obamacare

[birdog1960]

Yes it's the insurance companies' fault that medical costs are high.

 

How's this doctor? Why don't you cut your fees by 50% across the board if you're so humane.

yes, it's the overpaid primary care docs fault for the high costs. how many docs do you think could be paid on the salary of united healthcare's ceo?

[GaryPinC]

Yeah...one problem with this conversation is that "reform" is not a point event. Reforming the health care system in this country is going to take years (for starters: because it's so big, and because it's so !@#$ed up). So asking "What sort of reform do you want?" is something of a fallacious question, since it implies that any of us have some sort of magical ability to untangle the Gordian knot the system's become with no unforeseen consequences.

 

And while I do have an answer of where I'd start (and no, this legislation is NOT a good start, and repealing it does further efforts to address costs, because this legislation claims to but doesn't, because it doesn't even know what costs are. Like I said, it's not just bad. It's actively counter-productive), it's late and I'm tired...so another time. But one thing I do want to address before I'm outta here...

 

 

 

1) it's not socialist (and you can't possibly expect me to accept "it just is" as an argument - either tell why it is, or don't say it is), it's market-driven. At its simplist, you pay into a pool a rate based on participation in that pool and the payout of that pool. That is not socialist. I'm not even sure insurance, in principle, can be a socialist concept (really not sure...I'll have to read up). That's also the worst part of the legislation - why should everyone have insurance? So everyone has care. Again, confusing the insurance with the care, which are not the same thing (and we'll ignore the "managed care" concept for now, since it is late). But then you pass a bill to provide everyone insurance (or that you claim does - even though it doesn't), but under terms where it's actually optional and under certain conditions cost-effective for the consumer to not buy it (e.g. I'm 20-something, healthy, and don't need it unless I get a serious illness - say, a brain tumor - in which case I can just go ahead and buy it when I get sick because the pre-existing condition now can't be refused). So now you haven't reformed health care at all...you've reformed health insurance, by adversely affecting the pay-in, while doing nothing to affect the pay out (because you haven't addressed actual costs), and basically reformed the US health care system in a way that takes it from "inefficient" to "inefficient and completely unsustainable".

 

Because all you've really done is shifted the burden of health care costs from the consumer to the insurance industry, which sounds nice when you're stumping, but doesn't actually work because the money still has to come from somewhere. The insurance industry can't pass the cost on (rate increases are capped, they can't deny coverage), but they still have to pay the cost. They will eventually be paying out more than they take in. If you were to design legislation to kill an industry, this is how you'd do it.And that's just the very simple view. Now convince me that's a good idea.

 

It's a great idea if you intend for the government to take over health insurance.

Edited March 29, 2012 by GaryPinC

[Rob's House]

yes, it's the overpaid primary care docs fault for the high costs. how many docs do you think could be paid on the salary of united healthcare's ceo?

What's the CEO's salary and how many people are insured by his company? I'm pretty sure if you divide the former by the latter you'll see why this argument doesn't work.

[birdog1960]

What's the CEO's salary and how many people are insured by his company? I'm pretty sure if you divide the former by the latter you'll see why this argument doesn't work.

my argument works just fine if you accept the premise that private insurance is totally unecessary to the delivery of health care to a population.

[GG]

my argument works just fine if you accept the premise that private insurance is totally unecessary to the delivery of health care to a population.

 

You're right, you don't need private insurance to deliver healthcare, because insurance companies DO NOT DELIVER HEALTHCARE.

 

Other than that, what's your point again?

[Doc]

Doctors' salaries account for just 15% of healthcare expenditures. But that's the only place the government is working to lower costs, not the other 85%.

 

And those who use the system the most need to have to pay more into it. That means the sick and the old. Co-pays need to be raised and if you don't pay it up-front, you don't get care and/or you get kicked-out.

[Rob's House]

my argument works just fine if you accept the premise that private insurance is totally unecessary to the delivery of health care to a population.

No, you're not going to wiggle out of this. Your implication was that insurance company CEO pay is a substantial factor in this discussion. But as a % of labor cost company wide or indusry wide it's relatively insignificant. As a % of overall healthcare costs the salaries of all the CEOs for all the health insurance companies combined is a squirt of piss in the ocean.

[B-Man]

From yesterday's transcript. An exchange with Justice Kagen;

 

 

Justice Kagan wants to know why a "big gift from the Federal Government" is coercion. "The Federal Government is here saying, we are giving you a boatload of money."

