Tell Congress to Go to Hell

fuck-youWednesday’s Democrat victory / compromise / cave-in is a harbinger. A public option won’t be able to negotiate for lower costs. Hmmm. Who benefits. Hospitals? Check. Big pharma? Check. Insurance companies? Check. People, sick or otherwise? Wonnnnnk. The smart money on Wall Street has been betting we’d be screwed and they’d get richer. Enough to make me hope nothing passes.

Not. Can’t go there. This is the most important thing this Congress and this President can do for about a hundred million of us who duck doctors and hospital bill collectors while we wince in pain. Not the most important thing this year … they’ve already shafted us on that — the stimulus (aka: bailout for the gloriously happy rich). No, this is life and death and they have chosen profits and to pretend (CNN wants you to believe that, too) that Wall Street mirrors America.

All to save a hundred billion over ten years? Sure. There is not a human being on the planet that believes any of it. Many trillions to make sure Ben Bernanke’s friends stay super-wealthy and the US government needs to screw me and my hundred million peers? F-them..

As God is my witness (oops, God left on the last train to the coast and is now on a slow-boat to China where they bailed-out people instead of banks), I will spend every moment I can afford (Hah! When this is passed, I won’t afford anything) working to defeat every single-sniveling-cowardly-corrupt-lobby-sucking-dickhead-congress-person I can find. I’ll march. I’ll picket. I’ll write. Email. You-tube. Twitter those [expletive deleted by editor] assholes the rest of my life. (Note to the Secret Service: strictly metaphorical threats.)

Folks, this ain’t over, but it will be soon.

I know. I know. I know. We just need to pass health care reform and will fix it in post (a video and audio production term that allows you to record something really badly and use various computer techniques — like Photoshop —  to make it seem better when people see it). Not this time. We’ll be dead broke and mostly dead before they take the power out of the cold live hands of the lobbyists.

I don’t have any power except to write you. If you can reach out and touch one, just one of the cretins we called leaders, please do it for me — or for one of the hundred million others who are more likeable.

49 thoughts on “Tell Congress to Go to Hell

  1. Keith Graham

    This fight is turning out to be harder than it ought to be — yet again. The opposition to universal health care is doing a pretty good job of cynically playing to people’s fears, maybe because people are so fearful. Not all members of Congress deserve to go to hell — let’s give John Lewis, for one, a break — but a lot of them do, including (but definitely not limited to) the Blue Dog Democrats. Maybe one way to get the attention of these people who are supposed to represent the people — and not represent the lobbyists — would be to take away their generous health care packages that other people who can’t get insurance help to pay for. But it’s definitely time for everyone who believes affordable health care should be available to all to speak out loud and clear. I’ll join that march.

    Reply
  2. Terri Evans

    I confess to apathy, a particularly insidious disease (speaking of health care). OK, the truth is, I suffer more from hopelessness, which has led to the chronic apathy. I wish; I wish; I wish, but can hardly allow my hope to go there for fear of heartbreak (also an insidious disease), as I expect that this tragic loss of opportunity to fix our broken healthcare will instead: A) Fail to put even a cast on the break B) Cause rising temperatures and rising blood pressure C) Make us vomit up more money resulting in severe dehydration D) Cause an epidemic of hope anemia E) Create a rash of further discrimination F) By-pass every potentially open artery to unclog the lobbyist machine, and Pay for Viagra but not birth control.

    Reply
  3. Brenden

    I loved reading your comments, too. It really demonstrates how pitifully out-of-ideas supporters of measures like nationalized healthcare are. There is no economic or rational case made here. I mean, you use every tired cliche to denigrate productive endeavor and paint Americans as a class of victims to be protected by … um, who, exactly? You’ve nicely synthesized the goals of those who promote these policies — they’re merely trying to gain political control by dictat, rather than an appeal to reason.

    Nationalized healthcare will destroy quality in that very large sector of the economy. It will destroy it because the gov’t will attempt to dictate prices. Doctors will not recover their marginal business costs. No one will enter difficult/risky specialties like anesthesiology, ob-gyn, etc. And the overall supply of doctors and healthcare will decline. To the extent one posits economic facts — here they are.

    What you fail to realize is that a market-based system actually INCREASES social welfare. Profit motivates suppliers to compete to develop increasingly efficient production methods that lower consumer costs. You probably think that notion is some sort of facist heresy, but it is borne by considerable empirical evidence.

    There are problems with uninsured and soaring costs. But let’s first look at increasing costs as a result of liability insurance — yes, tort reform. Then let’s talk about having a national market for insurance so I can buy a more competitive policy in Idaho rather than Georgia. Let’s talk about mandating private insurance for workers to expand the risk pool to offset risks of older, chronically ill patients by young healthy patients.

    Or let’s just do you as you suggest and hand the whole mess over to the feckless bureaucrats you complain about here.

    Reply
  4. Billy Howard

    Brenden: If you want reason, read Paul Krugman’s editorial in the New York Times today. Brilliant. It also reveals how most people with health insurance through either their employers or Medicare are already receiving government support for their heathcare (not to mention the caviar healthcare our political leaders receive) it’s just that the current system completely leaves out those of us who work for ourselves or in small businesses. So, I pay taxes for your health insurance while being told tough luck by people like you. Your happy to complain about benefits for others, but it’s hands off to your government subsidies. Or are you anxious to pay your health care freight when you retire all on your own? And, oh yeah, I have pre-existing conditions and when I attempted to get an individual policy this year I was denied by four different carriers. It’s not that they offered me an extremely expensive option, they offered no option at all!

