The Sneaky Back Door to Single Payer Health Care

Ronald Bailey | May 13, 2009

As part of his health care reform package, President Barack Obama wants to offer a low-cost government health insurance policy modeled on Medicare to compete with private health insurance policies. The government policy will be low cost, in large part, because agency bureaucrats will be able to impose price controls on hospitals, doctors, and drug companies. But not to worry says, Obama as he repeats his soothing mantra:

"Under the Obama health care plan, you will be able to keep your doctor and your health insurance if you want."

Not really so, says former Food and Drug Administration official and American Enterprise Institute fellow, Dr. Scott Gottlieb, in a smart Wall Street Journal op/ed yesterday. Gottlieb points out:

While the public option is meant for the uninsured, employers will realize it's easier -- and cheaper -- to move employees into the government plan than continue workplace coverage.

The Lewin Group, a health-care policy research and consulting firm, estimates that enrollment in the public option will reach 131 million people if it's open to everyone and pays Medicare rates, as many expect. Fully two-thirds of the privately insured will move out of or lose coverage. As patients shift to a lower-paying government plan, doctors' incomes will decline by as much as 15% to 20% depending on their specialty.

Of course, for supporters of a single payer government health care this shift would be, as they say, a feature, not a bug. 

Whole Gottlieb op/ed is well worth reading here. My column on the menace of the Obama administration's health care corporatism can be found here. 

Comments

|5.13.09 @ 9:34AM|#

This plan is the alliance from hell between socialized medicine advocates and big business. Corporations would love nothing better than to dump the medical costs of their workers on the government. Socialized medicine advocates would love nothing better than to take them. The end result is going to be that everyone gets the same shitty care whether they work their whole lives, got their legs blown off in Iraq or are a crack addict or serial killer rotting in prison. That is fairness for socialists and big money for big business. What is not to love?

Xeones|5.13.09 @ 9:43AM|#

Fuck, yo.

robc|5.13.09 @ 9:47AM|#

I guess those who said Obama isnt a socialist may be right. Seems like fascism instead.

z|5.13.09 @ 9:49AM|#

Hmm, price controls. How long will it be for there to be a shortage of supply(Doctors)? Certainly, many providers will choose to simply retire. Long term, less will decide to embark on that career.

|5.13.09 @ 9:50AM|#

"Hmm, price controls. How long will it be for there to be a shortage of supply(Doctors)? Certainly, many providers will choose to simply retire. Long term, less will decide to embark on that career."

Low pay combined with the enormous cost of medical school and the AMA stranglehold on the supply of doctors and it is not hard to figure out what is going to happen.

Seward|5.13.09 @ 9:51AM|#

Ronald Bailey,

The thing is, medicare is far, far more expensive than private health insurance generally. Much of that has to do with the price controls.

Xeones|5.13.09 @ 9:51AM|#

Well, fascism and socialism differ only in degree, not in kind. I'm not sure that he won't find a happy medium.

Seward|5.13.09 @ 9:53AM|#

I should also note that price controls have a consistent history of failure.

Kyle Jordan|5.13.09 @ 9:54AM|#

"Hmm, price controls. How long will it be for there to be a shortage of supply(Doctors)? Certainly, many providers will choose to simply retire. Long term, less will decide to embark on that career."

Nah. The Government will start to send more and more aid towards students if they choose a career in medicine. Well, more than they do now that is. Government can do anything.

|5.13.09 @ 9:55AM|#

While the public option is meant for the uninsured, employers will realize it's easier -- and cheaper -- to move employees into the government plan than continue workplace coverage.

And there is ample evidence this is exactly what will happen from the last round of health "care" "reform" at the state level in the '90s.

Also, ample evidence that the actually cost of the expanded program will vastly exceed predictions.

Certainly, many providers will choose to simply retire.

Many doctors postponed retirement when their investments evaporated last year. Impoverishing doctors will keep the old ones around, so the inevitable shortage may be masked for awhile.

Kyle Jordan|5.13.09 @ 9:56AM|#

And is anyone else amazed at how fast shit like this is coming and how much of it we have to put up with? I expected Obama and the Obamalytes to make some dastardly moves but this is even more than I was thinking.

Just waiting for the Gun Control to swing fully in to effect.

|5.13.09 @ 9:57AM|#

"The thing is, medicare is far, far more expensive than private health insurance generally. Much of that has to do with the price controls."

The problem with medicare is that because it is not market driven, the only mechanism to ensure the right price is bureaucratic control. So that means you spend billions trying to ferret out fraud and the private sector spends billions more trying to keep good records to keep from being charged with fraud. You end up with people like Michelle Obama making more than even the most highly skilled surgeon for doing nothing but making sure the government stays off the hospital's back. But of course when they say "we have to cut costs" the Michelle Obama's of the world will never give up their $300,000 a year salary. No, cutting costs will mean paying doctors less and providing worse care. Look at the major city school districts where administrators make high six figure salaries but kids don't have text books and you can see where our medical services are heading.

Nikola T|5.13.09 @ 9:58AM|#

What a country! We get life, liberty, the pursuit of happiness, retirement savings, free education, a productive auto industry, stable banks, and now free health care for all!

Is there anything this government can't do?

