"You write "According to Census and HHS data, 10 million have incomes more than three hundred percent of the poverty line, meaning they could afford coverage but for some reason choose to forgo it."
When I read these words, I wanted to come out of my chair. This is one of 10 million people with incomes in excess of 300% of the poverty level who CHOOSE not to buy health care. I thought about a post here in which I respond with all the vitriol I could muster. But I read further and came across this most appropriate response:
"Having seen the response from one of your correspondents that health insurance is too expensive for recent graduates, I thought I would check to see if much had changed in the last 15 years. When I finished my graduate degree, my first employer in Richmond did not provide health insurance, but I was able to get an Anthem (formerly Blue Cross) policy in Richmond, VA for about $75.00 a month. According to a brief internet search, a 25 year-old non-smoking male living in Richmond, Virginia can get a basic Anthem policy (much like an employer is likely to offer) for $111.00 a month with a $500.00 deductible and $30 copays or $79.00 a month for a $2,500 deductible and $30 co-pays. Thus, your other correspondent is not stretching when he referenced "Cable TV". Give up the Comcast Triple Play and get health insurance. Alternatively, give up one or two nights out a month, and cover your health insurance. What the correspondent seems to miss is that he cannot logically maintain that health insurance is so important that it is a moral obligation for the government to provide it to all of its citizens, but it isn't worth two dates at TGIFriday's a month for an individual."
Perfect.
For those twenty somethings who refuse to give up their 20 mocha lattes a month for health insurance I have no pity.
ReplyDeleteFor those people who don't pay taxes and are here under the radar while trying to eke out a living for their naturally born citizen children, I have slightly more pity; but, I refuse still to pay their healthcare until they incorporate themselves into the system like my ancestors did.
I have pity for those, like my soon-to-be uncle, who is a pastor of a very small church and forgoes much of his salary to pump money into the small and growing ministry. He has three children who have healthcare. Meanwhile, he and his wife, their mother, do not. These people do exist.
Furthermore, he meets scores of people annually for whom the skyrocketing cost of death and disease financially drain families from which they come.
I agree with Our Most Beloved Leader that "something must be done."
I disagree with the left's exaggerated numbers, and sincerely illogical claims.
Someone needs to get in there and inject life AND logic to the right, who had squandered their chances of solidifying their base by neglecting their duty.
Hello CW, I agree that this person is a kid who doesn't have his priorities straight if he carries cable but not health insurance.
ReplyDeleteI can see the changes our 29-year old software designer will have to make with health care reform as it's been presented: he will be required to carry basic health insurance, just as most states require us to carry auto insurance. If he proves that he can't afford it (and not because the payments on his fancy new car-of-the-year Hyundai are putting a dent in his pocket), there will be a hardship waiver (much like that in place for 95% of all small businesses, whose size and narrow profit margin would exempt them from these requirements.) So, I can see why he might be against this plan, which puts responsibility for himself in his own hands.
But you say that this is someone that the rest of our health insurance is going to be messed with to protect. How is that? What would change about your or my health insurance when health care reform goes into effect?
GHP--so good of you to cherry pick some non-controversial aspects of (some) of the Dem plans floating around---especially one aspect (mandatory coverage) that I'm already on record in this blog as saying I support.
ReplyDeleteI got two words that answer your quesion; public option. A public option will destroy the private health insurance market as we know it. It is the camel's nose in the tent, just ask your boy St. Barney of Frank, who is on record as saying as much.
CW - I'm glad you didn't resort to vitriol. There's ample vitriol and it doesn't really accomplish much. Reasoned, rational debate such as "most appropriate response" provided is always more effective and it takes the argument that we are "just a party of angry white men" away from those who resort to debating to the depth of a bumper sticker.
ReplyDeleteI am interested in your support of mandatory health insurance coverage as well as Ghost's (and others') analogous use of driving to living. My difficulty with this comparison is that driving is pretty widely regarded as a privilege whereby the collective provides for highways and traffic signs and lights etc and we, upon meeting a basic demonstration of capability and paying certain fees, are granted permission to use them according to the laws and regulations put in place to ensure that green on a light means go in all states and that if I drive on the right side of the road, I generally should not have to worry about you driving on the left side of the road. I have no problem with government providing for reasonable regulation of those activities.
