WSJ - you won’t be able to “keep your health-care plan”

[Anonymous]

1426--we sort of have the stacked town hall when Obama did his "informerical" on ABC. Love also how he tells which reporters will be called on ahead of time. Bet that doesn't affect the questions at all.

[Anonymous]

Anonymous wrote:

Then why don't they follow that advice when building the roads or subsidizing the airports or subsidized home ownership through the mortgage interest deduction or paying for public school and subsidizing state universities? Somehow someone decided they owed me a chance with regards to these items instead of making me pay the full cost.

One might argue that it is in the interest of society to pay for these public goods. I would argue that this is true as well with health care. A country cannot be a strong democracy with a huge gap between the haves and the have nots. While our gap has not been as large as that of other countries, it has been growing in recent years. I am interested in the long-term survival of our democracy and I don't see it as being in our interest to have a segment of our society which is impoverished through medical bills.

The Constitution envisioned the funding of common "public goods" when it provided a taxing power to Congress. Roads, airports, and railroads are the historically cited fundamental examples of "public goods," and, when you think about it, it makes sense because those "goods" truly benefit ALL of us, in the sense that roads, airports, and railroads not only carry people from state to state, but also provide for the broad interstate transport of goods. Moreover, because public goods -- by definition -- benefit everyone, no one individual is generally inclined to provide for that good. In other words, its is unlikely that Amtrak would have invested in a nationwide system of public rail. That is an instance where the government must step in for the public benefit.

Your argument that this should apply to health insurance doesn't translate. First, it is questionable whether health insurance is a "public good" in the sense that some need it, some don't; some want it, some don't. The backbone of society does not rely on the provision of insurance in the way that it does rely on the these other goods discussed above. Second, private insurers -have- stepped in to provide this product to society, presumably prior to the government's involvement. And where it has not done so, the government has provided backstops in the form of Medicare and Medicaid. As I noted in my lengthy diatribe above, I am not opposed to the idea of the government providing a backstop where absolutely necessary; but to usurp private competition where utterly unnecessary is the last thing that the federal government should be doing, particularly where there are other viable, less damaging solutions (e.g., simply mandating insurance coverage and providing a Medicare-Medicaid hybrid to those who cannot get coverage due to pre-existing conditions; removing the antitrust exemption; and allowing insurers to cross state lines to compete).

Your second point is rather unrelated to your first, and very similar to Jsteel's comments. You are simply reiterating your viewpoint that a "strong democracy" cannot exist where there is a "huge gap" between the "haves" and the "have nots." I disagree. I believe that a "strong democracy" is one in which the government does -not- take care of everything for you. And I think you bring up a great point with mortgage interest deductions -- the tax system incentivizes certain behaviors, one of which is home purchasing -- and look where that got us. But again, this appears (to me) to be unrelated to your original "public good" argument vis-a-vis health insurance.

[Anonymous]

I'm the PP from above at 14:46. I should also add, that if we were to extend the "public goods" argument to cover health care, where would it end? Shouldn't we then cover housing, transportation, and other 'fundamentals' that some of us can afford and some of us cannot?

[Anonymous]

PP - I agree. Moreover, the public good analogy does not relate to healthcare where people are responsible for the taking care of themselves, and failing that, must have health care provided to them. It's like saying a person can take a jack hammer to a public road and expect the government to come fix it without the person having any responsibility for paying for the fix. Too many people ignore their own health or worse, damage themselves through behavior (for example, smoking) and then expect the publich to pay for them to get healthcare.

Or the person who comes over the border, hand out, without ever paying a lick in taxes.

