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Author Topic:   How Does Republican Platform Help Middle Class?
Catholic Scientist
Member
Posts: 9249
From: near St. Louis
Joined: 01-27-2005
Member Rating: 2.2


Message 406 of 440 (613181)
04-22-2011 11:38 AM
Reply to: Message 405 by ZenMonkey
04-22-2011 11:17 AM


Re: side-question
Of course they do.

Badly phrased, I meant: Do you charge more for the service?

For an hour session paid out of pocket, on the other hand, I charge $75.

For a typical plan, the patient pays a $25 copay and the insurance company pays me $25,

Do you still charge $75/hour for the service? How much do you charge the insurance company?


Background on me asking:

I was going to the same dentist forever back in the day, covered under my parents' insurance. After I graduated college, I was no longer covered and went to the dentist to pay out of pocket. He ended up changing me a lot less because I was paying out of pocket. The rational was this: he charges the insurance company for the service, and then they pay a portion of what he charges. For example (adjusted for easy math), let's say he needs to make $100 for a service. The insurance company pays 50% of what he charges them, so he charges them $200 for the service, they pay their portion and he gets his $100. When I went in to pay out of pocket, he just charged me the $100 that he needed to make and that was that.


This message is a reply to:
 Message 405 by ZenMonkey, posted 04-22-2011 11:17 AM ZenMonkey has responded

Replies to this message:
 Message 407 by crashfrog, posted 04-22-2011 11:48 AM Catholic Scientist has responded
 Message 409 by ZenMonkey, posted 04-22-2011 12:29 PM Catholic Scientist has not yet responded

  
crashfrog
Inactive Member


Message 407 of 440 (613182)
04-22-2011 11:48 AM
Reply to: Message 406 by Catholic Scientist
04-22-2011 11:38 AM


Re: side-question
Most insurance companies follow the Medicare model and pay a predetermined amount for medical services; medical service providers have to submit a bill coded with the insurance company's proprietary billing codes for procedures. For instance, if a hospital bills for a laparoscopic surgery, there's an associated billing code for "laparoscopic surgery to the knee" or whatever, and associated codes for the materials used up in the surgery (dressings, bandages, anesthetic, etc.)

Basically the insurance company uses its monopsony power to say "we'll pay you exactly $8000 for billing code LPS-12 (a laparoscopic surgery to the knee), or you can fuck off and not accept patients on our insurance. Since that's about 30% of the people who live and work here in your county, that would be a pretty stupid thing to do." Medicare does the same thing. It's a powerful means of health care cost control, of course, doctors hate it. And, of course, when it's just you and your wallet, you have no bargaining power at all, so the doctor can charge you more to make up for insurance and Medicare paying him less.

And of course, since each insurer has it's own incompatible system of billing codes - one code for each possible medical procedure, medication, and consumable - so perhaps a hundred thousand codes per insurer, plus the Medicare billing code system, plus a Medicaid billing system (one per state.) Now you can see why billing is more than 50% of the administrative costs, on average, of any health care provider, and why moving to single-payer (and therefore a single unified billing system) stands to reap such an enormous increase in efficiency.


This message is a reply to:
 Message 406 by Catholic Scientist, posted 04-22-2011 11:38 AM Catholic Scientist has responded

Replies to this message:
 Message 408 by Catholic Scientist, posted 04-22-2011 12:15 PM crashfrog has responded

  
Catholic Scientist
Member
Posts: 9249
From: near St. Louis
Joined: 01-27-2005
Member Rating: 2.2


Message 408 of 440 (613187)
04-22-2011 12:15 PM
Reply to: Message 407 by crashfrog
04-22-2011 11:48 AM


Re: side-question
Most insurance companies follow the Medicare model and pay a predetermined amount for medical services; medical service providers have to submit a bill coded with the insurance company's proprietary billing codes for procedures. For instance, if a hospital bills for a laparoscopic surgery, there's an associated billing code for "laparoscopic surgery to the knee" or whatever, and associated codes for the materials used up in the surgery (dressings, bandages, anesthetic, etc.)
Basically the insurance company uses its monopsony power to say "we'll pay you exactly $8000 for billing code LPS-12 (a laparoscopic surgery to the knee), or you can fuck off and not accept patients on our insurance. Since that's about 30% of the people who live and work here in your county, that would be a pretty stupid thing to do." Medicare does the same thing. It's a powerful means of health care cost control, of course, doctors hate it.

I've seen those TV commercials for various types of educations to get jobs where one of them is "Medical Billing and Coding". In the back of my mind I always wondered just why that would require going to one of those schools....

And, of course, when it's just you and your wallet, you have no bargaining power at all, so the doctor can charge you more to make up for insurance and Medicare paying him less.

That's kinda shitty.

And of course, since each insurer has it's own incompatible system of billing codes - one code for each possible medical procedure, medication, and consumable - so perhaps a hundred thousand codes per insurer, plus the Medicare billing code system, plus a Medicaid billing system (one per state.) Now you can see why billing is more than 50% of the administrative costs, on average, of any health care provider, and why moving to single-payer (and therefore a single unified billing system) stands to reap such an enormous increase in efficiency.

Yeah, there certainly are some things that would be better.

Thanks for the reply.


