Krugman: Health Care Hopes

[RamboLiberal]

All the evidence suggests that it has finally become politically possible to give Americans what citizens of every other advanced nation already have: guaranteed health insurance. The economics of universal health care are sound, and polls show strong public support for guaranteed care. The only thing we have to fear is fear itself.

Unfortunately, there’s a lot of that around.

True, one kind of fear seems, provisionally, to have been overcome: the timidity of Democratic politicians scarred by the failure of the original Clinton health plan.

To see how much things have changed, consider Hillary Clinton’s evolution. Just 15 months ago, The New York Times reported that “her plans to expand coverage are tempered and incremental,” and that “she continues to shy from the ultimate challenge: describing what a comprehensive Democratic health care plan would look like.”

http://www.nytimes.com/2007/09/21/opinion/21krugman.html?hp

[MannyGoldstein]

1. Why Should We Cover The Working Poor? Fucking Parasites On Society!!!

Sure, we'd all save money and have better health care if we went for Medicare For All. But the working poor would get good care, and that's just wrong. Just wrong. After all, they don't have the ability to bundle hundreds of thousands in political contributions, so why should they get a fucking thing? I say let 'em suffer and die.

:sarcasm:

http://www.michaelmoore.com/sicko/sickos-for-sale/candidates/

[McCamy Taylor]

2. A Health Insurance Policy NEVER replaces single payer cradle to grave, here is why

In our current system, if you are lucky, you have a profession in which you are serially employed by companies that offer health insurance for you and your family. Your employer will change health insurance providers regularly, sometimes as often as every year, because insurance companies will offer reduced rates to attract new business, and this is a way for companies to save money. Also, if you change jobs, you change insurance companies. This means that the average person will be insured by many different plans and companies throughout his life. Therefore, there is little financial incentive for a health insurance company to invest in preventive health care that will reap financial benefits in decreased heart disease, stroke, diabetes and cancer thirty or forty years down the line--since that company will not be your insurance provider then. Instead, insurers make a profit by writing policies for healthy people and excluding sick people. They do this by insuring working people (if you are healthy enough to work, you are likely to be healthy), young people, people without pre-existing disease, people with good family histories. If you change jobs and have a health problem, you will only be able to sign up for new insurance if your new employer offers an HMO or PPO (they have no pre-existing condition clauses), otherwise its high priced COBRA for you then on to your state's high risk insurance pool or Medicare for those who have really bad health problems. Eventually, everyone who is really sick---premature heart disease, end stage renal disease, AIDS--gets on Medicare, Medicaid or both, which means that the government pays for all the sick people as well as the elderly, who are also sick---really sick, since they have spent their lives getting no preventive care on their employer sponsored health insurance. At age 65, Medicare starts playing "catch up", bypassing those coronary arteries that could have been kept clean with exercise and a healthy diet and dialyzing those kidneys that could have been protected if diabetes had been prevented with weight management and blood pressure had been controlled and replacing those knees and hips that also could have been saved with weight management. The government spends A LOT of money playing catch up on people aged 65 to death. And the catch up money does not buy quality of life anywhere near as good as the person would have had if he had been the beneficiary of medical prevention and a sound heart, sound joints and good kidneys.

The net result is a lot of money goes into the profit coffers of private, for profit health insurance plans, which spend the money on CEO salaries and anything except health care. And the taxpayer pays for the health care of most of the sickest people in the US. And people in the US are sicker than they are in almost every other industrialized nation on earth. Go check out the numbers. The US spends twice as much per capita on health care as the next most spend thrift country, Switzerland, and yet our health indicators put us below the countries of eastern Europe. That is because we do not prevent disease (cheap, cheap, cheap). We apply great big fat expensive band aids to disease that could have been prevented. And those big fat band aids make Merck and Pfizer and Johnson and Johnson and a lot of hospitals and surgeons very, very wealthy. That is why health care is such an insane portion of our GDP.

Now, consider the alternative, single payer, cradle to grave insurance. It does not even have to be the government. There could be a lottery and one lucky health insurer like Blue Cross could be selected to run it. The key is that once you sign on as a baby, you are on that plan until the day you die. Suddenly, you insurer has a great new way to save money. It can prevent disease. It can encourage you to go for check ups. It can encourage you to keep a good weight and blood pressure and cholesterol and not smoke and exercise. These are cheap interventions, and they will pay off big time in the future. Since the single payer will have a huge volume of enrollees, it will easily be able to absorb those who have existing conditions---the premiums from all the well people will finance the care of the sick ones. And by keeping the well ones well, the insurer can eventually cut costs. With only a single insurance product to run---no twenty different provider lists, no twenty different sets of rules-- the overhead will be low. There will be no need to market the plan. There will no advertising costs. Everything can go into research into medical prevention and efficacy.

Now, Merck, Pfizer, Johnson and Johnson will make out like bandits in the early days of this change, as people who did not have insurance get their problems fixed. But later, they are going to lose out, as people become less ill, and American stops spending twice as much per person as Switzerland on health care. So, the pharmaceutical and durable medical goods and some other medical industries may not like the switch in health care systems and they will argue that our present system is better (because more medical waste means money in their pockets). But, in the long run, it will make us healthier and save us money.