And there is no even distribution of taxes. I pay more by percent in my income than lower brackets, AND I AM SUBJECT TO THE AMT - therefore, about the only "real" deduction I get is my mortgage, but not even my charitable contributions are deductible.What I pay in state taxes sure isn't, but it is for lower brackets. Gee, I am already paying more than my share. A share I work hard to earn. My new favorite (forced) charity is going to be the Obama health plan. Forget what I want to give and to whom. If I don't want to lose my house, I'll need to cut back once my pockets are wiped clean by Obama. I can't save for my daughter's school or my retirement. It goes out the door in taxes. My daughter won't be eligible for financial aid or federal loans because I "make too much", so how is my daughter gong to go to college? Wait, she'll have to go into debt or I won't be able to retire until I am 80. I waited to have kids so that I could support them, but all that did was put me in a higher tax bracket to be robbed of her school money and my own future. I made good choices, played by the rules, always, even when broke, found money for my own health insurance, but now I have to pay for others who didn't. That's not democracy or the free market foundations of this country. That's Socialism. Plain and simple.

And the ridiculing of those who speak up in the town halls is the hallmarks of repressive rule not a government for the people.

If you want to fix health care, and not run all the doctors out of the business, then there needs to be a serious study of how insurance companies work, and how doctors get paid. It's fundamentally flawed. I feel sorry for the doctors out there and the AMA is out of its mind.

[jsteele]

Anonymous wrote:
I am very late to this game, but I so vehemently disagree with this that I can't resist chiming in here:

"we don't know what, if any taxes, will be included"

Yes, actually, we do -- the surcharges against the so-called wealthy have already been announced. This means that my husband and I will be paying more out of our pockets -- even though we have good insurance that we are happy with -- to support you and yours. That makes me angry. What we don't yet know (and here's where you are right) is whether the so-called "middle class" will now also be on the hook for the bill (given the statements last weekend -- "whatever it takes"...).

You may want to review the legislative process. Laws are not created by announcements. A single House committee has proposed a surcharge. The House has yet to agree on a single bill. I am not aware of a surcharge proposal in the Senate, but important Senate committees that must act on this bill have not even released drafts. So, we don't actually know what will be in the final bill. Second, you will never be supporting me and mine. I am quite capable of supporting myself and mine and don't require nor desire your assistance. In fact, I may even end up with a surcharge.

Anonymous wrote:
"we don't know the cost of the public option"

Didn't the CBO just release its estimates of the cost of Obama's plan that absolutely dwarfed the administration's estimates of the same? Haven't several economists made the point (even Obama's own economists this past weekend, indirectly!) that you can tax us "Richie McRichies" to high heaven and it still won't cover the costs of this trainwreck?

The CBO released a preliminary estimate based on one House bill. The CBO has subsequently said that the public option actually lowers the cost. I have no idea what you refer to in your second sentence.

Anonymous wrote:
"we don't know what will be offered in the public option" / "Because the "rationing" you fear is already taking place with faceless insurance company bureaucrats who are paid not to pay for our services making the decisions. I have experienced within my immediate family what it is like to have the insurance company refuse to cover procedures."

We don't know for sure, but here's where your Pollyanna responses to other PPs really bother me; how do you suppose the government will attempt to (a) extend health care coverage whilst simultaneously (b) allegedly control costs? It's not possible without some form of (aggressive) rationing of care. This is just common sense. You don't need to know the details of any plan to understand the economics of (a) more care plus (b) lower cost = lower quality of care. The worst part of this plan, unfortunately, is that (see above to the "cost of the public option" comment) the cost of the care will likely -not- be lower, but the quality of care will be.

Actually, do need to know the details. Commenting without knowing the details leads to confusing false assumptions with common sense. Take any basic private insurance policy available today and remove the corporate profits, corporate taxes, and outrageous executive compensation. Voila, you have a plan that provides the same coverage at a lower cost. Now, offer that plan to the currently uninsured. Get those people using normal medical care rather than the emergency room. Use economies of scale to get lower costs on medicine, supplies, etc. Now, you have extended the same coverage to others while achieving cost savings.

Anonymous wrote:
As for the latter point, this is certainly true, but right now people have a choice to go to another (more expensive plan) that suits them better. That choice won't exist if the new monopolist (the government) wipes out the competition. Then you get one choice, period.

