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Topic: Government run Health care! yes or no?

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Vendetta

241. Posted:

WW, you needn't use me or my alleged "unbelievably simplistic and naive view" (laughable) as your excuse to give your hands the workout up there. Nor should you assume that I didn't read what you wrote earlier just because I don't get in line good-little-soldier-style with your views.
You make it sound as though healthcare insurance is like this maaaagic exception to free markets when insurance of all other types proves otherwise, and ooooonly Uncle Sam can come rescue us from the big bad corporate suits.
This conversation has become one of costs, primarily. And anyone who thinks the US Government is good - better than free markets even - at cost control is, well.... in need of a good optical insurance policy.

Edited on by Vendetta

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The_Fox

242. Posted:

warioswoods wrote:

Vendetta wrote:

Ciao Fox. The private industry competes on quality and price. They only ever increase the quality and/or lower the price to beat out other vendors. Airlines, PCs, electronics, automobiles, you name it. Healthcare insurance is no different. Being a profit-driven company is what keeps costs DOWN in a competitive market. If the US Government steps in the game, competition goes out the window. Private sector will compete with the government the way a cow competes with a butcher. Anyone who believes otherwise is deluded. Lower the costs to helathcare providers by taking them out of the crosshairs of ambulance-chasing shysters, and the costs they pass on to the insurance companies to cover the patients will be reduced also.

I am all for exception handling, whether by allocated taxes or medical industry windfall taxes or other means, the roughly 1 in 10 people (very agressive estimate) who don't have health care insurance and can't legitimately afford it - keeping in mind this number will be even less when costs are reduced.

Strange that you position yourself as the defender of all things capitalist and competitive, yet you have such a unbelievably simplistic and naive view of competition in the health insurance business (in any business it's far more complicated and prone to problems than your description, but we'll leave that aside for now). One of the core problems here is the fact that your two opening sentences are absolutely false. It would be nice if health insurers simply competed on quality and price; unfortunately this is one of those "products" that simply does not compete on the same grounds as others.

When an insurance provider takes you on as a customer, it's essentially examining you and making a calculated wager as to how much you are likely to cost them; in order to be a profitable insurance company, their number one mission is to ensure that you do not end up costing them more than you pay them. To attain this goal, they do several things. First off, they exclude patients who have "preexisting conditions," or who in other words already have health conditions that indicate that they would end up costing the insurer a good bit of payout. Next, even if you are accepted, they run a risk analysis of your current characteristics (any that they can legally access -- age, background, profession, etc), and try to set a price (and deductible, etc) that is high enough so that you'll pay them more in the long run than you'll hopefully cost. Now from these first two tactics (excluding and careful price-setting to cover what you'll cost them), they will certainly get it wrong sometimes and have you cost them more than you paid in, but a successful insurance company is simply one that manages to beat the curve and predict your costs better than others.

The third way that health insurance providers ensure you don't cost them more than you pay--and this is the most problematic tactic of all--is that they obfuscate the insurance you are purchasing, so that it is very difficult to understand exactly what scenarios will and won't be covered, because there will be all manner of loopholes and hidden conditions that will allow the insurance company to avoid paying for expensive treatment right when you need it. This is a much bigger problem for health insurance than for any other type of insurance, for the matters involved are extraordinarily complicated, and most consumers simply aren't prepared to read through and give a sound appraisal of all the fine print regarding how their insurance will respond to different scenarios, and the insurers depend upon this lack of transparency in order to profit from you. Coming just after the tremendous financial meltdown of last year, one should hopefully be aware of just how severe a problem obfuscation and lack of transparency can be, as that is precisely why all the mortgage-backed securities and other increasingly complex financial derivates distorted the market and eventually imploded: they, just like health insurance, reached a level of complexity and opacity that kills the proper connection between the consumer and the knowledge of exactly what it is that they are purchasing.

As for your final sentences in the quote above: even though you claimed a few posts above that you read all the preceding posts, you clearly didn't read my long post on page 10, or perhaps skimmed it a bit too quickly, for the fact is that you have causality somewhat backwards: costs are not likely to come down in the individual insurance market, or in health care in general, unless we can get those that are currently uninsured into the system. That's based on two larger arguments that I won't repeat here, but in summary: a larger risk pool means better prices across the board when it comes to insurance, which is a basic principle of how insurance works; second, the uninsured are already costing all of us a fortune and killing efficiency at hospitals across the country, as they get no preventative care and just show up to clog emergency rooms when their problems become too severe to ignore.

Well, Warioswoods, you have summed up my thoughts on it better than I could have, I think. I'm going to try to limit my exposure to this thread today, though, as I don't really want to find myself getting all worked up again.

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Vendetta

243. Posted:

The+Fox wrote:

I'm going to try to limit my exposure to this thread today, though, as I don't really want to find myself getting all worked up again.

