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The landslide Republican victory, in taking the House and electing some strong conservatives to the Senate, can be interpreted as a mandate to rein in government spending, and specifically to repeal ObamaCare, as these issues were clearly behind the large turnout. There is still a very real possibility the Supreme Court will find the “individual mandate” to buy private insurance unconstitutional. If this provision is thrown out, it’s hard to see how the law survives, since the mandate is needed to finance it.
Now is an excellent time to construct a conservative alternative vision for true reform of our health care delivery system. Since most current problems with the health care system stem from government, a conservative plan should seek to reduce its role.
It goes without saying that the Patient Protection and Affordable Care Act must be repealed since, like all the laws passed by this administration, it does precisely the opposite of what its name suggests. By massively increasing the health care bureaucracy at the expense of actual providers of care, it will make care harder to access and more expensive. Many physicians will take early retirement and the already great physician shortage will be exacerbated.
The law is too large and complex to waste time foraging for items to salvage. There is a great risk of leaving behind hidden mandates and rules that will be harmful. Better to scrap the whole thing. With Democrat Senators running scared for their jobs in 2012, it is conceivable the Senate would also vote for repeal (Harry Reid notwithstanding). But not even the most generous view of Barack Obama’s ideological flexibility has him signing a repeal bill, and a veto override is out of the question for now.
It may be possible, however, to enact affirmative measures that make ObamaCare irrelevant. Here are some common sense, free market proposals, many of which were proposed and discussed, but ignored by the President and the Congressional leadership in the run-up to passage of ObamaCare.
1. Transfer the tax deduction for health care spending from employers to individuals. This would end the absurdity of purchasing health insurance at the “company store,” a practice that limits individual choice and liberty, nourishes a sense of dependency, and promotes overuse of care. This policy, an accident of WW II wage and price controls, was the “original sin” in health care financing; doing away with it would empower consumers to shop for the best plan for their families, which will lower premiums.
2. Remove barriers to the interstate sale of health insurance. There is broad agreement on this proposition. It would increase choice and competition between insurers and drive down premiums by effectively ending state mandates that drive them up.
3. Deregulate and allow greater contributions to Health Savings Accounts. These fabulous tax shelters give individuals more control over their health spending, and, coupled with an inexpensive policy to cover catastrophic illness (i.e., true insurance), are all most people need. By returning most health care purchasing decisions to consumers, spending will immediately be slowed and prices curbed. This is the conservative, free market, already tested and proven way to “bend the cost curve down.”
4. Follow the recommendations of the bipartisan Breaux Commission and give Medicare beneficiaries a means-tested stipend to buy private insurance. This solution came during the Clinton era but was too free-market to pass muster with Bill and Hillary. With Medicare moments from insolvency, there should again be a bipartisan consensus to reform this behemoth.
5. Transfer (gradually) all Medicaid responsibility to the states. Federal support for Medicaid allows much greater spending than would otherwise occur. It forces frugal states to subsidize lavish coverage in New York, California, and elsewhere. States should have complete freedom to organize their Medicaid systems along their own priorities, in exchange for losing, over perhaps five years, the federal subsidy. This would encourage states to find innovative ways of providing health insurance for the poor, such as individual health accounts, or subsidies to buy private insurance.
The latter two points would allow the mammoth Center for Medicare and Medicaid Services to be mothballed, though Medicare could retain a role as insurer of last resort for those with pre-existing, expensive, chronic diseases.
6. Institute a “loser pays” system for medical malpractice to cut frivolous lawsuits. The ability to launch a lawsuit (and this applies beyond medical malpractice) with minimal financial risk is the reason behind the explosion of malpractice litigation, with all the associated costs. Tort reform at the federal level would require the Senate to override the trial lawyers’ veto, which could be a problem. This reform should be pushed at the state level.
7. Finally, for true patient protection, let’s propose a constitutional amendment to guarantee the individual’s right to privately contract for medical care. This will eliminate for all time the threat to the private practice of medicine and assure that, no matter what system is in place, patients will always be allowed to spend their own money on care.
The above points are clear, simple and practical solutions. They empower the individual and greatly reduce malignant government influence and unburden the taxpayer. It is the conservative way forward on health care.
