Free “Sex-Change” Surgeries

[Tammy Hope]

For the record, I don't defend corporations. they operate on a greed motive rather than a power motive but that doesn't make it more noble. there's no upside for a big corporation to have power over people, but there is upside in increasing the bottom line.

The difference is, in my view, that when you are empowered to be a smart shopper, then you have a weapon against there greed motive - you pit your self interest against there self interest.

where's your weapon against government power (in any field - pick an issue that you sympathize with the anti-government position such as pacifism or being against the CP or being pro-choice: what's your weapon against government power once government has acquired the power?)


and yes, I mean government and politicians in general - left OR right wing. They are both threats, just in different areas.

[tekla]

there's no upside for a big corporation to have power over people, but there is upside in increasing the bottom line.

In a democratically based nation, there are lots of reasons, most of which do enhance the bottom line, but for separate reasons also, that corporations seek power over people, particularity over the people in power, or those that might vote those into power.

The health care debate is just one example of how large corporations seek power over people, via the media, or though what are called 'astroturf' movements (things engineered to look grassroots, but are not), or through outright intimidation and lying. 

I spend most of today in a union negotiation with a huge corporation.  One of the biggest.  God, they plead poverty so hard that I almost wrapped up the extra doughnuts for them to take home with them so their kids didn't starve.  They could have loaded them into the brand new E class Benz, the brand new BMW, and the brand new SUV the three of them drove to the meeting.

[Tammy Hope]

there's no upside for a big corporation to have power over people, but there is upside in increasing the bottom line.
or though what are called 'astroturf' movements (things engineered to look grassroots, but are not),

Riiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiight.

Because only those who protest the war, or for abortion rights, or for gay right, or for any good and noble left wing causes (and against evil right wing republican plans) are REAL people.

god knows if anyone turns out to protest the noble acts done on our behalf by liberals, surely THAT is a manufactured protest.

I would like to find it stunning people actually believe that....but really, i don't.

[tekla]

I've seen non-organized, leaderless protests, we have one a month in SF called Critical Mass.  The spontaneous anti-war demonstrations at the beginning of Gulf War II in SF were totally unorganized too.  Others were put together by coalitions that were not so unorganized.  But tell me, ain't it kind of funny that a bunch of elderly people - all of whom benefit from some form of socialized medicine - are in these town halls protesting socialized medicine?  Or you, who's kids are getting it? 

And, to be sure, no one is talking about socialized medicine on the English model.  The proposal is NOT for single payer (though it might well go in that direction over time), but for a pool (which is all any insurance coverage is, a pool) of insurance so that people who are not covered, can be covered.

So sure, hospitals can not refuse emergency treatment on the basis of payment.  Thank Nancy Pelosi's predecessor, SF Congressman Phil Burton for that one. But the problem is that emergency room care is the most expensive care there is.  Treating problems before they become emergencies is a cheaper, and better alternative.  The least expensive health option is preventative care, designed to stop problems before they become problems. So why should we favor something that only covers the highest priced items, when it would be far less expensive, and far less of a burden on the industry, to treat stuff at the early stages?

And the costs, as noted below, are spiraling ever higher to the point that even people who work good jobs are having trouble with the coverage premiums these days. Our union is self-insured, the number of members has remained stable (as have the number of retirees), yet the health care costs which were once around 8% a decade and a half ago (and had been very stable for a long time before that), are now approaching 14%, and that's a huge increase.  During those years we have consistently chosen to lessen the coverage at that.  The policy from 20 years ago would now cost us about 20%.  For the same kind of care.  So we tell each other, not in jest either, that if your going to have a heart attack, please have it at work so it would be a workman's comp claim, and not a policy claim.  That does not seem right.

At $2,350 a family policy is almost $30K a year, outside the ability of most families to afford.  Now, much like driving the new E class Benz, vs. me on my new Schwinn, rich people are always going to have options that other people don't have.  It will never be a 'one size fits all' deal, because people who can afford better coverage, are going to have the option of going in that direction.  I would assume that most of the union guys/girls I work with will stick with the union policy, as they are going to pay for it anyway. Private employers might well offer special policies as a way to attract and retain quality workers, a perk if you will.  So private insurance is not going to go away.

There is a very interesting question regarding end of life treatment and quality of life issues and I don't know how that works out.  The figures I've read put the rate at even higher than your numbers Laura.  That about 80% of the total cost of your lifetime health care bill will be spend in the last year of life. Many people I know have taken positive steps in their life - called Living Wills/DNR statements - to prevent huge heroic measures from taking place in a time and space where they will do not real good. The idea that we are not going to spend money where it could do a lot of good, and spend huge amounts where its not going to matter is a huge problem to be sure.

I have no idea what to do about that, except what I can do as a person to prevent it from happening to me.

[tekla]

For those with Real Player you might want to watch this, a Democracy Now! interview of Wendell Potter. He's the ex-vice president in charge of public relations at CIGNA health care.  Funny how this got no coverage on the mainstream press, but its Congressional testimony and you ought to listen to what he has to say.