Is there anything they won't try to do?!

Kyle Jordan|5.13.09 @ 9:59AM|#

"Look at the major city school districts where administrators make high six figure salaries but kids don't have text books and you can see where our medical services are heading."

That's fucking depressing.

|5.13.09 @ 10:00AM|#

I think I'm going to run for the Senate in 2010. I can't take it any more. At least a Senate campaign will allow me to publicly vent.

Nikola T|5.13.09 @ 10:02AM|#

You know the Republican response to the eventual problems of too many people getting on the government's health plan, will be to provide their cronies in big businesses huge tax credits to insure their own employees.

It's a win/win in the government's eyes...

The Dems get the poor with your money, the GOP gets the donor money, with your money.

Nice. These guys have it all figured out.

robc|5.13.09 @ 10:03AM|#

fascism and socialism differ only in degree, not in kind

Yeah, I was going to point that out, but it defeated the purpose of my post. :)

Xeones|5.13.09 @ 10:04AM|#

You know, i've always thought that trying to go to the doctor should be even more like a trip to the DMV than it already is.

|5.13.09 @ 10:04AM|#

"I think I'm going to run for the Senate in 2010. I can't take it any more. At least a Senate campaign will allow me to publicly vent."

I want to run in Maryland. Maryland has the most pathetic corrupt Republican Party ever. There is no way I could do any worse than whoever they plan to run. If the Republicans had any brains, which they don't, they would go out and find totally new people to run in blue states like Maryland. It is not like they are going to do any worse and things are so bad in Washington right now, someone new and totally unconnected to politics might do okay.

robc|5.13.09 @ 10:07AM|#

I think I'm going to run for the Senate in 2010. I can't take it any more. At least a Senate campaign will allow me to publicly vent.

Rumor is that Rand* Paul is going to run for Bunning's senate seat in 2010. So I can vent via supporting him without having to run myself (Im not sure he can win the primary versus Grayson, who is McConnell's pick for the spot).

*or is it another Paul son that lives in Bowling Green, KY?

robc|5.13.09 @ 10:08AM|#

http://www.rand2010.com/

I guess it isnt a rumor.

|5.13.09 @ 10:09AM|#

Gee, a health care plan modeled on medicare? What a great idea. Up next, a plan for drug-free Americans based on prohibition. Or a plan for a border wall modeled on the Maginot Line. Or a plan for the airline industry modeled after the Hindenburg. Swell!

Xeones|5.13.09 @ 10:12AM|#

sage, you're leaving out the plan for the economy, based on the Titanic's maiden voyage.

|5.13.09 @ 10:13AM|#

Reason should pick up this story from the wsj: Dems Moving to Limit Compensation at Non-Tarp Banks

|5.13.09 @ 10:14AM|#

The Sneaky Back Door to Single Payer Health Care

The sneaky back door? Like a shocker? Pretty apt so far.

Chuck|5.13.09 @ 10:14AM|#

I think I'm going to run for the Senate in 2010. I can't take it any more. At least a Senate campaign will allow me to publicly vent.

I'll vote for you. But only if you wear a purple toga.

Seriously, though, 2010 might be a good time for a run. Look at the competition...

|5.13.09 @ 10:16AM|#

Look at the competition...

He'd be up against Crist.

Old Bull Lee|5.13.09 @ 10:17AM|#

Another reason people will lose their private coverage:

Most people send their kids to public school regardless of preference because they're already forced to pay for it. Sending them to private school is essentially paying for school twice. Unless they just had that much extra money to spend, having health care set up the same way will have the same effect.

Anonymous|5.13.09 @ 10:19AM|#

Boring. Fascism spreads, you all know why this is wrong, and gulching isn't being taken seriously enough. Where am I, the 20th Century or something?

not the real jb|5.13.09 @ 10:23AM|#

Reminds me of working a student job at a private university. I didn't have a bank account in the state, and I worked entirely in cash. I would pick up my paycheck, cash it, pay rent, by stuff, save for books, etc.

The HR dept started pushing direct deposit hard. They had little giveaways if you signed up for this "option," came to office meetings to pitch the system and its supposed advantages, etc.

A year later I got a notice that said the university would no longer offer the "service" of a paycheck. If we didn't sign up for direct deposit now, we wouldn't get paid. Offended, I did some research and found that state law allowed employers to do this if 66% or more of their employees were already on direct deposit.

Watch for similar system here: Right now the Obama plan is an "option," but once it gains traction, it will become a requirement.

|5.13.09 @ 10:24AM|#

The only problem I see is that Crist beats me in the tanned, rested, and ready category. Particularly his tan, which is positively Hamiltonian in scope.

If I really ran, I'd be reading some of my Hit & Run comments or Urkobold posts in the paper, wouldn't I? Uh, oh.

|5.13.09 @ 10:24AM|#

You know the Republican response to the eventual problems of too many people getting on the government's health plan, will be to provide their cronies in big businesses huge tax credits to insure their own employees.

Of course it will, because the alternative, giving people a tax credit to buy health insurance as individuals and weaning people off the big business subsidy was the most attacked part of McCain's suggestions as a candidate. I saw a commercial by Obama every ten minutes attacking the idea of moving away from subsidies for employer insurance.

|5.13.09 @ 10:27AM|#

"Watch for similar system here: Right now the Obama plan is an "option," but once it gains traction, it will become a requirement."

