[slap_j]

Originally Posted by scarlet.starlet

When Bush was in power, it was "I don't care what you guys say; I'm going to spend your money to kill children on the other side of the world, and in the process, kill your children as well."

I'm no fan of Bush's foreign policy but this isn't quite fair. Obama has expanded the war on terror. He authorized the deployment of another 17,000 troops in Afghanistan in February. He's increased the defense budget beyond what Bush's was in his last year in office (by $14 billion iirc).

[ApparentlyNothing]

Originally Posted by Epaphras

The Gates folks understand the implications of a public option in the health care market, and are abandoning ship as they observe the iceberg approaching. A public ensurer will crowd out the private insurers, and we'll end up with a single-payer system anyway.

I honestly don't understand this debate. We already know that a government run program can coexist with a private run program. Want to send a package? UPS, FedEx, DHL, etc., are all thriving next to the USPS. Sending your kid to school? Private schools and colleges do well against public schools.

Why should MY tax dollars go to pay for YOUR kid's education and to send YOUR letters? But, I suppose I'd much rather it go to those things than to pay to keep you healthy and alive. They're much more important.

[Epaphras]

Originally Posted by ApparentlyNothing

I honestly don't understand this debate. We already know that a government run program can coexist with a private run program. Want to send a package? UPS, FedEx, DHL, etc., are all thriving next to the USPS. Sending your kid to school? Private schools and colleges do well against public schools.

Why should MY tax dollars go to pay for YOUR kid's education and to send YOUR letters? But, I suppose I'd much rather it go to those things than to pay to keep you healthy and alive. They're much more important.

I know; someone pointed out to me yesterday the inconsistency of saying out of one side of my mouth, "A public option will be less efficient and cost more", and out of the other side, "A public option will drive private insurers out of business." Either there really is something to the "public option playing by a different set of market rules" argument, OR one of the previous statements is wrong.

The administration believes a public option will be a stabilizing force in the market and expose the misconduct of the insurance oligargy, and will force them to shape up by ending pre-existing conditions, etc. But part of me doubts even that, because the insurance companies are being eerily silent in all this. Either they feel they can do just fine with a public option, or they are getting a sweet buy-out deal from the government or something. Anyone else wondering why they aren't speaking out against this?

By the way, something I just thought of: a lot of people say the government plan would "dictate" who gets care and when, that it will be up to a bureaucrat to determine health care. Isn't that what the problem is with private insurance? Often times it's doctors and patients against the insurance company. So, at worst instead of a private, unaccountable (well, only accountable to shareholders) private insurer bureaucrat, we have a public bureaucrat (who is at least accountable to taxpayers through his supervisor who eventually is a political appointee, plus you have the Congressional oversight), and at best we have a system where there is no antagonism between doctors and "insurers" or bureaucrats. The only question for the bureaucrat is "How fast can I process this claim?". Something to think about...

As you can see, I'm torn on all this and can't make up my mind!

[TunerSteve]

Originally Posted by Epaphras

As you can see, I'm torn on all this and can't make up my mind!

But apparently the Gates Foundation has made up their mind.

The troubling thought about their decision to pull out of many of those organizations is that many were working to bring medical care to very poor areas of the world. Guess it still goes to show you...follow the money. Bill Gates has been following the money for years.

[PatchworkMan]

Originally Posted by slap_j

I'm no fan of Bush's foreign policy but this isn't quite fair. Obama has expanded the war on terror. He authorized the deployment of another 17,000 troops in Afghanistan in February. He's increased the defense budget beyond what Bush's was in his last year in office (by $14 billion iirc).

But he has set a timeline for withdrawl from Iraq, which will drastically reduce American military activity in the long run, and thus American military spending. I have a lot of issues with Obama, but I think he's on the right track with the military. He's getting us out of the sidetrack war that's been an embarassment to America and getting us back into the war we should have been fighting all along.

[PatchworkMan]

Originally Posted by Epaphras

The administration believes a public option will be a stabilizing force in the market and expose the misconduct of the insurance oligargy, and will force them to shape up by ending pre-existing conditions, etc. But part of me doubts even that, because the insurance companies are being eerily silent in all this. Either they feel they can do just fine with a public option, or they are getting a sweet buy-out deal from the government or something. Anyone else wondering why they aren't speaking out against this?

Because it wouldn't do them any good. Their money is better spent on contributions to those who are against the public option.

