This story was previously titled "A Public Option Isn?t a Curse, or a Cure"
A Public Option Isn't a Curse, or a Cure »
Posted By deathray 3 months, 1 week ago in Political Opinion
WE clearly don't need any more distractions from the two main issues of health care reform : how to deal with our large uninsured population and how to make the entire system more cost effective. So, for now, let's ignore the shouted rhetoric about whether "death panels" want to kill off Grandma or whether President Obama wants to turn the country into a socialist state.
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deathray
Hm...summarizing a life...Investment banker, sailor, unintentional gourmet cook. Ex US Naval officer, also Foreign Service. Split my time between NYC and Miami Beach ...
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deathray3 months, 1 week ago
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ok, a couple of things:
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the link to the story, if you don't want to register with the NYT is:
http://www.nytimes.com/2009/08/16/business/economy...
if you can't be civil, don't post. the words socialist, nazi, con, lib, pejorative comments, and personal attacks won't be countenanced. stay on topic.
Richard H. Thaler is a professor of economics and behavioral science at the Booth School of Business at the University of Chicago. I don't necessarily agree with his conclusions, but it's hard to dispute the environment he sets up.-
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Beau78903 months, 1 week ago
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I have a dispute with one of Thaler's arguments.
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He dismisses the comparison of private insurance's ability to compete with a public option to the experience of FedEx and UPS competing with the USPS. He says the US post office can't compete with private businesses unless it runs a deficit, and argues it must run a deficit because political machinations thwart cost-cutting efforts. Thaler then moves on, as if the post office's deficit spending should eliminate its consideration from the healthcare debate, though his very first sentence stipulates both goals of healthcare reform: cost-cutting and making healthcare available to more people.
Though Thaler doesn't explicitly state the inference, it's hard to ignore--cost-cutting and making healthcare more widely available run at cross purposes. There's simply no way to fulfill both goals completely.
The post office offers a relatively low-level service at a low cost to consumers. In order to compare the postal service to healthcare, one must imagine the post office as a life-or-death concern. In that case, there is a need for a public option--possibly not the best service, but one the poor can afford and that beats none at all. UPS and FedEx charge up to 30 times what the post office does--and they stay in business while doing it. A public healthcare option will give people who can't afford private insurance something they can use.
In this sense, if enough costs are cut from projected total healthcare spending, a public option is worthwhile, as it fulfills both stated goals of reform. I have yet to see an idea that would make a system without a public option affordable to those who can't afford private insurance. -
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hyperbola3 months ago
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Well DR, I arrive very late, but having scanned through many of the replies, it seems to me that there is a curious omission in them.
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The fact is that the inefficient, costly health care system in the US is a serious disadvantage for American businesses trying to compete in the world. Surprisingly enough all of the "free marketeers" here seem to overlook the fact that the present system of allowing a "manipulated health care market" (we do NOT have a private system with real competition) to gouge other businesses is a good way of losing competitiveness on the world scene. Something we cannot afford to continue doing.
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deathray3 months, 1 week ago
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fta:
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"So here’s some free advice to members of Congress: While you are enjoying your August recess and town hall meetings, instead of arguing about whether to have a public option, argue about the ground rules.
To the Republicans, I say this: If you can get real assurances that the public option has to break even, and that it will get no special deals from suppliers, let the Democrats have it but ask for concessions on tort reform in return. (That could actually save some money.) The resulting public plan will be too small to notice.
To the Democrats, I say this: If you want competition in health care, you won’t get it if the public option can make deals its competitors can’t. So either give the Republicans hard assurances that the public option would have to break even and not get special treatment, or, better yet, just give it up to ensure that some useful health care reform is passed. A public option is neither necessary nor sufficient for achieving the real goals of reform, and those goals are too important to risk losing the war. " -
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SonOfTheMask3 months, 1 week ago
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Let's say the author is right and a public health insurance option (with sensible rules) neither saves nor dooms the healthcare system. If so, what is the point?