This message is a reply to:
 Message 407 by crashfrog, posted 04-22-2011 11:48 AM crashfrog has responded

Replies to this message:
 Message 410 by crashfrog, posted 04-22-2011 5:30 PM Catholic Scientist has not yet responded

  
ZenMonkey
Member (Idle past 883 days)
Posts: 428
From: Portland, OR USA
Joined: 09-25-2009


(1)
Message 409 of 440 (613190)
04-22-2011 12:29 PM
Reply to: Message 406 by Catholic Scientist
04-22-2011 11:38 AM


Re: side-question
Catholic Scientist writes:

Of course they do.

Badly phrased, I meant: Do you charge more for the service?

For an hour session paid out of pocket, on the other hand, I charge $75.

For a typical plan, the patient pays a $25 copay and the insurance company pays me $25,

Do you still charge $75/hour for the service? How much do you charge the insurance company?


Background on me asking:

I was going to the same dentist forever back in the day, covered under my parents' insurance. After I graduated college, I was no longer covered and went to the dentist to pay out of pocket. He ended up changing me a lot less because I was paying out of pocket. The rational was this: he charges the insurance company for the service, and then they pay a portion of what he charges. For example (adjusted for easy math), let's say he needs to make $100 for a service. The insurance company pays 50% of what he charges them, so he charges them $200 for the service, they pay their portion and he gets his $100. When I went in to pay out of pocket, he just charged me the $100 that he needed to make and that was that.

Ah, I see. Here's how it works. I have a fee schedule, which says that I charge $40 per 15 minute unit for massage therapy. On the other hand, my published out of pocket fees are as I described: $50 for a half hour, $75 for an hour, $100 for 90 minutes, etc., with a disclaimer saying that prices reflect a discount for payment at time of service, i.e. I'm not billing insurance. When I bill insurance, I bill them $40 per 15 minute unit, just like my fee schedule says. Why am I billing them that much? For the most part, it doesn't matter in the least what I bill the insurance company; they're going to pay me a set rate whether I bill $50 or $5000. They've determined that an hour of my time is worth $25 from them and $25 from the patient and that's that. However, other plans, notably those for federal employees, pay at a higher rate. Motor Vehichle Accicent cases, which are paid for out of automobile insurance in Oregon and not private insurance, do pay out at that maximum rate. (They also require a doctor's prescription and a hellish amount of documentation.) So I bill the maximum allowable under any given plan no matter what they'll pay in order to be uniform in my pricing, and in order to get the maximum compensation allowable. (Good old free market.) In the end, sometimes that's $50 for an hour of my time, sometimes (much, much more rarely) that can come out to $80 for half an hour. Mostly I do make more when the patient is paying out of pocket.

It took much pain and suffering and many frustrating phone calls for me to even start to learn how to work this system. Do I wish that I didn't have to take insurance patients at all? You bet. Considering the time I spend filing claims, calling to verify elligiblity, and refiling denied claims, it really doesn't pay that well. Can I stop taking insurance? Not so long as that's the only way that most of my patients can afford to see me. But I would gladly work with a single-payer system that offered reasonable compenstation to me and reasonable co-pays for my patients.


I have no time for lies and fantasy, and neither should you. Enjoy or die.
-John Lydon

Reality has a well-known liberal bias.
-Steven Colbert

I never meant to say that the Conservatives are generally stupid. I meant to say that stupid people are generally Conservative. I believe that is so obviously and universally admitted a principle that I hardly think any gentleman will deny it.
- John Stuart Mill


This message is a reply to:
 Message 406 by Catholic Scientist, posted 04-22-2011 11:38 AM Catholic Scientist has not yet responded

  
crashfrog
Inactive Member


Message 410 of 440 (613207)
04-22-2011 5:30 PM
Reply to: Message 408 by Catholic Scientist
04-22-2011 12:15 PM


Re: side-question
I've seen those TV commercials for various types of educations to get jobs where one of them is "Medical Billing and Coding". In the back of my mind I always wondered just why that would require going to one of those schools....

Well, there you go! It's a growth industry, like the rest of the health care sector.

That's kinda shitty.

And it's why the "free market" doesn't end up controlling costs, but inflating them.

Think of it another way - heath care providers, like any manufacturing provider, give discounts if you buy in bulk. (Buy 50 knee laparos, get the 51st free!) If you buy one at a time, you pay full price. If you gather everybody who needs a laparo together and bill for it all at once, you can pass the savings on to them. It's like when an office all goes in together for sandwiches so that they can split the delivery charge.

In any marketplace, bulk purchasing is a way for buyers to get some leverage on sellers. In the market for health care, where people are usually quite motivated to pay whatever it costs regardless of whether it works or not - see "homeopathy" - bulk purchasing power is the most promising way to control the rise in health care costs. Of course, the larger your "bulk" the better, so the logical terminus of that is a single-payer system that covers all Americans, simplifies billing, and uses monopsony power ("bulk purchasing" power taken to the logical extreme of a single buyer in the entire market) to exert force against the increase in prices and the marketing of expensive but useless snake oils.

Thanks for the reply.

