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A supporter of “Health Care Reform” can take comfort in thinking that opponents of “reform” are simply stupid or nuts.
But what if there are real, explainable reasons for opposing these changes ? What then ?
Will proponents have to address their objections and reservations ? Might that slow down the “reform” train, which has a full head of steam ?
If there are any thoughtful objections, but folks never get the chance to raise them at Townhall meetings, does it make even a little sense to disrupt an effort that is apparently being railroaded through, despite these objections ?
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At the risk of legitimizing your opponents, or treating them with a modicum of respect, please try to state why you think there is so much fear of the changes threatened by a major overhaul of the nation’s health care delivery system.
I have not given this topic as much consideration as it obviously deserves;
my primary focus remains on ending the war against the Iraqi people.
I don’t believe either major party wants to end the real stimulus program, aka the Global War on Muslims.
So my charge to you is to state as best you can why opponents of reform are afraid. What do they think they’ll lose ?
If you simply don’t believe that they have any legitimate concerns, please post that elsewhere.
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What’s doing those people a disservice are the people who are shouting, getting angry, and committing acts of political and physical violence.
If the opposition to the Democratic plan was phrased the way you’ve phrased it here, then I think there would be a much more civil debate going on in this country.
I think that what the people who are carrying swastikas, and shouting that “the terrorists will in!” are afraid of is that the Democratic plan will work. If it does, and people who have been struggling for years to find affordable health care finally do, then there’s a rather large chance they won’t vote for Republicans for while.
Just as the Republican Party dominated politics for 30 plus years, the middle being given given something they’ve been asking for for such a long time might make this a Democratic country for the next generation or so.
I’ve asked conservatives to give me specifics of the plan that they’re worried about–not made up things, or Ayn Rand fantasy hypotheticals, but real specific worries, and I haven’t heard very many.
So what I would say to you, is to pose your question back to you: what are they really afraid of?
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But when has that ever stopped me ?
Big picture, I think folks see the amount of health care available as a pie, and if someone who doesn’t have much now gets a bigger slice, that means someone who has a bigger slice will get a smaller slice.
Now, the Obama argument against that is that the expansion of delivered care will come not out of the zero-sum pie, but will come out of health insurance company administrative costs and profits.
That’s Hope for ya. That’s the Community Organizer talking. I don’t think an accountant can find those savings. Ask Obama’s bean counter, Richard Orsazg.
So, in the naked, cold light of putting one set of selfish interests ahead of another, people don’t want to have their health care cut back.
The thinking seems to be that a person either gains or loses, but nobody is unaffected.
In this paradigm, the folks shouting down their Congressmen think that the Obama group, who mostly have OK coverage, are willing to sacrifice for the greater good, but are going to require even the opponents of change to share in that sacrifice.
Sacrificing by giving up watching a favorite TV show, or even sacrificing by paying higher taxes, these grumblers would grin and bear it, in the end. But to sacrifice their health, when its already in noticeable decline, that’s just too much to ask.
I’m thinkin’.
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Total cost of reform
Whether reform will be effective
Fear of being forced into a worse system and not allowed to pay for something different
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and couldn’t figure out how to edit the poll.
The only choice I can think of would be to delete and start over, but I don’t know if I could preserve the existing comments, so I think it best to just leave it alone. Sorry.
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Do you see it as moral imperative to create some sort of change that allows the 40 million who have exactly zero coverage (like me) to get access to health care?
I do.
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Because they aren’t well-developed, I’m not trying to defend my views here, or even present them. For example, I think that the biggest reform needed is to align Medicare/ Medicaid costs with money raised to pay for them, in an actuarily sound way. That probably means both higher taxes and restricting benefits based on lifestyle choices.
E.g., no pulmonary or cardiac services for smokers. No ICU or brain surgery for someone who rides a motorcycle without an approved helmet. I don’t see it as generous or charitable to subsidize such choices with tax revenues. Let some philanthropist or religious group pay for that.
How can anyone sell THAT pint of view ?
Ther may be 40 million without, maybe more, but they aren’t all like you. There are folks who won’t join – maybe 15 million, maybe 5 or 25 million – who will not participate unless we make it totally free and painless, and I don’t agree with that.