Richard Amerling, MD, is a nephrologist practicing in New York City. He is an Associate Professor of clinical medicine at Albert Einstein College of Medicine in New York, and the Director of Outpatient Dialysis at the Beth Israel Medical Center. Dr. Amerling studied medicine at the Catholic University of Louvain in Belgium, graduating cum laude in 1981. He completed a medical residency at the New York Hospital Queens and a nephrology fellowship at the Hospital of the University of Pennsylvania. He has written and lectured extensively on health care issues and is a Director of the Association of American Physicians and Surgeons. Dr. Amerling is the author of the Physicians’ Declaration of Independence (http://www.aapsonline.org/medicare/doi.htm).
Categories: Uncategorized
“The PPACA OOP limits are much higher than in Switzerland.”
Depends if your measuring the $ or the %. On a dollar basis you are right on a % basis I am correct.
“You really believe that?”
When your argument can’t stand up quack you resort to posting generalities no one can respond to? What part do you question? Rather people can sue insurance companies? It happens every day, or that people can change insurance companies, happens tens of thousands of times every first of the month. Thank you for the inteligent discourse.
TTT if your going to post try to stick to facts, no one wants to wste their time reading your 1990 gripes.
” them using it to bump off people who had pre-existing conditions”
This has been illegal for almopst two decades so you can shove that complaint not even addressing rather I was ok with it or not.
“something called a lifetime coverage cap.”
Let me educate you on insurance. Insurance is charging a premium to cover a risk. Most states require insurance companies have so much capital to cover claims, lets say 30% for argument sakes. What is 30% of infinity? It is also an infinit number. Now calculate a premium that is 120% of infinity divided by 12, how would you like to start paying that monthly?
Lifetime maximums were a financial insrtrument needed to reserve and calculate risk, reinsurance and the operaiton of the policies. the rationing done by death panels, comparitive effectivness or anythng else has nothing to do with lifetime limits. Does your life insurance policy have no limit? How about your home, auto and every other type of insurance you have ever seen?
If you don’t grasp the concept of freedom no sense me trying to explain it to you in a blog post. Communism will always be a comfortable home for people like you. If you want a government to dictate the terms and length of your life then move to such a country.
Every private insurance company already has a “death panel.” I don’t know why Nate is okay with them using it to bump off people who had pre-existing conditions or who reached something called a lifetime coverage cap. I also don’t know why the deaths they’ve already caused and continue to cause are less disturbing than the deaths government might cause if it enacted policies that it won’t actually enact because they aren’t in the legislation, but I’m sure it would make a fascinating yarn.
“I can change insurance companies within a matter of days in most cases and I can sue corporations when they do wrong.”
Now that is funny. You really believe that? Oh well.
LAUGHABLE
How generous the OWEbama crew is — as long it is NOT their money.
Always someone else’s fault. Ignore that Canadian provincial officials fly to the USA life-saving treatments. Ignore that OweBama role model Fidel has Harvard-trained surgeons fly in from Spain when he’s sick (got that, Fat Mike)?
See you in court, OWEbama. Fight your INCOMPETENCE, with our dying breaths.
LAUGHABLE
Howe generous the OWEbama crew is — as long it is NOT their money.
Always someone else’s fault. Ignore that Canadian provincial officials fly to the USA life-saving treatments. Ignore that OweBama role model Fidel has Harvard-trained surgeons fly in from Spain when he’s sick (got that, Fat Mike)?
See you in court, OWEbama. Fight your INCOMPETENCE, with our dying breaths.
“I can change insurance companies within a matter of days in most cases”
Not in 36 states if you are already sick.
“Paolo who is this strawman talking about lavish Medicaid benefits?”
These are the exact words from the “conservative” plan by Richard Amerlang (see point 5 at the top).
“Obamacare exacerbates this even more by capping OOP at artifically low amounts. Very anti-Swissish.”
Wrong again. The PPACA OOP limits are much higher than in Switzerland.
“I can change insurance companies within a matter of days in most cases”
Not in 36 states if you are already sick.
“Paolo who is this strawman talking about lavish Medicaid benefits?”
These are the exact words from the “conservative” plan by Richard Amerlang (see point 5 at the top).
“Obamacare exacerbates this even more by capping OOP at artifically low amounts. Very anti-Swissish.”
