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No time for debate; just an observation - The Fucking Bluebird of Goddamn Happiness [entries|archive|friends|userinfo]
Zoethe

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No time for debate; just an observation [Sep. 1st, 2009|09:33 am]
Zoethe
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After the complete bank collapse and the securitized mortgage fiasco of last year? After Enron? After the S&L crisis?

How can conservatives even manage to say, "If we just open up to the free market, the health care crisis will take care of itself!" with a straight face?

(And, yes, I know that a "real" free market wouldn't have bailed out AIG and all those banks. That we've taught these big industries to rely on the government because they are "too big to fail," and we should never have gotten started down that road. Whatever; imagine that it's you or your kid lying in the hospital when the free market in health care "adjusts" itself.)
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Comments:
[User Picture]From: iscari0t
2009-09-01 02:01 pm (UTC)
I saw this the other day, and liked it enough to put it on my fridge.

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[User Picture]From: zoethe
2009-09-01 02:27 pm (UTC)
Heh. Yeah.
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[User Picture]From: pkthunder
2009-09-01 03:47 pm (UTC)
A) All of those are local public options.

B) You know why my local transit authority hasn't eliminated cars (or at the very least, my car)? Because even though 80% of it's revenue comes from sales and use taxes, I still have to pay full price for a ride to work, and it is more expensive than me driving my car.

I'm not saying a public option is necessarily bad, and I'm still undecided on the way health care on a national level should be handled. Just sayin' that this cartoon, not really applicable.
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[User Picture]From: kenp_v3
2009-09-01 04:13 pm (UTC)
This reminds me of how effective Obama is at defending the public option:

http://www.youtube.com/watch?v=5XTi-WdOu2s

Oh I'm not arguing for and against public option here and I do understand what the President was trying to say. Just shaking my head that he'd defend one "public option" by making a joke about how inefficient another "public option" is. Jeez.
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[User Picture]From: wdomburg
2009-09-01 02:04 pm (UTC)
The counter argument being, "With the looming bankruptcy of Medicate, Social Security and the post office? After the bailouts of Fannie Mae and Freddie Mac after they fueled the housing bubble by providing a market for mortgage base conservatives? After a $2.1T miscalculation in the ten deficit? How can liberals even manage to say, 'If we just add more bureaucracy, the health care crisis will be taken care of' with a straight face?"

One of the key conservative arguments is against sudden, drastic changes specifically because legislators are terrible about predicting second and third order effects. And there is far more to conservative proposals than "just open up the free market". I'm going to be doing something of a run down as soon as I can find a chance, but there are several bills that have been introduced in the legislature, numerous op-eds by people like Romney and Pawlenty who have had experience tackling health care issues on the state level as well as independent commentary and analysis.
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[User Picture]From: kibbles
2009-09-01 02:18 pm (UTC)
I'm not sure how much more bureaucracy would be added. I know both private and public very well. Not just my private, and working in HR, and the way plans have been done, but with public. I have a disabled child, and was a military dependent, and I've also dealt with POA for medicare and VA stuff.

As far as $ goes, are you aware of premium prices for single or family insurance where you are?
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[User Picture]From: wdomburg
2009-09-01 03:13 pm (UTC)
Have you looked much at the proposed bill? They add a whole new administrative branch (the "Health Choices Administration"), the insurance exchange, several new commissions, research centers, care organizations, blah, blah, et cetera. Significant policy areas are left to the discretion of the new commissioner, including which existing policies constitute "acceptable coverage". Given the government track record, it's a fair certainty that the thousand page bill will spawn thousands more pages of policy written by unelected bureaucrats.

Insurance here is significantly more expensive than average, likely due (at least in part) to New York having strict guaranteed issue laws. Somewhere in the range of $12k/yr for families. But I'm not sure how that's pertinent. Criticism of one proposal to reform health care in no way equates to a defense of the status quo.
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[User Picture]From: zoethe
2009-09-01 02:37 pm (UTC)
I have objected strenuously to the bailouts, and I think that there are real flaws in a bureaucratic solution. Fixing this is not going to be easy. But the people who pretend that the only problem is regulation drive me crazy.
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[User Picture]From: wdomburg
2009-09-01 02:54 pm (UTC)
I find they're a minority on both sides of the aisle, though. Despite claims from certain politicians to the contrary, very few are sounding the clarion call for either the status quo or a completely unregulated free for all.