You're welcome. I don't know why it worked differently at your dentist's office; my suspicion is that it doesn't work that way anymore, that he simply can't pad the bills for most insurers since they pay set rates for set procedures, and that therefore he's charging the out-of-pocket patients a lot more these days. I know when I had four cavities filled and a crown installed a few years ago, I paid out of pocket and it was almost two grand. (And I got the cheap mercury fillings!)


This message is a reply to:
 Message 408 by Catholic Scientist, posted 04-22-2011 12:15 PM Catholic Scientist has not yet responded

  
ZenMonkey
Member (Idle past 883 days)
Posts: 428
From: Portland, OR USA
Joined: 09-25-2009


Message 411 of 440 (613211)
04-22-2011 7:03 PM


A dose of reality.
Yesterday Andrew Sullivan (who is not a liberal by any means) linked to this op-ed by Paul Krugman on why it's misguided to think of health care as a commercial commodity. Here's part of Krugman's column:

Now, what House Republicans propose is that the government simply push the problem of rising health care costs on to seniors; that is, that we replace Medicare with vouchers that can be applied to private insurance, and that we count on seniors and insurance companies to work it out somehow. This, they claim, would be superior to expert review because it would open health care to the wonders of consumer choice.

Whats wrong with this idea (aside from the grossly inadequate value of the proposed vouchers)? One answer is that it wouldnt work. Consumer-based medicine has been a bust everywhere it has been tried. To take the most directly relevant example, Medicare Advantage, which was originally called Medicare + Choice, was supposed to save money; it ended up costing substantially more than traditional Medicare. America has the most consumer-driven health care system in the advanced world. It also has by far the highest costs yet provides a quality of care no better than far cheaper systems in other countries.

Sullivan also links to this blog post by an ER physician, who I think we can all agree should know what he's talking about.

First, here's the graph illustrating the data to which he's refering:

He says:

Though the data is a few years old, I doubt the distribution has changed. To emphasize, HALF of all health care costs in the US is concentrated in only 5% of the population, and 80% of costs are accounted for by the top quintile! (source: Kaiser Foundation PDF)

So the effect here is that with such a concentration of costs in such a small segment of the population, the ability of the larger population to move the market is highly restricted. You can make 80% of consumers highly price sensitive, but they can only affect a tiny fraction of healthcare spending. And for the generally well, their costs are probably those which are least responsible for the spiraling inflation. They're not getting $30,000 stents or prolonged ICU stays, or needing complex chronic disease management.

Conversely, those who are high consumers of health care simply cannot be made more price sensitive, since their costs are probably well beyond what they could pay in any event, and for most are well beyond the limits of even a catastrophic health insurance policy. Once you are told that you need a bypass/chemo/stent/dialysis/NICU etc, etc, etc, the costs are so overwhelming that a consumer cannot possibly pay them out of pocket. Since, by definition, these catastrophic costs are paid by some form of insurance, the consumer cannot have much financial interest in cost containment. For most, when they are confronted with a major or life-threatening illness, their entire focus shifts to survival, and they could care less about the cost. Further, many who are in this sick/expensive category have some diminished capacity with regard to their information gathering and decision-making. I'm thinking particularly of the elderly and those who have had strokes or any one of a multitude of illnesses which impact cognitive function or other functional capacity. These patients struggle with their activities of daily living -- getting dressed, bathing, transportation, housing, taking their meds. Their ability (let alone interest) in price-shopping their doctors is minimal to nonexistent, even if they had an economic incentive to do so. Taking someone who has a serious illness and making them have more "skin in the game" would represent a cruel additional hardship, but would be ineffective in creating an economic environment in which consumer behavior brought down spiraling health care costs.

I also see that over one fifth of health care costs in the US is accounted for by only 1% of the population. Also, half of the people in the US are paying less than $724 a year on health care. That means that those who claim that providing access to a basic level of health care to all Americans will lead to a huge wave of people demanding every expensive procedure known to medical science are misguided to say the least. Yes, under universal health care system there would have to be some money spent for those who haven't been able to afford any health care at all. But most people simply don't need or use that much health care.

To me the lesson is obvious. The idea that there is a "free market" solution to health care costs is wrong. It doesn't work. The only people who are being served by the present system are insurance company shareholders.


I have no time for lies and fantasy, and neither should you. Enjoy or die.
-John Lydon

Reality has a well-known liberal bias.
-Steven Colbert

I never meant to say that the Conservatives are generally stupid. I meant to say that stupid people are generally Conservative. I believe that is so obviously and universally admitted a principle that I hardly think any gentleman will deny it.
- John Stuart Mill


  
marc9000
Member
Posts: 634
From: Ky U.S.
Joined: 12-25-2009


Message 412 of 440 (613720)
04-26-2011 9:28 PM


MESSAGE 386

DrAdequate writes:

But in this particular case, as I have shown, there's no point in appealing to the intent of the Founders and Framers because they did not have a single collective intent.

Did not have a single collective intent, and youre going to school me in American History?

In ALL cases, including this particular one, their single collective intent was to ensure that the federal government they were establishing would not threaten the principles they fought for during the revolutionary war. They did not want their government to ever become like the government they were freeing themselves from.

_______________________

MESSAGE 369

Jon writes:

You never bothered answering my question to you in Message 369. Here it is again in case you missed it:

Okay, let's assume that's true (it's not, by the way; Thuglicans are against welfare programs of any kind no matter what level of government they work at). Would you support a measure by the Federal government that required all states to implement a state-run health care system?