I am less inclined, however, for an equivalent ease of imposing regulation upon my inalienable right, to wit: life, and the decisions that I make regarding that right. So long as I do not make decisions that put other people's lives at risk (i.e. conducting rifle practice over a shopping mall or school yard or, oh, I don't know, voting democrat--kidding Ghost), I am quite reluctant to grant government sufficient authority to tell me I must enter into a business arrangement with some entity (whether private or "public") to cover me in the event of injury or illness.
If the government shouldn't be able to compel someone to responsibly purchase insurance, yet we agree (I think) that it is unfair that the responsibly insured should bear the distributed cost of emergent (or otherwise) health care for those uninsured, shouldn't then the government be allowed to say no health care. Choices should have consequences, no?
ReplyDeleteMudge. Good question, one to which I do not have a principled, conservative response. I do however, have a pragmatic response.
ReplyDeleteOur country is moving toward universal health care, and I fear a single payer system more than any other. As I seek ways to compromise on the issues, I look to compulsory health insurance as the more preferable route to universal coverage than a single payer system.
Of course, I when I say "mandatory", I include the potential for folks to still not want to buy insurance, in which case I'd have no problem with their decision costing them money--i.e. a fine. This money would go toward the cost of defraying their health care when they do need it (in the emergency room) and for those who cannot afford health insurance.
If I thought that we as a society could or would do as you imply and Chicken Middle suggests--let people suffer the consequences of their stupid decisions and not provide medical care to those who could afford health care but who choose not to buy it--I might be less inclined to support the public option. But we'll never do that.
Moving past your prim prickliness about perceived questioning strategies -- yes, devious of me to ask about that obscure first line and seeming point of your post --
ReplyDeleteI agree that the public option will be disruptive to the market -- intentionally so. But destructive? I don't know. I think that if there were significant competition in the private health-insurance markets, prices would be better controlled. They key will be in the pricing of that public option.
In Switzerland, competition among that country’s 85 private health insurers have resulted in price decreases since 2005 and widespread public support. Our health-insurance prices rose by 16.5% (I've seen some higher numbers, but am using the most conservative).
I'm trying to wrap my head around why you would not be a supporter of aggressive market competition in this case.
Do you think that a competitive public option will destroy your own health insurance provider -- will you and your colleagues choose the public option over what you have now?
Health care insurance is such a different animal than these, it's not a consumer-driven model, but I'm looking for some parallels in the structure: Does having mass transit available put Audi out of business, does the US Post Office shake Federal Express?
I see the public option as a backstop to catch the people like this 29 YO. And like MrClean's Uncle-to-be, like the 70YO woman whose husband dies and along with him goes their pension and health coverage. I'm keeping my high-end insurance: I pay a bundle for it and I'm willing to pay that premium (literally) to ensure and insure my family's health, my 3YO.
Ghost - The way government can encourage competition is to loosen the strings they attach to it. I am still trying to understand why on one hand Democrats frequently cite how citizens lose their existing coverage (and become subjected to "pre-existing condition" coverage exemptions) when they take a job in another state or how certain states have only one or two companies providing coverage. If that were truly the problem they were trying to fix AND they wanted to increase competition, wouldn't it make sense to eliminate the laws that restrict health care insurance being an interstate commerce? Open up the playing field and you just addressed that issue and you did it with less cost to government (us) and you increased competition. "Competing" with government is not competition. It is commercial pillage by the government and it is considerably more "un-American" than those pesky, annoying and rather rude town hall rabble rousers (aka "American Citizens") that our Speaker deemed "un-American").
ReplyDeleteBravo Mudge!
ReplyDeletemudge, I hadn't brought up pre-existing conditions, I was focusing my response to cw on the market aspect of the public option, so I'll leave the responding to whichever dem. might have started that aspect of the discussion.
