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How Does Universal Health Care Save Money? Easy…

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Yes, the government will save money by providing universal health care. How it works is easy to understand — at least for those who try to comprehend both sides of the story. It all starts with something akin to a quote from an old motor oil commercial: “You can pay me now, or pay me later." It really isn’t that much different from investing a little now to avoid paying (or at least not receiving) a lot more later.

The government needs funding in order to operate. Taxes, like death, are a part of life. The more taxes a government takes in, the more that government is able to do. But when the country’s citizenry have a lower income (or a static income that does not rise in proportion to inflation), the government will take in less taxes, and that hurts the government’s ability at all levels — federal, state, local — to provide essential services such as fire, police, schools, roads, judicial systems, military. The list is almost endless.

Conservatives like to say that government is the problem, but without government protection and regulation and provision of essential infrastructure, business dies. I repeat — without government protection and regulation and provision of essential infrastructure, business dies. It becomes a vicious circle: less business means fewer jobs which means less ability for the government to enable business. Unless business takes responsibility for providing all of that protection/regulation/infrastructure a la the British East India Company, business needs to make sure the government has enough money to do those things.

What does this have to do with an overall financial benefit from universal health care? Patience — I’ll get to that.

Conservatives also like to point out government inefficiency. How is it, then, that if government is so corrupt, that Medicare operates quite well, taking care of the hideously expensive health needs of the elderly and disabled, with only a 2% administrative overhead, while privatized health insurance agencies — which tend to care for the healthier (and less expensive) segment of the population — average a 26% administrative overhead?

Where, then, is the greater inefficiency? Medicare (caring for the least healthy) with a 2% admin overhead, or private insurance (caring for the healthier segment) with a 26% admin overhead? Will somebody please explain the logic of this?

And then conservatives decry government corruption — despite the 2%-to-26% disparity illustrated above. If Medicare’s so corrupt, then how about we look at their government-mandated salaries? It’s only from 2003 (the info’s not easy to find), but this article shows that at the time, the administrator for the Centers for Medicare and Medicaid, their top officer, made $134,000 a year, while the CEOs of the top 25 HMOs all make at least seventeen times that much, and at the top, make well over one hundred times the salary of the administrator of Medicare and Medicaid! And that’s before we get to corporate perks like resorts and private jets.

So where, really is the corruption? In the maybe $200K per year government administrator of Medicare and Medicaid? Or the $29 million per year of the CEO of the Oxford Health Plans?

Alright. So how, then, does universal health care save America money?

It’s really easy, if one will think it through. I’ll use my family as an example. If we had not had either military health care or a very good private health insurance plan, my wife’s three emergency room visits and subsequent surgery would have cost us tens of thousands — and there’s no way we could have afforded that! With no insurance, we would have been forced into bankruptcy. Even if we’d had private insurance, that’s no guarantee we’d have been able to avoid bankruptcy, because half of all bankruptcies are due at least in part to health care expenses, even when 68% of all who filed bankruptcy already had health insurance!

So if we had been forced into bankruptcy, not only do we lose our livelihood (the medically-fragile children we care for), but we lose our house and in all likelihood would be forced to live in section eight housing, again at government expense. Not only that, but we now have a substantial income, and we provide jobs for eight other people. They, too, would lose their jobs, so not only would the government receive far less tax income from my family, but they would receive less tax income from our employees.

On top of all of this is the increased burden placed on the government and the taxpayer whenever anyone falls below the poverty line.

Can America afford more taxes? After all, the Republicans love to point out how America has the second-highest corporate tax rate in the industrialized world. What they don't point out is how even the Bush administration admitted we have the second-lowest effective corporate tax rate in the industrialized world (see page 42 of this report). They also don’t want to admit that, according to this GAO report, thanks to loopholes, write-offs, and subsidies, most corporations pay no income tax at all, and many even get rebates!

Compare that information to when our economy was the envy of all the world in the 1950s, when corporate tax rates were 52% of all corporate income over $25,000 (and 30% for corporate incomes $25,000 and under)! The conservative drumbeat that tax cuts are the cure for all that ails us is a lie wrapped in a willful ignorance of history.

In summary, taking care of the health of the population really is a matter of “pay me now, or pay me later.” The government (i.e. the taxpayers) will pay – either up front with universal health care, or in the end by having a greater burden on the government not only to provide for those forced into poverty because they couldn’t pay (or their private health insurance couldn’t or wouldn’t pay) for their health care, but having to do so with a lower level of tax income from those who were forced into poverty.