    Reply
  5. Lee Leslie

    Brenden:
    You and I have some common ground. Neither of us want our feckless bureaucrats, nor do we want increased costs or fewer doctors.
    The problems with American healthcare costs are, sadly, not because of the free-market. Wish they were. We could fix that easier. The fact is we have a system that has long been socialized. Very few of us pay directly for our care (paying hospital retail is nuts as they discount to insurance by 75%). The reimbursements rates are not set by markets, they are dominated by private, for-profit, loosely regulated insurance companies and Medicare/Medicaid whose rates are most often influenced by Congress, who are influenced by the special interest of lobbyists. The result is a system that has grown to more than 18% of our economy and increasing -- I believe that you would agree, this is totally unsustainable.
    Add to this that we have competing incentives in the system: the insurance companies’ incentive is profit through capping costs, limiting procedures and authorized procedures. Our doctors are only reimbursed for procedures. People (you and I included) want to be well and stay well so we can be good little taxpayers, but preventive care is not incented, protected or widely available in our system.
    In most states, 80% or more of insurance coverage is provided by only one or two companies. They operate as monopolies (so does big-Pharma) and dominate consumers, providers and regulators. Apply anti-trust laws, and perhaps, free-enterprise could lead us back to a solution, but there is no reason to think that our feckless regulators, bench, or Congress would go along with it -- the insurance industry provides way too much in campaign contributions.
    Your suggestion of a national market for insurance sounds like a good idea, except that states are the only regulators we have (and it is unlikely the Supreme Court would allow it another way). Remove their protection and the industry would consolidate more, creating few choices, higher rates, poorer service, fewer authorization, fewer market forces, etc.
    Add all of this to the nutty notion that business should provide health insurance for employees. I’m in small business and I am terrified at the costs and the responsibility to employees should I fail. Let’s give business a break and get them out of the healthcare business and more competitive, instead of requiring employee coverage, which is what Congress is planning.
    You got me pegged when you say “how pitifully out-of-ideas supporters of measures like nationalized healthcare are.” We have been patient. Long-suffering (really). Many going broke paying (78% of bankruptcies are a result of healthcare costs) while hoping some other idea would work, but each new experiment has made it worse. I believe this is an emergency. I believe that national healthcare is the only answer (Richard Nixon proposed national healthcare in 1974 and Harry Truman 20+ years before him). I know people who work in government and aren’t feckless. Just the opposite. Unlike the insurance companies, their motivation would be to help those they serve.
    This isn’t about welfare. We already pick up the cost of the uninsured and indigent (it is why hospitals charge exorbitant retail rates -- that is the basis for how they are reimbursed). We already pay the cost of sick and disabled workers who are not able to be productive and tax-paying members of society (they pay, too).
    But it is about the things that are are right and wrong. There is no reason why all of our children don’t have access to good healthcare and women to pre-natal care. We are better than that. There is no reason we are doing more to treat obesity and the harm from smoking. There is no reason that we don’t allow our doctors and their professional assistants to earn a good living and help people to stay well (don’t underestimate their ability to adapt). We are a better country than that. And there’s no reason that people who lost their jobs are losing their insurance and have already lost their ability to make co-pays just because Congress didn’t regulate Wall Street because the K-streeters bought their campaigns.
    Your point about medical liability insurance is a good one, and the answer to reform is healthcare for all -- most of the suits are to pay for it. I’ll gladly endorse a Federal reform that limits practice liability assuming it doesn’t protect criminals. However, in their last session, the Supreme Court “reformed” tort law making it almost impossible to bring suit or force discovery.
    I know the start-up costs will be high (when I was growing up, healthcare was about 5% of our economy -- how high can it go?). I recognize there will be some “rationed” care (it is already rationed by insurance companies -- and I say that with the full knowledge and bias of being a kidney cancer survivior). I know there will be some abuses (sure are a lot already). I know there are privacy concerns (good luck with that). I know that change will be hard, but my outrage is that our Congress looks like it will take all the broken things in our system, keep them and sweeten them; add pieces of what we ought to be doing and take cover until the next election.
    Our system is broken. People are suffering. Congress can’t prop this camel up much longer. We might have the greatest healthcare in the world, but we pay more, have less care and like it less than any other modern country.
    Thank you for reading the Dew and your thoughtful comment. We have different views on the answers, but I do believe that debate can lead to respect for each other’s ideas and can help us find the solutions that we both want.

    Reply
  6. Brenden

    To me that article did not “reveal” the fact of medical-tax deductions or retiree subsidies. Already knew that. I dare say that the reason healthcare costs skyrocket now is because of too much government involvement at the moment. Any more and the healthcare system will go bust.

    I am not for transfers/subsidies of any kind. If my healthcare contributions are rolled up into my taxable income, fine, as long as in exchange policy makers normalize the regulatory/liability atmosphere — to lower cost!

    As to your particulars, Billy, you undoubtedly represent a large segment of America — but not the whole damn country. Why would you insist that the entire country endure diminished healthcare in order for you to obtain satisfactory medical care? Not that I think you should suffer unnecessarily, but be clear about what you’re asking for: when gov’t takes over healthcare, dictates prices, hires incompetent bureaucrats to run the system and ulimately rations care for the politically connected — I don’t think you’re going to get what you want.

    Krugman’s point I suppose is that insurers attempt to control costs by denying claims. Fair enough, they do. Insurers can’t control prices like the government.

    I also noticed, Billy, that you didn’t address any of my limited-gov’t solutions. I’m not surprised but I find it appalling that folks engaged in this debate on your side refuse to contenance small-scale, demonstrable, market-based changes instead wholescale, ruinous nationalization.