Wrong again. The PPACA OOP limits are much higher than in Switzerland.
I’m all for coping parts of Switzerland systems, for example we can start with people paying 30% of all healthcare out of pocket, that would solve all sorts of problems by its self. When our OOP spending went from 50% to 12% today has cauesd a large portion of our problems. Obamacare exacerbates this even more by capping OOP at artifically low amounts. Very anti-Swissish.
Before that we can start with the French model of people paying their doctor then getting reimbursed, assignment of benefits was another montrosity we need to get rid of.
Quack,
I can change insurance companies within a matter of days in most cases and I can sue corporations when they do wrong. Neither option is available when it is the government.
Paolo who is this strawman talking about lavish Medicaid benefits? Maybe you should have that conversation with them?
Medicaid is adequatly funded the problem is waste and fraud. If the program was properly and efficently ran we could deliver all the care to all the people that need it and do it for less then we spend today. Just as Education is adequatly funded and Medicare is adequatly funded the problem is none of them are adequatly administered or designed.
“And if you are truly concerned about spending/benefit restrictions in the exchanges, then look at places where these exchanges exist: Massachusetts, Switzerland, and the Netherlands (not the UK).”
Which one of those have planned spending billions on Comparitive Effectiveness studies and programs? Your argument lacks relavance, when those systems are allocating billions to vague rationing programs with no oversight then lets discuss how they operate.
PPACA does cap the tax deductiblity of certain care and make it more difficult to pre-tax other, sounds like a first step to me….
It’s ironic that the same people who complain about Medicaid’s “lavish benefits” will then complain when someone they know doesn’t get some benefit through Medicaid. I guess it’s only lavish when it’s for somebody you don’t know. If you are truly concerned about ALL Medicaid beneficiaries getting adequate care, then support adequate funding for it. In Massachusetts, bariatric surgery is covered by Medicaid.
And if you are truly concerned about the future of Medicaid, then either support equalizing Medicaid payments with Medicare (as suggested by Barry) or support the transferring of Medicaid members into the exchanges, both of which cost money.
And if you are truly concerned about spending/benefit restrictions in the exchanges, then look at places where these exchanges exist: Massachusetts, Switzerland, and the Netherlands (not the UK). There is no upper limit to the benefits people can purchase with their own money. There is no limit in the PPACA either.
Hmmm…so it is OK when an insurance company “plays God” but not when the government does? The government is accountable in some small way to the voters. The corporation is accountable only to its board and a few major stockholders. I’ll take the government, thank you.
Here is a real world example to consider, lap band surgery. Medicaid won’t cover it, plans subject to Ohio State regualtion wont. The employee has tried everything, they medically can’t lose weight. If this was 2014 and they were no in the exchange and the exchange said it is not allowed and to protect against people paying for it themself they won’t cover complications or any care after someone has one then this person would have no way of getting the surgery.
Since this group is about to be self funded we can step back and look at the big picture. They are on a fist full of meds because of their weight, they have a good support system, they follow care protocals, they are an ideal canidate to try it. Long term it makes economic sense to pay for the surgery. Its going to kill this years budget but that shouldn’t be the deciding factor. When government controls healthcare these decisions become financial not medical no matter how much medical justification they come up with to put behind it.
The problem is not comparitive effectivness or even rationing. They are both needed. The problem is when an entity that is responsible for paying for 50% or 100% of care is the one undertaking these endeavers. When Waswhington is presented with a budget crisis and needs to save 100 billion would you trust your life with them making the right decision?
When Medicare has been over budget for the past 40 years has washington attached fraud, abuse, and inefficnecy? No, they cut reimbursements for good care and bad care.
When schools are short of money do they reduce excessive pensions or administrator salaries? No they increase class size or eliminate sports or put off buying new books.
Liverpool Care Pathways was never written up as a law or voted on in the UK. It was developed by a single institution, Beurcrats saw that it could save money and expnaded it across the NHS system. The puiblic never had an opportunity to comment on let alone oppose the new policies.
Now look what is bveing pushed here in the US;
Government currently pays for 50% of care and as of 2014 is pushing that to 75-80%.