Absolutely it will be. In order for the plan to function even at a low level, it needs young, healthy people who don't require much medical care paying into it to subsidize the old and the sick. What is going to happen is the young are going to be forced to buy health insurance even if it is a bad investment and they don't want it to subsidize everyone else. Most things Obama does come down to stealing from the young to give to the boomers. If it wasn't so sad, it would be downright hillarious that all these dumb fuck college students voted for him.

|5.13.09 @ 10:28AM|#

"If I really ran, I'd be reading some of my Hit & Run comments or Urkobold posts in the paper, wouldn't I? Uh, oh."

I have already lined up someone to take the fall and claim they were posting on here as me.

|5.13.09 @ 10:29AM|#

Come to think of it, I do have a pre-packaged campaign strategy: Calling Crist the Anti-Crist.

The real GOP opposition to Crist is Mark Rubio, who I recall doing some ungood things as Speaker of the Florida House. Then again, I think he's got to be much better than Crist.

Seward|5.13.09 @ 10:29AM|#

John,

So that means you spend billions trying to ferret out fraud...

Well, the government does a poor job at this as well.

ed|5.13.09 @ 10:30AM|#

employers will realize it's easier -- and cheaper -- to move employees into the government plan than continue workplace coverage

No worries. Obama has figured out a way to neutralize Gresham's Law. He truly is miraculous.

Dr. Lawyer|5.13.09 @ 10:33AM|#

What some of you realize and some of you will soon realize is that single payer health care is inevitable.

You whine and moan about nonsense that doesn't really have any effect on you. Why don't you see this development for the miracle that it really is?

I'm since retired, but I made a boatload working for a malpractice firm. We gamed the system (perfectly legally) and gave hell to plenty of doctors. The old system was corrupt. Everthing was incentivized by money or "who is screwing who over". Nobody really gave a shit for the patient, except ostensibly the doctors.

We need this system to get rid of the blood-sucking in our current health model. When the government can assume control, doctors will just be caregivers. No one will try to screw people. Patients will get better care.

Your collective whining falls on deaf ears. This is what the country needs and wants. Accept it, smile, you'll be taken care of.

|5.13.09 @ 10:34AM|#

Do it, Pro! That Crist fuck knows all about creating a single payer insurance scheme.

|5.13.09 @ 10:38AM|#

I'm going to say Dr. Lawyer is a performance art. Pretty good, too.

|5.13.09 @ 10:40AM|#

I could run on a strict government sucks platform. I want to join the Senate to stop the madness. Thanks for your vote.

Seward|5.13.09 @ 10:41AM|#

Dr. Lawyer,

Are you serious?

When the government can assume control...

Yes, that has such a bright and wonderful track record. Indeed, isn't that why we have collectivized food production in the U.S.?

...doctors will just be caregivers.

No, doctors will be an interest group (I mean, they already are, but they will be more so) which lobbies the government.

robc|5.13.09 @ 10:41AM|#

If I really ran, I'd be reading some of my Hit & Run comments or Urkobold posts in the paper, wouldn't I? Uh, oh.


I already decided I just need to promise to use the word FUCK on the floor of the senate as often as I do on H&R. That would gain me youth votes, right?

|5.13.09 @ 10:42AM|#

"Your collective whining falls on deaf ears. This is what the country needs and wants. Accept it, smile, you'll be taken care of."

Dr. Lawyer are in anyway self aware enough to realize how creepy that sounds? Do you have any moral conscience that might bother you that you apparently got rich ripping off doctors and gaming the system? Sine you apparently are bereft of moral values, what makes you think government bureaucrats won't be the same way?

|5.13.09 @ 10:43AM|#

robc,

I have your campaign slogan. You may recognize it: "America, fuck yeah!"

Alice Bowie|5.13.09 @ 10:44AM|#

I have to agree with u Dr. Lawyer.

This is what we all need. And the Conservatives and Libertarians will probably enjoy the benefits more than anyone.

bubba|5.13.09 @ 10:45AM|#

This whole plan *could* find a happy medium if doctors/hospitals are free to decline to participate. Employees will demand private insurance, and/or purchase supplemental insurance.

Of course if that actually happens, then the government will simply require doctors/hospitals to participate.

|5.13.09 @ 10:48AM|#

Pro Libertate

I think you have him beat on the number of tries to pass the bar, don't you?

I'm assuming everyone knows to treat this like a golf score.

|5.13.09 @ 10:49AM|#

"This is what we all need. And the Conservatives and Libertarians will probably enjoy the benefits more than anyone."

Just like they did in Canada and the UK where the hospitals are filthy, the cancer survival rates are third world and you wait a year or more to get routine surgery or the chance to see a specialist. Oh goody.

|5.13.09 @ 10:49AM|#

I like how all these extraordinarily radical changes have to be implemented as quickly as possible with minimal public discussion. Because, of course, they're so obviously correct that no dissent can possibly exist.

Isaac,

I scored a hole in one. How many times did Crist take it?

|5.13.09 @ 10:49AM|#

"This is what we all need. And the Conservatives and Libertarians will probably enjoy the benefits more than anyone."