As for the "stablizing force in the market", I'm not so sure about that. That argument rests on the assumption that insurance companies are all run by evil robber barons who are cheating us out of our money because they want to get rich. If this were really the case, it would be pretty easy for one company to be a little nicer and drop their prices a little and take all of the business away from their competitors. No one is doing this, which no one thinks they can do this, which in turn means health insurance companies are doing things the way they're doing them because they think it's the only way they can make a profit right now. And that leads me to believe that a public option will only squeeze insurance companies harder and hurt everyone who isn't directly benefitting from its coverage.

Now, the argument could be made that a barebones fallback for those who can't afford private health insurance wouldn't hurt the private providers too much, and I'd be willing to listen to it. But I am hearing no such argument from Washington.

[slap_j]

Originally Posted by PatchworkMan

But he has set a timeline for withdrawl from Iraq, which will drastically reduce American military activity in the long run, and thus American military spending.

Even after "combat brigades" withdraw he is leaving 50,000 troops there. Probably indefinitely like in South Korea.

I have a lot of issues with Obama, but I think he's on the right track with the military.

I'm not convinced of that. Obama seems to have co-opted the Bush administration's reasoning for the Iraq war, at least in part. Look at his words when he spoke at Camp Lejeune:

"We sent our troops to Iraq to do away with Saddam Hussein's regime and you got the job done,"

I will reserve judgment though. It's only fair. And at least the war in Afghanistan makes some kind of sense.

Okay, finished with this digression!

[Bryan]

let's stop the discussion about Iraq and the military now, please. before it gets out of control.

[tlj009]

I know; someone pointed out to me yesterday the inconsistency of saying out of one side of my mouth, "A public option will be less efficient and cost more", and out of the other side, "A public option will drive private insurers out of business." Either there really is something to the "public option playing by a different set of market rules" argument, OR one of the previous statements is wrong.

How can the public option not be playing by a different set of market rules? If it receives funding through taxes, it plays by a different set of rules. If it places more pressure on the doctors and hospitals to drive down their prices because they are the government, the doctors and hospitals will make up the difference from the private companies. If it doesn't make a profit, it doesn't follow by the same set of market rules. If it can't be sued (you can't sue the government), it plays by a different set of rules.

The devil is in the details, but I simply don't see how a public option could follow the same set of market rules. Maybe by keeping medicare/medicade to receive taxes and add another public option that was funded strictly through premiums? But even then you would have to be very careful to not skew the market toward the public option. You would have to be sure that there is enough added to the premiums to account for the fact that the government can't be sued and that the private companies must make a profit. I almost forgot about the Insurance Exchange. That new level of bureaucracy will cause an increase to the overhead of private companies but will likely run the public option. So it has the potential of making the private companies pay the overhead for the public option. Yet another detail that would have to be worked out.

[Epaphras]

Patchworkman -- this goes back to my original "playing by a different set of rules" thing.

A public option would - for all intents and purposes - look just like a private insurer. It would be a public/private enterprise like the USPS or PBS, which have private counterparts in FedEX, UPS, DHL, and network television. The only thing different is it would receive a subsidy from the Treasury to cover the costs of the "uninsurable", something the current private insurance market does not receive. So that -- coupled with stricter rules for private insurers -- means you have private insurers on the one hand who don't get the subsidy yet are required to eat more costs by covering risky people, versus a subsidized public option that doesn't feel that squeeze because daddy is writing the big checks for them.

If PBS were not subsidized, would it survive in against ABC, NBC, and CBS? Would Jim Lehrer really hold a market over Charles Gibson? If FedEX and UPS were allowed to send letters for less than $0.44 (or whatever it is) a letter, would the USPS remain in business long if not for the subsidies?

And that leads me to believe that a public option will only squeeze insurance companies harder and hurt everyone who isn't directly benefitting from its coverage.

I won't go so far as to say it's a conspiracy of the government to reach the end-goal of a single-payer system, but if the private market is squeezed out and we end up with everyone enrolled in the public plan anyway, the end is achieved. I'm fine with a single-payer system if it's equitable, efficient, and effective. BUT, what I'm worried about is that a deficient public option would be propped up with subsidies (as in, it can't survive "naked" in the market) and that would lead to it's monopolization. So you end up with one big lumbering ineffective health provider, because of the way the rules are written and because of who is paying the bills.

In other words: I'm open to a government-run or government-sponsored health care system in this country, IF it can be demonstrated that such a system would continue to provide the level of care and innovation that the "free" market system provides today. If Medicare and VA recipients are more satisfied with those systems over private insurance, then I'm all for a universal Medicare system. But you usually don't hear good things about the patient experience under those systems, PLUS they don't seem to be financially sustainable.