Government already has the ability to dictate via public plans how care is delivered and even what care is allowed. When they take over private insurance via the exchanges they will have the ability to disctate to the entire system, opting out of Medicare and Medicaid will no longer get you out from under government direction. There will be no where else to do but underground and back alley medicine.
The government is setting up panels and organizations that are not answerable or even transparent to the public to start determining what is effective.
This is almost the exact same path that LCP took. People like you and rbar want to mock Palin and anyone that is concerned about the ability of these non accountable organization to come up with care mandates we don’t agree with and implement them across the system with no public scrutiny or input or option to opt out.
What about the above is not true or a possibility? Why do we not have a right to be concerned this could happen here? When people attack us for wanting to discuss it with smear and troll labels shouldn’t that make us even more concerned?
In 2014 what prevents the government from deciding the care you need is not covered and not allowed to be delivered by a provider accepting public payment, now 75% of all care?
Nate, since I have hope for everybody, I will try to answer your questions.
“Germany has a Fee for service system, if we pass a bill based on global reimbursements why would we be discussing the German model as a comparison?”
The bill authorizes experimentation with global payments. It is not “based” on it. If you ask me, I have no objection to fee for service.
Comparative Effectiveness – You wrote here many times about your work and how you help employees use generics instead of brand name meds. This is a form of comparative effectiveness. I don’t think you will object to using cheap drug therapy instead of expensive invasive procedures, if the outcomes are comparable. So you cannot be opposed to comparing effectiveness of various courses of treatments and all things being equal, pick the cheapest one.
If you are talking about all that QALY stuff, I am as opposed to it as you are, if you indeed are. If memory serves, I think you agreed here with not having others pay for “excessive” measures at the end of life. So you are more CER oriented than I am.
“When did I ever claim everything would end up just like the NHS?”
Several lines above the question. Reread your comment.
“I assume rbar and Margalit don’t want death panels in the US….you do agree they are bad don’t you? Why don’t you discuss how we prevent that instead of attacking anyone that ask the question?”
From the sound of it, they must be bad, but I have no idea what they are because nobody proposed anything that sounds like execution tribunals anywhere and I read most of the law. Is it a bunch of people reviewing every admission to see if it would be cheaper to kill the patient than to treat him/her?
How can we discuss prevention of monsters in the closet? What is it you would suggest in the form of prevention? Legislation stating that no hospital and no clinician shall withhold treatment from any person desirous of said treatment providing that said person has enough money to pay for the treatment and has no expectation that the health insurance carrier will foot the bill? Would you feel better if such legislation was passed? I would not.
Nate – If you want to read a left-wing English paper, I suggest you read The Guardian. The Daily Mail and Telegraph are conservative. And if you are looking for stories about replacing the NHS “nightmare” with a US-style system I suggest you stay close to Upper Kentucky. You are not likely to get that opinion from any English paper or political party, left, center, or right.
” NHS style health care is not the only alternative to our current system.”
Nice straw man Margalit. No one including me said it was. But when you pass a bill and start heading in a direction similar to one specific system then comparison to that system are valid. Germany has a Fee for service system, if we pass a bill based on global reimbursements why would we be discussing the German model as a comparison?
What other countries have comparitive effectiveness bodies? What others systems besides NHS have systems in place that you would like to compare these changes to?
” it is not a realistic possibility in the US anyway.”
Up until 1964 Medicare was not a realistic possiblity yet here it is, same for Medicaid. When was a 13 trillion national debt a realistic possibility? Yet we have one. That is the thing with liberals, what your promised is never what you get in the end. Liberals wont write a death panel bill, it will have a nice warm name and be wrapped in promises of better and cheaper care. 10 years later we will have Obame Care Pathyway and be wondering how the hell we got there.
” Nate is apparently not really sure whether he wants more cost effective care or not”
I’m quit sure of what my clients and I want rbar, the difference is I actually deliver on it while the government some how manages to fail almost every time they try. Unlike people like you I know how to deliver more cost effective care and do it every day. We could do an even better job if Washington would stop screwing things up.
