I couldn’t be certain, but I think the Patient Protection & Affordable Care Act (“ObamaCare”) is on its second to last leg. But give it credit, for such an awfully asinine law that accomplishes almost nothing to reign in health care costs, it’s stuck around for awhile. Consider, too, that it actually increases costs and you begin to believe the government is run by circus clowns.
But there’s little need to discuss all the problems with ObamaCare since it’s been done ad nauseam. Instead, I’d like to hear replacement plans. What would you replace ObamaCare with, if anything? Should we go back to the way things were before? Should we expand ObamaCare and go the way of Canada and Great Britain? Should we expand Medicaid? What can we do for those lacking health insurance?
Thoughts?
Sifting Reality 
I sorta think you’re burying something that ain’t dead.
That’s the problem with echo chambers.
~Dan
Dan the troll is here again. Charming.
If there is to be a national health care plan (like Canada has which makes getting to see a doctor a long-time wait of months sometimes – and, yes, I have first-hand knowledge with Canadian friends), then it should be a voluntary plan vs the mandatory crap of Obamacare. It should also pay the going rate for medical care instead of stiffing people, but it should also not over-pay, nor have such a large bureaucracy that more money goes to them than medical care. It should also cover ONLY medical necessities, which immediately eliminates birth control, abortion, genital mutilation to pretend to be a member of the opposite sex, etc. An annual physical would be fine.
BUT it should also have higher premiums for those who live hazardous lifestyles, such as clinically obese, smokers, drunks, drug addicts, etc.
Dan,
Would you keep or replace ObamaCare?
Glenn,
Your plan sounds reasonable, but I disagree with the last portion of it. I once had a doctor tell me that what we now call obese was considered healthy 20 years ago. Also, how would you weed out the drunks and druggies? How would you know?
Let the medicos figure it out.
The much easier solution to cover the uninsured would have been to allow then to participate in medicare/medicaid with some sort of graduated premium and/or co pay depending on income. This seems like the best way to get the uninsured covered. Then I would allow companies to compete across state lines, put reasonable limits on liability. At least that would be a good start. Oh, and I wouldn’t lie about how awesome it will be.
As it is, P-BO care won’t be covering all of the uninsured (Leaves out about 15 million), it won’t allow people to choose the coverages that make the most sense for them, and it won’t save the average family $2,500 per year. It will force insurance companies to cancel peoples existing coverages, forcing them into more expensive plans that cover things they don’t want or need for the sole purpose of subsidizing those who “can’t afford” insurance.
I’m from Australia, and it’s worthwhile checking out our system. I think it works quite well and ensures that all citizens are able to get essential health care (however those with private health insurance can often get it faster and get non-essential health care.)
The main system is called Medicare. See http://en.wikipedia.org/wiki/Medicare_(Australia).
Terrance, I have to tell you, on this question, I have no great position. I think we need a better way of getting healthcare to people, on the one hand. On the other hand, I dislike the very notion of insurance (so there’s a big problem right off – with any insurance approach!)
I have some problems with rules in the ACA (the rule that requires people to get healthcare insurance, even if it is against their beliefs), but I also understand the argument for it (if everyone is not helping pay for it, then it becomes increasingly more un-affordable and un-doable).
I just hold no strong opinions on this question – it’s a very complicated question morally, financially, etc, and I’m open to leaving the “hows” to someone else because, as noted, I just don’t know the right answer.
I’m nowhere near as adamant against this plan as its opponents, nor near as supportive as its supporters. I certainly don’t think that those promoting this plan have the intent of promoting “socialism” or any of the other charges thrown towards Obama, so I have to tell you – just from the argument styles of its opponents – I tend to favor it. I hate demagoguing and demonization and, if that’s one’s argument against any proposal, I will quickly lean away from that side.
Of course, in this case, you have both “sides” doing some demagoguing and demonization, so…
~Dan
Dan,
Fair enough.
I think it should go back to how it was with a few minor changes.
Allow purchase of policies across state lines.
Allow portable policies. You can bring your current state if you move.
For those who cannot afford insurance they could be added to currently existing government health insurance programs.
John,
Any reversion MUST include a provision that doesn’t allow insurance companies to reject someone because of preexisting conditions. We’re not talking about brick & mortar buildings so save me the house fire reference. We’re talking about flesh and blood human beings and there are simply too many things that can go wrong. Some people, I’m sure, only decide to get insurance after getting sick, but other people fall through the cracks. Maybe they missed some payments for whatever reason and were canceled, then got sick, whatever. Hundred different things could be the cause.
Terrance I agree in principle. If you are talking about someone who wants insurance but has high blood pressure or something, I agree. Although, they shouldn’t pay the same premium as someone with out a preexisting condition, they should be able to get covered. In practice I think you’ll see people who will not insure until they are really sick/injured/hurt. I completely agree that a preexisting condition shouldn’t affect the transfer of insurance, but just being able to show up at the hospital and make some random insurance company pay for your heart transplant, I don’t think that’s a good plan at all.
It seems that you don’t like the analogy, but it seems apt. You can’t take out homeowners insurance while flames lick your roof, you can’t take out flood insurance when after the water starts to rise. Why should you be able to game the system with health insurance.
