Some carriers like Blue Cross Blue Shield in Illinois offer guaranteed issue at any time without underwriting or pre-existing conditions.

The key for Medicare-eligible individuals is to take the time during their open enrollment period to educate themselves about Medicare and the Supplements to ensure that they are making the right decision. A very informative site out there is http://www.over65insure.com. It is easy to navigate with easy to read content, plus people can cost compare carriers and their premiums.

All Supplement Plans are standardized by the government – so people need to understand that carriers charge different premiums for the same coverage!

Do drop by for a visit.

A definite great read..Jim Bean

How do I reconcile two perfectly-consistent concepts? Quite easily.

If the representatives are not doing the will of the people, are you suggesting our system of government is broken, and it’s time for a revolt and a new system?

FYI I don’t believe in something called “the will of the people”. The representatives are by definition doing the will of the representatives. In many cases this may indeed because they perceive their choices to maximize their chance of re-election, as inferred from public opinion. But there need be no direct connection, and in some cases our representatives can and even should be at odds with public opinion (if that’s what “the will of the people” means). Our Founding Fathers distrusted pure democracy. Notice that Senators were originally appointed, not elected. We have a Constitution to restrain government power from always implementing “the will of the people”. Etc.

So, that is how our government is set up. Whether this state of affairs demands a revolt because government doesn’t directly obey something called “the will of the people” is up to the beholder. I’m generally ok with it (especially since I don’t believe in t.w.o.t.p.), my main complaint I suppose being just that constitutional limitations are not often applied to our government’s decisions anymore.

it would simply bundle said regulation, creating a marketplace that is more open to influence from corporate interests than that which exists now. What I don’t understand is how relinquishing state regulation would result in a less regulated marketplace, which is, unless I’m mistaken, your overall goal.

Again you seem to be speaking as if there is a sort of pseudo-physical law, the ‘Conservation Of Total Regulation’. According to this supposed law, it’s somehow not physically possible to reduce Regulation at one level without increasing Regulation at another level. The Total Amount Of Regulation, it seems, is some sort of universal constant, like the Speed Of Light or Planck’s Constant.

I thought I made it clear last time you spoke this way that I do not believe in the Conservation Of Total Regulation. I have a policy preference for less overall regulation. You can disagree with that policy preference, or think it’s stupid, but what you’re trying to do here is to make that policy preference seem as if it’s physically impossible. Which is really weird, if nothing else. Again, I do not recognize such a Conservation principle.

Perhaps you’re just saying that what’s likely to happen will not go according to my policy preferences. Well of course not, what else is new?? But this is a discussion, I thought, about how we think things should be. This is how I think things should be (and you’re voicing how you think things should be). If we’re required to constrain our answers by ‘what’s likely to happen’ at all times, we may as well stop right now and just watch TV and see what happens.

However, I don’t see how your idea of opening up the market is going to somehow lower the cost of medical school, make MRI machines cost less than $1,000,000, [...] But lowering rates would require lowering costs. [...] oil changes, tire rotations, and car washes (even when performed by a certified mechanic) are not so costly [etc]

You seem unaware that prices are not static and come from known market forces. You speak of how much all these things ‘cost’ as if those numbers are written down in a special golden holy book somewhere. I’m speaking about market forces that help to prop up the ‘cost’ of these things in rather obvious ways. Perhaps I have not identified all of them, perhaps I overstate the effect of some, etc., but if you refuse to acknowledge that market forces that affect prices (‘cost’) even exist and take the ‘cost’ of each thing as a static, universal constant number (much like the Total Amount Of Regulation, I suppose) then of course you’ll fail to see my point throughout.

And “freeing up the market” is not an answer – it’s a principle, and a theory, but it contains no proven real world results.

Yeah, free markets have never operated to supply better goods and services to humans at lowered prices before. There’s literally no record of it happening. That’s why I’m typing this on my $3000 Texas Instruments LED-display 8-digit calculator.

[free markets] It certainly didn’t put the CDS market within the reach of the average person,

Bizarre non sequitur. What ‘average person’ wanted to buy CDS or even knew what they were? Why would any ‘average person’ even want one? Also, the problem with CDS is not and has never been that they are ‘unaffordable to the average person’. That has nothing to do with anything. You’re really reaching there.

Your basic argument is that, somehow, creating a freer market will increase competition which will lower costs, but you’ve failed to give a single example of when this has been the case.

I actually challenge you to find a single example of when this hasn’t been the case.

AIDS patients who signed up for health care before the were diagnosed, but who actually contracted the disease before their health care was approved and then get denied care. [etc]

How were their insurance contracts written? If the contracts considered this a pre-existing condition, there’s no problem. If they didn’t, the insurance company should be sued (and I assume would be). There’s no impetus here I can see for further government action than that.

The problem here is that the industry has been allowed to define, in many cases, what a “pre-existing condition” is

If that really bothers you so much, perhaps you shouldn’t be signing a contract that is written that way. Shop around. A lot.

Of course, that’s pretty hard when you show up for a job and are given a packet stating ‘here are your three choices of insurance package, pick one’. Which is precisely what I seek to end, of course.

Of course “insurance” is not as crucial to health/life as food.