 

Just a big old boatload of money is coercive, Clement says confidently. But the actual bill has a "very big condition."

 

Kagan interrupts, trying to make her point that a big boatload of money is not coercive. What if someone offered you a job and would pay you $10 million a year. Of course, you say yes, but you're not coerced are you?

 

Clement lays down one of the cleverest teasers I have ever heard: "Well, I guess I would want to know where the money came from."

 

"Wow. Wow." says Kagan. (Has a Supreme Court ever said "Wow. Wow" before?) She can't believe you'd do anything other than snap up that money. "I'm offering you $10 million a year to come work for me, and you are saying that this is anything but a great choice?"

 

 

Clement springs his trap: "Sure, if I told you, actually, it came from my own bank account."

 

 

Ann Althouse

 

.

[Doc]

From yesterday's transcript. An exchange with Justice Kagen;

 

 

 

 

 

Ann Althouse.

Unbelievable! I read part of the transcript and apparently libs actually believe that "the govenment's" money is truly a "gift" that rains down from heaven, that it's so great that it can't possible be forced on someone even though it comes with major conditions, and that it should just be taken with no questions asked.

[UConn James]

No, I absolutely do not, because it is quite simply a badly designed piece of legislation that tries to be a compromise between two systems (market-based and socialized), and as such effectively implements neither. It is written by people who don't even understand economics at even a basic high school level, and implemented for no practical reason other than to give its proponents something to point to and say "See! We're for reform!" and to pander to the segment of the electorate (and it's a VERY large segment in this case) that doesn't know any better. It is very basically flawed and doesn't address the basic issues it claims to address (for example: it confuses health insurance premiums with health care costs, then proceeds to "control" health care "costs" by regulating insurance premiums and passing the actual costs - which it does nothing to address - to the insurers).

 

Anyone who's for health care reform should embrace the repeal of this abortive piece of legislation as a step towards real reform. The Democrats, including Obama, should never have pushed for passage of this steaming pile of crap - once it was clear that the "reform" they were going to get was going to be a half-assed compromise that was not only useless but actively counter-productive to reform, they should have just ****-canned it and started over from square one.

 

And to get to Dayman's point of why waste time and resources by repeal (estimates say that repeal will cost in the hundreds of millions), I would say... Well, whose ing fault was that? They passed something that enough people warned would be unconstitutional that they might have listened, but no. They passed something so they could say they passed something.

 

Again, I reflect --- how would Obamacare being struck down measure WRT a defining/overarching moment of a presidency? Fifty years from now, how is this country going to remember the Obama Years? It would be for spending a lot of $/increasing the debt more than any other president and that he spent a lot of time, political capital, and public treasure on passing something that was ruled unconstitutional. Just thinking about the historical impact while we're in the moment. Would it be on par with a censure or is it roughly equivalent to getting publicly face-slapped?

[birdog1960]

From yesterday's transcript. An exchange with Justice Kagen;

 

 

 

 

 

Ann Althouse

 

.

um, isn't the point of the debate to persuade justices to vote your way? ya think jousting and gamesmanship like this advances his purported purpose? you applaud, i applaud but for very different reasons.

[B-Man]

um, isn't the point of the debate to persuade justices to vote your way? ya think jousting and gamesmanship like this advances his purported purpose? you applaud, i applaud but for very different reasons.

 

 

 

LOL................really?

 

I believe that Mr. Clement is sufficiently wise enough (as well as everyone else) to know that Justice Kagen's decision has long been made.

 

Pointing out the fallacy of her "argument" was for the other judges who are trying to decide ...as well as for the general public.

 

Nice spin though............

 

 

.

[birdog1960]

LOL................really?

 

I believe that Mr. Clement is sufficiently wise enough (as well as everyone else) to know that Justice Kagen's decision has long been made.

 

Pointing out the fallacy of her "argument" was for the other judges who are trying to decide ...as well as for the general public.

 

Nice spin though............

 

 

.

disrespect and snarkiness may win the day here but i don't think it works so well in the supreme court, even among conservatives. the exception, of course being, when a justice does it.

[ieatcrayonz]

disrespect and snarkiness may win the day here but i don't think it works so well in the supreme court, even among conservatives. the exception, of course being, when a justice does it.

I only read the quote provided but don't you the the judge was being snarky by implying the money came from the sky?

 

I mean if he replied by calling her "Tubby" or something that would have been snarky but his answer seemed legit to me.

