Originally Posted by Justin '77

Health "insurance", on the other hand, is something that people are expected [at least, the industry would like it to be so] to have if they elect to be alive.

Comparing the two as if they had anything in common other than the misused moniker of 'insurance' is wholly disingenuous.

Shit still happens to your health, no matter how much you try to prevent it.

Originally Posted by independent

There is also the issue of what Obama campaigned on. Hillary had a mandate, Edwards had a mandate, and Obama stood up to both of them and said it was a bad idea because the vast majority of people who don't have insurance because they can't afford it.

If the voters wanted a mandated approach, why not vote for someone who was offering it in the first place?

Excellent point, and it was one of the reasons that I preferred Obama's approach during the primary season.

I also understand Playwrite's argument about spreading the risk around and subsidizing the costs for poorer folks.

I propose to pass a plan with a public option, and to mandate only catastrophic coverage.

I'm not so sure I agree with the opposition to mandates.. The reality is that everyone should be covered by an insurance plan that includes preventative medicine and copays/deductibles low enough not to bankrupt a person should the require extensive care. A mandate forces this to happen. If people were forced to purchase insurance, the government would have to take what ever steps are necessary to make it reasonably affordable. The alternative would be electoral disaster. Thus, I see a mandate as a commitment to really solving this problem.

If this was going to work, we could just make a law that says you have to pay your mortgage on time.

Voilà! I just solved the entire financial crisis

But let's remember what's not in the Baucus bill:

• A public, not-for-profit insurance provider (health lobby)
• Health administration reform - 25% overhead (health lobby)
• Education for doctors - $200,000 in student loans (banksters lobby)
• Tort reform (lawyers lobby)
• Federal negotiation on drug prices (pharma lobby)
• Imports of foreign medicine (pharma lobby)

Now excuse me, I'm going to go invest in prison bonds and insurance stock so I can break even on this deal.

Originally Posted by independent

If this was going to work, we could just make a law that says you have to pay your mortgage on time.

Voilà! I just solved the entire financial crisis

But let's remember what's not in the Baucus bill:

• A public, not-for-profit insurance provider (health lobby)
• Health administration reform - 25% overhead (health lobby)
• Education for doctors - $200,000 in student loans (banksters lobby)
• Tort reform (lawyers lobby)
• Federal negotiation on drug prices (pharma lobby)
• Imports of foreign medicine (pharma lobby)

Now excuse me, I'm going to go invest in prison bonds and insurance stock so I can break even on this deal.

I'm not arguing that mandates in themselves solve the problem, but that they existence of the mandate force the Democrats to solve this problem if they want to keep winning elections. I don't think there is much at this point that could push the dems. from power, forcing people to buy health insurance they can't afford is probably one of the few!

As for the list of items you give, let's not forget that this Senate bill is kind of a charade anyhow. It seems pretty clear that the goal is to get something, anything out of the Senate. The bill has to be such that it provides cover to the 60+ senators who vote for cloture on it while at the same time some what resembling the final bill so the dems. don't take too much heat on germaneness. The real bill is what comes out of the conference committee.

Originally Posted by Child of Socrates

Shit still happens to your health, no matter how much you try to prevent it.

Absolutely. You can not avoid the need, at some point in your life, for medical care.

You can, on the other hand, absolutely avoid the need to pay for an incident arising when you were operating a motor vehicle (by not operating one). The two 'insurances' are fundamentally not comparable.

Originally Posted by independent

If this was going to work, we could just make a law that says you have to pay your mortgage on time.

Voilà! I just solved the entire financial crisis

But let's remember what's not in the Baucus bill:

• A public, not-for-profit insurance provider (health lobby)
• Health administration reform - 25% overhead (health lobby)
• Education for doctors - $200,000 in student loans (banksters lobby)
• Tort reform (lawyers lobby)
• Federal negotiation on drug prices (pharma lobby)
• Imports of foreign medicine (pharma lobby)

Now excuse me, I'm going to go invest in prison bonds and insurance stock so I can break even on this deal.

The sh*t Baucus bill is NOT going to be the final legislation, many in the House, including Speaker Pelosi, have publically stated that the finally bill MUST have a strong public option.