Glad we agree.

But then, it’s also not nearly as expensive to buy a weeks worth of food as it is to get an MRI.

Which, of course, makes perfect sense, since the two are not comparable – I can’t envision circumstances where someone would need let alone get ‘an MRI a week’ for any extended period.

However, the food market, as I’ve pointed out, is *very* heavily regulated. But the price of food is not so high as to be out of reach of most people.

Food may be regulated for safety, but
-we don’t get food via our employers garnishing our paychecks and giving us a ‘Food Plan’
-we are not insulated/kept ignorant of the prices we pay for food, we see the actual numbers at the supermarket
-we are allowed to buy cheaper vs more expensive food as we see fit, with a wide variety of choices

Yes the food market is regulated. It’s also highly distorted by various subsidies. And of course there is a safety net/food stamps. Which makes it all the more striking that despite all that the relatively-freer market in food is so much better than the less-free market in health care. So there’s your example. We don’t even have to free up the market all that much (because I agree, the food market is not perfectly ‘free’) to show gains.

[Medicaid] How does a broken program that already exists render a discussion on reform of the industry moot?

Because the program supposedly exists to address all the things you’re complaining about. Otherwise, why do we even have it? If the program is ‘broken’, why aren’t you focused on fixing the actual program instead of all this other stuff? Or if we need all this other stuff, because Medicaid is ‘broken’, does that mean we can shut down Medicaid?

Wow…ummm…only response I can really give to this one is, do you have a tinge of humanistic empathy

What I said was: I’d like those things phased out, if possible. Wouldn’t you like it to be possible to phase out social programs for the destitute? Do you want there to always be destitute? Do you envision there being destitute who need ‘Medicaid’ for all time? In the year 9999? In the year 19999? Still Medicaid, food stamps, “section 8″? in the year 999999? On and on and on? What a bleak outlook. Who’s the one without empathy?

Ok, I read it again. And yup, I still see that, for patients between 24-30, the savings would outweigh expenditures by $6 billion over 25 years. I’d have to posit that as a savings.

Uh huh. And what about other demographics? You get to ignore them because..? In actuality the actual article cited 24-30 as the only demographic showing savings. To judge from the excerpt, it was certainly not an article about All The Bountiful Savings To Be Had. Of course if you get to cherry-pick the one particular demographic that shows savings, you’ll show savings. Not sure what that proves really.

Minimum coverage requirements are, in theory, instituted in order to make sure than insurers cannot sell insurance to someone that includes creative language that allows the company to stack the deck in their favor. Do you have a suggestion that would somehow work better?
You’ve already suggested your two basic regulations, which in theory would cover this issue

exactly, glad we agree

As such, what clarification would you recommend to take the place of minimum coverage requirements in order to make certain the insurance industry is not taking undue advantage of consumers?

I am not an insurance expert. I couldn’t tell you from scratch off the top of my head how to write up the specifics of fraud/contract law in the area of telecommunications, either. But so what?

Ummm…have you not seen the arguments above? That’s like saying “why should people keep up on the oil change in their cars when it is money they don’t need to spend?

People shouldn’t get oil changes more often than they need to. This is tautological. One thing to add is that people probably also shouldn’t get oil changes if they woke up one morning and suddenly found that all Jiffy Lubes charged $99,000 per oil change. That would be crazy. People should use their brains, look at prices, comparison shop, and weigh tradeoffs. In some cases (e.g. the $99k situation) yes indeed it might be a good idea to just go without oil changes forever. After all $99k would buy you at least a couple new cars. Et cetera. In fairly short order the price would come down to find buyers.

The point is that none of these normal, healthy, basic, longstanding human market mechanisms are even possible in the health care market. Let’s make them more possible. Are you really opposed to that? If so heavens why? If not then why argue?

[license] Just like I have a basic degree of trust in licensed mechanics, lawyers, magicians….

Heh..well, to each his own

Who would license physicians if not the government?

It’s not even ‘the government’ per se, but various ‘Boards’ who do it now. The ‘Boards’ certainly need not be part of government/state agencies (in cases where they are). What government does in addition is make licensing a precondition for ‘certification’ of hospitals/clinics, for Medicare compensation, etc. Judging from experience, I’m just not sure how much added value all of that creates.

But when it comes time to read those results, and prescribe the medication needed if the result is positive, we tend to prefer a licensed physician with a medical degree to handle that.

Hey, suit yourself. Choose that option then.

there’s a lot of countries that have a semi-socialized system of health care, some that even have fully socialized ones. The quality of that care is, in many cases, equivalent to ours,

I question how you’re defining ‘quality’ and ‘equivalent’.

Ok, so taking all the factors you state into account, I STILL don’t see the savings adding up to anything close to the 400% increase that we’ve seen in recent years.

Not sure how it was decided that I’m required to somehow prove that whatever changes I prefer would lead to savings adding up to this magic number “400%” you have somehow decided upon, if they were implemented (such a thing is unmeasurable unless/until we try it anyway). I am identifying things that tend to make prices higher, according to well-understood market forces. I am then suggesting that removal of those things would lower prices. Do I somehow know for a fact that the reduction would be 400% or any other number? Of course not. But that is a ridiculous standard that, if applied seriously, would lead to paralysis.