Link to the vid and to the transcript at Democracry Now!
http://www.democracynow.org/2009/7/16/former_insurance_exec_wendell_porter\

EXCERPT

WENDELL POTTER: Well, the game plan is based on scare tactics. And, of course, the thing they fear most is that the country will at some point gravitate toward a single-payer plan. That's the ultimate fear that they have. But currently—and they know that right now that is not something that's on the legislative table. And they've been very successful in making sure that it isn't. They fear even the public insurance option that's being proposed, that was part of President Obama's campaign platform, his healthcare platform. And they'll pull out all the stops they can to defeat that.

And they'll be working with their ideological allies, with the business community, with conservative pundits and editorial writers, to try to scare people into thinking that embracing a public health insurance option would lead us down the slippery—excuse me, slippery slope toward socialism and that you will be, in essence, putting a government bureaucrat between you and your doctor. That is—you know, they've used those talking points for years, and in years past they've always worked.

AMY GOODMAN: What turned you? Why did you change?

WENDELL POTTER: I changed because over the last two or three years I began seeing more than I'd ever seen before and became more knowledgeable of how health insurance—how health insurance companies make money, how they maximize profits.

The companies that I worked for were two of the biggest for-profit health insurance companies. And over the past fifteen years, since the last time we had this debate, the health insurance industry has consolidated to the point that now there are about seven very large for-profit health insurance companies that dominate the market.

They have begun shifting their business model away from managed care, which, frankly, I used to think was a great model, a great concept, for the delivery of healthcare. But they've moved—they're moving away from that to what they refer to as consumer-driven or consumer-directed care, and it really is just a euphemism for shifting the financial burden from insurers and employers onto the shoulders of working men and women. I saw that happening. But I also saw how—you know, the things that they do to maximize their profit, which really boils down to dumping the sick.

[cindianna_jones]

My parents on Medicare get better coverage than I do with my expensive plan.  And I am in a coop managed by Blue Cross.  There have been times when I have had to get legal counsel to get basic medical bills paid.

Right now, the excessive costs are in administration.  Medicare runs with a 4% overhead.  Veterans medical run at 2%.  Insurance companies run anywhere from 22 to 40 percent overhead.  Just last year, United Healthcare, the largest in the country routed 1 dollar of every 7 it received just to the CEO's salary.  He got over one billion in salary.  I've heard two figures... 1.2 and 1.7   billion.  That's a lot of health care dollars going to nothing.

I really don't care who administers the plan.... just keep the costs of that administration low.  A corporation simply can not do that.  We have the working models right in front of our face.  The government plans are working.  The doctors and nurses are the same.  The hospitals and clinics are the same. But the corporations charge more to cover their expensive overhead and executive salaries.  To me, it is as plain as day.

What this all boils down to are a couple of points:

1) Do we consider health maintenance a personal right in this country?  I believe that it does. The constitution has a phrase in their .... it says something like.... "in order to provide for the common welfare"... or something like that. I'm being lazy here to not look it up.  Other countries believe that it is a right. We are the ONLY industrialized nation that does not.
2) People in our country have this unnerving idea .... "I earned my way and so should you."  Well, I agree to some extent.  I have a nice home because I earned it.  But the state of my health is not something that I can "earn". I do the best that I can but I may have an accident.  My diabetes may destroy my eyesight.... who knows what may befall me.  People less fortunate, who do not have decent care, may not have the opportunities that I had because of health problems (and a host of other reasons).  I do not believe that people are naturally lazy.  I really believe that our society has this feeling of individualism carried too far. We seem to think that we have no need to watch out for each other where all things money are concerned.

Oh, and for the record.  I do believe that a government OR corporate sponsored health care should aid us in our transitions.  I think that over the past several decades that the proof is in.  These fairly inexpensive surgeries solve a huge problem in our lives. Once concluded, we become productive workers without this constant and incessant crap running through our brains.  It can almost instantly be resolved.  That IS worth the price....so much so that even we, some of us very poor, manage to find the money to make it happen at great personal risk and loss.

Chin up!

Cindi

[Tammy Hope]

I've seen non-organized, leaderless protests, we have one a month in SF called Critical Mass.  The spontaneous anti-war demonstrations at the beginning of Gulf War II in SF were totally unorganized too.  Others were put together by coalitions that were not so unorganized.

How organized is, just to pull a name out of the air, code Pink?

But tell me, ain't it kind of funny that a bunch of elderly people - all of whom benefit from some form of socialized medicine - are in these town halls protesting socialized medicine?  Or you, who's kids are getting it? 

Not remotely. In their case, Elderly people only have to know about the opinions of people like Ezekiel Emanuel that people like them are a bad investment of health care dollars in order to be worried.

In my case, I don't have to agree with a program to take advantage of it. It would be the ultimate self-defeating stupidity to take a stand on principle and refuse to take assistance when it's the only assistance available.

You will note if you read carefully that I am not rejecting it (single payer) on the basis that it is a government program, but on the basis that it is not financially sound.

Neither is Medicaid or Medicare which is why they are poor arguments FOR single payer. But if a ill-conceived program will help you, and the program will exist whether or not you accept, you might as well play along. You won't hurt the program or the thinkers behind it by refusing.

