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Obama OK with ditching public option

Health Care Public Option 2009

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#21 Omega

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Posted 16 August 2009 - 09:34 PM

View PostSpectacles, on Aug 17 2009, 12:24 AM, said:

That's backwards, Omega. A public option would cost less to administer and would save money

But since the system as it exists would still exist, any additional administration cost is just that: additional cost.  The operation of that one particular program may be cheaper than existing programs, but it does nothing to reduce existing high costs except compete with them.  That competition would only have effect if it was cheaper for the end user, and if it actually is cheaper, there's really no point in having a public option instead of just socializing the entire system, because market forces dictate that everyone would move to the cheapest available plan.  Which, mind you, isn't evil incarnate.  But I firmly believe that all other things being equal, a capitalist system is much better suited to the realities of the world than a socialist system.  Just because we don't have a well-run capitalist system right now doesn't mean one can't be made to exist.

#22 Omega

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Posted 17 August 2009 - 06:35 AM

I would like at this point to make clear that nobody filed a complaint about the use of the term "tea baggers".  "Tea baggers" has been used in the past as an insult to describe all protesters everywhere in the US of the last few months, not just the irrational and loud minority of them opposed by Specs (and, I suspect, most of us; the loud and irrational are the enemies of everyone, as far as I'm concerned).  Since vaguely defined insults have a way of finding targets that they weren't intended for, I contacted Specs and asked her to define her insults more carefully in the future.  I did not intend to imply that anyone had complained.

I appreciate Specs' clarification.  Without it, there was the possibility that "tea baggers" could have been interpreted to include all those who oppose a public option healthcare scheme.  Even though it wasn't intended that way, we've all seen far too many cases where things have spiraled out of control because of a misunderstanding.

I want to also make clear, I do not consider Specs original post to be combative or antagonistic in any way.  I can simply imagine a situation where someone else might perceive it as so, which is something to be avoided if reasonably possible.  This has been part of our attempt to improve the atmosphere in OT, by trying to clarify away anything that might be misinterpreted as the "partisan bickering" so many avoid this forum over.  Once again, Specs, thanks for your cooperation.

Edited by Omega, 17 August 2009 - 07:15 AM.


#23 Mark

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Posted 17 August 2009 - 07:42 AM

Spectacles:

Quote

But then, I didn't buy into the "change" rhetoric, anyway, and I wondered just what exactly he'd fight for--aside from getting elected. I'm still wondering

Mark:
Yep. Took the words right outta my mouth. When a politician gets on his campaign stage, and offers the public "change", shouldn't that same public be asking what specific changes they're talking about?

Spectacles:

Quote

That's backwards, Omega. A public option would cost less to administer and would save money

Mark: As I've pointed out in another thread, the estimate that this public health care option would save money was only projected for the first 10 years of the program (as conducted by a Congressional committee). It's been said by some others who have dug further into the projected future of expenditures regarding the program that the bottom falls out when expanded to a 15-20 year estimate. IOW, it may save us money temporarily, but in the long run, taxpayers would be shelling out the loot.  I think we MUST look at all long-term projections for this proposed program, and take into consideration all the possible worst-case scenarios, and provide contingencies for as many of those as possible.
I think one of the main problems with Obama's Administration is that he's really pushing too hard, and too fast for people to take a good look. He's like a mechanic that starts working on your car before you can get an estimate of total cost, and even before you really understand what he's about to do. Then by the time the owner of the car does get all the information, there is already a hefty bill for services already rendered! I've had that happen to me, and it's no fun at all.

Also, I've had that same thing happen to me in the Emergency Room of a hospital. My doctor started ordering all these diagnostics to be run on me, and even with my protest against them (for money reasons) he talked me into getting them done. Then I get the $1000 bill from the hospital 3 months later, and a $500 doctor fee 6 months later. All that for a pinched nerve in my back that I knew was the problem when I went in. All they had to do was give me a shot of Dimmerall (sp), and my muscles would have stopped spasm. So, what actually cost me the money? The doctor demanding to X-ray my back. That's all. Oh, I nearly forgot...the shot of Dimmerall, which I had already told him would cure me. I get that same nerve pinch in my back about twice a year, so I already knew the problem, and the remedy. I only went to the ER b because my regular doctor was on vacation, and the pain was acute, and had me falling to the floor screaming in pain. I couldn't walk, crawl, or anything. Just going from the bed to the bathroom was an ordeal that caused me to sweat, curse, and fall to the floor. It took me 30 minutes to go the 5 yards from bed to bathroom.