No.

For example, the Federal government could give all the states an amount of money determined to be necessary for funding such health care.

It would have to be borrowed money, the federal government has no money. It is actually trillions of dollars in debt.

The states would then have to provide health care of a minimum standard to all of their citizens using the extra money along with some state-raised money. Depending on how efficient of a system the states could implement, they would be able to keep any extra Federal money left over after providing the minimum care for all of their citizens.
Would you support a 'competitive' state-run program like this?

No. It clearly violates whats stated in
federalist paper #45 Its a somewhat long read, but it has one paragraph that summarizes it pretty well.

quote:
The powers delegated by the proposed Constitution to the federal government are few and defined. Those which are to remain in the State governments are numerous and indefinite. The former will be exercised principally on external objects, as war, peace, negotiation, and foreign commerce; with which last the power of taxation will, for the most part, be connected. The powers reserved to the several States will extend to all the objects which, in the ordinary course of affairs, concern the lives, liberties, and properties of the people, and the internal order, improvement, and prosperity of the State.

"DEFINED", "EXTERNAL", despite what your European expert on American history tells you.

____________________________

MESSAGE 388

crashfrog writes:

Well, that's simply not true. The EPA can only go as far as it is legally empowered to do so. Its capacity to levy fines and take other actions were established by Federal law.

No, completely wrong. Whatever powers a "new government agency" might or might not have would be determined by the law passed by Congress that creates it and the executive branch that administrates it.

Here, read about mission creep. You can claim that it doesnt matter, that bureaucrats like Browner are caring people, but you cant claim that actions like hers dont take place.

Is there some reason you're having such extreme difficulty answering direct questions? I feel like you're here just to work some relentless-contrarian kick, not to actually discuss issues.

And what are you here for? To be a member of a shout-down gang? If you get confused by answers that go into an explanatory mode, that require comparisons and use parallels to the questions, I can't help you.

Why are conservatives always afraid of discussion?

You'd have to check with Jar on that Message 145 I'm an independent myself.

__________________________--

MESSAGE 395

ZenMonkey writes:

So the US has high cancer survival rates. I assume that that's for people who can afford to be treated in the first place. Does that include all the people who go undiagnosed because they can't afford regular check-ups? It's also true that we have a lot of expensive medical equipment in this country. How many people actually have access to it?

Currently, prison inmates have full access to it. There is a convicted rapist named Kenneth Pike (recently in the news) who is about to get an $800,000 heart transplant operation, paid for by taxpayers. It goes back to what I said in an earlier message about the mere existence of costly medical technologies being demanded by everyone, not just those who they were developed by and for. You blame free markets for health care problems in the U.S. , and I blame current government involvement with health care problems in the U.S. Thats where we are, and I have little more to say about the health care issue.

I believe that Dr Adequate has done an excellent job of addressing this particular claim in Message 376. Have you come up with any substantial answer to his evisceration of your assertions? Thought not.

Why not try to learn something about U.S. foundings on your own, and not rely on a European who does nothing but c/p far left political talking points off the internet? Use some common sense, if the founders intended the government, along with 51% of the population, to be able to do absolutely anything it wanted to do/ grow as big as it wants, why did they go to the trouble to write a constitution and bill of rights? Why even have them? Did you know that Alexander Hamiltion said this:

quote:
"We are now forming a Republican form of government. Real Liberty is not found in the extremes of democracy, but in moderate governments. If we incline too much to democracy, we shall soon shoot into a monarchy, or some other form of dictatorship."

Extremes of democracy, do you suppose he knew something about the paragraph attributed to Alexander Fraser Tytler, that I showed in message 383? You never bothered addressing that, here it is again in case you missed it;

quote:
A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves largesse from the public treasury. From that moment on, the majority always votes for the candidates promising the most benefits the public treasury with the result that a democracy always collapses over lousy fiscal policy, always followed by a dictatorship. The average of the worlds great civilizations before they decline has been 200 years. These nations have progressed in this sequence: From bondage to spiritual faith; from faith to great courage; from courage to liberty; from liberty to abundance; from abundance to selfishness; from selfishness to Complacency; from complacency to apathy; from apathy to dependency; from dependency back again to bondage.

Where are we today? Id like to say were only at the from abundance to selfishness point, but considering were trillions in debt, continue to borrow millions each day, and continue to give prison inmates heart transplants while allowing the EPA to continue to impose costly new regulations, Id say its much later than that.

marc9000 writes:

Those should be state issues. The modernization of society shouldn't change the basics in how new issues should be handled.

Sez who?

Madison, in Federalist #45. It is largely undisputed by any historian that Madison was the "father" of the constitution, that is, he had more to do with it than any other founder. More than Hamilton, and Jefferson.

Have any states stepped forward yet to provide universal health care to its citizens? Thought not.

Uh, Minnesota care has been discussed in this thread, your Re: Minnesota Care (Message 380) even had that reference in its title.

So you looked out the window, sniffed, and determined that the air quality in Cincinnati was pristine?

Do you think that maybe the EPA and NOAA had more accurate means of determining air quality than you did?