Originally Posted by Justin '77

Absolutely. You can not avoid the need, at some point in your life, for medical care.

You can, on the other hand, absolutely avoid the need to pay for an incident arising when you were operating a motor vehicle (by not operating one). The two 'insurances' are fundamentally not comparable.

What is comparable is the burden placed on those that do have insurance - that is the point.

Yes, planes are not automobiles, but one can compare relative costs, risks etc...

Yes, fruits are not vegtables, but one can compare costs, benefits

Yes, men are not women, but one can still compare which ones are turkeys
(not suggesting that you are, by the way! )


On another note -

Earlier, you posted some Investors' Business Daily (that might have given one a hint) poll that claimed doctors would be leaving their profession in droves should health reform passes -
http://www.fourthturning.com/forum/s...&postcount=326

Let's see what Nate Silver has to say about that poll (Silver has become one of the most, if not THE most, respective polls analyst around right now) -

http://www.fivethirtyeight.com/2009/...ustworthy.html

IBD/TIPP Doctors Poll Is Not Trustworthy

1. The survey was conducted by mail, which is unusual. The only other mail-based poll that I'm aware of is that conducted by the Columbus Dispatch, which was associated with an average error of about 7 percentage points -- the highest of any pollster that we tested.

2. At least one of the questions is blatantly biased: "Do you believe the government can cover 47 million more people and it will cost less money and th quality of care will be better?". Holy run-on-sentence, Batman? A pollster who asks a question like this one is not intending to be objective.

3. As we learned during the Presidntial campaign -- when, among other things, they had John McCain winning the youth vote 74-22 -- the IBD/TIPP polling operation has literally no idea what they're doing. I mean, literally none. For example, I don't trust IBD/TIPP to have competently selected anything resembling a random panel, which is harder to do than you'd think.

4. They say, somewhat ambiguously: "Responses are still coming in." This is also highly unorthodox. Professional pollsters generally do not report results before the survey period is compete.

5. There is virtually no disclosure about methodology. For example, IBD doesn't bother to define the term "practicing physician", which could mean almost anything. Nor do they explain how their randomization procedure worked, provide the entire question battery, or anything like that.

My advice would be to completely ignore this poll. There are pollsters out there that have an agenda but are highly competent, and there are pollsters that are nonpartisan but not particularly skilled. Rarely, however, do you find the whole package: that special pollster which is both biased and inept. IBD/TIPP is one of the few exceptions.

Justin, I've been noticing a slip in your due diligence, if not your analytical skepticism. Still light-years ahead of most of the those from your nitch on the political spectrum, but still some concern here. Could it be a result of moving back to the States or perhaps some poorly chosen Pac NW wild mushrooms?

Originally Posted by Justin '77

- btw, your arbitrary 88K number (why not 87.5? or 88.1?) is also a load of crap. But it's just like the magical 7670th/7671st day of each American's life. The mindless bureaucracy needs a number -- any number -- if it is to function.

I have no idea what your point is here. At some point, the law will settle on inflection points - always has, always will. So what is the big deal?

Originally Posted by independent

...

$7.25 x 40 x 52 = $15,080
150% of Poverty

I stand corrected. Nice catch.

I believe the 88K still holds because that was specified in the press release.

Bottom line is that one needs to understand how the mandate is considerably ameliorated for those with lower incomes by proposed exemptions and subsidies.

Originally Posted by independent

Why would ANYONE want to buy a product that comes with a 30% administrative overhead? Maybe its "still worth it" because they're extorting your very life and well-being, but its an incredibly inefficient product that would never survive in a competitive market.

Normally, people avoid bad products or purchase a substitute. In this case, the only reasonable substitute is keeping enough money saved up to pay cash for medical crisis. With a mandate and no public option, the terrible product not only survives, it continues to grow in consumption.

Its also estimates that private insurance adminsitration and overhead consumes $1000+ per person per year across the entire population.

There is also the issue of what Obama campaigned on. Hillary had a mandate, Edwards had a mandate, and Obama stood up to both of them and said it was a bad idea because the vast majority of people who don't have insurance because they can't afford it.

If the voters wanted a mandated approach, why not vote for someone who was offering it in the first place?

