The Official Washington Talking Point against health care reform seems to now be that it is too expensive (here; here). Krugman points out:
Yes, the Congressional Budget Office’s preliminary cost estimates for Senate plans were higher than expected, and caused considerable consternation last week. But the fundamental fact is that we can afford universal health insurance — even those high estimates were less than the $1.8 trillion cost of the Bush tax cuts.
The CBO numbers ($1.6 trillion) were also about half of the estimated long-range costs of the Iraq war.
Don’t get me wrong, I think that it’s very important that health care reform be fiscally responsible, but where the hell was all this consternation when we were invading Iraq (even at the time, some experts were estimating costs as high as $1.6 trillion — see James Fallows’ definitive “Blind Into Baghdad“)? Where was it when we were running $300 billion deficits during an economic expansion?
Liberals have often claimed complained that our government has plenty of money for tax cuts and wars, but never enough for education and health care. And it’s easy to turn that into an a preachy slogan or bumper-sticker.
But at a certain point, everyone should admit that it is true.
The Grand Panjandrum
Is that what you meant to write? Otherwise I’m not quite sure what you’re getting at.
But yes it is true the healthcare solution will not be free. Some of us will actually have to pay for it.
DougJ
@TGP
You’re right.
El Cid
A lot of stuff that liberals say gets dismissed by the establishmentarians for various reasons and it seems that they do so despite that stuff being true.
But in itself that’s not true — stuff liberals say is dismissed precisely because it’s true, ’cause the true stuff can get in the way of what the establishmentarians want to do.
** Atanarjuat **
Yeah, Dougy-Doug… I think you meant “conservatives” rather than “liberals” in the sentence TGP quoted above.
Otherwise, that’s some pure, 100% snark!
-A
Kris
Tupac said it best:
“We have money for wars but can’t feed the poor.”
Gee DougJ I thought that would have been your title, brotha.
Cassidy
Because dropping bombs on shit makes for much better ratings than sick people? UNless it’s Grey’s Anatomy, but the show stinks anyway.
bob h
$700 billion flowed into bank rescues at the stroke of a pen. Had to do it, but the yearly costs of health reform are small potatoes really.
DougJ
Would have been a much better title for this post.
Scruffy McSnufflepuss
The older I get, the more issues the DFHs are proven to be correct about. Usually way after the fact, when it’s too late to be meaningful. But really, apart from the occasional outburst of overblown alarmism on an issue or two, I can’t think of a single thing the DFHs have been wrong about. Maybe that’s why I’ve always tried to be one, though. Maybe that’s just my filter biasing me. Can anyone else think of an issue the DFHs have been proven to have been wrong about?
Zach
The analysis was there, but it was lost in the fog of endless, tired jokes about Al Gore’s lockbox.
And Bush’s tax cuts cost 1.8 trillion through 2010. Republicans acquiesced to the sunset provisions in the bill knowing that the inertia of the cuts would ensure their extension (which turned out to be a bad assumption for the top 2 brackets) because it lowered the apparent cost. The numbers Bush used to project future deficits assumed that they’d completely sunset (except when he was trying to doom and gloom on Social Security). Since there’s no political will or popular support to repeal the cuts in full, they’ll cost hundreds of billions of dollars year over year until we cave and increase revenue–absolutely dwarfing the Social Security deficit.
The real consequences of Bush’s extreme governing-to-win-the-moment philosophy are coming to bare today. Also see: the Axis of Evil speech and Iran; no clue why no one is pointing out that people are dying in Iran today to get a President who’s ideologically equivalent to the Iranian President on 9/11.
Montysano
Here’s what drives me insane: never, NEVER, do you hear an opponent of universal health care say “Wouldn’t it be great if we could find a way to do it”. Never do we hear “Yeah, the UK fucked up health care, but dammit, we’re Amurkans, we’ll get it right”. All we ever hear is “No! Nooooooooo!”.
Fulcanelli
@Cassidy:
Because dropping bombs on people results in a jobs program for all 50 states and a number of foreign economic allies to some degree. Christ, it’s about the only manufacturing sector the greedy Wall Street investment Brahmans haven’t completely shipped offshore to increase profits. Yet.
Fulcanelli
Funny how price tag is never an issue for Government when devising and paying for ways to kill people, but keeping them alive? Nah, too expensive.
Yo Scruffy, good point. We DFH’s have been right about everything for over 40 years to no avail and I’ve got the ulcer to prove it.
John S.
Wait. Some intrepid young conservative will figure out that having individual components manufactured overseas and assembled here really isn’t a security risk and provides significant cost- benefit.
The lure of greed is too powerful for these people. Blackwater aka Xe was just the beginning.
anonevent
But to conservatives, this is all a feature, not a bug. If the government were to actually pay for health care and education, it might get spent on a black person or a foreigner, or some poor white person may start to think that they don’t belong at the bottom. Better rich white people control their own money so that everyone knows their place.
Montysano
@Fulcanelli:
Bingo! I live in Rocket City, USA, which was recently named by Kiplinger’s magazine as the best, most economically viable place to live in the USA. Our business is war. Well….. some aerospace, but 90% war. And business is good.
Just stumbled on a pack of DFHs: National Priorities Project.
Steve
Don’t forget, the Iraq War is supposed to pay for itself! But healthcare reform has to be paid for by us, and we can’t have that.
Aaron
Surely the millions of dollars the pharmaceutical industry pours into political campaigns has little to do with this . . .
