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

Anonymous
Anonymous wrote:
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.

Okay, I disagree with you on what public goods serve society well but I respect your opinion. You've clearly thought about it. I just get annoyed when people go on about how all these undeserving people are leeching off of them. There will always be undeserving people who get some public good but we decide to accept that in the greater interest of society. The question is what should be a public good -- does it make our society stronger and more democratic or not? That's where you and I disagree. I'm okay with that.
Anonymous
jsteele wrote:
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.


Jeff, I think you know what I was asking. If the government sets fixed prices on drugs and technology than companies may be less willing to put as much into research. Especially, if rationing is implemented and competition is killed. The systems in UK and Canada are highly dependent on the research that comes out of our country. When was the last time you heard of someone flying to the UK for cutting edge health care?
jsteele
Site Admin Online
Anonymous wrote:
Jeff, I think you know what I was asking. If the government sets fixed prices on drugs and technology than companies may be less willing to put as much into research. Especially, if rationing is implemented and competition is killed. The systems in UK and Canada are highly dependent on the research that comes out of our country. When was the last time you heard of someone flying to the UK for cutting edge health care?


Any rates will be negotiated rather than "set". Moreover, Obama already agreed with the pharmaceutical industry on a limit to the savings that would be rung out of that industry. So, as long as the Congress respects that agreement, the pharmaceutical industry will be fine.

I don't necessarily accept your premise that the US is essentially subsidizing drugs in other countries. But, for the sake of argument, let's assume it's true. Lower prices in the US would force those other countries to either start paying their way or risk losing access to the drugs. I can't accept that we should refuse health care to our own citizens in order to keep drug prices lower for other countries (while paying higher prices to boot).

The UK is a popular destination for wealthy Arabs in need of medical care. It's probably true for people from other parts of the world as well. The rich don't have a problem getting the best care and that's not going to change. At the moment, the poor have a challenge to get any care. That's what will change.
Anonymous
jsteele wrote:
Anonymous wrote:
Jeff, I think you know what I was asking. If the government sets fixed prices on drugs and technology than companies may be less willing to put as much into research. Especially, if rationing is implemented and competition is killed. The systems in UK and Canada are highly dependent on the research that comes out of our country. When was the last time you heard of someone flying to the UK for cutting edge health care?


Any rates will be negotiated rather than "set". Moreover, Obama already agreed with the pharmaceutical industry on a limit to the savings that would be rung out of that industry. So, as long as the Congress respects that agreement, the pharmaceutical industry will be fine.

I don't necessarily accept your premise that the US is essentially subsidizing drugs in other countries. But, for the sake of argument, let's assume it's true. Lower prices in the US would force those other countries to either start paying their way or risk losing access to the drugs. I can't accept that we should refuse health care to our own citizens in order to keep drug prices lower for other countries (while paying higher prices to boot).

The UK is a popular destination for wealthy Arabs in need of medical care. It's probably true for people from other parts of the world as well. The rich don't have a problem getting the best care and that's not going to change. At the moment, the poor have a challenge to get any care. That's what will change.


One of the provisions in the health care bill is the formation of a board to review drug effectiveness. Currently, clinical trials do not test newly available pharmaceutical drugs against each other. One one hand, it would be nice to know what the most effective drug for a disease is. On the other hand, this suggests that the government will only pay for the drug that performs the best in the trials. Unfortunately, cancer patients often have different responses to various drugs. For many cancers, there is no one best treatment. Many other factors need to be taken into consideration. I fear that the government option will outline certain treatments for certain disease and that is the only treatment they will pay for.
Anonymous
How does a health care free for all lead to a better democracy? Reminder - democracy is a political philosophy, which the US technically does not follow. The US is republic, in which representatives make the decisions. If it were a democracy, the people would get to vote directly on this legislation. Right now, the people are stuck with Town Halls to try to convince their representatives.

More specifically, health care for all paid for by some via the government is socialized medicine (you might catch the similarity to the word socialisim here.) It's a fiscal philosophy contrary to the capitalism (which is not a dirty word) that made this country great.

