Health Care Bill It's about Fire and Money

[ziggy29]

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Originally Posted by ERD50 The "Do Not Call List" came close - that was wildly supported by the public. But Congress played politics with it and exempted themselves. What better way to tell us that they are "above the law", than by making lawmakers exempt from a law?

"[Congress] can make no law which will not have its full operation on themselves and their friends, as well as on the great mass of the society. This has always been deemed one of the strongest bonds by which human policy can connect the rulers and the people together. It creates between them that communion of interests and sympathy of sentiments, of which few governments have furnished examples; but without which every government degenerates into tyranny." -- James Madison, Federalist #57

[MichaelB]

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So when I talk about being irrational, I am talking about people who deliberately distort the facts. If you read the pages on the matter of "End of life Counceling", there is nothing proposed that remotely suggests euthanasia. It is about filling out forms and taking care of end of life decisions, which everyone should be doing anyway. So when people say this is euthanasia, and use this as an argument against the bill, I say their statements are irrational. (assuming they can read) I am not stating that people who don't agree with my way of thinking are irrational. I am saying that some of the statements I have heard "opposer's" use in their argument is irrational and unfounded.

We’re mostly in agreement - I wasn’t being critical. One has to work hard to find rational, reasonable and well-articulated argument on both sides. Certainly the media seems to have no incentive to promote this, politicians even less so.

There is a clear lack of leadership – both political and professional (health care industry) in the drive for health care reform. Until the need for reform is clearly articulated out for those that currently have care and coverage, progress toward consensus is unlikely. This troubles me greatly – health care coverage is our (my) greatest financial risk, far exceeding the aggregate of government financial mismanagement.

[ERD50]

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Originally Posted by ziggy29 "[Congress] can make no law which will not have its full operation on themselves and their friends, as well as on the great mass of the society. This has always been deemed one of the strongest bonds by which human policy can connect the rulers and the people together. It creates between them that communion of interests and sympathy of sentiments, of which few governments have furnished examples; but without which every government degenerates into tyranny." -- James Madison, Federalist #57

Are you saying that the political exemption to the Do Not Call law is (may be) unconstitutional? Fascinating if that's the case. And I think Madison has an excellent point (not surprisingly).

I'm fine with my reps calling me about an issue, an upcoming town hall meeting and the like. But I should have the right to "opt out" of their campaign commercials that invade my privacy.

-ERD50

[ziggy29]

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Originally Posted by ERD50 Are you saying that the political exemption to the Do Not Call law is (may be) unconstitutional? Fascinating if that's the case. And I think Madison has an excellent point (not surprisingly).

No, I'm not saying that at all; the Federalist Papers are not the Constitution. And there is no Constitutional requirement that Congress bind itself to the laws they pass. As much as I agree with Madison in principle here, this passage does not have any legal standing.

But it does provide an insight into the thoughts and goals of the founders, and it shows how much the original egalitarian ideal of citizen government has given way to an elitist, careerist ruling class which practices "do as I say, not as I do."

[modhatter]

Yes, I am concerned with costs too. However, how long have we waited for the goverment to take on this issue and do something. When Clinton was in office and we were in much better financial shape. They were still successful in defeating it.

I agree there must be a means of supporting the program, and this is still being debated. The fact is. It is doable. Many countries have good working programs that involve government intervention. Even those that are not run by the government, but regulated by the government such as the Netherlands.

They use private insurance companies, but everyone is required to carry insurance, same as having to carry insurance if you drive a car. However, no one is singled out because of pre-existing conditions or price gouged, or denied because of it. No insurance company is allowed to drop a person because they are too ill. They also set limits on what can be charged. They are spending 9% of GDP compared to our current 16%. There life expectancy is two years greater than ours.

If this is a more preferable solution, why has this never been proposed when the Rebublicans were in power? Why did they not propose any solution? Do you really feel we can't figure out a way to pay for it like other countries have? To me, it's a question of priorities when it comes to government spending. Every govenment has it's limits in what it can spend. Our government has been notorious in ignoring this I know.

