(09-19-2013 01:44 PM)Tom in Lazybrook Wrote: The plan could be better (making it universal and stripping away the link between employment and access to health care, making doctors who gained their careers with taxpayer help actually being required to serve the taxpayers and stopping the gigantic ripoff of American consumers by pharma, etc.) but it is far better for millions like myself.
The critical issue is one of ever increasing compensation of health care executives. They can continue to raise prices at will due to the inelastisity of health care demand (they raise the price, you'll keep paying for it until you can't access money anymore) as well as the fact that there are barriers to entry (certificate of need restrictions on competition) that make the health care market inefficient.
I can't vote to change a private health care monopoly/oligopoly (effectively what we have in Texas). I can vote to change a government that runs a public health care system.
The private health care system has failed the American people (not just poor Americans, even RICH Americans who have pre-existing conditions).
Tom, you have the talking points well memorized, but you don't appear to have a clue what they mean.
Making health care universal, at least at the basic level, and de-linking employment and health insurance are good ideas. There are many ways to do those things. The best approach by far, based on the experience of the rest of the world, is the Bismarck universal insurance approach. The worst approach, again based on documented world experience, is the single-payer approach (like Canada) that democrats claim to want to go to, and the second worst is the single-provider system (like UK) that is what I think democrats seem to mean when they say single-payer.
As for doctors who gained their careers with taxpayer help, when they get out of med school owing several hundred thousand dollars worth of student loans, sounds like they didn't get enough help. There is a system where docs do in fact gain their careers with government help--France, a Bismarck system--and in return commit to work for the "free" system for a period of years. That would be a sensible thing to do if we went to a Bismarck system.
What is actually happening in you call the ripoff of American consumers by pharma is pretty easy to understand. Pharma spends huge R&D money developing new treatments. Since most of the R&D money is spent here (research is one of the few places where the tax benefits are better here than anywhere east), the R&D costs accumulate here, and other countries won't let us pass them on. So Americans have to eat the R&D costs, and everybody else gets to skate at our expense. What we need is a president with enough cojones to tell the rest of the world--at least the developed countries--to pay their fair share. It's not pharma who is ripping off US customers--it's Italy and UK and the like.
You leave out the cost of malpractice--and it's a lot more than just the insurance premiums. I read a couple of days ago about a new study from a left-leaning think tank saying that malpractice adds only about $50 billion a year to the costs of health care. That's supposedly only 2.4% of total cost, although I can't verify any of the data in that report. I've seen estimates by right-leaning think tanks as high as 20-30%. It's probably somewhere in between, and almost certainly too much. We could emulate Sweden, and do no-fault malpractice. But even taking the little number above, that's way, way more that those executive salaries that you want to blame.
As for barriers to entry, we're getting ready to see a huge one caused by "you can't make any money doing that." CBO, in their report that got widely bandied about as saying that Obamacare would reduce the deificit and debt (it didn't actually say that, but who notices when there's a good sound byte to be had), had some interesting comments in the last few pages. Basically, CBO thinks the only way to contain costs will be cheaper admin (by the time you add in IPAB, HCC, CCO, and the other regulatory and bureaucratic overload, forget that), lower quality, and reduced access. I'm all onboard for reduced quality and access, aren't you? Woo too.
You may be able to vote for president and congress, but you have no vote for the unaccountable bureaucrats who will actually run the system. Who did you vote for, for HCC commissioner last time? Oh, you didn't vote for anyone? You won't. Ever. You can vote with your feet and your wallet in private systems. That's why Bismarck works better than single-payer or single-provider.
The private health care system has not failed me. In fact, it's served me quite well. Far better than I expect Obamacare to. Let me get this straight. We're going to increase demand by adding 30 million people to the system. We're going to cut costs by paying docs less to work more, and we're NOT going to have shortages and queues, and lower quality? Really? Can you name one time in recorded history when that has worked?
I do think that shutting down government to kill Obamacare is stupid.
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So Obama will negotiate with Russia, Syria and Iran, but not with
