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50 comments

1 researchok  Sat, Jun 30, 2012 2:50:33pm

The political response (spin) as opposed to actually examing what this means is what concerns me.

I'm absolutely for health care reform and the ACA is a good start. That said, my concern is the costs, both short and long term.

The talking points of 'saving money' are nice but have you ever heard of a government program that actually ended saving money?

I would have much rather seen a phased in program and allow insurance companies to sell across state lines, like they do with car insurance and other kinds of insurance.

The insurance industry lobbied Washington hard because they didn't want that (competition!) and we're all going to pay for that.

2 EiMitch  Sat, Jun 30, 2012 3:30:00pm

Its not necessarily bad to talk about private insurance, medicare, medicaid, individual mandate, single-payer, etc. But all these things only refers to who pays for health care and how.

I'm more concerned with why hospital bills are so expensive in first place. Focusing on how to pay for them just sweeps the source of the problem under the rug. We need reforms designed to end the price-gouging, not just make someone else deal with it behind closed doors.

3 Obdicut  Sat, Jun 30, 2012 4:09:19pm

re: #1 researchok

The talking points of 'saving money' are nice but have you ever heard of a government program that actually ended saving money?

Yes. Many government programs save money. You're just kidding with that kind of extremist talk, right?

Easy examples: Levees, canals, and other water projects which limit the damage from flooding.

Immunizations, which saves tons of money on medical treatment.

Fire departments, which save the cost of entire neighborhoods burning down. Etc. etc.


And in this case, we're talking about a system where the government is already underwriting the bill in many ways, from subsidizing hospitals to subsidizing doctor's educations. The cost of the uninsured already largely falls on the government.

The money is already being spent.

4 The Winning Words Project  Sat, Jun 30, 2012 5:46:13pm

re: #1 researchok

Have I ever heard of a government program that actually ended up saving money? Yes, Medicare.

Medicare is the most effective and cost efficient healthcare program in the nation.

And because more people will now be receiving basic and preventative healthcare, and because they will all be covered by insurance, there will be fewer catastrophic illnesses that end up having to be covered by taxpayers, and that alone will effect a huge cost savings to the country.

There are many ways we will start seeing savings. This is just the beginning, though. Give it a chance.

5 The Winning Words Project  Sat, Jun 30, 2012 5:51:29pm

re: #2 EiMitch

Hospital bills are so expensive right now because there is no one entity to oversee checks and balances on their billing practices, for one. Hospital bills for Medicare patients are significantly lower than the bills for for-profit insurance-holders. Insurance companies have little incentive to keep costs low because they can use high costs as an excuse to raise their premiums and skim a little more off the top each time.

When the people's government has the ability to negotiate on a national scale, hospitals fall in line with appropriate billing practices.

6 researchok  Sat, Jun 30, 2012 6:25:54pm

re: #3 Obdicut

Would you like to compare the costs (both real and legacy) of the projects you mentioned, versus private projects?

Speaking of levees, do you believe the NOLA system was money well spent over the decades?

Immunizations do save money, of course but are the programs that administer them as efficient (again, factor in legacy costs) as private programs?

The same applies to Medicare- future expenditures remain unfunded because money was taken to pay current bills.

One has to wonder why, if government spending is so efficient both Congress and the Executive branch are so keen on cutting those expenditures.

7 EiMitch  Sat, Jun 30, 2012 6:41:55pm

re: #5 The Winning Words Project

That would be an argument for a single-payer system. Then again, thats not the only solution to the problem.

Regardless of one's political leaning, I'm certain we would be much better off if these unconscionable over-billing practices were the focus of reform. I'm not saying private insurance didn't need reform. I'm just saying we had let go of the biggest fish without a fight.

8 Obdicut  Sat, Jun 30, 2012 6:52:49pm

re: #6 researchok

Would you like to compare the costs (both real and legacy) of the projects you mentioned, versus private projects?

Sure. Go for it.

For example, the VA, medicare, and medicaid all outperform private insurance. That would be the appropriate comparison, right?

Speaking of levees, do you believe the NOLA system was money well spent over the decades?