For conservatives who are so eager to say otherwise, first explain why, if government is so inefficient and corrupt, Medicare and Medicaid (caring for the most expensive — the elderly and disabled) operates at one-thirteenth of the admin overhead that private health insurance companies do (even though they cover the healthier segment of the population), and the guy in charge of Medicare and Medicaid works for just over one-twentieth of the salary of any CEO in the top 25 HMOs.

And while you’re at it, explain how just having the option, the freedom to choose government-run health care is a bad thing, considering the disparities above. After all, if the private health insurance companies can’t stand a little competition, then how else are they going to learn to provide health care as cheaply and as efficiently as the government of the United States? I say it’s time for them to see if they can walk the walk, instead of just paying off politicians to talk their talking points.

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About Glenn Contrarian

White. Male. Raised in the deepest of the Deep South. Retired Navy. Strong Christian. Proud Liberal. Thus, Contrarian!
  • http://www.republicofdave.com Dave Nalle

    Glenn, among the many faulty assumptions and strawmen you use in this article, I just wanted to point to one.

    Twice you say that medicare is more efficient despite the fact that it deals mostly with old people who need more medical care. But administrative efficiency actually has no relationship to the costliness of treating the patients. The patient costs no more or less to treat just because the administrator is paid less or takes less of a cut.

    You also provide no basis for your assumption that the elderly cost more to treat than the young and healthy. The young and HEALTHY cost nothing to treat, but the young and unhealthy cost a great deal more than the elderly. The operations and treatment they need cost substantially more and treatments last substantially longer than with the elderly.

    When you put a 80 year old on an expensive medication you put him on it for a few years. When you put a 40 year old on that medication you put him on it for decades. Far more espensive. The elderly generally don’t qualify for major organ transplants which cost hundreds of thousands of dollars, but 50 year-olds who are otherwise healthy certainly do. So this basic assumption about the relative costs of care which you make is false.

    Dave

  • http://biggesttent.blogspot.com/ Silas Kain

    January, 2009 – American Medical Association PAC gives $15,000 each to DEMOCRATIC CONGRESSIONAL CAMPAIGN COMMITTEE and DEMOCRATIC SENATORIAL CAMPAIGN

    April, 2009 – American Medical Association PAC gives $15,000 each to NATIONAL REPUBLICAN CONGRESSIONAL COMMITTEE (3/11/09), NATIONAL REPUBLICAN SENATORIAL COMMITTEE, REPUBLICAN NATIONAL COMMITTEE. They also gave $5,000 each to BLUE DOG POLITICAL ACTION COMMITTEE, SENATOR CHARLES E SCHUMER (D-NY), and the SENATE MAJORITY FUND.

    True health care reform will never be achieved until we stop the flow of cash into the political treasure chests. Wake up, America, we’re getting screwed.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    That’s why every motherfucker in Washington, D.C. is corrupt to the core.

  • http://biggesttent.blogspot.com/ Silas Kain

    Simple yet eloquent, Roger. For three years I have sounded like a broken record when it comes to Congress. I’m going to try and make this as simple as possible. You know how when someone tries to tell a parent of their child’s bad behavior the first reaction is “not my kid”? It’s like that with our members of Congress. These people are our neighbors, friends and coworkers. We have a propensity to blame all the other members of Congress and maintain that it’s “not my Congressman”.

    Barack Obama will fail. He will not accomplish 50% of his mission. We treat politics like a monotheistic religion. One God, one political leader. The problem is that we have 535 “apostles” in the Capitol who are the signers of the checks. Yet we are too damn stupid to even comprehend the basic configuration of our Federal Government.

    The difference between the Iranian people and we of the United States is that Iranians know what’s at stake and have the guts to take to the streets to achieve change. We have NO clue what’s at stake but as long as it doesn’t interfere with our ability to shop at WalMart — who cares?

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    You know what I think, Silas. Nothing will happen until we somehow revamp our political process from ground-up. I don’t know what it will take. Individual communities must make a stand and insist that they count. We’ve got to forget the idea that politics starts and ends at election time. It has got to become part and parcel of everyday life, the life of a local community. So there’s only one thing that may possibly emerge out of this crisis – some kind of a wakeup call. But I don’t really believe it will happen either. The people are too fucking lethargic and fail to understand that they’re all bound together, and that what affects one affects all.

    Unless the communities start acting in unison, with one voice, nothing will happen.

