrication and waste — whose counting anyway. Yet, as if to deprive full redemption, the mere act of exposing a solar panel to the sun, results in global warming.

- end post -

Nov 10, 2009 - 10:31 pm 22. Distaught:

To the public:

I recently posted on hear regarding the current Health Care and Climate Change policies. And I want to tell you now that I did speak to soon.

I apologize to all for that.

I have recently found more information on the subject, and will be posting here as soon as a am able to write up a summary.

Again. Please ignore may claims against the Health Care and Climate Change bills, as they were not fully informed.

Nov 12, 2009 - 11:21 am 23. Distraught:

No. sorry. I can’t repeal my post as it is still how I feel. And I think it stands on facts and observations within. It is not an authority on anything, but it is meant to be rational. And to that you have my word.

Nov 12, 2009 - 11:27 am