Now, if you want to get creative and set some sort of mandatory public funding that would insure that those with preexisting conditions would be treated if they don’t have insurance that might be something that could be debated. Or if there was some way for Medicare/Medicaid to fill the gap, again it’s worth considering.
Craig,
Because as previously mentioned, not everyone is “gaming the system.” There are too many possibilities and circumstance to believe that even half the people are doing this. And I don’t like the fire analogy because we’re not talking about brick and mortar, but flesh and blood human beings. This issue cannot be approached from a sheerly financial point of view’. Compassion and empathy are more important than the almighty dollar, in my view.
According to John C. Goodman, Nat’l Ctr for Policy Analysis (and I’m going by memory here, having just heard him on the radio this past week), there has always been a means by which people with preexisting conditions could find coverage. There had already been a pool established for this purpose. The number of people with preexisting conditions who are in a situation where they have lost coverage due to job loss, or have been otherwise unable to find insurance, is relatively low. Something like only 100,000 have accessed this pool (I might have the numbers wrong—I’m still checking out this guy’s arguments). In any case, his point was that this method has been overlooked, but was a viable means of dealing with this issue. Obamacare, and “comprehensive” plans like it, were unnecessary. Just do what has been done and do more of it.
Personally, it was always my opinion that Obamacare was more concerned with control rather than reducing health care costs. If costs were the issue, then the first step is to review all the reasons for the rise in cost and attack each one separately. Likely, much could have been corrected simply by terminating whatever gov’t interference (regulation) was put in place that resulted in a rise in costs. So that is my first step as well. Void Obamcare and start from the beginning and deal with the causes of price increases, not the symptoms.
Terrance,
Compassion and empathy are all good, but what of those concerns for those who must foot the bill? Insurance companies are not in business to throw away money, and those with policies aren’t either. The burning house analogy is apt and the idea is what to do with those who are already burning without having insurance. When someone with a preexisting condition comes to an insurance company, what is basically happening is that the insurers are merely giving away money to someone who has never contributed to the pool. That cannot be overlooked in trying to solve this conundrum as it does lead to increased costs for everyone else.
Terrance,
I agree that the burning building analogy only goes so far, but it’s as good as I’ve seen. The problem remains, if you are suggesting that insurance companies must cover preexisting conditions in every case, no matter when, then there has to be some mechanism for the insurance companies to price the policies accordingly.
Since we don’t really have a mechanism to force insurance companies to commit financial suicide by forcing them to cover some random cancer patient who has chosen not to have insurance, we can’t do that. I know you’re worried about flesh and blood people,but if you get enough folks waiting until they’re sick to get insurance, then when the companies go belly up, you’re just leaving the rest of the customers who did things the right way without insurance either.
I’m not saying there isn’t an answer, I’m saying that you can’t expect insurance companies to price preexisting conditions insurance the same way you would for a healthy 20 year old.
Marshall,
I didn’t realize that saving, prolonging, and benefiting the lives of those with financial difficulties was “throwing away money.” And clearly you don’t believe compassion and empathy are “all good,” because you immediately, within one reply, renewed your allegiance to the almighty dollar.
It’s heartless thinking. Seriously, comparing flesh and blood human beings with brick and mortar buildings? Ridiculous. The burning house analogy is asinine and about as related to this issue as tulips and polar bears.Our insurance system is employer-based for the majority of working Americans, which means those who leave or change jobs are often leaving their health insurance behind. The rest aren’t fortunate enough to have a job that provides insurance and many of those people lack the finances to continually cover themselves in a private plan. What are these individuals to do if they have a preexisting condition? Nothing?
Lastly, I do not oppose the process of underwriting. I have no problem with premiums being determined by age and other demographic factors. I see it as the best method, within our old system, to contain the cost of health-care for those with preexisting conditions.
Craig,
Then maybe this is the one area of private enterprise that government ought to involve itself, if for no other reason than to underwrite insurance companies that accept patients with preexisting conditions. Because this notion that we do nothing ain’t gonna get it. It’s wrong and immoral, in my view. And also, it’s a horrible platform for the GOP to run on.
It seems to make more sense to fold those people into the existing Medicare/Medicaid system than to involve the feds in private business any more than they are already.
Craig,
Either way government is venturing into areas conservatives are not comfortable: entering into private enterprise or expanding what amounts to socialized medicine. It doesn’t bother me either way because I’ve given up the delusion that America is a free market economy. It most assuredly is not.
“I think the Patient Protection & Affordable Care Act (“ObamaCare”) is on its second to last leg.”
Really? I see no evidence of this at all. What makes you say that? Just curious, I don’t want to be overly optimistic here.
Terrance,
Your reply to me sounds very Dan-like. I am not pledging allegiance to the almighty dollar. I’m defending dollars that don’t belong to me. YOU, on the other hand, like any lefty, is willing to demand that others pay for what you think should be in place. Real nice. Where do you get off? Why is it the duty of anyone but yourself to shell out dough for the sake of other people? Insurance is meant for protection against future illness or injury, not to pay someone’s medical bills just because they came knocking. If you want to protect those who are dealing with preexisting issues, then the aim would be to allow them to remain a part of the pool their former employers provided even if it means paying the full cost of their share now that they are not with that employer.