And your unlicensed doctor, lightly regulated industry has about as much chance of seeing the light of day, so I guess it is equally moot?

Heh. Probably.

Yes, actually, I think there is a huge difference between MRIs and mammograms. For one, the price of the machine. For another, the training required to properly do the procedure.

I actually wasn’t aware the ‘training’ was all that different. (I used to work around x-rays, CT machines, and linear accelerators BTW, but not MRIs, although I worked with MRI images.) In my observation though, which admittedly is limited, a 2-year/community college ‘Associate’s’ type degree was basically sufficient for either one (x-ray tech or MRI tech), I genuinely don’t know what the difference wuld be nor understand why you have the impression the latter would require so much more ‘training’. Maybe I misunderstood something *shrug*

It’s [training] why MRIs are far more costly a procedure than mammograms.

I’m just not sure I’m buying that FYI. That may, come to think of it, be the story that med techs, medical physicists, doctors, hospitals, and MRI-manufacturers etc peddle in order to justify billing far more for MRIs than for x-rays (if indeed they do). But really, I don’t see the huge gulf.

Your point relies on 60 Senators agreeing on something without compromise in the first place. Do you honestly believe that happens?

No, but obviously they don’t need to compromise with the other 40. Right? Why are you still arguing this? You know I’m right. I’m stating boring, obvious mathematical facts. What’s your point?

I find it sad that you don’t seem to have a problem with this, or see any reason to find compromise in order to move forward as a nation.

Interestingly, this brings us back to the post at the top (and my first comment here). No, I absolutely do not see a reason to ‘compromise’ qua compromise in order to move forward. I see a reason to implement good ideas rather than bad ones in order to move forward. I see no reason to ‘compromise’ with what I believe to be bad ideas. I don’t consider that ‘moving forward’. Why aren’t the bad-idea people required to ‘compromise’ with me? Better yet, why don’t they adopt good ideas, or at least defend their own, instead of trying to win political battles by this passive-aggressive sleight of hand that involves – rather than sincerely addressing their arguments and objections – complaining that people who genuinely, sincerely disagree with them ‘aren’t compromising’ which is ‘bad for the country’? It’s almost offensive, the more I think about it.

best

Again, while I may agree with a general principle, that does not require me to agree with the details of how you would implement it. That should not be striking. It strikes me that you, while seeming to be a fairly intelligent, well spoken person, find it so strange that someone could possibly come to a different conclusion than you on an issue in which they may agree on the overall premise, but not the details.

re: Obama vetoing/Congress not passing a bill with a mandate if it is not the will of the people – “No I do not agree with that proposition”

How do you reconcile this statement with your later statement that “our government was ‘designed to’ have representatives pass laws, or not, by majority vote, as long as the President doesn’t veto. So, if more than half of each house of Congress, and the President, want something done, it will be done, regardless of what I think, and this is how our government works.” If the representatives are not doing the will of the people, are you suggesting our system of government is broken, and it’s time for a revolt and a new system?

“Again, from government mandating purchase of their product. Microsoft can only dream of such a thing. But if you don’t see it, you don’t see it; I probably can’t help you.”

Except Microsoft would then have to compete with the government designed and subsidized OS, which seems to be the problem you have. What I don’t understand is how you can state that government mandating health insurance while entering the market to provide said insurance would increase corporate control of the market. I understand that it would greatly increase government control over the market. But how does that equate to corporate control?

“Weird, so (1) you complained that deregulation would increase corporate ‘influence’ over the contracts they sign etc, I said (2) yes, that’s my goal, and now you say (3) you don’t see how it’ll help me reach my goal. Who are you arguing with? Yourself it seems.”

I said it would increase corporate influence by allowing corporations an easier time influencing the politicians who legislate regulation, and allowing less direct control of said regulation by individual states. Your stated goal of deregulation is to create a more free marketplace that is less regulated, therefore more competitive which, you have stated, will result in a reduction of costs. I am not arguing that relinquishing regulation at the state level would create an overall less regulated marketplace. In fact, I have stated that it would simply bundle said regulation, creating a marketplace that is more open to influence from corporate interests than that which exists now. What I don’t understand is how relinquishing state regulation would result in a less regulated marketplace, which is, unless I’m mistaken, your overall goal.

“I am. That’s why – while I certainly want them to have control over their own contracts, I want them to have less control over health/well-being – no employer-tax-credit, no ‘mandate’, no minimal-coverage requirements, freer market. Make people less reliant on ‘insurance companies’ in general.”

Great idea, in theory. And if you could somehow actually lower the cost of health care, you might have an argument I could find some truth in here. However, I don’t see how your idea of opening up the market is going to somehow lower the cost of medical school, make MRI machines cost less than $1,000,000, or do anything else to lower the cost of administration or facilities required for modern health care.

“I didn’t ‘fail to address’ this. If someone can’t afford insurance, they can’t afford insurance. Maybe they shouldn’t get any. Maybe consumers should boycott insurance en masse until rates are lowered.”