    Reply
  7. Brenden

    I posted that last before reading Lee’s comment. So I guess I would just add this. I’m one of the knuckle-draggers out there who fights this ridiculuous nationalized healthcare travesty with every fiber of his being. And that is because of the economic consequences. But also because of the consequences to the flickering vestiges of liberty. I agree we should aspire to healthcare for as many people as possible, especially expecting mothers and children because they’re the future workers. But don’t reach your hand in my family’s wallet because you think someone else is **entitled** to what I sweated for. And don’t have the neighborhood welfare police breach my privacy and confiscate my property to redistribute my wealth either. Any lofty goal must come from “consent of the govern’d” as a founding document tells us. There is no “right” to healthcare and if you want one then let’s start a Constitutional Convention and amend the Constitution. Turning over control of the healthcare system to the government threatens personal liberty and choice more than any single area of gov’t intervention that I can think of.

    There is no unlimited pool of resources for us draw from to solve the entire country’s problems. In fact, this country is going down the tubes because we have political leadership — even among so-called conservatives — dedicated to redirecting wealth to unproductive, politically-favored groups. They’re long on promises and short on results, as budget deficits show. Lee you blame lobbyists or capitalists or whomever. Doesn’t matter whom you want to boogey-man: when national wealth is not invested in productive outcomes, that wealth will diminish and disappear over the long term.

    On the other hand, promoting investment in productive outcomes increases wealth, employs workers, raises standards of living and fosters innovation. Healthcare is in every sense a marketplace and source of American global competitive advantage where such free-market priciples are on display. Let’s not destroy it.

    Reply
  8. Lee Leslie

    Brenden: I hear where you are coming from and respect you for your beliefs. I’m not blaming my problems on lobbyists or capitalists -- I’m one of them (I lobby here). I am simply saying our government -- that government that gets its power and right to exist from us -- has been highjacked by K-Street, special interests and companies too big to let free enterprise work properly. They are taking from all of us and subsidizing companies and industries that are betraying our way of life. I have no desire to turn over the control to the government. I’d be tickled red if we could go back to a time where we could empower specialized companies for the public good (they were called public utilities, back then, but no longer operate like them). That said, I do believe heathcare is an investment in a productive outcome. Without health, how can work long enough to pay for Wall Street, our wars, our farm subsidies and our monumental government?

    Reply
  9. Brenden

    Lee,

    The opening statement of your oped…

    Wednesday’s Democrat victory / compromise / cave-in is a harbinger. A public option won’t be able to negotiate for lower costs.

    …versus the statement you made in the comment above…

    I have no desire to turn over the control to the government.

    …seem to me at acute variance. I presume you want the “public option” which I interpret as basically making the entire country eligible for Medicare. How is that not turning control over to the gov’t? I mean, when the gov’t dictates prices, it will control the market. The technical term is, “monopsony,” or the demand-side equivanent of a monopolist. I believe you also complain about monopolist practices above. There seems to be some inconsistencies here.

    As I alluded to above, if we invoke the heinous “public option” the gov’t will set prices below the marginal cost level of doctors and insurers alike. The result will be fewer doctors and insurers, hence diminshed overall quality of care.

    Reply
  10. Lee Leslie

    Government already controls the reimbursements -- insurance companies just follow and take advantage. What it looks like the Blue Dogs won in the bill that you consider a an acute variance” was forcing the public option to negotiate with private for-profit insurance companies for services.
    As I said before, the health insurance monopolies are screwing all us in private plans, while the government is doing to/for those in public plans for 20-35% less (profit and overhead), depending on who you believe. There is no free market now and there won’t be under anyone’s plan in Congress.
    So who do you trust? So insurance underwriter whose incentive plan is based on not paying your bills, canceling your policy if you get sick and whose plan costs more -- or a system that won’t cancel you, is designed only to limit fraud and is promised to be cheaper? Now, I didn’t just fall off a turnip truck, but I know what I get from my insurance company and in what orifice I get it. I also know that those on Medicare, love having it.
    You can have the last word. I’m going for beer. Thanks for your comments, interest in what’s important for America, etc. -- Lee

    Note: This comment was edited on 8/1/2009 to remove a statement that was inaccurate. If you missed and want to know what stupid thing I posted that I felt needed changing, write me.

    Reply
  11. Lee Leslie

    I know, I said you could have the last word (and you can), but I failed to say anything about private insurance and supplemental insurance -- as they do in so successfully in Australia and other places. I’m all for it, just as long as our Congress doesn’t hand out billions to make them competitive (as they did with the Bush prescription plan) or billions in tax breaks (as we have done all along). I don’t care as long as they have to obey the rules by punishing the aged, infirmed, self-employed or unemployed.
    And then there’s that thing about extending patent prescription drug protection and the genius of our founding fathers who wanted it limited… maybe that is for another time.

    Reply
  12. Lee Leslie Post author

    Update from OpenCongress.org
    Big Deal?
    July 31, 2009 -- by Donny Shaw
    No details on this yet, but the AP this morning is reporting that liberals, Blue Dogs and every Democrat in between on the E&C Committee have struck a deal on the health care bill:
    “We have agreed we need to pull together,” said Energy and Commerce Committee Chairman Henry Waxman, D-Calif. Liberals, moderates, and conservatives negotiated late into the night Thursday to reach a deal that would restore some subsidies to help low-to-middle income people pay their health insurance premiums, would preserve a strong public insurance option, and would cut drug costs more deeply, Waxman said. […]

    The last-minute agreement mollified liberals who were outraged by a deal Waxman struck earlier in the week with conservatives known as the Blue Dog Democrats. Friday, lawmakers from both camps joined him to say they were now in accord.
    UPDATE: CQ has some more details now. Essentially, the Blue Dogs get to keep the concession they won earlier in the week requiring the government to negotiate rates for their public insurance option directly with private companies. The main thing liberals and moderates in the Energy and Commerce Committee seem to have won today is an agreement to restore subsidies to low income households for buying health insurance. With this deal in place, the committee is expected to pass the bill later this afternoon.
    Remember, this is just an agreement within the Energy and Commerce Committee where the Blue Dogs yield proportionally more influence than they do among the House Democratic Caucus overall. More on that here.