And, to be sure, no one is talking about socialized medicine on the English model.  The proposal is NOT for single payer (though it might well go in that direction over time), but for a pool (which is all any insurance coverage is, a pool) of insurance so that people who are not covered, can be covered.

I understand it's not single payer. I also know, from Obama's own mouth, that that is his ultimate goal.

So sure, hospitals can not refuse emergency treatment on the basis of payment.  Thank Nancy Pelosi's predecessor, SF Congressman Phil Burton for that one. But the problem is that emergency room care is the most expensive care there is.  Treating problems before they become emergencies is a cheaper, and better alternative.

I agree.

But I wasn't arguing what was most efficient. I was correcting the persistent myth which crops up in these discussions that poor people go without care.

No one argues it's the b\est possible arrangement. the point is, there is a difference in having no coverage and having no care.

  The least expensive health option is preventative care, designed to stop problems before they become problems. So why should we favor something that only covers the highest priced items, when it would be far less expensive, and far less of a burden on the industry, to treat stuff at the early stages?

didn't say you should - I was just correcting the falsehood.

It behooves all of us to not appeal to emotion if we want to make good decisions - and crying for the poor who "have no health care" is an appeal to emotion.

In point of fact, the only reason that so many are under the illusion there is a "crisis" - there's not - is directly because of appeals to emotion.

On CNN last night (hardly a right wing mouthpiece) they reported that there poll (not the phone poll, the scientific one) showed that 83% of Americans are happy with their health care and 74% are happy with their insurance coverage.

So WHY is there this big hue and cry to reform health care? Because those who WANT government CONTROL of our lives have appealed to the emotions of otherwise content people by creating the ILLUSION that millions are suffering great harm in our system and the populace takes their word for it. Just like they have believed other widely inflated lies before.

So then the public is up in arms about the supposed harm being suffered by other people, while almost all of them are perfectly happy with their current situation. Based on emotions.

Emotions are a poor basis for decision making at this level.

That's not to argue changes don't need to be made and things can't get better - its only to point out that the proposals put forth now, and those which will follow after them if they are enacted, are FAR from the only solution.

And the costs, as noted below, are spiraling ever higher to the point that even people who work good jobs are having trouble with the coverage premiums these days.

And yet, 3 of 4 are pleased with their coverage and more than 4 of 5 with their care.

How is that possible?

Our union is self-insured, the number of members has remained stable (as have the number of retirees), yet the health care costs which were once around 8% a decade and a half ago (and had been very stable for a long time before that), are now approaching 14%, and that's a huge increase.

Wait - the costs were stable for decades and then, in the last 15 years, they almost doubled?

Why?

The insurance companies didn't suddenly get greedy 15 years ago, of course. The big Pharma companies didn't have a secret meeting in the dead of the night 15 years ago and decide to collectively screw us all over ....so what's different now?

Seems to me if you want to solve a problem, it might be good to look at what changed to create the problem.

  During those years we have consistently chosen to lessen the coverage at that.  The policy from 20 years ago would now cost us about 20%.  For the same kind of care.  So we tell each other, not in jest either, that if your going to have a heart attack, please have it at work so it would be a workman's comp claim, and not a policy claim.  That does not seem right.

I'm not disputing what seems right about the current system, I'm questioning the effectiveness of the proposed solutions.

At $2,350 a family policy is almost $30K a year, outside the ability of most families to afford.  Now, much like driving the new E class Benz, vs. me on my new Schwinn, rich people are always going to have options that other people don't have.  It will never be a 'one size fits all' deal, because people who can afford better coverage, are going to have the option of going in that direction.

That's not what Obama wants. It's what he's willing to settle for until we gullably believe that's all he wants.

You are being very naive if you think what's on the table now is as far as they want to go or will eventually go.

  I would assume that most of the union guys/girls I work with will stick with the union policy, as they are going to pay for it anyway. Private employers might well offer special policies as a way to attract and retain quality workers, a perk if you will.  So private insurance is not going to go away.

Would that we could revisit this exchange in 20 years...maybe less.

There is a very interesting question regarding end of life treatment and quality of life issues and I don't know how that works out.  The figures I've read put the rate at even higher than your numbers Laura.  That about 80% of the total cost of your lifetime health care bill will be spend in the last year of life. Many people I know have taken positive steps in their life - called Living Wills/DNR statements - to prevent huge heroic measures from taking place in a time and space where they will do not real good. The idea that we are not going to spend money where it could do a lot of good, and spend huge amounts where its not going to matter is a huge problem to be sure.

Which I agree with and is absolutely a good and wise decision - for an individual to make for themselves.

Which is entirely different than giving the government the power to makes those decisions.

I have no idea what to do about that, except what I can do as a person to prevent it from happening to me.

Which is as it should be - YOU doing it for YOURSELF.

Post Merge: August 07, 2009, 02:45:30 PM

No one doubts that there are "real people" among t-baggers and the "no health reform" groups, the birthers seem to have been started all by theirselves, Laura.

The point is that the t-baggers and the "no health-care reformers" are financed by big money. In the case of baggers both financed and given free-publicity (Faux News.) Does Dick Armey have every right to lead an org that proposes that the only thing broke with health-care is that there is not enough private insurance?