Yep, it's better for our health. ;)
Seriously though - we've pretty much said what we had to say. I'm okay walking away from this thread knowing we share good will and intentions for our neighbors. And while I might post here again at some point, I'm looking forward to seeing you and everyone else in other, more light-hearted threads.

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Zenman

244. Posted:

brooks83 wrote:

Zenman did you watch that vid? That was the proof you asked me to link

again, even if the insurance companies are eliminated, couldn't the employees get hired by the government insurance OPTION... also, statements made in 2003 are probably not in the bill; and if they are, at least we won't get screwed by insurance filing an HMO...did you knoww that even nixon opposed them? NIXON!
EDIT!: i am glad to see that at least vendetta aggrees that everyone should have good health insurance, even if we cant agree on how! :D
EDIT2: @ vendetta agreed, i have no hard feelings toward any of you guys, i just see it as healthy debate

Edited on by Zenman

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warioswoods

245. Posted:

@Vendetta

It's not a "maaaagic" exception to free markets, it's a very complicated one, but that you have so far only portrayed in a cartoon version of capitalist competition, whereas I've opened up a debate about all the ways in which it clearly is not an area where the usual models of competition for a better product apply (and insurance of other types does not prove otherwise; I specifically cited issues where health insurance is uniquely prone to certain problems such as obfuscation and opacity, but that's just the start of the problem, one could workout one's hands a whole lot more and not even begin to scratch the surface of the issue). This is not a topic for the usual capitalism vs. socialism nonsense, as the issues are far more interwoven here and require a great deal of precision if we're going to sort out any viable solution.

Case in point:

This conversation has become one of costs, primarily. And anyone who thinks the US Government is good - better than free markets even - at cost control is, well.... in need of a good optical insurance policy.

The fact is that the present debate can't be framed so simplistically as government vs. private. You do realize that the government is already effectively subsidizing employer-based health care, yes? The reason that we have a model that depends so heavily on employer health care is that, long ago and for reasons largely unrelated to the present debates, any health benefits or coverage provided by employers was deemed 100% tax exempt. What that has done is to distort the way health coverage operates in several ways, and to cause incentive problems that we're still grappling with.

Case in point: a very substantial part of the crippling legacy costs that helped to kill our auto industries came from precisely this issue. Decades ago, when the auto makers were negotiating with their employees over benefits and compensation, they opted, like many companies, to provide great health benefits, rather than simply raise the wages, because it was a way of giving a tax-free compensation that would not cost the company all that much in the short term -- but in the long term, once your original workforce enters old age and retirement, those costs skyrocket. Our automakers ended up in a situation where they were paying more for health care than for parts and supplies, which shows the absurdity the employer-based system can easily lead to.

It's a basic issue of time-distorted incentive, which again is exactly the sort of thing which helped lead to the recent crisis, as the incentive for financial institutions became weighted far too heavily in favor of short term gain through high risk exposure, leading to a process where long-term collapse became inevitable. This can't be framed as a matter of individual irresponsible firms or companies that made the wrong decisions, either, for it's now become necessary for any large employer in the middle or higher salary range to provide health benefits for its workers due simply to the fact that purchasing it as an individual puts one at a severe disadvantage, because you don't get the crucial advantages of a larger pooled buy-in and therefore have your insurer essentially calculating a way to make certain you don't end up costing them more than you pay them as an individual.

You should recall that Obama initially proposed taxing employer provided benefits to pay for the necessary subsidies and new regulations to make it possible for individuals to buy into larger pools outside their employment with terms that are set out in clear packages mandating exactly what insurers must cover and the ways in which they may not deny membership or coverage. That was unpopular and had to be dropped, but it's not a left-wing matter: recall that McCain (advised by his free-market economists) wanted to do exactly the same thing with regards to taxing employer-provided health coverage in order to correct the distortion and provide funding to subsidize individuals to buy in on their own at a more reasonable price. The problem with his plan was that he didn't see the need to properly regulate the terms of the insurance to be provided, and even opened the door further to complete deregulation by suggesting that one should be able to buy across state lines--one shouldn't be in any illusion as to what that means, as states are the ones that specify their local fair terms or what must be covered, who you can't deny, what demographic details you can use to price someone's plan, etc. If you can buy outside your state, all regulation disappears and the obfuscation / opacity problems that cripple individual healthcare purchases only deepen. McCain also didn't see the urgency and benefit of getting the largest number of uninsureds possible into the system in order to stop the clogging of emergency rooms and widen the risk pools according to the basic principals of insurance.

Again, as I stated in my longer post, the real issues at stake are ones that have everything to do with making our workforce more competitive, but in a way that is outside the terms you keep trying to use to frame the conversation. The fact that our current system makes purchasing insurance as an individual so costly and problematic leads to less mobility and flexibility in the workforce, more difficulties for the self-employed and for those who primarily do contract work, and generally less efficiency in the basic sense that all economic theory uses that term.