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If such a system is NOT going to get market share compared to private healthcare insurance, why make the effort? Seems like it would be another exercise in fiscal irresponsibility to help some politicians "look good" to their constituents.-
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deathray3 months, 1 week ago
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i think it depends on the quality of the plan offered in the public option vis a vis private options, and the availability and price of the coverage to people. i'd like to see those details.
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it's really an argument about choice.
i'd think you'd be in favor of that. -
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Beau78903 months, 1 week ago
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The very first sentence of Thaler's piece states "the two main issues of healthcare reform, one of which is "how to deal with our large uninsured population."
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If private insurance won't or can't satisfy the demand for affordable options, then why wouldn't a public option get market share from those who can't afford the private ones?
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deathray3 months, 1 week ago
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one of the issues i'd like to see addressed in more detail is tort reform.
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is tort reform a red herring to justify overutilization by health care providers? what percentage of overutiliation is attributable to fear of malpractice suits?
additionally, if tort reform is enacted, how much money would it save? what would the protection of the consumer against the health care companies be, should the latter be able to deny any liability for their actions?-
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Beeboppin713 months, 1 week ago
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Reasonable tort reform could cut malpractice costs by 50 percent.(PNHP) Keep in mind that malpractice issues are only 1% of our total health care dollars.
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Here are some ideas on reform:
Placing caps on damages clearly do decrease malpractice insurance costs, and they do it without placing caps on specific damages such as actual expenses and loss of income. They cap only punitive damages and general damages, the pain and suffering award for which no amount of dollar value can be objectively determined.
General damages are important because they provide the buffer for allowing the attorney to profit without dipping excessively into the specific damages which rightfully belong to the injured patient. As much as we want to support our colleagues in the legal profession who represent patients with genuine entitlement to legal redress, we must plea with them to accept caps that are high enough to fairly compensate injured patients, but at a level that would prevent excessive enrichment of the plaintiffs’ attorneys. Using health care dollars to create mega-wealth for attorneys is just as immoral as using them to create mega-wealth for insurance executives.
And for egregious acts that warrant punishment, the criminal courts would provide a more appropriate venue for retribution. Punitive awards are a misuse of health care dollars. If the attorneys want to participate in a lottery, they should buy a ticket. -
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Natureboy3 months ago
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Many RNs have left the caregiving end of their profession because they were forced by greedy hospitals, HMOs etc to handle so many patients that they knew it was only a matter of time before they slipped up and killed somebody. Many doctors have fscked up and done somebody grievous harm because they were trying to treat as many patients as they could in order to optimize profits.
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Should "tort reform" be the bandaid that allows such situations to continue?
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calitennflo3 months, 1 week ago
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http://www.gpoaccess.gov/usbudget/fy10/browse.html
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Budget of the uS 2010
Does anyone know what the government spends in one year as management costs?-
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mesodude3 months, 1 week ago
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"Does anyone know what the government spends in one year as management costs?"
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--Why do right wingers make these simplistically self-serving arguments? Why do you pretend we don't all know of examples (either domestically or in the international community) of effective government? Why can't you admit that you *know* government can work and that what you're really afraid of is that it can and does work here and elsewhere and that people are often quite satisfied with government?
You people aren't afraid that government won't work. You're terrified that it *will*. The fact is you want (and need) government to fail because if it succeeds, you can't continue the charade that capitalism is superior or always the approach we should use. That's why you're always attacking government and doing everything in your power to make this belief that government is inherenty corrupt a self-fulfilling prophecy.
If you need any proof of what I"m saying, just look at what Bush alone did to any number of government agencies over the past 8 years (Justice, FEMA, EPA, FDA, CPSC, NSF, the Courts, Education, and on and on. You people even have the nerve to slam the IRS--all the while benefitting from the complexity and bureacracy you decry. When will you people realize that most of America is on to you? Just because you can point to flaws in government doesn't mean that government is inherently flawed or that this or that bureaucracy cannot be reformed. It certainly does not mean that the free market is always the way to go because, after this past year, we sure don't need evidence that it isn't.
Stop trying to peddle the lie that government can't work when we all know that you have every reason to make sure that it *doesn't* (or at least to make people believe that it can't be effective). Seriously, we're onto you. Surely you must understand this by now. Why are you convinced you're so clever? -
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Natureboy3 months ago
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Asking about "government" without specificity casts far too broad a net.