There is no benefit to expanding the current private insurance system. No benefit outside Wall Street, anyway.

No thanks. Put me in jail, if you will, but I'm not paying another penny to the medical profit machine. Not one more penny to Blue Cross, or Cigna, or Humana. They got their share from me already and the incompetence, corruption, and greed of the system still leaves a bad taste in my mouth.

Hard to argue with much of this. Your argument is more valid, however, if done within the true context of how the mandate works with other aspects of the package.

In fact, when one examines your argument, it sure seems that your beef is not with the mandate so much as it is with the lack of a viable public option that would bring the costs down - unless, of course, your convinced you (or your spouse, kids) will never get sick or injured (if that is the case, then basically you just need a few more years of maturation )

Oh, in regard to the jail thingee. The enforcement of this is turned over to the IRS as part of the income tax process. They have no problem with putting people in jail.

Originally Posted by scotths

I'm not so sure I agree with the opposition to mandates.. The reality is that everyone should be covered by an insurance plan that includes preventative medicine and copays/deductibles low enough not to bankrupt a person should the require extensive care. A mandate forces this to happen. If people were forced to purchase insurance, the government would have to take what ever steps are necessary to make it reasonably affordable. The alternative would be electoral disaster. Thus, I see a mandate as a commitment to really solving this problem.

You need a mandate for a universal system to work. But you also need cost control for a mandate to work. We don't have that so a mandate will be a problem. As is usual, we Americans are going about this issue ass backwards.

Too much focus on how to pay for it. This is just silly. Universal health care, properly done, will cost less than what we have now. And there will be no rationing of the sort scare mongers talk about now. Here's why.

One only need to look at the Japanese, the grandmasters of health care cost control. The Japanese get three times more MRI's and twice as many Cat scans as Americans. They see their doctor an average of fifteen times a year, compared to five for Americans. Their average hospitalization length is more than twice as long as in the US. To provide all that care, they have more hospital beds and doctors per capita than in the US. Japanese consume more pills and receive more injections than Americans.

Japan is a prodigious consumer of medical services, largely because they have an old population. And they get their money's worth, they live longer, enjoy higher rates of improvement from treatable ailments, and boast a whole range of superior stats relative to the US. And they do all this for half the money we spend. Every two years the Ministry of Health negotiates with the Japanese Medical Society, the hospital trade group, and the major pharamacetical companies on behalf of the thousands of private health insurers in Japan. Prices are agreed on for thousands of procedures. These prices are the same everywhere in the country and they are published in an Atlas-sized book.

How do they do it? Well the "Book prices" for medical services are lower, way lower. As an example, consider MRIs. An MRI of the head in America costs somewhere between $1000 and $1400. In Japan it's $105, period. Everywhere in the country it's $105. Since their MRIs cost much less than ours, even though they have more of them, they spend less on MRIs in general. And this is the case for most procedures.

Since the price for MRIs is so low, Japanese doctors cannot use them as American doctors do. It is simply impossible to do MRIs for $105 a scan with a multimillion dollar machine. So the Japanese doctors petitioned Japanese MRI makers to come up with a basic model for a tenth the price. They did so. Japanese clinics will often have their own inexpensive MRI machine for doing small scans like the MRI of the head. With these cheap machines they can afford to do scans for $105.

As a result, patients needing a head scan get it done with the cheap machine; they are not referred to an MRI facility with one of the expensive models, as happens in the US.

Since Japanese doctors do three times the scans as American doctors, the majority of their scans are done in situations when American doctors don't do any scan. Since the basic scans are cheap in Japan (the scans get done on the cheap machines) they can afford to do so many scans. Most of the time it probably wasn't necessary, as the American doctors conclude. But sometimes they do find something. The reason the Japanese and American doctors practice differently has a lot to do with how expensive the procedure they are considering is.

One thing that is not cheap in Japan is major surgery. Major surgery costs about half of what it costs here, but the cost of an operation is still many thousands of dollars. Since non-surgical treatments are much cheaper than in the US, while surgery is only moderately cheaper, there is a bigger difference between the cost of surgical verus non-surgical treatments in Japan than there is in America. As a result, Japanese doctors are more reticent about surgery, preferring to try drugs and other therapies first. As a result, Japanese have fewer surgeries per capita than Americans, but much more of nonsurgical treatments.