Some of it was. It wasn't well done enough recently. Obviously you're not enough of a fool to say that the failure of those levees means all levy building is somehow suspect.

But please explain how and when private levees would be built to protect a city.

Immunizations do save money, of course but are the programs that administer them as efficient (again, factor in legacy costs) as private programs?

What private programs for immunization? Be specific.

One has to wonder why, if government spending is so efficient both Congress and the Executive branch are so keen on cutting those expenditures.

Because idiots who insist that government is naturally wasteful have taken over the national discourse, simpletons who recommend cutting spending during a recession, even while we can see the negative effects of austerity in Europe. And they may very well continue to win the argument, and the economy will double-dip. Fucking awesome.

However, it's rather obviously untrue to say the Executive branch is keen on cutting expenditures. Obama is attempting to get something, anything out with a completely hostile GOP house. I completely agree he's fumbled it in terms of presentation and bought into the stupid cost-cutting meme, when he should be making the argument that ten years ago, nobody dreamed of cutting costs in a depression aside from the rankest of Randites; everyone knew that when the private sector faltered, that cutting government spending at the same time was disastrous.

The same applies to Medicare- future expenditures remain unfunded because money was taken to pay current bills.

What are you talking about? How is that anything like a comparison of whether medicare is cheaper and better-run than private insurance?

It is. It mainly is through savings on salaries, administrative costs, and advertising. It would be really weird if it weren't more efficient than private sector, since it doesn't have the advertising costs.

Can you explain what magical transformation you think happens to people when they work for the government that makes them become inefficient, that doesn't happen at a big corporation?

It boggles the fucking mind that people actually believe there's any efficiencies that benefit the consumer in the private insurance market.

My wife just got yet another stupid letter from her insurance company asking if she had other insurance. She gets this after every time she submits a claim, because if she doesn't respond to it, they can use that as an excuse to not pay the claim. That's an efficiency of private insurance, the only thing it's an efficiency for them making a profit, not for them serving the actual customer. Because health insurance is a naturally broken market.

9 Interesting Times  Sat, Jun 30, 2012 7:02:30pm

re: #6 researchok

No offense, but that all reads like an extreme over-simplification to me. This isn't about short-term bean-counting, but the big picture - what saves the most money in the long run, when all factors are taken into account.

Consider the very serious problem of drug-resistant bacteria, and a lack of new antibiotics to treat them. Why is there a shortage of antibiotics? Because the profit-driven drug industry doesn't make as much money from them!

Common sense, when you think of it - the medications which people are pretty much stuck with for life (e.g. blood pressure control, anti-depressants, etc) - would naturally turn more profit for a pharmaceutical than something you only take for a week. Ergo, their financial incentive is to invest in research for chronic condition treatment, not cures for a bacterial disease. Without government investment in the research for the latter, we may very well find ourselves in a world of hurt someday (to say nothing of the aggressive anti-science agenda of the GOP, but I digress)

That right there tells you that, bean-counting aside, there are certain things in the public interest that cannot be "efficiently" privatized in a manner that results in a net benefit to society.

10 researchok  Sat, Jun 30, 2012 7:15:28pm

Consider these (and there are a mountain of similar links)

The Money Traps in U.S. Health Care

Medicare: $24.8 trillionObligation per household: $212,500

Hospital-based Versus Freestanding Outpatient Imaging Services

Referring to your wife and her unfortunate travails in no way makes the case for a more efficient government service.

See this- Deny, Until I Die

We can also discuss hospital services in Canada vs US, if you like.

That will have to wait for tomorrow though.

11 Obdicut  Sat, Jun 30, 2012 7:25:10pm

re: #10 researchok

Or we can discuss the hospital service in every other first world country with the US. People arguing against single-payer like to chose Canada because they're anomalous among the single-payer countries in having longer wait times, though.

The articles you cite don't support your position in the least. Did you read them? How do you feel they support you?