It totally sucks to be in such a position. But being in that position does not give me the right to demand that others shell out dough on my behalf. If you truly have compassion for the unfortunate, dig deeply, but dig only in your own pockets keeping your hands out of the pockets of others.
By the way, when I lost my job three or four years ago, I flipped off Cobra and found a policy of my own. Fortunately, I had no existing issues, but now that I’m working again, I still have the same policy. With this Obamacare crap hanging over everyone’s heads, I don’t know if it’s worth hooking up with my employer’s plan at this time. I might be forced to at some later date. I’m for going back to pre-Obamacare times when 85% of the population was happy with their coverage, and attacking what drove prices higher in the first place.
Marshall,
You are defending those who pledge allegiance to the almighty dollar. I’m sorry, but I see no real distinction.
First, I’m not a “lefty” – unless the term now refers to those who believe human life is more important than money. Second, not everyone with a preexisting condition is bilking the system, since “preexisting condition” can be anything from asthma to cancer. Take it from me, a person with moderate asthma is not taking more than they pay out.
In the real world not everyone is fortunate enough to work or have worked for a company that provides health insurance, and not everyone is financially able to continually pay for a private plan. You don’t support socialized medicine – which seems to rule out Medicaid – and you seem more concerned with the rights of insurance companies than the rights of patients, so do you have another idea?
There is a price to be paid for living in a civilized nation such as ours. We don’t allow people – or shouldn’t, anyway – to crawl into corners and die because they lack the financial resources to pay some doctor or hospital. We live in a civilized nation and the general welfare of society takes precedent over individual greed. You don’t have to be a “lefty” to recognize this immutable fact.
I’m happy you were able to pull yourself up by the bootstraps and I’m sorry that ObamaCare is going to make things more difficult. But I don’t support ObamaCare, which should have be clear from the original post I wrote. My point is that it is wrong to deny people healthcare because they have a preexisting issue – and I’m right about that, too. It is wrong. We are the richest nation in the world so how can it be that we allow such things to happen?
People don’t like it. Hell, even unions are begging Obama to bail them out. It’s not a popular law and it won’t be around for long, in my view.
Terrance,
“You are defending those who pledge allegiance to the almighty dollar.”
Absolutely not. And I’m quite clear in demonstrating my opposition to those who would dictate how other people spend their money, which is what you are doing, which makes you “like any lefty” (which does not mean I accused you of being a leftist–your position simply is like a lefty’s).
It’s pretty crappy to suggest that I’m putting money above lives, when clearly I’m not. Civilized societies are not marked by how one digs into the pockets of others and by doing so pretends to care about the lives of others. Dig into your own pockets.
And I don’t believe that anyone is denied health care in this country, especially considering how easy it is for illegal aliens to waltz into any emergency room for help with their earaches. The issue is who pays, and you demand that others pony up for everyone else.
Marshal,
You don’t support socialized medicine – which, again, rules out Medicaid – and you don’t believe that insurance companies are obligated to accept those with preexisting conditions, and your only argument in opposition to either one seems to be based on finance. Why is that?
Civilized societies are absolutely marked by government digging into the pockets of those who have benefited from our society and using that money to promote the general welfare. Everyone hates taxes, but with them you purchase civilization. (Oliver Wendall Holmes).
People are not denied emergency, stabilizing care – but Emergency Room care does nothing for people with longterm problems that require longterm care, like asthma or cancer. But you already knew that, Marshall, because you aren’t dumb.
I demand that society pay, yes, because that’s what civilized societies do.
Terrance,
Again you go off like a lefty. Perhaps you lean that way more than you’d care to admit. In answer to the concluding question of your first paragraph, I’m not basing my position on finance. I’m basing it on the outrage of some people who feel they can demand that others cough up big bucks to secure health care for a third group.
Your second paragraph adds to the opinion that you are indeed listing to port. Most people who “benefit from society”, in the sense your statement suggests, have done so through their own efforts, or the efforts of their fathers. Those who truly benefit from our society are those who receive without having contributed.
People experiencing symptoms of their asthma, cancer or any health issue will be treated at any hospital emergency room. They won’t let you suffer from an asthma attack, just sending you on your way. But you already knew that, Terrance, because you aren’t deaf.
What civilized societies do is to maintain a gov’t that won’t interfere with the normal flow of the free market so that more people are employed and able to spend their own money to provide for their own needs. What you want is to put another band-aid on symptoms without addressing the cause of the disease (a timely metaphor). While you’re telling yourself you have compassion for those in need, you burden those from whom you force monetary donations, further depressing the overall economy and therefore exacerbating the problem.
Marshall,
Yeah. Anyone that isn’t rigidly conservative is a lefty. My bad. I forgot.