Edited at 2009-09-01 03:14 pm (UTC)
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[User Picture]From: ccr1138
2009-09-02 03:18 pm (UTC)
This.

But the liberals who are bent on a public option (with a not-so-secret hope that it will lead to single payer) are too busy setting up straw men to look at the OTHER plans on offer. It's easy to win a debate if you can successfully mis-state and twist your opponent's side of the argument to make them look unreasonable.
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[User Picture]From: wdomburg
2009-09-02 03:37 pm (UTC)
Man, just noticed while looking at a reply the typos in this entry. That should be Medicare, not Medicate. And "mortgage based securities" instead of "mortgage base conservatives".

I'm embarrassed now. :)
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[User Picture]From: zoethe
2009-09-02 05:12 pm (UTC)
I didn't even notice. No worries.
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[User Picture]From: kibbles
2009-09-01 02:24 pm (UTC)
Not everyone would pay Dr. Bob, even if he gave his services away. Dr. Bob could be a complete idiot. Medicine isn't entirely price driven. Maybe for people who have a physical a year, but the reality for a huge number of people is that they go with the doctor that doesn't piss them off.

The OTHER reality is a lot of communities have only a Dr. George. Or no doctor. I have to travel 90 miles to see one of my son's doctor's. Oh, another one I have to get a special waiver from our insurance company. The local one is not in our network, and the nearest one is over 45 miles away. If we had single payer then I could use any of that specialist I wanted, right? I *should* have more options because my son has both private (which we pay $9 an hour for. Every hour my husband works, $9 goes into his medical fund which requires he works 800 hours a year) and public, because of his disability. So that is two different networks (public surprisingly covers a LOT that private doesn't, for example most of his physical therapy, all of his speech and occupational).

Anyways, medical care is not like buying milk or gas. A lot more than price is in the decision making process.

Funny thing is I know lots and lots of doctors that change their prices...I wonder what insurance company won't allow your doctor to do what others do.
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[User Picture]From: ccr1138
2009-09-02 03:28 pm (UTC)
If you had single payer, you could NOT see any specialist you wanted. You would first wait an unconscionably long time to see your family physician (if you could find one), who is the gatekeeper for all your medical care. He or she would then write a letter to a specialist asking for an appointment for you. At that appointment, which would happen weeks or months later, you would be examined and then set a date for your actual treatment -- if they deemed you in need of it -- also weeks or months later. (Granted, if it's a life-threatening emergency you'd get in right away. If it's not ... get ready to wait, and wait, and wait.)

If you wanted a different doctor or if you didn't want to wait so long, you would just have to lump it. No matter how much money you were willing to spend, you would not be able to pay for a private doctor or get served any faster. There would be no appeal process. There would be no suing the government to give you what you think you deserve. You take what you are given, no matter how crappy, and that's it.

This is the reality of single-payer medicine. I know because I live in Canada, and this is exactly how my medical care works. Trust me, you do not want this. Fix America's system, yeah. Single-payer? Hell no.
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[User Picture]From: iscari0t
2009-09-01 02:29 pm (UTC)
if Dr. Bob down the street is only charging $15 for an office visit, and Dr. George is charging $40 for the same visit, it would stand to reason that Dr. Bob would get more business. Thus Dr. George would eventually have to lower his rates because he isn't going to get business when he's charging more than double for the exact same services.