Napoleon
Not to pick on what you say as opposed to anyone else, but there is almost an unspoke assumption that pervades the discussion of this subject that if the government doesn’t spend the money on health care the money is not “spent”. Unless we as a society decide that we are going to simply let people die in the street if they reach a certain age or contract a certain disease, then the money is going to get spent and it has to come from somewhere. If someone screams that the government can not afford it they had better be willing to not only propose an alternative but it should be an alternative that is more efficient then a government system. Of course many of the government systems being proposed are in fact more efficient then a purely private system, that is why they are attractive. Just because a proposed system may move an expenditure from the private side of the ledger to the public side of the ledger is not a reason in and of itself to oppose the expenditure.
By the way, late Friday I wrote an e-mail to my Democratic Senator who has stated in the past that he supports the public option that was maybe a little harsh. In any event I told him it is the time to grow a pair and make it clear he will not vote for sham plans like Baucus’ and that a real public plan is a min. requirement or else he will not vote for it. It is time for push back against clowns like Nelson, Baucus, Bayh, etc.
(by the way, we are seeing this same dynamic in spades from the neo-con right in foreign affairs now. Graham goes on the Sunday shows yesterday to scream Obama has to do more but fails to propose what more should be, and Graham is not alone).
robertdsc
How about taxing the stock market? Every share that goes through the national exchanges gets a 2 cent fee added on. Given the billions of shares that trade every day, we could be rolling in cash, no?
liberal
@Montysano:
How’d the UK f*ck up health care?
While health care delivery might be relatively stodgy in the UK compared to other nations with single payer, it’s extremely cheap as a fraction of GDP, IIRC—even compared to many other single payer nations.
And outcomes? Not all that bad.
Bill E Pilgrim
Actually, both waging war and the health care system in the US are about enriching corporations. In the former it’s the corporate defense contractors that they’re enriching, and in the latter it’s the health insurance industry.
There’s always plenty of money for corporations no matter what, that’s the real principle involved.
greennotGreen
I wonder if this failure to adequately fund health care and education is related to Jesus’s statement, “The poor you will always have with you.” I don’t think Christianists have interpreted that correctly, but since ignorance and sickness are similarly chronic problems to poverty (in that children aren’t born educated and just because you treat one sick person doesn’t mean someone else won’t get sick) is it sort of a fatalism, or even worse, that society isn’t supposed to solve those problems because Jesus said they would always be with us?
liberal
@bob h:
Oh, it’s much worse than that. IIRC that’s Treasury’s share.
IIRC if you add in all the stuff the Fed is doing, it’s more like $4T.
Of course, it’s not necessarily true that all that money is gone, but some reasonably large fraction of it must be, if you include indirect costs.
Zach
I don’t know why Congress doesn’t ask the CBO to do a 50-year projection of the deficit with and without these health reform bills… Orzsag was famous for those sorts of things so they have the capability. If they did, Dems could say the bill saves something like ten trillion dollars. Republicans would call it fuzzy math and the press would laugh at them because that’s what they said about Gore and they were wrong then.
Montysano
@liberal:
I was just parroting a GOP talking point. Do you watch the teevee? These fucknuts are on there every single day, saying “We don’t want to be like FRANCE!@, do we???”
Well yeah, I kinda do want to be more like France.
Wilson Heath
The next establishment jackass who says we need to keep subsidizing U.S. firms offshoring jobs and business activity to maintain “competitiveness” but doesn’t see that lack public health care is part of our economic disadvantage, well, said jackass gets a big mug of STFU.
You know why the evangelical right was an essential component of the Reagan revolution? Because you can’t sell a majority on the message that “all you proletariat schmucks are on your own.” And the single goal of undoing the New Deal is basically putting that FU into action. Even a divisive, watered-down Christianity sells better than this nihilism.
liberal
@robertdsc:
I think that’s the “Tobin tax.” Though I’m not sure it’d just be on the stock market, or on all such trade, including e.g. bonds.
It’s a great idea, but since it’s a tax on the privileged, it’s a no-go.
liberal
@Montysano:
France I’m sure is pretty good, but at the same time, their system is more expensive than the UK’s.
IMHO the idea that we should have single payer but no intelligent rationing system (“treatment decisions should be between the patient and her doctor”) is a bad one. (Not saying France is like that.) While medicine is pretty complicated and thus some decision making is often particular to a given case, the idea that there should be no standards for what treatments should be provided is a bad one.
Even the UK has this problem. IIRC there is some cancer drug for some cancer women get (can’t recall if it’s breast or ovarian, etc). The number needed to treat is pretty high, though, and the cost is hundreds of thousands of $$ per “successful” treatment, where “success” isn’t even necessarily a life saved. But the patient lobby has put enormous pressure on the health service to pay for the drug. (Can’t recall if they “won”.) IMHO it’s quite reasonable not to pay for stuff like that.
Of course, we should go after the low hanging fruit first. Like the “spinal fusion” industry, which costs us a few $B a year for a treatment which in most (if not all cases) has been shown to be ineffective.
Third Eye Open
DougJ,
Silly Libturd, your open mind has allowed your brains to fall on the floor. Once the plebes expect quality, inexpensive healthcare, next thing you know they will want government run education, roads and mail delivery and that would be very sad to Big Baby Jesus and Ronald Reagan. The laser-like focus that comes from having to make decisions between food and medicine sharpens the mind and makes all manner of boot-strap pulling possible. Fear is the only thing that keeps humans moral. If god wanted us to be healthy he wouldn’t have invented twinkies and gin.
PeakVT
Can anyone else think of an issue the DFHs have been proven to have been wrong about?