I don’t think a therapist or a physician should be conscripted into government service, unless they also joined the military.
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In this diary, I’m asking folks to try to imagine that their opponents have real, legit concerns. If you can’t do that, then how can you expect them to respect your positions and opinions ?
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This is one of the lies that has been pushed out.
You do make a very good point about lifestyle change though. France is often quoted as having the best healthcare in the world, but in addition to having a more streamlined health care system, their society is generally healthier than ours due to lifestyle differences (mainly that they walk places unlike a lot of Americans).
Unfortunately, there is no way to mandate lifestyle changes without infringing on personal liberties. However, we can streamline the health care system and start working towards lifestyle changes in the private/non-profit sector ala the anti-smoking campaign.
“No ICU or brain surgery for someone who rides a motorcycle without an approved helmet.”
A few years back I lived in another state and they were fighting a big legislative battle about helmets. In an backward looking, predictive analysis, data suggested that helmets actually drove up public health costs. That riders involved in serious crashes without one were far, far more likely to die (And be organ donors) in a crash than their helmet wearing brethren.
Data was also presented that showed there were far, far more head injuries to operators and passengers in cars and trucks. So to make the public policy that injured cyclists with no helmets can’t get ICU or brain surgery (nor presumably other expensive medical procedures) is shortsightred. The public policy, if attempting to balance cost and behavior, really should make that argument for car and truck operators and passengers.
It would be like finding out that people who eat Tootsie pops are 50 times more likely to get cancer than people who smoke- but cutting off healthcare for smokers.
I’m not advocating riding without a helmet (though I should advocate for driving with one) nor am I advocating smoking.
I’m making that point that from a good/best public policy point of view, things are usually a little more complicated than they seem.
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that I haven’t thought this through. I’m throwing ideas out for discussion, and your correcting is appreciated.
But there need to be data-driven choices that ration care based on not spending public dollars to correct injurious lifestyle choices.
And, as asked earlier, I think the family ought to be able to sell their home to pay an out-of-system provider to care for their smoker Grampa’s lung transplant, if that’s their choice.
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that grandpa can qualify for the transplant list, find a surgeon who will do the procedure and etc – I agree.(And I look forward to te day where grandpa’s dr can offer to grow him new lungs from his own tissue and transplant those)
But the larger point now is whether health insurance and/or health care are best delivered by a free market or not.
I get my water from a municipal system. It ain’t perfect – but I hate to think what it would cost if I had to buy from a private provider (ask the good people of Stockton CA). Likewise dozens – if not hundreds or thousands of other municipal or publicly regulated services. (police, bridges, interstate highways, electricity, gas, the FAA, Customs, etc, etc, etc)
In fact, I get the majority of my health insurance (Tricare) and some of my health care (VA) from “public options” and my complaints are minor.
Yes- people make bad choices. And yes, I am offended by even the appearance of having to carry any of the weight or burden of the consequence of their poor choice. But the line is rarely bright and obvious.
Forget motorcycles- how about dangerous or injury inducing recreational activities (skiing, rock climbing , white water rafting, illegal drugs and substance abuse, and other poor choices (self induced obesity, dui, etc) ?
Sure – let’s evaluate the choices. Yes, let’s make public policy that incents better choices and discourages poor choices. But let’s be careful.
One of my favorite examples is from the early days of panic in the AIDS pandemic. (I was on active duty in the Air Force and was part of a group advising the base commander whether we would follow the same rules on base.) A large county in Texas attempting to deal with HIV as a public health concern passed a law making it a felony to knowingly expose someone to HIV. Ie- if you knew you had HIV and had unprotected sex, you could be convicted of a felony. But if you didn’t know – no crime was committed. this created an incentive not to know your HIV status. Which was counter to the public health goal of minimizing the transmission.