But why does that matter? do not all protesters have some source of funding? Does MoveOn.org not funnel money to eft wing protest organizations? does George Soros not spend billions to influence American politics?

Did MSNBC not happily chortle over anti-Bush protests for years?

Why does any of this make the opinions expressed less genuine?

Of course he does. But at the same time it has to be recognized and reported that he is being bought and paid to do this by big pharma, hospital corp of america, and the massed private medical insurance industry to organize opposition to any changes that might tend to bring their money-flow to a stop.

That, my dear is power: power of wealth, power of communication (the media that can be bought and locked up by that wealth so that people like yourself who have this fanatic fear of any gub-mint at all can be whipped into a frenzy over govt-run health-care.)

and it's exactly the same sort of actions that got Obama elected in the first place.

do I deny that money and power make things happen in politics?

Not remotely.

Rather, I am not under the delusion that left wing politics is good and noble and pure and right wing politics is corrupt and evil.

I do not care to defend the nobility of the right winger - rather, I laugh at the mythology created when a left winger goes on TV and implies that the right wing is doing something they themselves have never down before and so many naive people believe that lie.

And, by the way, what's exactly is the difference in being afraid of big government and being afraid of big business?

either one is to be feared and the other pure....or both are ok...or both to be feared.

I would consider it VERY foolish to fear business and trust government.
In the end, government has far more power to take away your freedoms that big business does.

You say that govt-run health-care is poor. Actually, my dear, the gov't merely pays for your Medicaid procedures. They don't run the care at all.

Where did I say the care was poor? I said it wasn't financially sound.

And your paid-for procedures and those of your family are necessities for you, aren't they? Question is: do we spend the money for baseline healthcare for all or leave things as they are? Do uninsured people continue to go to ERs for basic treatment after their conditions have progressed to the point where they must go to the ER?

Remedying an unfortunate circumstance with a solution which is worse makes no sense. I am not arguing nothing needs changing - I am suggesting that what is at work here is a manipulation of public emotion in order to pass a far more extreme "solution" than the given problem requires.

it's like me trying to manipulate you into buying a new car because your oil needs to be changed.

Besides, I stated earlier that there is a reform system which I favor - I am not arguing for "leave well enough alone"

Is there a necessity to warehouse people in mental health facilities when with a sense that they could receive, and perhaps would, on-going wellness treatment that lowers their chances of having a huge psychotic break? Or do we prefer the "savings" brought about by treatment of preventable childhood and adult illness prior to their becoming acute at clinics and offices of medical professionals?

IF we pass government managed health care, "savings" will be the bottom line - and if it's more cost efficient to "warehouse" people or do "maintenance"  care instead of mor expensive care...that's exactly what you'll get.

You would suggest I am TOO paranoid about the government - I would counter you are not paranoid enough. The government has no more  motivation to spend more for better care than any HMO. And anything the HMO would do to reduce overall costs - whether that's preventative care or "warehousing" - the government will do as well. Finances demand it.

AETNA and CIGNA and BlueCross/BlueShield, Kaiser Permanente and other insurance providers are definitely going to give you an answer that disagrees with mine. They are going to say, "yep keep our money flowing and we'll handle health-care and treament based on what's best for our bottom-line, not based on what the patient needs and what the best treatment options are."

thing is though, I have no idea what those people think nor do I care. I suspect their motives every bit as much as i suspect Obama's. I'm basing my arguments on common sense observations about the way government is working and has always worked.

I DON'T argue the current system is very efficent. I believe, in fact, in free market forces and insurance coverage for routine procedures squashes market forces and is EXACTLY the reason, IMO, that we have inflated health care costs today. The more that insurance coverage was expanded to pay for routine services, the more the cost of services across the board could inflate with no market forces to check them,

I challenge you to find me a position statement from AMY big insurance provider that says anything at all about applying market forces to health care inflation.

I don't think it's out there - I sure haven't seen it.

What you continue to say, it seems to me, is that that policy works just fine and dandy.

then, with all due respect, you have no idea at all what I've been saying.

You cannot get a particular effective treatment for your wife's ovarian cancer because it hasn't been around for 10+ years and the health-insurance companies still refer to it as experimental.

But trust me, when Dick Armey's wife gets that same ovarian cancer she will receive the best practices treatment.

When your child, heaven forfend, gets addicted to heroin or cocaine, he'll get 7 days of "de-tox" at a medical ward provided he can get in, more likely he'll get placed on a wait-list because the ward has seven beds and is full allatime.

OTH, Dick Armey's child will get at least 28 days at Caron Foundation or Betty Ford or Michael's Place in a nice comfortable surrounding in the desert, on the beach, or on a mountaintop in Pennsylvania.

and you REALLY think ObamaCare (or whatever it's officially called) WILL approve the experimental procedure or the Betty Ford?

Surely you don't.

Now, you may distrust gub-mint all you wish. But to trust in the greed and the power that pursues that greed rather than to trust any gub-mint at all defies your own interest. The interests of your children.

but, my friend, you have read your assumptions into my words if you think I trust ANYONE in this debate - I don't. As with all such things, BOTH sides have selfish agendas.