Anyway, why do you oppose the use of tax dollars to cover those with preexisting conditions – unless you’re worried that your taxes will be raised to pay for it. Taxes are a necessarily evil, so why not put them to good use? And it seems to me if we stopped all the corporate welfare we might be on our way to having the money, and we’ll be that much closer to being a real “free market” economy…
Your second paragraph is an unprovable assumption, not fact, and therefore silly.
People experiencing symptoms of asthma or cancer will indeed be STABILIZED at a hospital, but they will not receive longterm treatment and so their condition will get worse and eventually no hospital will be able to stabilize them – and they’ll die. So what’s your plan? Just throw up our hands, pretend sorrow, and go on about our lives?
The government cannot promote the General Welfare of society without collecting taxes from those who have benefited from our civilized society – whether through hard-work, family connections, or luck. Either you like living in a civilized society or you don’t. It’s that simple. You can’t have it both ways. If you want a civilized society such as ours then government has a responsibility to promote the General Welfare of the people, and I think that saving an entire class from dying needlessly is an example of that ideal being put into action.
You may be comfortable with people dying off for no other reason than shallow pockets, but I’m not. And you can act outraged and accuse me of being “Dan-sque” all you want, but I’ve asked you repeatedly for another solution and you’ve come up with nothing. Why is that, I wonder? Because you have nothing. You believe that people are poor because they choose to be that way and so why help them? To hell with those low-lives, ‘eh? Yeah. It’s a disease all right…It’s called Social Darwinism and you, sir, are severely afflicted.
Terrance,
“Yeah. Anyone that isn’t rigidly conservative is a lefty. My bad. I forgot.”
Try to control yourself. I didn’t say you WERE a lefty. My point is that on this issue, you’re speaking like one. What I oppose is the assumption that a problem such as this is best resolved by taking money from some people (rather than donating your own) and giving it to others. In the meantime, you haven’t done a damn thing to make health care more affordable for anyone, least of all those with the greatest need. Thus, the problem is NOT resolved. The idea is to alter government policies in a way the results in economic growth, which provides more people with the means to handle their own health care needs. Altering government policies regarding regulation will also lead to lower costs for all.
If I’m not mistaken, I believe you have recently stated that you are not a wealthy man. It’s pretty easy, then, to presume to suggest what the wealthy should be doing with their money. All this leads me to insist that, yes indeed, on this issue you definitely sound leftist.
“Your second paragraph is an unprovable assumption, not fact, and therefore silly.”
So, you’re saying then, that those who busted their asses, made the most of their talents and opportunities are the ones who benefited from our society. Conversely, those who are drawing benefits paid by the taxes paid by the former group are NOT benefiting from our society. Interesting.
“So what’s your plan? Just throw up our hands, pretend sorrow, and go on about our lives?”
My plan begins with the concepts described above. In the meantime, I have no issue with you donating your own money, or encouraging others to donate some of theirs, to provide for those struggling with medical costs.
Also, I believe I mentioned John C. Goodman and I would refer you to his work in order to find what he was saying about there already being help available for those with preexisting conditions and no insurance. I have yet to find the time to fully peruse his stuff, but its his thing, so I am eager to see details. From what I heard, there’s a good plan already in place.
As to the “General Welfare”, that term is mightily abused these days in the move to tax more for more recipients. I don’t believe you serve the general welfare by placing a greater burden on those doing the producing. Indeed, it is clear from history that the result is more people in need. Overall, your last two paragraphs are little more than sniveling, and I’ll have to postpone my response for the time being.
So then obviously you’re okay with ad hominem attacks. Good to know! You reject my argument because I am, according to you, “speaking like a lefty.”
I didn’t suggest that. I suggested that government provide basic healthcare in the same way they provide police and fire protection.
Don’t speak like you know me. I took care of mentally disabled people in a private home for a long time and took minimum wage pay because that’s all the guys could afford, even though I could have gone across town and nearly doubled the money working for a corporation with patients fortunate enough to have Blue Cross/Blue Shield.
So you go ahead and keep talking.
You are obviously lacking common sense this evening. If citizens were provided at least basic, preventative healthcare, overall cost would decrease because people wouldn’t have to wait until they were chronically and critically ill, which typically requires more extensive and thus more expensive treatment. All the uninsured ER visits paid for by those with insurance would decrease.
Economic productivity would increase with a healthier populace that lives longer and contributes more to society. But I forgot. You view poverty as a choice, a disease people choose to live with, so obviously you’ll reject this argument.
Bankruptcies would decrease; people would have more money to purchase other goods and services if they didn’t have to worry about exorbitant healthcare costs; and people may be more apt to start their own business. All of this is good for the economy.
I didn’t say that. But then again I live in a reality-based community where not all rich people worked their asses off and not all poor people are scourges who choose to remain in poverty.
I’ll have to look into John C. Goodman’s plan, but already it seems like a bunch of rightwing bullshit. You said yourself that his plan was in place before ObamaCare and that most people didn’t have it that bad. Clearly, that’s not true. Look at the bankruptcies filed due to medical bills. Some years it’s over 60%.
Conservatives believe “General Welfare” has a limited definition and liberals believe it has a broad definition. I think there should be a middle-ground. It seems common sense that “General Welfare,” at its most basic level, should include police and fire protection, schooling, and basic healthcare. Why is this objectionable?