Like the lower quality care and the rationing? Like fewer life saving medicines and technology coming onto the market? I can hardly wait!

robc|5.13.09 @ 10:53AM|#

I have your campaign slogan. You may recognize it: "America, fuck yeah!"

Thanks, CS Lewis alright wrote my campaign platform, so now I have my slogan too. Sweet.

[1]To live his life in his own way,
[2]to call his house his castle,
[3]to enjoy the fruits of his own labour,
[4]to educate his children as his conscience directs,
[5]to save for their prosperity after his death
--- these are wishes deeply ingrained in civilised man.

A 5 pt platform (bolding numbering added by me).

|5.13.09 @ 10:55AM|#

"Thanks, CS Lewis alright wrote my campaign platform, so now I have my slogan too. Sweet.

[1]To live his life in his own way,
[2]to call his house his castle,
[3]to enjoy the fruits of his own labour,
[4]to educate his children as his conscience directs,
[5]to save for their prosperity after his death
--- these are wishes deeply ingrained in civilised man."

Yesterdays man. Today that platform would just be neocon fundie crap.

|5.13.09 @ 10:55AM|#

It was reported last night on The News Hour that Medicare will become insolvent sooner than had been expected (2017, just 8 years from now). So yes, let's expand the program.

|5.13.09 @ 10:56AM|#

So- government zombie health care will create a situation where *nobody* can make money, and then Nancy Pelosi will tell us we have to "rescue" Humana.

Is that about right?

robc|5.13.09 @ 10:57AM|#

Today that platform would just be neocon fundie crap.

Huh? Not sure what your comment meant there.

Morris|5.13.09 @ 10:58AM|#

It's all a left-wing plot. Universal health care will mean longer life spnas, which will mean more need for wellfare. Die young, Live free!

|5.13.09 @ 11:00AM|#

"Is there anything they won't try to do?!"

Yes, they won't try to keep the DC voucher plan going.

|5.13.09 @ 11:01AM|#

This whole plan *could* find a happy medium if doctors/hospitals are free to decline to participate.

As with Medicare itself, very few doctors and no hospitals can afford to turn away that many patients, no matter how modest their coverage or onerous the bureaucratic requirements.

these are wishes deeply ingrained in civilised man

Then I guess Americans are no longer, for the most part, civilized. There seems to be a solid voting majority that has these wishes deeply ingrained:

[1]To have others live their lives as I direct,
[2]to have the state pay for my house, and give it free access thereto,
[3]to enjoy the fruits of others' labour,
[4]to educate my children as others direct,
[5]to tax future generations for my prosperity before I die

|5.13.09 @ 11:04AM|#

Morris, if you view every Democrat policy with the understanding that the book The Population Bomb is their bible, then you would know that longer life spans isn't in the plan.

robc|5.13.09 @ 11:04AM|#

Then I guess Americans are no longer, for the most part, civilized

It seems that way.

|5.13.09 @ 11:04AM|#

Individual self-determination. Freedom. These concepts mean nothing to too many people now. Or, perhaps nothing is the wrong word. They mean two or three discreet things to people now, and are no longer widely accepted general principles.

It would be nice to have that openly acknowledged by certain political leaders, because I think maybe that would jolt many Americans out of their slumber and make them think about the road we're walking down.

|5.13.09 @ 11:05AM|#

"Today that platform would just be neocon fundie crap.

Huh? Not sure what your comment meant there."

I mean that what is an utterly reasonable and thoughtful position, would today be dismissed by liberals as right wing lunacy.

|5.13.09 @ 11:07AM|#

I could run on a strict government sucks platform. I want to join the Senate to stop the madness. Thanks for your vote.

Pro Lib- you can offer yourself up as the People's Monkey Wrench, to jam the gears of the machine.

You'll get slaughtered, but you'll open some eyes, too.

Now go out and get yourself a nice, whippy, lightweight walking stick.

|5.13.09 @ 11:10AM|#

"We need this system to get rid of the blood-sucking in our current health model. When the government can assume control, doctors will just be caregivers. No one will try to screw people. Patients will get better care."

At what price? My barber just turned 65 and he told me that the best thing about that was he now qualifies for Medicare. He said that as a small business owner, he had only been able fo afford medical coverage with a $5,000 deductible. He had wanted to get a CAT-Scan but at an out-of-pocket cost of $2,800, there was just no way he was going to pay for that. But ass soon as he got on Medicare he made an appointment to get that CAT-Scan. He's very excited about it.

Alice Bowie|5.13.09 @ 11:11AM|#

oh it'll b ok.

If Doctors/Hospitals/Providers were guarranteed payment from the Government ... they wouldn't have to spend so so so so so so much time and MONEY on insurance crap.

|5.13.09 @ 11:11AM|#

"Morris, if you view every Democrat policy with the understanding that the book The Population Bomb is their bible, then you would know that longer life spans isn't in the plan."