The misplaced trust here is not mine - for i trust none of them - it's yours for trusting that politicians have your best interest or mine at heart.

Government is not always the reason for "things that do not work" anyhow. Much of the reason things don't work is that the greed-heads have so finagled the final products to exploit the money-making machinery to their own well-being (how does a corporate entity have a well-being in the way you have a well-being?) that the changes are rigged from the git to screw you and screw up the system in the interest of the corporate bottom-line of Pfizer, Glaxo and Bristol-Meyers-Squibb. AETNA, CIGNA, HCA and other "players?"

That's a clause of the law of unintended consequences.

Whatever the government does, even on the occasion it is totally well meaning, is always vulnerable to manipulation.

And sometimes, the simple fact is that the nobel and laudable goal of legislation simple doesn't work in the real world.

LBJ's "War on Poverty" was certainly noble - yet it has created far more problems than it solved because the well intentioned (naive) policies didn't actually work on the ground.

so mistrusting the government is not only about mistrusting motives, it's about mistrusting the wisdom of the professed intended outcome.

[sd]

It also implies that said death rate will be lower. in point of fact, what's more likely to happen is that you will have MORE deaths under single payer, but those deaths willbe old people that the bean counters consider a poor investment and it will be impossible to prove they wouldn't have died anyway.

How is that any different than insurance. They can easily do the same thing, and have, and not even to just elderly. The uninsured alone are not causing our high infant mortality rate to be so low.

We do have care for everyone - what we don't have is coverage for everyone, which is a different thing.To repeat - zero coverage is NOT zero care.

Okay, this, is way wrong. Sorry, but it is.
A hospital cannot deny emergency care. That is all.
That is VERY, VERY different from medical care. You may as well hand me a bandage, whic is effectively all they are doing. My first aid training is worth as much.

If you have cancer, they are not going to treat it. If you have aids, they are not going to treat it. Flu, nope. They only have to stabilize you and send you on your way so that you aren't going to immediately die in front of them. If you are homeless and a repeat visitor, they have been known to get you stable, and then put you on a bus to another state so they don't have to deal with you anymore.

How is that care?
It's okay to die a slow agonizing death, but we will stop you from dying for as long as possible. They will treat the problems as they occur, but not treat the actual illness. High blood pressure, oh well, high cholesterol, oh well. Need a back or knee operation, Nope. None of this is immediately life threatening and therefore not going to be treated unless it is bad enough to send me to an emergency room.

Our medical system is a joke as it currently sits.

Also, who will pay for that emergency care I receive?  Will they take my car? Clean out my bank account,? Ruin my credit?  How does any of that help pay for it? How does any of that help me? All it does it make it harder to get back on top of things.

[Tammy Hope]

My parents on Medicare get better coverage than I do with my expensive plan.  And I am in a coop managed by Blue Cross.  There have been times when I have had to get legal counsel to get basic medical bills paid.

Of course. Because the government has no need for a profit motive. They can always come to you and get more money when the program is about to go broke (which it's been "fixed" a couple of times already and projections have it going back into the red soon (within the next decade I think?)

The false assumption is that the government can continue to come up with even more revenue to pay for all the goodies people want. Eventually, that illusion will be shattered in a most unpleasant way.

Right now, the excessive costs are in administration.  Medicare runs with a 4% overhead.  Veterans medical run at 2%.  Insurance companies run anywhere from 22 to 40 percent overhead.  Just last year, United Healthcare, the largest in the country routed 1 dollar of every 7 it received just to the CEO's salary.  He got over one billion in salary.  I've heard two figures... 1.2 and 1.7   billion.  That's a lot of health care dollars going to nothing.

You will not catch me defending such practices. I carry no brief in defense of those people. But that doesn't blind me to the fact that medicare, even with low overhead (taking your figures for the sake of discussion even though I suspect that they are the result of creative accounting on the part of someone) is still going broke.

The "tax the rich" mythology can't prop up these illusions forever.

I really don't care who administers the plan.... just keep the costs of that administration low.  A corporation simply can not do that.  We have the working models right in front of our face.  The government plans are working.

No!
that's exactly my point - they DON'T work.

Just because your parents are getting good care that is being paid for by your grandkids' dollars doesn't mean that's a financially viable model. You can go to a restaurant that is loosing money and headed for bankruptcy and get a good meal....for now....and leave with the ILLUSION that the business model works because your stomach is full. But it's just that - an illusion. six months from now he'll be out of business.

  The doctors and nurses are the same.  The hospitals and clinics are the same. But the corporations charge more to cover their expensive overhead and executive salaries.  To me, it is as plain as day.

What this all boils down to are a couple of points:

1) Do we consider health maintenance a personal right in this country?  I believe that it does. The constitution has a phrase in their .... it says something like.... "in order to provide for the common welfare"... or something like that. I'm being lazy here to not look it up.  Other countries believe that it is a right. We are the ONLY industrialized nation that does not.

Specifically - "to promote the general welfare" - but is the general welfare promoted if the government goes bankrupt? Or taxes all the prosperity out of the economy?

there's more to the general welfare than how healthy people are, and the general welfare was just fine for many decades before the government ever lifted a finger on health care.