There is no proposal on the table that would wipe out private insurers. Not everyone has the choice to join a better plan. If your employer offers a crappy plan, you would have to purchase individual insurance at a considerably higher cost that may not be feasible. Also, such insurance may not even be available due to pre-existing conditions, etc.

Anonymous wrote:
"Because reducing medical costs for everyone will benefit you"

Possibly true, given the system we have now, whereby the uninsured are treated in emergency rooms. I'd be interested in seeing some hard numbers that would actually compare what we pay for the uninsured now versus what we will pay to insure those same people. Some economic data might make me more inclined to support some type of "universal" coverage for those currently uninsured (if I will actually be paying less in that scenario). however, given the surcharges that will be directly applied to my taxes, plus the fact that I will still be on my employer-based insurance coverage (presumably paying the same amount), I don't believe that, overall, I will be paying less because some amorphous "total" number is reduced. (If indeed the total costs are reduced.)

Now, you are on the right track. I doubt any "surcharge" -- if there even is one -- would be noticeable to you. But, insurance for the uninsured would be very noticeable to them.

Anonymous wrote:
"Because when our citizens are healthier, the entire country is better off."

This is just moralization on your part; you believe that, I don't. I believe that you're responsible for keeping you healthy, and I could care less whether or not you do that.

Yep, that's were you and I are different. If I saw a sick person in the street, I'd stop and help. I assume that you would be aggravated by any delays that might be caused.

Anonymous wrote:
"Because a lot of our fellow citizens are one medical emergency away from bankruptcy, and that shouldn't be the case"

Again, this is moralization and a subjective point of view (a very liberal one); I have a fundamental belief that differs from yours, and that is that -I- shouldn't be paying the bill to keep someone else away from bankruptcy.

I hope that you will never find yourself facing a medical emergency that drains your financial resources. However, if you do, I hope you won't encounter people who hold your attitudes.

Anonymous wrote:
"Because lower health costs will help make American companies more competitive internationally."

This assumes lower health costs. An alternative solution would be lower taxes. But, from your other points, I'm guessing that you're part of the "high taxes are patriotic" crowd. (Please get back to me if/when Obama raises your taxes. I'll be pleased if you feel the same way then.)

I will happily pay additional taxes if they will go to protecting the health of my fellow citizens. My parents and grandparents drilled in to me that your health is the most important thing. You can loose anything else and still go on, as long as you have your health. People once felt as you do about public education. Why should my tax dollars go to educate the children of those refuse to pay for school themselves? Then, people realized that the more educated our citizens, the better our country. In time, you will realize that the same is true for healthcare.

[Anonymous]

Anonymous wrote:I'm the PP from above at 14:46. I should also add, that if we were to extend the "public goods" argument to cover health care, where would it end? Shouldn't we then cover housing, transportation, and other 'fundamentals' that some of us can afford and some of us cannot?

But we are covering housing (mortgage interest deduction), transportation (subsidizing roads, mass transportation), and other fundamentals (education). As well, we provide Medicare to everyone over a certain age. Everyone gets it whether they worked hard or not and we as a society are better off for it because it keeps the elderly from being a burden on society and their families.

Some of you are so willing to take 'public goods' from the government when it comes to Social Security, public schools, state universities, police and fire fighters, Medicare, mortgage interest deductions, and subsidized student loans. Do you convince yourself that you deserve it or do you decide it is good for society in general? Well, the fact is that you get it whether you deserve it or not (your worthiness has nothing to do with it) -- the reasons these things are out there is because those who promoted them were convinced they was good for our society, making it stronger.

But if your primary concern is to make sure that unworthy people don't get government help, then it's time to throw out most of the programs I mentioned. Why should a lazy student be able to go to a public school? Why should an active alcoholic be able to drive on the roads? Why should an old person who has never saved any money be able to use Medicare? Why should someone who is generally a jerk to other people be able to call the police and ask for help? Why should a smoker be able to call the fire department when s/he carelessly starts a fire with a cigarette? The answer is that our society functions better when people can rely on public safety programs and learn how to read and write and calculate at school and can promote commerce via the use of the roads/trains/airports and when people don't have to struggle in their old age. The fact is that we're all benefiting from public goods already and it's time to be honest about that. But if you're willing to give all those things back and go it alone entirely on your own, then I'll be more convinced that you really adhere to the notion that people should pull themselves up by their own bootstraps and I can respect that.