Longer life spans is not what socialized medicine is about as older people tend to be rationed out of the system. Just ask my wife's friend from Holland. She's horrified about that system being brought here. With limited money to pay for the system, people get rationed out of the system. The elderly have lived their lives, so why waste money on them. In America, we try to save everybody regardless of age.

robc|5.13.09 @ 11:11AM|#

I mean that what is an utterly reasonable and thoughtful position, would today be dismissed by liberals as right wing lunacy.

Okay, I agree.

|5.13.09 @ 11:11AM|#

"Individual self-determination. Freedom. These concepts mean nothing to too many people now. Or, perhaps nothing is the wrong word. They mean two or three discreet things to people now, and are no longer widely accepted general principles."


In order to respect self-determination, you have to be willing not to judge people and accept the fact that people will sometimes chose things you find repugnant or which may in fact be, to the outside world, self destructive. Many people, especially liberals, can't do this. It just drives them crazy to think that someone out there is doing something that may be self destructive or distasteful to them. For that reason, they can never embrace freedom and self determinism no matter how much rethoric they put out to the contrary.

|5.13.09 @ 11:13AM|#

"If Doctors/Hospitals/Providers were guarranteed payment from the Government ... they wouldn't have to spend so so so so so so much time and MONEY on insurance crap."

So why do so many doctors not accept Medicare and Medicaid patients? It's because the government doesn't pay them enough.

|5.13.09 @ 11:15AM|#

"In order to respect self-determination, you have to be willing not to judge people and accept the fact that people will sometimes chose things you find repugnant or which may in fact be, to the outside world, self destructive. Many people, especially liberals, can't do this. It just drives them crazy to think that someone out there is doing something that may be self destructive or distasteful to them. For that reason, they can never embrace freedom and self determinism no matter how much rethoric they put out to the contrary."

Conservatives are just as guilty as that in their support for the war on drugs.

|5.13.09 @ 11:18AM|#

"Longer life spans is not what socialized medicine is about as older people tend to be rationed out of the system. Just ask my wife's friend from Holland. She's horrified about that system being brought here. With limited money to pay for the system, people get rationed out of the system. The elderly have lived their lives, so why waste money on them. In America, we try to save everybody regardless of age."

That is exactly what they want. William Saleton wrote a piece in Slate last year about how lifespan is unfair. It is unfair that some people live so long and others don't and that we need to ration healthcare based on that principle. It was the most repugnant immoral thing I have ever read. But it didn't so much as raise an eyebrow among liberal Slate readers.

Kyle Jordan|5.13.09 @ 11:20AM|#

"Individual self-determination. Freedom. These concepts mean nothing to too many people now. Or, perhaps nothing is the wrong word. They mean two or three discreet things to people now, and are no longer widely accepted general principles."

No, you had it right the first time. I can't tell you how disheatening, enraging, and ultimately toxic it is to work around a large group of people who are like this.

I've actually heard the statement "What good is Freedom if you can't be safe and have to make all the choices yourself?" uttered to me in complete seriousness. The concept of an individual having control of their own lives seems to no longer exist.

|5.13.09 @ 11:30AM|#

I'm finally starting to get disturbed that Obama may truly be worse than I ever expected. I mean, I thought both candidates were terrible, but I just didn't think Obama would move on this shit as aggressively as he has. He seemed to just want the adulation.

The only positive aspect, I suppose, is that the more rapidly and aggressively he moves, the more powerful any coming eloctoral backlash will be. I hope.

See why I don't vote? SEE?!?

Xeones|5.13.09 @ 11:35AM|#

Now go out and get yourself a nice, whippy, lightweight walking stick.

...with THIS MACHINE KILLS FASCISTS carved down its length.

Dr. Lawyer|5.13.09 @ 11:39AM|#

I will now address questions.

Dr. Lawyer are in anyway self aware enough to realize how creepy that sounds?
Yes.


Indeed, isn't that why we have collectivized food production in the U.S.?
Of course, you just don't realize it yet.

what makes you think government bureaucrats won't be the same way?

Dr. Lawyer|5.13.09 @ 11:40AM|#

Stupid buttons. Buffoonery all around, I'm going home!

|5.13.09 @ 11:45AM|#

You people worry too much. The smart people are in charge now. If we shoot for socialized medicine and it turns out to be a failure, team Obama will revert us to the way things were. They won't declare it underfunded and forge ahead. They will call the whole thing off on account of it having been a bad idea in the first place. This is how government works now. Have faith.

Xeones|5.13.09 @ 11:47AM|#

As performance art, Dr. Lawyer, you're actually pretty lousy. Try to be more like Morris/Lefiti/Edward, whose incandescent rage is impervious to fact, logic, and hygiene.

Alice Bowie, as anti-prohibitionist as i am... you really need to take less drugs, yo.

|5.13.09 @ 11:49AM|#

Alice Bowie, as anti-prohibitionist as i am... you really need to take less drugs, yo.

...or should he take more?

|5.13.09 @ 11:51AM|#

Pro Lib

From the infallible Wiki:

After graduating, Crist failed the Florida bar exam twice, before passing it on the third attempt.

It was brought up in the campaign for AG when he ran. I've forgotten whether it was his primary rival or in the general. But it is part of why I consider him something of a mental lightweight.

But I've got to admit that he seems to be awfully well-liked. He seems to be getting Obama-levels of sycophantic praise from the Florida press. Or at least in the Orblando Slantinel he is. And I seem to recall a HitnRunner from Jax saying about the same there.