“such as: everything government run will be like NHS)”
Nice made up argument, what one would expect from a partisian that doesn’t know enough to actually debate the facts. When did I ever claim everything would end up just like the NHS? If you could read you would be able to see the reason I raise the questions now is so it doesn’t end up like NHS. The time to prevent our system ending up like NHS is before it happens. But liberals are incapable of having an honest discussion to facilitate this. You want to dismiss the possibility of LCP happening here as if there is some magical forcefield that stops it from crossing the ocean. Why are you liberals so afraid to discuss the facts?
I assume rbar and Margalit don’t want death panels in the US….you do agree they are bad don’t you? Why don’t you discuss how we prevent that instead of attacking anyone that ask the question?
What in the current regualtions prevent the same scenerio from playing out?
” Yet, the only place where I hear these nightmare scenarios on European “socialized” medicine is in the US right-wing media,”
Paolo you must not travel or read much, Daily mail and Telegraph are both English papers, how can you claim the only place you hear about my hooror stories are from right wing US media when the links are left wing European? Perfect example of a liberal argument, no facts all propoganda. Who’s the troll, the person posting facts or the three liberals void of any argument or logic just making stuff up? Or maybe its your geography that is off, maybe you thought UK was Upper Kentucky?
rbar – Amen.
I travel a lot and have been to almost every developed country in Europe, Asia, and Australia. I have many work colleagues, friends, and even some family living in these places. The topic of health care comes up pretty often in conversation. Yet, the only place where I hear these nightmare scenarios on European “socialized” medicine is in the US right-wing media, where each little incident then gets repeated ad-nauseum by people who have never been outside the US and have no clue about what life is like in the UK, France, or Germany.
The European health care systems (they are very different from each other) are far from perfect. The UK system gets frequently criticized by other Europeans. People complain all the time (as people do here) about problems, medical errors, waiting times, and other ways to improve their systems. Yet, I’ve never met a European or Australian (rich or poor, conservative or liberal) who wanted to adopt our system. Even the people who have come to the US for treatment (and I have known a few) are generally pretty happy with their guaranteed systems at home and the option to seek additional private treatment elsewhere (usually in their own country). As is the case everywhere, the rich usually get better treatment than the poor, but the poor don’t have to decide between medicine and bankruptcy.
“How about the difference between a fact and pure fantasy?”
O-bumbler is an expert at that — insulting SCOTUS, deceiving CEOs, angering the Medicare crowd.
Which is why NO ONE WITH A BRAIN believes him. And he’s launched 10,000+ lawsuits. And Pelosi rejected, out of hand, his panel’s plan for defecit cuts.
A one-termer, a lame duck.
There are multiple horror stories to tell from Germany, Switzerland and the US. As soon as palliative care is considered, there is room for error (i.e. misdiagnosis of – or within the context of – a terminal condition). If the bar for palliative care (PC) is laid higher (i.e. you try to treat/examine near everything), you have fewer mistakes doing PC while treatment could have been possible (so I would not be surprised if GB spending much less on medical care has more such mistakes, and we have less).
What most (lay)people are not aware of are the downsides/dangers (apart from cost) of overtreatment (nosokomial infections, bad outcomes of surgery, unwarranted aggressive treatment with poor patient comfort). We definitely have much, much more of this in the US; for example, our system kills or cripples many by doing way to many complex back surgeries. Nate is apparently not really sure whether he wants more cost effective care or not, or he wants money to be the sole decisionmaker (ignoring the fact that even with a single payor system or strong government option, privately paid care for the “100 k 1 week saving” chemo that he claims to be concerned about is entirely possible). I have given up on him, he is a partisan hack trying to dominate the discussion by pulling up anecdotes, pseudoarguments (such as: everything government run will be like NHS) or unprovable assertions (such as “when you come to me, I will give you policy X with deductible Y, entirely affordable”) from his rectum. Once you realize this pattern and consider all his invectives, a sane person would treat him as what he is: a troll.
Nate, for the gazillionth time: NHS style health care is not the only alternative to our current system. Perhaps some are advocating for that type of system here, but I certainly don’t and it is not a realistic possibility in the US anyway.
Do you have any horror stories from Switzerland or Germany or France?
“He died within two weeks — only for a post-mortem examination to reveal that he died of pneumonia, not cancer — an illness which could have been treated with antibiotics.
It is a shocking case. His widow Pat described his treatment as ‘barbaric’ and was this week awarded an £18,000 payout over her ordeal.”