Back on topic...Also, this bill must be a work in progress, so how CAN we decide whether or not we completely approve until it's finished? I'm not sure anybody really understands all it would entail, but starting up a MASSIVE new government bureau would cost millions...just for the new buildings which would have to be made, the new paperwork, and entire infrastructure of the program with it's new employees. Gads...how is that going to save money for anybody?
Mark
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#24 Spectacles

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Posted 17 August 2009 - 07:46 AM

View PostOmega, on Aug 16 2009, 10:34 PM, said:

View PostSpectacles, on Aug 17 2009, 12:24 AM, said:

That's backwards, Omega. A public option would cost less to administer and would save money

But since the system as it exists would still exist, any additional administration cost is just that: additional cost.  The operation of that one particular program may be cheaper than existing programs, but it does nothing to reduce existing high costs except compete with them.  That competition would only have effect if it was cheaper for the end user, and if it actually is cheaper, there's really no point in having a public option instead of just socializing the entire system, because market forces dictate that everyone would move to the cheapest available plan.  Which, mind you, isn't evil incarnate.  But I firmly believe that all other things being equal, a capitalist system is much better suited to the realities of the world than a socialist system.  Just because we don't have a well-run capitalist system right now doesn't mean one can't be made to exist.

If a public-provided health care option gives the taxpayer a better deal, then it's true that Blue Cross and other private insurers would lose business if they were unable to provide the same services at the same prices. That does seem to be a concern--which is actually an admission that private insurance is likely not a better deal for consumers.

The insurers naturally fight this. They argue that we either support their right to make a profit gambling on our health, or we support socialism. However, that is not true. If support of any government-provided insurance makes one a socialist, then there are a lot of over-65 "socialists" and their families in this country. Medicare is a socialist health insurance program that takes care of the demographic group that most private insurers are happy to ditch because they are more costly, needing more health care.

I don't believe that providing a public option--which would likely be more affordable and more dependable than private insurance--would destroy capitalism in the U.S.. It would not unleash a desire among the populace to nationalize hamburger chains and stores and all other industries. It may threaten the existence of some private insurers, but it would likely help to improve the profits of all other businesses, which would be free of the cost of providing health insurance.

I'm all for letting the private sector do what it can do best. And I'm all for letting government do what it does best. If the private sector would be unable to compete with a public health insurance option, then that's an indication that the public option would be a better deal for the consumer.


P.S. And thanks for your post on the "teabaggers" issue, Omega. I had erroneously assumed that someone had complained. I actually appreciate your being attentive and proactive like this; we don't always realize that our words can set off a tangential flame-fest, so it's helpful when staff steps in and points out to us that others may take offense. As I told you via PM, I'll avoid the term in the future.
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#25 Nick

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Posted 17 August 2009 - 08:18 AM

Nate Silver has an interesting writeup about why the Public option doesn't have enough votes and probably never did.  He's got a nasty habit of being right about these things . . . so I'm beginning to believe the Public Option really is doomed.  Too damn many bought-and-paid for Senators.

#26 Palisades

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Posted 17 August 2009 - 08:54 AM

View PostSpectacles, on Aug 17 2009, 06:46 AM, said:

If a public-provided health care option gives the taxpayer a better deal, then it's true that Blue Cross and other private insurers would lose business if they were unable to provide the same services at the same prices.

Medicare is said to engage in cost-shifting, where the price it allows itself to be charged is less than the cost to perform the medical procedure on a per patient basis. The hospital makes up the difference by charging those with private insurance more. If the public option also does this, then of course private insurance wouldn't be able to offer the same services at the same price. Likewise, private insurers wouldn't be able to compete if the public option paid the same price for medical services the private insurers do but the government funneled extra taxpayer money into the public option program on top of the premiums, meaning that the government program could lose money based on premiums alone because it was making up the difference with the extra infusion of taxpayer money.

Edited by Palisade, 17 August 2009 - 08:56 AM.

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#27 Balderdash

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Posted 17 August 2009 - 08:57 AM

View PostMark, on Aug 17 2009, 05:42 AM, said:

Spectacles:

Quote

But then, I didn't buy into the "change" rhetoric, anyway, and I wondered just what exactly he'd fight for--aside from getting elected. I'm still wondering

Mark:
Yep. Took the words right outta my mouth. When a politician gets on his campaign stage, and offers the public "change", shouldn't that same public be asking what specific changes they're talking about?