Japan has private health insurance. You must sign up. They must go with the insurance plan their employer chooses. Premiums are fixed for all plans. For employees of big firms, the company and the employee share the premium. For small companies the government assists the company. Unemployed have the company's portion paid for by the government. Subsidies exists for the poor.

France and Germany have similar systems (in fact the Japanese copied the Germans when they set up their system long ago). There systems all use private insurers and private providers, although there are public hospitals and clinics too, just like we have our VA and municipal hospitals.

But the system is tightly regulated by the government, sort of like basic telephone service in the US. The insurers are all nonprofit, by law. They must take any customer who applies, regardless of pre-existing conditions. They cannot drop anyone. They are only required to cover things that are in the book, and so they know exactly what the costs of all procedures they must cover will be. Their premiums are also fixed, set by law, so they cannot compete on price.

They compete on service and on offering coverage for extras that are not in the book. Although the insurance companies are non-profit, their executives earnings are based on how many customers they have on the books. The better the service they can provide with their fixed revenue stream, the more customers they will get and the more they get paid and the higher their status.

"Bismarck countries" like Japan, France, Germany, and Switzerland do not have "natonal health insurance" like US Medicare or the Canadian and Taiwanese systems. Nor do they have "socialized medicine" (where the government provides medical care) like the US Veterans Adminstration or Britain and Italy. But because of the regulated market they function much like a system with single payer or government-provided medicine.

Originally Posted by Odin

The sh*t Baucus bill is NOT going to be the final legislation, many in the House, including Speaker Pelosi, have publically stated that the finally bill MUST have a strong public option.

The sh*t Baucus bill is what the President outlined in his Joint Session. Do you dare to disagree with your Leader?

Originally Posted by Mikebert

You need a mandate for a universal system to work. But you also need cost control for a mandate to work. We don't have that so a mandate will be a problem. ...Too much focus on how to pay for it. This is just silly. Universal health care, properly done, will cost less than what we have now. ...Japan has private health insurance. You must sign up. They must go with the insurance plan their employer chooses. ...

But the system is tightly regulated by the government, ... The better the service they can provide with their fixed revenue stream, the more customers they will get and the more they get paid and the higher their status.
....

Great review of health systems in other countries and exactly the type discussion we need to foster to make progress. Although not as tightly regulated the underlying approach of the Health care system for US Govt. workers has some common aspects. It is critical that this be implemented primarily by private insurers, with strong Govt. oversight. The major hurdle for the US is to find way to include all who are not covered by an adequate employer plan. I am convinced that there are enough cost savings with a real system in place to pay for all (at least most) of the costs. We should not be afraid to adopt & adapt other models that work.

Senate Hearings - Public Option

Live bloggin brought to you by the NYT

http://prescriptions.blogs.nytimes.c...lic-option/?hp

fascinating stuff

Now I'm not going to say something snide about country bumpkins coming to the big city...

I realize when a NY'er takes his jacket off, its time to get cautious, but come on, Grassley, try to keep it together! Note how, after my Senator bores in on him, the last few tongued-tied Grassely lines about 'wanting to give choice' -is assley becoming a Liberal? -

http://www.youtube.com/watch?v=KwtkqXu0ym8

Maybe this is why the Repugs demanded lunch! Had to clean their pants.

this Senator, Maria Cantwell, from Wash. State, seems to be an emerging force to be reckoned with. She has added two amendments that have garnered a lot of attention.

but what I like about her -

A Democratic Dig | 2:14 p.m. Senator Maria Cantwell, Democrat of Washington, speaks in favor of the public option. But first, she slyly makes the point that if a state renders health care efficiently — a state, like, oh, say, North Dakota, home to Mr. Conrad, who opposes a public option — that state would be rewarded for its efficiency. Mr. Conrad was just returning to his seat as she was finishing her point, so it is not clear whether her fellow Democrat caught her drift.

Well the best thing that can be said is that we are coming near the end of the Baucus fiasco.