    Link: http://www.opencongress.org/articles/view/1138-Big-Deal-

    Reply
  13. Brenden

    The “blue dog” resistance was largely a Potemkin villiage designed to give a fig leaf of political coverage to all those conservative Democrats that Rahm Emmanual recruited in 2006. This is all worthless political theater because there are no such conservatives in the Democrat leadership. I knew a public option would come of the House, and probably the Senate. Then Obama will sign it. I just want to let you know all know who support this ridiculous, anti-competitive, centrally-planned healthcare solution what you’re in for.

    So Krugman’s point is that insurers deny claims and filter subscribers only by who’s healthiest, or who can afford to pay high premiums. I don’t deny this. This leaves much to be desired. However, at least the insurers have data and hire experts on how much procedures cost and what, ideally, the reimbursement rate should be. Same with pharma companies: they know the tremendous financial risks in researching and marketing a new drug. They know the costs, how much they need to put up and what the probabilities are of gaining a financial return. Finally, doctors also are quite familiar with how much eight or ten years in med school costs, starting a practice, joining a specialty group, cost of staff and hardware etc. These are the “marginal costs” I mentioned: the next incremental cost of obtaining a new machine or specialization.

    These are very difficult questions of cost best left to experts — that is, the people taking the risks. The bureaucrats you hold such faith in lack this expertise and aren’t assuming any of the risks of failure. This is the whole point of competitive markets as a means of price discovery. Krugman should be familiar with this. The suppliers will only incur such costs upon which they expect to receive a return. When doctors receive a high reward for buying an additional machine or spending extra time for a specialty credential, they will take the risk and gain the reward.

    Insurers can afford to pay doctors at rates actually higher than their patients could otherwise afford because of advanced quantitative risk management techniques. Risk managers are hired to hedge the risks of older, chronically ill patients with younger, healthy premium payers. The risk managers can further hedge risks by investing premia in assets outside of healthcare. Yes, risky derivatives and such. Risk management again is tremendously complicated work best left to experts, i.e., those receiving rewards of successful risk management in terms of bonuses or high salaries. These workers often have advanced mathematical degrees that allow them to assess probabilities and distributions and how to optimize a portfolio of diverse assets.

    Will some politically connected gov’t flunky be able to determine the appropriate level of reimbursement for a difficult medical specialty like ob-gyn? Will they be able to optimize a diverse asset pool to hedge the risks of a dynamic demographic distribution of insurance premium holders?

    Hell no. When this competitive cycle is broken — as Pelosi, Waxman and Obama intend — the system fails. What you supporters of this public option are asking for is the government to determine prices based upon the patients’ ability to afford treatment. By definition you get worse treatment! I don’t want that and I don’t want you to want that for me!

    Further, the bureaucrats determining the reimbursement rate have no “skin in the game.” They’re not obtaining the education or assuming any of the financial risk of med school or expensive machines. They have no information on the margininal costs of care. They’re horrible risk managers as the nation’s current fiscal and monetary failures demonstrate.

    I don’t care about Krugman’s credential or awards, he is wrong about this: “unregulated markets don’t work for health care — never have, never will.” Markets are our last, best hope to maximize social healthcare welfare.

    Reply
  14. Lee Leslie Post author

    Brenden -- I have respect for your pro-market, pro-individual, pro-capitalist, anti-tax arguments, but this comment seems better suited for with a job application as a medical insurance apologist -- do you get paid for this?
    Surely you don’t really believe this crap? You discount a Nobel-prize winner and then say that we should somehow trust these insurance companies because what they do is too complicated for us or government to understand? Where I have heard that before? Hmmm. Oh, yeah, hedge-funders and investment bankers preach that. Worked really well, too.
    Your argument that big-pharma takes tremendous financial risk in researching and marketing a new drug is true. Except big-pharma doesn’t develop new drugs. They buy them from small-pharma and government-sponsored university research. Big-pharma’s research is on marketing studies and their expense is bribing congress and doctors, forcing approvals through the FDA and buying TV time.
    Now for doctors -- I have tremendous empathy for their problem -- most practice areas have been totally screwed. I’d gladly skip an expensive test for an extra 15 minutes with a doctor, they just can’t afford to deliver service that way because of reimbursements.
    Then, of course, we have the for-profit hospitals, clinics and labs (owned by more conflict of interest types that they almost make incest seems a family value) who have to generate ROI on those state-of-the-art too-often-used multi-million-dollar-devices they must have to make their TV ads look sexy.
    I also take exception to your characterization of government employees. Political appointees don’t the business of government -- the civil service does. Admittedly during the Gingrich years they starved civil service and we lost a great many terrific people -- and, there was an grotesque attempt to subvert our laws by the Bush administration to replace qualified, experienced people with flunkies (Brownie keeps coming to mind), general our civil servants are descent, intelligent, hard-working people just like you and I.
    No. You haven’t convinced me to accept your faith-based argument that I’d be better off with corporate, for-profit, interest-conflicted, mega-insurance companies making decisions for me.
    In this respect, perhaps we are better off with the private option for you and the public option for me. I’ll happily invite you to join when your trusted insurance company cancels you after your next diagnosis.