Final note for now:

That argument rests on the assumption that insurance companies are all run by evil robber barons who are cheating us out of our money because they want to get rich.

If you ask me, it is not possible for a publicly-traded company to put the needs of its customers ahead of the demands of its investors and shareholders. It would be disingenuous to investors and shareholders. Only a truly not-for-profit insurance company (which most of these were 70 years ago when they started) would have the kind of accountability needed to ensure that customers' and patients' interests are put before investors'. That doesn't mean it doesn't earn a profit; it simply means the profit does not go to shareholders, but rather back into the organization, perhaps into the pool designated for the "high risk" customers, or towards keeping everyone's premiums down.

The never-ending battle of patients and doctors (and hospitals) versus insurance companies proves to me that insurance companies do not have the attitude of "Let's make sure this doctor gets what he needs to care for his patient", but rather, "How can we avoid paying for this procedure?". It betrays the insurance companies' true priorities and true loyalties, if you ask me.

[ApparentlyNothing]

Originally Posted by Epaphras

I know; someone pointed out to me yesterday the inconsistency of saying out of one side of my mouth, "A public option will be less efficient and cost more", and out of the other side, "A public option will drive private insurers out of business." Either there really is something to the "public option playing by a different set of market rules" argument, OR one of the previous statements is wrong.

The administration believes a public option will be a stabilizing force in the market and expose the misconduct of the insurance oligargy, and will force them to shape up by ending pre-existing conditions, etc. But part of me doubts even that, because the insurance companies are being eerily silent in all this. Either they feel they can do just fine with a public option, or they are getting a sweet buy-out deal from the government or something. Anyone else wondering why they aren't speaking out against this?

By the way, something I just thought of: a lot of people say the government plan would "dictate" who gets care and when, that it will be up to a bureaucrat to determine health care. Isn't that what the problem is with private insurance? Often times it's doctors and patients against the insurance company. So, at worst instead of a private, unaccountable (well, only accountable to shareholders) private insurer bureaucrat, we have a public bureaucrat (who is at least accountable to taxpayers through his supervisor who eventually is a political appointee, plus you have the Congressional oversight), and at best we have a system where there is no antagonism between doctors and "insurers" or bureaucrats. The only question for the bureaucrat is "How fast can I process this claim?". Something to think about...

As you can see, I'm torn on all this and can't make up my mind!

Well..... I was not expecting that. You basically said everything I was planning on saying after you were supposed to respond, "Oh, but those public services are horrible and inefficient!"

So, I guess we agree then

And, I think the insurance companies are speaking out against this... just not with words. You have to believe that their money is doing the talking. I know some are saying they paid a lot of the protesters that showed up at the town hall meetings. I don't know whether that's true or not, but it would certainly make sense. And if it's not true, I'm sure their money is going towards lobbying and other ways to push things in a way that makes sure they still make as big of a profit as they are making now.

[Mattlock]

Originally Posted by tlj009

Those are very skewed statements. If you want them on the same ground you can rephrase like this "I don't care what you guys say, I'm going to spend your money to fight in another country so that we don't have to fight on American soil"

Wait, which one are you implying; that the incompetent Iraqi military was going to fight us on our soil, or the non-existent Iraqi terrorists were going to fight us on our soil, or the Iraqi insurgents who just want us to get the hell out of their country were going to fight us on our soil?

I mean, all three of those options are absurd, I just need some clarification.

[adamwagg]

Iraq? Terrorists? Health Care?

Not normally three things I think of together. Can we jplease ump back to health care reform thanks!

[tlj009]

Wait, which one are you implying; that the incompetent Iraqi military was going to fight us on our soil, or the non-existent Iraqi terrorists were going to fight us on our soil, or the Iraqi insurgents who just want us to get the hell out of their country were going to fight us on our soil?

I mean, all three of those options are absurd, I just need some clarification.

I was implying that the original statements were skewed toward one side.

[nolidad]

Originally Posted by PatchworkMan

But he has set a timeline for withdrawl from Iraq, which will drastically reduce American military activity in the long run, and thus American military spending. I have a lot of issues with Obama, but I think he's on the right track with the military. He's getting us out of the sidetrack war that's been an embarassment to America and getting us back into the war we should have been fighting all along.

After Bush already had negotiated timelines for reductions. Works for me though. Glad we went- glad to get teh troops home.