It polled well – cause it sure felt good to try and punish those who would knowingly expose anyone else. But it was stoopid. LIke our own CO legislator who earlier this year wanted to make sure the CO legislature didn’t test pregnant women for HIV in order to try and prevent transmission to their babies.
see http://coloradopols.com/showDi…
In part his thinking was that the legislature does too much to shield people from the consequence of their bad choices. Even though pregnant women could have become infected without making the kind of poor choices we automatically associate with HIV infection. Perhaps her husband had affairs or shared dirty needles. Perhaps she didn’t know she was infected- nor that she could be.
But think about the policy implications- test the pregnant women and treat to prevent infant transmission (high % of success) or don’t test and have more babies with AIDS. (Schulteis is clearly blinded by ignorance and vindictiveness because he also said babies with AIDS would be a good thing because maybe the mom would feel guilty.)
Ok- so let’s test and treat only the pregnant women who didn’t use needles, didn’t sleep around, and were married to the father of their baby, etc. I.e, let’s really intrude in a bizarre, and ultimately useless, attempt to not cover those who made bad choices.
“Ultimately useless” because anyone with adequate information would be less than truthful. And in this case, its even dumber because the baby born with AIDS didn’t do anything that any sane person could qualify as bad behavior or a poor choice.
If we could prevent babies being born with HIV, we should because it’s better for all of us. Even though it may shield some mom from the potential consequence of her bad behavior; I mean maybe she did now how HIV can be transmitted, may she did share needles and have unprotected sex with multiple partners. Maybe she even is a bad person.
So what? All boats rise in a rising tide. And if she gets shielded form some part of the consequence of her poor choices – her baby isn’t born with AIDS – because it’s good for all us to have fewer AIDS babies – so be it.
Taken to a less obvious but similar extension- there are plenty of people who live under the security umbrella provided by the USA who don’t deserve it. They aren’t American citizens, they actually hate the USA, they pay no taxes even though they could, and etc. But in order to provide that security bubble to those who do deserve it- others get a free ride. So what – I still want the US to have a strong national security. Or for a more pointed- example: the 9/11 hijackers could count on their planes taking off safely and not crashing or breaking down because of the FAA.
Hey, maybe because you live here?
I’ve never heard any other nation or culture with this secular Protestant perspective.
birthcontrol pills are associated with a higher risk of breast cancer….Should women who used them be excluded from health coverage for breast cancer or heart problems? What about only unmarried women????
What about people with HIV/AIDS??? What if they caught HIV/AIDS in Africa from dirty needles when they were in a car crash, serving as missionaries??? How would you know where the HIV/AIDs came from??? DNA testing??
What about diet which is connected to diabetics…..only now they think maybe Type I Diabetics may be connected to a virus; what if you exclude Type II Diabetics because that is so influenced by lifestyle choice and then scientists discovered, after many had died, that it too was caused by a virus???
but I digress. Most people dying of lung cancer are suffering terribly, payment enough for their sins…doctors don’t do lung transplants on people with lung cancer…they might pull a lung….
I think it is a slippery slope you have started down…..What about higher premiums for those who smoke and/or drink???
Three points I would like to make:
1) I think that most of the people I have seen protesting at “Town Halls” and based on their comments, already have insurance and are fighting to keep what they have….which your poll reflects. The only people who should not be afraid of losing what insurance they currently have are those of us on Medicare. It is universal and you cannot be dropped.
Everyone else is vulnerable. Medicare receipants are supported by working men and women, many of whom cannot afford insurance for their themselves and their kids and yet every paycheck they pay a medicare tax to support senior citizens. Many of whom are fighting tooth and nail to keep those working people from having the same health security which seniors enjoy because of the taxes paid by those working families. Old people are mean and selfish. That is one of the reasons we got to be old. The backlash against seniors will be huge at some point.
2) You are on the right track to look at medicare. It is subsidized by the government and going broke because it is so effective that the population it serves is living longer.
Seniors pay $96 a month for insurance which covers 80% of doctors fees and associated medical costs; hospitalization is of no cost to seniors. The monthly payment covers about 25% of the actual cost. Seniors should and most can pay more per month for this insurance. Medicare payroll taxes should increase incrementally by a few cents each month, also. SEniors will squawk like hell at any increase, but trust me a few dollars more a month is doable and could begin to make a difference.