    Reply
  15. Brenden

    Ah, Lee, you traffic in the most predictable, hackneyed leftist rhetoric that brought us to the current state of political leadership. “Medical insurance apologist,” puh-leeze. The payment I receive for engaging in arguments like these is to have public forum to demonstrate your ignorance and intellectual bankruptcy as you support a government that seeks confiscate private property without due process. Hmm, who’s the more facist? Now my turn to wax political since we’ve moved a bit off-topic.

    You’re demonstrating your ignorance by ad homenim arguments because you have no understanding of elementary, well, intermediate economics. As someone formally educated in this area, I am quite comfortable calling Krugman out on his faulty logic when it he throws it in my face and tries to make me pay for it. And what did he win his Nobel prize for, an interesting application of econometrics or game theory? No, it’s the leftist, politically-motivated drool his piddles all over the pages of the New York Times which happened to occur most frequently when his commrades staged a putsch on the awards committe. The Nobel Prize in Economics USED to be an academic prize, now it’s for the most-eloquent fabian socialist apologist runner up of the Peace Prize, usually reserved to the most eloquent anti-semite. Quite an irony for Krugman.

    Bottom line: you don’t understand my arguments, you are unwilling to educate yourself to learn their assumptions, inferences and conclusions — so you denigrate me with insults. To which I respond: “Whatever, dude.”

    “big-pharma” … “hedge-funders” … “must have to make their TV ads look sexy” … “Bush” … “Brownie” … “faith-based” … I reckognize all these politically-charged digressions as social currency you are paying the audience of the web site to turn them against me. I know quite well the folks who run this web site, and they know me. I don’t care. You’re, er, unsophisticated in your assessment of the problems and solutions to healthcare policy debate and I merely want to demonstrate that. I have exceeded even my own humblest expectations in this respect.

    You are not addressing the arguments, again because you don’t understand them. So you try to brand me a heretic. So very predictable and lame and 16th Century. So here comes the coupe de grace when insulting a leftist: I am smarter and more informed than you. Live with it.

    I win. All the best.

    Reply
  16. Billy Howard

    Speaking of hackneyed, how about the habit of conservatives to declare victory despite evidence to the contrary, like the Supreme Court appointing a president despite credible evidence he wasn’t elected, or that president declaring war despite credible evidence his reasoning was defective at best and made up at worst or the claim that we’re fighting for capitalism and a free market when the markets are already skewed so unfairly with loopholes and benefits for big business (including big pharma and insurance) that it amounts to reverse socialism, more like social-capitalism, feed the rich, starve the poor. And in a strange reverse world conservatives quit to serve and bring war on intellectualism and science, denying the most basic understandings of science with their ideology based in faith that their dear leaders are supreme and far be it from any of us to question them as they are so much smarter and wiser. Public schools have also been starved and the humanities are on their collective death bed, the bedrock of a civil society, thus a culture that doesn’t understand culture and is able to listen to big words strung together by same said quit to win politician who says nothing, which is exactly what it seems her followers want to hear. It allows them to listen without sticking their heads in the sand, but the effect is the same. So continue cheerleading for leaders who are bought and paid for by companies who care nothing for anything but the bottom line. They count their profits while the very people who are starved to pay for their lifestyles rally around the flag to protect them from the very people who the founding fathers sought to empower: The People.

    Reply
  17. Lee Leslie Post author

    Here are some options that come to mind in answer to the question you pose:
    1) Fact is overrated; gossip is more fun than fact; speculation easier than research; scandal more interesting than real life; blame is more comfortable than understanding; denial makes it easier to sleep at night; Twitter-length spin is the max of our attention span; celebrity news has led to vicarious fans of opinion; assignation of ideas has become our national sport.
    2) Infotainment, talk TV, talk radio, opinion blogs (like this one), have replaced literacy.
    3) We are sheep -- we love to hang out with other sheep, satisfied with the grass we have to eat, happy our shepherds will keep us safe from the wolves, and blessed we don’t pay much attention to those missing among us who were served on the shepherd’s dinner table.
    4) As long as we keep pointing fingers at each other, we won’t notice the barn door is wide open.
    5) There are just two teams to root for and you got to sit somewhere.
    6) My father (or mother or spouse or friend or boss, etc.) was a (fill in the blank).
    7) Accepting facts is a slippery slope that leads straight to eternal damnation.
    8) We live most of our lives on cruise control.
    9) I love America and to believe our (fill in the blank with a corrupt leader) is unpatriotic.
    10) The power given to our government didn’t come from the people, it came from our rich, white, powerful, founding fathers and it is still that way.

    Reply
  18. Matt Edmond

    I may be late to the discussion here, but Brenden was so proud of his discourse that he saw fit to forward this on to me. I won’t dispute that the free market generally does a good job of apportioning of goods and services efficiently, and that much of what’s wrong with the current system was caused at least in part by government intervention. The only reason we have a largely employer-based health insurance system today is due to the employer response to government wage and price controls during WWII.

    However, Brenden’s paean to the free market fails to acknowledge that several assumptions that must loosely apply for its proper functioning do not exist when it comes to health care insurance. Granted, I don’t have a fancy degree in economics like Brenden, but I’ll give it a stab anyway. Free markets should have many willing buyers and sellers. How does this apply when buyers are sick, or in fear of getting sick, and insurance companies operate with monopoly status with respect to individuals and monopsony status with respect to providers? Free markets should have free (or near free) and abundant information. How does this apply to health care? Have you ever asked a provider how much a specific procedure or service will cost? Give it a try some time.