The problem with any current proposals is that they have not seen the light of day, and the final bill, once negotiated-out on the Hill, will be voted on without ever getting full public scrutiny.

Social security and medicare are both virtually bankrupt.
Anonymous
Anonymous wrote:
jsteele wrote:
Anonymous wrote:
Jeff, I think you know what I was asking. If the government sets fixed prices on drugs and technology than companies may be less willing to put as much into research. Especially, if rationing is implemented and competition is killed. The systems in UK and Canada are highly dependent on the research that comes out of our country. When was the last time you heard of someone flying to the UK for cutting edge health care?


Any rates will be negotiated rather than "set". Moreover, Obama already agreed with the pharmaceutical industry on a limit to the savings that would be rung out of that industry. So, as long as the Congress respects that agreement, the pharmaceutical industry will be fine.

I don't necessarily accept your premise that the US is essentially subsidizing drugs in other countries. But, for the sake of argument, let's assume it's true. Lower prices in the US would force those other countries to either start paying their way or risk losing access to the drugs. I can't accept that we should refuse health care to our own citizens in order to keep drug prices lower for other countries (while paying higher prices to boot).

The UK is a popular destination for wealthy Arabs in need of medical care. It's probably true for people from other parts of the world as well. The rich don't have a problem getting the best care and that's not going to change. At the moment, the poor have a challenge to get any care. That's what will change.


One of the provisions in the health care bill is the formation of a board to review drug effectiveness. Currently, clinical trials do not test newly available pharmaceutical drugs against each other. One one hand, it would be nice to know what the most effective drug for a disease is. On the other hand, this suggests that the government will only pay for the drug that performs the best in the trials. Unfortunately, cancer patients often have different responses to various drugs. For many cancers, there is no one best treatment. Many other factors need to be taken into consideration. I fear that the government option will outline certain treatments for certain disease and that is the only treatment they will pay for.


I am somewhat troubled by this since I come from a family that has a history of having adverse reactions to drugs that most people tollerate well. Will we be limited to medications that serve 80 - 90% of the population well, but are harmful to to a small percentage? Or am I going to have to "prove" that I am adversely impacted every single time I need a new prescription? I like the idea of putting drugs up against one another to test effectiveness, but I want my doctor and I to decide what prescriptions drugs I take, not some board.

jsteele
Site Admin Online
Anonymous wrote:
One of the provisions in the health care bill is the formation of a board to review drug effectiveness. Currently, clinical trials do not test newly available pharmaceutical drugs against each other. One one hand, it would be nice to know what the most effective drug for a disease is. On the other hand, this suggests that the government will only pay for the drug that performs the best in the trials. Unfortunately, cancer patients often have different responses to various drugs. For many cancers, there is no one best treatment. Many other factors need to be taken into consideration. I fear that the government option will outline certain treatments for certain disease and that is the only treatment they will pay for.


It's a valid concern, but seems like you are really reaching for a worst case scenario. In Obama's press conference, he said the role of the board is simply to provide information. I'm not sure there is a basis for your conclusion that the Board's findings will affect medicinal payments by the public plan. But, remember that the public plan is for those unable to obtain insurance otherwise. Those folks already lack access to many treatments. For them, having access to even a limited number of treatments would be an improvement.

It's a shame that Congress was not able to get even a rough draft of a potential bill put together. Now, we are left with various committee drafts and rumors of what might happen. That creates a situation in which opponents of reform are free to create any claim imaginable ("Obama will kill your grandparents"), while defenders don't have anything authoritative to which to refer.
Anonymous
jsteele wrote:
Anonymous wrote:
One of the provisions in the health care bill is the formation of a board to review drug effectiveness. Currently, clinical trials do not test newly available pharmaceutical drugs against each other. One one hand, it would be nice to know what the most effective drug for a disease is. On the other hand, this suggests that the government will only pay for the drug that performs the best in the trials. Unfortunately, cancer patients often have different responses to various drugs. For many cancers, there is no one best treatment. Many other factors need to be taken into consideration. I fear that the government option will outline certain treatments for certain disease and that is the only treatment they will pay for.