Spectacles:

Quote

That's backwards, Omega. A public option would cost less to administer and would save money

Mark: As I've pointed out in another thread, the estimate that this public health care option would save money was only projected for the first 10 years of the program (as conducted by a Congressional committee). It's been said by some others who have dug further into the projected future of expenditures regarding the program that the bottom falls out when expanded to a 15-20 year estimate. IOW, it may save us money temporarily, but in the long run, taxpayers would be shelling out the loot. I think we MUST look at all long-term projections for this proposed program, and take into consideration all the possible worst-case scenarios, and provide contingencies for as many of those as possible.
I think one of the main problems with Obama's Administration is that he's really pushing too hard, and too fast for people to take a good look. He's like a mechanic that starts working on your car before you can get an estimate of total cost, and even before you really understand what he's about to do. Then by the time the owner of the car does get all the information, there is already a hefty bill for services already rendered! I've had that happen to me, and it's no fun at all.

Also, I've had that same thing happen to me in the Emergency Room of a hospital. My doctor started ordering all these diagnostics to be run on me, and even with my protest against them (for money reasons) he talked me into getting them done. Then I get the $1000 bill from the hospital 3 months later, and a $500 doctor fee 6 months later. All that for a pinched nerve in my back that I knew was the problem when I went in. All they had to do was give me a shot of Dimmerall (sp), and my muscles would have stopped spasm. So, what actually cost me the money? The doctor demanding to X-ray my back. That's all. Oh, I nearly forgot...the shot of Dimmerall, which I had already told him would cure me. I get that same nerve pinch in my back about twice a year, so I already knew the problem, and the remedy. I only went to the ER b because my regular doctor was on vacation, and the pain was acute, and had me falling to the floor screaming in pain. I couldn't walk, crawl, or anything. Just going from the bed to the bathroom was an ordeal that caused me to sweat, curse, and fall to the floor. It took me 30 minutes to go the 5 yards from bed to bathroom.

Back on topic...Also, this bill must be a work in progress, so how CAN we decide whether or not we completely approve until it's finished? I'm not sure anybody really understands all it would entail, but starting up a MASSIVE new government bureau would cost millions...just for the new buildings which would have to be made, the new paperwork, and entire infrastructure of the program with it's new employees. Gads...how is that going to save money for anybody?


Actually Mark, I provided you and everyone else the projections put out by CBO (Congressional Budget Office) but here it is again: http://edlabor.house...eficit-ne.shtml

Another Democrat leaning Independent that has to search for truth because it can't be found on Fox News OR MSNBC.



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#28 Palisades

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Posted 17 August 2009 - 09:02 AM

^ The Democrats are spinning what the CBO actually said regarding the health 'reform' legislation being deficit-neutral.

Edited by Palisade, 17 August 2009 - 09:04 AM.

"When the Fed is the bartender everybody drinks until they fall down." —Paul McCulley

"In truth, 'too big to fail' is not the worst thing we should fear – our financial institutions are now on their way to becoming 'too big to save'." —Simon Johnson

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#29 Balderdash

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Posted 17 August 2009 - 09:04 AM

View PostPalisade, on Aug 17 2009, 07:02 AM, said:

^ The Democrats are spinning what the CBO actually said regarding the health 'reform' legislation being deficit-neutral.


The link that I provided is from the CBO, no spin from either side.

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#30 Palisades

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Posted 17 August 2009 - 09:08 AM

^ The link you provided is from the House Democrats, not the CBO.

Here is the CBO's site: http://www.cbo.gov/

Which is quite a bit different from a link that starts with http://edlabor.house.gov/

Edited by Palisade, 17 August 2009 - 09:08 AM.

"When the Fed is the bartender everybody drinks until they fall down." —Paul McCulley

"In truth, 'too big to fail' is not the worst thing we should fear – our financial institutions are now on their way to becoming 'too big to save'." —Simon Johnson

FKA:
TWP / An Affirming Flame / Solar Wind / Palisade

#31 Balderdash

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Posted 17 August 2009 - 10:38 AM

View PostPalisade, on Aug 17 2009, 07:08 AM, said:

^ The link you provided is from the House Democrats, not the CBO.

Here is the CBO's site: http://www.cbo.gov/

Which is quite a bit different from a link that starts with http://edlabor.house.gov/

Well, your link takes you right to the CBO's analysis but it can also begotten to by way of my link.

Edited by Balderdash, 17 August 2009 - 10:38 AM.