But lowering rates would require lowering costs. As such, how do you suggest we lower the cost enough to make rates within reach of consumers without employer assistance? And “freeing up the market” is not an answer – it’s a principle, and a theory, but it contains no proven real world results.

“That’s precisely why it’s idiotic for insurance to be linked to one’s employment in any way, of course. My solution, mentioned several times now, is to eliminate the tax credit that causes this linkage.”

I still don’t see how removing tax credits and “freeing up the market” is somehow going to lower costs enough that said person would find health insurance within their reach without some kind of employer or government subsidy entering into the picture. It certainly didn’t put the CDS market within the reach of the average person, nor has it created an economic situation that has been favorable to most of the people who live in this country. Your basic argument is that, somehow, creating a freer market will increase competition which will lower costs, but you’ve failed to give a single example of when this has been the case. By contrast, one need only look to our neighbor to the north to find a system in which more people have access to health care at a cheaper cost.

“You’re taking the highness of rates as a given, as some sort of universal constant. But if things were different maybe rates wouldn’t be as high as they are.”

If things were different, maybe? Not exactly a strong argument. Where’s the information to back that theory up?

“I think this is a misrepresentation of what this ‘pre-existing condition’ thing refers to. Correct me if I’m wrong but here’s what that refers to:

-the insurance company, when you sign, says you must disclose any pre-existing conditions

-there are cases where people didn’t (either willfully or just forgot)

-and then when something happens and they make a claim, the ins. co refuses, citing the failure to disclose said pre-existing condition.

In such cases, according to the contract, nothing untoward has taken place except of course the insurance buyer signing a contract under false pretenses – claiming he disclosed all pre-existing conditions when he didn’t.

Or if that’s not the sort of thing you’re talking about, what is?”

Oh, I don’t know…AIDS patients who signed up for health care before the were diagnosed, but who actually contracted the disease before their health care was approved and then get denied care. Or cancer patients in similar situations. Or the woman who gets denied care when she files a claim after finally leaving her husband who was abusive. The problem here is that the industry has been allowed to define, in many cases, what a “pre-existing condition” is – and doing so is directly tied to their profit margin, so they’re naturally pretty lenient with that definition. Does this not strike you as being a little off the mark?

“Not to me. Heck, the food industry is intrinsically engaged in a market necessary to keep people healthy. People can’t live without food. But actually, people can live without “insurance”. Insurance is actually a relatively recent invention. People lived for millenia without it. To hear you speak, that should be impossible. So you must admit that however crucial you think “insurance” is to health/life, food is even more so.”

People lived for millenia without a lot of things, including sanitation and a system to deliver clean water. Doesn’t mean we would want to live without them now. Nor do I see how that is an argument that holds water in the current discussion. We have developed the systems we have as society has advanced. It is part of how and why we have advanced. Of course “insurance” is not as crucial to health/life as food. But then, it’s also not nearly as expensive to buy a weeks worth of food as it is to get an MRI. And if you can’t afford to go to the restaurant to have someone cook it for you, food can be easily prepared safely at home. Last time I checked, there’s not a lot of medical care that can be safely performed on a DIY basis.

“Yet people don’t have all these strange ideas about food, or speak of ‘food care’, or think the food market should somehow be treated differently.”

However, the food market, as I’ve pointed out, is *very* heavily regulated. But the price of food is not so high as to be out of reach of most people.

“One big reason is because auto insurance is more like actual insurance: defraying of large, unexpected, irregular costs. What we call health ‘insurance’ is actually a distortion of the word. It’s not really ‘insurance’ at all, it’s a prepayment plan. For some reason people expect their health ‘insurance’ to pay for or at least defray doctors’ checkups, vaccines, bottles of aspirin. Notice nobody expects auto insurance to defray oil changes, tire rotations, or car washes. And so it doesn’t. It’s only for the big stuff (repairs after an accident, etc) and that’s how people use it. Which makes it completely understandable why the premiums can be cheaper.”

Except again, oil changes, tire rotations, and car washes (even when performed by a certified mechanic) are not so costly as to be out of the reach of most people. And all of those things are within the abilities of people to do on their own. It’s why we have auto shop class in many high schools. But even something as simple as performing blood work is complicated enough to require advanced training, especially when it comes to translating the results. Granted, it might not take a lot of training to learn how to draw the blood (although, having had some experience with people drawing blood, I’d argue that it requires a little more than basic training…I’ve had more than one bad experience with nurses who are trained who still can’t seem to find a vein…). It certainly does, however, require a great deal of advanced training to interpret those results in a useful manner.

“Those things are safety nets not nationalizations. And notice one of them is Medicaid, our health-care safety net. Which renders much of this discussion moot.”

Except Medicaid is as broken as the rest of the insurance industry. And it’s a VERY wide net. To quote from one study, “It is estimated that approximately 60 percent of poor Americans are not covered by Medicaid.” How does a broken program that already exists render a discussion on reform of the industry moot?

“Well all else equal I would like those other things done away with if possible, of course. Just didn’t come up yet; this discussion can’t touch on every single subject (though it’s getting there )”

Wow…ummm…only response I can really give to this one is, do you have a tinge of humanistic empathy somewhere under that hardened exterior? ‘Cause you seem to be arguing in a way that would end up destroying any government sponsorship of humanistic programs that are designed to help those in need. If so, then we have a much greater rift in our basic methods of thinking than I originally thought.

