Does the Public Plan Have a Chance After All?

Peter Suderman | June 30, 2009

The Politico reports on an interview with Sen. Olympia Snowe in which she expressed interest in including a government-run insurance option in the health-care reform bill now making its way through Congress — provided the public plan's creation is dependent on a "trigger" mechanism. In other words, the public plan would be implemented down the road if (and only if) the private market wasn't able to accomplish certain goals like bringing down costs or increasing coverage. The thinking is that the threat of a public plan would pressure insurance companies to become more efficient in order to ensure that a government-run plan never actually comes into existence.

The Politico calls the AP interview a "bombshell," which seems kind of overblown given that Snowe has mentioned her support for a triggered public plan before, but it does point toward what I suggested in my article yesterday: A public plan might pass, but if it does, it's very likely to be in a weak form that's rather less powerful than progressive advocates hoped.

In addition to yesterday's article, I also wrote about various aspects of the public option here, here, and here.

Comments

|6.30.09 @ 3:10PM|#

Considering that Snowe has an IQ somewhere south of 90, it is not at all a bombshell that she would think a public plan is a good idea. Of course, if you could put the date off long enough, it would allow a later Congress to kill it.

|6.30.09 @ 3:23PM|#

I still wonder why Olympia Snowe even still bothers to call herself a Republican.

It's not like she needs to to get elected in Maine.

I mean it's not like it's 1936.

Billy!|6.30.09 @ 3:35PM|#

If this public option is really going to be revenue neutral, funded by it's own premiums, as the folks in power say they want, then it's just another insurance company albeit a non-profit one. Can somebody please explain to me why having one more insurance company, even if it's non-profit is going to do anything for the cost of medical care? If Bill gates said, "I'm gonna pay for start up funding for a non-profit health care company to insure the uninsureds." Would the Democrats be saying, "Hooray! That's exactly what's needed to solve the problem!"

Paul|6.30.09 @ 3:40PM|#

Threadjack: Minn Supreme Court rules Franken is next Senator.

http://seattletimes.nwsource.com/html/politics/2009283091_apusminnesotasenate.html

Apologies if this was covered elsewhere.

stuartl|6.30.09 @ 3:43PM|#

In other words, the public plan would be implemented down the road if (and only if) the private market wasn't able to accomplish certain goals like bringing down costs or increasing coverage.

How is the private market supposed to achieve this in the present overly controlled market? Last I heard, private companies do not have the authority to pass a law that makes all health care costs tax deductable. (Or make all costs taxable; just get rid of the cost differential between employer provided "insurance" and other services).

Paul|6.30.09 @ 3:43PM|#

The thinking is that the threat of a public plan would pressure insurance companies to become more efficient in order to ensure that a government-run plan never actually comes into existence.

If Fed Ex and UPS don't improve their service, reduce costs and expand coverage, the government will launch its own Postal system, called the USPS.

|6.30.09 @ 3:44PM|#

A public plan might pass, but if it does, it's very likely to be in a weak form that's rather less powerful than progressive advocates hoped.

Under salami-slice socialism, that's just fine. Rest assured that once even a weak form of redistribution and control is on the books it will grow and strengthen over time.

Fluffy|6.30.09 @ 3:50PM|#

If this public option is really going to be revenue neutral, funded by it's own premiums, as the folks in power say they want, then it's just another insurance company albeit a non-profit one. Can somebody please explain to me why having one more insurance company, even if it's non-profit is going to do anything for the cost of medical care?

It's not going to be funded by its own premiums. Whenever someone conditions their support of a public option on its being self-funding, the Daily Kos gang freaks out. Tax dollars will be used to subsidize public option premiums if a public option becomes law - count on it.

Here's the only public option compromise I would consider:

Step One: All mandates currently placed on private insurance companies are lifted. No community-based pricing, no requirement to cover particular conditions, no requirement to cover pre-existing conditions. Allow companies to over coverage across state lines.

Step Two: Create a public plan for people who get bounced from all available private plans. Fund it with a mixture of premiums and taxes.

This would allow the private insurance market to actually function like a market, but would provide some protection for hardship cases.

Doing it this way would probably be more expensive in the short run than having a broader-based public plan, since the public plan would end up with the sickest people and those least able to pay, but it would avoid most of the demand-pumping aspects of a broad-based public plan, and would prevent the public plan from instituting de facto rationing and from crushing health care providers once private insurers were driven from the field.

Naturally, the standard libertarian disclaimer applies here. But if we can't get a free market in health care and a public option is politically inevitable, that is how I would want it to be.

|6.30.09 @ 3:52PM|#

Any word on whether or not Democrats are going to start getting honest and start addressing real problems like the mandates (my state has 53) and the problem with competition between insurance companies from different states (I should say, LACK of competition thanks to state law that prohibits it)?

|6.30.09 @ 3:58PM|#

Well, if the public option in medical insurance works as well as the public option for homeowners insurance in Florida everything will be just fine.

NOT!!!

|6.30.09 @ 3:59PM|#

A private plan will draw off many people who currently get insurance through work, simply because employers will want to avoid the expense. I would understand if my employer cut me off. Why pay for something your employees can get for free? well, they will probably end up putting in an tiered income based pricing scheme to charge the wealthy more. At some point it will be easier to get insurance as an indigent with no job, than it will by working for a living. I already pay more for basic healthcare, soon I won't be able to get better service.

|6.30.09 @ 4:07PM|#

Fluffy and Patrick R both bring up good points regarding state regulation of insurance markets.

I don't know exactly what the legal and constitutional* ramifications are but I, for one, would be perfectly happy to see a fully national market in all forms of insurance. Full ability to market across state lines, and full portability across state lines.

Oh, and get rid of the connection between work and health insurance. No, I don't want to ban it but I would like to see the perverse incentives that sustain it gone.

*since when has that bothered the solons, though.

|6.30.09 @ 4:07PM|#

The Politico calls the AP interview a "bombshell," which seems kind of overblown given that Snowe has mentioned her support for a triggered public plan before, but it does point toward what I suggested in my article yesterday: A public plan might pass, but if it does, it's very likely to be in a weak form that's rather less powerful than progressive advocates hoped.

Schumer on the other hand has basically said triggers are a non-starter.

If I were a betting man, I'd bet on Schumer's take over Snowe's take.

hammeredHead|6.30.09 @ 4:10PM|#

Well, if the public option in medical insurance works as well as the public option for homeowners insurance in Florida everything will be just fine.

There was an obvious flaw in the Florida plan. The maximum rate allowed was set below the market rate. Therefore, Citizens became the only insurer available for many.

24AheadDotCom|6.30.09 @ 4:12PM|#

While Reason is wondering, I'm actually doing something. Of course, I'm not in DC and I don't have a .tv division, so Reason could do a lot more. Yet, they refuse to do so. Those Beltway cocktail party invites are worth their weight in gold!

|6.30.09 @ 4:17PM|#

In an Associated Press interview in Portland, Snowe said it would be unfair to include a government-run health insurance option that would take effect immediately.

"If you establish a public option at the forefront that goes head-to-head and competes with the private health insurance market ... the public option will have significant price advantages," she said.

Is this really something that she thinks will make people oppose a public option???

That's the point of health care reform senator. It's a feature not a bug.

The point is to get costs down and get as many people covered as possible.

Not to make sure that insurance companies can keep making their profits (by raising premiums, and making the claims process as hard as possible and denying as many claims as possible and by attrition)

Rich|6.30.09 @ 4:20PM|#

My question for 24Ahead: "Is that a rhetorical question?"

Peter|6.30.09 @ 4:21PM|#

they will probably end up putting in an tiered income based pricing scheme to charge the wealthy more.

I bet they already wrote this in the bill, although no one will read it so we won't find out until they start giving away healthcare with welfare checks.

|6.30.09 @ 4:24PM|#

Quick; he forgot the StandardDisclaimer! LAUNCH AD HOMS THAT PROVE OUR CHILDISH, ANIT-INTELLECTUAL NATURE!

|6.30.09 @ 4:26PM|#

What guarantee is there that a government plan would lower costs and increase coverage? Okay, okay, they could pass a law requiring the poor to buy their insurance. And throw the bums in jail who refuse to pony up the money. But what makes them think that it will be cheaper?

|6.30.09 @ 4:28PM|#

LAUNCH AD HOMS THAT PROVE OUR CHILDISH, ANIT-INTELLECTUAL NATURE!

Hey LoneWanker! You're a poopie-head! Pfffffft!

|6.30.09 @ 4:33PM|#

At some point it will be easier to get insurance as an indigent with no job, than it will by working for a living.