Again, we are already subsidizing health care through employers by way of the complete tax exemption, and we are already providing enormously popular government-based coverage for seniors through Medicare, but what we need to do is: restructure in order to make it easier and less costly for individuals to buy health insurance, get more people into the system who are pulling hospital / clinic efficiency down by not having proper access to preventative care, regulate the terms so that the consumer can get a fair deal without all the loopholes that will allow their provider to cut them out of coverage when they need it, and, most importantly, we need to stop acting as if this debate has anything to do with socialism vs. capitalism.

Perhaps I came off more hostile than I intended with the remark that you hadn't read my post, but that was in direct response to your post a page or so back where you claimed that you had read everything in the thread and found nothing that in any way challenged your statements. That's false: I'm challenging the entire thought process you've used to argue in this thread, and you haven't once descended into a single real detail of the policy matters that are at stake, instead opting to keep beating the dead horse of private vs. public, even conflating the difference between public ownership or management of health care (which is not under debate) and public insurance or publicly regulated / subsidized private insurance (which is a big part of the conversation right now).

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Zenman

246. Posted:

wow WW you could be a politician with those arguments!

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RabidPikachu

247. Posted:

Pikachu says Obama is taking too many risks. If this health care thing goes through people will abuse it. Plus abortion scares me.

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WolfRamHeart

248. Posted:

Ugh, the abortion issue has risen. I'm outta here!:P

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RabidPikachu

249. Posted:

WolfRamHeart wrote:

Ugh, the abortion issue has risen. I'm outta here!:P

Well a girl can die getting one, especially if the dr. doesn't know what he's doing. Plus what did the baby ever do to her?

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Zenman

250. Posted:

^ yep...the devolving of this thread is accellerating!
I

Edited on by Zenman

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The_Fox

251. Posted:

Zenman wrote:

^ yep...the devolving of this thread is accellerating!
I

I agree with you there, Zenman.
RabidPikachu, the topic is already charged enough. Bringing abortion in really won't add anything.

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Turbo_Genesis_64

252. Posted:

RabidPikachu you are entitled to your fears.

However, some women might be more likely to keep their child if their was universal health care available for her and her family.

Personally, I don't believe anyone uses abortion as their choice of birth control. That's like saying I'm not going to brush my teeth or get dental cleanings I'm just going wait to get an extremely painful and vastly more expensive root canal every 7 years. It doesn't make sense. Also, that overly simplifies the hardest decision of their life.

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Zenman

253. Posted:

The+Fox wrote:

Zenman wrote:

^ yep...the devolving of this thread is accellerating!
I

I agree with you there, Zenman.
RabidPikachu, the topic is already charged enough. Bringing abortion in really won't add anything.

Untitled
that is all.

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RJay

254. Posted:

No one...and I mean no one is going to win this argument. Everyone has their own beliefs and no one is going to ever be swayed.

How about we settle this with a game of Water Warfare. Those against National Health Insurance on one team and those for it on the other!!! lol

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Unca_Lz

255. Posted:

RJay wrote:

No one...and I mean no one is going to win this argument. Everyone has their own beliefs and no one is going to ever be swayed.

How about we settle this with a game of Water Warfare. Those against National Health Insurance on one team and those for it on the other!!! lol

That would never end either. That's like an argument between Republicans and Democrats over whose ideals are better for the country

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Machu

256. Posted:

This is just silly. Now we have crazy right wing Americans bashing the NHS, prompting the British public to defend the system they are proud of. I'm disgusted. welovetheNHS

Untitled

I'm not generalizing here (so don't take offense), but there are some major fruit loops over there, I even heard one guy on the radio comparing Obama to Hitler. Beyond belief! :O

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The_Fox

257. Posted:

@Machu
Sadly the health care talks are getting plain ugly over here. And those comparing Obama to Hitler are just crazier than a sh*thouse rat. I blame Fox News, myself.

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Machu

258. Posted:

@The Fox: It must be getting crazy over there, because it has now spilled over here. A whole hour on BBC 5live this morning, and pictures of kids with protest placards on the news. Needless to say I now know more than i did when i first barged in here. :)

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Rawr!

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The_Fox

259. Posted:

@Machu
Just be glad you don't have the town hall meetings over there. What those people lack in knowledge they make up for with a combination of screaming and yelling, with a splash of delusional paranoia thrown in. By the time this is said and done everyone is going to be sick of the words health care.

"The government of the United States is not, in any sense, founded on the Christian religion."

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Treaty of Tripoly, article 11

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Machu

260. Posted:

@The Fox: It sounds like you are already. :)

Unfortunately, Obama may have to get used to this kind of reaction, as it seems in places the protests are aimed at him and not the actual issue on the table. Oh well, I wish him luck, he's gonna need it.

Rawr!

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