Well done (as always). Mark Levin is reading your post on his radio show as I write this. Just thought you would want to know.

Maybe–if they are given the chance to make the decision themselves.

Imagine a system in which the older folks (like yours truly) are given this choice: Spend gobs on you or give a big chunk of what we would have spent on you to someone of your choosing.

If it’s just a nonspecific “someone else” that would benefit from the money the older guy chooses not to have spent on him, it’s not the same.

When the spending you forgo for yourself goes to someone else that you can’t pick, don’t you have the “commons problem”? It’s every man for himself, since giving up anything doesn’t benefit you or someone you want to receive the benefit.

As was often the case, his “disloyalty” consisted of his being perceived by Stalin as a potential threat.

But, as I said, I do not compare this regime with the Soviet monstrosity. Their fledgling collectivist programs are another step in the direction of a corporate state, yes, but not in that league at all.

I just think it is fascinating to watch the same people who were convinced that previous administrations were monitoring their phone calls and mail and library books, etc., by illegally employing the CIA, FBI, and NSA to watch their every move, suddenly become so enthusiastic about turning their entire medical history, and the responsibility for future determinations of possible medical care, over to the same threatening state which so recently planned, they claimed repeatedly, to put them in concentration camps or void the elections of 2008.

Once the state has all this power and information, do they honestly believe that only friendly regimes will ever have access to it? The unbelieveable naivete’ of it all is simply astounding.

Stalin, of course, executed very large numbers of military officers for political deviations, shortly before WWII. Some of these were undoubtedly officers with much experience and great talent, who could have been very useful. How many Russians died unnecessarily in WWII because of these political judgments? The number could well be in the millions.

Obama/Pelosi/Reid intend to politicize every aspect of our national life. Healthcare and energy are just the beginning.

Very good thinking, Shannon. I love the word “decompartmentalization” because it always spells danger.

However, the entire point of socialized medicine is taking choice away from the client. Whatever their dispositions–and I question their trans-generational generosity–the elderly will certainly have less choice.

The much darker and more likely scenario is that career politicians would make more healthcare choices for all of us. Are these scoundrels motivated by the favor of their newborn constituents? Not likely. Look what they’ve done to disenfranchise 18 year olds.

Politicians do not share commercial advertisers’ fixation with youth. Contrarily, they like to push ever more societal resources into gratuities for their very best voters. Thus, an American version of socialized medicine will likely produce a spike in infant mortality to compliment the last months of life for the survivors.

Decompartmentalization kills.

Best regards, Helly

What that means, of course, is how loyal and faithful to party doctrine you were matters more than your military skill and bravery.

I am not trying to compare the current administration to Soviet Russia, I think that rhetoric is badly overblown. The broader point from the example, however, does apply.

One of the reasons that limited government is better than expansive government is that there are certain issues that should be decided non-politically.

Economic decisions should be made based on economic principles, not political ones. Educational issues should be decided on what is best for students academically and developmentally, not what is politically correct. Legal issues should be decided based on the law, not political considerations, i.e., see the GM bankruptcy travesty.

Medical issues should be decided medically, by doctors and patients, with their families, not by anonymous bureaucrats or unelected commissions set up by some vaguely worded legislation.

The 20th century was a labratory experiment in real life of several different forms of very powerful government structures, from authoritarian to full blown totalitarianism. Contrary to the starry-eyed predictions of the statists and collectivists, the more powerful the government in its control of the daily lives of its citizens, the worse things turned out for the common man and woman.

The archives have been opened, the walls have fallen, there is no possibility of any intellectually honest contention that the many repressive regimes of the past were better, or even half as good, as the liberal democratically structured states based on the Westminster/Constitutional model of limited state power and expansive individual liberties and rights.

For the proponents of these various state run medical schemes now percolating through the legislature to claim that they would be more economical, or more responsive, or more conducive to future medical innovation than a privately controlled system is to deny not only the documented history of failure in past attempts at such a system with several other sectors of national economies around the world, and in the US, but also to deny the very clear examples of waste, inefficiency, and substandard care to be found in the current state run systems of Medicare, Medicaid, and Veterans’ medical benefits and hospitals.