It already is. Fill out a Medicaid form, and if you qualify, you're in.

What guarantee is there that a government plan would lower costs and increase coverage?

Because Obama said so!

Is this really something that she thinks will make people oppose a public option???

Nah. People oppose the public option because it will be subsidized, expensive for taxpayers, and will crowd out the private insurance that most people are happy with now.

Creech|6.30.09 @ 4:35PM|#

My company's insurance broker sees a lot of opporunity in this recession to cut insurance company admin costs, even with mandates in place. No state, apparently, mandates what the co-pay must be or what the deductibles will be. So, appeal to businesses that are tired of increased premiums by jacking up the co-pays and deductibles to the point where the tons of paperwork generated by dollar one (or low dollar coverage) is eliminated. Businesses are off the hook because they can tell the employees "this is the best plan we can buy now that the Obama administration has mandated health costs be cut." Before the recession, employees could walk; now they are mostly happy to have a job. Now my employer doesn't want to take anything away from the employees---but recognizes that the only way to cut health costs is to deny coverage for some procedures or eliminate admin. costs by getting the routine procedures out of the reimbursement stream.

Or maybe the health socializers can show us the way by creating a private, non-profit plan that eliminates administration costs while still guarding against fraud, pays moderate salaries to its employees, covers pre-existing conditions, keeps the providers happy with the amounts paid them, o.k.s all experimental treatments even if believed to have no palliative result. Should be easy to eliminate the greedy doctors, greedy administrators, greedy shareholders, etc. and cover all their expenses, right?

|6.30.09 @ 4:36PM|#

The maximum rate allowed was set below the market rate.

And the temptation to do this with the national healt plan (or whatever) will be overwhelming too, I suspect.

Therefore, Citizens became the only insurer available for many.

I think this is exactly the hazard that some opponents of the public option are warning against.

Florida offers many warnings about insurance. Floridians have consistantly elected populists to the Insurance Comissioner's chair. These populists have consistantly held premium increases down much to the satisfaction of policy holders. When the benign spell in the weather ended in the late eighties/early nineties (a period that coincidentaly was a period of the state's greatest growth) the chickens came home to roost and many insurers left the state.

Many policyholders were simply not ready for the premium increases they saw but it was really just a catchup with reality.

I don't know about anyone else's state but in Florida insurance is one of the most regulated businesses going.

|6.30.09 @ 4:36PM|#

If it is inevitable anyway, I tend to lean toward the Swiss method. Make insurance compulsory for everyone, with standard coverages, purchased from private companies. And allow the purchase of supplemental insurance for those that want better treatment.

|6.30.09 @ 4:39PM|#

What was that bill that Crist just vetoed?

|6.30.09 @ 4:39PM|#

In other words, the public plan would be implemented down the road if (and only if) the private market wasn't able to accomplish certain goals like bringing down costs or increasing coverage. The thinking is that the threat of a public plan would pressure insurance companies to become more efficient in order to ensure that a government-run plan never actually comes into existence.

Just curious, will there also be a reverse trigger mechanism that automatically dismantles the public plan if it fails to accomplish certain goals? The thinking being that the threat of losing their pet project would pressure government bureaucrats to become more efficient to ensure that the government-run plan remains in existence.

Peter|6.30.09 @ 4:42PM|#

I'm going to start my own non-profit insurance company where you pay no premiums and the co-pay is dependant on the cost of the procedure, equal to double 50% of the cost. I will have 1 employee (myself) and Obama can go stick it in someone else's butt (himself).

The Angry Optimist|6.30.09 @ 4:43PM|#

Not to make sure that insurance companies can keep making their profits (by raising premiums, and making the claims process as hard as possible and denying as many claims as possible and by attrition)

PROFITS BAD! OOGITY-BOOGITY!

Peter|6.30.09 @ 4:48PM|#

PROFITS BAD! OOGITY-BOOGITY!

I heard that Hitler made profits.

|6.30.09 @ 4:48PM|#

What was that bill that Crist just vetoed?

You talkin' ta me?

Resisting pressure from a chorus of large and politically influential industry groups, Gov. Charlie Crist on Wednesday vetoed legislation aimed at enticing large property insurance companies to write policies in Florida.

That one?

The decision all but ensures State Farm Florida will push ahead with plans to stop writing policies for property owners here, an exit that insurance experts warn could be devastating to hurricane-prone Florida.

...

State Farm executives say state regulators are not allowing them to charge realistic rates that cover their potential storm losses, and they have announced plans to gradually withdraw from the insurance market here.

Kevin|6.30.09 @ 4:49PM|#

I don't know exactly what the legal and constitutional* ramifications are but I, for one, would be perfectly happy to see a fully national market in all forms of insurance. Full ability to market across state lines, and full portability across state lines.

Being a hard-to-insure person, I can tell you about this. There is a federal law that prohibits insurance across state lines. In the Bush years, NFIB supported legislation to undo the law. This was opposed by the Dems, who argued that it would undermine state regulations. (Go figure, this one time they respected states' rights). It never passed, even with a Republican congress.

I always thought this would have made a huge positive impact on insurance/health care. I also think it was one of the biggest failures of that useless-as-tits-on-a-bull Republican majority we had a few years ago.

|6.30.09 @ 4:50PM|#

I gues he shoed 'em, huh.

Charlie was always a populist. As AG he was always out in front catching the "price-gougers" after a storm.

|6.30.09 @ 4:52PM|#

There is a federal law that prohibits insurance across state lines.

Naturally the public option health insurance plan will be excempt from this law, right?

|6.30.09 @ 4:53PM|#

AMERICA'S NATIONAL HEALTHCARE EMERGENCY!

It's official. America and the World are now in a GLOBAL PANDEMIC. A World EPIDEMIC with potential catastrophic consequences for ALL of the American people. The first PANDEMIC in 41 years. And WE THE PEOPLE OF THE UNITED STATES will have to face this PANDEMIC with the 37th worst quality of healthcare in the developed World.

STAND READY AMERICA TO SEIZE CONTROL OF YOUR NATIONAL HEALTHCARE SYSTEM.

We spend over twice as much of our GDP on healthcare as any other country in the World. And Individual American spend about ten times as much out of pocket on healthcare as any other people in the World. All because of GREED! And the PRIVATE FOR PROFIT healthcare system in America.

And while all this is going on, some members of congress seem mostly concern about how to protect the corporate PROFITS! of our GREED DRIVEN, PRIVATE FOR PROFIT NATIONAL DISGRACE. A PRIVATE FOR PROFIT DISGRACE that is in fact, totally valueless to the public health. And a detriment to national security, public safety, and the public health.

Progressive democrats the Tri-Caucus and others should stand firm in their demand for a robust public option for all Americans, with all of the minimum requirements progressive democrats demanded. If congress can not pass a robust public option with at least 51 votes and all robust minimum requirements, congress should immediately move to scrap healthcare reform and request that President Obama declare a state of NATIONAL HEALTHCARE EMERGENCY! Seizing and replacing all PRIVATE FOR PROFIT health insurance plans with the immediate implementation of National Healthcare for all Americans under the provisions of HR676 (A Single-payer National Healthcare Plan For All).

Coverage can begin immediately through our current medicare system. With immediate expansion through recruitment of displaced workers from the canceled private sector insurance industry. Funding can also begin immediately by substitution of payroll deductions for private insurance plans with payroll deductions for the national healthcare plan. This is what the vast majority of the American people want. And this is what all objective experts unanimously agree would be the best, and most cost effective for the American people and our economy.

In Mexico on average people who received medical care for A-H1N1 (Swine Flu) with in 3 days survived. People who did not receive medical care until 7 days or more died. This has been the same results in the US. But 50 million Americans don't even have any healthcare coverage. And at least 200 million of you with insurance could not get in to see your private insurance plans doctors in 2 or 3 days, even if your life depended on it. WHICH IT DOES!

If President Obama has to declare a NATIONAL STATE OF EMERGENCY to rescue the American people from our healthcare crisis, he will need all the sustained support you can give him. STICK WITH HIM! He's doing a brilliant job.

THIS IS THE BIG ONE!

THE BATTLE OF GOOD Vs EVIL!

Join the fight.

Contact congress and your representatives NOW! AND SPREAD THE WORD!

God Bless You

Jacksmith - WORKING CLASS

The Angry Optimist|6.30.09 @ 4:55PM|#

equest that President Obama declare a state of NATIONAL HEALTHCARE EMERGENCY! Seizing and replacing all PRIVATE FOR PROFIT health insurance plans with the immediate implementation of National Healthcare for all Americans

Dude, if that happens, it's wartime. No fuckin' around.