However, what has priority in spending? Health care for all citizens or going to the moon and occupying 50 countries. Don't jump on me for those two examples. There is a long list to pick from.

[M Paquette]

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Originally Posted by ziggy29 The problem is, in the absence of such directives, someone other than the patient has to make these decisions, and if the government is involved in the decision there will be a vested financial interest in choosing to let the patient die -- not just in terms of saving health care costs but other things as well -- Social Security, public pensions, et cetera.

So, it sounds like the current Medicare funding of one discussion with a doctor during the Part B physical about getting an advance directive is a good thing, and the proposed law to fund discussions 'as often as' every 5 years is probably a good idea as well, in case the patient changes his mind.

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I'm not saying it's a bad thing to forego "heroic" measures with relatively low chances of a positive outcome, but to me it's a little scary to think the government has a vested interest in letting you die.

This is already the case, of course. Roughly half of all healthcare spending in the United States comes through government channels already, through Department of Defense, TRICARE, Veterans Health Administration, Indian Health Service, State Children's Health Insurance Program, Medicare, and Medicaid. About 27.8% of the population is covered under these programs. The high spending per capita of the programs reflects the relatively high cost of care for the covered patients in some of these groups.

[samclem]

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Originally Posted by modhatter However, what has priority in spending?

Well, a good place to start our search for proper government spending priorities might be the US Constitution, where the responsibilities of the US Government are outlined. I think many Americans might be shocked at how limited that role is supposed to be. It is a lengthy document, and covers some important areas in rather minute detail (e.g. even going into such issues as the day of the year that Congress will convene, defining the precise physical area to be occupied by the US Capitol, etc). The founders took time to address the big issues of defense, courts, etc. Regarding going to the moon--the constitution even says the government should be advancing science. But, somehow not a damn thing was said about the federal government taking money from some people in order to give it to other people. There's nothing in there about the government establishing a health care system for all Americans. All these other "good ideas" have been somehow seen as having been implied by the very innocent and innocuous "promote the general welfare" clause. Talk about driving a battleship through the eye of a needle . . .

[eridanus]

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Originally Posted by samclem But, somehow not a damn thing was said about the federal government taking money from some people in order to give it to other people. There's nothing in there about the government establishing a health care system for all Americans. All these other "good ideas" have been somehow seen as having been implied by the very innocent and innocuous "promote the general welfare" clause. Talk about driving a battleship through the eye of a needle . . .

??

The 16th Amendment allows the Federal Government to levy an income tax. If that's not taking money from someone and giving it to someone else, I don't know what is.

Congress has been empowered by the Constitution to enact laws. It is the duty of the Supreme Court to decide if those laws contradict the Constitution (Article 1, etc.)

[ERD50]

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Originally Posted by modhatter They use private insurance companies, but everyone is required to carry insurance, same as having to carry insurance if you drive a car. However, no one is singled out because of pre-existing conditions or price gouged, or denied because of it. No insurance company is allowed to drop a person because they are too ill.

This is in-line with what samclem has posted previously. Makes sense to me, I'd take it (devil in the details though).

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If this is a more preferable solution, why has this never been proposed when the Rebublicans were in power?

As an independent I like to try to keep partisan politics out of it. The fact is, the party now in power is going to have to come up with a solution - it's doubtful anything from the other side will gain traction - that's politics. Same as when the other party has a majority.

So, what is the current admin waiting for? If they proposed that, I think they could get some support. If they have not already used up any momentum they had.

-ERD50

[ziggy29]

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Originally Posted by eridanus The 16th Amendment allows the Federal Government to levy an income tax. If that's not taking money from someone and giving it to someone else, I don't know what is.

OK -- so if you're not one of those people who claim the 16th Amendment was never really ratified, if we accept the Constitutional legitimacy of a federal income tax, what about other forms of taxation proposed for health care such as payroll taxes and value added taxes?

Payroll taxes aren't strictly income taxes because they don't hit all income, but only *earned* income, and as such they are somewhat regressive.