YES, people had poor health and suffered for it. but, again, the "general welfare" is not just about health care, or even primarily so. It's about the balance of all considerations. for instance, a person on minimum wage would have a better general welfare if he made $30 an hour - so pass it right? no, because there are other consequences to a $30 minimum wage.

Also, I disagree with the idea that health coverage is a basic right. TREATMENT is, arguable, but not coverage.

2) People in our country have this unnerving idea .... "I earned my way and so should you."  Well, I agree to some extent.  I have a nice home because I earned it.  But the state of my health is not something that I can "earn". I do the best that I can but I may have an accident.  My diabetes may destroy my eyesight.... who knows what may befall me.  People less fortunate, who do not have decent care, may not have the opportunities that I had because of health problems (and a host of other reasons).  I do not believe that people are naturally lazy.  I really believe that our society has this feeling of individualism carried too far. We seem to think that we have no need to watch out for each other where all things money are concerned.

I agree. I simply would suggest that (a) it's done so in an economically sound way; and (b) that we are careful about unintended consequences

Oh, and for the record.  I do believe that a government OR corporate sponsored health care should aid us in our transitions.  I think that over the past several decades that the proof is in.  These fairly inexpensive surgeries solve a huge problem in our lives. Once concluded, we become productive workers without this constant and incessant crap running through our brains.  It can almost instantly be resolved.  That IS worth the price....so much so that even we, some of us very poor, manage to find the money to make it happen at great personal risk and loss.

Chin up!

Cindi

I think I'd mostly agree with your last paragraph, within the context of the overall program being economically sound.

Post Merge: August 07, 2009, 03:55:13 PM

How is that any different than insurance.

It's not, that's the point. There is an illusion that the government run care will be better or more compassionate - it won't.

Money drives all, whoever is in charge.

They can easily do the same thing, and have, and not even to just elderly. The uninsured alone are not causing our high infant mortality rate to be so low.

Again with the IMR - correlation is not causation.

Okay, this, is way wrong. Sorry, but it is.
A hospital cannot deny emergency care. That is all.
That is VERY, VERY different from medical care. You may as well hand me a bandage, which is effectively all they are doing. My first aid training is worth as much.

If you have cancer, they are not going to treat it. If you have aids, they are not going to treat it. Flu, nope. They only have to stabilize you and send you on your way so that you aren't going to immediately die in front of them. If you are homeless and a repeat visitor, they have been known to get you stable, and then put you on a bus to another state so they don't have to deal with you anymore.

If we are swapping anecdotes, I have a son who had non-emergency oral surgery that medicaid did not cover which left me with a bill of some thousands of dollars I couldn't pay (which, I shouldn't have but that's a long story) and they knew going in I couldn't pay.

Still never has been paid and they eventually quit asking.

I cannot confidently assert no one has ever been neglected, but I know of many many cases first hand where people in such a situation were not.

but, again, noting that there IS a problem - and there is - doesn't remove the responsibility of being wise about how such a problem is addressed.

If you read back, you will find that I said I FAVORED guaranteed catastrophic care insurance, be it private or federal.

but I digress. to go back to your point - I would suggest that even if it is true that if I came up with prostate cancer on my next doctor's visit and I could not pay for treatment and thus received none...and even if I eat a bullet because I can't stand the pain at some point - as tragic as that might be...it is not a solid argument for enacting a bad plan.

How is that care?
It's okay to die a slow agonizing death, but we will stop you from dying for as long as possible. They will treat the problems as they occur, but not treat the actual illness. High blood pressure, oh well, high cholesterol, oh well. Need a back or knee operation, Nope. None of this is immediately life threatening and therefore not going to be treated unless it is bad enough to send me to an emergency room.

And you are under the impression that federal health care WILL provide the back or knee operation swiftly? What of the stories we hear from other countries of people dying while on the waiting list for months or years for such operations? What of the people  who are considered a "bad investment" so they don't get the operation at all?

Seriously, I'm stunned that so many people blithly assume that the government is actually motivated by your best interest.

let me give you a kind off of topic example. I like in rent-supported housing...but I cannot live in this house is I make NOTHING. there is a minimum income to qualify. Same with Medicaid - I can't qualify if I make over about $140 a week, but on the other hand, I don't qwualify if I have no money at all.

Why? If the government REALLY has my best interest at heart, shouldn't the person with NO income be most in need of housing and health coverage?

I'll tell you why - the bottom line. They can't AFFORD to cover every person, in either case, who has no income at all - so they use that filter to thin out the demand.

So much for "taking care" of people, right? Another example: The Disability system virtually automatically rejects every claim on the first and second attempt, no matter how valid. My sister in law had a stroke and is losing the useage of the right side of her body, she can barely get up and down her doorstep or drive her car - she's been denied three times.

Why? Because the government cares?

No, because they hope she will go away and quit asking and they can save the money they would have spent on her.

THAT is the true nature of the people you guys are turning to to make sure "everyone gets care"

Our medical system is a joke as it currently sits.

Also, who will pay for that emergency care I receive?  Will they take my car? Clean out my bank account,? Ruin my credit?  How does any of that help pay for it? How does any of that help me? All it does it make it harder to get back on top of things.