But considering his positions on most issues I still can't figure out why he's a Republican. Maybe he just decided he wanted to be on the winning side.

phalkor as Dr. Lawyer|5.13.09 @ 11:53AM|#

yeah I fucked that one up. I'm okay with it though. I pretty much was trying to put up a post of a character that was anathema to how I feel on this issue. I REALLY hate malpractice lawyers. I hate malpractice lawyers that used to be surgeons even more. (They exist and are vampyres)

So I give myself a C+ for this one. However, since most of the class failed and we grade on a curve, that C+ becomes an A-. Hooray for fairness!

|5.13.09 @ 11:55AM|#

However, since most of the class failed and we grade on a curve, that C+ becomes an A-. Hooray for fairness!

We're all winners, now.

BakedPenguin|5.13.09 @ 12:00PM|#

See why I don't vote? SEE?!?

I vote Libertarian. It's sort of the same thing, and it definitely produces the same result as not voting, but it makes me feel good about myself.

I'm reminded of a poster I had when I was young. At the bottom was the dictionary definition of "defiance". Above that was a drawing of a huge hawk that was coming down to hunt and kill a mouse. The mouse was just standing there, flipping off the hawk.

A pointless gesture, meaningless to stop the inevitable and imminent destruction. But if the destruction is coming anyway, there's no point in not making that gesture.

nebby|5.13.09 @ 12:05PM|#

" I REALLY hate malpractice lawyers. I hate malpractice lawyers that used to be surgeons even more. (They exist and are vampyres)"

No one likes being held accountable for their failures.

|5.13.09 @ 12:06PM|#

I think it's time to roll out a new label for the public plan- "predatory health insurance." It seems to have worked when combined with "lender" and "pricing."

|5.13.09 @ 12:09PM|#

phalkor,

Your initial post was pretty good. But you just couldn't back it up. Sadly, your first post is all too typical. There are guys out there like that. I have met them.

|5.13.09 @ 12:10PM|#

Dr. Lawyer: Oh, right, because we all know that when the government runs things, there's never any "blood-sucking" involved? Try Googling "Medicare fraud" or "John Murtha."

Two more huge aspects of this: illegal immigration and elective procedures. Does anyone think that the Obama administration is going to be carefully checking citizenship papers before letting people get in line for treatment? And that there won't be a constant push to expand the definition of "necessary" procedures? How long will it be before people are flying in from South America for Lasik eye surgery and boob jobs on the taxpayer's dime?

|5.13.09 @ 12:22PM|#

How Jeb Bush and Crist are popular in the same state at the same time befuddles me. Bush was, largely, a fiscal conservative with some reasonably libertarian impulses (L'Affaire Schiavo excepted). Crist is not fiscally responsible and panders to every idiotic popular cause that he can.

Of course, Bush has said some stupid things since leaving office, like implying that the GOP needs to co-opt some of the Democrats' "winning" ideas. WTF?

|5.13.09 @ 12:32PM|#

implying that the GOP needs to co-opt some of the Democrats' "winning" ideas.

Maybe he meant running a candidate who doesn't have one foot in the grave.

tekende|5.13.09 @ 12:41PM|#

Oh, great. I WORK for the government. Goodbye, semi-decent health plan I have now...

|5.13.09 @ 12:42PM|#

Get this. i met a woman over the weekend who worked for CIGNA. Turns out that CIGNA employees do not get insurance.
Instead, they have HRAs.

Xeones|5.13.09 @ 12:45PM|#

...or should he take more?

Considering that he/she is apparently down to 2 brain cells now, and one of them is flickering, it might be time for an intervention.

Mokers|5.13.09 @ 12:51PM|#

The worst thing about the sneaky back door to single payer health care is that the government probably won't have the courtesy to attempt the reach around.

|5.13.09 @ 12:56PM|#

"""While the public option is meant for the uninsured, employers will realize it's easier -- and cheaper -- to move employees into the government plan than continue workplace coverage."""

Isn't this the problem with the MA state plan Romney was touting?

"""Absolutely it will be. In order for the plan to function even at a low level, it needs young, healthy people who don't require much medical care paying into it to subsidize the old and the sick."""

So does the current insurance system.

Health care, for those who can afford it or work for someone who can, isn't really busted. Naturally, problems arise when you increase the enrollement of those who can't pay.

The problem is with health insurance costing a family as much as their mortgage. But what to do? Reduce the cost? or find a new way to pay the cost?

MNG|5.13.09 @ 1:01PM|#

How will they "impose" price controls? Through negotiating a group rate because they have so many people in the plan? If so, then is all this bitching because a government run plan can cover people for less than a bunch of private ones?

If its some other way I of course retract. But I wanna know (and am too lazy to read the whole thread if its been discussed, so I apologize if that is the case)

robc|5.13.09 @ 1:01PM|#

Instead, they have HRAs.

All HRAs have a high deductible insurance policy as part of the plan.

robc|5.13.09 @ 1:03PM|#

If its some other way I of course retract.

Medicare doesnt negotiate. They tell doctors what they will pay for procedure X. I assume this will be the same way.