Good question. Maybe my mental filter is blocking, too, but I’m having a hard time coming up with one in the last 20 years. Perhaps the declarations of doom on “ending welfare as we know it” rose to the level of being wrong, but the effects of changing the program are still debated.
Given the billions of shares that trade every day, we could be rolling in cash, no?
We wouldn’t be rolling in cash because a lot of transactions are very marginal, so volume would go way down. However, I think that would be a good thing as the amount of energy and brainpower that currently goes into zero-sum gamesmanship is mind-boggling.
dslak
@liberal: Could you say a bit more about the “spinal fusion” issue? My step-mother had to have some spinal fusions to treat degenerative disc disorder.
tofubo
how much of that $1 or $1.6 or $1.8 trillion figure we hear that it will cost include people already on gov’t paid health care (federal, state, local employees, medicare, medicaid, the VA, the military, congress, prisoners, etc)
how much would be ‘new’ costs compared to how much we are spending already, or is the trillion dollar (over ten years) figures only just new costs to be added to the existing ones we are already paying for ??
just askin’
Mojotron
Theirs is also the #1 rated health care system, while we’re the top spender and come in at #37.
We need to get someone on the teevee to explain this in simple sports metaphors that even joe sixpack can understand- we’ve got the NY Yankees payroll and the Milwaukee Brewers win record, why are we focusing on what the UK & Canada (the #18 & #30 teams in the league) are doing wrong instead of looking at what the #1 team is doing right?
Bill E Pilgrim
@Montysano:
@liberal:
We do have to be careful about ending up like France. One important aspect is wait times. For example I just called a doctor this morning, a specialist, and asked for an appointment. The receptionist was apologetic because as she said “it’s impossible this week, I’m sorry!” That’s okay I said, how soon can I get in? “Next week, July 1st?” she proposed. She apologized again before we said goodbye.
In addition to the quick appointment, I won’t pay anything for any of this because my insurance is so complete.
Oh and one more detail: I live in France.
From what I’ve seen of the UK, BTW, what little more we pay in France for health care is well worth it.
Don’t let anyone scare you about France. I’ve waited months for appointments in the US, never in France. The number of people who will literally go bankrupt here this year from health care costs? Zero.
Bill E Pilgrim
Never mind. Escape from moderation is futile.
Jennifer
We could fix this problem once and for all if we all simply cancelled our insurance en masse and waited the 3 – 6 months it would take for the insurers to go broke.
Here’s what gets me about this issue: we have in our hands the key to solving it. Insurers own Congress? Then get rid of the insurers. Stop giving them your money. It’s not like you are legally required to carry insurance – yet.
Inevitably, whenever I bring this up, someone will start hand-wringing about their pre-existing condition, about “what if” something bad happens during those few months they go without insurance, etc. This is why our government has no fear of us. They know we’ll whine for a little while about the shit sandwich they’re force-feeding us, and then we’ll meekly comply, because our fear and our greed is way stronger than our outrage.
Fixing health care is going to first require us to stand up to our own fears of what might happen if we go without coverage for a few months. We’re not going to get reform without some drastic action on our part. In Iran, people are being shot in the streets because they’re fed up. Here in the US, we’ll complain but ultimately get screwed because none of us can be arsed to step out of our comfort zone.
What if senators, congressmen, and health insurers were to all get 20 or 30 million letters from constiuents/customers all in the same week that essentially said, “public option by date x or we’re going to burn this motherfucker to the ground”? You think the insurers wouldn’t be the first ones to the phones demanding that congress stave off catastrophe by passing a public option toot sweet? Put yourself in the shoes of a member of congress – you want to stand aside and watch 20% of the economy burn to the ground – during the worst recession in 70 years – in an act of arson you had fair warning was coming and you did nothing to stop? Imagine what that would do to the unemployment rate. Imagine what that would do to your re-election prospects. You think if you allowed things to go far enough that anyone was uninsured for even one day that you’d be getting their vote?
It’s time to play hardball, folks. They aren’t going to do the right thing unless we force them to do it. And here’s the thing – all of those people with pre-existing conditions who use their insurance for meds etc, all of those with individual policies that they might not be able to get re-instated if the effort failed – they wouldn’t even have to be a part of it if all of those who have employer-provided group plans and good health stepped up to the plate to take the risk. That’s enough of us – something like 30 – 50% of all insured people – who can fairly easily get back on our employer plan if we don’t succeed in killing the insurers. Besides, having insurance now isn’t much protection against financial ruin anyway. We have 750,000 medical bankruptcies per year – most of them had insurance. Multiply that out by 40 years, and unless we fix this bitch, your personal odds of medical bankruptcy at some point in your life is something like 1 in 10. If you’re living with that risk now, you can live with the risk of going uninsured for 3 – 6 months.
I’m serious here – I think 20 or 30 million letters to insurers that say “if you continue to stand in the way of a private option, and it does not pass by x date, consider that the cancellation date on my policy” would fix this. The question is, are there 20 or 30 million Americans left with enough courage to write a friggin’ letter? Unfortunately, if I had to guess, I’d say “no”. We got into this position because we’re wimps, and we’ll continue to take whatever they dish out for the same reason – our fear and concern for ourselves outweighs any and all other considerations.
/Rant off/
tc125231
@El Cid:
Jennifer
Please unmoderate my comment @ 9:23. It is a worthy rant.
gbear
You answered you’re own question within two sentences. Just because the government and media told us to STFU didn’t mean we weren’t sayin’ anything. Conservatives don’t get to claim that we were silent on the issue. They were just drowning it all out with a chorus of ‘LA LA LA!!s.