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Focus. Look at the typical overhead of a governmental health plan compared with that of a private insurer.
Governmental health plans are not just a little cheaper, they're a LOT cheaper. Medicaid plans frequently have administrative overheads of two percent or less. For private insurers, it's roughly 30 cents on the dollar.
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coolrayfruge3 months, 1 week ago
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It should be provided Freely.
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By the people,for the people.
We should work together and share the Technology and rescources to make our lives better for all of humanity.
To preserve our Freedom to live freely on this planet.
this planet provides freely all the rescources we need.
It is man that put financual burdens on it.
It should be provided Freely.
Not controled by privately owned companys or the governments run by the wealthy elite.
We compromised our freedom and Libertys because of this money system.
I've watched and seen how much control and power over the years, they have gained over our lives with money.
they have gained control over land and recourses with money.
Restricting our living with high cost.
In the days of the Hunter gatherers people live freely off the land, independently they provided food and shelter for themselves and their familys.It wasn't until the agricultural age when the people started fighting over territory.
We started to lose our Freedoms.
With this burden of money.
We now depend on others to provide for us.
We depend on them for jobs to have the money to pay for what once was free.
And we are at their mercy when it comes to getting a job.
We now have to meet their qualifications,pass background checks,credit checks,**** test,fill out a personnality questionaire,fill out a complete work history of your life.
and lets not for get a tax form so that can take out their percentage out of your pay chack.
Cause if you don't you can't have a job.
Most of all we have to put up with their arrogance cause they know they have control.-
beavis617bComment removed: Retracted by user1 Reply
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Beeboppin713 months, 1 week ago
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The article makes a few good points. It's been difficult for me to stand behind the proposed bill because after four years of careful research, I am 100% for a single payer plan like the one proposed by H.R. 676. However, too many obstacles stand in the way of that happening. It's a shame. As the article states, the real issues are dealing with the large proportions of uninsured or under insured, and the continually rising costs of care. I feel as if the public option only covers half that problem. I am skeptical but must back the government's efforts to try.
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The private sector has been out of control for some time now. They must be taught that playing with the lives of their policy holders will not be tolerated. That's not to say that I'm against all capitalistic ideas. I'm not. I love the fact that a nobody can start their own business and rise to the top. I just don't feel like a person's health should be included in that category.-
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fsev413 months, 1 week ago
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I agree, single payer is the way to go. One political drawback (I know there are many) is that it would necessitate Obama going back on his no tax increase for the middle class It would need to be a tax that would apply to every working person and their dependents and be applied before income tax and SS. Medicare would no longer exist as such. One of the trickier parts would be designing incentives for healthy life styles and regular preventative care and controls for hypochondriac types and those who fail to properly follow medical advice. No matter how you cut it real reform is a project of a magnitude that would create a huge change in our country. It's badly needed but may simply be unattainable in a unanimously acceptable way.
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jordan113 months, 1 week ago
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There can be no other option. All that's left is 'for profit', and as we see, for profit does not benefit health care. It leaves people without, or drops millions who pay into it. And they do this with impunity.
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The analogy that 'government doesn't run other things well' is a cop out. Doing nothing is not an option. People are dying. People need care. People are losing their jobs and their ability to pay for skyrocketing premium increases. Hospitals are closing from losing a fortune in services without payment. We MUST offer health care insurance that is NOT for profit.
And like it or not, we already are paying BILLIONS for those without care, more than needs be because they are stuck with going to high cost emergency rooms for care.
There is no choice! The consequences if we don't do this are unacceptable.-
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chevydog3 months ago
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The studies dealing with whether emergency room care is "high cost" are few; and some of them make contradictory assumptions, leading naturally to contradictory results.
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I'm not going to make the argument that "govt can't run things"; mostly because I don't believe it. But I do think that private companies will develop ways to protect and perpetuate the profits they currently make; mostly by diverting borderline cases to any govt entity involved. So I think that costs involved for any govt entity will turn out to be far higher than anything currently envisioned. It's not a matter of ineptitude. But govt programs almost always end up costing more than originally thought; mostly because the govt assumes that the environment will not change. The idea that a govt action may incite a counter-action is generally ignored.