“No, what you’re doing is relying on arguments that, if valid, would be arguments for nationalization. So I’m rebutting them in a very standard, rather obvious way, by pointing that out.”

Except the arguments I pose rely on PARTIAL nationalization, not total nationalization. Do you see that there is a difference, or is your view of the world one that is so black and white that the two sides can never meet?

Quoting from the Washington Post:
“For diabetes patients, only about two-thirds of that cost would be recovered in the first decade, when fewer complications materialize, and more than three-quarters would be recovered over 25 years, the study found. Only for the youngest patients, those aged 24 to 30, would spending on preventive care wind up producing a net savings: the study calculates that $21 billion spent on younger patients would cut overall spending on their health care by $6 billion over 25 years.”

Sounds to me like that puts us ahead in the long run, not behind.

“Heh. Did you even read your own excerpt? try again”

Ok, I read it again. And yup, I still see that, for patients between 24-30, the savings would outweigh expenditures by $6 billion over 25 years. I’d have to posit that as a savings.

re: minimum coverage requirements – “You’re probably right, that’s how they are usually thought of. Which is equally economically illiterate.”
Easy to say, but how do you support this statement? Minimum coverage requirements are, in theory, instituted in order to make sure than insurers cannot sell insurance to someone that includes creative language that allows the company to stack the deck in their favor. Do you have a suggestion that would somehow work better? You’ve already suggested your two basic regulations, which in theory would cover this issue…except as we’ve already established, there needs to be further clarification of your two regulations in order for them to work. As such, what clarification would you recommend to take the place of minimum coverage requirements in order to make certain the insurance industry is not taking undue advantage of consumers?

“Well good. Why should they spend money that’s not absolutely necessary to spend?

After all, you’re the one complaining about how much money “we” spend on health care. Well I suggested a mechanism to counter that. Your response? “But then people wouldn’t spend on health care!” I can’t win…”

Ummm…have you not seen the arguments above? That’s like saying “why should people keep up on the oil change in their cars when it is money they don’t need to spend? Just wait until it’s so bad the problem becomes catastrophic and you have to replace the whole engine”. And before you ask, yes, I know a few mechanics who have debated the necessity of oil changes, and will cite multiple examples of cars that have run for over 100,000 miles without ever having their oil changed.

“So you really trust CPAs because of that license, do ya?”

Nope, not solely because of that license. But it certainly gives me a good starting point. Just like I have a basic degree of trust in licensed mechanics, lawyers, magicians….

Who would license physicians if not the government?

“Who says anyone needs to “license” physicians at all?

Why does someone need a “license” to dab a cotton swab on your tongue and send it to a lab to test for strep?”

And quite commonly, the person who’s doing that swabbing is not a licensed physician. That’s why there are nurses, and registered nurses, and physicians assistants, and any number of other levels of people working within the health care industry. But when it comes time to read those results, and prescribe the medication needed if the result is positive, we tend to prefer a licensed physician with a medical degree to handle that. It allows us a level of certainty that the person who is handling the more elaborate parts of our medical care has a basic level of education and skills.

“There are many, many basic tasks we currently have $300k+ doctors with 12 years of schooling perform that could be done by someone hired from the Manpower temp agency. I’m not saying that’s ideal, mind you, but once again, if the goal is to save money – and you CLAIM yours is!! – I’m identifying sources of high cost. Licensing/etc is one of them”

Again, see above. Many of those tasks are already performed by (essentially) people hired from the Manpower temp agency. I don’t see how this has anything to do with removing the licensing restrictions on physicians.

“What I hear you saying now – just as with having consumers not divorced from how their health care dollars are spent – is a whole lot of “but then” (bla bla bla)!!! Well, you can’t have it both ways. These are some pretty obvious, well-understood factors that contribute to making health care expensive in this country. Eliminate/mitigate them, or stop whining about the high cost of health care. Pick one, not zero. There is no zero option.”

Ummm…yeahhhh…about that…there’s a lot of countries that have a semi-socialized system of health care, some that even have fully socialized ones. The quality of that care is, in many cases, equivalent to ours, and their costs are lower than ours. And they still license physicians, and regulate the industry, in many cases more heavily than we do. So, why is it that I have to choose between your two options when there are many other options that exist?

“Don’t recall mentioning health insurance companies in this process/context at all”

you’re right. I just found it very hard to believe that you honestly think that doctors should have no licensing body. If it’s not done by the state/governmental board, as you seem to suggest you would like to see, then who should be responsible for making certain that physicians are licensed and regulated?

“Sigh. ok, so the factor may be small. But it’s there!

It’s irritating when I give a long list of factors (litigation risk was #5) and then people sequentially isolate each one, pretend my WHOLE ARGUMENT was based on that one ALONE, and pick on that one in isolation. and then repeat.”

Ok, so taking all the factors you state into account, I STILL don’t see the savings adding up to anything close to the 400% increase that we’ve seen in recent years. This says to me that there must be another reason (or, more likely, several other reasons) for the spiraling cost of health care.