3) Medicare, unlike Medicaid, is already a public/private model. The medicare monthly payment of the $96 comes right out of a senior’s social security payment, so the administrative cost is negligible. But that insurance only covers 80% of the cost. Private insurers offer a supplemental policy to cover what medicare does not. I get bombarded with these offers every year….they go from plain to the very fancy……I don’t see why this model cannot be used to extend universal coverage to everyone…..except for the cost to the government.
almost exactly- because Tricare works a lot like Medicare.
The active duty military have no “premium” in the form of cash payments (though the Bush admin wanted to change that- and had McCain’s support) they pay their premium by wearing the uniform and all that entails.
MIlitary retirees choose between three flavors of Tricare- one that functions like an HMO, one that functions like a PPO and one that functions a lot like Medicare. Supplements are available from the market.
So- remove the age requirement for Medicare eligibility. Set a premium that more nearly covers the cost of the program. And make it 100% optional for anyone with “qualifying insurance.”
I could draft legislation in about 4 or 5 pages to accomplish this (you still have to define “qualifying insurance”, exclude illegal aliens, still have to figure out how the program interacts with the market and other public programs, etc)
There would be questions- could an employer force their employees into Medicare and just offer the supplement? (They would eventually- even Cigna, United and other health insurance providers)
What about the chronic unemployed who pay little or no payroll tax?
How do you cover kids of unmarried parents? Who pays their premiums?
But you get closer to 100% coverage, with portability and universal access.
Make one public option independent of employee/employer relationship and jave premiums taken from taxes annually, or premiums could be paid based on sliding scale based on need….with the gov picking up for the poor.
For me, it’s about personal liberty for precisely this reason. When the government takes over paying for health care (in one way or another), it leads to very legitimate questions such as the ones you pose above. Legitimate in that they’re the ones footing the bill.
I understand that some rationing of care has to occur in any situation, no matter who’s paying the price. But when it’s government rationing care, you’re at a significant disadvantage. After all, if your insurance company denies a claim you find legitimate you can (at least in theory) tell them to buzz off. But if the government does so, where do you go? Into the labrynth of the soft tyranny of bureaucracy searching for a solution among those who write the laws, interpret the rules, and run the courts?
Worse than that is where that soft tyranny goes next. As I mentioned above, the people who write the laws and make the “lifestyle choices” for people become one and the same. Can’t get a law through the courts restricting a certain behavior? Deny coverage for it through the medical arm of the government. You get your social change without all the trouble of actually running it through the consent of the governed.
Sure, some will claim “slippery slope.” But the fact remains that all insurance companies make the same decisions, and when government pays, they either have to make the same liberty-reducing and politically-charged decisions, or pay for everything. One is tyranny, the other is the fast train to Deficit-ville.
That, and I can’t for the life of me see an authorization for Congress or the Executive to run a health insurance company in the Constitution. But I’m old school like that.
I have it. I can never lose it, under existing law. I am guaranteed coverage; there is no exclusion for pre-existing conditions; if i get poorer, the government will pay for the “gap” that is not already covered by the government. Your taxes pay for this, LB. Thankyou.
I have better insurance than your kids And, I sure as hell don’t have to work three jobs to afford it.
You can see people like me at the “Town Hall” mtgs….screamig like stuck pig that the “govermit” is going to get its hands on my medicare and give medical care to kids and minorities…..(I think this may be a “snark.”_
I work for a physicians group advocacy group with offices in DC that are working closely with the congressmen drafting the bills. Therefore, my opinion has more weight than anyone here so you should listen to me.
Totally kidding with that one, but I will say from an insider’s perspective on this issue that real reform is needed and wanted. Our group is pretty evenly split politically, but even the conservatives in the industry want real changes because they will be out of work very soon if the status quo remains.
Having worked in health care for awhile now, it is still tough for me to wrap my head around exactly what is wrong and what needs to be changed, but I can tell you that there is a reason why the insurance companies are the biggest funder of the opposition. I would equate what is going on now to the mortgage crisis of the early 2000’s, except that we are trying to change the industry while the companies involved are still profitable and haven’t collapsed upon themselves.