ReplyDeleteAnd I may be misreading, small iPhone screen while sitting outside my daughter's piano lesson, but are you suggesting that a gov't - run health care option is un-American? Or just ribbing me? Medicare? My father's, brother's, some of us commenter's and posters' insurance providers are gov't run.
Mudge, I'm sure you're kidding around now; advocating federal regulation over state regulation ... Are you coming over from the dark side? We lefties would love to have you.
ReplyDeletePardon any spelling or punctuation mistakes, I'm typing this on my BlackBerry while drinking bloody marys at the Saturday morning polo matches.
ReplyDeleteLook up "No American Should Have to Choose Between Health Insurance and Getting Drunk" on Reason.com. I'll try to include the link below:
http://www.reason.com/blog/show/135985.html
A lefty on my Facebook page commented that: "What if you're a teacher and you're looking at a $600 bill for your daughter's emergency MRI and that's about half your monthly mortgage payment..."
I didn't have the heart to mention the private schools her daughters attend or the international travel photos that are included on her site. I did ask what if it were a $600 auto repair bill and pointed out that she lives in a great sysrem that has 3 times more MRI capablity than the Euro systems she admires.
Ghost - You underestimate me. First, my response was aimed at your pronouncement that competition was lacking and that somehow, in this sky-is-something-other-than-blue world of many democrats, government intrusion into the marketplace would improve competition. While you in fact did not mention one of the mantras of health care reform democrats, to wit, that insurers should be forced to take on pre-existing conditions, it is a frequent suffix to the issue of lacking competition, hence, I took the liberty of adding it to my post. I don't believe I anywhere attributed it to you specifically. If I did, I apologize for unintentionally attributing such utter nonsensical claims to someone as clearly intelligent as I have genuinely come to believe you are. I too would be incensed at such an attribution.
ReplyDeleteBut to assume that I would so readily ignore something so essential to the core of our national ethos as rejecting states' rights is equally incensing. What I suggested was not that the currently unchecked and imbalanced federal legislature and executive branch should usurp states' rights; rather, what I suggested is that DEMOCRATS who cite the lack of competition and who suggest, with astounding ignorance of reality, that government entry into the marketplace will improve that situation, IF they are so genuinely concerned about this capitalist notion of competition, they could equally exert their influence on their state legislators to undo this clear governmental hurdle to more effective insurance coverage. But it really boils down to this. When I hear the President of the United States of America and his followers denounce an entire industry of American business people and their employees, and in the same breath decry the lack of competition as a root cause of the horrible state of [the finest in the world--my opinion] American health care, I can't help but to assume that he has another agenda. Of course, it may be that I've been swayed by his many pronouncements in videos that he really seeks to eliminate the American health insurance industry and replace it with a single-payer option. I almost want to shout, "You Lie!" when I hear him say the same things you wrote about lack of competition. My question to you, an intelligent, observant and, I sincerely hope, passionate-about-her-country, GoHP, is what will it take for you to look with a critical eye to what our President has said, the people with which he chooses to surround himself and the increasingly substantial body of evidence that he seeks to alter the very core of this nation to a model that has time and again failed its citizens? We didn't get where we are as a nation by following failed models of government. As someone of apparent courage, are you able to focus that courage to look critically at our President? And since I can already detect your brainwaves forming the question: yes, I did, frequently, question what President Bush was doing. Whenever he suggested that every American should own a home or when he said we should bail out failing businesses, I questioned him. I questioned him when he continued to pursue an obviously weakening strategy in Iraq and for giving up so quickly on Social Security reform. I don't know what he was smoking when he nominated his General Counsel for the Supreme Court and I thought he was one of the worst orators we've had in perhaps a century for a head of state. But now that we have one of the best orators...well, I'll forgive President Bush that final shortcoming.
GHP--"Prickly"? Let's remember, I'm a conservative, white male. It is my JOB to be prickly.
ReplyDeleteThat said, I enter this fascinating discourse (thanks to both you and Mudge for the elevated discussion here) long enough to answer a point or two you raised.