12 researchok  Sat, Jun 30, 2012 7:25:22pm

One more thing- you mentioned inefficiencies

GAO Report Finds Government Inefficiencies, Encourages Action

The Myth of Efficient Government Service

GAO Details Billions in Federal Waste --- Report Obtained by Fox News

(Yes, it's FOX but that doesn't negate the document)

GAO HIGHLIGHTS INEFFICIENCIES IN THE FEDERAL GOVERNMENT

It is true corporations can be inefficient of course, but to categorically declare government ron healthcare will be efficient is quite a stretch.

It would stand a better chance if a) the program were phased in (as it was in Canada) and b) if insurance companies were forced to compete with each other.

13 Obdicut  Sat, Jun 30, 2012 7:26:12pm

re: #10 researchok

And my wife's story was supposed to make you think about the purposeful inefficient nature of private health insurance, which does not seek to make payments, but instead seeks to find reasons to deny payment. That is where their efficiencies are focused. Do you not get that?

14 Obdicut  Sat, Jun 30, 2012 7:27:02pm

re: #12 researchok

Holy shit you're quoting the Von Mises institute now.

And apparently pretending I said that there are no inefficiencies in any government programs.

What the fuck.

15 researchok  Sat, Jun 30, 2012 7:42:40pm

re: #11 Obdicut

Until recently, Canada's health care system was referred by some as the North Korean model because until the Supreme Court of Canada knocked down a law that forbade Canadian doctors from providing services outside the system for a fee and forbade citizens from seeking those services.

As soon as the law changed, the Premier of Ontario

Wait times for surgery in Canada is far greater than it is here. There are 26.5 MRI's in the US for every 1 million people, 6.2 in Canada for every 1 million.

For non-emergency cases, there is a 32 hour wait in the US and 39 days in Canada.

New study shows Canada below OECD median for rates of scanners, despite increase over four years

The Premier of Newfoundland chose a US hospital over a Canadian facility for hsi own surgery. This is not new of course. For years Canadian doctors have been referring seriously ill patients to the US and cities close to tegh border do a bang up medical business. servicing Canadians.

One if the Ontario political leaders also chose a private hospital for his own medical care.

The Canadian system is not without it's problems.

16 researchok  Sat, Jun 30, 2012 7:46:00pm

re: #13 Obdicut

Your wife's story is anecdotal. There are some people whgo get very good service from insurance companies and some who get excellent service from the VA.

It's the overall here we need to be concerned with.

17 researchok  Sat, Jun 30, 2012 7:48:14pm

re: #14 Obdicut

Yes- and what exactly is wrong with the argument? Where is their data and information incorrect?

Please, be specific.

Simply asserting a bias does not invalidate what they have to say on the subject unless you can prove their data and assertions incorrect.

In any event, there are plethora of other articles and studies that make similar arguments.

18 researchok  Sat, Jun 30, 2012 7:50:01pm

re: #15 researchok

I should be clear- the OECD study was done in 2008, though it is not apparent there has been much change.

19 researchok  Sat, Jun 30, 2012 7:51:14pm
And apparently pretending I said that there are no inefficiencies in any government programs.

Where did I say that?

20 Obdicut  Sat, Jun 30, 2012 8:07:05pm

re: #19 researchok

Where did I say that?

Why else are you providing examples of inefficiency in government programs? I'm pointing out that you're being a hyperoblic, ridiculous extremist when you say that government programs can't save money. They can, and they do, all the time.

Can you explain how an article detailing the difference in costs between tests done at an imaging center vs. a hospital is relevant to the conversation? Are you somehow under the impression that all hospitals are government-run, and all imaging centers are privately run?

Can you please, please include the other first-world countries with universal health care, instead of focusing on Canada specifically because it's an outlier?

Can you please, please, just stop and think about the market for health insurance, and think about what incentive that private health insurance companies have to keep a sick person on their rolls?

21 watching you tiny alien kittens are  Sat, Jun 30, 2012 8:26:28pm

Pay a dollar into private insurance and 49 cents of it goes to overhead and only 51 cents into actual medical payments (on average).

Pay a dollar into medicare and 3 cents of it goes to overhead and the other 97 cents go to medical payments (on average).

See, I told ya! This goddamn wasteful non-efficient government can't do anything right!!1!11...oh wait...