[Anonymous]

I haven't seen this posted on the health care threads but I am wondering how a public option might affect research and development. Right now, Canada and the UK benefit from the many drugs and health care technologies we develop in the US. Sure, they are covering all of their citizens but they also have the benefit of another country, the U.S., which puts an enormous amount of money into research and development. They also use our private health care system as a back-up plan whereby they can always come see a specialist in the US if they have enough money. What happens if we end up with a single payer/public plan here? Will innovative technologies continue to thrive? What great health care research has come out of the UK? They have some of the worst cancer survival rates around.

[jsteele]

Anonymous wrote:I haven't seen this posted on the health care threads but I am wondering how a public option might affect research and development. Right now, Canada and the UK benefit from the many drugs and health care technologies we develop in the US. Sure, they are covering all of their citizens but they also have the benefit of another country, the U.S., which puts an enormous amount of money into research and development. They also use our private health care system as a back-up plan whereby they can always come see a specialist in the US if they have enough money. What happens if we end up with a single payer/public plan here? Will innovative technologies continue to thrive? What great health care research has come out of the UK? They have some of the worst cancer survival rates around.

Are you seriously suggesting that insurance companies have an important role in medical research and development? I am not aware of AETNA or Blue Cross supporting the NIH or CDC. In fact, those institutions are bastions of state-funded (socialist) research.

[Anonymous]

"You may want to review the legislative process. Laws are not created by announcements. A single House committee has proposed a surcharge. The House has yet to agree on a single bill."

Okay, I'm just going to respond by rolling my eyes here (unfortunately, you can't see me). I went to what's considered a pretty decent law school in this country, so I've taken Admin and Con Law, and have heard of this thing you refer to as the "legislative process," thank you. Perhaps you're privy all of the back-room House/Senate outrage at the proposed surcharges? Oh, wait -- you haven't heard any outrage? Yeah, neither have I. So I'll continue to assume that what has been proposed will actually be implemented.

"The CBO released a preliminary estimate based on one House bill. The CBO has subsequently said that the public option actually lowers the cost."

When has the CBO released anything suggesting that the public option -lowers- the cost? Please cite to a reputable source.

"I have no idea what you refer to in your second sentence."

I'm referring to the fact that numerous sources, including the CBO, have suggested that there is no conceivable way that the surcharges currently proposed by the Obama administration could pay for the massive increase in spending that would be required to pay for it.

"Take any basic private insurance policy available today and remove the corporate profits, corporate taxes, and outrageous executive compensation. Voila, you have a plan that provides the same coverage at a lower cost."

Talk about false assumptions and oversimplification. Because government intervention always leads to lower cost. (I'm rolling my eyes again here, FYI.)

"There is no proposal on the table that would wipe out private insurers. Not everyone has the choice to join a better plan."

Okay, I'm going to try this again -- when one large company is able to undercut its competitors through unfair advantage (say, the government), competitors cannot survive. I never suggested that the government is proposing to get rid of other insurers (although, in my view, that's clearly the ultimate goal); I merely suggested that the establishment of a dominant player with strong advantages typically leads to that outcome. Perhaps you've heard of this thing we call antitrust and competition policy?

"Yep, that's were you and I are different. If I saw a sick person in the street, I'd stop and help. I assume that you would be aggravated by any delays that might be caused."

Very smug for someone who appears to have a much better grasp of flowery ideals than of hard facts.

"I will happily pay additional taxes if they will go to protecting the health of my fellow citizens."