Peter|6.30.09 @ 5:04PM|#

Dude, if that happens, it's wartime. No fuckin' around.

If this happens I think it will be the first time that we follow the example of Honduras.

BakedPenguin|6.30.09 @ 5:07PM|#

I don't know about health insurance, but all other forms are only regulated at the state level.

|6.30.09 @ 5:07PM|#

If it is inevitable anyway, I tend to lean toward the Swiss method. Make insurance compulsory for everyone, with standard coverages, purchased from private companies. And allow the purchase of supplemental insurance for those that want better treatment.

Also the Dutch approach. Seems to work reasonably well.

Will never happen here, of course. Would render whole buildings, nay, townships, of regulators and beancounters supernumerary, as the gargantuan Medicare/Medicaid edifice would be obsolete.

Rich|6.30.09 @ 5:11PM|#

> ... until they start giving away healthcare with welfare checks.

Peter, I was musing along similar lines: negative co-payments.

BakedPenguin|6.30.09 @ 5:15PM|#

There is a federal law that prohibits insurance across state lines.

Again, I have no experience with health insurance (though I can't imagine it's any different), but in practice, insurance companies file individually in all 50 states, meaning that a national business can get property or liability insurance from one company.

Peter|6.30.09 @ 5:18PM|#

Peter, I was musing along similar lines: negative co-payments.

They already stated with the cap-n-trade bill that the poorest people will actually save $40 a month through subsidies while the highest group will pay $300+, the $175 per household is just an average, I will expect no different here.

Warty|6.30.09 @ 5:24PM|#

Is jacksmith a retard troll, or a sophisticated meta-jokester? We may never know.

Lauren|6.30.09 @ 5:26PM|#

I'm confused - most of these comments act as if a public plan has never been seen or heard of before, and we have no idea what it will do to our country. Are there not dozens of examples in countries similar to ours around the world? I suppose that kind of research would require time and effort, though, and we all know how little of that bloggers have...

Kevin|6.30.09 @ 5:27PM|#

BakedPenguin, I'm not sure how that works for nationwide corporations. But as an individual, you or I couldn't shop around and get health insurance from a company based in a state other than our own, unless they had an office in your state. So even if there are states with less regulation where it would be easier for us to get a policy, that's not an option for us.

|6.30.09 @ 5:36PM|#

Isaac,

God help us if Crist gets in the Senate.

BakedPenguin|6.30.09 @ 5:40PM|#

Kevin, I see your point. The problem is that the insurance industry will fight tooth and nail to avoid federal regulation.

The Angry Optimist|6.30.09 @ 5:46PM|#

I see Lauren's here again. Good for you!

anyway, Lauren, given that you're new, there is a bevy of information about other "public" healthcare systems on this site. Please do not assume that reason started coverage of this the minute you got here.

Here is a good start: The Cato Institute on public health care.

Here's just one article on why the public option won't work.

most of these comments act as if a public plan has never been seen or heard of before, and we have no idea what it will do to our country.

No, we know exactly what it will do and we oppose it on those grounds (plus a thorough grounding in negative-rights theory).

Rich|6.30.09 @ 5:47PM|#

> Are there not dozens of examples in countries similar to ours around the world? I suppose that kind of research would require time and effort, though, and we all know how little of that bloggers have...

Lauren, I believe this concern has been met with responses such as (paraphrasing) "We need a uniquely American plan."

Rich|6.30.09 @ 5:49PM|#

What TAO said.

(I meant "met by the administration".)

Peter|6.30.09 @ 5:53PM|#

TAO, what is "negative-rights theory"? I've heard it here a couple of times but I'm too busy blogging to look it up, can a brotha get a Hier?

The Angry Optimist|6.30.09 @ 5:57PM|#

Peter: Hier ist a good start.

anyway, the long story short is that creating a "positive right" (that is, a right to something) in health care is a violation of the negative rights of liberty and property.

Peter|6.30.09 @ 6:06PM|#

Oh, so you're objecting to the employer/personal mandate to purchase? I believe there will be ways around this.

Me from earlier:
I'm going to start my own non-profit insurance company where you pay no premiums and the co-pay is dependant on the cost of the procedure, equal to 100% of the cost.

You guys can feel free to join if you want, I'll make my own business cards and everything.

The Angry Optimist|6.30.09 @ 6:09PM|#

I'm objecting to the notion that there exists a positive right to health care, that's all.

Peter|6.30.09 @ 6:17PM|#

Oh, well yeah, I guess there is that angle too. Depends on your definition of "life" I guess.

The Angry Optimist|6.30.09 @ 6:19PM|#

not really. if you assert that you have a positive "right" to anything that furthers your life, that implies a positive obligation on somebody else to provide it to you. And that kind of system is unsustainable.

Lauren|6.30.09 @ 6:27PM|#

TAO,
I read the article you cited about why the public option would be sooo expensive. The article really only addressed the cost, which is, I'm sure, your biggest concern as well.
I come from a different perspective. One of the reasons I think we can decrease the amount of sick and unhealthy in this country is simply because this country is very fucking unhealthy. (I do non-paid work in this field, somewhat). For instance: child obesity has increased 70% in the last 10 years. Americans have gotten fatter and sicker at an exponential rate, and complaining about the cost of health care is not really addressing the problem of the health system. In reality, the American people need to be making serious life-altering changes, but that becomes increasingly difficult the more health bills you have, the less you can afford it, the more debt increases, the more other costs increase, oh, and add to that a recession - just for good measure.
Yea, what a great time to leave people fending for themselves.
I understand the desire for your freedom - some people have it worse than you, and they could drag you down with something like this public plan - "picking your pockets" someone said. A: They (we) already are. B: This is happening in more than just health care - schools, prisons, wars.
There was a C... oh well. I'm sure I've said it all before.
I'm just coming from a different perspective than the financial one, which was all that article talked about, and all anyone in here really talks about - mostly.

Dean Ornish, the founder of the Preventative Medicine Research Institute, has a really excellent talk on TED, highly worth 16 minutes and 50 seconds of your time - in fact, it's worth 33 minutes - watch it twice:

http://www.ted.com/talks/lang/eng/dean_ornish_on_healing.html

|6.30.09 @ 6:30PM|#

Are there not dozens of examples in countries similar to ours around the world?

Actually, not really. The largest country with a function "public" system is about a fifth of the size of the USA. And such countries lack the ethic and racial diversity of this one.

Or, if they do have racial and ethnic minorities they don't do awfully well at delivering social services to them, but are saved by the fact that their expectations are low and the majority population doesn't care.

Except in France, that is. Well, of course, the majority population still doesn't care about "les beurs" there either.

Lauren|6.30.09 @ 6:35PM|#

Blaming it on the size of population, and ethnic diversity... I understand the former, but not the latter.
Population growth is a serious problem, and it's affects in health care are really just the beginning of that room-is-getting-small feeling.

The Angry Optimist|6.30.09 @ 6:36PM|#

Lauren, you are absolutely all over the map. First of all, you say that Americans are getting "exponentially sicker and fatter". I don't think you know what the word "exponentially" means, but it doesn't mean "by a whole whole lot". Secondly, given that is no doubt what you meant, I would dispute your noncited figures on that anyway. What is the measurement used to calculate obesity? If it's that rank joke known as BMI, I know you're not using serious dietary science.

There are doubtlessly some people who have it worse than me, but not many. I, in the short term, would absolutely benefit from a public-health care option. I have to pay for health care through my educational institution for an exorbitant rate (about 2000 a year, just for me).

I understand the desire for your freedom

Look, don't condescend to me, and say irritating things like "oh, I understand your desire for freedom...but fuck that noise!" If you don't like the freedom that the current model offers and you desire "more government", state it plainly and don't claim to understand libertarianism.

you can come from any perspective you like, Lauren, but your recitation of "facts" about how sick we all are is missing one important link to the current argument: you have yet to prove how the government is going to make it any better. I mean, what's your point in stating that you're coming from a "health perspective" and then you fail to state how that perspective is relevant and how health is going to get better under a public plan?

The Angry Optimist|6.30.09 @ 6:42PM|#

and for all of Dr. Ornish's recommendations about healthy living, that doesn't excuse his rank statism. He'd probably advocate mandatory morning exercises if he could get away with it.

|6.30.09 @ 6:45PM|#

God help us if Crist gets in the Senate.

No kidding.

I was so put of by the last slate for governor, that I was seriously considering registering as a Dem and voting for Rod Smith in the primary. I know he was a prosecutor and a bit of a union darling, but he was good on a bunch of issues, especially gun rights (probably the best in the whole field).