“Well, what I understand is that your ‘public care-conditional-on-government-scheduled-checkups’ idea has no chance of resembling any reform that goes through, so I guess it’s moot.”
And your unlicensed doctor, lightly regulated industry has about as much chance of seeing the light of day, so I guess it is equally moot?

“I love how you pulled a 5% number out of your hat, calculated $70 billion, and congratulated yourself. Question: how much did it cost to prevent that 5% of loss productivity? Less than 70 billion or more? You don’t know. You actually didn’t even attempt to address that side of the equation. Your task is really easy when you get to ignore one side of all equations at will.”

Actually, according to the Kaiser institute, the cost of paying for medical care for all uninsured Americans would be about $126 billion, with an overall reduction in cost to the system due to increased preventive care of about $86 billion. Add those the $86 billion in savings to the $70 billion (a conservative estimate) in increased productivity, and it becomes $156 billion. By my calculations, that’s a net gain of about $30 billion per year.

“Sigh…fine, replace “MRI” by “mammogram” in my sentence. It doesn’t change my point one iota, you think it does? (I don’t even see the huge difference, they are both internal imaging modalities, one uses x-rays the other uses magnetic fields, bit whoop)

By the way, I’m always puzzled when people bring up mammograms as the exhibit A of ‘preventative care’. Mammograms are x-rays of breasts. They do not ‘prevent’ anything.”

Yes, actually, I think there is a huge difference between MRIs and mammograms. For one, the price of the machine. For another, the training required to properly do the procedure. It’s why MRIs are far more costly a procedure than mammograms. And mammograms are thought of as a preventive measure because they screen for a type of cancer that, if detected early, is highly treatable. That means they, by definition, are a procedure designed to prevent an illness from developing into something life threatening. Isn’t that the definition of preventive medicine?

“It’s been a while since civics, but seems to me our government was ‘designed to’ have representatives pass laws, or not, by majority vote, as long as the President doesn’t veto. So, if more than half of each house of Congress, and the President, want something done, it will be done, regardless of what I think, and this is how our government works. ‘Compromise’ need not enter into it. I need not ‘compromise’ with them and they need not (and, of course, won’t) ‘compromise’ with me. So I really don’t know what you’re talking about by this ‘need to compromise’ stuff.”

Ummm…isn’t the idea of having multiple branches of government, with multiple congressman from each state, one that was put into our Constitution in order to make certain that each state had a voice, and that voice was heard, and in order for something to happen on the national level, congressional representatives would have to find a way to work together to get enough votes in order to pass anything? That sounds like a system that was designed to include compromise in its nature to me. But maybe my definition of compromise differs from yours.

“They ‘need’ do nothing of the sort. If 51 Senators and 218 Congressmen want a bill passed, it can be passed, and if the President doesn’t veto, it will become the law of the land. Those majorities ‘need’ not compromise with the minority 49 and 217 one iota, let alone vice versa. (Yes I realize I’m glossing over the currently Senate parliamentary rules that make it practically impossible for the Senate to pass something w/o 60 votes; change “51″ to “60″ above, doesn’t change my point.)”

Your point relies on 60 Senators agreeing on something without compromise in the first place. Do you honestly believe that happens?

“Yes, that seems a far more accurate description of our system of government to me. Well done.”

I find it sad that you don’t seem to have a problem with this, or see any reason to find compromise in order to move forward as a nation.

“How can you think I favor “anarchy” when I’ve already stated I want laws protecting property rights and against fraud? Anarchy is absence of government full-stop, not absence of, like, regulatory agencies and elaborate social-engineering tax credits….

So where on earth do you get “anarchy”? Sheesh, it’s as if you’ve been so far down a hole for so long that ‘10 feet upward’ seems like ‘outer space’ to you….”

Definition 3 of the word Anarchy:
“A social state in which there is no governing person or group of people, but each individual has absolute liberty (without the implication of disorder).”

That seems to be pretty in line with the “system” you have argued in favor of. No regulatory body, with each individual corporation having absolute liberty, but (somehow) without the implication of disorder. Your arguments are equally as anarchistic as mine are socialistic/fascistic. By your own branding of me, you’ve shown that one need not be a purist about the belief they are branded with in order to be labeled as such.

Ok, to be clearer: the striking part is that you still bother to argue even when/where you grudgingly agree w/what I actually said.

Does this mean you also agree that Obama/government will either not include a mandate or veto any bill that contains a mandate if it is not wanted by a majority of the public?

No I do not agree with that proposition

Except there is a separation of government/corporate. Therefore, if said mandate is taken care of at a basic level by government, then where is this new corporate influence/control of the marketplace coming from? [...] I still don’t see how this would increase corporate control.

Again, from government mandating purchase of their product. Microsoft can only dream of such a thing. But if you don’t see it, you don’t see it; I probably can’t help you.

I still don’t see how deregulating at the state level would let your stated goal come into effect.

Weird, so (1) you complained that deregulation would increase corporate ‘influence’ over the contracts they sign etc, I said (2) yes, that’s my goal, and now you say (3) you don’t see how it’ll help me reach my goal. Who are you arguing with? Yourself it seems.