I’m sorry but the way you talk about the poor, it’s not hard to believe you are a Social Darwinist.
I’d also mention that I’m disgusted with your constant assault on poor people and their character. This is not the first time. I’ve always written it off as frustration on your part, but that’s no excuse. I grew up poor and I know firsthand that none of us chose it. I saw my mom bust her ass for our family my entire life, and it pisses me off that people would suggest that somehow our poverty was the result of poor decisions, laziness, or whatever the hell else you guys come up with. Seriously, your assaults on poor people are redolent of the arguments made by Social Darwinists in the 20s and 30s. Those arguments were bullshit and so are yours.
Terrance,
You’re either suffering from mental disorders of your own, or you simply don’t take the time read with calm objectivity or…well now I’d be getting into ad homs, so I’ll leave it there. I’m simply going to go through a list of really surprisingly idiotic responses and provide some clarification (for which you could have merely requested in the first place):
“I didn’t realize that saving, prolonging, and benefiting the lives of those with financial difficulties was “throwing away money.””
First of all, if you had been cool enough to actually read what I wrote, you’d have seen that I said “giving away money” and not “throwing away money”. The distinction may be lost on you, but I’ll concede the point except to say that giving away money is what you expect the insurers to do. Your argument is that it is perfectly fine to demand money from total strangers in order to resolve a personal issue. That’s the reality of forcing insurers to cover preexisting conditions of new customers. I have an equally fine idea: Let’s have those very same customers come to Terrance’s house and demand that money from him. What’s the difference? While an insurer might have more money in the till, that money came from Terrance and many others who have been paying premiums for years. Once again, you fail to remember the purpose of insurance. It is to protect one financially from the possibility that illness or injury might befall one. It is not to simply pay everyone’s bills just because they showed up at the door with a pile of statements.
Secondly, you seem to assume that all people with preexisting conditions that are without insurance are in financial straights, dire or otherwise. Are you suggesting that only poor people have preexisting conditions?
“The burning house analogy is asinine”
No it isn’t, but you are. The analogy is merely an illustration of what is taking place. It is NOT a comparison of a building to a body. The suggestion is asinine. The impact on the insurer, and their existing customers, is what point of the analogy. Every customer hopes to stay healthy, but in taking out a policy agrees that if he manages to stay healthy, the money he spent on premiums will likely be used to cover expenses of another customer who entered into the same agreement while also healthy. In the meantime, the insurer makes his living on the difference between the income from all those healthy customers, and the outlays for all those customers who lodged a claim. The profit margin for insurers is not among the highest in the market place, and adding to those outlays expenses for those who never paid into the system can, and will be financially crippling, driving up costs for premiums even higher.
“First, I’m not a “lefty” – unless the term now refers to those who believe human life is more important than money.”
I believe I addressed this, but as I re-read it I felt it was such a dumbshit thing to say that I had to reiterate. My position is not a reflection of any sentiment that seeks to place greater importance on money over life. It is asinine to even suggest such a thing of me, especially without evidence. None exists in any of my comments. Your position is leftist due to the intention of using tax dollars as a means to address the issue, when doing so will likely result in more people needing assistance. Taxes and regulations make it harder to employ people and you want more taxes for this.
“Second, not everyone with a preexisting condition is bilking the system…”
Nowhere have I even hinted that anyone with a preexisting condition is “bilking” the system.
“you seem more concerned with the rights of insurance companies than the rights of patients”
I guess you need to believe this to deflect righteous derision from your demand that others pay for your idea. But your lack of concern for the rights of insurers to run their business their way will only mean higher costs for everyone. So actually I’m demonstrating far greater concern for ALL patients by exposing the obvious flaws of your idea. Plus, its asinine to make such an accusation without some real justification.
“We live in a civilized nation and the general welfare of society takes precedent over individual greed. You don’t have to be a “lefty” to recognize this immutable fact.”
You do have to be a lefty to believe it is a fact. That is to say that protecting the rights of a person to run a business his own way (which in this case is the way it was meant to be run all along as well as the way that makes it sustainable as a business) is not “individual greed”. It is also lefty-like to suggest that only your idea is what is required to be civilized concerning this issue. The issue between us is a difference in how to account for these people with preexisting conditions. Your idea sucks. It is not conducive to a sustaining a civilized society.
“My point is that it is wrong to deny people healthcare because they have a preexisting issue – and I’m right about that, too.”
But they aren’t denied health care. They’re denied health insurance if their condition comes before their attempt to acquire insurance. And I don’t believe that it is true that too many people are even denied insurance. As I have been reading as much as I can regarding Goodman’s stuff, he puts it like this: This is really a case of politicians creating a solution and then trying to find people who have the problem for which the solution is meant. (And really, your post was not even dedicated to the issue of preexisting conditions anyway. The closest you came was a mention of people without insurance. But a great deal of those are people who simply chose not to pay for any as opposed to people who can’t afford it.)
That’s it for now. Time to crash. But don’t bother responding just yet. I’ve more, including (I hope) links to some of Goodman’s stuff.