  • http://biggesttent.blogspot.com/ Silas Kain

    Indeed, Roger. If one looks at the problems we have in society today, it all comes down to one thing: EDUCATION. We’ve done a piss poor job of educating our young for the last 50 years. While many cite the Greatest Generation in exhibiting American resolve, I submit an entirely different attitude.

    Those who served in World War II are, without a doubt, the greatest generation. They saw such horror and made such sacrifice that when peace was achieved they vowed to create a world where their children would never have to experience that which they had. Out of love for us, they tried to make our lives easier. They were so busy working to give us a “better life” that they lost sight of the values they had when they went to war. It’s understandable. While they were the “Greatest Generation”, in the end they may be remembered as the beginning of the end of the American ideal.

  • Baronius

    Silas, fifteen thousand dollars? Do you actually think that Congress is corrupted by the annual earnings of a paperboy? They’re not corrupt; they earnestly implement terrible policies.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    It’s a drop in a bucket. But lobbying money is a stream and it comes in all year round from a variety of source. It’s a way of life.

  • http://biggesttent.blogspot.com/ Silas Kain

    See, Baronius, it’s not about the AMOUNT of money. $15K is a drop in the bucket. But go to the Federal Elections Commission and see for yourself. If you’ve got some poor blue-collared slob who gets the political bug watch out. They get a $5000 check from somebody and they’re sucked in. We need revamping of our election cycles and funding system. Most of all, we need to get K Street Svengalis OUT of Washington. Enough drops fall in that bucket, Baronius, and you get a flood. Americans could take a page out of the Iranian protester’s play book. It’s time for us to wage our own protest.

  • Baronius

    Silas, if a cause gives to both you and your opponent as the AMA does, how does that translate into influence? And what’s so bad about lobbying, anyway?

  • http://biggesttent.blogspot.com/ Silas Kain

    Baronius, please tell me you’re not serious. Spencer Bacchus gets $10,000 from the NY Life Insurance PAC just this year. Even the Congressional Black Caucus got $5000 from the same group. Now, Baronius, do you honestly thing the members of the Congressional Black Caucus are going to make that money count for something back in their districts? Each of the political parties received $30,000. Sure, they play both sides. Washington is the stage. The members of Congress are the puppets. Enough is enough.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    The whole point is, Silas, they want to have their dirty fingers in every pot, regardless who wins. I know it, you know it, and Baronius knows it.

  • http://biggesttent.blogspot.com/ Silas Kain

    So maybe it is time that all of us who KNOW it, do something ABOUT it!

  • Baronius

    Silas, I’m serious. You’re not explaining where the corruption is. Money isn’t necessarily influence, and influence isn’t necessarily corruption.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    I supposed wrong. Baronius doesn’t know it.

  • http://biggesttent.blogspot.com/ Silas Kain

    Baronius, there are times when the appearance of impropriety is sufficient. This is that time.

    When one wades through the mountains of data from the Federal Election Commission one must wonder just where does all this money come from? Baronius, I assume that you are intelligent enough to recognize that ultimately it is the consumer who pays the price. We have not only the cost of a product’s manufacture but there are the advertising and so-called “operating” costs involved. Imagine, for a moment, that severe limitations were placed upon PACs and special interest groups. That would change the dynamics dramatically.

    What amazes me is that those on the Far Right who wear the Cross as a badge of honor forgot a very important chapter in the saga of the Christ — he went into the Temple and turned over the tables of the money changers. If these Zealots want to imitate Christ, they could begin by turning the tables on K Street.

  • Clavos

    If these Zealots want to imitate Christ, they could begin by turning the tables on K Street.

    If that were to happen, unlikely — everyone in Washington benefits from the arrangement, but if it were to happen, the whole process would just go underground and continue merrily along.

  • Bliffle

    Baronius: “Money isn’t necessarily influence, and influence isn’t necessarily corruption.”

    You’ve gotta be kidding.

    Lobbyists give money to politicians EXPLICITLY (they make no bones about this) to get access to the candidates.

    Influence is even more corrupt than bribery (‘campaign contributions’), cf. Lord Acton.

  • http://www.indyboomer46.blogspot.com Baritone

    No doubt that access and influence are purchased. But, what is the alternative? Being a pol at any level maybe above dog catcher is a very expensive matter.

    The fellow that most of you hate was able to win the presidency largely through small donations from individuals. Even so, his campaign DID receive a lot of money from any number of corporate interests as did McCain’s.

    If a national campaign could be waged for a relative pittance, there would be no need for huge campaign chests. Alas, that’s not the case.