22 researchok  Sat, Jun 30, 2012 8:34:01pm

re: #20 Obdicut

And apparently pretending I said that there are no inefficiencies in any government programs.

I did no such thing.

Onward. What makes you say Canada is an outlier?

Can you please, please, just stop and think about the market for health insurance, and think about what incentive that private health insurance companies have to keep a sick person on their rolls?

And what makes you believe government run health care has no incentives of it's own that are not altruiistic?

The fifth largest employer in the world is Britain's National Health Service. Pretty impressive given the population of 62 million.

Government jobs and government pensions are a pretty big incentive. Keeping sick people on the rolls applies to them as well.

Can you explain how an article detailing the difference in costs between tests done at an imaging center vs. a hospital is relevant to the conversation? Are you somehow under the impression that all hospitals are government-run, and all imaging centers are privately run?

No, not all hospitals are government run. Virtual all hospitals do get government money. Take away the bureaucratic infrastructure and the private clinics provide services more efficiently and cost effectively.

The hospitals negotiate with Medicare, for example and the government pays higher fees than they would if the patient went to a private provider- which is exactly why insurance companies love these services.

There are all kinds of similar examples.

...please include the other first-world countries with universal health care, instead of focusing on Canada specifically because it's an outlier?

Sure. Both Britain and France have serious problems as well. In Britain, a mandate to reduce ER waiting time resulted in patients being kept in ambulances in the parking lot so as to reduce official waiti times in the ER.

There are plenty of other documented ills.

In France (as far better system in terms of quality of care) the cost of good care is high. Taxes just for medicalo care are 20 plus percent of earnings- that is before income taxes. Notwithstanding Hollande's bravado, those kinds of numbers are not sustainable. Whatever they call it, austerity is on the Horizon.

I'm pointing out that you're being a hyperoblic, ridiculous extremist

That really made mne laugh, given out exchange. Thank you for the comc relief.


Now, to repeat, I am all for healthcare reform. My concern remains funding and implementation.

Also, that the insurance lobby have effectivey guaranteed ACA's failures is unacceptable. By not allowing free market competition the federal government will fight a battle they cannot win.

23 Obdicut  Sat, Jun 30, 2012 8:37:08pm

re: #22 researchok

I did no such thing.

Well, then all your citations of GAO inefficiencies, what are they supposed to prove, then?

And what makes you believe government run health care has no incentives of it's own that are not altruiistic?

I don't believe that.

Government jobs and government pensions are a pretty big incentive. Keeping sick people on the rolls applies to them as well.

Er, no. It doesn't. Why do you believe it does?

[quote]No, not all hospitals are government run. Virtual all hospitals do get government money. Take away the bureaucratic infrastructure and the private clinics provide services more efficiently and cost effectively.[/quote]

Hate to break it to you, but those private imaging clinics also probably get government money. And seriously, dude, now you're just saying that, even at a private hospital, the government funding somehow corrupts it. This is getting fucking pathetic.


[quote]Sure. Both Britain and France have serious problems as well. In Britain, a mandate to reduce ER waiting time resulted in patients being kept in ambulances in the parking lot so as to reduce official waiti times in the ER.[/quote]

Hey, look, it's the guy who was complaining about anecdotes using an anecdote! Fucking awesome.

I'm done with this. You're being goddamn ridiculous.

24 researchok  Sat, Jun 30, 2012 8:40:00pm

re: #21 Tiny Alien Kitties are Watching You

I don't know enough about Medicare expenditures but I just found this article.

Private Insurance Is More Efficient than Medicare–By Far

Diane Archer has a post at the Health Affairs blog arguing that Medicare is more efficient than private insurance. One can only reach such a conclusion through such sleights of hand as conflating spending with cost, and by ignoring most of Medicare’s administrative costs.

I'll need to digest some of that.

25 Interesting Times  Sat, Jun 30, 2012 8:45:08pm

re: #24 researchok

I don't know enough about Medicare expenditures but I just found this article.

Private Insurance Is More Efficient than Medicare–By Far

I'll need to digest some of that.