UofAZGrad
Doug’s questions of affording wars/tax cuts while balking at healthcare/education is quite naive. First, everyone knows that wars are free and that military spending is invisible. Why else would deficit hawks never mention cutting the defense budget? Second, tax cuts have no cost, quite the opposite they increase revenues. It’s true that commies in the CBO insist on formulas that reject revealed truth (the laffer curve), but they are government employees and, as such, cannot possibly be competant or they would be rich and successful in the private sector like credit default swap traders or credit agency analysts.
It’s amazing that these arguments have to be made over and over again despite Reagan’s agenda proving these facts by causing the internet boom of the 90s (the only thing that prevented Clinton’s tax hikes from crippling the economy but only just barely).
tc125231
@Kris:
BDeevDad
People can’t afford their employer sponsored healthcare already.
SpotWeld
Has anyone been able to reliably crunch the numbers that show: excellent health care = less people sick = more people working = better economy = more tax revenues?
(Though I suspect such a study would get dismissed as quickly as one that proported to show tax cuts pay for themselves.)
Keith G
The political dynamics are a bit discouraging. Worthwhile (to me/us) reform requires a lot of ducks in a lot of rows. Those who oppose reform only need to delay and delay and inject a bit of dissention among the various coalition. Sigh.
Jennifer
Keith G – we need to drive the insurers into bankruptcy, as I said in MY COMMENT AWAITING MODERATION!!!!!
Just stop sending them your money. That will take down several rows of ducks.
BDeevDad
For stories on why we need healthcare reform see the Children’s Hospital Family Advocacy Day blog. I just wonder how many of the families have granite counter tops.
Napoleon
@Jennifer:
You have said that in the past and all I can say is that it is an incredibly stupid idea. 1) I bet the vast majority of money the insurance companies get are from employers and damned if I want my employer to effectively cut my pay by not paying for my insurance and 2) if you then happen to get sick while not paying your insurance you are screwed – only a moron would put themselves in that position (particular if your insurance may cover your kids who may not want to put their health on the line for your crusade).
tc125231
@Wilson Heath:
Brian J
As Jonathon Zasloff pointed out last week, Washington pissed its collective pants at the price tag for health care expansion, but it passed Bush’s larger, more expensive tax cuts for the wealthy in a matter of a few weeks. It’s outrageous, in a number of ways.
It is a lot of money, yes, but there are sources of it that haven’t been mentioned yet. Specifically, I’m talking about a securities transaction tax, something that people like Dean Baker have pointed out could raise $100-150 billion a year. That’s most, if not all, of the cost of health care expansion, before we realize any savings because of integration and realistic service cuts. Why isn’t this being mentioned, if only because a tax paid for by Wall Street would probably be a much easier sell politically?
kay
@Napoleon:
I agree with this completely. Why are we pretending that we aren’t paying for the uninsured? Their health care isn’t free. We’re paying for it.
By the way, late Friday I wrote an e-mail to my Democratic Senator who has stated in the past that he supports the public option that was maybe a little harsh. In any event I told him it is the time to grow a pair and make it clear he will not vote for sham plans like Baucus’ and that a real public plan is a min. requirement or else he will not vote for it. It is time for push back against clowns like Nelson, Baucus, Bayh, etc.
This made me laugh, because I did the same thing, but Sunday, not Friday.
I think we have to pressure Congress. I really think they have to hear from a lot of people. A lot. Millions.
Napoleon
@kay:
I seem to recall you are in Ohio like I am. If so did you send it to Brown?
Jennifer
@Napoleon:
And this is why you’ll continue to keep eating the shit sandwich “health care” they feed you.
Because you’re afraid and you’re more concerned that someone else might benefit out of the deal (in this case your employer) than you are with fixing the damn thing.
...now I try to be amused
The Right got to enact their agenda precisely because of preachy slogans and bumper stickers. Why not use techniques that work?
Leelee for Obama
@Jennifer: Perhaps we could take a page from Iran? I have been admiring their courage since the election there. Apparently, they have decided all the regime can do is kill them, and they don’t want to live with things the way they are..Patrick Henry comes to mind….
Scruffy McSnufflepuss
@PeakVT:
Yeah, but that kind of stuff is the hysterical alarmism I was thinking of. The DFHs could still be proven right on that in the long run, too- and on the Iraq war producing a hundred future Bin Ladens, and on nuclear weapons one day destroying us all. I think all of those things might be proven true someday, or it might be proven that the DFHs were a bit overwrought. We’ll see. But meanwhile, I can’t think of a single issue where they (we) have been proven utterly, unequivocally wrong. Not like, say, the neocons on Iraq, or the conservatives on the economy, for example.
kay
@Napoleon:
Yes, and yes. I arranged this meet and greet type thing for Brown’s wife during his campaign. I live in a red county that he wanted, badly, so they contacted me a lot, and I did what I could.
I reminded him of this. Then I added a shameless and completely unrelated compliment to his wife, because he seems to adore her, and, well, I’ll say anything. She was great, though, so it isn’t a lie.
Napoleon
@kay:
That is who I sent mine to on the theory that what needs to happen it Senators who believe in the public option need to be willing to go to the mat for it, and that is basically what I told him. The Dems who are not for it have to be put in a stark position of either opossing it or being responsible for killing health care reform. I truely believe it is better to get no bill then anything remotely like what Baucus is proposing.
Connie Shutlz (Brown’s wife) seems like an interesting woman and I occasionally read her column in the paper.
kay
@Napoleon:
Brown has done well here. He was sort of onto the populist train ahead of anyone else. I don’t know why he would blow all that earned good will on some crappy compromise.