Marshall,
You said,
Why should anyone take you seriously, Marshall, when you don’t even remember your own words?
The problem with you Marshall is that your views are based on Nozickian Morality – and that isn’t morality at all. In such a world the only moral requirement an individual has is what he freely brings on himself, like an agreement or contract. This is a disgusting point of view. Say, for example, you’re walking down the street and see a woman being raped and beaten. In the Nozickian point of view, you are not morally obligated to help her – since you made no contract, agreement, or obligation to help her.
Similarly, it is Nozickian Morality that says insurance companies are not morally obligated to help people with the cost of preexisting conditions. The insurance company has a contract and doesn’t have to do anything beyond satisfying it as written.
And I’m not interested in demanding money from people. Instead, I’d rather insurance companies behave responsibly with the money they already have. Right now, insurance companies spend 31 cents of every dollar – $600-billion a year – on corporate profits, stock options, executive salaries, and marketing. You may find this morally acceptable but I do not. I believe everyone, including business, has a moral responsibility to perpetuate our civilized society, and the economic free-for-all envisioned by the extreme right is anything but civilized.
No, I didn’t suggest that. But those with money don’t have to worry about paying for their preexisting conditions, now do they?
The only person in this conversation lacking sense is you.
It is an objectionable “illustration” because it doesn’t differentiate between the value of a brick & mortar building and the value of a flesh & blood human being. The two are treated as moral equals – yet they are not.
Yes, it is. But if not, you’d better stop that crazy person from using your name.
Before making wild statements like this you should probably address my arguments. I clearly explained why, in my mind, it would benefit the economy. You’ve failed to respond.
It’s been suggested – not by you, that I recall – that if preexisting conditions were covered people would only purchase health insurance when needed. I was responding to that general sentiment and not necessarily something you said.
Not everything revolves around money, Marshall, and that’s what you don’t understand. Society has a moral responsibility to care for human life.
Regardless, stop making sweeping statements (i.e., “higher costs for everyone”) until you address my economic arguments. The overall economy will benefit, likely nullifying any increased health insurance costs.
It is a fact. The for-profit healthcare system is based entirely on greed. And while I’m a believer in capitalism, it must have a sound moral foundation, otherwise it is “not conducive to a [sic] sustaining a civilized society.” You cannot intelligently argue that its civilized to allow people to suffer and die because they lack financial resources – yet that seems to be your argument.
I’ll be waiting for your Goodman stuff. But I wouldn’t put too much stock in it. All you have to do is review a few studies to know that lack of healthcare is a common problem. And like I said, over 60% of bankruptcies are related to healthcare costs. This is not conducive to a sound economy.
The for-profit healthcare system is based entirely on greed.
Terrance, unless you are able to read their minds and know their hearts, or hear their testimony which says greed is what they base their system on, they you really need to be careful about such accusations against someone who is not here to defend themselves.
“Why should anyone take you seriously, Marshall, when you don’t even remember your own words?”
You’re really a bit of an asshole, aren’t you? I conceded the point and it turns out I used both expressions, thus you think you’ve earned points by catching what I overlooked? Kudos to you for that, small mind. You get a shiny star and now my entire premise is shot to hell because of my overlooking this one tiny bit. Sure. Right. But the point stands. Insurers are NOT in business to give away their services, any more than any other business out there, INCLUDING hospital emergency rooms. Somebody must pay and you are all for forcing others to pay for that which YOU think they are somehow obligated in YOUR idea of a civilized world.
” I believe everyone, including business, has a moral responsibility to perpetuate our civilized society, and the economic free-for-all envisioned by the extreme right is anything but civilized.”
No one’s talking about anything akin to an “economic free-for-all”. We’re talking about people like you demanding from an industry that averages net profit margins in the 3.5% range to just give money away in a manner that conflicts with their purpose—which is to make money, just like any other business. What’s more, it is not insurers who are driving up costs in health care. But your idea (shared by Barry O) will drives up costs even more. What we’re looking to do is lower costs, as well as to grow the economy so that fewer and fewer people are left with no job (or only jobs that pay crappy) so that they can afford whatever care they need. In the meantime, your idea is indeed a demand for money of other people to cover the costs of people with preexisting conditions. You think insurance companies are charities, or should be. Fine. Start one of your own and you can be the man. But civilized people do NOT dip into the pockets of others to satisfy their personal ideas of what constitutes civilization.
“It is an objectionable “illustration” because it doesn’t differentiate between the value of a brick & mortar building and the value of a flesh & blood human being. The two are treated as moral equals – yet they are not.”
This from the child who dares insist it is I who lacks sense. It doesn’t have to differentiate between the two as it isn’t making the comparison between what and/or whom is insured. It is only used to illustrate how insurance works and to demonstrate the obvious flaw in your suggestion. If you like, you can instead consider the fear of those who are willing to risk the fines rather than enroll in Barry’s plan. The system will be out all that money and still have to pay out the claims of the newly enrolled when they get sick or hurt enough to rack up medical bills. It also is the basis for insisting on individual and employer mandates, so that there is a constant stream of income in order to cover all the preexisting condition patients and every other hangnail Barrycare wants covered. Without the mandate, preexisting conditions cannot be covered without forcing higher costs (though it will still have that effect).