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#32 Palisades

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Posted 17 August 2009 - 10:45 AM

^ According to the AP article I linked to, the CBO says the House bill adds to the deficit.
"When the Fed is the bartender everybody drinks until they fall down." —Paul McCulley

"In truth, 'too big to fail' is not the worst thing we should fear – our financial institutions are now on their way to becoming 'too big to save'." —Simon Johnson

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#33 Palisades

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Posted 17 August 2009 - 11:20 AM

Matt Taibbi has gone off on Obama for his "pre-emptive health care surrender."
"When the Fed is the bartender everybody drinks until they fall down." —Paul McCulley

"In truth, 'too big to fail' is not the worst thing we should fear – our financial institutions are now on their way to becoming 'too big to save'." —Simon Johnson

FKA:
TWP / An Affirming Flame / Solar Wind / Palisade

#34 Lin731

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Posted 17 August 2009 - 03:23 PM

Quote

I'm glad my health insurance is safe and that we can be sure we won't have a public option that engages in cost-shifting.

It truly warms the cockles of my heart to know that YOUR insurance is safe, while I work fulltime without any coverage at all while also paying into coverage for other peoples kids (while my own kids have nothing), the elderly and the poor (poorer than me) and benefits for those useless sobs in DC. Afterall America was built on the concept of "Screw you, I got mine". BTW...insurance copays and premiuims are projected to continue their upward climb, while companies continue to downgrade or eliminate coverage altogether. So enjoy your coverage while it lasts.
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#35 Nick

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Posted 17 August 2009 - 03:27 PM

View PostPalisade, on Aug 17 2009, 09:54 AM, said:

Likewise, private insurers wouldn't be able to compete if the public option paid the same price for medical services the private insurers do but the government funneled extra taxpayer money into the public option program on top of the premiums, meaning that the government program could lose money based on premiums alone because it was making up the difference with the extra infusion of taxpayer money.

My understanding is the subsidies will operate as separate programs.  The public plan operates as a private entity for all intents and purposes, and any low-income subscribers get a subsidy, but they can chose any plan in the exchange--public or private.

Or are the subsidies usable for the public plan only as you seem to suggest?

(Edit to add:  Lin's post reminds me of something that's been bugging me at some of the debate I've heard).  Not wanting to "pay for anyone else's healthcare" is a silly reason to reject a public plan.  Most of us are already paying for other people's healthcare.  That's how insurance works.  Whether you're paying into a pool with all the other United Healthcare or Blue Cross or Kaiser Permanente subscribers, other subscribers in your pool get health coverage--and if the cost of their care exceeds the premiums they've paid in, then they're getting care on your dime.

The only way to ensure you're only paying for your own care is by forgoing insurance entirely and paying out of pocket for everything.  Of course, other costs still get passed on to you, you pay full menu price rather than what your insurer would have paid, and your hospital-clinic winds up squeezing you for other patients who defaulted on debts/were forgiven/etc.

So the only real way to pay for just yourself is to provide your own healthcare and treat yourself for what ails you.  I imagine this might make surgery a tad trickier.

Edited by Nick, 17 August 2009 - 03:32 PM.


#36 Omega

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Posted 17 August 2009 - 03:54 PM

[mod hat]

View PostLin731, on Aug 17 2009, 08:23 PM, said:

Quote

I'm glad my health insurance is safe and that we can be sure we won't have a public option that engages in cost-shifting.

It truly warms the cockles of my heart to know that YOUR insurance is safe, while I work fulltime without any coverage at all while also paying into coverage for other peoples kids (while my own kids have nothing), the elderly and the poor (poorer than me) and benefits for those useless sobs in DC. Afterall America was built on the concept of "Screw you, I got mine". BTW...insurance copays and premiuims are projected to continue their upward climb, while companies continue to downgrade or eliminate coverage altogether. So enjoy your coverage while it lasts.

I understand that you are in a difficult situation.  I have family in a similar position.  Your points are perfectly valid.  However, stating an argument in a combative fashion does help the presentation of your case, nor does it further the general discussion.

[/mod hat]

#37 Palisades

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Posted 17 August 2009 - 04:02 PM

^ Nick, I assume both the public option (if offered) and the private options would have government subsidies available.

Let me restate the text you quoted in a different way. Let's say the public option's premium works out to $4000 per year per insuree to cover the public option's payouts and administrative overhead. However, the govt decides that it will set the premium at $3500 per insuree. (That's before any subsidies low-to-mid income people may get.) Thus, the govt may advertise that its public option only costs $3500 in premiums, allowing it to undercut private insurers, but behind the scenes the govt is pouring an extra $500 per insuree into the public option program to make up the shortfall. It's possible the public option program won't do this, but if it does, it becomes very hard if not impossible for private insurers to offer the same coverage for the same premium. (Plus, as I said, if the public option engages in cost-shifting, that's another unfair advantage the public option program would have.)