Only under a government system can your murder someone and it only cost you £18,000. Costing someone an extra day in the hospital in the US would cost you more then that with our malpratice system
For those not familar with what Liverpool Care Pathway is you can see the Liberal definition here;
http://en.wikipedia.org/wiki/Liverpool_Care_Pathway
To see what happens when politicians and governments pass laws in matters they don’t understand and the consiquences it can have see these;
http://www.dailymail.co.uk/debate/article-1220221/ROS-COWARD-If-proof-folly-doctors-playing-God-mans-barbaric-death.html
http://www.telegraph.co.uk/health/healthnews/6127514/Sentenced-to-death-on-the-NHS.html
http://www.tldm.org/News12/Britain%27sPathwayToEuthanasia.htm
These are called facts Margalit, they have names, they have familes, and they had lives before people like you decided to play God.
Margalit,
NHS does exactly what I said now. For once, any liberal, please exaplin why if it is already happening in England we in America should not worry about it happening here. Just once, one of you have the inteligence to actually debate the facts and stop the snarky comments.
“If my family wants to pull their money and buy me some medicine the government says is not cost effective they should not be allowed to prevent me from doing so with force or coercion. When government has taken over a majority of care provision it is only a matter of time before they ration care.”
“rbar you don’t seem to understand the difference between a fact and something alleged.”
How about the difference between a fact and pure fantasy?
“There are many points that you don’t answer as well”
Such as?
“your attempts of defending the death panel smear while claiming to be concerned about HC cost control are impossible to maintain at the same time with a straight face.”
How is this? Government has never succeded at controling cost, why do you believe only government can control cost with this histroical record? In America it is not the governments place to determine what care Americans can and can not buy. If my family wants to pull their money and buy me some medicine the government says is not cost effective they should not be allowed to prevent me from doing so with force or coercion. When government has taken over a majority of care provision it is only a matter of time before they ration care. We have seen this exact behavior when Medicare was passed guaranteeing providers fair payment then when the competition and options eliminated the repealled that portion.
There is a reason liberals and people such as your self cower from a debate on death panels, you can’t win it. History has shown our government act in this manner and other countires have gone down the exact same road. That is why you dismiss the argument instead of even attempting to answer it.
“but to just point out alleged mistakes”
rbar you don’t seem to understand the difference between a fact and something alleged. It is not alleged they “lost” the historical temp data when outside scientist tired to peer review their work, its a fact. Its is not alleged the Russian claimate data was made up that has been proven. Its not alleged Soros funds a number of the most vocal AGW advocates. Again your intelectually bested so you attack the method and hide from the facts.
I can buy a spell checker for my inferior spelling your stuck with your inferior thinking.
DEATH PANELS
Bwarney Fwrank, Chris “CountryWide Mortgage” Dodd, Fannie Mae, Freddie Mac.
“I’m here from the government, and I’m here to help.” (Myself. So I can coast to retirement.)
If O-Bumbler thinks he can sell his BS now — he needs to quit. Today.
DEBT KILLS
Ask Ireland and Greece. Duh.
—
@Frank
“While liberalism has BANKRUPTED Ireland and Greece, with the USA one click away, thanks to O-BUMBLER”
Uh, no. The problems in the USA can be laid squarely at the feet of Reagan, Bush 1, Clinton, and Bush 2. Obama, for all that he is a big-business lackey, is trying to fix them (however half-heatedly and without being punitive to business people themselves, much to my dismay).
Nate, I am not going to answer these absolutely stupid republican talking points. There are many points that you don’t answer as well, and your attempts of defending the death panel smear while claiming to be concerned about HC cost control are impossible to maintain at the same time with a straight face. With regards to “mistakes” in the peer review process that you mention – no human process is flawless, but to just point out alleged mistakes and claiming that it proves your point is exactly the trick used by debating creationists and holocaust deniers – Michael Shermer wrote an interesting book about that. Let’s face it, you are THCBs Joad Cressbeckler, with the differences of health insurance expertise but inferior spelling.
Once again avoiding the hard questions,
“It’s the same nonsensical argument that there are “interests” touting global warming – the opposite is the case (you can build a carreer by doubting manmade climate change with a poor scientific background/expertise, but the opposite isn’t true).”