No I dont. The air was basically the same 5 years before the programs started, stayed the same during the program, and is now the same 6 years after it ended. The only thing that really changed was the millions of dollars earned in my area that went to a California testing company. But the EPA got plenty of information, like how the public reacted to it, how many miles different age cars are driven (they were recording mileages, just what that had to do with making a car run cleaner is uncertain) and public reaction (how many car engines were destroyed by test officials, how many claims were filed, etc.) First class testing stations, funded by taxpayers, are sitting empty today. Who knows what the plans are for them. They have 14 high clearances, yet they were built only for testing cars and light trucks. Either they prepared for hiring some very tall employees, or they had the biggest diesel trucks in mind for future tests. Im sure well find out soon.

Do you think perhaps the whole point was to keep the air in Cincinnati clean?

No, it was about power and money. (mission creep) Im sure the California testing company was very appreciative to the EPA, probably funded a few get-togethers.

Or do you think that we really ought to be choking on exhaust before someone takes action?

That would be the time to do it, yes. When there is a common sense need for it. Why is it that big government advocates think there is no going back when something is dirty? Cleanliness can be achieved after something is dirty. What there is almost never any going back from is big government bureaucracy. Sure, their useless emission test program was eliminated in my area, but they gathered information about how it went, and it will be back. They werent accountable in any way for its failure. Private companies PAY for failures like that, often with dissolution.


Replies to this message:
 Message 414 by crashfrog, posted 04-27-2011 12:07 AM marc9000 has responded
 Message 415 by Jon, posted 04-27-2011 12:29 AM marc9000 has not yet responded
 Message 417 by Dr Adequate, posted 04-27-2011 4:09 AM marc9000 has responded
 Message 418 by ZenMonkey, posted 04-27-2011 4:25 PM marc9000 has responded
 Message 419 by Dr Adequate, posted 04-27-2011 5:19 PM marc9000 has not yet responded
 Message 420 by Malcolm, posted 04-27-2011 9:17 PM marc9000 has responded

  
marc9000
Member
Posts: 634
From: Ky U.S.
Joined: 12-25-2009


Message 413 of 440 (613721)
04-26-2011 9:31 PM
Reply to: Message 399 by Dr Adequate
04-22-2011 4:13 AM


The Founding Fathers knew perfectly well that left to themselves some people will enrich themselves unjustly at the expense of others;

And where did they reference this? Where does it say that in the constitution? Which Federalist paper?


This message is a reply to:
 Message 399 by Dr Adequate, posted 04-22-2011 4:13 AM Dr Adequate has responded

Replies to this message:
 Message 416 by Dr Adequate, posted 04-27-2011 1:42 AM marc9000 has responded

  
crashfrog
Inactive Member


Message 414 of 440 (613738)
04-27-2011 12:07 AM
Reply to: Message 412 by marc9000
04-26-2011 9:28 PM


Here, read about mission creep. You can claim that it doesnt matter, that bureaucrats like Browner are caring people, but you cant claim that actions like hers dont take place.

I don't recall making any claims about who was, or wasn't, a "caring person"; to me it seems more like a function of personal incentive. Someone who makes money as a direct percentage of company profits - the owner and CEO, for instance - has a lot to gain, personally, by making the decision to violate the property rights of others and steal from them by polluting into their water, rather that paying for costly disposal of hazardous wastes. They might even write an article in Forbes redefining "property rights" as the right to violate other people's property rights to their air and water. A bureaucrat, on the other hand, gets paid the same regardless, basically, so what's their incentive to "mission creep" besides the legitimate need for regulation?

And what actions are you talking about, specifically? Restructuring the EPA with the approval of Congress? This would seem to be proof of my position - the function of any regulatory agency is circumscribed by the laws it has to follow.

And what are you here for?

To discuss with you. That's why I'm posing direct questions and answering yours. It'd be nice if you could return the same courtesy.

To be a member of a shout-down gang?

That's a tired canard, Marc. We have no power to "shout you down" - no matter how many times we post, it won't prevent you from saying whatever you want. You're under no obligation to respond to anybody you don't want to. You're free to invite any participants you like to a Great Debate thread, on any topic you choose, where others literally will not be able to post.

Of course, then you'd have no excuse to complain about being "shouted down."

You'd have to check with Jar on that Message 145 I'm an independent myself.

"Independent" is a voting affiliation, not an ideology. Ideologically, you're a conservative. Obviously.

And I've had my own issues with Jar; we're hardly monolithic.


This message is a reply to:
 Message 412 by marc9000, posted 04-26-2011 9:28 PM marc9000 has responded

Replies to this message:
 Message 421 by marc9000, posted 04-30-2011 9:30 PM crashfrog has responded

  
Jon
Member
Posts: 3942
From: Minnesota, U.S.A.
Joined: 12-29-2005


Message 415 of 440 (613742)
04-27-2011 12:29 AM
Reply to: Message 412 by marc9000
04-26-2011 9:28 PM


State-run, Federally-funded Health Care
Jon writes:

You never bothered answering my question to you in Message 369. Here it is again in case you missed it:

Okay, let's assume that's true (it's not, by the way; Thuglicans are against welfare programs of any kind no matter what level of government they work at). Would you support a measure by the Federal government that required all states to implement a state-run health care system?

No.

And why not?

