A health care debate I'm currently engaged in, online....

[Independent_Voice]

So here's a debate I'm having with someone on a friend's Facebook.

My friend (to whom the Facebook belongs) is a very progressive, left-leaning individual who ideally would like to see single-payer health care. For the purposes of this post, we'll call her Winter_Warrior.

Her friend (whom I've never met, but have recently been debating on Winter_Warrior's Facebook), says he voted for Obama and supports some kind of health care reform, but he doesn't trust letting the government run it. For the purposes of this post, we'll call him Obama_Capitalist.

Winter_Warrior originally posted a political cartoon endorsing single-payer, and here's how our three-way exchange has proceeded...

Here's our conversation thus far:

*****************************************************

( Note: these are NOT DemocraticUnderground screen names, with the exception of mine )

Obama_Capitalist:
The federal goverment is highly inefficient in almost everything it does. Let's look at the example of Medicare. The Medicare program is costing more and more every year and they do not collect enough money to let it run on its own. Same thing with the postal service, that's why stamp prices always go up. How about the armed forces? Again...billions of dollars of taxpayer money every year. Every other example he gave was run by state or local government, meaning that it has to answer to your needs on a more personal level. The fire department relies heavily on volunteers. This cartoon just looks at everything from miles away rather than at a close up level and doesn't really propose any solutions other than saying "we need it." That's the problem right now, no one wants to talk out a solution, they just want to force through what they have on the table. Let's just say that anyone who doesn't vote for it just wants everyone to die. Work it like they did the Patriot Bill. The example of Medicare is also relatively laughable because I believe that they are claiming that they will pay from the new program with a portion of the Medicare money because they claim it's inefficient.

Winter_Warrior:
I don't know who "they" is. I just know that the plan being proposed by Congress is better than what exists right now. I also know that health care is broken. People I love and care about are having their lives ruined by the current broken system.

Obama_Capitalist:
I put "they" because I didn't want to put President Obama there, because it seems like everyone writes you off then as a guy that hates him. I voted for him too, but I don't think he's doing the right thing by trying to force something through based on the fact that it's making him look bad that he hasn't come through with anything yet. It's difficult to alter things like that once they are passed.

Independent_Voice:
There are multiple health care reform plans being considered by the House and Senate, and the only one that matters is the reconciled version of the bill that comes up for a vote (and potentially crosses the president's desk for him to sign or veto). The only form of mandated health care that I support would be one with a strong, affordable PUBLIC option of some sort for low-income people. I oppose some of these so-called "compromise" proposals to mandate that all Americans buy insurance from private-run companies or regional co-opts, because that's basically a government "bailout" to the for-profit health insurers.

Winter_Warrior:
Independent_Voice, I think you are right on, but I would rather have a compromise than keep the current system we have right now.

Independent_Voice:
Well I don't mind if the final bill is a compromise in some form...I just don't want to see people forced by the government to buy insurance that they don't have the disposable income to pay for. That's the whole reason WHY so many people are uninsured at present, and if the president agrees to mandated private insurance then it wouldn't make health coverage more affordable -- so in that scenario it wouldn't really be a compromise, but more of a gift to for-profit lobbyists that doesn't improve the status quo.

Obama_Capitalist jumps back in:
Not all insurance companies are for-profit. Mutual insurance companies return any excess premium collected to customers. In most states there is an option for low-income individuals called Medicaid and many hospitals are willing to give discounts to low income individuals and set up payment plans if needed. I don't see a reason why requiring insurance and using co-ops of some sort wouldn't work because it would allow the insurance companies to pool the overall risks and build them into the rates so one person's risk is spread out over many. By the way, a lot of people hate the idea of pooled risk because they don't want premiums to go up because other people had to file claims.

Independent_Voice:
But what about the people who don't qualify for Medicaid or special discounts, yet their income still isn't high enough for them to take out their own insurance plans?...people who fall through the cracks. How could we be certain they wouldn't be price-gouged by these private co-ops?

*****************************************************

So what am I missing here? Am I totally off-base?

How should I be responding within the context of this debate?

[babylonsister]

1. Maybe you can glean some info from here...

http://www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=389&topic_id=6138293

"What has the government ever done better than the private sector?"

[WillYourVoteBCounted]

2. lets ditch those socialistic "government run" wars

how bout that?

[Jackpine Radical]

3. Medicare is relatively expensive on a per-capita basis because

it mostly covers the very sickest part of the population, the old, at that time of their lives when they are the most expensive to the system. If the young & healthy were aso included under the Medicare umbrella, the prices per capita would be DRAMATICALLY lower.

[Oregone]

4. "The Medicare program is costing more and more every year and they do not collect enough money to "

Of course it does. There are more and more enrollees every year as the elderly population expands.

And no, its not supposed to collect enough money to run on its own. That would be regressive, making the elderly (those on tight budgets) fund their own health care. Instead, it is partially progressively funded via taxation. This is of design.

Medicare has under a 3% overhead AND has low negotiated rates. Switching these people to private insurance would cost 30-50% more per head. Medicare does a fine job with this population, reducing overall per capita health costs.

[Independent_Voice]

5. UPDATE: His most recent response to me....

Obama_Capitalist writes:

Insurance rates have to be filed with the commissioner of insurance in each state and the commissioner enforces any rules for insurance and acts as an advocate for the customer to make sure that rates are justified by actual risk and not profit. Question for you: Are these same people that you speak of spending money on houses they can't afford and on other things that are more frivolous than what they need causing them to go into debt at the expense of health care? No one wants to pay for insurance until they need it.

[Zodiak]

6. Tell him this

People who HAVE health insurance are going bankrupt. 50% of people going bankrupt do so because of medical expenses, and of those, 80% HAVE HEALTH INSURANCE.

I'm glad you can put up with this line of argumentation because the whole "people don't deserve help because they spent their money on X or Y" pisses me off.

I just do not understand why people feel so righteous in blaming the victim.

And the commissioner of insurance system isn't working (local and state officials are more easily bought off/ appointed as a crony), or we would not have the most expensive healthcare in the world.

[Independent_Voice]

8. What should I say to him, when....

...he asks where I got those statistics (50% and 80%) that you've cited?

Which he inevitably will ask.

[quakerboy]

7. You had it right.

Take, say, me. I spend that money on the cheapest rent I have been able to find, and on paying student loans. My wife and I spend less on food than any other family I am aware of. I do splurge 25/month on cable TV, though it reduces the cost of the cable internet that my work requires me to have, so its actual end cost to me is less. I cant afford a real hobby, so I collect business cards. Most of it is going to student loans, and will for the next 15 or more years.

I make to much for any of the assistance programs, even though its all sucked away for those student loans. I guess we should have skipped getting an education. But I was 17 when I made that choice, and didn't know any better.

There is also a moral aspect to this. Some areas, I rather suspect, do not have any available "nonprofit" insurance. And even in "nonprofit" set ups, the CEO's are often skimming quite a nice chunk for themselves.