I am just more offended by allowing corporate interests to have control over said conditions when it directly relates to health and well being. Why aren’t you?

I am. That’s why – while I certainly want them to have control over their own contracts, I want them to have less control over health/well-being – no employer-tax-credit, no ‘mandate’, no minimal-coverage requirements, freer market. Make people less reliant on ‘insurance companies’ in general.

You are correct in your analysis. But you fail to address the point of the consumers rate being raised to a level he can’t pay in the first place.

I didn’t ‘fail to address’ this. If someone can’t afford insurance, they can’t afford insurance. Maybe they shouldn’t get any. Maybe consumers should boycott insurance en masse until rates are lowered.

And what if the consumer is simply someone who lost his job, and therefore lost his employer-sponsored health insurance?

That’s precisely why it’s idiotic for insurance to be linked to one’s employment in any way, of course. My solution, mentioned several times now, is to eliminate the tax credit that causes this linkage.

As much as you might rail against employer sponsoring of health insurance, can you deny that without it, with rates being as high as they are, health insurance would be (and is) out of the reach of many people?

You’re taking the highness of rates as a given, as some sort of universal constant. But if things were different maybe rates wouldn’t be as high as they are.

Yes, but once I enter into that contract, I’m not allowed to deny parts of it because of some pre-existing condition,

I think this is a misrepresentation of what this ‘pre-existing condition’ thing refers to. Correct me if I’m wrong but here’s what that refers to:

-the insurance company, when you sign, says you must disclose any pre-existing conditions

-there are cases where people didn’t (either willfully or just forgot)

-and then when something happens and they make a claim, the ins. co refuses, citing the failure to disclose said pre-existing condition.

In such cases, according to the contract, nothing untoward has taken place except of course the insurance buyer signing a contract under false pretenses – claiming he disclosed all pre-existing conditions when he didn’t.

Or if that’s not the sort of thing you’re talking about, what is?

The health insurance industry is intrinsically engaged in the market of financing the care required to keep people healthy. Does this not place the health insurance marketplace into a different category?

Not to me. Heck, the food industry is intrinsically engaged in a market necessary to keep people healthy. People can’t live without food. But actually, people can live without “insurance”. Insurance is actually a relatively recent invention. People lived for millenia without it. To hear you speak, that should be impossible. So you must admit that however crucial you think “insurance” is to health/life, food is even more so.

Yet people don’t have all these strange ideas about food, or speak of ‘food care’, or think the food market should somehow be treated differently.

True. How, then, is it that the auto insurance industry seems to have rates that are within the range of most peoples finances, but we debate health insurance issues because it is out of the realm of many peoples pocketbook?

One big reason is because auto insurance is more like actual insurance: defraying of large, unexpected, irregular costs. What we call health ‘insurance’ is actually a distortion of the word. It’s not really ‘insurance’ at all, it’s a prepayment plan. For some reason people expect their health ‘insurance’ to pay for or at least defray doctors’ checkups, vaccines, bottles of aspirin. Notice nobody expects auto insurance to defray oil changes, tire rotations, or car washes. And so it doesn’t. It’s only for the big stuff (repairs after an accident, etc) and that’s how people use it. Which makes it completely understandable why the premiums can be cheaper.

Except we kind of have nationalized everything, through programs like food stamps, section 8 housing, Medicaid/Care, etc.

Those things are safety nets not nationalizations. And notice one of them is Medicaid, our health-care safety net. Which renders much of this discussion moot.

And I don’t see you arguing that those programs should be put to pasture because they are destroying the free markets they exist within.

Well all else equal I would like those other things done away with if possible, of course. Just didn’t come up yet; this discussion can’t touch on every single subject (though it’s getting there )

Your argument seems to rely on me suggesting 100% nationalization of an industry, which I have never done.

No, what you’re doing is relying on arguments that, if valid, would be arguments for nationalization. So I’m rebutting them in a very standard, rather obvious way, by pointing that out.

Quoting from the Washington Post:
“For diabetes patients, only about two-thirds of that cost would be recovered in the first decade, when fewer complications materialize, and more than three-quarters would be recovered over 25 years, the study found. Only for the youngest patients, those aged 24 to 30, would spending on preventive care wind up producing a net savings: the study calculates that $21 billion spent on younger patients would cut overall spending on their health care by $6 billion over 25 years.”

Sounds to me like that puts us ahead in the long run, not behind.

Heh. Did you even read your own excerpt? try again

Auto insurance has minimum coverage requirements. So does fire insurance. And flood insurance. They are usually thought of as protective devices to the consumer.

You’re probably right, that’s how they are usually thought of. Which is equally economically illiterate.

And yet studies show that creating a “health savings account” style model in which consumers pay out of pocket ends up in less people getting the care they need, because they don’t want to be divorced from the money in the savings account until it becomes absolutely necessary,

Well good. Why should they spend money that’s not absolutely necessary to spend?

After all, you’re the one complaining about how much money “we” spend on health care. Well I suggested a mechanism to counter that. Your response? “But then people wouldn’t spend on health care!” I can’t win…

And government licensing requirements for CPAs might make it more expensive to have someone prepare my taxes and keep my books. And yet, short of those licensing requirements, what means do we have to trust that people in such positions have a basic amount of schooling and knowledge?