Jon writes:

For example, the Federal government could give all the states an amount of money determined to be necessary for funding such health care.

It would have to be borrowed money, the federal government has no money. It is actually trillions of dollars in debt.

Completely irrelevant.

Jon writes:

The states would then have to provide health care of a minimum standard to all of their citizens using the extra money along with some state-raised money. Depending on how efficient of a system the states could implement, they would be able to keep any extra Federal money left over after providing the minimum care for all of their citizens.
Would you support a 'competitive' state-run program like this?

No. It clearly violates whats stated in
federalist paper #45

The Federalist Papers are irrelevant.

You blame free markets for health care problems in the U.S. , and I blame current government involvement with health care problems in the U.S. Thats where we are, and I have little more to say about the health care issue.

If only you could offer a shred of evidence to support your position...

Why not try to learn something about U.S. foundings on your own, and not rely on a European who does nothing but c/p far left political talking points off the internet? Use some common sense, if the founders intended the government, along with 51% of the population, to be able to do absolutely anything it wanted to do/ grow as big as it wants, why did they go to the trouble to write a constitution and bill of rights? Why even have them? Did you know that Alexander Hamiltion said this:

The Founders are irrelevant.

ZenMonkey writes:

Have any states stepped forward yet to provide universal health care to its citizens? Thought not.


Uh, Minnesota care has been discussed in this thread, your Re: Minnesota Care (Message 380) even had that reference in its title.

Minnesota Care does not provide universal health care. It only provides care for the poorest citizens who are not already on other health 'care' plans. And, with the current crop of legislators, the program is being dismantled as we speak.

Jon

Edited by Jon, : relevancy


Love your enemies!
This message is a reply to:
 Message 412 by marc9000, posted 04-26-2011 9:28 PM marc9000 has not yet responded

  
Dr Adequate
Member
Posts: 12597
Joined: 07-20-2006
Member Rating: 2.8


Message 416 of 440 (613759)
04-27-2011 1:42 AM
Reply to: Message 413 by marc9000
04-26-2011 9:31 PM


And where did they reference this? Where does it say that in the constitution? Which Federalist paper?

I based my assertion on the proposition that the Founding Fathers were neither retarded nor gibbering mad.

Obviously some people enrich themselves unjustly at the expense of others. For example, muggers. Burglars. Pickpockets. Swindlers. Forgers. I do not need to quote the Federalist Papers or the Constitution to demonstrate that the Founding Fathers knew this, any more than I need to quote the Federalist Papers or the Constitution to prove that they knew that grass is green and water is wet. These are facts universally conceded.


This message is a reply to:
 Message 413 by marc9000, posted 04-26-2011 9:31 PM marc9000 has responded

Replies to this message:
 Message 422 by marc9000, posted 04-30-2011 9:40 PM Dr Adequate has responded

  
Dr Adequate
Member
Posts: 12597
Joined: 07-20-2006
Member Rating: 2.8


(1)
Message 417 of 440 (613768)
04-27-2011 4:09 AM
Reply to: Message 412 by marc9000
04-26-2011 9:28 PM


Did not have a single collective intent, and youre going to school me in American History?

Yes, I am. Though I doubt whether you are capable of profiting from it.

It is obvious that they did not have a common intent as to what the General Welfare Clause should mean, since as a matter of well-established historical fact they disagreed about what it did in fact mean.

In ALL cases, including this particular one, their single collective intent was to ensure that the federal government they were establishing would not threaten the principles they fought for during the revolutionary war.

Since the War of Independence was not to any degree fought over the meaning of the General Welfare Clause, which had not at that time been written, this hardly seems to apply.

Perhaps this explains why the Founding Fathers had different interpretations of the General Welfare Clause, rather than a single collective interpretation.

They did not want their government to ever become like the government they were freeing themselves from.

And obviously King George III and his government had no opinion as to the interpretation of the General Welfare Clause, due to their lamentable inability to travel through time and visit the future.

Whereas the Founding Fathers had more than one interpretation of the General Welfare Clause.


This message is a reply to:
 Message 412 by marc9000, posted 04-26-2011 9:28 PM marc9000 has responded

Replies to this message:
 Message 423 by marc9000, posted 04-30-2011 9:43 PM Dr Adequate has not yet responded

  
ZenMonkey
Member (Idle past 883 days)
Posts: 428
From: Portland, OR USA
Joined: 09-25-2009


(1)
Message 418 of 440 (613826)
04-27-2011 4:25 PM
Reply to: Message 412 by marc9000
04-26-2011 9:28 PM


marc9000 writes:

ZenMonkey writes:

So the US has high cancer survival rates. I assume that that's for people who can afford to be treated in the first place. Does that include all the people who go undiagnosed because they can't afford regular check-ups? It's also true that we have a lot of expensive medical equipment in this country. How many people actually have access to it?

Currently, prison inmates have full access to it. There is a convicted rapist named Kenneth Pike (recently in the news) who is about to get an $800,000 heart transplant operation, paid for by taxpayers.

You mean the guy who just turned down the opportunity to receive a heart transplant?

quote:
Transplant centers have the right to turn patients away, but physicians are required to care for every patient they see, according to Arthur Caplan, director of the Center for Bioethics and the Sydney D. Caplan professor of bioethics at the University of Pennsylvania.