Simple question then who is getting Soros’ millions?
Why every time I ask you a hard question do you run from it?
I understand the peer review system very well, Unlike you I am also inteligent enough to know it is not infallible.
Curious do you not know about the East Anglia emails or just like to pretend they don’t exist. I could point out 100 failures in peer review in an hour. Anyone that blindly beleives in peer review just blindly beleives. Not that you even know enough to debate AGW with me but care to explain how you peer review temp data when jones et all lost it? Made up Russian data points are peer reviewed how?
I’m very aware of the anti AGW lobby and some of the bad science they peddle, it just doesn’t begin to measure up to the tax funded junk science AGW is putting out there.
The same problem we have with AGW we have with healthcare, bad science and regualtion passed for political purposes. i.e. Kyoto treaty that was the most import treaty ever that accomplished nothing, no one meet their goals but some how us not signing it was the first step to then end of the world.
@Frank
“While liberalism has BANKRUPTED Ireland and Greece, with the USA one click away, thanks to O-BUMBLER”
Uh, no. The problems in the USA can be laid squarely at the feet of Reagan, Bush 1, Clinton, and Bush 2. Obama, for all that he is a big-business lackey, is trying to fix them (however half-heatedly and without being punitive to business people themselves, much to my dismay).
The problem with PPACA is that it is NOT liberal. It is conservative to the point of being fascist. People are being legally obliged to buy the insurance companies’ crappy, no-value-added products. The use of state power in the service of corporate power is a criterion of fascism. I despise the Democrats because they are conservatives, not liberals. They are certainly not social democrats like myself.
A truly liberal solution would have been to nationalize/state-ize(?) the entire healthcare industry. An alternate would have been to regulate the industry like the utilities. Health care workers would become government employees on salary. We could then unionize to protect ourselves, collectively bargain, and strike when necessary.
The assets of insurance companies, for-profit hospitals and for-profit clinics would be seized and put to use actually providing health care to people. Health care can then be rationed based upon need, not personal wealth (as it is rationed today).
I write this in answer to the OP. PPACA is not a liberal policy. It is conservative to the point of fascist. Obamacare is just Romneycare write large.
The whole point of conservatism is NOT to go forward.
—
While liberalism has BANKRUPTED Ireland and Greece, with the USA one click away, thanks to O-BUMBLER
FATAL FLAW
” ,, One of my influences in changing whom I associate with was seeing a PBS report on how the Swiss ..”
.. are NOTHING like the USA. Like comparing O-bumbler with Jack Welch.
Stupidest BS ever produced. T.R. Reid ought to be ashamed for being such a tool.
“Pretty sure Florida has an open enrollment date for the self empoloyed end of summer which is guarantee issue. CT also has self employed GI. MI Has there’s. I’ll find another dozen for you.”
FYI, there are exactly 14 states that have some type of guarantee issue mandate for the individual market. In some cases, it’s only for some individuals, or only for some period of time, or there is some other limitation. In 36 states there is no GI mandate whatsoever.
Once again avoiding the hard questions,
“It’s the same nonsensical argument that there are “interests” touting global warming – the opposite is the case (you can build a carreer by doubting manmade climate change with a poor scientific background/expertise, but the opposite isn’t true).”
Simple question then who is getting Soros’ millions?
Why every time I ask you a hard question do you run from it?
I understand the peer review system very well, Unlike you I am also inteligent enough to know it is not infallible.
Curious do you not know about the East Anglia emails or just like to pretend they don’t exist. I could point out 100 failures in peer review in an hour. Anyone that blindly beleives in peer review just blindly beleives. Not that you even know enough to debate AGW with me but care to explain how you peer review temp data when jones et all lost it? Made up Russian data points are peer reviewed how?
I’m very aware of the anti AGW lobby and some of the bad science they peddle, it just doesn’t begin to measure up to the tax funded junk science AGW is putting out there.
The same problem we have with AGW we have with healthcare, bad science and regualtion passed for political purposes. i.e. Kyoto treaty that was the most import treaty ever that accomplished nothing, no one meet their goals but some how us not signing it was the first step to then end of the world.
Why don’t you stop changing the subject and answer for some of the ignorant statements you have made.
How did Medicare benefit the 13% of seniors it was passed to help?