    As to the healthcare situation, one of the main arguments against it is the “Do you want the government coming between you and your doctor?” Perhaps, perhaps not. But, how is that any different than having an HMO or insurance company making medical decisions, denying care, denying payment, all in the interest of padding their bottom line?

    Does a public option amount to government competing with the private sector? I guess so. But I really don’t give a rat’s ass. It would take a great deal to make me shed a tear for insurance companies.

    The medical insurance arm of the industry is relatively young. The larger portion of the insurance industry has been around far longer offering many other types of insurance. I am confident that they could withstand government competition in the medical insurance sector.

    And talk about a “strawman” argument. Dave once again cites what he would have you believe are hard facts and figures rather than simply bullshit picked out of the air.

    The numbers of elderly people who are being treated in our medical facilities far outnumber the young. Does Dave imagine that hip or knee replacements are cheap? Does he believe they are giving away heart bypass procedures? Does he believe that home health care is had simply with a gratuity, or that long term care in a nursing home is tantamount to spending a few nights at Motel 6?

    I find it interesting how people rage against the notion of “socialized” health care can be found roaming the halls of our local VA hospital. What, pray tell, is the VA if not “socialized” medicine? And it seems to work pretty well.

    Perhaps the HMOs and other medical insurance providers would not be so niggardly with their payouts if they weren’t obligated to pay their upper level execs multi-millions of dollars every year, and be primarily concerned with their investors dividend payments.

    B

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    You know what’s even a more ridiculous argument? That private insurance companies cannot compete effectively against the government plan – compared to like putting a frog and an alligator in the same pool.

  • Clavos

    What, pray tell, is the VA if not “socialized” medicine? And it seems to work pretty well.

    The VA only serves about 5 million people, not 335 million, so no, it’s not “socialized medicine” by definition, it’s only available to a select few — hardly more than the number served by each of the largest medical insurance companies.

    The best thing about the VA is it’s free. Oh wait, it’s NOT free for everyone.

  • Clavos

    You know what’s even a more ridiculous argument? That private insurance companies cannot compete effectively against the government plan…

    They can’t if they are selling their services and the gummint is giving theirs away.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    But the point that’s being missed here is the following: why should they want to garner the market? We know the reason(s) of course.
    Why not instead tailor the private plan(s) to those who can afford it? It’s like if I want to buy a VW, I can get it from the government. They should be thinking Rolls Royce. Unless they want to be all things to all people.

  • Clavos

    Um, the insurance business is based on spreading the risk. If the pool of insured people is too small, the insurance companies can’t insure each client for less than the cost of the service insured, so what’s the point in buying their product, if you’re going to have to pay for it what you would pay the docs and hospital?

    If the government starts giving away free or nearly free insurance, practically no one will be willing to buy it; certainly not enough people to make up an adequate pool.

    Even you, Roger, should be able to see that a commercial enterprise can’t compete with an organization which is giving the product or service away.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    I don’t deny the latter. Perhaps the whole concept of insurance should be evaluated – as to the kinds of circumstances and types of “objects” to which insurance is most applicable. I understand, I think, spreading the risk idea. But there must be a way to offer premium services to some and standard ones to others and maintain thus a sufficiently large customer base.

  • http://www.indyboomer46.blogspot.com Baritone

    “The VA only serves about 5 million people, not 335 million, so no, it’s not “socialized medicine” by definition, it’s only available to a select few…”

    In practice the VA IS tantamount to socialized medicine. The VA can serve as a very good model for a much broader health care program.

    Actually, as far as I understand, the VA’s services are not “free” to anyone. I currently owe them about $250. Every visit costs around $50. The cost of prescriptions has gone up to around $25 per scrip. I could actually purchase my medication at Wall Mart for $4. I choose not to as I want to keep everything under one roof and $25 for 3 months ain’t gonna break my bank (at least not yet.)

    Again – who gives a rat’s ass about the insurance companies, Clav? Do you believe that any of them would shed a crocodile tear about your and your wife’s predicament? If they all discontinued the offering of medical insurance owing to government competition, then most everyone would turn to the govt plan. The insurance companies would survive. Personally, I’d like to see the profit motive removed from health care as much as possible.

  • http://www.indyboomer46.blogspot.com Baritone

    And another thing!

    It is often the cost of providing medical insurance for employees that has driven many a small business to ruin. It is a huge burden on large corporations. Many companies are no longer offering group plans or have so reduced their contributions that employees find themselves paying most of the costs out of pocket. This would not be an issue for the majority of working Americans or the companies for whom they work if the government offered affordable medical coverage.