In 1976, the U.S. Supreme Court ruled that prisoners were entitled to the same medical and dental treatment as everyone else in their communitities. Prisons that withhold necessary care from inmates can be held liable for violating constitutional bans against cruel and unusual punishment.

Prison facilities often pay a negotiated reduced fee with contracted hospitals across the state, according to Peter Cutler, spokesman for the New York State Department of Corrections and Community Supervision. But Strong Memorial Hospital in Rochester, where Pike is reported to have been transferred, is not one of them.

"We are constitutionally obligated to provide health care services to any inmate," said Cutler, citing the Eighth Amendment of the Constutition. "We're a state agency doing our job."


Your point is irrelevant. You have a single case of one inmate who could have received an relatively expensive procedure, but won't. This is hardly evidence of a widespread demand for expensive medical procedures among the US inmate population as a whole. Inmates actually have a Constitutional right to health care. How many of the 2.3 million other people in prison in the US are demanding $800,000 operations? How many are actually getting them?

marc9000 writes:

It goes back to what I said in an earlier message about the mere existence of costly medical technologies being demanded by everyone, not just those who they were developed by and for. You blame free markets for health care problems in the U.S. , and I blame current government involvement with health care problems in the U.S. Thats where we are, and I have little more to say about the health care issue.

You're wrong, and if you actually looked at the documentation I provided in Message 411, you'd see that it's not my opinion, it's a fact. The free market offers no solution to the cost of health care. Americans spend more than anyone else on health care, and get less actual care for their money. When fully half of all health care costs in the US come from just 5% of the population, and 80% of those costs come from just the top 20%, there's very little that "consumer choice" can do to drive down costs.

Considering that you have nothing to counter these facts other than the bare assertion that government is to blame, I can see why you now have nothing left to say.

Also, exactly who do you mean when you refer to the people who costly medical technologies developed by and for? Do you somehow think that medical researchers are saying, "Well, we don't want this new antibiotic to go to those sorts of people. It's only for our sort of people."? Do you know anything about medical ethics at all?

marc9000 writes:

Why not try to learn something about U.S. foundings on your own, and not rely on a European who does nothing but c/p far left political talking points off the internet?

Dr Adequate was using citations from the Constitution itself, as well as a pertinent statement from Alexander Hamilton, and a clear factual analysis of the subsequent history of the interpretation of the General Welfare clause. Exactly what part of that is "far left talking points from the internet?" Do you have a particular site in mind that you think he plagiarized from?

marc9000 writes:

Use some common sense, if the founders intended the government, along with 51% of the population, to be able to do absolutely anything it wanted to do/ grow as big as it wants, why did they go to the trouble to write a constitution and bill of rights? Why even have them?

You seem to have an inability to think in anything other than extremes. To a rational mind, there is an significant difference between Congress being responsible for expenditures for the General Welfare, and doing "absolutely anything it wanted." When someone invites you into their house and says, "Make yourself at home," do you then eat all of his food, spray paint the walls, wreck his car, and set fire to the kitchen?

marc9000 writes:

Did you know that Alexander Hamiltion said this:

quote:
"We are now forming a Republican form of government. Real Liberty is not found in the extremes of democracy, but in moderate governments. If we incline too much to democracy, we shall soon shoot into a monarchy, or some other form of dictatorship."

Extremes of democracy, do you suppose he knew something about the paragraph attributed to Alexander Fraser Tytler, that I showed in message 383? You never bothered addressing that, here it is again in case you missed it;

quote:
A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves largesse from the public treasury. From that moment on, the majority always votes for the candidates promising the most benefits the public treasury with the result that a democracy always collapses over lousy fiscal policy, always followed by a dictatorship. The average of the worlds great civilizations before they decline has been 200 years. These nations have progressed in this sequence: From bondage to spiritual faith; from faith to great courage; from courage to liberty; from liberty to abundance; from abundance to selfishness; from selfishness to Complacency; from complacency to apathy; from apathy to dependency; from dependency back again to bondage.

First, Tytler never said that; you're simply passing on yet another Made-up Quote for Conservatives. Second, considering that Tytler most significant book was on how best to translate Greek and Latin, that doesn't necessarily lend him a tremendous amount of authority in matters of political analysis. Third, if he did have something significant to say about democratic forms of government, it's not likely that Hamilton or anyone else would have known about it, as the book that Tytler did write on history was apparently published posthumously in 1850.

Again, you're presenting an argument ad absurdum. Way absurdum.

marc9000 writes:

Where are we today? Id like to say were only at the from abundance to selfishness point, but considering were trillions in debt, continue to borrow millions each day, and continue to give prison inmates heart transplants while allowing the EPA to continue to impose costly new regulations, Id say its much later than that.

Any documentation to show how much of that debt can be attributed to inmate heart transplants and EPA regulations? Perhaps a $689 billion annual defence budget might have a little more to do with it? A $700 billion bank bailout in 2008?

marc9000 writes:

Sez who?

Madison, in Federalist #45. It is largely undisputed by any historian that Madison was the "father" of the constitution, that is, he had more to do with it than any other founder. More than Hamilton, and Jefferson.