I just though it was so precious when Crist tried to play the outdoorsman and hunter. You just knew it was such an act.

Give me a Field ansd Stream Democrat over any of those Republicans faking the gun nut act to get an NRA endorsement any day.

|6.30.09 @ 6:50PM|#

That's not his only act. His tan's fake, too.

After enduring Crist, I wish Jeb Bush had taken the sandtrout as his skin and declared himself God Emperor of Florida.

Lauren|6.30.09 @ 7:01PM|#

Hm, TAO, no, I don't think that government would make any of our real health issues better. I think, perhaps education would, and a health system that is strictly motivated by its function rather than its profit would, as well. But the real role for a public option would be to catch those falling through the private insurance net, and prevent our lower class from blossoming with a bunch of poor sick people who can't work and who, I think, deserve to be buoyed back up. That said, people who have a job should be taxed for that health service via their income. That, of course, relies on having jobs available. But it also relies on the health of the individual to get a job, or start a business, or maintain any kind of relationship with the world.
None of this concerns you, I suppose. The only things that concern you are taxes, and the scary image of the big bad government breathing down your neck or some such nonsense..

Lauren|6.30.09 @ 7:03PM|#

I used the term "exponential" because of the rise in percentage of overweight and obese Americans in the last few decades - the data is out there, shall I get back to you on that? It would take some bookmark digging, but if you're incapable of finding that information, I could probably help you.

The Angry Optimist|6.30.09 @ 7:08PM|#

I don't know what bizarro world you reside in, Lauren, where there are apparently millions of just deathly ill people desperate to work...if only government could magically revive and heal them!

But the real role for a public option would be to catch those falling through the private insurance net

These programs already exist: they are called Medicare and Medicaid.

Look, Lauren, you need to develop some coherency to your argument. Americans are getting sick, but you acknowledge that public health option won't help that anyway. Profits are bad...except for all of those for-profit companies that provide food, shelter, clothing and a ton of other stuff at much better success rates than the government does.

people who can't work and who, I think, deserve to be buoyed back up. That said, people who have a job should be taxed for that health service via their income.

Do you know how incentives work? You want to punish people for getting jobs and reward them for staying unemployed and sick.

|6.30.09 @ 7:09PM|#

I liked Jeb, too PL. It's too bad his brother got to be prez and fucked it all up for him.

I really think the country's had its fill of shrubs for the nonce. Jeb could probably take the Senate seat if he wanted it but I can't see him going anywhere nationally.

I was going to say stupid brother but remembered there's an even stupider one.

|6.30.09 @ 7:15PM|#

Blaming it on the size of population, and ethnic diversity... I understand the former, but not the latter.

If you don't understand how racial and ethnic frictions affect the disbursement of social services I don't think I can explain it to you.

You might try rereading my original post though. I do touch on an explanation there.

The Angry Optimist|6.30.09 @ 7:16PM|#

kinda the same reason everyone gets a bug up their ass about the border with Mexico as opposed to the border with Canada.

The Angry Optimist|6.30.09 @ 7:21PM|#

look, Lauren, I mean this in the best way possible: you absolutely need to start over when it comes to arguing about this stuff.

Do you know what a "right" is?
What, if any, do you believe the limitations of government should be?
Do you recognize that private corporations have no power to force you to do anything, and the government does? Do you also recognize that most of the benefits of life come from businesses, not the government?

I don't know if we can talk about anything unless you've explored some of those basic ethical and political questions.

|6.30.09 @ 7:38PM|#

TAO, looks like Lauren neglected to include anarchy in her list of your concerns and fears.

Abner MacGillicuddy|6.30.09 @ 7:40PM|#

Shorter Lauren, "mean people suck"

She might write multi paragraph posts, but all of it can be summarised in empty platitudes. When she writes, she probably dots her "i"s with little hearts or smileyfaces.

If you doubt it, check out the last healthcare thread. I checked out but I lurked a while longer but finally quit following it because you can only stand reading the same vapid argument so many times.

Lauren|6.30.09 @ 7:40PM|#

Hey, you want to go back to basics? I can do that.
What is a "right"? Is it "inalienable"? "God-given"? Just made up?
I think that we humans created rights because we found them to be morally appealing and even necessary. I think that's why the UN's and the US's Bill of Rights even exist - because we made them up, because we like them and WANT them to be enforced - yea, that's right, enforced. If my right of free speech can't be enforced, then what good is it? (I am not under the illusion, by the way, that we have many of these "rights" left after 9/11).
So why did we create these things? Why didn't we stay smaller in number and territory, individualistic and competing, as societies? Well, because we do bigger, greater things when we are bigger and more interconnected, sharing our resources, and our fates - like going to the moon, or revising a health care system.
The direction of our society, and our defense of our "rights," come from our basic principles of what is morally good or bad.
Do I think there is such thing as objective moral good? Yes, and I will explain why:
Through observation, it is easy to describe the evolution of natural systems as moving towards increasing complexity - I'm sure you already know where I'm going. Stars form galaxies, they form more complex elements (like carbon and iron), and galaxies form superclusters; life itself has a tendency to develop where and when it can. It is like a "tendency" that is ever-present. It is why I think that life would develop again if it all was evaporated from this Earth, and that complex life forms would develop again, and, if given the time, intelligent life as well.
The counter-balance to this increasing complexity is entropy, and I don't know where I stand on that yet, but I think that they balance each other out.
My moral principles don't come from a sense of a God, but rather a sense of the natural direction of life and existence, which is towards greater interconnection and complexity.
Hence, killing, to me, would be wrong. So too is war. Instead, my philosophical leanings are much more oriented towards communication, interconnection, meditation, collective solutions to societal problems...
I'm sure somewhere along these lines you have disagreed many times already, so, since you wanted to start over in the first place, hit me with some capitalism and competition, please.

The Angry Optimist|6.30.09 @ 7:41PM|#

after watching Lauren blather on in the other health care thread by doing nothing more than appealing to emotions and "what civilized societies do", I've pretty much decided that logical argumentation is beyond her.

The Angry Optimist|6.30.09 @ 7:45PM|#

Hence, killing, to me, would be wrong. So too is war. Instead, my philosophical leanings are much more oriented towards communication, interconnection, meditation, collective solutions to societal problems...

Good, great! Then one wonders why it is you're spending all of your time advocating for forcing others to produce for others. Is that not called slavery, Lauren?

Sorry, but Abner's right: you speak in broad, pretty platitudes, but I am not seeing any kind of direction, purpose or definition to this line of "arguments". Because we're all interconnected (which is causally true but tautological and ergo intellectually irrelevant), we have a collective "fate"?

Lauren, simple question: are individuals (i.e. people, a person) sovereign entities to be treated as ends unto themselves?

Lauren|6.30.09 @ 8:06PM|#

It isn't really as much about force as you would like it to be - because that's easy to argue against. But having a public health care plan won't force people to be healthy, and incentives towards health only go so far.
What really does need to change, as I said before, is the habits of the individual - and there, you've got it all the way - individuals are sovereign entities. And yes, they "contract" out to the government when they sign up to become a citizen of a state (I'm a big fan of Rousseau).
Are individuals ends unto themselves? By that, are you asking me if a person has worth just by being a human, not because of what they can do? Yes, to me, that is true.

And, TAO,
just a simple request...
skip all of the puny little jabs at my character, intelligence or personality whatsoever, and stick to the debate - you would be sorely out of place in a real philosophical discussion.

The Angry Optimist|6.30.09 @ 8:20PM|#

ha, that's a good one. anyways...

What really does need to change, as I said before, is the habits of the individual - and there, you've got it all the way - individuals are sovereign entities.

If individuals are sovereign entities, how is it that you want to force them to change, at the point of a gun?

And yes, they "contract" out to the government when they sign up to become a citizen of a state

Does this mean that the state is permitted to do whatever it wants, whenever it wants, without limits?

Again, what, if any, are the limits that should be imposed on the state?

Are individuals ends unto themselves? By that, are you asking me if a person has worth just by being a human, not because of what they can do?

No, that's not what I am asking you. What I am asking you is how you can hold in your head the idea that people are sovereign individuals, ends unto themselves, and yet still advocate for their imprisonment if they fail to cooperate with a state-run scheme?

In other words, Lauren, by what right do you order around individuals, telling them what they can and cannot do? If I want to have a private health insurer, that should be my right. Conversely, you should not be able to force me to pay for your health insurance scheme.

I am an individual. The fruits of my labor are extensions of myself. When I voluntarily contract with another, that contract is between myself and that person.

Given that the lack of health care for the poor is not my fault, why do you want me to be forced to provide for it? I'm glad to donate my time, money and effort, but that's me doing that voluntarily. Why should I be forced to do it?