Edited by Palisade, 17 August 2009 - 04:04 PM.

"When the Fed is the bartender everybody drinks until they fall down." —Paul McCulley

"In truth, 'too big to fail' is not the worst thing we should fear – our financial institutions are now on their way to becoming 'too big to save'." —Simon Johnson

FKA:
TWP / An Affirming Flame / Solar Wind / Palisade

#38 Omega

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Posted 17 August 2009 - 04:06 PM

View PostNick, on Aug 17 2009, 08:27 PM, said:

Not wanting to "pay for anyone else's healthcare" is a silly reason to reject a public plan.  Most of us are already paying for other people's healthcare.  That's how insurance works.  Whether you're paying into a pool with all the other United Healthcare or Blue Cross or Kaiser Permanente subscribers, other subscribers in your pool get health coverage--and if the cost of their care exceeds the premiums they've paid in, then they're getting care on your dime.

This is true, and paying for healthcare of others is not an unreasonable idea under those circumstances.  However, there are certain limits which the idea of truly universal health coverage defeats.  Look at people who engage in self-destructive behavior, such as smokers, the immobile obese, cutters, what have you.  Paying for some assistance in stopping, I can see that as being reasonable.  But paying for the treatment of people who actively poison or harm themselves, and will continue to do so?  That's a complete waste of money unless the people involved are going to stop.

Everyone gets sick, everyone needs medical care some time, so pooling money to pay for it is not unreasonable.  But there needs to be a line drawn somewhere where people can't shove the responsibility for the consequences of their own actions onto others.  Right now, that line is drawn by the market, poorly as it may function, charging higher premiums to people who engage in high-risk behavior.  Does the government plan to draw such a line?

#39 Palisades

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Posted 17 August 2009 - 04:10 PM

View PostLin731, on Aug 17 2009, 02:23 PM, said:

Quote

I'm glad my health insurance is safe and that we can be sure we won't have a public option that engages in cost-shifting.

It truly warms the cockles of my heart to know that YOUR insurance is safe, while I work fulltime without any coverage at all while also paying into coverage for other peoples kids (while my own kids have nothing), the elderly and the poor (poorer than me) and benefits for those useless sobs in DC. Afterall America was built on the concept of "Screw you, I got mine". BTW...insurance copays and premiuims are projected to continue their upward climb, while companies continue to downgrade or eliminate coverage altogether. So enjoy your coverage while it lasts.

What the heck? I've done absolutely nothing to you.

Surely, you can understand why I wouldn't want to support a health-care 'reform' plan that would possibly result in employers pushing their employees into the 'public option' -- a 'public option' whose supporters in Congress won't commit to taking for themselves if the legislation gets passed. If they won't eat their own cooking, why would I want to get forced into it?
"When the Fed is the bartender everybody drinks until they fall down." —Paul McCulley

"In truth, 'too big to fail' is not the worst thing we should fear – our financial institutions are now on their way to becoming 'too big to save'." —Simon Johnson

FKA:
TWP / An Affirming Flame / Solar Wind / Palisade

#40 Gambler

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Posted 17 August 2009 - 05:07 PM

View PostPalisade, on Aug 17 2009, 02:10 PM, said:

View PostLin731, on Aug 17 2009, 02:23 PM, said:

Quote

I'm glad my health insurance is safe and that we can be sure we won't have a public option that engages in cost-shifting.

It truly warms the cockles of my heart to know that YOUR insurance is safe, while I work fulltime without any coverage at all while also paying into coverage for other peoples kids (while my own kids have nothing), the elderly and the poor (poorer than me) and benefits for those useless sobs in DC. Afterall America was built on the concept of "Screw you, I got mine". BTW...insurance copays and premiuims are projected to continue their upward climb, while companies continue to downgrade or eliminate coverage altogether. So enjoy your coverage while it lasts.

What the heck? I've done absolutely nothing to you.

Surely, you can understand why I wouldn't want to support a health-care 'reform' plan that would possibly result in employers pushing their employees into the 'public option' -- a 'public option' whose supporters in Congress won't commit to taking for themselves if the legislation gets passed. If they won't eat their own cooking, why would I want to get forced into it?


It is my opinion that it sounded as if you were bragging.....i.e., I've got MY health insurance.

Just what it sounded like to me.



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