MNG|5.13.09 @ 1:06PM|#

robc
Do doctors by law have to take what Medicare patients and the amount the gov gives for their care?

phalkor as herself|5.13.09 @ 1:09PM|#

No one likes being held accountable for their failures.


True, holding people accountable is a tough job. I'm glad that our government is responsible and will be able to hold itself accountable for the future successes.

John, PapayaSF. Yar right!

The current system and any new system are ripe for the raping. I don't know how to fix it. I sure as hell know Obama doesn't know either. The healthcare system rapists are "Dr. Lawyer" and have vast powers of cognitive dissonance or are willfully blind.


I do believe a single payer system will be forced through regardless of anything. All current systems are too easily abused to be good models for the coming clusterfuck. I'm worried.

robc|5.13.09 @ 1:16PM|#

Do doctors by law have to take what Medicare patients and the amount the gov gives for their care?

Yes, if they treat them.

How did I know what your response was going to be?

Sure, they can turn them down as a patient, that works fine for now, but as government monopoly power grows, it doesnt work.


ALL monopolies are created by government power.
If it was a company and not the government I would be fine with them demanding a certain price. Every doctor could say NO. But, companies arent governments and shouldnt be treated the same way.

^^^Yes throwing out some future responses to skip ahead.

robc|5.13.09 @ 1:17PM|#

Doctors shoud unionize and then refuse to deal with government agencies. That would throw the left into a tizzy? What is our position?

|5.13.09 @ 1:22PM|#

I'm finally starting to get disturbed that Obama may truly be worse than I ever expected. I mean, I thought both candidates were terrible, but I just didn't think Obama would move on this shit as aggressively as he has. He seemed to just want the adulation.

I thought that both candidates were pretty terrible, but I also thought at the same time that, as confused as he can be, Senator McCain was about as libertarian as a candidate could be that would have a chance of winning. (That's based on the overall practical positions, not on any sort of consistent theoretical grounding for those positions, certainly something he's short on.) He's both considerably more anti-spending and less socially conservative than any of the elected Republican Presidents in my lifetime. (Gerald Ford was not elected, and would be less socially conservative.) Far from perfect, particularly in failing to realize the effects of regulation that don't show up in a budget, but I never got all the hate for him.

That said, I was hoping that at least there would be areas where President Obama might be better. Seriously, what are they? Has he done anything on Gitmo, torture, gays in the military, gay marriage, the Drug War, transparency, immigration, cutting useless military programs, etc. that McCain didn't support both during the campaign and before? (Remember, McCain opposed amending the Constitution to ban gay marriage when it mattered.) Obama may have talked big, but he ended up adopting the same minor tweaks and "nearly the same policy, but with better people in charge" positions on those things that McCain had already made his trademark even before the campaign. I suppose that possible legalization and taxation of online gambling might be one possible issue, but it's overall pretty weak.

That's not even getting into the issues, like farm subsidies or ethanol or health insurance or card check, where McCain was obviously better from a libertarian perspective. I realize that there were issues where you could say that McCain was as bad as Obama, but I'm not sure I've ever seen an election where the one candidate was either the same or worse from a libertarian perspective on basically every issue. (Aside from hopeful comments about, "well, we know he doesn't really mean it," or "if only he did what he wants to do.")

Perhaps it is all about him being old or whatever, but I think it also means that a lot of libertarians are fooling themselves about the popularity of libertarianism. True, McCain lost libertarians because GWB wasn't libertarian, but he also lost all sorts of non-libertarians because his positions were too libertarian for them.

phalkor as a ballerina|5.13.09 @ 1:30PM|#

You mean people want to be controlled?

That's what this is about after all. People want to be told what to do, how to do it, and have somebody else pay for it. (even though they end up paying, they always pay in the end.

Obama is just deliver the goods that were ordered. People don't like freedom because it requires too much personal responsibility. People like simulated freedom while having the major problems in their lives already dictated and decided for them.

It's just what the people want, yah dig?

|5.13.09 @ 1:31PM|#

John Thacker,

I voted for Paul in the primary and for Barr in the general, but I would've voted for McCain over Obama. No question about it. I actually expected Spendapalooza and the Voracity of Hope with an all-Democratic government.

|5.13.09 @ 1:55PM|#

"True, McCain lost libertarians because GWB wasn't libertarian"

I was opposed to McCain because I believed him to be more of a warmonger than Bush. If McCain had won, would we be at war with Iran now? Would McCain have renewed the Cold War with Russia? I'm dissapointed with the way Obama has expanded the war in AfPak and for keeping us in Iraq and not getting out fast enough, but at least he's willing to open up a dialogue with Iran and Cuba and criticizes the Israeli government.

I voted for Barr, but was cheering for Obama just because I can't stand McCain. If I had it to do over again, I would still cheer for Obama over McCain.

On economics, Obama is a big dissapointment but I didn't really expect much good from him in that regard. I at least hoped he would reach across the aisle and work with Republicans and find some middle ground, but he seems to be moving as far and as fast to the left as he can. I hope it blows up in his face and that we'll be able to undo some of the damage he will have done to this country.

robc|5.13.09 @ 1:57PM|#

Pro Lib,

Yeah, with a full IRV ballot, McCain would have been like my 3rd choice and Obama my 5th or 6th.