The Angry Optimist|6.30.09 @ 8:25PM|#

and a request, Lauren: the questions above really only require a few, on-point sentences affirming or denying the proposition. If you're unable (and I mean this as best I can) to stay on point without meandering into irrelevancies, I don't think debate is going to be possible.

Alice Bowie|6.30.09 @ 8:33PM|#

Hey Mr. Optimist,

I want to congratulate you on your personal success. It's a luxury to be a conservative or a libertarian...or whatever you call yourself.

You see no reason why you and others should help the poor. This is a sign that things are going very well for you financial and health wise. Good for you...and I hope you have a good run.

I hope you, or any of your children, never need the help of the masses...who probabaly share your opininon...until their child comes down with cancer.

But, best of luck to you, and all of the other conservatives/libertarians that are doing very well and require nobodies help.

Perhaps someday you c an live in a world were you keep every penny you make and not need to give to the poor, the sick, and the unable.

The Angry Optimist|6.30.09 @ 8:35PM|#

Hey, Alice, learn the difference between voluntary donations and force ones.

|6.30.09 @ 8:45PM|#

Lauren, the fact is our rights as Americans doesn't come from the fact that we 'made them up.' In fact, our founding documents are pretty clear that we have the rights we do merely through existing... that these were given to us at birth. You seem to claim that 'society' gave these rights to us... well if society gave them to me, then society can take them away, and then they're not inalienable rights, are they?

As someone stated earlier, a right cannot be claimed if it causes an obligation on the part of someone else. This is indentured servitude, and last time I checked was outlawed by the 13th amendment.

I want my rights enforced only such that the government cannot prevent me from having those rights, (e.g. speech, right to face my accuser, undue search & seizure, trial by jury) as is so often the case in human history. If you read much of the Constitution, it's a list of things the Congress and the government are not allowed to do.

You claim that your moral direction comes from the "natural direction of life and existence". Well unfortunately, sister, not all of us think that's where our moral compass comes from. We think murder is wrong because it violates a man's birthright to exist (life, liberty, pursuit of happiness and all that), not because of interconnectivity. Some of us may not want to move in the same "natural direction" you are, and we like being able to live free.

|6.30.09 @ 8:48PM|#

Alice, most conservatives and libertarians believe in helping the poor and the needy. In fact, I contribute often to help the poor through my local church, and various charities I support.

The difference is we don't think government with it's police power, should force us to be compassionate. Many of us are of our own accord.

|6.30.09 @ 8:52PM|#

You see no reason why you and others should help the poor.

I think a lot of us see plenty of reason to help the poor. I give quite a bit to various organizations that I believe can help humanity as a whole. I also think it's wrong to force someone to do so. I believe people are a little more altruistic that you seem to think.

|6.30.09 @ 8:59PM|#

The difference is we don't think government with it's police power, should force us to be compassionate

I like the way this is stated, and I think this is one of the largest roots for the more succesful or wealthy feeling bitterness against the less fortunate. I got pissed last year when I saw my W2. There was a $30,000 difference between what I made and what I took home. I could have done a lot with that money. The instant (and stronger) reaction is anger, not compassion, and that's the reaction that tends to linger.

Lauren|6.30.09 @ 9:09PM|#

"If individuals are sovereign entities, how is it that you want to force them to change, at the point of a gun?"
- I don't want to force anyone to change, clearly that is impossible. People need to change, this is true, and they need to do it on their own - this is true as well. Having a public option available only gives us more options - like building a federal post office next to a UPS store. It will, if anything increase competition and decrease costs, and there is no evidence in any other country that it will dissolve the private insurance companies. So I hope that explains why I don't think force is a part of what I'm arguing for - mentioning the gun was just an added affect, so much for a "few on-point sentences."

"Does this mean that the state is permitted to do whatever it wants, whenever it wants, without limits?"
- No, clearly, when I mention the word "accountability," I'm talking about the state being answerable to the public on policy and services. Theoretically, this keeps corruption in check, especially the MORE involved we are, rather than the less.

"what, if any, are the limits that should be imposed on the state?"
- This is a matter of democracy, and political debate. But, certainly there should be more limits on the state than on the individual. The state should be answerable to the public, and should have interest in the public good, and so on - I like the idea of a social contract, here.

"What I am asking you is how you can hold in your head the idea that people are sovereign individuals, ends unto themselves, and yet still advocate for their imprisonment if they fail to cooperate with a state-run scheme?"
- "ends unto themselves" remains unexplained. "fail to cooperate" must refer to a failure to pay taxes, since a public option would increase taxes, but would not mandate that you be a part of the public option. This is one thing I don't like about Obama's plan, actually, is the mandatory coverage - I would rather simply have a free public health care system that was paid for in taxes, and not have a form of "government insurance." But such are the dreams of an idealist...

"In other words, Lauren, by what right do you order around individuals, telling them what they can and cannot do?"
- This goes back to the social contract. When you enter the contract with the state, there are certain things you give up the right to do, or you will be imprisoned - for instance, because you live here, you no longer have the right to carry a gun into a school. That is a law because it was considered in the public interest. I find nothing wrong with government intervention here, or in other places. It is part of the balance. We, theoretically, control the direction of our country. Maybe when someone you like becomes president, he will repeal that law, who knows.

"I am an individual. The fruits of my labor are extensions of myself. When I voluntarily contract with another, that contract is between myself and that person."
- You have voluntarily entered a contract with this country. When this country passes legislation, you have every right to protest, to write to your legislators, and so on. Unless you are one of those people who thinks that the legitimacy of government has completely disappeared.

"Given that the lack of health care for the poor is not my fault, why do you want me to be forced to provide for it? I'm glad to donate my time, money and effort, but that's me doing that voluntarily. Why should I be forced to do it?"
- This sounds like the argument my pot smoker friends use, somewhat. If the state you voluntarily submitted to in the first place passes legislation, you have lots of avenues you can use to try and oppose it. This is still quite a free country, and having traveled the world I can say that with an experienced certainty, instead of an idealistic fantasy.

Alice Bowie|6.30.09 @ 9:13PM|#

most conservatives and libertarians believe in helping the poor and the needy. In fact, I contribute often to help the poor through my local church, and various charities I support.


Nothing further from the truth. It's clear to see from every Conservative/Libertarian effort since Ronald Reagan to eliminate everything from the poor including access to medicine, education, housing, etc. etc.

And for what? To give to the BIG guys to that the regular guy (who happens to have a sick child or is sick himself) has to depend on their charity...whatever it may be.

I can clearly see how charitable the conservatives/libertarians are. You people believe that people should fend for themselves. And, if you don't have the money, then go hang yourself.

Like i said earlier, that compassionate-conservative is great for people as long as things are going well. And best of luck to all of you. I hope your lives are full of richness and good health.

Jordan|6.30.09 @ 9:14PM|#

Having a public option available only gives us more options - like building a federal post office next to a UPS store.

No, it doesn't. The money to fund a public option has to come from someone who could have otherwise have spent it on something else that they value.

o I hope that explains why I don't think force is a part of what I'm arguing for - mentioning the gun was just an added affect, so much for a "few on-point sentences."

Unless you're advocating that the public option be funded voluntarily, then yes you are advocating for the use of force.

Alice Bowie|6.30.09 @ 9:16PM|#

believe people are a little more altruistic that you seem to think.


Look at Mexico. Look at Latin America and all of the other countries (like india) where the wealthy are not required to contribute to education and health. Yea, Yea, Yea...U have a mother-theresa here, and there, giving out boiled water with spit in it.

If people weren't forced to accept black people in the front of the bus...it would have NEVER happened.

Lauren|6.30.09 @ 9:17PM|#

thew83 -

"The instant (and stronger) reaction is anger, not compassion, and that's the reaction that tends to linger."

I think this is a huge part of the overall problem of discussing health care reform. We often see the immediate effects, such as increased taxes, and our long-view telescopes do not see the long-term benefits of these taxes. Gradual improvement in health infrastructure is hard to measure, and would take a long time to report the beginnings of notable change.
This short-sightedness often causes us to make errors in judgment of value - Dan Gilbert does an excellent presentation on this at TED, highly worth watching if you like psychology at all:

http://www.ted.com/talks/lang/eng/dan_gilbert_researches_happiness.html

|6.30.09 @ 9:19PM|#

Nothing further from the truth. It's clear to see from every Conservative/Libertarian effort since Ronald Reagan to eliminate everything from the poor including access to medicine, education, housing, etc. etc.

