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Tuesday, March 27. 2012
Instead of 2000-page Obamacare, with its vast new omnipotent and costly bureaucracies, they should have simply gone for Medicare for all. Eliminate Medicaid, Chip, etc. and put everybody on Medicare.
While I detest any expansions of government power, I think that, politically, it would have been more popular. Wrong, but more popular.
My preference would be to have the federal government out of medical care, and education, entirely. And out of a few other industries and enterprises too.
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Having been through the Medicare fiasco for two grandparents and three parents/in-laws and the Medicaid fiasco with a few foster children, I don't think so. The errors were atrocious. If people are not personally responsible for paying the bill or worried about their insurance increasing, they ignore such irritating little details -- like $10,000 here or $5,000 there -- not to mention misdiagnosis. That is why end-of-life care is so expensive. People are scared into outrageously expensive procedures that do nothing to improve quality of life.
An excellent example is a friend's mother who was diagnosed with breast cancer at age 94. The docs immediately scheduled her for PET scans, blood work and surgery to remove both breasts with follow-up chemo and radiation. My friend flew in to slow them down and get a second opinion. The second doctor suggested that treatment would not lengthen a 94-year-old's life span sufficiently to undergo all the discomfort and rehab time. She lived another three years in reasonably good health, visiting her great-grandchildren, enjoying her friends and hobbies, etc.
I have never seen anything improved by putting the government in charge. Education, housing, healthcare, pot holes? Amtrak, the post office, flood plain management?Anyone? Anyone? Anyone? Ferris Bueller?
I read your blog to get a balance (I think its balanced), objective discussion on the topics of the day. Your writing has helped me to formalize some of the things that I feel or think.
As to the government mandate for health insurance.....
I have the opinion that people think that it is inevitable that the government will be caring for you in the future. The underlying tone of this health care discussion is that the government will be wiping your a** because the insurance companies won't.
Wait a minute here....I thought I was buying health insurance, through my employer, so that the government wouldn't be wiping my......
I'm being the responsible adult and buying health insurance for future anticipated health problems and now society is saying that the inevitable provider is going to be the government?
I hear this all the time from progressives; you can't smoke because, "you will cost the government too much for your health care". Or, "you have to lose weight because the government will have to pay for your diabetes control". WHAT, I bought health insurance so that my health insurance will pay for my health care! Why do they think the government is going to jump in and take over my care?
In my mind, that is the crux of this whole discussion; we have a core group of society that ignores the responsibile course of adulthood and abdicates their responsibility to the big brother government. In so doing, they give the rest of society this "inevitable arguement".
We need to counter this arguement with some reasoned thinking and discussion.
The OP did say "wrong, but more popular." Presumably constitutional, too. But they didn't want to admit that that's what they were up to, so they were too clever by half.
We have to resolve the dilemma of being unwilling to watch sick broke people go without medical care, while at the same time being unwilling to admit that if we want to scratch that itch, we'll have to pay for it ourselves. There's no way to force people to save up enough money to enable them to pay for (or insure against) all their own emergencies. Some of them will always eat the marshmallow.
Let me interject one point here, which the liberals are studiously ignoring. Those folks who are residing here and do not have health insurance, I understand that they can [and are when they present themselves at an emergency room treated in emergency rooms. As I understand it, it is already a Federal law that those folks who are in need of emergency care should get it. Am I wrong about this? I think that the Democrats don't want us to know about this, because it negates the urgency of the Obamacare mandate.
They certainly can receive emergency medical care, however, who pays for it? Hospitals do get a never big enough check thru medicaid for providing this care but the physicians don't, while tax laws (and medicare rules) keep them from writing it off.
Its all a mess and not getting better as every one keeps reinventing the wheel.
BTW, ever read your explanation of benefits from health insurance? Amused that in my case, $250 of lab work is marked paid in full after I pay a $20 co pay.
Please correct your spelling mistake.
"federal government" is incorrect.
"feral government" is the accepted orthography.
When I'm not worrying about the outcome of this case, I worry that the benighted folks in Congress will try to substitute an "improved" version.
I suspect that a lot could be improved in the free market if physicians and other suppliers posted their prices. The current situation protects docs from customer complaints, but the customer has no way to make a considered choice. Too often the doctors themselves don't know what a prescription costs or what the specialist he just sent you to charges.
Paul Starr's "The Social Transformation of American Medicine" (Pulitzer 1984) is the definitive account of how we got into this mess in the first place. I have it, but haven't read it for years. I'll have to reread it.
"politically, it would have been more popular. Wrong, but more popular."
What Reich wrote in his article is what I wrote here on a different discussion thread just a few short days ago: had the Dems proposed a healthcare law that was based on a tax like Social Security or Medicare, the constitutionality of the law would not now be in doubt. That said, the problem of funding such a massive expansion of healthcare would not be solved just by reformulating the law so as to pass constitutional muster. The economic difficulties would remain, especially since we have been told that the Medicare trust fund is going broke faster than is SS. Legal or not, the financing disaster would be just a few short years off. Like the good Democrat that he is, Reich did not bother to address the issue of how an expansion of Medicare would be paid for....which of course is the problem for all the Great Society programs the Dems have imposed on the nation since FDR's administration. Somehow they never get around to figuring out how to fund the costly social welfare programs they back. They always seem to think the benefits are "Free".
Another issue that I don't see discussed often enough is the definition of a "minimally-sufficient amount of health-care insurance" that the individual mandate is supposed to purchase.
What is "minimal," and epecially important to this discussion, what is "sufficient"??
Should a man, without a family (parents, siblings, wife, shildren, etc.) be forced to pay for birth control? abortions?
Should a woman be forced to purchase coverage for prostrate cancer treatements?
Also, as jma pointed out, is one diagnosis sufficient? Will second opinions be allowed / covered?
Again, who decides?