A Cato Institute-affiliated site? Sorry, I'm in no mood to swallow that. Thanks to their odious track records, libertarian "think" thanks are liars until proven otherwise. You might as well be posting a breitbart link.

26 Joanne  Sat, Jun 30, 2012 8:47:02pm

re: #8 Obdicut

Sure. Go for it.

For example, the VA, medicare, and medicaid all outperform private insurance. That would be the appropriate comparison, right?

Some of it was. It wasn't well done enough recently. Obviously you're not enough of a fool to say that the failure of those levees means all levy building is somehow suspect.

But please explain how and when private levees would be built to protect a city.

What private programs for immunization? Be specific.

Because idiots who insist that government is naturally wasteful have taken over the national discourse, simpletons who recommend cutting spending during a recession, even while we can see the negative effects of austerity in Europe. And they may very well continue to win the argument, and the economy will double-dip. Fucking awesome.

However, it's rather obviously untrue to say the Executive branch is keen on cutting expenditures. Obama is attempting to get something, anything out with a completely hostile GOP house. I completely agree he's fumbled it in terms of presentation and bought into the stupid cost-cutting meme, when he should be making the argument that ten years ago, nobody dreamed of cutting costs in a depression aside from the rankest of Randites; everyone knew that when the private sector faltered, that cutting government spending at the same time was disastrous.

What are you talking about? How is that anything like a comparison of whether medicare is cheaper and better-run than private insurance?

It is. It mainly is through savings on salaries, administrative costs, and advertising. It would be really weird if it weren't more efficient than private sector, since it doesn't have the advertising costs.

Can you explain what magical transformation you think happens to people when they work for the government that makes them become inefficient, that doesn't happen at a big corporation?

It boggles the fucking mind that people actually believe there's any efficiencies that benefit the consumer in the private insurance market.

My wife just got yet another stupid letter from her insurance company asking if she had other insurance. She gets this after every time she submits a claim, because if she doesn't respond to it, they can use that as an excuse to not pay the claim. That's an efficiency of private insurance, the only thing it's an efficiency for them making a profit, not for them serving the actual customer. Because health insurance is a naturally broken market.

TOTALLY worth repeating!

27 researchok  Sat, Jun 30, 2012 8:54:39pm

re: #23 Obdicut

You said

And apparently pretending I said that there are no inefficiencies in any government programs.

Again, I did no such thing.

Well, then all your citations of GAO inefficiencies, what are they supposed to prove, then?

They prove that your assertions of an efficient government run health care are at best, debatable.

Inasmuch as I have a modicum of experience working with government types, allow me to explain how government works. I could write reams about the subject but I'll keep it simple:

There is no incentive whatsoever to shrink the size of government or shrink spending because if there is a surplus of either human capital or budgets, that amount (in human capital and funds) are removed from the budget. This applies across the board. That is why the budget goes up for every department in every agency every year. If you are efficient and do not spend the money, not only will you not get more more money, you will lose the amount of money you saved. And if you are the one who saved the money, it is a lock you wil have pissed off your boss and will get canned.

The more money and agencey gets, the more money a department gets, the power it wields. The more people who work for the agency, the greater the stranglehold that agency has on appropriations.

THis is not unique to America. The phenomena is global- which is how Britain's NHS ended up as the 5th largest employer in the world. There are more paper pushers than there are actual health care providers.

Sure. Both Britain and France have serious problems as well. In Britain, a mandate to reduce ER waiting time resulted in patients being kept in ambulances in the parking lot so as to reduce official waiti times in the ER.

Hey, look, it's the guy who was complaining about anecdotes using an anecdote! Fucking awesome.

Those are not anecdotes. Those are documented, recorded and verified facts.

I'm done with this. You're being goddamn ridiculous.

I understand. I really do.

28 researchok  Sat, Jun 30, 2012 8:58:15pm

re: #25 Interesting Times

I'm surprised to hear that.

Is there anything incorrect in the article?

Ezra Klein, on CATO

...That’s because Cato is, well, “the foremost advocate for small-government principles in American life.” It advocates those principles when Democrats are in power, and when Republicans are in power. When I read Cato’s take on a policy question, I can trust that it is informed by more than partisan convenience. The same can’t be said for other think tanks in town...