Actually this has more to do with corruption and the horrible inneffectiveness of government programs than idealism. And the left is just as corrupt and ineffective as the right so don't expect anything to get any better if socialized healthcare gets through.

|6.30.09 @ 9:27PM|#

I'm sorry Alice, I wasn't aware you took a look at my tax return this year and had a chance to take a look at how much I gave to charities. Want to talk about compassion? How about the vice-president of the United States, who makes FAR more than I did last year, but contributed FAR less in charitable contributions. Here's a story from September 2008 to show how compassionate Mr. Biden is:

http://www.usatoday.com/news/politics/election2008/2008-09-12-biden-financial_N.htm

The fact is that I don't want the government telling me I have to give to the poor. You know why? Because I think they do a pretty shitty job of taking care of the poor. So I'd rather put my money somewhere that I can see that it's being put to good use. Unfortunately most of our tax dollars get lost in the giant bureaucracy vacuum.

Just because we don't want the almighty government to demand us to be charitable, doesn't mean we don't care. We just believe that we can do a better job ourselves. Obviously you believe the opposite. I'm sure the Treasury Department will be awaiting a monthly check from you to help fund their programs, on top of your taxes.

Alice Bowie|6.30.09 @ 9:43PM|#

Look. I'd rather not give money to arm Israel, Sierra Leon, South Korea, etc. etc. etc. One may call me in-compassionate since I'm not willing to give money to my fellow jew, my fellow negro, or my fellow china-man to kill other people....Especially people that are trying to kill them.

Unfortunately, we were born into a world were we, as a community, contribute for the upkeep of the roads, the infrastructure, the general welfare of the poor and the retired, and of course the various wars we sponsor throughout the world.

Can we really change any of that. I just wish people were more motivated to STOP the government from selling machinery to IRAQ that kills people and burns them beyond recognition. And by the way, the people that are getting killed and burned beyond recognition is OUR YOUNG MEN and WOMEN.

You, so called compassionate-conservatives, are more alarmed about giving to the poor than giving our top-secret technologies to our 'friends-today...enemies-tomorrow' crew.

I know a lot of people would rather live in a world where there are NO taxes and we pay to drive down the street to the private owner of the street, carry our own machine guns so that we don't have to pay taxes to support the police department, and are completely capable of putting out you own fires...fine!!!

Nonetheless, it's a silly fantasy...and we're never going to change the system.

Peter|6.30.09 @ 10:06PM|#

Nonetheless, it's a silly fantasy...and we're never going to change the system.

So the direction I want the country to go in is a "silly fantasy" and yet your direction has to be enacted by law in order to make sure the system is changed?

Lauren|6.30.09 @ 10:08PM|#

Peter,
You think people would be nice and charitable to each other without rule of law in a society?
I'm assuming this means you're anarchist, at least somewhat.

|6.30.09 @ 10:09PM|#

You, so called compassionate-conservatives, are more alarmed about giving to the poor than giving our top-secret technologies to our 'friends-today...enemies-tomorrow' crew.

I'm not conservative, and not necessarily. That just happens not to be the topic of this thread.

My previous post failed to show up. I basically stated one of the types of charities I contribute to is education so that people in poorer more subjugated countries can have the knowledge required to pull themselves up by their own bootstraps, and that I think we eventually would have allowed black people into our fold and that the forcing more than likely caused some violence, and that I'd look at Lauren's vid but I lay the blame of the healthcare debacle on regulated and employer provided health care.

Lauren|6.30.09 @ 10:12PM|#

The "vid" wasn't about health care, it was about the way our brains tend to mis-interpret real quality and value - time distorts, as well as other things. It's interesting - again, if you like psychology.

Peter|6.30.09 @ 10:15PM|#

You think people would be nice and charitable to each other without rule of law in a society?
I'm assuming this means you're anarchist, at least somewhat.

You know what they say about assumptions...

Why is it that you want the government to charitable to the people who need help?

|6.30.09 @ 10:17PM|#

Lauren: I'm aware of that and I'm sorry I wasn't very clear. The thread in general is about gov't provided health care and I was using what I perceive to be true about people to argue that people would rather choose to help than be forced. I had assumed that the vid had something to do with that.

The Angry Optimist|6.30.09 @ 10:20PM|#

Lauren - what determines when a state has lost its legitimacy?

Lauren|6.30.09 @ 10:20PM|#

Well, at least we're all open about our assumptions. That's a step forward in conversational code, especially online. We're getting clearer about this, and I hope I'm starting to understand the free-market side a bit more.

Why, Peter, do I want government to be "charitable." Because I see a public option as more beneficial to the production and evolution of our society than a competitive, private insurance system would be. That, to me, is not charity, it is more like self-interest. It is reasonable.

Lauren|6.30.09 @ 10:23PM|#

Oo, when does a state lose it's legitimacy? That depends on the conditions set when it was founded, which determine it's functions. Our system is very fluid, in that it was built to adapt to unforeseen developments in our culture, infrastructure, economy.
So, in terms of the US, our legitimacy would be measured by the efficiency of certain public services, systems, structures - the three branches, the voting method, the enactment of legislation... many different levels of potential legitimacy or corruption.
For you, TAO, what determines when a state loses it's legitimacy? I'm sure you have a much more exact answer than I did.

|6.30.09 @ 10:26PM|#

Wow. According to this guy I'm wierd. I got the r-word question correct.

Jordan|6.30.09 @ 10:30PM|#

Because I see a public option as more beneficial to the production and evolution of our society than a competitive, private insurance system would be. That, to me, is not charity, it is more like self-interest. It is reasonable.

"The ends justify the means" is not reasonable. Many horrendous policies have been and can be justified on the basis of utilitarian considerations.

Lauren|6.30.09 @ 10:35PM|#

I agree, I am not trying to be utilitarian, I think the means are important as well. I see no problem with government run health, I've experienced it in other countries and had the best health care experience of my life. There is no reason for me to believe that this policy would be, as you say, "horrendous."

|6.30.09 @ 10:37PM|#

"You have voluntarily entered a contract with this country."

When? Seriously, what day and at what time did you enter into a contract with this country? Can you post a copy of the signed and duly notarized document on line. We'd all love to see one of those.

I'll confess to having a deep and abiding affection for this country and all the times I've been away I have thought about when I might return.

But any thought that this country loved me disappeared when the President decided he had a ticket to a certain southeast asian country waiting for me if I came home. Having come to the conclusion that the particular enterprise he was promoting was particularly pointless I decided to decline his offer and delayed my return until that particular idiocy was over.Perhaps this was when I was supposed to sign my "contract".

Some of my friends didn't have my option and their tickets turned out to be one-way.

Sorry, I never saw any "agreement" that my life belonged to any all that demanded a piece of it. And if it had been offered to me I'd have politely declined it.

If this is not clear enough, so be it. I'll not try to explain it further. If you think your life belongs to every loser around, fine, give it. But as far as I can tell you don't have anything to offer.

Perhaps that's why you demand so much.

Oh, also, go fuck yourself, Alice Bowie. Your incoherent babblings are really fucking annoying.

|6.30.09 @ 10:39PM|#

I see no problem with government run health

I was in the Navy for 6 years, believe me, our government has an enormous capacity for fraud, waste, abuse, and general inefficiency.

Jordan|6.30.09 @ 10:40PM|#

I agree, I am not trying to be utilitarian, I think the means are important as well. I see no problem with government run health, I've experienced it in other countries and had the best health care experience of my life. There is no reason for me to believe that this policy would be, as you say, "horrendous."

Uh, you're confusing the end with the means.

The Angry Optimist|6.30.09 @ 10:40PM|#

I see a public option as more beneficial to the production and evolution of our society

*sigh* what does that even mean?

For you, TAO, what determines when a state loses it's legitimacy?

when it ceases to act as an agent to secure negative rights and becomes a Hobbesian war of all against all. and government-run health care is just another step in that direction.

Lauren, let's say that I smoke, and that we are under a government-run health plan. Are you going to deny me treatment because of my smoking?

What if I am overweight?

What if I don't exercise?

The fact is, is that when you make health care government-run, it becomes a war of everyone versus everyone. It's the opposite of civilization. Now I have a vested, selfish interest in making sure you aren't making poor decisions, because I have to pay for them, and vice versa. Now everyone is in everybody else's business.

The Angry Optimist|6.30.09 @ 10:43PM|#

I am not trying to be utilitarian

Yes, you are. you have appealed to other countries' "working" health care systems.

Do you know why those other countries' health care systems have the luxury of working? Because the "Atlas" of the United States medical industry is carrying them. Our relatively free system of medical care is what fosters the massive leaps forward in technology, and then other nations free-ride off our willingness to experiment.