He’s the perfect spokesperson for the public option. I want to see him on tv, instead of Dodd.
Did they think this was going to be easy? Why?
BDeevDad
@kay: They did a study and found the cost of the uninsured adds an extra $1,000 a year to your premiums.
Little Dreamer
@El Cid:
Their want doesn’t trump our need. Fuck that business.
jcricket
This please. If the right can use slogans, bumper stickers and simple words to pass outright bullshit that does the opposite of what they claim, why can’t we use the tactics to pass shit that will help America?
Call it the “healthcare cost reduction act” and stuff the public plan in it. Tell them Republicans are committed to bankrupting millions of Americans directly, and ultimately the entire united states by opposing healthcare reform.
Tell them greedy fat-cat insurance company execs want to kill your kids and your grandma in the name of preserving profits.
You know the lobbyists for big companies will come back to the teat no matter what is passed. They’re like cockroaches. You can’t kill em.
Jennifer
@Napoleon:
Helpfully underlining my point:
The question is, are there 20 or 30 million Americans left with enough courage to write a friggin’ letter? Unfortunately, if I had to guess, I’d say “no”. We got into this position because we’re wimps, and we’ll continue to take whatever they dish out for the same reason – our fear and concern for ourselves outweighs any and all other considerations.
kay
@BDeevDad:
I’m glad someone put a number on it. I don’t directly pay any premiums, because my husband has a part time contract job with the state, a contract that came with health insurance, which is the one and only reason he entered into it. It pays next to nothing, but we get health insurance, so he couldn’t turn it down.
Here’s my personal health care history:
federal employee plan, then no health care plan for a period of years, state university plan that I purchased, then no health care plan for a period of years, private plan that I purchased, then it got too expensive, so I went without for years, currently on the state plan.
It’s just stupid. It makes no sense.
bvac
“We know now there were no weapons of mass destruction over there, But Coretta knew and we knew that there are weapons of misdirection right down here. Millions without health insurance. Poverty abounds. For war billions more, but no more for the poor.”
Mnemosyne
@Jennifer:
My employer has about 50,000 employees in the US alone. My canceling my coverage means that the insurance company will still get money for the other 49,999 employees, they just won’t get my $2,000 a year or so. So please explain again how my canceling my insurance coverage will convince the insurance companies to change their ways.
steve s
It’s very easy to go to Congress.org and email your senators to support the public option. I just emailed Bill Nelson and Mel Martinez:
YellowJournalism
My parents pay over 700 dollars a month in insurance. There is no eye or dental coverage, deductables are outrageous, and it barely covers most prescriptions (and always generic first or at all). There’s a $3,000 deductable on major surgeries. The only point in having it is to avoid going into bankruptcy should one of my parents need major surgery or have a major medical disaster. My mother says it’s no longer health insurance, it’s “catastrophe” insurance.
Please, someone, tell me again why it’s not okay for the US health care system to be more like France, the UK, or Canada?
Jennifer
Mnemosyne – you alone won’t. It’s got to be group action.
And again, if enough people got on board and committed to doing it, it’s extremely unlikely you’d ever even end up dropping the policy. Just the threat of mass action on date X coming from 20 – 30 million people would light the fire under their asses. The insurers would be first in line in demanding that congress bend to our will. They’d much rather be in the position of having a chance to survive as opposed to being assured of death in the very very near future.
But Napolean illustrates why mass action no longer works in this country – because we’re all too self-absorbed and fearful to even consider doing anything that might put ourselves at risk to help people other than ourselves, even if it helps us personally as well.
steve s
20 million americans threatening to cancel their insurance en masse will never happen. Spend your time on realistic strategy instead.
jcricket
BTW – that probably won’t work either. Your parents better make sure to get some “catastrophe” that’s covered, but doesn’t exhaust their lifetime maximum. Or make sure that things like hospital stays are covered for a long enough period, etc.
The private healthcare insurance industry in America, as it exists now, is an amazing profit making machine – but is most certainly not interested in helping Americans get/keep/use medical coverage. It’s mirrored only by the defense/contracting industry in its ability to avoid any kind of market forces whatsoever.
Jennifer
Millions of people marching in the streets will never happen either, until it does.
I don’t know why everyone has such a hard time pointing the finger at themselves, but while we diddle around hoping that the people we elect will, in a triumph of hope over experience, do the right thing, we continue to ENABLE our own abuse.
I don’t pay a crappy auto mechanic for not fixing my car; I don’t hire a crappy carpenter to work on my home – why should I pay a crappy health insurer to defraud me? Whose fault is that, ultimately? Theirs, or mine?
Mnemosyne
@Jennifer:
Great. So how do you propose I go about getting the other 49,999 individuals who get health insurance through my company to go along with threatening to drop their coverage?
If you have an actual, practical suggestion, please present it. Otherwise, all you’re doing is wildly swinging around calling all of us wimps because we don’t see how your proposal will do any good whatsoever, because insurance companies don’t care what individuals do. In fact, they count on people making futile individual gestures.
The only way to hurt them in their pocketbooks is to get our employers to threaten to cancel their contracts, because that’s where 90 percent of the money comes from. If you have any ideas how to go about doing that, let’s hear them.
Jennifer
@Mnemosyne:
Wrong. Your employer pays based on the number of employees enrolled in the program. If you drop coverage, your employer pays less. And perhaps you’ve got a really good employer plan – a lot of people don’t and are picking up half of the cost with payroll deductions. Whatever the company is paying to cover that individual is the amount their insurance bill will go down when that individual drops coverage. You don’t need every person in your company to drop coverage – in fact, you could be the only one dropping it – if there are people in other companies dropping out as well to the extent that the insurer is collecting premiums for 20% fewer enrollees.