It's a valid concern, but seems like you are really reaching for a worst case scenario. In Obama's press conference, he said the role of the board is simply to provide information. I'm not sure there is a basis for your conclusion that the Board's findings will affect medicinal payments by the public plan. But, remember that the public plan is for those unable to obtain insurance otherwise. Those folks already lack access to many treatments. For them, having access to even a limited number of treatments would be an improvement.

It's a shame that Congress was not able to get even a rough draft of a potential bill put together. Now, we are left with various committee drafts and rumors of what might happen. That creates a situation in which opponents of reform are free to create any claim imaginable ("Obama will kill your grandparents"), while defenders don't have anything authoritative to which to refer.


I don't think this is a worst case scenario at all. This is exactly what currently takes place in the UK everyday. The government reviews treatment options and decides which ones they will fund and which ones they won't. Besides effectiveness, cost will most definitely be taken into consideration. Whether cost will trump effectiveness, I don't know, but it often does in the UK. We cannot have the best health care and the newest treatments at the lowest cost for everyone. We can't afford it. If you want to cover everyone, there will have to be rationing. To suggest otherwise is disingenuous.

Congress did a terrible job with this legislation. If this was such a major piece of legislation for Democrats, they should have done a better job of crafting and communicating the bill. Meanwhile, the Republicans have failed to offer any decent alternatives. So, I do agree with you here.
jsteele
Site Admin Online
Anonymous wrote:
I don't think this is a worst case scenario at all. This is exactly what currently takes place in the UK everyday. The government reviews treatment options and decides which ones they will fund and which ones they won't. Besides effectiveness, cost will most definitely be taken into consideration. Whether cost will trump effectiveness, I don't know, but it often does in the UK. We cannot have the best health care and the newest treatments at the lowest cost for everyone. We can't afford it. If you want to cover everyone, there will have to be rationing. To suggest otherwise is disingenuous.


The proposed reforms in the US are not modeled on those in the UK. The UK has a government-run healthcare system. Nobody is proposing that for the US. Even the public option is simply Government-administered insurance.

You are misstating the goals of reform efforts. "[T]he best health care and the newest treatments at the lowest cost for everyone" does not represent what health reform is aimed at achieving. It is of course easy to tear down strawmen. There is a goal to reduce costs and a number of specific proposals for achieving that goal. There is another goal to provide universal or near-universal access to healthcare and separate proposals for achieving that goal (among them, the public option). But, nobody should expect that the public option is going to be an open-ended ticket to any treatment imaginable any more than they should expect that a goal of public education is to send every student to Harvard. Indeed, private insurances also restrict available treatment options.

The specter of rationing -- like the various strawmen arguments that constantly come up -- is a good means of spreading fear. But, as I've said a number of times, rationing is already taking place. Not everyone who wants a heart or kidney transplant gets one. Insurance companies decide daily who gets what treatment and who doesn't. See this thread where Aetna didn't cover the poster's ultrasound:

http://www.dcurbanmom.com/jforum/posts/list/64279.page

Nobody wants to be refused medical treatment. But, right now, such decisions are being made by those with a financial incentive not to provide coverage. It is truly sad that medical treatments compete with corporate profits in the decision-making process.

Anonymous
Anonymous wrote:How does a health care free for all lead to a better democracy? Reminder - democracy is a political philosophy, which the US technically does not follow. The US is republic, in which representatives make the decisions. If it were a democracy, the people would get to vote directly on this legislation. Right now, the people are stuck with Town Halls to try to convince their representatives.

More specifically, health care for all paid for by some via the government is socialized medicine (you might catch the similarity to the word socialisim here.) It's a fiscal philosophy contrary to the capitalism (which is not a dirty word) that made this country great.

The problem with any current proposals is that they have not seen the light of day, and the final bill, once negotiated-out on the Hill, will be voted on without ever getting full public scrutiny.

Social security and medicare are both virtually bankrupt.