Lauren|6.30.09 @ 10:44PM|#

Well, if you have high risk or poor health, private companies may not insure you, or may cancel your claim and then drop you right when you needed them, so I fail to see right away your point about "what if...", certainly a government plan is meant to catch everyone, as I've said before, so yea, it would cover you if you smoked.
I don't understand the "war of everyone vs. everyone," in fact that sounds like your describing capitalism and competition, unless you would perhaps explain further?

And Jordan, you're right, I forgot, it's the money you guys care about. Money would be the "means," right?

Peter|6.30.09 @ 10:45PM|#

Why, Peter, do I want government to be "charitable." Because I see a public option as more beneficial to the production and evolution of our society than a competitive, private insurance system would be. That, to me, is not charity, it is more like self-interest. It is reasonable.

First of all it isn't reasonable to compare private industry vs. government run in a bubble. It also it's reasonable to believe that government run would win a) without any proof and b) despite all the previous circumstances that show the opposite.

You claim that we need better medicine and education but who will fund that? The government? Then we will have to pay taxes for research, insurance, and healthcare individually, with all of them going through bureaucracy, how will this be better than the single high cost of private insurance?

|6.30.09 @ 10:49PM|#

Lauren - In a real free market insurers that drop people would develop a reputation for doing so and loose customers.

The Angry Optimist|6.30.09 @ 10:51PM|#

no, Lauren, capitalism is the free trading, the voluntary contracting of one consenting individual with another. Nobody is forced to do anything they have no desire to do.

In government-run health care, you are going to foster resentment. In your response above, you said "of course the smoker will be covered!" Do you think people are going to stand for that? Do you really believe that people are going to want a cautious gym bunny with a good diet to pay for the health care of a reckless steeplejack? Or shark hunter?

See, in the private system, the shark hunter, the smoker, the overweight, they pay more for their choices without imposing those costs on everybody else, because the market provides for different pricing systems for people according to risk.

If you just say "Oh boy! Now everyone's covered!" you're creating resentment. You're forcing people to subsidize the lifestyle choices of other people. Why shouldn't I overeat? I can just get the government to pay for my bariatric surgery! Why shouldn't I smoke? I can just get the government to pay for my lung transplant!

Competition is, no lie, generally unforgiving and does favor those who can compete, which is kind of the purpose. But the government has the unique ability to force you to pay for other people's choices.

Peter|6.30.09 @ 10:51PM|#

And Jordan, you're right, I forgot, it's the money you guys care about. Money would be the "means," right?

And what is it that you care about? If you offer a bill of free healthcare with no government funding (i.e. taxpayer funding) that will take care of everyone who falls through the cracks then I don't see why anyone would have a problem with that, mostly because that is impossible. The only reason you want the government to supply the care is to take the money from taxpayers and give it to everyone else who is in a less fortunate circumstance, even if that is at their own fault.

The Angry Optimist|6.30.09 @ 10:56PM|#

yes, I am not understanding how it is somehow bad or heartless to consider cost when you're talking about government programs. Do you think that money just comes from nowhere? That you can just tax and tax and spend and there will be no negative repercussions?

Libertarians are not concerned about the cost of things because we're selfish beasts. We're concerned about it because, fundamentally, when you make people work for no compensation, that's just a little bit more slavery added to the system. Hence, you should avoid transfer payments (welfare, corporate welfare, health care) and furnish only public goods (roads, military, police and fire), because public goods represent the least expensive and least imposing government enslavement.

Peter|6.30.09 @ 10:58PM|#

Lauren, would you support government care paying for me to permanently alter my skin pigment so that I can receive more benefit from minority sponsoring programs?

|6.30.09 @ 11:03PM|#

Lauren, would you support government care paying for me to permanently alter my skin pigment so that I can receive more benefit from minority sponsoring programs?

Yea colloidal silver!
Blue people will prevail!

Lauren|6.30.09 @ 11:07PM|#

Some public goods, TAO, are expensive. Especially when there are many sick Americans.
It's true that people's bad habits make them smokers, or overweight, and that we often pay in our taxes for these decisions already. But, I don't think we can exempt our society from fault of these behaviors. We have a culture that fosters behavior like smoking, drinking, and eating a lot. Want to know something about capitalism and fast food? It isn't enough for McDonalds to just sell the same amount of food each year - they have to increase their growth *rate* - that makes it an exponential growth. But because it became hard to get people to buy two fries, for instance, they created "Supersize" options, which meant that people could just buy more food with one purchase instead of purchasing two of the same size. It was back in the 80s when it began, and since then the amount of food they sell per year, and their profits, rise exponentially. For McD's and every other private company, to grow at an increasing rate is the goal. With this trend of unhealthy food, and other social changes like suburban sprawl, we walk less, exercise less, and on and on.
While government cannot do much about these habits, I do think that, if you accept the affects of society upon the individual in these contexts, society has a responsibility for the state of health of the nation. And with that in mind, I see no reason to complain so vigorously about paying to take care of people. If we also concentrate on prevention medicine and healthy habits for communities, we can start spiraling up instead of down in health quality.
I understand the real value of money, but I place the value of good health above the value of money - it is worth it, to me, to have higher taxes in trade for this basic service.
Also, I think that a government plan, if it is non-profit, would give better service than a for-profit plan, because there would be an assurance that decisions (for instance to have an expensive test) will be made in interest of the patient, not in interest of money.
It's interesting to note, from these replies, how important money is to many of you. I understand what it is to be with and without money, but I've never understood the incredible amount of value we place upon it as a source of happiness.

The Angry Optimist|6.30.09 @ 11:13PM|#

Some public goods, TAO, are expensive. Especially when there are many sick Americans.

look, your post above, where you demonstrate you don't know what a public good is...

A long meandering post blaming McDonald's for the choices people make to eat there?

And this?

It's interesting to note, from these replies, how important money is to many of you. I understand what it is to be with and without money, but I've never understood the incredible amount of value we place upon it as a source of happiness.

you're not even putting our arguments in any good-faith kind of light.

you're absolutely hopeless.

sorry. conversation over.

Peter|6.30.09 @ 11:16PM|#

With this trend of unhealthy food, and other social changes like suburban sprawl, we walk less, exercise less, and on and on.
While government cannot do much about these habits...

But the individuals can, which is why we should foster individual thinking and not pick and choose what industries are "bad" and then fight them through the government. If people wanted to eat healthy, would McDonald's still supersize their fries? Burger King has apple dippers for kids meals now (McDonald's might as well), if these innovations were purchased more frequently you can bet you would see a lot more health food instead of burgers and fries.

I understand the real value of money, but I place the value of good health above the value of money - it is worth it, to me, to have higher taxes in trade for this basic service.


If health is worth more than money then why are you against exchanging money directly for healthcare? Why would you want to send that money through a bureaucracy so that the power of that money is ultimately diluted and gives you less healthcare?

Meaningless Phrases|6.30.09 @ 11:17PM|#

if you accept the affects of society upon the individual in these contexts, society has a responsibility for the state of health of the nation

We have a culture that fosters behavior like smoking, drinking, and eating a lot.

Oo, when does a state lose it's legitimacy? That depends on the conditions set when it was founded, which determine it's functions. Our system is very fluid, in that it was built to adapt to unforeseen developments in our culture, infrastructure, economy.

you really don't have anything all that interesting to say.

The Angry Optimist|6.30.09 @ 11:22PM|#

Peter, just let it go, brosephus. every response is going to be a vacuous platitude.

Lauren|6.30.09 @ 11:24PM|#

Peter, actually I think that's not a bad idea, to get rid of any kind of middle negotiation and return to direct patient-doctor system would be, well, idealistic - but it's definitely worth considering. Too bad no one will seriously consider it.

TAO.. disappointing response. My point about "blaming McDonalds" was just to show the subtle nature of societal influence... I guess that was a little too subtle for you to fully understand.
And, I'm honestly *trying* to put your arguments in a "good-faith kind of light," but it's difficult when your repetitive response is to criticize the cost, and the government as a whole, and in defense of a public option there are so many good reasons for it (that you should already know about, if you're at all concerned with the issue,) that completely outweigh the cost.

You can end the conversation as negative as you'd like, but I suspect you're just tired and going to bed, and didn't want to concede retreat so easily, so instead you mustered up some lame insults, non-responses, and dipped away.
Disappointing.. my friend told me the Reason blogs would be more worthwhile for engaged debate about shit than this has turned out to be..

Jordan|6.30.09 @ 11:54PM|#

It's interesting to note, from these replies, how important money is to many of you. I understand what it is to be with and without money, but I've never understood the incredible amount of value we place upon it as a source of happiness.