    I await the dunce cap sure to be awarded by Brenden for my efforts…

    Reply
  19. Lee Leslie Post author

    I have asked providers how much specific procedure and services costs and encourage anyone to do the same. It is great way to be able to ration your own care. It helped me decide, for instance, whether to get my recent CT scans at Piedmont hospital (I live in Atlanta) for about $9,600 retail. Of course, Piedmont discounts the scans to Blue Cross by $4,800 (50%). Once my deductible is added ($1,500) and a co-pay is added $660, leaves me paying $2,160 (oh yeah, though they don’t mention it in their estimate, they sent the scans to Radiology Associates for reading -- retail: $740 which was discounted to $380, but Blue Cross would only pay $290, leaving me to pay the balance of $90.

    Or I could go to a quasi-independent Dekalb scanning firm that charges $1,770 retail, offers no discount to Blue Cross leaving me to pay all of it (they send it out to be read, too with the same result). Net savings to me of $390 which would be quickly eaten up by my doctor having them re-read at Piedmont for additional charges too complicated to present here.

    By the way, my doctor, considered to be one of the best in the world in his speciality, made a total of $80 (1/2 from me, 1/2 from Blue Cross) and that included 2 appointments with him and one with his PA.

    That’s one example of well the free-market system now works.

    Reply
  20. Lee Leslie Post author

    A couple aspects of this healthcare debate that I thought I’d read comment and haven’t have to do with the problems caused to American competitiveness. I know how we became the only country in the world where business pays for employee healthcare, I just can’t believe the Chambers of Commerce and other pro-business groups haven’t done something to change it.
    The auto industry’s #1 expense in building an American car is healthcare insurance. Healthcare costs are factored into the price of everything we make and is a huge contributor to our declining manufacturing capacity and mind-blowing trade defict.
    One of the primary reasons that laid-off older Americans are unemployable (except at Walmart who is now pro-public plan) is the potential company healthcare cost of hiring them.
    By far, the greatest part of disability claims against employers in healthcare.
    This doesn’t pass any common sense test, yet one of the major “reforms” planned in this bill is to REQUIRE every business to provide it. Seem anti-business. Where’s the outrage?

    Reply
  21. Brenden

    I have a few motivations for participating in this forum. One is my observation that our political culture is falling in love with central planners because, they hope, those planners will maximize social welfare. I know this is a tough pill to swallow, but in theoretical and empirical terms, the research shows that markets actually maximize social welfare for reasons I already mentioned. Fundementally: once the gov’t takes over, price discovery will disappear along with quality medical care.

    So 1) I agree with you all the employers should not provide healthcare; that we should all buy individual private insurance plans from private providers. 2) These private insurance providers should be able to compete in a national market.

    I also agree that insurers operate as regional monopolies in 50 states, under 50 state regulatory regimes. Obviously the cost in providing insurance in all these regulatory fiefdoms is a barrier to entry, limiting competition by other providers. So here is an instance where gov’t involvement acts anti-competitively against consumer interest. Doctors, too, face 50 state licensing regimes along with 50 state flavors of medical liability law. If we could normalize this regulatory environment, no doubt it would lower consumer costs. Why not start the reform conversation in this small-scale limited area? There is an example of a normalized regulatory environment that covers consumer transactions to lower costs: the Uniform Commercial Code adopted by all 50 state legislatures that covers most routine commercial transactions. We can do this. As Lee would say, where’s the outrage?

    I don’t deny there are many problems in the quasi-private system we have now. Patients are uncertain as to how much they have to pay; doctors are uncertain how much they will be paid by insurers. People are dropped and denied coverage. Hospitals billing different rates for the same procedures. I don’t have the answers. However, I know the solution is NOT to hand the system over to the government. The government will destroy it as similar government controls destroyed the Soviet Union, Zimbabwe, Cuba, etc., etc.

    You public-option lovers need to realize there really is no option involved here; Obama lies when he claims this. One of the favored left-lib-progressive malefactors supporting this measure is Wal-Mart. They realize to the extent they cover their employees now, at great cost, they will not have to do so under a public option. The low-skill, low-education labor markets will be the first moved into the public system. Insurers will have fewer premia payers, then the next lowest-skilled employee group will be moved into the public system — insurers will lose those policy holders. Eventually, they will reach the folks with fancy graduate degrees in economics. They will then not have enough policy holders to continue business and then private insurance will disappear or become so expensive as to be unattainable. Except for the politically favored classes.

    My other motivation for participating in this debate, on this particular forum, is to demonstrate that the supporters of healthcare nationalization engage in the most flimsy and emotional arguments. I don’t say I won the argument because I convinced anyone of my side but rather I won because Lee lost in a purely rhetorical sense, to wit:

    1) Emotional, non-rational arguments: “Ben Bernanke’s friends stay super-wealthy and the US government needs to screw me and my hundred million peers? F-them…”

    2) Contradiction: “I believe that national healthcare is the only answer,” Comment 14 versus Comment 17, “I have no desire to turn over the control to the government.”

    3) Every manner of boogey-manning, projection, deflection and as pretense to invoke fear of the fictional phantasmorphic specter of the horned, pitchforked Dick Cheney baby-stabbing his way to pressure-spray another barrel of oil to melt the ice caps of the pristine arctic wilderness: “Admittedly during the Gingrich years they starved civil service and we lost a great many terrific people – and, there was an grotesque attempt to subvert our laws by the Bush administration.”