“My position is not a reflection of any sentiment that seeks to place greater importance on money over life.
Yes, it is.”
Not at all, you who lacks sense. It is a reflection of the simple-mindedness of your position which doesn’t take into account the ramifications of imposing this on insurers. You think money grows on trees.
“I clearly explained why, in my mind, it would benefit the economy. You’ve failed to respond.”
Of course I did. But here’s another response: What’s in your mind is not reality.
“Not everything revolves around money, Marshall, and that’s what you don’t understand. Society has a moral responsibility to care for human life.”
You seem to believe that morally responsible action is free or comes without costs to someone, and those costs do not have a negative impact elsewhere. What’s more, your idea does not address what will be the ongoing situation of people dealing with this kind of hardship. My position leads to people being able to handle their own issues.
“The for-profit healthcare system is based entirely on greed.”
An absolutely leftist thing to say. You truly are a lefty. I didn’t want to believe it, but it is true or you couldn’t say anything so idiotic. Because an industry expects to be paid for it’s services it’s greedy? Again with the sense-free comments! Do you work for free, or are you a greedy bastard who hopes to squander your pay on food, clothes and housing??!! What an arrogant and demonizing position! This paper gives a good overview of the situation. “Fact” my ass.
“And like I said, over 60% of bankruptcies are related to healthcare costs.”
And here’s a short piece by Goodman. Note #7.
Here’s one about preexisting conditions.
Glenn,
It’s evident that health insurance companies are in it for the money. Look at the stock options and increases in executive salary, for crying out loud.
I don’t mean healthcare professionals. I worked in healthcare on several levels and I definately didn’t do it for the money. I’m talking about the insurance companies.
Terrance,
Being in business for making money is what ALL businesses do. If they weren’t in it to make money, there wouldn’t be ANY business. But being in a business to make money is not the same as being greedy.
I play my bagpipes to make money; in your logic I’m doing it because I’m greedy! But if that was the case then I’d never do a freebie (which I do a lot of). If people want my service, they will pay what I ask, and my rates are based on time, distance, type of performance, etc; I have to make more than it costs me in order to make it worth while.
So with health care insurance; they base their fees on many variables so as to be able to cover all the costs and still make money. You may think they are overpaid, by I wonder how they compare with Hollywood stars or professional sports players?
Marshall your post was held in moderation because of all the links. I approved it, as is.
No.
I just thought it was funny that you went on some tirade about my not paying attention and getting all worked up over things you didn’t say – only for you to find out that you did, in fact, say them.
Your entire premise about me is shot to hell, but not your overall argument – at least not on account of this. Your overall premise is shot to hell because it is morally bankrupt and economically foolish.
Insurance companies benefit from our society by making billions of dollars. It’s not too much to ask that they engage in morally responsible behavior and cover those with preexisting conditions, if for no other reason than the overall economic benefit such a policy would produce.
Furthermore, are you seriously suggesting EMTALA be repealed? You don’t think Emergency Rooms should have to treat those with no insurance and no money to pay? If so then you’re an even bigger asshole than I thought.
So your idea of a civilized society is the opposite of mine? My ideal society is one in which people don’t suffer and die because they can’t pay for healthcare – and you reject that. How nice.
If companies have no moral obligation beyond revenue production, then that’s exactly what you’re talking about – an economic free-for-all.
Oh, give me a f*cking break. You act like insurance companies are paupers or something. You’re talking about a $2 trillion dollar industry, so even if that 3.5% figure is correct, that’s still billions of dollars. Like I said, they spend $600 billion a year on corporate profits, stock options, executive salaries, and marketing. A third of their income is spent on things that have absolutely nothing to do with healthcare – and you object to the notion that they are morally obligated to help the less fortunate?
Insurance companies are raising premiums by as much as 116% even while profits soar – but let’s not mention that. Let’s just keep on blaming Obama for a morally decrepit industry.
Furthermore, my plan WOULD help grow the economy. Like I said, over 60% of bankruptcies are healthcare related. The exorbitant costs are putting people in the poor house, for crying out loud, and you don’t think that lifting that burden would improve the economy? The money saved on healthcare would be used for other goods and services, and may reduce unemployment. How many people, I wonder, would like to start their own business but don’t because leaving their current job would cost them their healthcare? Relieving them of that burden would enable them to become entrepreneurs and innovators. All of this is good for the economy!
You really are a stupid sonuvabtch, aren’t ya? It draws an invalid comparison – as I have explained. You cannot liken insurance used to care for human life with insurance used to repair a building. The comparison, while attempting to illustrate a point, is missing the point! Human life is of significantly higher value and so the insurance should and does work differently.
I realize you can’t expect much from corporate America. Instead of simply fulfilling their moral obligation to help society in this way, they’ll no doubt attempt to recover the cost. But that’s why government should step in and set a cap on what those assholes can charge. Either that or do away with the entire private insurance industry and provide Medicaid for all. I believe healthcare is a human right so I have no problem with a socialized system.
