Sunday, September 20, 2009

Healthcare Debate (email from last year.)


My time to comment on all of this is limited but I had some stuff I wanted to get off my chest ...

1.   Rationing should be a matter of choice.   If you want to spend the money for care then you should be able to get it.   What your insurance covers is also a matter of choice, depending upon how much you want to spend.   The real problem with American healthcare is that we don't care about costs because we have come to expect someone else to pay for it.

2.   The article #1 at the bottom of this email reflects the concern of many that this is not just extending benefits to a few uninsured.   (If so, then let us call it public assistance and not have something so comprehensive.)   The proposed system stacks the deck (at taxpayer expense) in such a way that employers and everyone else will find it more cost efficient to go with the public option.   This isn't just additional "competition."   This is public subsidy, which always drives out the private sector.

This notional that the president said that the public option will pay for itself is contradicted by the fact that it will cost a trillion over ten years.   I don't even believe that this will be the real cost, because many have projected that the bill will lead to a single payer system within ten years.

It also takes away choice by forcing existing plans to meet government mandates if they make changes.   I have read that everyone will be under these government mandates within 5 years.   It will force people to have insurance even if they don't want it.

This is long term complete takeover of the healthcare system disguised as incremental changes.   This is the biggest power grab by the government in a long time.

3.   Insurance is not the same as healthcare.   People at one time paid for their healthcare out of their pocket, but since then everyone expects someone else to pay for their healthcare.

Lack of insurance is not the same as the lack of healthcare.   Emergency rooms are required by law to treat people regardless of if they can pay or not.

4.   There are provisions in the bill to limit medical advances as a means to limit cost increases.   It is not only counter to freedom but counter to progress.

5.   It has been documented in many places and at many times that the GDP per capita of all the countries of the world is inversely proportional to their tax rates.   We should caution against increasing the burden of government.   I am against the stimulus bill on this basis.

6.   Human beings are born selfish.   Little children want what other people have.

Over time most of them grow to take into account the feelings of others, but not all them do.   In recent years the political landscape has not been about protecting people's rights, which is the real reason for government, but seeing how many freebies people can get from the government, regardless if this is at the expense of others.

The only way to get elected today is to promise people something for nothing.   This is especially true in the healthcare bill.   People have come to expect something for nothing.

The left portrays Republicans as selfish people, but Republicans give more to private charity than Democrats.   It is because Republicans believe in private charity.   Democrats believe in giving away other people's money.

The left doesn't mind stealing from people because they have bought into the notion, and sold the notion to the American people, that people don't deserve the wealth that they have, and that they got wealth by unsavory means.   The corporations are portrayed as the bad guys.   They believe that the government should somehow equalize wealth in the country and bring down those who are wealthy.   However this notion that government programs can be paid for by soaking the rich is flawed, as it has been documented that if you taxed every millionaire at 100% of his income, that you wouldn't even come close to paying for the deficit from 2 years ago, and certainly not the current deficit or the current budget.

6.   Saying that Canada and England have a better healthcare system is a delusional fantasy.

"As a person who has lived on both sides of the border, I can attest to the superior quality of American medicine.   Services that took six months or longer to receive in Canada are delivered within hours here.   Doctors treat you as a paying customer worthy of their time, rather than an inconvenience; and after you factor in direct and indirect tax savings, I'm not paying much more for this higher level of service."

They may have more coverage, but not better care.   The vast majority of medical advances have been made in the United States.

There are countless horror stories of people dying while on waiting lists.   Coming to America for care.   People not able to get the best drugs for cancer.

I can't find the source of this story but I have seen the source before ....

They may have better results, we are comparing different lifestyles.

The issue of the American system is one of cost and coverage, not care.

They may say that they are more satisfied, but at least half the people are getting more out of the system than what they are paying in.   I would say that I am satisfied too if I am getting it for free.

7.   Saying that people parrot that the U.S. has a best healthcare system is to imply that we are somehow stupid.   It is typical liberal name calling.

8.   The constitution limits the power of the federal government, especially in the 10nth amendment.   That should be end of the argument.   Period.   Don't tell me that we should violate the Constitution because we will be better off.   Saying that we would have to abandon regulation if we followed the constitution is a straw man argument.   I believe in a regulated economy.