So you really trust CPAs because of that license, do ya?

Who would license physicians if not the government?

Who says anyone needs to “license” physicians at all?

Why does someone need a “license” to dab a cotton swab on your tongue and send it to a lab to test for strep?

There are many, many basic tasks we currently have $300k+ doctors with 12 years of schooling perform that could be done by someone hired from the Manpower temp agency. I’m not saying that’s ideal, mind you, but once again, if the goal is to save money – and you CLAIM yours is!! – I’m identifying sources of high cost. Licensing/etc is one of them.

What I hear you saying now – just as with having consumers not divorced from how their health care dollars are spent – is a whole lot of “but then” (bla bla bla)!!! Well, you can’t have it both ways. These are some pretty obvious, well-understood factors that contribute to making health care expensive in this country. Eliminate/mitigate them, or stop whining about the high cost of health care. Pick one, not zero. There is no zero option.

Are you suggesting that the health insurance companies be allowed to license their own doctors, thereby allowing them to further control the rate of care?

Don’t recall mentioning health insurance companies in this process/context at all

The problem I have here is that studies have shown that the (granted somewhat limited) tort reform we’ve already put in place has already lowered the cost of litigation on the system to where it is, according to the most reliable estimates, no more than 2% of overall cost.

Sigh. ok, so the factor may be small. But it’s there!

It’s irritating when I give a long list of factors (litigation risk was #5) and then people sequentially isolate each one, pretend my WHOLE ARGUMENT was based on that one ALONE, and pick on that one in isolation. and then repeat.

That’s the great part about it being an option. You have the OPTION to include yourself or not. It would only be fascistic if I were proposing said care be mandated, and as I’ve consistently stated, I do not support a mandate, nor does most of the country. Rather, we support an option. Do you understand the difference?

Well, what I understand is that your ‘public care-conditional-on-government-scheduled-checkups’ idea has no chance of resembling any reform that goes through, so I guess it’s moot

According to one recent study, loss of productivity due to illness is a drain of 1.4 trillion dollars per year on the US economy. Let’s say we could prevent 5% of that. By my calculation, that amounts to about $70 billion dollars. Coupled with the increased savings from preventative care and lower costs of health care due to government not-for-profit intervention, that pretty easily offsets the projected drain on the budget from a public option.

I love how you pulled a 5% number out of your hat, calculated $70 billion, and congratulated yourself. Question: how much did it cost to prevent that 5% of loss productivity? Less than 70 billion or more? You don’t know. You actually didn’t even attempt to address that side of the equation. Your task is really easy when you get to ignore one side of all equations at will.

I’ve never suggested MRIs or further advanced procedures as a part of regular preventive care. I’m talking about things like mammograms..

Sigh…fine, replace “MRI” by “mammogram” in my sentence. It doesn’t change my point one iota, you think it does? (I don’t even see the huge difference, they are both internal imaging modalities, one uses x-rays the other uses magnetic fields, bit whoop)

By the way, I’m always puzzled when people bring up mammograms as the exhibit A of ‘preventative care’. Mammograms are x-rays of breasts. They do not ‘prevent’ anything.

[why there 'has to' be compromise]
Because it’s what our system of government was designed to do.

It’s been a while since civics, but seems to me our government was ‘designed to’ have representatives pass laws, or not, by majority vote, as long as the President doesn’t veto. So, if more than half of each house of Congress, and the President, want something done, it will be done, regardless of what I think, and this is how our government works. ‘Compromise’ need not enter into it. I need not ‘compromise’ with them and they need not (and, of course, won’t) ‘compromise’ with me. So I really don’t know what you’re talking about by this ‘need to compromise’ stuff.

If our representative democracy is to work as it was intended, the sides must find some kind of common ground on which to make it work.

They ‘need’ do nothing of the sort. If 51 Senators and 218 Congressmen want a bill passed, it can be passed, and if the President doesn’t veto, it will become the law of the land. Those majorities ‘need’ not compromise with the minority 49 and 217 one iota, let alone vice versa. (Yes I realize I’m glossing over the currently Senate parliamentary rules that make it practically impossible for the Senate to pass something w/o 60 votes; change “51″ to “60″ above, doesn’t change my point.)

Without that, we simply bounce between two extremes depending on who’s in the majority at the time, with each side spending as much time undoing what the last majority did as they do putting forth any new ideas.

Yes, that seems a far more accurate description of our system of government to me. Well done.

We do actually refer to those things as our food distribution system.

What you mean ‘we’? Certainly not me. I wouldn’t be caught dead talking like that.

Your response again seems to beg a question you’ve neglected to answer in the past – are you so opposed to anything resembling a system you would suggest anarchy?

How can you think I favor “anarchy” when I’ve already stated I want laws protecting property rights and against fraud? Anarchy is absence of government full-stop, not absence of, like, regulatory agencies and elaborate social-engineering tax credits….

So where on earth do you get “anarchy”? Sheesh, it’s as if you’ve been so far down a hole for so long that ‘10 feet upward’ seems like ‘outer space’ to you….