...On policy, I probably agree more frequently with the Heritage Foundation than with Cato. But I can’t trust Heritage. I trust Cato. I don’t agree with its health-care expert, Michael Cannon, who considers universal coverage an absurd and deleterious goal. But I take his analysis seriously, and his critiques have informed my thinking. I’m certainly more skeptical of single-payer programs than I would have been without having read his arguments.

Ezra Klein is hardly a wingnut.

29 Joanne  Sat, Jun 30, 2012 9:05:04pm

Canada works on a triage system where the sickest people get care first. I don't see that as a problem when waiting for something non life critical is an issue.

Canadians walk into ER, get care and leave not owing money. They're cared for. Period. ER isn't a bank breaker. Nor is cancer, heart attacks or critical accidents.

Where Canada has most problems is delivery because of a lesser population spread against a larger land mass. Coupled with the extreme cold in the more northern areas, and how much of that is rural, you wind up with a Nirtgern Exposure situation where HC professionals aren't beating down the doors to serve those communities.

Canada negotiates drug prices so even those without drug plans pay less for drugs than we do.


I'm married to a Canadian and went to the ER today (first time using Canadian HC and I'm not yet a landed immigrant yet). I went to ER. Waited the same amount if time as in a US ER. Paid a whopping $281 IN TOTAL, plus $13.00 for meds. That same thing in the US would have cost at least $1000. Last time I walked into a walk-in clinic in the states it cost me $263 above what my insurance paid. And that was more than six years ago when I was on a biz trip.

Canada's system may not be perfect but it is by far and away better than the system we have which is solely based on how much money you have and where citizens die because insurance companies fuck over their insureds and poor people die simply because they have no money.

30 Interesting Times  Sat, Jun 30, 2012 9:05:09pm

re: #28 researchok

Cato are AGW deniers. I don't trust anyone who chooses that path.

On another note, why did you ignore the very serious problem with some aspects of privatization I pointed out here?

31 Joanne  Sat, Jun 30, 2012 9:08:13pm

re: #29 Joanne (JustJay)

*Nirtgern = Northern (Exposure. TV show.)

Sorry, posting on my iPhone.

32 Joanne  Sat, Jun 30, 2012 9:11:24pm

re: #30 Interesting Times

Isn't Cato Koch owned? Isn't that the org that's been going through a legal battle over board ownership and the Koch's just won putting three more board members on and whose sole purpose is to put out papers that favor their causes so they can then make the rounds in Fox, Drudge, Rush and winger blogs? THAT Cato?

33 Joanne  Sat, Jun 30, 2012 9:14:19pm

Cato/Koch: [Link: www.google.ca...]

34 researchok  Sat, Jun 30, 2012 9:16:02pm

re: #30 Interesting Times

Sorry- I missed that comment! No intent to avoid the conversation.

Now, you raise an intereting pouint. No question we have issues with drug companies and orphan drugs, but where should that fit in the health care debate? Are you suggesting the government get involved in more research, funding research, or get into the medication dispensing business by purchasing certain drugs directly?

Ikind of like the idea of forcing Big Pharma's hand by allowing the purchase and importation of these same and other lower cost drugs from Canada, the UK, FRance, Israel, et., all nations with stringent protections and oversight.

I don't believe we are on opposite sides of teh drug/medication page.

My issue and concern is with health care delivery. I'm all fro reform, even the ACA. It;s just the funding and delivery that concern me.

You can be on the same side of an issue and still have plenty to talk about.

35 researchok  Sat, Jun 30, 2012 9:17:24pm

re: #32 Joanne (JustJay)

I don't know if they are Koch owned yet- I do know they made a bid to buy them.

We'll have to see how that plays out.

I sure as hell hope the Koch's don't get their hands on it.

36 researchok  Sat, Jun 30, 2012 9:19:43pm

re: #33 Joanne (JustJay)

Just found this

Billionaire Koch brothers, Cato Institute ready to settle lawsuits over think tank’s ownership

They say they will remains hands off- we'l see.