[frank78]

3. None of you has a clue about economics or healthcare

How did health care get to be so expensive in this country??? The govt is THE cause for the out of control increases in health care costs and insurance rates. The govt has worked in collusion with insurance companies to make sure health care costs are high. I've spent a fair amount of time going over with this on another site, so I'll keep this short.

Let's get one thing established. Central planning doesn't work. It failed in the USSR, it is going the way of the dinosaur in China and in India. Their lives are only improving by embracing free markets. If you do not agree with this premise at all, then you are most likely a socialist or ignorant of history and economics and everything else from here on out will fall on deaf ears.
Socialism eventually becomes dictatorship or more generally authoritarianism. History. We study it for a reason. And there's a reason people always say it repeats itself.


There is virtually no free market in health care. Hasn't been any semblance of one for decades. In a free market costs go DOWN and quality goes up simultaneously. The ONLY solution is to get govt out of health care completely. There are only 3 major proper roles for govt in the health care industry as I see it.
1. Watch over transactions to assure no fraud. In short, hold up the rule of law.
2. Force health care facilities to be up front about costs. Would you wait for 3 weeks after someone remodeled your kitchen or did repairs on your car to find out about the costs?? Of course not. It should be known up front. Every other business model includes this. Why is health care the exception to this rule?? Because they are shielded by laws that allow health care facilities. Heck, getting your wisdom teeth pulled or any dental work you can know the costs up front. Very difficult to do with health care. One word sums this idea up--- transparency. The game has been rigged and the federal govt has been doing most of string pulling.
3. Get insurance companies to write policies that people can actually understand. Pages and pages of stuff that they write in part just to make people not read it is not the way things should be.

The govt pays for roughly 60% of all health care dollars spent in the US, so they get to call all the shots. Not only that, special interest groups have succeeded in bribing our Congress to pass laws that keep health care costs expensive.

-You can't buy insurance across state lines. Live in NY and have BCBS?? Ok. Want to buy a BCBS policy in say Maryland or Massachsetts?? Nope. Can't do that. That would cause competition and thus lower costs to the consumer. We can't have any of that.
-Medicare is a looming crisis that is going to be the biggist financial disaster in the history of the world. That is no exaggeration. It faces $34 trillion in budget shortfalls over the next 75 years. That's about $440 billion per year. That means that EACH YEAR on average, the Medicare deficit will equal 4.5 years of the war in Iraq. Niiice. And that's just for people over 65. Now we're going to insure everybody with everybody else's money???

-An insurance program where no one can be turned away increases the costs for everyone in that same insurer. This means insurance costs go way up for every single private insurer at our detriment. Either that or the insurers ask for direct subsidies and you have govt having complete control of healthcare. When no one can be turned away, it creates what economists call a moral hazard. People will get fatter and live more unhealthy lifestyles than they already do. Why stop eating ice cream by the gallon when 'someone else' is paying your bills??


I can type for pages. I suggest most people on this site get an education in reality. Socialism is a race to the bottom for humankind. It is a direct violation of our human rights. I just don't get how some smart people can fall for this trap. The govt rigs the system in hundreds of ways, then when things get really costly (as they will do in system clouded with secrecy in prices and anti-competitive protections by the govt), the govt claims they are the only way to improve things. What a joke. I suggest reading something other than leftist blogs and such if you want a reality check.

[eridani]

4. People who think that health care is a market like iPods are really stupid

How stupid do you have to be to think that three competing fire departments in a city will decrease fire protection costs? There aren't going to be more fires just because your bill for equipment has just tripled. Same thing applies to hospitals--given the same population, the more hospitals a town has, the more expensive health care is. That's because really expensive illnesses and fires are rare, but extremely damaging to their victims. You aren't going to see more heart attacks just because you open a second cardiac center and duplicate all that expensive equipment. The way any sane society deals with this situation is to have everybody share the risk and pay something.

Central planning doesn't work for iPods or fall fashions, but it works just fine for roads, schools, police and fire protection and the military. Like all of those things, it is a public good.

Private insurance companies are parasitic institutions that exist to deny health care and shift the pool of health care dollars to their stockholders, and government currently contributes to the problem by subsidizing them. Get rid of them, and we will have decent health care just like every other industrialized country in the world.

[Joe Bacon]

5. Your Ayn Randian Invisible Hand Ain't Working

Your ridiculous comments clearly show that you float up up up in the rarefied air of Ayn as in Mine Rand's LAISSEZ FAIRYLAND where every problem is solved by the Invisible Hand of the Free Market. That bullshit works fine in Ayn as in Mine's fairy tales, but it does NOT work in the real world, something you have no clue about.

You and your fellow deluded Ayn Randites have pushed the United Stats to the brink. Your obsession with selfishness has infected every facet of American life. your pal Reagan opened the door when he said in his debate with Carter, "are YOU better off now than YOU were four years ago?". Not WE, no President Pruneface would never emphasie WE, with that selfish materialist it was always YOU. Reagan opened the door for selfishnessand his Ayn Randian pals got the blank check to permeate American society.

Canadians and Western Europeans do NOT think in terms of themselves, they think in terms of the whole society. SiCKO show how far better off the people are there than here.