Left Coast Rebel suggested on Sunday that Nancy Pelosi was "stupid" for suggesting that substantial savings could be wrung out of Medicare and Medicaid. I am a little surprised that someone who wants to eliminate Medicare is so dubious about the possiblity that the program has substantial wastage. In any event, I sent the following response, which has not been posted on his site, and likely never will:
It looks like you have misinterpreted what Ms. Pelosi said, which is completely consistent with the President's proposals. Ms. Pelosi said that substantial savings could be achieved throughout the entire health care system, not just Medicare and Medicaid. That is what the President has said all along, so I am not sure why you find this so shocking. For example, there is no reason for the size of current government subsidies to Medicare Advantage plans. But it requires a system in which everyone is brought under the health care umbrella. For example, when families have health insurance, they do not need to use hyper-expensive hospital emergency rooms as primary care clinics. Public exchanges can exert pressure on provider groups to adopt the "medical home" service model in place of fee for service arrangements. There are dozens of savings ideas that flow out of trying to create a rational system that covers all Americans. This isn't fanciful speculation - the ideas were reviewed in depth in the Dartmouth Atlas medical cost project that was reviewed in the February 26, 2009 New England Journal of Medicine. So, as far as "stupidity" is concerned, seems to be more up to date in the academic research on health care economics than others one might name.
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I see LCR really got under your skin, enough to start your own blog. I like LCR. I also think it's great that you have decided to create your own blog/forum. Some folks on blogger run their blogs as 'moderated forums' because ultimately it's their blog—their own online journal/forum. We aren't always going to agree with other viewpoints and just because someone opposes what someone else writes, even through civil discourse, doesn't mean that person has to post what the other thinks. It's just the nature of blogging.
ReplyDeleteOn a different note, I'm not a fan of your use of the word 'teabagger' to describe what I feel is an important citizen's movement. I feel that it is derogatory as well as a blanket term to cover many people that I know of, including myself, who protest what we feel is an over-reaching federal government with out-of-control spending and such.
Then again, some folks are offended by inferences to Obama being akin to Hitler so therein I guess all's fair in political debate.
Good luck with your blog.
Nyp, I just don't believe that the government can or will run our health care efficiently or well. To institute government health care you will eliminate all competition and create a government monopoly. That's a formula for huge bureaucracy, inefficiency and even contempt for the patients, who can't take their business anywhere else.
ReplyDeleteYou can argue specifics until you are blue in the face, but the experience of other countries who nationalized health care is very bad. I don't want it.
Oh, by the way, you should name your blog with something that appeals to you and not something derivative of another blog.
ReplyDeleteThank you for the comments. I will deal with the substantive ones first, and then get to the fun 'n games.
ReplyDelete1. Stogie says "I just don't believe that the government can or will run our health care efficiently or well." There are so many ways to answer that! Here are a few:
(a) the President's plan does not "run" healthcare in this country. I preserves the very mixed system of public and private care that we already have. (Perhaps, in deference to conservative Democratic sensibilities, it does so to too great an extent.) A whole host of consumer protections are imposed on private insurers to eliminate the abuses (pre-existing condition exclusions, etc.) that we have heard so much about. To make those new regulations "work" economically for the insurers, they will get millions of new customers. To keep insurers from acting oligarchically, a "public option" will exist to keep the private players honest.
(b) the government already runs two highly-regarded major health plans: Medicare and the VA "Tri-care" program. Non-partisan research has shown both to be more cost-efficient than the private system and more popular with their clients.
(c) Every one of our major competitors has universal health care. Every one manages to cover virtually all of their citizens, yet spends only a fraction of what we spend on health care. One can always pick out individual treatment statistics to try to show we have superior care (for those who can afford it!) but most studies of suc neutral indicators as "amenable mortality" (don't ask) show that we lag behind or peer group, despite spending much more, despite leaving tens of millions uninsured, and despite leaving tens of millions more badly uninsured. So I disagree with you that "the experience of other countries who nationalized health care is very bad." Doesn't it say something that no one in those countries is clamoring to adopt our system? In fact, as I pointed out on LeftCoastRebel blog (before he decided that he did not wish to entertain dissenting points of view,) any elected politician in any other country who advocated scrapping their system and adopting ours would not remain in elective office for very long!