Eventually? the taxpayer - the same people who will pay in the proposed system. Oh, they will squeeze you and screw up your credit and so forth in the meantime - which DOES suck and DOES need fixing.

Just not fixing with the currently proposed ideas.

[sd]

Nevermind, I'm done.

I can quote and quote and quote instances showing how the insurance companies are taking you for a ride, you will still say they only need a slight change.

I can quote over and over again, how gov. care has worked, you will not believe it.

I can show you exact instances where hospitals literally dumped people on the street after just stopping a heart attack. You probably won't believe it.


Other countries have PROVEN single payer (and with optional coverage) works better than our own system. However some people will always argue that we don't need it, until they do.


I won't say Obamas plan is great, nothing usually is first time around, but you have to start somewhere. We have gone well over 40 years trying to "get started" and we are still at square one.

[Tammy Hope]

Nevermind, I'm done.

I can quote and quote and quote instances showing how the insurance companies are taking you for a ride, you will still say they only need a slight change.

If you would actually take the time to READ what I described above as a plan that I would favor, I don't think you could call that "slight change"

Perhaps you wouldn't be so frusterated if you would comment on what I'm actually saying instead of the cliches you are reading into my points?

I can quote over and over again, how gov. care has worked, you will not believe it.

Well, you got me there.

I can show you exact instances where hospitals literally dumped people on the street after just stopping a heart attack. You probably won't believe it.

I do believe you.

Other countries have PROVEN single payer (and with optional coverage) works better than our own system.

I suppose it's far too complex a discussion - and one in which we both know no minds will be changed - for me to challenge that claim, I will only note for the record that I am not convinced by it.

However some people will always argue that we don't need it, until they do.

I know perfectly well that I will need it. it doesn't persuade me that the kind and noble government is going to take good care of me. I know from personal experience that they are not.

My own personal need is not presuasive. For example, if i walk out in the morning and start my car and it throws a rod - I'm screwed. i cannot remotely buy another, nor can I earn an income without it.

does this mean I should favor a program in which the government provides me a car?

I won't say Obamas plan is great, nothing usually is first time around, but you have to start somewhere. We have gone well over 40 years trying to "get started" and we are still at square one.

"Starting somewhere" is great - force feeding a MASSIVE plan, which is not only untested BUT not even well considered and examined is very very bad.

IF in face we REALLY want to do the best thing we possibly can to fix the system, then WHY is it necessary to demand that it get passed before the recess when every member of Congress freely confesses - and the president should - that they don't even know what all is in the bill, let alone have thoughtfully considered all the possible unintended consequences?

If it must be done, should we not carefully consider every facet, rather than just shovel a bunch of s--- and hope it somehow works out better than the s--- we have now?

What's the rush?

Let me suggest that IF your REAL concern is making things right, you will act slowly and carefully...but IF your REAL concern is expanding government control over people's lives, then you want to act very quickly before the people catch on to what you have in mind.

What's the greater risk - that people will continue to suffer negative outcomes from the current system for another year or so but in the long run you have a much more efficient and sustainable model? or that you cobble together something as quickly as possible and a decade from now have to figure out how to "rescue" it the way we have to rescue medicare every decade or so?

[sd]

If you would actually take the time to READ what I described above as a plan that I would favor, I don't think you could call that "slight change"

I did.
Your plan isn't on the table, and never will be.

[Tammy Hope]

I did.
Your plan isn't on the table, and never will be.

Which is why I voice my respectful dissent to what IS on the table.

Nevertheless, the point remains - those who are preaching at me do so from the implication that I am defending the status quo and do not care about the "victims" of the current system.

This happens not to be the case.

Even if what I described is not on the table, that reality does nothing to change th fact that my position is not "leave well enough alone"

which was my point when I referred you to it.

Post Merge: August 07, 2009, 05:37:26 PM

One thing sure, Laura. I find your "logic" less than impelling, but I've been doing that for some time. Your over-long sentence-by-sentence quotes coupled with the screeds you place behind them are just impossible for me to read after a bit.

The alternative then, is that I simply concede the discussion to those I disagree with.

Neither side conceding without a thoughtful exchange of ideas helps anything.

In fact, such stonewalling is pretty much a good description of how politics works and why it serves us so poorly.

OK, you've learned the staid ole internetz argument style. Congratulations.

Oh please, if we were discussing this over coffee would you accuse me of trying to "baffle with bull->-bleeped-<-" just to get you to back down?

Why is it so difficult for people to just discuss things? Clearly we all disagree. clearly I could have just kept my head down and said nothing on this or any other controversial subject - is that what you want? Is that what any of us want from folks they disagree with? to just shut up and go away?

Maybe I'm alone when I say this, but i feel like my thinking is strengthened and my reasoning sharpened when my positions are challenged and my conclusions questioned - I have NO desire to have e people "give up" in the face of my case.

Maybe I haven't learned internet debating in the way you think I have. It seems to me that another facet of internet debates are the folks who just walk away saying "I think what i think and I have no interest in having it questioned"

But, my friend, my eyes are well glazed long before you run out of bandwidth and finger-strength.