 

If that guy giving me a 10 million dollar job was Tony Soprano I would realize the $$$ came with a loss of some freedom. Why is the government boatload any different?

[Rob's House]

disrespect and snarkiness may win the day here but i don't think it works so well in the supreme court, even among conservatives. the exception, of course being, when a justice does it.

Disrespect and snakiness? Really? I know we all have our biases but you take political hackery to a whole new level. You are to liberalism what Rick Santorum is to Catholocism. I don't think I've ever seen anything from you that indicates so much as a hint of critical thinking.

[DC Tom]

finally, none of dc's ideas address the need for universal coverage.

 

None of my ideas addressed any need for anything, you !@#$ing nitwit. I specifically stated I wasn't going to get into "what's the best reform" yesterday.

 

If you're going to criticize my post for something, do it for something related to the actual content of the post, dipshit.

[birdog1960]

Disrespect and snakiness? Really? I know we all have our biases but you take political hackery to a whole new level. You are to liberalism what Rick Santorum is to Catholocism. I don't think I've ever seen anything from you that indicates so much as a hint of critical thinking.

when in rome...

[Doc]

disrespect and snarkiness may win the day here but i don't think it works so well in the supreme court, even among conservatives. the exception, of course being, when a justice does it.

Where do you get that Clement was snarky and disrespectful of Kagan? Because he made her look like a fool?

[dayman]

1) it's not socialist (and you can't possibly expect me to accept "it just is" as an argument - either tell why it is, or don't say it is), it's market-driven. At its simplist, you pay into a pool a rate based on participation in that pool and the payout of that pool. That is not socialist. I'm not even sure insurance, in principle, can be a socialist concept (really not sure...I'll have to read up). That's also the worst part of the legislation - why should everyone have insurance? So everyone has care. Again, confusing the insurance with the care, which are not the same thing (and we'll ignore the "managed care" concept for now, since it is late). But then you pass a bill to provide everyone insurance (or that you claim does - even though it doesn't), but under terms where it's actually optional and under certain conditions cost-effective for the consumer to not buy it (e.g. I'm 20-something, healthy, and don't need it unless I get a serious illness - say, a brain tumor - in which case I can just go ahead and buy it when I get sick because the pre-existing condition now can't be refused). So now you haven't reformed health care at all...you've reformed health insurance, by adversely affecting the pay-in, while doing nothing to affect the pay out (because you haven't addressed actual costs), and basically reformed the US health care system in a way that takes it from "inefficient" to "inefficient and completely unsustainable".

 

Because all you've really done is shifted the burden of health care costs from the consumer to the insurance industry, which sounds nice when you're stumping, but doesn't actually work because the money still has to come from somewhere. The insurance industry can't pass the cost on (rate increases are capped, they can't deny coverage), but they still have to pay the cost. They will eventually be paying out more than they take in. If you were to design legislation to kill an industry, this is how you'd do it.

 

And that's just the very simple view. Now convince me that's a good idea.

 

Haha, ok so then the mandate is constitutional b/c it's actually optional if it's cost effective to you!? What? Were you not of the opposite opinion earlier? (I could be wrong I don't keep a notebook of everybody's positions).

 

Anyway the idea there is no link between everyone having the means to afford care, and everyone receiving care isn't something I'll debate. The idea that there should still be FURTHER reform directed at the care industry itself, is fine but doesn't depend on this bill being destroyed. And the point is the uninsured freeriders are ALREADY shifting the burden to the healthcare companies/doctors/us which you know, so they need to be coerced into a plan. Nobody on either side, and no economist, predicts the plan will result somehow in more freeriders and more shifted costs. The scenario where all the healthy 25 year old blow off the mandate in enormous numbers wait until they get sick and then go get insurance they can't be refused and thus take down the entire industry is not something any economist or lawyer has argued. The healthcare industry, if having no other thoughts about the plan, views it as a way to expand the quantity of policy holders getting more healthy people in the pool (reducing the cost of insurance) as well as reducing the amount of uncompensated care doctors end up giving out (and thus reducing the cost of care).

 

Where do you get that Clement was snarky and disrespectful of Kagan? Because he made her look like a fool?

 

To me, Clement put on a show. He was a far superior advocate to any of the other lawyers who argued this issue. Also, I don't think he made Kagan look like a fool.

Edited March 29, 2012 by dayman

[birdog1960]

some data relevant to the discussion: "many or most of the patients with the higher health care costs in the nation have private insurance and higher relative incomes and are white."