(I will respond to the other comments in a second post.)
OK, now for the mud-wrestling:
ReplyDelete1) Stogie objects to my use of the term "tea-bagger." Fair enough, although I could torture you with example after example of protestors who used that exact phrase to describe themselves, and, as Stogie concedes, it is hard to feel sympathy for the tender sensibilities of people who routinely label the President of the United States a Nazi, a Communist, a "Czar of Czars," an evil joker, a man intent on establishing a "shadow government," a secret Muslum, a secret Kenyan, and a person who has a "deep-seated hatred of white people." And that's just what they call the President! In the post to which I originally responded, LeftCoastRebel called Speaker Pelosi "stupid" because she relied on academic studies that suggested that substantial savings could be obtained from Medicaid and Medicare.
So it is a close question. I will leave it to my commentators to help me decide whether, under the circumstances, it is reasonable to refer to a segment of the President's opponents as "teabaggers."
2. The blog name: Perhaps my commentators are correct and I should not start out in reaction to someone else's blog. On the other hand [as you can see, I write with a lot of hands!] I thought what "LeftcoastRebel" did was both stupid and offensive. It was stupid because his blog is simply boring and derivitive without a lively back and forth among those reading the blog. It was offensive because, more than ever, we need more civil, if spirited discussions among Americans of different political persuasions. We are all aware of the modern phenomenon of different groups talking past each other. For about a week I actually had a series of useful dialogues with intelligent conservatives. I believe I had the better of most of those discussions, and that is the primary reason why "LeftCoastRebel" decided to go so far as completely changing his posting policy simply to get rid of my critical posts.
3. In any event, I will try not to repeat "LeftCoastRebel's" mistake. I welcome your critical comments. Who knows? Perhaps you will change my mind on some points.
And perhaps in the near future I will find a name for this blog that does not reflect back on an intellectual failure.
Nyp, you can disagree about the other countries but your disagreement isn't based on facts. The UK, Canada and France have rationed health care. What good is cheap health care if it isn't available? That's always the result with socialist schemes -- they don't work. They create scarcities. A couple of weeks ago the media reported that pregnant women in the UK have to wait 10 months for a hospital bed, which is inconvenient since pregnancies only take 9 months. As a result those women are having their babies in hospital bathrooms and corridors.
ReplyDeleteAs for the uninsured, it's up to them to buy their own insurance, it is not up to me to pay for it. I don't want to pay for their insurance, their rent, their cars, their gas, or anything else. I also don't want the government forcing me into a socialized health care system that I don't want. Is that freedom?
As for no one in those other countries "clamoring to adopt our system," plenty of them come here for medical treatment that they can't get at home due to long waits and rationed care. If you want their system, move. You aren't forcing it on me.
There are far better ways to reduce the cost of health care than creating a government run bureaucratic monopoly. Remove the barriers from allowing insurance companies to compete across state lines. Enact meaningful tort reform. Find ways to create more doctors.
Oh and one more thing, LCR has nothing to fear from you, so don't flatter yourself. Memorizing a ton of Democrat talking points is not the same thing as being wise or informed. Socialized medicine is a disaster wherever it's been tried. No matter how clever you think you are, there is no such thing as "something for nothing." We will pay for these socialist schemes in higher costs as well as in reduced quality and availability of health care.
ReplyDeleteAs for Medicare, it's bankrupt -- or didn't you know that?
Stogie: My disagreement with you is indeed based on facts. I presented them, and you ignore them in favor of assertion ("they ration!) and anecdote ("what about this heart-wrenching story in the newspaper!").
ReplyDelete1) The "fact" is that by accepted international standards of health care comparisons, the U.S. lags behind all industrial nations. See, for example, the peer-reviewed study "Measuring The Health Of Nations: Updating An Earlier Analysis" in the Jan/Feb. 2008 issue of "Health Affairs".