You’ve yet to explain why I’m wrong. You’ve been given ample opportunity to refute my economic arguments but have failed to do so, balking yet again.
Goodman’s piece is a bunch of bullshit. People get healthcare, sure, in the Emergency Room – but where is the preventative healthcare so people’s preexisting conditions do not worsen? Plus, Goodman fails to address the problem of healthcare debt – except to deny the problem exists. Look at the facts. Over 60% of bankruptcies are the result of healthcare debt.
Like I predicted, a bunch of rightwing nonsense.
Glenn,
I get why businesses are in business. I’m a business-owner myself – and of course I want to make money. But I believe businesses have a moral obligation – and you seem to believe this as well, Glenn. Why again do you avoid Wal-Mart?
I avoid WalMart because 99% of what they sell is from China. I will avoid buying from China wherever possible, because Chinese goods put American manufacturers out of business. I will buy from Mexico before China, but I don’t like them either. I will spend extra money to get American-made products – something almost impossible to fine at Walmart. Even Target has more non-chinese goods!
Terrance,
Just to let you know, I haven’t blown this discussion off. I work lots of hours and do not want to just post any quick comment that doesn’t fully reflect my position. I admit also to having been distracted by some nonsense of one R. Nash on the post about American Exceptionalism. I’ll be responding to you soon.
Marshal,
I can understand that. I’ve found myself terribly busy as of late. We can continue the discussion whenever you get time, but let’s do so with more civility. I know much of the incivility is my fault, and I apologize. But this is just a frustrating issue for me.
I may be a contributor/moderator here, but this is John’s blog and I know he’d appreciate a more civil discussion.
Screw John! (just kidding—I agree with your sentiment)
Terrance,
Sorry to keep you waiting. I want to begin with the following, as I believe it is an argument you made that you feel wasn’t addressed by me. There were three paragraphs that I’ll address one by one:
“You are obviously lacking common sense this evening. If citizens were provided at least basic, preventative healthcare, overall cost would decrease because people wouldn’t have to wait until they were chronically and critically ill, which typically requires more extensive and thus more expensive treatment. All the uninsured ER visits paid for by those with insurance would decrease.
Economic productivity would increase with a healthier populace that lives longer and contributes more to society. But I forgot. You view poverty as a choice, a disease people choose to live with, so obviously you’ll reject this argument.
Bankruptcies would decrease; people would have more money to purchase other goods and services if they didn’t have to worry about exorbitant healthcare costs; and people may be more apt to start their own business. All of this is good for the economy.”
1st paragraph:
First, I’m not sure you are using the term “preventative healthcare” properly. Why does anyone need a doctor for preventative care? Proper diet, exercise, 7-8 hours of sleep…these are all the basis of preventative care that requires no doctor. In other words, when anyone lives with some attention to their own health, one’s medical bills consist of yearly checkups. While these might cost a few hundred depending on how detailed a physical one chooses, there are few maladies one will suffer that requires more. The idea, as far as keeping costs low, is to avoid frivolous claims on one’s insurance, or, assuming one has no insurance, avoiding a frivolous lifestyle. As you seem to be speaking of overall costs of a patient, this is essential. Despite the fact that I am not a perfect example of my own advice, I do not suffer from colds and flu like most people because I do think in terms of eating properly, supplementing with quality products and getting sleep. I no longer smoke, I don’t drink to excess and I don’t drive like an asshole. As I have an individual insurance plan, I have a high deductible and don’t much care to spend the cash, so I take precautions. See how that works? When people have to pay themselves, they do more to avoid getting sick or injured. That’s what insurance as we have it now has done—it has made people act as if health care is free. Prevention is individual responsibility first. Being responsible lowers my cost because I am not using doctors and hospitals to begin with.
2nd paragraph:
So by people acting responsibly, they will stay healthy and able to be more productive, employers will not lose money due to preventable lost man hours and their group insurance costs will be less likely to rise.
I’ve never said that poverty is a choice. I said poverty is the result of choices made or not made. That’s not the same thing, but you insist on portraying people like John and myself as heartless for stating the truth. Poor people don’t do what rich people have done to get rich. Most non-wealthy people WON’T do what wealthy people have done to gain wealth. And this is a prime example. As a less than wealthy person myself, I know I cannot ignore my health and expect to weather the bills a serious injury or illness will bring. (A wealthy person might be able to, but I doubt they ignore their health, either.) Because of my economic status, I must be much more vigilant, just as I try to be with every other aspect of my life that impacts my finances. It is another choice I feel I have to make.
3rd:
Thus, by acting responsibly, both with their health, and with what little income they might have, bankruptcies due to medical costs, assuming they are the main reason a person files as opposed to one of many reasons in their lives, would be lessened. In other words, I’m saying that you look at this situation from the middle. I’m looking at it from the beginning. Few people just become so ill or injured just out of the blue. But for such people where they exist, there are still avenues open to them, such as state risk pools, which do much of what you seem to be asking for, including assistance from insurance companies. There are currently 35 states that offer them. If we must have government involved, it should be on the state level, not the federal.