I'm sorry, but I just didn't even read all of your reply to tekla. Let alone any of what you wrote to me, Cindi or Leslie Ann.

So, you win as far as I am concerned.

that's kinda sad. But you're entitled I guess. i don't see what's served by dismissing a person who's thoughts you are unwilling to hear.

not to mention it is (unintentionally I'm sure) kind of objectifying to be told "You talk too much so I decline to listen to you"

right or wrong, I'm unworthy of being heard because you have no real interest in having your opinion altered.

But forgive me: I'll still be supporting a health-care re-form.

Just as you will be praising the unregulated "free-enterprise system" as they take the last dollar you have and offer your children's lives to make a profit for themselves somewhere in a desert, jungle or steppe far away. So it goes.

And see, this is the one part of it that gets me - dismiss me as unworthy of being heard?

Your privilege.

But dismiss me WHILE describing my position in terms of your pre-assumed cliches and assumptions instead of what I actually think is a discredit to both of us.

It's a perfect example of why we are becoming a nation of people who talk past each other instead of coming to solutions.

[Tammy Hope]

As an aside, check out this video from Kathy Castor's "Town Hall" and note well WHICH side is represented by organizers wearing t-shirts, and tags, and passing out signs and propaganda.

The irony of people complaining the opposition is "astroturf" and artificially organized while at the same time stacking the crowd in their favor AND passing out signs and propaganda is beyond words....

Castor Oil Part 1

[lizbeth]

I think "beyond words" is what I would call it as well...

[Suzy]

I have stayed out of this debate because I have quite mixed feelings.  I personally do not like going into the hospital and paying for several other people to be there at the same time.  I would like it even less if someone had to pay for me to be there.  Now I hear it said that many of us just want to work, pay our insurance, and get on with our lives.  Maybe I am the "syringe half empty" kind of girl, but the notion that anyone in America "just pays their bill" is a myth.  The cost of their care gets picked up somewhere.  And that is why your itemized hospital bill will totally shock you.  You will see those $5 aspirins and all of that.  How is this possibly fair to anyone?

Having just participated in another country's medical system, I asked the doctor how he could possibly offer services for so much less than a comparable procedure in the US.  I supposed it was because his cost of living was less.  But no.  He answered that he did not have to have malpractice insurance like his American counterparts.  So this has gotten me wondering.  I have heard nothing about how the new plan would handle the malpractice issue.  Maybe someone has heard.  Would it eventually be impossible to sue for malpractice because basically the doctors would be controlled by the government?  Or has this even been addressed.  And, if GRS is included (which I think would be just awesome) would it be possible to sue the doctor if you change your mind, as we are seeing now?

Just some questions.

Kristi

[lizbeth]

malpractice insurance accounts from the low range of $80 billion a year and high range of up to $250 billion a year in an industry that costs 2+ trillion dollars a year to operate. it's is definately a place that there can be some savings, but not nearly enough to reform the system in any meaningful way.

a big reason (almost the only reason) that people will go after large amounts of money in a malpractice suit is for future medical costs. a single payer system would do more to help doctors with the high cost of malpractice insurance than any proposed tort reforms even with the best of estimates since there would never be a reason to go after future medical costs.

*edit* a peer review board should be able to put a stop to most of the other frivolous lawsuits as well, if a majority admits to a potential negligence, then the board would move ahead with charges. they have a similar system in australia IIRC. In the specific case of GRS and other cosmetic surgeries (oh no, i went there again!) I just assume that there could just be a simple waiver.

[Tammy Hope]

That's assuming you would be allowed to seek legal recourse at all.

but I'll grant that particular point (your last sentence)

[lizbeth]

That's assuming you would be allowed to seek legal recourse at all.

come on Laura, if there is anything us socialist libs never get in the way of, it's trial lawyers, right?? 

* beth~chella places tounge firmly in cheek 

[Cindy Stephens]

     Most of the provisions in this bill don't even take effect for 4 years.  I firmly believe that cost saving provisions will be routinely addressed and enacted.  They have set up a medical utilization board that will look at and address this very issue.  The conservative have, in my opinion, been playing on the fears and ignorance of the general population by presenting the bug-a-boo of an impersonal, bureaucratic board that will make decisions.
     Read todays chapter of the Palin Saga  which concerns utilization.  Gee-EVERY medical insurance policy ALREADY has one! 97 year old people with virtually no chance of surviving the operation and, besides, they have lung cancer, don't get $500,000 heart transplants. You just don't see the decision being made.  Actually read your policy. I have to, I know a bit of what I am doing, and yet, I have to read it 3 or 4 times before I really feel comfortable with it.  Our corporate, standard Cigna policy has a clause describing who, what, and when they will make a decision on appropriate, necessary, accepted, and approved health care.  And their ruling is-FINAL-except to the extent overruled by state law.
   My own personal observation is that 90% of health care in US could be given by nurse practioners trained in two things-1. recognizing what has to be seen by a doctor, and 2. reciting the phrase "Go home, you have a cold, drink water, take an aspirin-no, you don't need a prescription, just a little rest".  There, I bet I could drop health care expenditures 40% just with that.