37 Joanne  Sat, Jun 30, 2012 9:20:21pm

re: #35 researchok

Go to the link I posted. First story. Completely Koch owned.

[Link: thecaucus.blogs.nytimes.com...]

38 Joanne  Sat, Jun 30, 2012 9:21:46pm

re: #36 researchok

Charles Koch and three more Koch appointed board members gives Koch's board control.

39 researchok  Sat, Jun 30, 2012 9:24:33pm

re: #37 Joanne (JustJay)

Apparently, the Koch's have been involved with Cato since it's inception.
From the article:

Charles Koch helped found Cato in 1977, and his family has donated more than $30 million to it over the years. But he and Mr. Crane had a bitter falling-out over management and philosophical differences, and the Kochs had been angling for Mr. Crane’s removal for years.

In March, the Kochs, who held two of the four founding “shareholder” seats on Cato’s board, brought their lawsuits to gain control of the seat of another shareholder who died...

“For a majority of Cato’s directors,” a joint statement by Cato and the Kochs said, “the agreement confirms Cato’s independence and ensures that Cato is not viewed as controlled by the Kochs.” It continued, “For Charles Koch and David Koch, the agreement helps ensure that Cato will be a principled organization that is effective in advancing a free society.”

Hopefully, they'll continue to keep their mitt's (pun intended) out of the organization

40 Joanne  Sat, Jun 30, 2012 9:25:41pm

re: #38 Joanne (JustJay)

Ooops, that's David Koch on the board, not Charles.

41 Joanne  Sat, Jun 30, 2012 9:30:25pm

re: #39 researchok

Do you seriously believe they're going to be a "principled organization" with more than half Koch appointed board members? Ask yourself why the Koch's went through legal channels for so long for control.

42 researchok  Sat, Jun 30, 2012 9:32:29pm

re: #40 Joanne (JustJay)

He's an interesting guy: Pro gay marriage, stem cell research,

Hard core libertarian..

And big time philanthropist

When you're rich you aren't nuts, you're just eccentric.

43 researchok  Sat, Jun 30, 2012 9:34:22pm

re: #41 Joanne (JustJay)

Do you seriously believe they're going to be a "principled organization" with more than half Koch appointed board members? Ask yourself why the Koch's went through legal channels for so long for control.

Because I believe if they weren't hands off the key player st CATO would ride off into the sunset.

In any event, they seem to have put the promise to lay off on paper.

Like I said, we'll see.

I'm curious to hear what Ezra Klein has to say about all this.

44 Joanne  Sat, Jun 30, 2012 9:37:53pm

re: #43 researchok

Watch the papers they put out. You're smart. You'll figure it out.

45 Interesting Times  Sat, Jun 30, 2012 10:19:29pm

re: #42 researchok

When you're rich you aren't nuts, you're just eccentric.

Well...if you consider funding lies that will kill hundreds of millions or even billions of people "eccentric", sure o_O

As for his "charitable" work, it's a classic case of give with one hand, take with the other - for example, D Koch acts like this great supporter of cancer research, all the while dumping chemicals that give the disease to other people! And preventing these chemicals from being rightly labeled carcinogens to begin with.

So yeah...anything the Kochs have their dirty, oily tentacles in should automatically be considered the rhetorical equivalent of noxious, toxic waste.

46 EiMitch  Sat, Jun 30, 2012 11:02:29pm

Great! More of the same ideological stuff clogging-up the health care debate. Drawing lines in the sand over whether or not the government can do whatever, nagging about whats wrong with Koch, Cato, Canada, etc.

I've heard these arguments before. Haven't you? And in the passion of all the free-market vs socialism arguments, the subject of the price-gouging hospital endemic gets forgotten. Everyone only cares about how the horribly inflated bills get paid, not how they got high to begin with.

Nor do they care about how hospital prices get marked-up. Zing!

47 jhrhv  Sun, Jul 1, 2012 1:43:18am

I've lived in Canada most of my life. All through the health care debate I've seen Canada's health care system used as an example of what is wrong with health care.