To those proponents I say—you are the blind, demanding that the rest of us close our eyes and follow you, even when we can see you walking, nay running, directly towards the cliff.

Why should anyone have to show you? The bill is online. Look up the finance section yourself. H.R. 676 Section 211.c.1

(1) INGENERAL.—There are appropriated to
the USNHC Trust Fund amounts sufficient to carry
out this Act from the following sources:
(A) Existing sources of Federal Govern-
ment revenues for health care.
(B) Increasing personal income taxes on
the top 5 percent income earners.
(C) Instituting a modest and progressive
excise tax on payroll and self-employment in-
come.
(D) Instituting a small tax on stock and
bond transactions.

So taxes on investment and job creation, taxes on upper income people (honest we promise never anyone else), a progressive i.e. non-flat payroll tax and general revenues.

Health care funding for the middle-class will be lumped in with health care funding for everyone else but the rich. Health care spending will compete with all other government financial needs both on the tax and on the spending side.

With Obamacare, that will change. The walls of the financial compartments will crumble. All medical spending for everyone will come out of one big financial pot.

Can somebody show me where in H.R. 676 it actually says this? There are far too many blank, unproved assertions flying around masquerading as “fact” that simply aren’t true. (Not that I’m saying this isn’t, but I don’t see anyone actually bothering to cite chapter and verse to convince me that this isn’t just some Republican talking point.)

Technological improvements would certainly help: cheaper/faster/smaller (i.e, more portable) equipment would help, of course. Of course, hand in glove with that comes new procedures, techniques, etc that are added to the demand side of the issue.

Tort reform has to happen but no Dem controlled admin or congress will go there.

Increase supply of health service providers would make doctors and nurses less expensive. Of course the AMA is not going to allow that to happen without a fight. But in all honesty we probably need to make entry into the medical professions less difficult and expensive. Who the heck is going to go to school for 10 years, emerging with 100s of thousands of debt, and work for $100K. Heck, without tort reform they’ll never be able to work for $250K.

Demand is potentially the toughest part of this to try and control. Some people run to a doctor for every sniffle, ache, or tummy upset. Some people never go. But everyone wants to be cured, or to live a reasonably decent life, should they have a disease.

I cannot back this up with hard data, but I do spend time with folks in the health care delivery and pharmacy worlds. They seem to agree that a disproportionate number of the type 2 diabetes suffers are also medicaid recipients. They also seem to largely agree that type 2 is one of the most preventable diseases. This applies as well to AIDS/HIV infected people – a largely preventable disease. Also enormously expensive to treat with drugs – the monthly costs are often in the high hundreds, even thousands. Is anyone going to tell these people to eat less, exercise more, drop a few hundred lbs? Or use condoms or abstinence?

And those what of the mentally ill using psych drugs. Many of them have no hope of ever being productive. Are we going to cut them off from treatment. And what about the kiddies getting all the crap this nutty system shoves down their throats. Sorry, kid, no red OR blue pill for you – get your act together and quit being disruptive.

What’s more preventable than pregnancy?

I see no possible way to reliably control demand for healthcare services without rationing.

If the discussion/debate/proposed legislation does not include tort reform and methods for increasing supply and decreasing demand then it is NOT about controlling costs. It’s about something else.

i disagree with your reply:

you wrote:

# Shannon Love Says:
August 13th, 2009 at 12:35 pm

Anonymous,

There’s a way to reduce costs without hurting our seniors or our doctors: Tort reform would reduce “defensive testing” and lower malpractice insurance fees and so reduce costs without reducing care.

Tort reform would only produce a one time savings. It wouldn’t alter the basic dynamic of increasing health care cost driven by increasingly powerful and expensive medical technology. Long-term it would only shift the growth curve over a couple of years into the future.

wrong.

it would end defensive testing, and it would lower malpractice insurance which would lower fees. these savings are recurrent, not just next year, but every year into the future (not just a couple!) driving the angle of the rate of increase from a 45Degree angle to a 15Degree angle.

as the population ages the savings go UP.

there is no other way to save as much.

none.

also:

it is intellectually dishonest to argue that improvements in healthcare technology is inflationary.

if you want to pay 1970 prices for healthcare today you csn: settle for 1970 healthcare.

if you want to drive a 1975 pinto you can for less than 2gees.

but telling me a honda civic at 15gees represents inflation of 700% is bogus.