The same way that other public goods (e.g., public education) and legislation (e.g., the 40 hour work week) lead to a better democracy -- by bolstering, strengthening, and expanding the middle class. You can't have a strong democracy without a strong middle class. Over the decades in the United States, some of us have been moving upward into the upper-middle and upper classes but a great many of us have been slipping out of the middle class. Countries with small groups of well-to-do at the top and large groups of poor folks at the bottom without much inbetween don't have thriving democracies.

I don't have time to look up the literature and I know there will be sneering responses about lazy people who won't take care of themselves but if you look around you will see that the stronger democracies of the world have a middle class -- and all of those countries (including us) have policies which aid and bolster the middle class. Everyone on DCUM -- even the most conservative poster -- has benefited from those policies.
Anonymous
What is your point? This healthcare reform will hurt the middleclass not help. Most of the middleclass already has good healthcare. This reform only helps if you are illegal or just worthless.
jsteele
Site Admin Online
Anonymous wrote:What is your point? This healthcare reform will hurt the middleclass not help. Most of the middleclass already has good healthcare. This reform only helps if you are illegal or just worthless.


I think the healthcare debate is nicely encapsulated by the above. Many on the right side of the political spectrum truly believe that there are people who are "worthless" and not deserving of even a penny being spent on their medical treatment. The left generally sees basic healthcare as a human right and does not consider any human being to be worthless.

Anonymous
Anonymous wrote:What is your point? This healthcare reform will hurt the middleclass not help. Most of the middleclass already has good healthcare. This reform only helps if you are illegal or just worthless.

Well, that was fast. Right to to the sneers.
So anyone who doesn't have health insurance must be worthless or illegal? Not much point in talking to someone who has decided that everyone who is struggling must deserve it.
I give up. The field is yours. Enjoy talking to yourself.
Anonymous
jsteele wrote:
Anonymous wrote:What is your point? This healthcare reform will hurt the middleclass not help. Most of the middleclass already has good healthcare. This reform only helps if you are illegal or just worthless.


I think the healthcare debate is nicely encapsulated by the above. Many on the right side of the political spectrum truly believe that there are people who are "worthless" and not deserving of even a penny being spent on their medical treatment. The left generally sees basic healthcare as a human right and does not consider any human being to be worthless.



I agree with Jeff's assessment. There is so much hatred and bile being spewed right now; this attitude of"worthless" people isn't even thinly veiled. It's just plain out there.

I honestly am so depressed right now by the rhetoric, the mob mentality, the false sense of indignation, the sense of entitlement. Who are these people? What has happened to them that their first instincts are to retreat into even less compassion for others? To fall back on bitterness, and ignorance, and fear. I despise hyperbole, but I see clips of these town-hall fools on TV and the flame-fanning congressmen and "news" anchors on Fox and CNN, I think, it's really not so hard to see how people are nudged into doing doing terrible things to their fellow human beings: they demean them in their minds so they don't even see them as human. They see them as "worthless," so it's easier to abuse them and to justify one's own selfishness. So depressing.
Anonymous
Anonymous wrote:

I honestly am so depressed right now by the rhetoric, the mob mentality, the false sense of indignation, the sense of entitlement. Who are these people? What has happened to them that their first instincts are to retreat into even less compassion for others? To fall back on bitterness, and ignorance, and fear. I despise hyperbole, but I see clips of these town-hall fools on TV and the flame-fanning congressmen and "news" anchors on Fox and CNN, I think, it's really not so hard to see how people are nudged into doing doing terrible things to their fellow human beings: they demean them in their minds so they don't even see them as human. They see them as "worthless," so it's easier to abuse them and to justify one's own selfishness. So depressing.

I agree. I'm astonished by the ignorant fear out there. For example, the people who think the government is going to tell them how they have to die when the point is only to make sure that doctors discuss end of life issues with their patients. It's as crazy as the left wing conspiracy theorists who think that the US government blew up the towers. It feels like what happened under Clinton -- that there will be all this talk and nothing will come of it and we'll end up with the same old dysfunctional health system that we already have.

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