2) The "fact" is that, despite ranking dead last in "amenable mortality," we spend 16% of our national income on health care The OECD average is 8.9 percent, according to "OECD Health Data 2009."
3. The "fact" is therefore that we spend twice as much on healthcare as our peers, obtain worse outcomes, and, at the same time
provide no insurance to 46 million Americans.
When you have something with which to dispute these facts, let us know.
Now, you attempt to move out of the realm of "fact" into some more abstract sphere by declaiming that you don't want to pay for the uninsureds' health care any more than you wish to pay for their gasoline. By that standard, as I pointed out to LeftCoastRebel before he censored my posts. you must as a matter of logic, wish to abolish Medicare and Social Security. Putting that aside, I still don't think you realize that you are paying through the nose for the uninsured (whom you seem to think are shiftless and lazy rather than, for example, simply having had the bad luck to have worked for a business that closed or for a company, such as Wal-Mart, which does not provide health insurance.) We have a system in which the uninsured use emergency rooms as primary care centers. I cannot think of a more literally insane system of providing health care to families of workers who have lost their jobs than to require them to wait until they have a full-fledged health crisis that requires them to be admitted to an emergency room.
By the way: you assert that Medicare is "bankrupt". That is not correct, but Medicare is on a completely unsustainable cost path. What is your proposed solution?
Name one thing, other than fight war, government does efficiently.
ReplyDeleteName one program government had designed that has saved money.
Name one thing government produces.
to "eman":
ReplyDeleteyou ask: "Name one thing, other than fight war, government does efficiently. Name one program government had designed that has saved money"
Eman, there are many answers to your questions, but here are a few:
a) Medicare
b) the VA "Tricare" health system
c) the universal healthcare systems of every other industrialized nation
Medicare and Tricare have significantly lower operating and administrative costs than the private health insurance system. Medicare has has higher patient satisfaction than private system. VA Tricare has been uniformly aclaimed (since its overhaul by President Clinton and continued support by President Bush) for the excellence of its care for vets, especially those who have been badly injured.
As for the universal care systems of our economic competitors, they all use a much lower percentage of their national wealth on healthcare, yet generally achieve equivalent or better health outcomes than we do. And citizens in those countries do not face financial ruin if they lose their jobs and have major medical bills, the way they do here.
You also ask: "name one thing government produces"
Again, there are many answers to your question, but I will start with this: human capital, through government-run colleges and universities and, especially, community colleges.
Here is another answer: clean air and water, through the regulaton of private externalities.
Here is a third answer: public parks.
If you disagree with any of these answers, feel free to speak up.
All the programs you have listed in your first paragraph lose money and the bureaucracies that run them are inefficient, uncaring and difficult if not impossible for the general public to deal with. They are labor intensive for the users and could be done much more efficiently by the privet sector. They bleed taxpayer money.
ReplyDeleteHuman capital? What the heck is human capital? The public education system in this country is not something you would wish to challenge me on. It’s a mess. Compared to other countries, we just plain suck.
Public parks, though mostly nice, are poorly policed and unsafe for many because of the drugs grown on them. They never make enough money to pay for up-keep and the employees needed to do the needed maintenance.
I quote you…“Medicare and Tricare have significantly lower operating and administrative costs than the private health insurance system. Medicare has has higher patient satisfaction than private system.”
Tell me… Why is it that our healthcare system is the one rich people all over the world run to when they become ill? The Canadian system is so bad the doctors are asking for the government to allow privet insurance companies. The wait times for surgery are ludicrous. If Bill Clinton had been a Canadian when he needed his quadruple bypass, he would have DIED!! The wait in nine months!!!
VA Tricare is only better than the care they had before but AGAIN, it is not self sustaining and taxpayers are paying for a poor system. It is not what you think it is. I know, my daughter is a Navy vet and she has more problems than Carter has peanuts.
Your arguments are hollow, shallow and untrue.