I know this is heresy to the "health care is a right" people; but I think each of us has to answer the question "how much is too much?" To me, that's simply a recognition that one cannot meet unlimited demand with limited resources. Nothing to do with "protecting obscene profits" or anything like that. It's just that there is a price for everything we do, whether "good" or 'bad". And every time we do something, we have to ask that question. It's our criteria for saying no that are different; not that the question exists and is valid.
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chevydog3 months, 1 week ago
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There are all sorts of categories of people in the ranks of the uninsured. One of those categories is those who are ininsured because private concerns don't think they can recover the costs of paying at agreed prices for their medical care. If these people go to the "public option", you will automatically have a base clientele of above-average cost.
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I can also see, as a mattter of tactical operation, many insurers declining to insure certain borderline subscribers that they now do, under the rationale that these guys can go to the "public option". That's another layer of above average cost clientele.
Now I haven't seen any cost estimates for the "public option". But it seems that if it's required to operate on a break-even basis, that the subsidies will need to much larger than we think. It's very existence will lead private companies to find ways to funnel costs to it.
I don't really worry that the "public option" will drive private insurers out of business. My worries are two: (1) that the "public option" will be, something like the Postal Service, basically set up to fail; or (2) that it will become just another insurance company. -
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berkeley3 months, 1 week ago
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ralph has a contribution:
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http://www.propeller.com/story/2009/08/16/ralph-na... -
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Natureboy3 months ago
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"Richard H. Thaler is a professor of economics and behavioral science at the Booth School of Business at the University of Chicago."
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And what do you know about the Chicago school of economics? It is the Cathedral of privatization and neoliberalism, isn't it?
Reason enough to sink this story.-
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deathray3 months ago
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natureboy -
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no need to give me attitude regarding the various schools of economic theory.
yes, i am no supporter of the chicago school, as beavith will attest. i don't necessarily submit opinion pieces with which i am entirely in agreement, however, this seemed like a good piece to provide a good thread, and, so far, my hunch has been borne out.
trust me, i'm no monetarist.
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DarkWizard3 months ago
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CRYMTYPHON,
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As I was reading the comments, I had come to the same conclusion.
I was thinking; If these individuals, with normally differing views can see a reasonable compromise within this health care conundrum, then there is hope for the politicians.
On the negative side: When profit and greed are involved with the decisions of men, compromise often means "more of the same" and nothing really gets resolved.
I am hopeful that we have enough progressive politicians in place to light a fire under the feet of the good ol' boy's club on the Hill.
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bluetexasvalley3 months ago
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If you are against socialized health care, sign this petition. Be counted where and when it counts!
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http://www.thepetitionsite.com/3/i-pledge-to-deny-... -
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DEMONSLAYAR3 months ago
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This is really simple. first, the only real objection to this health care plan is the lost revenue the insurance companies will endure.second, its a simple case that if gov runs plan there is no profit taking. when wall street runs it, profit is a must. Before the republicans started deregulating things our hospitals in America where "not for profit" organizations. The whole dam mess happened when they handed the hospitals to wall street. Read the plan then listen to what republicans are saying. It's like there are two different plans. But there is not two different plans. Just lies from the right wingers who hate "we the people" and would rather have stars and bars then have stars and stripes
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dgoodii3 months ago
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There are still all three types of Hospitals; for profit, non-profit, and not for-profit. There are also not for-profit insurance companies out there as well. So who is exactly not telling the truth here, seems like both sides seem to not tell the slightest bit of truth to get more control.
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joeblowe3 months ago
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I just want to point out that I saw an article this morning - from a doctor in Canada - allowing as how their socialized medicine plan isn't working all that perfectly. They apparently are having problems delivering quality care to all those who need it (kind of sounds like the "rationing" that the "right-wing fearmongers" have been talking about, doesn't it?) They have said they need to "reform" the system. Probably to make it MORE LIKE the one we have here in the U.S. You may now STOP using the Canadian health care system as an example of what WE ought to do - it isn't all that swell either.
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