We're talking about liberty, not money. Until you figure out the difference, TAO was right to walk away. He nailed it, but his points sailed right over your head.

[...]was just to show the subtle nature of societal influence...

What does this even mean?

The Angry Optimist|7.1.09 @ 12:05AM|#

nope, Lauren, still here. Just telling you that you're not worth engaging. This is just one example of what I'm talking about:

I'm honestly *trying* to put your arguments in a "good-faith kind of light," but it's difficult when your repetitive response is to criticize the cost, and the government as a whole, and in defense of a public option there are so many good reasons for it (that you should already know about, if you're at all concerned with the issue,) that completely outweigh the cost

See, you've already arrived at your decision despite any argumentation from anybody about the subject. you said yourself that benefits > costs, and that's the end of the subject, so case closed.

So you really aren't arguing in good faith at all. I've watched you do it. you basically say "oh, I get that you're concerned about freedom, but [insert argument about why that concern isn't important at all]". It's an old tactic to claim that the opposing side's POV matters and then summarily dismiss it, and it's a dishonest and condescending one to boot. Another example: I told you that the concern isn't the money, it's what the costs mean for liberty. Still, you ignored it.

Anyway, I'm still up and here, and I'm going to encourage people to stay away from you if and when you manage to argue coherently and logically.

The Angry Optimist|7.1.09 @ 12:08AM|#

*until you manage

The Angry Optimist|7.1.09 @ 12:11AM|#

just as a last minute shot-in-the-dark, Lauren, here's what we want:

- A clearly defined thesis (i.e. "We should have a public health option because...)
- Willingness to define what it is you feel government should do and what it should not do
- Why public health care is one of those things government should do
- Arguments in favor through comparison, using numbers, statistics and logical argumentation

Present a syllogism. Give me an "If A, then B, ergo C" kind of argument.

|7.1.09 @ 12:23AM|#

Lauren, what sort of work do you do? How would you feel about the government mandating that you do it for free?

I find it ironic that the people who think health care should be "free" -- so they can save money -- then turn around and accuse libertarians of being "obsessed with money" because *gasp* we think people should pay for only as much health care as they actually consume!

Peter|7.1.09 @ 12:33AM|#

Disappointing.. my friend told me the Reason blogs would be more worthwhile for engaged debate about shit than this has turned out to be..

Hmmm, this wouldn't be you slinking off to bed without conceding would it? The same thing you accused TAO of? No, you would do that...except that you haven't posted in about an hour so that seems to be the only answer.

Peter, actually I think that's not a bad idea, to get rid of any kind of middle negotiation and return to direct patient-doctor system would be, well, idealistic - but it's definitely worth considering. Too bad no one will seriously consider it.

Incase you come back...go here.

|7.1.09 @ 12:37AM|#

Has she gone? Dammit, I wanted to know if she still has the a copy of the contract she signed agreeing to be society's bitch.

The Angry Optimist|7.1.09 @ 12:43AM|#

well, see Isaac, Mickey D's increased its profits, and we all agreed to expand the suburbs. This led to a more sickly community, but because it was "society" that demanded Supersizing and suburbs, IT'S ALL OUR FAULT AND WE GOTTA PAY.

Duh.

alan|7.1.09 @ 2:32AM|#

If you think your life belongs to every loser around, fine, give it. But as far as I can tell you don't have anything to offer.

Butted heads with you a few times in the past, but, damn, that was brilliant, as was that entire post, and honest to the core.

|7.1.09 @ 4:03AM|#

What bothers me about Snowe's proposal is the implicit embrace of the idea of "insurance" being equal to "access to health care." We need a country where you can get health care -- excellent health care for prevention, routine problems, and even common emergencies -- WITHOUT INSURANCE, and without breaking the bank. When the metric for success is that the segment of the population WITH INSURANCE has increased, we will be going the wrong way, solving the wrong problem! The proper metric is the number of people who have access to adequate health care. This access could come through "insurance," but it could also come, for example, through paying out-of-pocket, or because some health care providers perform pro bono, or in exchange for compensation provided by a charitable fund. The number of people who are signed up with some "insurance" or "health plan" is both a bogus metric; is increase a counterproductive goal.

|7.1.09 @ 4:10AM|#

xxx The number of people who are signed up with some "insurance" or "health plan" is a bogus metric; its increase a counterproductive goal.


----


Sorry, got distracted there at the last offline and hit ENTER before final edits...

Lauren|7.1.09 @ 11:38AM|#

:sigh: If you really think you understood nothing of what I said, then I will attempt to follow your little guidelines for my theories. DISCLAIMER: These are theories, completely subject to criticism, whereas my character is not.

1. A clearly defined thesis (i.e. "We should have a public health option because...)
There are many reasons. One is that I think the majority public opinion should sway this country most times (not all). About 3/4 of the country, depending on the poll you see, wants a public plan. Another: costs in this country are out of control, and it's hard to determine why, but it's necessary to bring them down - we pay twice as much as the rest of the world, and we get back low-quality health care, as compared to these same countries paying half as much as us. I have traveled quite a bit, and I have seen the direct effects of a communist country and of universal health care, and I can observe the effects of the only more-free market than the US - Hong Kong, where the rich-poor distribution is so great. In all of my experience, there is not one example in the rest of the world that says that free-markets will help those in our country who cannot afford even cheap medicine, and no reason to believe that a government plan would dissolve private insurance - when you have some concrete examples, though, in the past, of the success of pure-free-markets, or the failure of private insurance in the wake of a gov't plan... do link me, please.

2. Willingness to define what it is you feel government should do and what it should not do
- I thought we got here with that bit about legitimacy, but this is a very long and difficult thing you ask. I cannot write up a Constitution of "should"s for you on a blog post - keep your requests limited to health care, maybe? Perhaps YOU should define what you think gov't should NOT do - how about public schools - no? Every single person should save up and pay for it themselves as well?

3. Why public health care is one of those things government should do
- This is a repetition of the first question - see above for the answer.

4. Arguments in favor through comparison, using numbers, statistics and logical argumentation
- Okay, yea, I figured I should get some stats for you guys, the TED talks weren't enough - though I hope you watched those, that website is really a gem of the Internet.
Here is a great study about the costs in the US, their correlation with GDP (our GDP suggests our costs should be about 40% lower), and this paper suggests that the rise of chronic diseases, such as obesity, are a big cause - remember me saying that earlier?:
http://www.commonwealthfund.org/Content/Publications/In-the-Literature/2008/Jul/Health-Spending-in-OECD-Countries-in-2004--An-Update.aspx

I'm sure you've already looked at the WHO statistical info, but in case you haven't...:
http://www.photius.com/rankings/healthranks.html - this is our overall rank, we're at 37
http://www.photius.com/rankings/healthy_life_table2.html - life expectancy, down at 24
http://www.photius.com/rankings/total_health_expenditure_as_pecent_of_gdp_2000_to_2005.html - health expenditure, very interesting

some obesity statistics:
http://www.annecollins.com/obesity/statistics-obesity.htm

Since you might not be very informed on the concept of "public health" as a whole, and its more community focus instead of individual focus.. you may learn something from this website:
http://www.whatispublichealth.org/what/index.html#Policy

Need more? Just let me know what information you want.

Also, I've noticed that most people here seem to think we will have LESS choices if we add the public option - this seems contradictory to me, if we assume that in at least the first 5 years or decade, private and public will compete, and judging based on the rest of the world, they will continue to do so beyond that. How is this an example of less choices?

Lauren|7.1.09 @ 11:48AM|#

This is a great study highlighting four big reasons to support public health - for your sake, I'll list them, and you can read it if you want.

1. Reducing premiums for everyone - the cost of providing health care for people without insurance reappears as a hidden tax - we all pay the price in higher medical bills and higher insurance premiums (which I, personally, cannot afford).

2. Promoting a healthy and productive workforce. - if more workers are covered by insurance and have access to health care, they will be more productive, more people will be able to work, and our economy will be stronger.

3. Slowing the growth in health care spending and meeting public goals - if everyone is in the health care system, health conditions can be monitored and treated early and easily before they become expensive problems, and public health goals to increase healthy habits can be met.

4. Protecting Americans from public health threats and epidemics - these two things cannot be properly monitored and addressed when so many people are uninsured and delay seeking care. - This is a card I didn't pull yet, but it's another great reason to have a government system - in order to handle the chaos a potential epidemic could cause.

Lauren|7.1.09 @ 11:48AM|#

Oops - forgot the link:

http://www.familiesusa.org/assets/pdfs/health-reform/invest-in-coverage.pdf