Mayken
@Jennifer: Um… no, sorry. Having on-going health issues absolutely precludes me from going without health insurance for even one month. I don’t have to be afraid of what “might” happen if I had no coverage. I know what WILL happen. I will have to chose between going broke to pay for my medications or go without them in hopes Congress moves fast enough that I don’t get really sick and need to be hospitalized. Just yesterday I had a $40 copay for just TWO of my meds, but the retail cost of just one of them is 4x that. Most of my meds are not available as generics so I cannot do the Walmart trick (even if I would ever shop at that hell-hole.)
I understand what you are getting at but please, let’s not pretend that millions of us are not trapped by the NEED for health insurance not just the fear that we might need it some day.
Jennifer
Mayken – perhaps you should go back and read my initial post if you think I’m suggesting you should drop your coverage. Your concerns were already addressed.
Mayken
@Jennifer: No, you really didn’t. Your first couple of paragraphs calls on people to cancel their insurance – stop sending them money. Bankrupt them and they will go away. Then you call some of us cowards or greedy because we might already have conditions that require on-going coverage. Telling me I am a coward, greedy and a hand wringer is hardly addressing my concern. And again, my concern is NOT a “what if” it is a “what will.” I KNOW what will happen if I have no insurance.
As for the idea of just sending millions of letters threatening to do so, I cannot make a threat I am not willing to back up. Why in the name of all that is holy would I ever even threaten to back out of my insurance when there is no possibility of backing that up?
Boycotts or threats of such by and large do not work. And that is pretty much what you are suggesting, whatever face you want to put on it.
Jennifer
@Mayken:
You know, twisting yourself up into faux outrage over things that were neither said nor implied probably isn’t going to do a lot of good when the original comment is right upthread in black and white where anyone who wants can read it.
No one suggested that you should cancel your insurance or even threaten to do it, your misreading notwithstanding. The call was explicitly issued to those with employer provided insurance who are IN GOOD HEALTH. Frankly, it would be stupid for anyone to suggest that those with chronic conditions cancel their insurance – your contribution to the effort is to help bleed the insurers dry while the good risks flee the pool.
Go ahead and take umbrage over imagined insults if you like, but it’s pretty clear to anyone who wants to look that I didn’t make them.
brantl
No, he’s afraid of needing real health care, and going broke, you dipshit. This is the bind that they have us all in.
Mayken
@Jennifer: Ah, yes, that little “gift” buried into the sixth paragraph of your rant. Your first several paragraphs said nothing about people being in good health and called anyone offering a concern about a pre-existing condition hand wringers and greedy and cowardly and I’m supposed to be impressed when you decide “gee, if you actually use your insurance you don’t have to do this.” Well, thanks but you’d already managed to give offense well before you offered that up.
However, I should also point out that the threat is still useless given that those with employer-provided health insurance can generally only make changes once a year, at enrollment time (unless they get married etc.) and therefor the threat to drop their insurance is hardly a unified front, even if millions of people say they will do it. The folks who make the threat have to wait until their next enrollment to make good on it. And when that doesn’t work, they have to wait until the next one after that to go back on. Not just a few months. So you are not asking people to risk a few months but as much as a year without insurance.
Also, a threat that amounts to “give us an option not to pay you or we won’t pay you” hardly seems likely to move the insurance companies on this issue.
Jennifer
brantl – gee, I guess that’s why he threw in that bit about how he doesn’t want his employer to pocket the money they won’t be paying out for his health coverage for a few months? Because of fear? Afraid not. That’s not a “fear” statement; that’s a “greed” statement – “someone else might benefit from my actions as well”.
As for being a “dipshit”, exactly what do you call a person who shovels out thousands of dollars per year to an insurer in the vague hope that if they get really sick, the insurer will do what they’re supposed to do and pay the bill, knowing all the while that they have a 10% chance of medical bankruptcy at some point in their life regardless of how much money they shovel out to the insurer?
BDeevDad
@Jennifer: Most people cannot cancel their insurance on a whim. Employers have open enrollment periods where the employees get to choose their benefits for an entire calendar year.
Jennifer
@Mayken:
Gee, excuse the hell out of me for not putting things in the order you would have preferred. This is why it’s best to read all the way through rather than make assumptions without full context. Are you my editor?
We have shit insurance because we accept it and continue to pay for it. You can dillydally here and there pointing out all the downsides of having NO insurance vs. shit insurance all you like, but the bottom line is, we’re weak and whiny and we get what we’re willing to accept. While Iranians are getting shot in the streets, we’re so concerned that a few of us might lose our STUFF that we’re willing to continue putting up with being raped, abused, and bankrupted by PRIVATE companies who we are not legally required to patronize. And the chorus of voices is all about getting SOMEONE ELSE to fix the problem – god forbid it might cost us something ourselves or entail risk for any of us. If that’s the case, we’ll just accept whatever crap they force on us, right? Hey, it’s the American way.
Mayken
@Jennifer: I read the whole thing, several times over. Wasn’t impressed by your belated idea that we who actually use our insurance don’t have to do this the first read through, wasn’t impressed on subsequent readings. I’m not talking editorial decisions here, I’m talking basic arguments. You started out arguing “you should boycott insurance even if you have a pre-existing condition or you are a coward” and only later decided “well, if you actually do have a pre-existing condition you don’t have to.” Too little too late. That is why I responded with my “hand wringing” anyway.