Tacos mmm...|5.13.09 @ 2:34PM|#

Whine whine, bitch bitch.

/thread

|5.13.09 @ 2:37PM|#

If you take a Medicare patient, you take the pay the government specifies during its annual rulemaking on Medicare rates.

You also take a heaping helping of regulatory bullshit, as well.

No hospital can afford not to take Medicare. A few doctors can, but not many.

There is no negotiation, and the room for opting out will only shrink as the program expands.

|5.13.09 @ 3:08PM|#

Pro Lib, I'm sitting on this slogan for my next run, so feel free to borrow it:

"Libertate for Senate 2010: There's a lot of work to undo."

|5.13.09 @ 3:19PM|#

The Undo Candidate.

Jason|5.13.09 @ 3:24PM|#

If you take a Medicare patient, you take the pay the government specifies during its annual rulemaking on Medicare rates.

Is it nationwide or adjusted for local cost of living?

Solanum|5.13.09 @ 3:28PM|#

And The Urkobold/George Takei on the Simian Ticket in '12.

|5.13.09 @ 3:43PM|#

Solanum,

Hey, that sounds familiar to me somehow ☺. We are due for another Vice President Takei posting. I'm a slacker, I admit.

|5.13.09 @ 4:19PM|#

I assume eliminating the tax deduction for employer-provided health insurance is part of this plan.

Lyn|5.13.09 @ 4:36PM|#

Good point about employers seeing this as an easy way to move their employees to government health plan. This will happen even faster when Obama gets tax law passed to tax the value of employer contributions to employee health insurance.

Don't blame big business for this. Blame Obama, blacks, and the growing number of Hispanics in this country. They're the ones Obama panders to with his socialist "reforms."

Tacos mmm...|5.13.09 @ 4:46PM|#

Is it nationwide or adjusted for local cost of living?

It's calculated by a rather complex formula, based on the billing code multiplied by a relative value unit, which is adjusted for by a cost of living factor (not actually very much - about 7% difference between the top in Manhattan and the bottom in Puerto Rico) and a small malpractice factor which is also adjusted by location (with much larger swings).

There are some pretty ridiculous injustices. For example, the "relative value unit" of work in Alaska is set by law to a minimum of 1.5 even when it is substantially lower everywhere else, with the result that for many billing codes, a doc makes 10-20% more in Alaska than the urban centers of Manhattan and San Francisco. This is largely the result of the political power of Alaskan legislators.

libertarians|5.13.09 @ 5:36PM|#

LIBTARDS!!!

|5.13.09 @ 7:32PM|#

Pro Libertate | May 13, 2009, 3:19pm | #
The Undo Candidate.

Forget about Senator. Run for governor.

On the Urkobold ticket - wither the taints of all those who oppose you.

You have my support if you promise to move the State Capitol to Taintsville and rename this county Taintsville County

|5.13.09 @ 8:50PM|#

The heart of Florida is Taintsville. Taintsville folk are good folk.

Solanum|5.13.09 @ 9:29PM|#

Receive free canned fried haggis fritters for life, or a withered taint. Your vote, your choice.

|5.14.09 @ 5:37AM|#

"...Or a plan for the airline industry modeled after the Hindenburg. Swell!"

The Hindenburg was a fairly well-designed and cost-effective vehicle. What made it mortally dangerous was ... wait for it ... THE US GOVERNMENT! That's right, kiddies. The US orchestrated a helium embargo so that Der Fuehrer would have to make the choice of inflating his airships with flammable hydrogen or grounding them. The Germans bet that their engineering and operations discipline could nullify the danger, but they lost: it only takes one mistake, leading to one deadly conflagration recorded and disseminated via newsreel, to flush the demand for airship travel down the drain.

Airships are back, by the way. Zeppelin is making airships for tourism and special cargo purposes. I did a back-o-th-napkin calculation a few months ago, the results of which indicated that a fleet of airships could carry as many passengers per day as the proposed California High Speed Rail system, charging a reasonable fare for a pleasant and memorable aerial journey, costing far less than the HSR system, and going into service years ahead of HSR, without tearing up the countryside or intruding into city centers or NIMBY-filled suburban neighborhoods as HSR is expected to do. Airships don't need airports and long landing strips; they can moor and let passengers board or disembark at stadiums, parks and open fields, or in many other places. Although they have issues with harsh weather, airships are very fuel-efficient, and can potentially provide pleasant, comfortable travel even for those who don't want to or cannot afford "first class" tickets.

At the moment, only the well-heeled can afford a sightseeing cruise of several hours via airship. But give it some time, and we may actually see a resurgence in affordable passenger airship service. As long as government stays out of the way, something good could happen.

W.M.|5.14.09 @ 8:00PM|#

"Government can do anything."

I'm still waiting for my flying, rainbow-crapping unicorn.

engineer|5.14.09 @ 8:05PM|#

"but at least he's willing to open up a dialogue with Iran and Cuba and criticizes the Israeli government."

Whoopee. We have a dialogue with psycho-Muslim and communist die-hard. And has he actually, for example, proposed reducing or eliminating aid to Israel? No? So could this all be meaningless posturing.