You mean Federalist #45, in which Madison argues that the Federal government will never be stronger than the respective state governments, since among other reasons, only state legislatures can elect the President, just as only state legislatures can elect US senators? Madison appears to be a bit behind the times. In case you never heard of it, the US fought a civil war sometime in the middle of the 19th century, and one of the issues that that war decided was that the Union was in fact more than an association of independent sovereign states. History is not on your side, nor is it on Madison's. You are correct in saying that Madison was a vital formative force in the shaping of the American form of government. However, on this particular point - the meaning of the General Welfare clause and the subsequent power of Congress to tax and spend - Madison's view did not prevail.

marc9000 writes:

Have any states stepped forward yet to provide universal health care to its citizens? Thought not.

Uh, Minnesota care has been discussed in this thread, your Re: Minnesota Care (Message 380) even had that reference in its title.

As has already been pointed out, Minnesota's program wasn't universal health care by any means; it apparently only covered individuals who couldn't otherwise get insurance at all. Big difference. Besides, Republicans are trying to destroy that program anyway.

marc9000 writes:

So you looked out the window, sniffed, and determined that the air quality in Cincinnati was pristine?

Do you think that maybe the EPA and NOAA had more accurate means of determining air quality than you did?

No I dont. The air was basically the same 5 years before the programs started, stayed the same during the program, and is now the same 6 years after it ended. The only thing that really changed was the millions of dollars earned in my area that went to a California testing company. But the EPA got plenty of information, like how the public reacted to it, how many miles different age cars are driven (they were recording mileages, just what that had to do with making a car run cleaner is uncertain) and public reaction (how many car engines were destroyed by test officials, how many claims were filed, etc.) First class testing stations, funded by taxpayers, are sitting empty today. Who knows what the plans are for them. They have 14 high clearances, yet they were built only for testing cars and light trucks. Either they prepared for hiring some very tall employees, or they had the biggest diesel trucks in mind for future tests. Im sure well find out soon.

Do you have any data at all to back up any of these assertions? I'd be interested to see it.

marc9000 writes:

Do you think perhaps the whole point was to keep the air in Cincinnati clean?

No, it was about power and money. (mission creep) Im sure the California testing company was very appreciative to the EPA, probably funded a few get-togethers.

Data, please. Anything?

marc9000 writes:

Or do you think that we really ought to be choking on exhaust before someone takes action?

That would be the time to do it, yes. When there is a common sense need for it. Why is it that big government advocates think there is no going back when something is dirty? Cleanliness can be achieved after something is dirty.

Well, for sane people, the time to dig the well is not when you're dying of thirst. You don't put off funding the fire department until after the house is already burning down. But that's just for sane people, I guess.

marc9000 writes:

What there is almost never any going back from is big government bureaucracy. Sure, their useless emission test program was eliminated in my area, but they gathered information about how it went, and it will be back. They werent accountable in any way for its failure. Private companies PAY for failures like that, often with dissolution.

Who said the program failed? You?


I have no time for lies and fantasy, and neither should you. Enjoy or die.
-John Lydon

Reality has a well-known liberal bias.
-Steven Colbert

I never meant to say that the Conservatives are generally stupid. I meant to say that stupid people are generally Conservative. I believe that is so obviously and universally admitted a principle that I hardly think any gentleman will deny it.
- John Stuart Mill


This message is a reply to:
 Message 412 by marc9000, posted 04-26-2011 9:28 PM marc9000 has responded

Replies to this message:
 Message 427 by marc9000, posted 04-30-2011 10:03 PM ZenMonkey has not yet responded

  
Dr Adequate
Member
Posts: 12597
Joined: 07-20-2006
Member Rating: 2.8


(1)
Message 419 of 440 (613831)
04-27-2011 5:19 PM
Reply to: Message 412 by marc9000
04-26-2011 9:28 PM


Why not try to learn something about U.S. foundings on your own, and not rely on a European who does nothing but c/p far left political talking points off the internet?

What a liar you are, to be sure.

Did you know that Alexander Hamiltion said this:

Did you know that Alexander Hamilton agreed with the Hamiltonian interpretation of the General Welfare Clause?

The clue's in the name.


This message is a reply to:
 Message 412 by marc9000, posted 04-26-2011 9:28 PM marc9000 has not yet responded

  
Malcolm
Member
Posts: 147
From: Scotland
Joined: 05-08-2006


(1)
Message 420 of 440 (613841)
04-27-2011 9:17 PM
Reply to: Message 412 by marc9000
04-26-2011 9:28 PM


marc9000 writes:

There is a convicted rapist named Kenneth Pike (recently in the news) who is about to get an $800,000 heart transplant operation, paid for by taxpayers

Just to say that in the UK the average cost of a heart transplant is about 30,000 ($50,000) which is still quite a lot, but is a fraction of what you have to pay. Is this the marvels of the free market you talk of? Over here the medications that companies provide are assessed by national committees which drive prices down as the companies are competing directly with each other, and know that if they're successful will be supplying their products to whole countries. As far as I can see this can't happen in the US as separate hospitals are responsible for their own budgets, and the specific medications will vary depending on individual patients and what their policies cover.


This message is a reply to:
 Message 412 by marc9000, posted 04-26-2011 9:28 PM marc9000 has responded

Replies to this message:
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