I oppose the public option for exactly the reason it is being proposed; and that is, it is seen by its many of its advocates as a necessary first step to a single payer system. You may not believe that GHP, but much of the progressive wing of the Democratic Party does (see this link for a survey http://www.verumserum.com/?p=6095) and they do so because it is a rational understanding of how a government option will dismantle the private insurance industry.
The federal government does not compete, it controls. Because it carries with it a regulatory power that other competitors do not have, the playing field is never level. Because it is run by people who have agendas other than profit and return to shareholders, its methods do not have to be responsive to those forces (unlike its competitors). When a competitor loses money, it must borrow or sell equity until a point at which it declares bankruptcy. When a government run enterprise loses money it simply turns to its creators to send it more.
I love the Post Office analogy--thanks for the hanging curveball high in the strike zone. The Post Office has a MONOPOLY on first class mail and it LOSES MONEY VIRTUALLY EVERY YEAR. If it were a business, it would have gone bankrupt long ago. I could go on, but I'll borrow some thoughts from The Heritage Foundation to explicate:
1.) The U.S. Post Office is the only entity allowed by federal law to deliver first class mail to your mailbox. In fact, Fedex and UPS are strictly prohibited from delivering “non-urgent” letters. If the government can fairly compete and is setting fair rules, wouldn’t the post office be open to competition at your mailbox?
2.) If Americans were offered “free” postage paid for by massive government spending and tax hikes, would Fedex and UPS still exist?
3.) The Post Office is on track to lose a staggering $7 billion this year alone. How will a government-run health care plan manage taxpayer resources more efficiently?
4.) Postmaster General John Potter says he lacks the “tools” necessary to run the Post Office effectively like a business. Would a government-run health care system have the tools it needs to run as effectively as the private sector entities it is replacing?
5.) On the one hand, the President remarks how great his public health care plan will be. On the other hand, he notes it won’t be good enough to crowd out your private insurance, i.e. the Post Office comparison. So which is it Mr. President? Will it be so great that private insurance disappears or so awful that it isn’t worth creating in the first place?
6.) But the most important question is this: if you have an urgent piece of mail you need delivered, life or death, who are you going to call? Everyone saying the government…please raise your hands. (crickets)
The most frightening line from Joe Nocera’s New York Times piece is this: “As for Mr. Potter himself, while he may want more freedom to run the Postal Service like a real business, he, too, seemed surprisingly wedded to outmoded ideas about mail service in America. ‘This country needs to have and to protect universal service,’ he said.”
Protecting universal service at the expense of cost, innovation, and quality of care. Sound familiar?
Enough of the post office, we'll move on now to mass transit vs. Audi. This is an interesting comparison, but not as apt as oh, say, a government run GM vs. Ford! Ah, so we've already got an example of the government "competing" with private industry. Does Ford get to threaten the banking industry with capped pay and increased regulation? Does Ford get to pressure senior debtholders into repudiating claims? We've only seen the tip of the iceberg with respect to what a government run automaker can do
Thanks Mudge & CW, for some really great points.
ReplyDeleteI'd like to go first to Mudge's 'heart of the matter'. Please don't misunderstand me when I refer to health care insurance in disparaging terms: I am not referring to the very separate health care services provided in our country, so hoping you are not questioning my love for country on that account. But if you think that I'm slamming the health care insurance/financial service industry - guilty.
I do wish there were a viable consumer-driven model that could bypass health care insurance altogether, but I don't know how that could be possible. Maybe the answer is single-payer, maybe something very different. Either way, I've not yet seen a model that works and I'm not in a position to draft one up on the back of an envelope. I'm not advocating the public option as a gateway drug into single payer approach, I'm advocating it a a much needed backstop insurance plan for those who otherwise wouldn't or couldn't enter or can't afford the private plans.
CW, as I said, there's not a comparable industry, because USPost and mass transit are consumer-driven service models and health care is not. I thought I made it explicit that I used these examples to demonstrate how the consumer would approach the options, not how those businesses would be run. I'm glad though that you got such great satisfaction in beating public option in effigy, in the form of USPost if not mass transit :). (Also, there's a big difference in gov't holding significant investments in a co. and gov't-run co's, and I'm pretty sure you know that and were playing to the masses by bringing up GM as an analog to the public option, but yes, that sounded pretty on the surface.)