You're certainly entitled to your point of view, just as I am entitled to mine. What bothers me about your string of posts is that you present your opinions as "facts" (for example, your "supporting facts" for "Why You Should All Support Obama's Health Care Plan"), when they are anything but. I appreciate that intelligent people can differ as to their opinions on matters, but you seem to be suggesting that no one else can have a valid opinion on the topic because we should all feel the same way you do. Obviously, we do not.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm the PP from above at 14:46. I should also add, that if we were to extend the "public goods" argument to cover health care, where would it end? Shouldn't we then cover housing, transportation, and other 'fundamentals' that some of us can afford and some of us cannot?

But we are covering housing (mortgage interest deduction), transportation (subsidizing roads, mass transportation), and other fundamentals (education). As well, we provide Medicare to everyone over a certain age. Everyone gets it whether they worked hard or not and we as a society are better off for it because it keeps the elderly from being a burden on society and their families.

Some of you are so willing to take 'public goods' from the government when it comes to Social Security, public schools, state universities, police and fire fighters, Medicare, mortgage interest deductions, and subsidized student loans. Do you convince yourself that you deserve it or do you decide it is good for society in general? Well, the fact is that you get it whether you deserve it or not (your worthiness has nothing to do with it) -- the reasons these things are out there is because those who promoted them were convinced they was good for our society, making it stronger.

But if your primary concern is to make sure that unworthy people don't get government help, then it's time to throw out most of the programs I mentioned. Why should a lazy student be able to go to a public school? Why should an active alcoholic be able to drive on the roads? Why should an old person who has never saved any money be able to use Medicare? Why should someone who is generally a jerk to other people be able to call the police and ask for help? Why should a smoker be able to call the fire department when s/he carelessly starts a fire with a cigarette? The answer is that our society functions better when people can rely on public safety programs and learn how to read and write and calculate at school and can promote commerce via the use of the roads/trains/airports and when people don't have to struggle in their old age. The fact is that we're all benefiting from public goods already and it's time to be honest about that. But if you're willing to give all those things back and go it alone entirely on your own, then I'll be more convinced that you really adhere to the notion that people should pull themselves up by their own bootstraps and I can respect that.

I explicitly referred to mortgage interest in an earlier post as one of those crazy things that should not exist. Moreover, as you suggest, in principle, I happen to be against MANY of the programs above that you describe. We can have a discussion about social security and Medicaid on another threat, however. This one is about health care.

[Anonymous]

oops -- typed too quickly; I meant "mortgage interest deductions" and "thread" ....

[Anonymous]

Anonymous wrote:

I explicitly referred to mortgage interest in an earlier post as one of those crazy things that should not exist. Moreover, as you suggest, in principle, I happen to be against MANY of the programs above that you describe. We can have a discussion about social security and Medicaid on another threat, however. This one is about health care.

Yes and this thread is about whether providing health care insurance is a useful public good -- and therefore a discussion of other public goods and why they should or should not exist is completely relevant to this thread.

And as I said, I assume you're willing to reject the other public goods from which you could benefit given that they are so corrosive to the average person's soul. BTW I never mentioned Medicaid -- it is not a universal public benefit -- I specifically addressed Medicare, which everyone will get if they live long enough. Feel free to go out and get your own health insurance policy instead when the time comes.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

I explicitly referred to mortgage interest in an earlier post as one of those crazy things that should not exist. Moreover, as you suggest, in principle, I happen to be against MANY of the programs above that you describe. We can have a discussion about social security and Medicaid on another threat, however. This one is about health care.

Yes and this thread is about whether providing health care insurance is a useful public good -- and therefore a discussion of other public goods and why they should or should not exist is completely relevant to this thread.

And as I said, I assume you're willing to reject the other public goods from which you could benefit given that they are so corrosive to the average person's soul. BTW I never mentioned Medicaid -- it is not a universal public benefit -- I specifically addressed Medicare, which everyone will get if they live long enough. Feel free to go out and get your own health insurance policy instead when the time comes.