You just described open market to a T. Why is the right opposed to this again? Or more to the point, are you saying they're pushing FOR set pay scales and AGAINST workers having the freedom to set their own wages?
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[User Picture]From: zoethe
2009-09-01 03:44 pm (UTC)
Dr. Bob might be a quack. And the truly expensive medical care is hospital care, long-term care, and specialists. Those costs aren't going to drop to manageable amounts just because Dr. Bob will take $15 or a chicken.
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[User Picture]From: zoethe
2009-09-01 02:45 pm (UTC)
That's all well and good, but this competition isn't going to lower the cost of a hospital stay to the point where Mr. Bill the lawn mower repairman can receive treatment for his colon cancer, at least not without bankrupting him. Office calls aren't so much the problem.
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[User Picture]From: phillipalden
2009-09-01 05:15 pm (UTC)
Remember these are the same people who are still seriously considering running Sarah Palin for President in 2012.

Most of them, especially the Radical Religious Right (RRR) are so deluded the truth totally escapes them. Many of them believe the whole housing crisis was caused by Black and Hispanic people buying houses they couldn't afford.

Yep. Blame it all on minorities. That's how these people roll.
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[User Picture]From: zoethe
2009-09-01 05:24 pm (UTC)
Post hoc, ergo proctor hoc.

And you can't argue them out of it.
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[User Picture]From: roaming
2009-09-01 08:26 pm (UTC)
They can say it with a straight face because they're bought and paid for by the "free market" Too Big to Fails.
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[User Picture]From: ccr1138
2009-09-02 06:51 am (UTC)
Is anybody actually saying this? I smell a straw man.
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[User Picture]From: zoethe
2009-09-02 11:26 am (UTC)
I've heard it, though I don't have sources I can point to.
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[User Picture]From: ccr1138
2009-09-02 03:10 pm (UTC)
Personally, I do think removing barriers to competition would solve several problems with the system. Do I think it is a panacea? No. But if every insurance company could compete in every market, the obscene profits would come down.

Then, if we added regulations to stop the the abuses (denying claims, dropping coverage, etc.), created co-operative risk pools for those whose employers don't offer insurance, and gave vouchers to the poor and working class so that they could choose the coverage they wanted in a free marketplace, that would get us to universal coverage and still leave room for a variety of choices, all without government interfering directly.

Other ways to reduce costs would be to institute a national medical records database, and most importantly, reforming the tort law so that doctors could pay less for malpractice insurance and stop ordering so many unnecessary procedures for the sake of "defensive" medicine. You'll notice the latter is nowhere in the president's plan, and it should be.

I don't see why we couldn't do everything I've just said FIRST, without adding a public option. Then, if that doesn't seem to be working, we could offer the public option as another competitor in the marketplace.

As long as we have free competition, the market will adjust prices to what is reasonable, and the companies will have to respond to demand if they want to attract customers. The reason they don't serve us well NOW is that the government has actually protected them from competition. As soon as you stifle competition or interfere in the marketplace through government fiat, you disrupt the mechanism of supply/demand/profit/loss which is the most efficient way to allocate limited resources.

The problem with the debate is that people have become entrenched on both sides, and the stances have polarized into all-or-nothing attitudes. A number of conservatives want NO reform, because they think it's unconstitutional. A number of liberals want single-payer or else. What is wrong with making incremental changes to see what works? I'm a pragmatist, not an idealist. All this posturing and scare-mongering makes me want to slap people.

I think most Americans would agree that universal coverage and increased efficiency are excellent goals. We just differ on how we think that can be achieved in a sustainable way. As long as we all have a CHOICE, I'm happy. I live with single-payer right now, and all choice has been removed. That is not acceptable IMNSHO.
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[User Picture]From: lordindra
2009-09-02 08:18 pm (UTC)
I'm willing to buy that less overall regulation might help, but these idiots seem to want to just throw out regulations just because they restrict business.

What should happen is a comprehensive review of the laws and regulatory policies that regulate businesses. See what is working, and what isn't. If a regulation isn't working, maybe throw it out. But some of them are probably not working because they don't go far enough, in those cases, they should be strengthened.

Overall less, possibly good. Assuming the same results, definitely good. But that shouldn't be the goal. The goal should be more intelligently targeted regulation. If that happens to mean less, great, but less should not be the goal.

Health care might start correcting itself if such a project was done. That said, there needs to be some way to ensure that everyone can afford at least basic preventative care. I don't see how this guarantee could be achieved without some degree of government involvement.
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