    4) I indulged in the smarter-than-you bit because I know how libs HATE that any conservative would consider themselves in any way superior — while the lefties naturally assume their moral, intellectual and spiritual superiority — in order to wring out a bit more untethered, spittle-flecked rage… “And in a strange reverse world conservatives quit to serve and bring war on intellectualism and science, denying the most basic understandings of science with their ideology based in faith that their dear leaders are supreme and far be it from any of us to question them as they are so much smarter and wiser.”

    I was not disappointed. Anyway, I may not be smarter than you. But certainly no dumber.

    5) Resignation: “We are sheep”

    In a two-person argument, you subtract the (rhetorical) loser and are left with the winner. Not that it matters. Obama, Pelosi and friends (I assume many of you here are their friends) are trying to dismantle free markets, competitive advantage and spend/transfer national wealth to oblivion. I just want you folks who support them to be informed of the other side, and the flaccid intellectual foundations that support your position.

    Reply
  22. Lee Leslie Post author

    Brenden:
    You are right. It is a difficult pill to swallow. However, I suggest to you that whether the monopoly is owned by business or government your long-term result is close to the same -- a system no longer sustainable. The question is which can be best managed over time to the greatest benefit of our society.
    So should we just allow the game to play out? Let them reach a point where the business of private insurance and the various entrenched interests find their pyramid scheme can no longer grow? I suggest no. The price to individuals and to mainstream business would be too high.
    Then it becomes a question of how we dismantle or “reform” these institutions and how quickly. I suggest the Medicare lobby is too powerful to fold easily. Ditto the health insurance or pharmaceutical lobbies. The states have far too much budget pressures to enact broad changes with unknown consequences -- nor frankly could one trust managing legislation in 50 states when neither you nor I have any trust in managing the legislation in one -- our Congress.
    The system is broken. Unsustainable. Unfair. And, bad for business. It must be changed. I believe is too late for a small-scale limited area attempt.
    Medicare has proven its ability to provide care for 50 plus years and is still popular with those it serves. Public/private option and single payer systems -- whether run by government or independent agencies -- have been proven in much of the world to provide greater access to physicians, lower costs and more satisfied beneficiaries -- not the countries you mention, but France, England, Canada, Australia, Sweden, etc.
    I give you that political tinkering and dishonest funding of these public subvert our trust -- but that is the main point of this article. We must hold our politicians to higher standards. We must stop the revolving door of government and K-Street. We must change the way candidates raise cash to power their incumbencies (no, I’m not a fan of public financing of campaigns -- I believe campaigns should be limited to contributions of people).
    Yes, it is naive to think the political process will change. Just as it is that insurance companies won’t profit from “reform.”
    As for my rhetorical defeat, I will live to write another day. I don’t plan to trade my passion or “emotional” arguments any more than you would trade your liberal labels or class baiting. However, it isn’t a contradiction to believe that national healthcare is the only answer and still have no desire to turn over the control to the government -- most of the bitter pills we swallow end up that way.
    And finally, sorry to disappoint, but I love being with people smarter than me. It makes me better. It gives me hope. And it allows me to sleep at night knowing they are there. Thanks for stopping by.

    Reply
  23. Billy Howard

    Brenden, Like all the bullies I have ever known, you start a fight and then when confronted, claimed your purpose in starting the fight was to show how the other side liked to fight. Kind of a win-win for you. I would call this hypocrisy, but to be hypocritical requires a little self-awareness, so perhaps clueless is a better word. But, regardless of intent, you have a good point, and Lee has shamed us both by ratcheting down the rhetoric and creating a reasoned conversation on an important issue. Alas, neither of us deserve to be in that conversation as yet and both of us should sit in the principals office until we can play nice. As far as exposing liberals for their “spittle-flecked rage” (nice metaphor, by the way) have you ever heard Rush Limbaugh? ummmm, perhaps hypocrisy was the right word after all. To sum up: I WIN, I WIN! (oops, I just got spittle on my computer monitor.)

    Reply
  24. Brenden

    Too busy at the coal plant these days to listen to Rush. I guess I’ll cop to being a fear-mongering right-winger because you all should be scared. You should be scared that gov’t will adopt the public option and wreck the healthcare system and the economy. There isn’t enough money in the country to cover everyone. Notice the leadership isn’t talking about substantive trade-offs to pay for their policy. They’re running around screaming “Crisis!” and speaking only in the moral imperative. I’m not one to complain about interest groups or lobbyists — I know they’re bad, uhm-kay — because we need to get centered around a policy that provides the best care to the greatest number. In a democratical society, we should then be able to articulate this to the voters. If not, all is lost. Maybe Lee’s right and it already is, so then it’s time to feed the tree of liberty with the blood of the patriots and the lobbyists.

    I’m happy to support any measure that takes sensible steps to reduce cost through tort reform and national regulatory normalization of the medical and insurance industries. Lower cost and provide a LIMITED, sustainable social safety net to limited groups — certainly not to cover able-bodied and -minded working-age adults. I’m for a system that also forces all healthy working adults pay into the healthcare system to offset high-risk, chronicially-ill patients; one that punishes them in tax policy for not participating. I’m also for a system that focuses on prevention, that makes people who have preventable conditions pay more for their mandatory private insurance coverage. Punish with higher rates overweight, beer-drinking bacon-eaters like me, who indulges in the occasional Camel Light; I will respond. I’m for a system that takes the burden from the employers to provide care and puts it on the individual. I’m for a system of transparent pricing for consumers for drugs, procedures, etc., I believe allowing individuals to bid for these services in a competitive market (as opposed to their employers) will take us down the road to transparent pricing. I’m for a system that sensibly regulates risky investments by risk managers in the insurance industry. Most importantly, I’m for a system that protects innovation through economic incentive that has given us the greatest, most advanced — though most expensive — healthcare system in the world. I’m for a quasi-public/private regulated and financed healthcare system. But a sensible one.