Schumer and Rockerfeller did succeed in leaving the impression that the tide may be turiing on the Public Option (PO) with a tactic of giving two choices bringing on Senators Nelson and Carper. It also made clear who the asshats are: Conrad; Lincoln and Baucus.

A good quick summary of what happen and what's to come -

The fact that the Schumer amendment picked up two Democratic votes should be a reassuring sign for supporters of a “public option” — a government-run insurance plan — even though liberals view the Schumer amendment as a weaker version than the Rockefeller proposal. But Tuesday afternoon’s votes highlight the tough fight ahead with conservative Democrats like Kent Conrad of North Dakota and Blanche Lincoln of Arkansas, who held out against the Schumer proposal.

The question now is whether the support shown today by at least some Democrats for the public option will be enough to persuade Senator Harry Reid of Nevada, the Democratic leader, to include it when he reconciles the Finance Committee bill with one from the more liberal health committee — which does include a public option.

That will be the big debate going on behind the scenes as the Finance Committee barrels through hundreds of additional amendments with the goal of wrapping up its bill by the end of the week.

Supporters of the public option hope that even if they cannot persuade Mr. Reid to include the measure in the combined bill, they have established enough momentum to bring it up on the Senate floor. Watch for the pressure on wavering Democrats from interest groups, like unions, to only increase.

My hope is that the final bill gets reported out without a single Repug vote - hopefully, to finally kill the notion that bipartisanship is at all viable with these asshats.

From there, my hope is PO gets added to the final bill and that Obama can get all 60 to do cloture for an "up or down vote" that will allow several DINOs the cover to vote against it. Barring that, we got a solid 50 count now for reonciliation. Doable if Reid's got the gonads.

Good analysis Playwrite. I see it evolving pretty much the same as you do.

Have a nice daydream that the Congress was on your side? Well, wake up!

Senate panel votes down public option proposal
Posted: September 29th, 2009 03:12 PM ET


Sen. Baucus was among the five Democrats who voted against adding a public option to the health care bill.



WASHINGTON (CNN) — The Senate Finance Committee on Tuesday rejected an amendment to include a government-run public health insurance option in the only compromise health care bill so far.

The amendment by Democratic Sen. Jay Rockefeller of West Virginia fell by a 15-8 vote, with committee chairman Sen. Max Baucus of Montana and four other Democrats joining all 10 Republicans in opposing the measure.

Originally Posted by independent

Have a nice daydream that the Congress was on your side? Well, wake up!

Senate panel votes down public option proposal
Posted: September 29th, 2009 03:12 PM ET


Sen. Baucus was among the five Democrats who voted against adding a public option to the health care bill.



WASHINGTON (CNN) — The Senate Finance Committee on Tuesday rejected an amendment to include a government-run public health insurance option in the only compromise health care bill so far.

The amendment by Democratic Sen. Jay Rockefeller of West Virginia fell by a 15-8 vote, with committee chairman Sen. Max Baucus of Montana and four other Democrats joining all 10 Republicans in opposing the measure.

Nice cherry pick, there, Indy. Not sure if it was yours or the Wash Post's.

The real news was that Schumer's PO amendment picked up 2 Blue Dogs with a final tally of 10-13, against - i.e., only two Blue Dogs needed to tie this baby up. The Finance Committee is way way more conservative in representation than the rest of the Senate. This was as bad as it could get and unexpectedly not as bad as we thought.

If Obama had played his hand here it would have been much closer, likely even have passed. But that might not have been the strategic way for making sausage. We need the sense of bipartisanship to be taken out and murdered first - I'm sure that the Repugs on the SFC are going to oblige us.

We are close, very close, and several points along the way for getting this baby done.

HARKIN: I believe that when we merge these two bills, we will have a public option in there that we will take to the floor of the Senate and we're going to pass it.

SCHULTZ: Well, okay, so despite what happened in the Senate Finance Committee today, you think you've got the votes to get a public option coming out of the Senate? Cause I'm not so worried about the House anymore and I think the American people, I mean, this is gonna be reported, all the talking heads are gonna say, "Hey, public option is dead." I need to have some confidence tonight with you, Senator Harkin, that you think you can get these votes out of the Senate.