The system of you wait in the ER based on priority is true and I believe most of us like that system. I went to the ER a couple of years ago for a torn muscle in my calf and was seen in less than 2 hours in case it was a blood clot. My hypochondriac sister in-law goes because it hurts when she pees and she waits for 7 hours. Makes sense to me.

Doctors here are capped on max pay. I don't know a single one that is hurting for cash though. Getting capped around 500k life isn't bad for them and it keeps overall costs down. Something most Dr's are willing to live with.

There are extra pay services like getting a semi-private room 2 people in a room instead of 4. 4 people in a room is the largest I've ever seen although I have seen people in beds in ER's for a day or two while they wait for a room to become free. That can suck but then there isn't much about being at a hospital that usually doesn't. I can't tell you what the room service fee is because I've never paid for it. My employer pays for it for me and my family. None of us have ever been in a hospital over night yet.

Most of the pay for services are silly things like getting a note for being off work and those fees are very low. I think a note is something like $15. None of these pay for things are important and I've never had to pay anything at a hospital or Dr's office ever.

Is medical care free in Canada no. Taxes are high here. I don't know anyone who pays less than about 30% tax. Still nice to know that when you get old if you're sick that you aren't going to have to give up all your saving to get care.

I have heard of people being sent to the US for care. Those were cases of people that would have had a unusually long wait time and or the US surgeon was a know for doing something you couldn't get here. Those cases were paid for by the health care system and didn't cost the person anything.

Is the government wasteful? Sure they are but they try to be efficient and improve the system. One of the big pushes here is in preventative care. I won't bother with the details but I don't know anyone here who doesn't know the benefits of taking care of yourself and who doesn't think taking care of yourself will improve your life long term. The kind of thinking that will save they system a bundle. They start people young thinking take care of yourself and that push comes for the health system. They know preventative medicine is something that makes for less waits and less cost. Lesson learned through trying to improve the system via keeping people from needing care. I don't think you will see many insurance providers trying to keep you from getting sick in the first place. They will just cut you off or not insure you.

Overall I think a universal medical system in the US will be a good thing. If parties work together to make it good by looking at how to do so by looking at existing systems. The US has a chance to be the best in the world at this. That or they can use it to politically attack each other for decades and turn it into an expensive piece of crap.

Long post for me but I think I hit the points I wanted to make.

48 Timmeh  Sun, Jul 1, 2012 7:20:55am

re: #1 researchok

I would have much rather seen a phased in program and allow insurance companies to sell across state lines, like they do with car insurance and other kinds of insurance.

The insurance industry lobbied Washington hard because they didn't want that (competition!) and we're all going to pay for that.

It seems that in fact insurance companies can sell insurance in multiple states.

The Debate Over Selling Insurance Across State Lines

What currently restricts insurers from selling policies outside of their home states?

States have primary regulatory authority over insurance. As a result, insurers are allowed to sell policies only in states where they are licensed to do business. Most insurers obtain licenses in multiple states. States have different laws regulating benefits, consumer protections and financial and solvency requirements.

How do the health overhaul bills approved by the House and Senate handle the issue of selling insurance across state lines?

The House would allow states to form health care "compacts" in which one state would allow their residents to buy coverage from an insurer based in another state. The states would determine which states' law applies to coverage sold through the compacts.

The Senate bill also allows states to form "compacts." But it would require that the coverage would be governed by the laws of the state in which the policies are "issued or written."

What's stopping states from forming these "compacts" right now? Conversely, just because states are allowed to form these compacts doesn't mean they will. It essentially means giving up their own sovereignty to do so.

49 researchok  Sun, Jul 1, 2012 10:05:09am

re: #48 Timmeh

The companies that do sell across state lines are regulated by approved upon rates so as not to undermine local companies and keep rates (and taxes!) high.

In car insurance for example, companies are free to sell across based on their actuarial tables and thus set their own levels of risk. The result? Lower prices.

50 Joanne  Sun, Jul 1, 2012 12:28:28pm

re: #49 researchok

And the companies selling across lines are often in states with the lowest regulations allowing them to offer mediocre coverage, AKA race to the bottom.


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