But, I think there's actually some common ground in what you said in your numbered points. The key to public option is in the pricing model. But even if that public option offers free health insurance (which it wouldn't/couldn't) vs. my $15K annual premium today, I'm not going to switch on a dime. Let's say instead of health care insurance, the vehicle that gets you to your doctor isn't a financial services company, but an actual automobile. On the lot, there's a $50K Hyundai, a $55K Corvette. If we're talking about offering an American-made equivalent of Volkswagen's 'most economical car' on the lot at $12K. Do you think that this will destroy the market for that Corvette?
Mudge, remember, I fall quite a bit to the left of our President, so if you think I don't eye his centrist notions with a critical eye, you're mistaken. It's just that my ideal probably isn't even on your radar and when I disagree with the President's policies I'm not likely to find any viable solutions over in the GOP's response. But believe me, I do look with faint hope. I'm not seeing answers there. I'm not seeing a great answer in what Obama is supporting, but I am seeing a viable approach to insurance reform without radical rethinking of how the health care market itself is structured and delivered. So, until we're ready for that level of change, I see this as a good step forward.
GHP--I need to take issue with the statement that USPost and Mass Transit are consumer driven models....they are clearly not. They are government services, both of which are subsidized. Unless of course you and I have different definitions of "consumer driven".
ReplyDeleteI suppose I am equating "consumer driven" with "market driven". If you believe our current system is market driven, I must disagree (see Mudge's remarks).
This is becoming a serve and volley, which is something I try to avoid (I'd rather let readers serve and volley, while I move onto something else). I'm through for the time being.
GoHP - Thanks for the clarifications.
ReplyDeleteI must say I have a difficult time imagining any measure of intellect that would anchor someone to the left of this President so I never imagined, even from your writings, that you considered yourself to be so stationed. I now see, through my limited cyber-knowledge of you, that it is possible for the two to coexist, I'm just struggling with how. I am fairly certain you must find it equally perplexing looking from afar in a rightward direction to those of us who consider ourselves conservative (unless you are convinced there is no intellect here).
I believe we will need to agree to disagree but I did want to correct what appeared to be an uncertainty on your part about my comment about your "love of country". I was not questioning it. I was assuming from your writings that you have it. I should have said "love of country that I BELIEVE you have" instead of "..hope you have." I have been steering away from that horribly abused word, "hope", in recent months and I see it got me in a bit of trouble here. But the reason I added that comment is because it is becoming apparent that there is an increasingly large corona of advisors around our President who not only do NOT love this country, but who actively despise it. Who seek to undo the very essence of what the founders established and what generations of Americans fought and died to preserve. How it got into such hands rightfully rests squarely in the lap of those of us who fumbled it to the degree that despite all the checks, all the balances, this phenomenally successful example for the entire world is now in such hands.
I've always loved my country, unlike our First Lady (and who knows, her husband?). And that love was strengthened by visiting other countries, especially socialist or communist countries and speaking to the citizens or more accurately subjects of those countries. And it was humbling to think of how incredibly blessed I was to have been born into the US when I witnessed people who gave up their life's possessions, left loved ones behind and boarded an absolutely unseaworthy vessel in the remotest hope that they might, just might be able to get to the USA...or die trying. Why, WHY would we want to undo that? Although it just might solve our illegal immigrant problem because I can't imagine anybody wanting to put all that a risk to be subjected to socialism, even if it is in USA.
It completely escapes my ability to comprehend it. Maybe I am lacking intellect after all.
CW, FedEx and an Audi are part of the consumer-driven market. Health care isn't. So I'm saying that these aren't good analogies for that reason (among others), but I was looking for a way to demonstrate how the consumer will look at a set of offerings that includes both private and public entries. I'm open to looking at other examples if govt-run and private options in the same industry, if you've got some better example.
ReplyDeleteDid my admittedly simplistic car lot example get the idea across more effectively?