The doctor and clinic and hospital then become really mostly diagnosticians. Once the situation is diagnosed, they can pretty much just look up on the govt website what treatment options they have, and then see if their organization offers any of those treatments at the too-low reimbursements offered–and, it may be a pretty limited list if it is a condition that is expensive to treat or the individual is at the wrong stage of life based on whatever criteria are used, and if the condition doesn’t have a strong political constituency.

This is what happens everywhere there is a single-payer system, and it is INEVITABLE. No way around it, not a matter of getting good people to run it, it is embedded in the logic.

There’s a way to reduce costs without hurting our seniors or our doctors: Tort reform would reduce “defensive testing” and lower malpractice insurance fees and so reduce costs without reducing care.

Tort reform would only produce a one time savings. It wouldn’t alter the basic dynamic of increasing health care cost driven by increasingly powerful and expensive medical technology. Long-term it would only shift the growth curve over a couple of years into the future.

——————————–
Sorry, Shannon, but you are way off base on this. You really have no idea how much defensive medicine is occurring in today’s litigious medical environment. It is NOT the increasingly powerful and expensive medical technology, but how OFTEN it is being utilized, many times to avoid it coming back to bite you in a lawsuit. Take the defensive component out of the equation and it probably drops 35% b itself. It most certainly would alter the basic dynamics.

And if we do get to universal health care provided by the government, do you honestly think they will allow the legal industry to continue this kind of medical lotto? Please. The current medical tort situation is just a temporary stalking horse mechanism the currently allow to produce their desired end-result.

One of my concerns is that is not what will happen, not that I support national health or Obama’s plan. The elderly are a voting block and will be pandered too by the politicians.

My son has cystic fibrosis. My fear is diseases that affect specific voting blocks will get all of the funding and those suffering from “orphan” diseases will get none. There are a lot more votes in making pronouncements about Breast Cancer & AIDS then there is helping the 30,000 souls with cystic fibrosis. Moreover, I fear that donations to the Cystic Fibrosis Foundation (www.cff.org) will dry up for two reasons. One – CFF gets some big time donations from those evil rich people Obama wants to tax poor. Two – Once the government takes over health care, ordinary people will not write the $10-$100 checks that get my small suburban fund raising committee bringing in >$150k per year. People will start to say, “The government will take care of paying for research, I am not donating.” I used to live in the UK and that is the attitude of the folks there.

There’s a way to reduce costs without hurting our seniors or our doctors: Tort reform would reduce “defensive testing” and lower malpractice insurance fees and so reduce costs without reducing care.

Tort reform would only produce a one time savings. It wouldn’t alter the basic dynamic of increasing health care cost driven by increasingly powerful and expensive medical technology. Long-term it would only shift the growth curve over a couple of years into the future.

Except that’s not how it’s working right now; the productive (real citizens who work real jobs) don’t have nearly as much power as the non-productive (Congress, POTUS, government workers).

Yes and no. We have a kind of general conflict of interest between taxpayers and taxconsumers. If a taxconsumers wants more money for their interpretive dance ensemble, that doesn’t cost the taxpayer anything but the money they have to toss into one huge collective pot. The taxpayer can still adjust their own spending to get what they need whether that is health care or dance lessons.

In dynamic of health care, the conflict is direct and immediate over the same service/benefit. Its dollars spent for health care and only health care. A dollar of health care spent on the elderly is a dollar not available for children. Even if you raise taxes, you still have the inherent conflict of splitting a larger pie. If a taxconsumer gets more health care, that means a taxpayer gets less health care. The taxpayer can’t get more health care by changing their own budget.

We should think long and hard before we set up a political dynamic that pits the interests of the productive and powerful against the interests of the non-productive and powerless.

Except that’s not how it’s working right now; the productive (real citizens who work real jobs) don’t have nearly as much power as the non-productive (Congress, POTUS, government workers). This is the dynamic that needs to change.