[samclem]

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Originally Posted by eridanus ?? The 16th Amendment allows the Federal Government to levy an income tax. If that's not taking money from someone and giving it to someone else, I don't know what is.

The question was about government spending priorities. The Constitution goes into some depth in describing the functions of the various branches of the federal government. I think it's safe to assume the taxes collected under the 16th Amendment and all other levies by the Government support these functions enumerated within the Constitution. I was pointing out that, though the Framers went to considerable lengths to specify these functions, a federally-mandated transfer of assets from some citizens to others and/or provision of medical care was not among the things they mentioned. They could have penned it in, but they did not.

For those who believe "free" health care is some kind of right, the proper course of action is to seek a constitutional amendment.

But, I digress. . . .we can return now to the real world.

[youbet]

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Originally Posted by modhatter When Clinton was in office and we were in much better financial shape. They were still successful in defeating it.

As I recall, that wasn't the case. In fact, Clinton (both Mr and Ms) failed to sell it.

[Martha]

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Originally Posted by youbet You've said this in more than one thread now and I'd like to challenge because you're misleading by leaving out the concept of equal ownership. Citizens already substantially own the means of production in our country, but some own much more than others. In socialism, we'd share ownership equally, with political leadership/operatives having control. In Canadian healthcare, my perception is that all Canadians "own" the health care system equally. The govt controls it.. . .

There is a difference between government paying for health care provided by private providers and government owning the hospitals and clinic. Too tired from a camping trip to talk about it more. Maybe later.

[M Paquette]

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Originally Posted by M Paquette So, it sounds like the current Medicare funding of one discussion with a doctor during the Part B physical about getting an advance directive is a good thing, and the proposed law to fund discussions 'as often as' every 5 years is probably a good idea as well, in case the patient changes his mind.

Well, now we won't need to worry about this. A Senate committee has pulled this clause from the health bill they are looking at.

Persons enrolling in Medicare Part B will be permitted the current one (1) chance to discuss an advance directive during the Part B physical under current (2009) rules, and the Medicare hospice care informational brochure printing will no longer be funded.

[M Paquette]

I'd just like to note that I am very concerned about the whole idea of government run death panels. That is a function that should remain with private insurance. The government simply cannot run death panels as efficiently as traditional profit-motive incentivized private free market death panels.

Shouldn't all Americans have access to death panels? Why does the proposed plan limit death panel access to those 65 and older? That's simple age discrimination. I strongly feel that killing should be merit-based; Priority should be given to the needy, such as whiners, people with hairy moles, outies.



*SIGH* Pardon me. I had to spend some time today in an office, waiting for paperwork to ever so slowly be processed. For entertainment, the office had a couple of drones carrying on about 'death panels', euthanasia, and how they didn't think the government should be involved in health care. One of those days that makes me question the idea that 18, warm and breathing is sufficient to qualify someone to vote...

[haha]

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Originally Posted by M Paquette I'd just like to note that I am very concerned about the whole idea of government run death panels. ..

Don't worry. This delicate job will be done by fully qualified personnel, GS-10 or higher.

[M Paquette]

I know, I know. It's not the Huffington Post, or the Conservative Political Report, but Jason Shafrin has done a pretty good job of producing a relatively unbiased survey and summary of health care and economics. (I can tell because he seems to have annoyed all sides equally, based on comments.)

Healthcare Economist · Healthcare Economist Manifesto

Take a look at his summary and links to articles on the Swiss healthcare system. The Swiss made a transition from a US-like system to a 'managed competition' plan in 1997, with mandated coverage for all, a specific set of base benefits, and all insurance being private insurance. Insurance is subsidized for low income persons, such that no individual pays more than 10% of income on insurance. Insurers compete on supplementary coverage beyond the bare minimum mandated.

Healthcare Economist · Health Care Around the World: Switzerland

One interesting point is that even with the government subsidy, the Swiss government pays about 1/4 of healthcare costs, compared to the US government paying 1/2 of the costs. (Yes. 1/2 of all the healthcare costs in the US are government funded. Medicare, Medicaid, VA programs, DOD active duty coverage, TRICARE, SCHIP, etc.)