HARKIN: Well here's one thing I will guarantee you, Ed, and I will tell you again as I've told you before -- we will have a bill on the President's desk before Christmas and it will have a public option.

SCHULTZ: Well that's what the American people want to hear. Now ...

HARKIN: I know it and most of the doctors want it, 73% of the doctors polled want a public option, uh, sixty-some percent of the American people want a public option and the vast majority of Democrats, over fifty in the United States Senate, also want a public option.

SCHULTZ: Okay now, are you going to have to go reconciliation? You're not going to get sixty at this point are you?

HARKIN: Well, I wouldn't give up on that yet. I still think that we can get sixty votes to bring the bill on the floor of the Senate. And then we'll have amendments and then we'll have, probably have to have a cloture on the bill to bring it to a close. Now that will be the tough vote. I still believe that we can get the sixty votes for that.

SCHULTZ: Okay, what about ...

HARKIN: But if we don't, Ed, if we don't, we're going to go to reconciliation. As I said to you, and as I say to the American people, we will have this bill on the President's desk by Christmas, one way or the other.

Wash Post? You mean CNN?

The Democrats are behaving like tools of the insurance industry, but somehow these failed amendments are a proof of progress.

Incredible. Democrats barely have a majority within their own party and all the leadership posts have been bought & paid for by corporate sponsors.

Originally Posted by independent

Wash Post? You mean CNN?

The Democrats are behaving like tools of the insurance industry, but somehow these failed amendments are a proof of progress.

Incredible. Democrats barely have a majority within their own party and all the leadership posts have been bought & paid for by corporate sponsors.

Anyone listening to Rockefeller or Schumer today can't possible accuse them of being in the pockets of the insurance industry. Baucus certainly is and a couple other Dogs are asshats as well. I don't think Reid is; I think he's just not competent enough.

We'll see.

Originally Posted by playwrite

Anyone listening to Rockefeller or Schumer today can't possible accuse them of being in the pockets of the insurance industry. Baucus certainly is and a couple other Dogs are asshats as well. I don't think Reid is; I think he's just not competent enough.

We'll see.

I do have to giggle at the idea that anyone named "Rockefeller" can at least take a swing at being anti-corporate.

The full Senate debate ought to to be fascinating viewing.

Originally Posted by playwrite

Anyone listening to Rockefeller or Schumer today can't possible accuse them of being in the pockets of the insurance industry.

Maybe not for the insurance industry, but they're definitely tools for someone:

• Senator Rockefeller began steering the Senate Intelligence Committee to grant retroactive immunity to telecommunications companies who were accused of unlawfully assisting the National Security Agency (NSA) in monitoring the communications of American citizens
• Rockefeller voted with a largely Republican majority to suspend habeas corpus provisions for anyone deemed by the Executive Branch an "unlawful combatant," barring them from challenging their detentions in court. Rockefeller's vote gave a retroactive, nine-year immunity to U.S. officials who authorized, ordered, or committed acts of torture and abuse, permitting the use of statements obtained through torture to be used in military tribunals so long as the abuse took place by December 30, 2005.
• On April 6, 2005 Alan Greenspan testified to Congress about the enormous portfolio of Fannie Mae and Freddie Mac. Schumer responded to the testimony "I see an analogy to Social Security," Mr. Schumer said. "Social Security has a problem and there are ideologues who want to undo it. Fannie and Freddie have problems, and there are ideologues who want to undo them."
• the New York Times published an article[57] on Schumer's role in the Wall Street meltdown. The article stated that Schumer "embraced the industry’s free-market, deregulatory agenda more than any other Democrat in Congress, even backing measures now blamed for contributing to the financial crisis... Schumer took steps to protect industry players from government oversight and tougher rules, a review of his record shows. Over the years, he has also helped save financial institutions billions of dollars in higher taxes or fees. He succeeded in limiting efforts to regulate credit-rating agencies." This article also charged that Schumer blocked ratings agencies reforms proposed by the Bush Administration and the Cox SEC.

These are your power-to-the-people representatives?

We're too forgiving if we let corrupt politicians redeem themselves by making a bit of noise in support of otherwise doomed provisions.

Independent... you can count to fifty , right?