Where does Soros money go if no one is getting paid to be pro AGW?
Nate, your comments speak for themselves. You may know a lot about health insurance, but you have obviously no idea about science and the peer review process. The peer review process rewards new/dissenting insights IF they can be scientifically validated. Also, I am not sure if you are unaware of the massive interests lobbying against independent climate science, or if you just pretend to be unaware. From now on, I think that I will see any supposedly “factual” statements of yours in a different light.
rbar when Soros is funding James Hansen what exactly do you call that? Hansen, Mann, all of them only have jobs becuase they push Global Warming. If you want published you better be pro global warming cause we have proof your work would be buried otherwise.
Pretty sure Florida has an open enrollment date for the self empoloyed end of summer which is guarantee issue.
CT also has self employed GI
MI Has there’s. I’ll find another dozen for you.
rbar I see you skip my specific example of how liberals have claimed to be helping people while doing the exact opposit, why is that? You seem to be running from the argument, how then “The best I can call this is intellectually dishonest”
Democrats when they passed Medicare admitted they hoodwinked the public. Any honest review of the political rhetoric used to pass it compared to the actual bill pass show it was all a lie. How are these facts you avoid intellectually dishonest?
The same scenerio played out in public education. The Democrats and their Union partners reap billions in personal gains while our children suffer.
Same played out with public housing, Democrats got rich while generations of poor suffered.
How do Liberals not gain power when the government nationalises 16% of the economy? Talk about intellectually dishonest. Do you have any idea how many union healthcare jobs they would control. Do you have any idea how many billions in campaign contributions they would kick back. I think it is IL or CA that is trying or has mandated that all visiting nurses must join the union and pay dues. This is all about power for the liberals.
” likely no gain in income ”
Medicare was likly to only cost a few billion.
PPACA is likly to save money. Funny how the sales job never makes it to reality. Might you likly see the number of physicians curtailed? Might you likly get fewer hours at the same pay under a government program? Might you likly
” It’s the same nonsensical argument that there are “interests” touting global warming ”
So Al Gore hasn’t made millions selling Global warming? Your so full of it rbar. How could you be so clueless?
” the opposite is the case (you can build a carreer by doubting manmade climate change with a poor scientific background/expertise, but the opposite isn’t true).”
Where do you think the money comes from to pay all the Scientist pushing Global Warming? Do you think they work for free? They get grants and jobs by publishing papers claiming global warming is caused by what ever spme special interest wants to attack. Special interest fund it to attack industry they don’t like. Government funds it as an excuse to increase or in the UN’s case charge new taxes.
make up some more BS for us to laugh at. To think someone actually gave you a degree is scary.
Nate, I believe I know your positions, and there is not much sense to continue arguing. But 2 things:
“The difference is I want to help the 5-10 million people that really need help, liberals want to take over 2 trillion plus in GDP and dictate to everyone what is in their best interest. I want to care for people you just want the power.”
The best I can call this is intellectually dishonest. It’s a typical conservative talking point when they try to discredit motive. I have no personal gain in power and – as a physician – likely no gain in income (probably rather a hit) from a strong government run alternative, and yet that’s what I stand for (although I think that the system could be greatly improved without that). It’s the same nonsensical argument that there are “interests” touting global warming – the opposite is the case (you can build a carreer by doubting manmade climate change with a poor scientific background/expertise, but the opposite isn’t true).
When argue like this (same thing with your silly defense the nonsensical death panel demagogy), I really have to doubt that you have anyone elses interests in mind (other than yours that obviously depends on the insurance business).
“Every state I am aware of has guarantee issue open enrollment periods were once a year the carrier needs to take anyone that applies”
This is true of Ohio. It is absolutely not true of most states.
For a summary of state laws regarding guarantee issue:
http://www.statehealthfacts.org/comparetable.jsp?ind=353&cat=7
Neither party’s extremist positions really offer realistic solutions to the quagmire that is health care now. So why do we keep allowing this pendulum of extremist views to bash us into submission?
There are moderate viewpoints that can embrace some of the logistical ideas each side offers. But, we aren’t dealing with people who want to negotiate. They just want to pontificate and eradicate.
Just the kind of thinking for health care solutions (as thick as sarcasm can get!)