Yes, I am willing to reject many other so-called public goods. As I said earlier, the true definition of what a "public good" is should be much narrower than what the government currently supports. You did say Medicare, not Medicaid; my apologies, I was responding quickly. I don't know how I feel about Medicare, I'd need more time to consider the issue. If we overhauled health care regulation (again, by freeing companies to cross state lines to compete, removing exemptions, possibly dealing with the malpractice issue as well), then I can't see why seniors could not find a private insurance plan that would be right for them. But, as it stands now, I'm not sure how accessible insurance plans are to retirees (I suspect not very).

As for police, fire fighters, and the military (which you don't mention), those would clearly fall under my earlier definition of "public goods" that must be provided for by government because they benefit ALL and no individual would have the incentive to finance or raise an army, a fire-fighting force, or a police force otherwise. These are the very limited functions that a government should provide. I personally feel the same way about public schools, but I am sure that someone could point out to me that this may an inconsistent viewpoint.

As for social security, it's appalling, and I'd get rid of it. But any time someone even mentions raising the retirement age (notwithstanding the fact that, when SS was originally enacted, life expectancy may have actually been shorter than the age at which one received SS benefits!), the AARP goes into overdrive, willing to sacrifice the future for the present, regardless of the realities of the Fourth Rail.

I think I've spent enough time on this issue now.

[jsteele]

Anonymous wrote:"You may want to review the legislative process. Laws are not created by announcements. A single House committee has proposed a surcharge. The House has yet to agree on a single bill."

Okay, I'm just going to respond by rolling my eyes here (unfortunately, you can't see me). I went to what's considered a pretty decent law school in this country, so I've taken Admin and Con Law, and have heard of this thing you refer to as the "legislative process," thank you. Perhaps you're privy all of the back-room House/Senate outrage at the proposed surcharges? Oh, wait -- you haven't heard any outrage? Yeah, neither have I. So I'll continue to assume that what has been proposed will actually be implemented.

I guess at your law school they used a slightly modified version of that old saying, "If the facts are on your side, argue the facts. Otherwise, roll your eyes."

Despite your vast education, it remains true that laws in this country are not created by announcements. There has been opposition in the House to the surcharge, not to mention the Senate where to my knowledge it has not even been proposed.

Anonymous wrote:
"The CBO released a preliminary estimate based on one House bill. The CBO has subsequently said that the public option actually lowers the cost."

When has the CBO released anything suggesting that the public option -lowers- the cost? Please cite to a reputable source.

A good start is here:

http://blogs.tnr.com/tnr/blogs/the_treatment/archive/2009/07/10/exclusive-early-cbo-score-on-public-plan-it-s-good.aspx

Anonymous wrote:
"Take any basic private insurance policy available today and remove the corporate profits, corporate taxes, and outrageous executive compensation. Voila, you have a plan that provides the same coverage at a lower cost."

Talk about false assumptions and oversimplification. Because government intervention always leads to lower cost. (I'm rolling my eyes again here, FYI.)

Along with eye-rolling, I see that you learned to defeat strawmen. That must have been some law school you attended. Basically what I described is Medicare. The scenario I suggested is working in real life.

Anonymous wrote:
"There is no proposal on the table that would wipe out private insurers. Not everyone has the choice to join a better plan."

Okay, I'm going to try this again -- when one large company is able to undercut its competitors through unfair advantage (say, the government), competitors cannot survive. I never suggested that the government is proposing to get rid of other insurers (although, in my view, that's clearly the ultimate goal); I merely suggested that the establishment of a dominant player with strong advantages typically leads to that outcome. Perhaps you've heard of this thing we call antitrust and competition policy?

Hold on, according to you, a public option would not be able to provide the same level of service at the same or lower cost. So, where are those unfair advantages? But, just to show a real life example of your hypothesis being wrong, Canada has single payer. Yet, Canada also has private health insurers. Perhaps those insurers, like me, don't understand antitrust and competition policy. They are too busy providing a service in exchange for cash.

[Anonymous]

Medicare is NOT working. It is insolvent. It's also getting harder and harder to find physicians who accept medicare, since the payment rates are so poor. More medicare is not what we need.