And calling other folks cowards and greedy because they won’t fall into line with you boycott idea isn’t good for any argument, no matter how soon you introduced the “only those with good health” line. Doesn’t stop the fact that it is an unworkable idea for many, many reasons already cited above.
And since I should not argue against an idea without offering an idea of my own – write your congress critters. Call you congress critters. Do it a lot. They know my name at all of mine now and I know several of the staffers by voice at this point. We still live in a democracy and your voice can make a difference.
BDeevDad
Why is this all the insurance companies fault?
Have you asked:
Why should you be able to see any doctor at anytime? Most HMOs don’t allow this but it seems to be a medicare/healthcare bill requirement.
Why do hospitals charge uninsured individuals 3-5x what they charge someone with insurance?
Why does your employer have such lousy insurance options?
I hate this idea that the insurance companies are completely to blame. There is much to go around.
Jennifer
You started out arguing “you should boycott insurance even if you have a pre-existing condition or you are a coward” and only later decided “well, if you actually do have a pre-existing condition you don’t have to.” Too little too late.
Oh wow, do you need to get over yourself or what? Let’s get this straight – anything that doesn’t address YOUR particular concerns in the lede paragraph is an insult to your delicate sensibilities? And please – cut and paste where I said “you should boycott insurance even if you have a pre-existing condition or you are a coward”.
As for the point on the general cowardice of Americans – feel free to offer up your alternate explanation about why we continue to put up with this bullshit, even keeping it going by giving them OUR MONEY. You can call a boycott “unworkable”, and given the general cowardice of the American public you’d be right. But let’s acknowledge other “unworkable” ideas – the Revolutionary War, the defeat of smallpox, the British evacuation from Dunkirk, the founding of Social Security – that never would have gotten done if we were relying on today’s brave Americans to stick out their necks.
Mayken
@BDeevDad: Well, I don’t disagree that insurance companies are not 100% of the problem – we as Americans tend to live less healthy lives and expect outcomes that may not be realistic from our health care system.
E.g. we often treat diseases more aggressively in the US than in European countries. We can argue whether this is good or bad (I’m on the fence about it – I have relatives in the Netherands and I envy their health care even as I shake my head at some lof the health care decisions made by their doctors) but it is certainly more expensive.
But I also do see a lot of the blame should be laid firmly at the feet of the profit motive of the insurance companies.
Leelee for Obama
@BDeevDad: I can’t address this stuff because I have only gotten close to having employer based health insurance once and then I left the Golf Club I was working for for a job with more opportunity to make enough to eat and pay rent. However, the question to ask is who benefits? If the patient doesn’t, then it shouldn’t be the program. Our problem is that we approach health care as a business. It’s not supposed to be-lives are at stake as well as productivity and national security-Swine flu anyone? If there is no public option, then they should renew the free clinic and public hospital model. The docs and nurses who work at them would be training for the bigs-but 47 million ppl would have someone to take care of them when hurt or sick. All the rest of this noise is bullshit. The only stuff that should be elective is vanity plastic surgery, boutique medicine, and unnecessary treatments that don’t improve outcome.
Who benefits from the labyrinth?
Just askin’
Mayken
@Jennifer: I wasn’t insulted by you not addressing my particular situation I was insulted because you were insulting rather while trying to put forward an idea. You’re trying to get people to get in line with a boycott but your start off by saying things like:
In these sentences alone you dismissed a rather large concern as “hand wringing” and then went on to say folks are only motivated by greed and fear for not doing what you think. Then in subsequent comments you’ve also attributed several other folk’s motivations for not going along with your idea to greed and fear.
Then you bring up the Iranians who are in the streets as some kind of grand comparison to out “inaction” because we want to do sane things like lobby our politicians? And I should get over myself? Please!
I am sorry, but your argument failed on many grounds. I understand your anger and your passion but as many folks have pointed out, this is not an actual workable solutions. There are no easy fixes to this issue and pretending there are won’t make it so.
Jennifer
Oh, so it’s now an insult to accurately report people’s reactions? Look upthread and see what they were. It’s “dismissive” to point out that people ALWAYS say these things every time the point is made? No. It’s reality. And it’s pertinent to bring it up first thing BECAUSE those things are always said, and they’re from the “can’t do anything to help ourselves” POV. It’s the excuse for inaction substituted for actually considering an idea.
As for the “sane” idea of lobbying our politicians – when’s the last time it worked, and you DO know the operational definition of INsanity, do you not?
I’d agree it’s not a “workable” solution – but let’s be clear on why it’s not – it’s because people in this country are controlled by fear and an overweening concern for themselves above all others. 47 million people in this country live without insurance all the time – but somehow it’s “impossible” for the rest of us to do without?
Whatever. Have you ever tried hanging out at Shakespeare’s Sister? I just kind of have an idea that you would fit in really well there.
Mayken
@Leelee for Obama: I agree with you to a large extent. However this is one of the places where there is room for a lot of argument:
This can be hard to determine. And I am not sure I want the government deciding this point anymore than I want insurance companies doing so. What gets covered will be an ongoing and shifting debate regardless of what happens with health care reform.
Mayken
@Jennifer:
Pointing out that the argument always gets made and then classifying it as “hand wringing” is an insult. Saying it is only motivated by a “cannot do anything about it” attitude and as an excuse for inaction is also an insult. Calling the motivations of other people who disagree with you fear and greed are insults. People who want to lobby congress, give money to organizations who lobby congress and work on actually getting a sane policy are clearly insane and whatever else you want to call us.
Way to win people over to your POV.