The states have the power to do this.   I think that the states should implement a single payer system if they want to.   They could band together to cooperate with each other.   If they federal government wants to implement a national program then it should be with the permission of the states.   The states should be able to opt out if they don't want to participate.

9.   Here is the real shocker:

Last year on my web site I endorsed a national single payer system.   Why?   Because we are halfway there now and there is no going back.   Because the current system is unsustainable.   Because I had learned of some success of the Japanese and other countries.   (Since then I have learned that the Japanese system is going broke, as are other countries.)   Because I don't think that the current system is really a free market system.   Because government created this third party payer system that caused costs to spiral out of control, and because government created monopolies, but only a single payer system would be able to fix prices.

I would prefer a free market approach to healthcare.   I just think that it is too late.   I don't think that it is politically feasible.   The government run healthcare programs aren't going to go away.

This is me looking at the political reality and not liking what I see.

I like the McCain plan very much.   I would much prefer this.

President Obama has made contradictory statements about lowering costs but increasing coverage and services, while claiming to save money on Medicare.   This is impossible without government controlling prices to some extent ...

Best wishes,

John Coffey

Article #1:

"Unfortunately, the public option, as proposed, fails in its execution. The program is scheduled to start with premium costs that appear to be much lower than market rate. Presented with the opportunity to opt into a health plan that presents such savings, it is reasonable to expect that many individuals and employers will be enticed to enroll in the government’s plan.

Absent any cost-reduction measures for the cost of providing care itself, however, the public option is almost certain to burn through its initial $2 billion reserves relatively quickly once the true costs of care begin to hit the system. The government will then be faced with the need to increase premiums within the public option or to increase taxes to pay for the public option.

This is what in business is known as a loss leader pricing strategy and, when applied to our national health care system, it could have dire consequences. Specifically, it brings into the realm of possibility the need to ration care in this country in order to control long-term costs.

In real terms, rationed care means that the entity that controls the health care system, in this case the government, will put a limit on the number of procedures that can be performed within the system in a given year.

It is not my opinion that the congressional leaders pushing the proposed health care bill are in favor of rationed care. To the contrary, I am certain they believe that the rationing of services will not result. However, studying the history of other countries and looking at the costs and drivers of cost in our own health care market suggest that it is a real possibility.

The public option will also take its toll on employers, who will be required to pay significant percentages toward their employees’ health care premiums (72.5 percent for single coverage, 65 percent for family coverage) if they choose to offer private insurance, or pay a tax equal to 8 percent of their total payroll toward the public option. As someone committed to the well-being of those who work with me, I can say that employers should invest in quality health care plans for their workers.

Because Congress has sidestepped the issue of addressing the cost of care, the proposed requirement on employers will make it very difficult for many organizations to offer private insurance, therefore forcing them into the public option and decreasing the choice available to individual workers."

Article #2:

On September 10, 2009, at 4:56 PM, CommonPaine wrote:

"For profit health insurance is a relatively new phenomenon. For most of the 20th century, health insurance was essentially a non-profit co-operative. Most of them are now gone, having converted themselves to for-profit companies. This conversion reached the tipping point in the 80s

Ever since, the insurance companies have become the vultures of health care. Those stories that the president relayed last night are nothing new. They have been an every day occurence for several decades. It is sufficiently common that local newspapers don't even bother writing about it anymore.

Let's face facts: health insurance companies bring nothing positive to our health care system. They provide no care at all. Their only fuction is to pool money. Even that they can not do ethically; they skim an obscene amount off the top by denying payment for care. I sold health insurance for a while back in the early 90s. One of the things I looked into was the loss ratios of the companies doing business in the state. For those who don't know what a loss ratio is, it is the percentage of premium dollars that gets paid out in care. I was astonished to find that a few companies paid out only 55%. They skimmed 45% off the top. Admittedly, these were not the majority of insurers. The majority were only skimming a paltry 25% - 40%. The really good ones generally kept a measly 12% - 20% for overhead. By way of contrast, the most efficient insurance plans around the world are all govt. programs. Single-payer plans typically require only about 3% - 5% for overhead, and preiums are way smaller as well.

While I have no problem with care providers earning a living by giving care, I see no reason why a company that gets rich by denying payment for care has any right to exist. You can idolize these vultures if you wish. They have proven themselves to be ethically corrupt and morally bankrupt."