    I don’t know if in my ideal system EVERYONE will be covered for every possible malady. People who want sex changes will certainly have to pay cash. The poor will definitely receive a lower level of care than the wealthy because they won’t be able to afford it. But if we get close, then the gov’t can go back to focus on its more important business: adjusting Earth’s temperature, developing futures markets for sub-prime mortgages, spreading democracy to third world countries, financing Social Security, awarding no-bid contracts, debasing the currency, organizing beer summits, supporting Honduran dictators, holding Treasury auctions, taking the UN seriously, masterbating interns and implementing Middle East peace. You know, all the projects that all those dedicated, thrifty, noble civil servants have acquitted themselves so honorably these many years.

    Reply
  25. Keith Graham

    I think everyone who has commented on this story could agree with Brenden on one point: that “we need to get centered around a policy that provides the best care to the greatest number.” We also seem to agree that the system we have today does not work as well as we would like and that some reforms are necessary.

    Reply
  26. Lee Leslie Post author

    Hey Brenden: Great post. It took over 10,000 words, but we’re on the same page. Except that I cop to being a fear-mongering left-winger. We should be scared. The devil is in the details, of course, or more likely, is writing them.

    Reply
  27. Terri Evans

    If Lee is right that the devil is writing the details in the healthcare plan, then we’re back where this debate began and to the story headline: Tell Congress to go to hell.

    Reply
  28. C Smith

    November of 2010 when we walk into a voting booth and stare at what choices we have the word “Incumbent” means GO TO HELL! Of course they will walk with “their” life time health insurance and if any of you guys that contributed here make a run for office I’ll vote to make your health insurance perminent. And if you screw up I’ll vote for you to take your health insurance and leave. Think I’ll run myself just for the health insurance.

    Reply
  29. Lee Leslie Post author

    Won’t work for me. I live in John Lewis’ district. The world needs him in Congress more than it needs me. Wish you luck. Let me know if you need non-financial help with your campaign. You might also contact your representatives in Congress. Write. Call. Email. Blog. Attend their events. Carry signs. Egg their houses, that sort of thing.

    Reply
  30. C Smith

    I haven’t demostrated of any kind since the 60s. I am sorry I commented on your article. I promise it want happen again.
    See ! That is the way people are getting elected these days. People just say the hell with it we will just let Washington go on as useual so I’ll let you go on as useual.

    Reply
  31. S. Baggett

    Lee- you have your work cut out for you. Krugman wrote a piece on the 6th about the town hall mobs who are not only showing up at meetings but who are sending a deluge of communiqués to key democrats. Given
    David Mayhew’s assessment, that members of congress are “single minded seekers of reelection”, my guess is that at this point, representatives do not know whether to “scratch their watch or wind their ass.”

    Reply
  32. Lee Leslie Post author

    S. Baggett:
    I believe you are going to see some change here. I just saw a new Gallup Poll (5% margin of error) showing that 51% of Americans nowbelieve their representatives should wind their ass.

    I’m afraid I have to discount some of the “astroturf” talk. People who are willing to spend their time (many not even being paid) to attend a public forum with their elected leaders, ask loud provocative made-for-youtube questions, carrying signs, shouting, etc., seems much more real than what is used at Boise State. One of the things that some might forget is that the opposition party represents almost half of us. They are motivated and organized. These people deserve some respect as they are demonstrating for, yet, another cause which is against their self-interest.

    What is it about liberals? The group willing to take to the streets against the wars, for civil rights, for gender rights, isn’t taking to the street on this issue? Fatique? Apathy? Laziness? Inconvenient? I don’t think so. I believe liberals are either working 2 jobs and don’t have time; looking for 2 jobs they can’t find and don’t have time; too sick and too poor to see a doctor and can’t get to a rally; are blogging about healthcare; reading blogs about healthcare; too polite to yell at leaders they voted for; or are on vacation. Love your thoughts here.

    I do believe the bill is in trouble. It has always been in trouble. It is so easier to get a campaign contribution from a company who will profit from increased spending through non-healthcare reform than from an individual too poor to afford health insurance. That, Mayhew’s assessment, and that the real work on the bill, any bill, is done by staff and lobbyists who write them -- seldom read until after the vote, and then too late.

    Reply
  33. S. Baggett

    Perhaps the reason that liberals are not taking to the streets is because we thought that we won the election- an election in which the majority of the country said that they wanted healthcare reform. And frankly, while we may be worried about cutbacks in Medicare, we are incredulous as to how anyone can actually believe the crazy euthanasia, death panel claims coming from the disinformation spokespersons. It turns out that President Obama is a pragmatist- willing to take 80% of the deal in order to get something passed. I suppose we have to decide if we believe that we should support a compromise, rather than risk achieving nothing after 2010, or if we think that we won, therefore we do not have to compromise. We can never forget what the Republican Party needs more than anything else -- gains in the mid-term elections. Nate Silver estimates that Obama will need about a 65-percent approval rating to hold the mid-terms. Make no mistake about this, there will be no republican support for the healthcare bill- a bipartisan healthcare bill is a paradox. The negotiations are with Blue Dogs whose seats are at risk. So we are back to David Mayhew.

    Reply
  34. Frank Povah

    Funny how some members of the financial industry like to use phrases such as “at the coal plant/face” to describe what it is they do. Is it because like the coal industry they deal in obfuscation and cling to Jurassic views of the world?

    Reply

Leave a Reply