It’s not workable because it is not possible to do what you are asking folks to do. Not only because there are people (even healthy ones) unable to take the risk for many reasons but because the system does not make it possible i.e. enrollment periods are fixed and “I want to opt out” is not an option in the middle of a year nor is “well, that didn’t work so let me back in.”
I’ve seen many times that the voice of the people has made a difference. Not every time, and not always when I would have liked it to. But it has and does work. We just have to get out voices heard.
There is room for protests. But I prefer them to be ones that are actually feasible.
Mayken
Hmmm… won’t let me edit my last comment. Oh, well, that last sentence in the first paragraph should read “So is implying people who want to lobby congress, give money to organizations who lobby congress and work on actually getting a sane policy are clearly insane and whatever else you want to call us.” Teach me to type too fast.
Jennifer
@Mayken:
You can characterize accurate statements as “insults” all you like; it doesn’t change their basic accuracy.
Just wait till you see what the lobbying and money donating and all that gets us – we can wager on it if you’d like, because I can already tell you what the “reform” is going to look like: we’re going to be required by law to pay private insurers for coverage at the current bloated-by-insurer-profit rates. Poor people will get a subsidy for purchasing their bloated-by-insurer-profit coverage – and you and I will pay for that, in addition to the profit-bloated premiums, co-pays, and deductibles we already pay. Insurers will continue to deny payment for treatment and cancel anyone with private insurance who comes down with the sniffles. Insured people will continue to go bankrupt due to medical expenses. And the insurers will continue to own our Congress and will nibble around the edges to continually make things worse and worse for the rest of us.
It will be more expensive than what we have now and will fail to address any of the problems in the system. But hey, we won’t have to do anything “insane” to get there!
Leelee for Obama
@Mayken: I have a recent example of what I mean here. Last year my 89 yo Mom, who has alzheimer’s, fell. She stood up too fast and blacked out, fell and broke a bone in her upper arm. I wanted her admitted to see if they could address the black-out issue. While there, they kept her at least 10 days longer than necessary for a internal cardiogram. She was there and they could fit her in eventually. It damn near killed her. She was sedated, which is never good with alz. She’s never been the same and even if they found something, we wouldn’t have done anything about it at her age. They didn’t solve the black-outs either. Another episode entailed mammograms on a 90 yo friend of the family-were they gonna treat her possible cancer? no.
Just a few…
Jennifer
Oh, and…for the record? Crow all you like about your efforts to change your congressman’s mind and get him to do the right thing. FWIW, I’ve been working with the Health Care for America Now coalition for the past 4 months signing up small business owners in support of public health insurance. I work on every “day off” on this issue…and week after week, before we even get out of the gate, I see it get a little more watered down. It’s to the point that I question whether it’s worthwhile to sign anyone else up just to have them disappointed when the shit sandwich gets served up.
I’ve worked this issue a lot harder than most of the people who are telling me how rude and insulting and crazy I am not to put my full faith in the Democrats doing the right thing. This ain’t my first time at the rodeo; I can see where this thing is going, and there’s not a damn thing you or anyone else can say that will change it.
Mayken
@Leelee for Obama: Yeah, I hear you. You’re right on that. Some things are pretty black and white. My grandmother is 88 and lives in the Netherlands and they discovered she needs a heart valve replaced. In consultation withher doctor, she opted not to go for the surgery because it was as likely to kill her as cure her. The right decision but I think it would have been different her in the US. But there are other grey areas. I think we need to make room for experimental treatments or use of some treatments in areas where the outcomes have not been studied (e.g. using drugs for off-label purposes.) To name just a couple. That’s my quibble about that particular point. The rest is spot on.
slip
My Dear Fellow Clergymen:
While confined here in the Birmingham city jail, I came across your recent statement calling my present activities “unwise and untimely.”
Mayken
@Jennifer: Kudos for you and your hard work. But why the need to descend once more into insulting folks who disagree with an idea you put forward?
You know that characterizing your point in the way you did was bound to get some folks riled. Acting like it shouldn’t strikes me as disingenuous. If you want to try to insult people into following your particular line of thinking, go for it. Just don’t be surprised and all insulted when folks bite back.
For the record, I do not think the idea of such a boycott is insane – I think it is unworkable. I think rising in the streets over health care right now under these conditions is insane – it was to that juxtaposition I was referring to when I argued that some of us preferred “sane” actions. Sorry if that wasn’t clear.
Edited to add that admittedly you never argued that we should be rising in the streets. That was an extrapolation from your using the Iranians in your argument.
Mayken
@slip:
To be clear, I am not making an argument against all forms of protest. I am arguing against this one form – an en masse (threat of) cancellation of insurance policies even by people who are healthy and have employer-provided policies to which they (probably) cannot be refused re-admission – because it is A) impractical for the many reasons cited above and B) not useful for the many reasons cited above. There are plenty of practical and useful forms of protest available. This particular idea is not among them.
That being said, if millions of folks do actually find a way to make this a workable threat and/or action and if it actually does cause the insurance industry to blink and let us have single payer or a public option, then I will happily admit I was wrong.
Mnemosyne
@Jennifer:
Okay, now you’ve completely contradicted yourself. Again, if my employer has 50,000 insured employees, why is my dropping my coverage useful at all? The insurance company isn’t going to care, because they’re going to still be getting premiums for the other 49,999 employees.
Other than being a completely futile, symbolic gesture, what would be the point of me canceling my company health insurance since the payments that I make and that my company makes on my behalf are a drop in the bucket to the insurance company given the size of our employee pool?
Jennifer
@Mnemosyne:
I see you’re a practitioner of selective reading as well.