    The really rich don’t need no stinkin’ health insurance. For them the cost of even an extended hospital stay is chump change.

    B

  • Glenn Contrarian

    Dave –

    You posted: “Twice you say that medicare is more efficient despite the fact that it deals mostly with old people who need more medical care. But administrative efficiency actually has no relationship to the costliness of treating the patients. The patient costs no more or less to treat just because the administrator is paid less or takes less of a cut.”

    Actually, you’re wrong. Why? Because the elderly who as a whole need much more medical care also – because greatly-increased medical care demands that much more administrative processing and oversight. That, sir, is not a strawman but a FACT.

    You also posted: “You also provide no basis for your assumption that the elderly cost more to treat than the young and healthy. The young and HEALTHY cost nothing to treat, but the young and unhealthy cost a great deal more than the elderly. The operations and treatment they need cost substantially more and treatments last substantially longer than with the elderly.”

    As Roger already pointed out, the number of elderly who require higher levels of medical care is FAR greater than that of the younger ones who do – and I do have a clue about this because my home is licensed as an Adult Family Home for up to six elderly residents, whereas I also take care of medically-fragile children. This is not proof of anything other than that I have a clue about the numbers of medically-fragile elderly as compared to the medically-fragile young.

    No, Dave, the strawmen were of your own construction. Personally, I deal in fact.

    When a household goes bankrupt, it’s not only the family that suffers, but it’s a greater load on local and state taxpayers, not to mention the manifold problems that arise when more people fall into poverty. That is a FACT.

    While the amount the local and state government loses whenever a household goes bankrupt may not be precisely measurable, I feel quite comfortable in claiming that it measures in the thousands, perhaps in the tens of thousands…and when the ripple effect of increased poverty in a particular neighborhood is taken into consideration, it’s easy to see how this can be in the millions…per neighborhood.

    Good night, Dave.

  • Glenn Contrarian

    Good morning, Dave –

    To illustrate the ‘ripple effect':

    In my housing development over the past two years the house prices dropped by at least 60K per house…and that means just under 1K less per year in taxes paid to the state. Our housing development is rather small – about 50 houses – so that means about a 50K in state and local taxes.

    And that’s just our housing development. That doesn’t take into consideration the rest of the city and county and state. Nor does it account for the plethora of business that have closed down, which failures added that much more to the shortfall.

    The Republicans’ BIG deal this past election was the state’s $5 billion dollar deficit. They wanted to claim it was the Dem governor’s fault – but it’s hard to balance the budget when all of a sudden you’re taking in billions less in tax dollars.

    And what does this have to do with health care? In at least HALF of all bankruptcies, health care costs were at least partially to blame.

    Just think, Dave – if we had universal health care as EVERY other modern democracy on the planet does, a significant percentage (perhaps even half) of ALL the bankruptcies in this past economic downturn could have been avoided.

    Our housing market wouldn’t have taken as heavy a hit, and neither would our businesses which have to compete with one hand tied behind their backs – that hand being tied by paying for health insurance that overseas companies don’t have to pay.

    It’s clear and plain for all to see, Dave – universal health care SAVES taxpayer money.

  • Clavos

    Actually, as far as I understand, the VA’s services are not “free” to anyone.

    Actually, they are. Priority 1 patients pay nothing — no copays, either for services or for meds, and they are not means tested.

  • Clavos

    B-tone,

    Priority 1 patients are those with a service-connected disability rating of 50% or higher (I think the bottom is 50%. It may actually be higher). And no, the VA is not socialized medicine, anymore than the congressclowns’ medical plan is socialized medicine. In both cases, only a select group qualifies, so by definition it’s not “socialized,” since it’s not available to everyone.

    The VA isn’t even insurance, really. It’s a government owned and operated medical system for specific individuals, you can’t, except under specific, special circumstances (primarily the absence of comparable and adequate VA care) go to a private doctor and get the the VA to pay for it.

  • Clavos

    The whole comparison of administrative costs between Medican’t and private insurance is a strawman, because the enormous costs of fraud against the government programs is not included in their “administrative costs” by the GAO, but it should be, because it’s the failure of CMS adequately to review claims that makes the government programs such tempting and easy targets for every grifter and con artist in the country.

  • Glenn Contrarian

    Clavos –

    Your ‘strawman’ comment about fraud against government programs is itself a strawman.

    Why?

    1 – you’re assuming that such fraud doesn’t happen (or is lessened) against private insurance companies…and I think it’s a mistake to think that the fraud committed against private insurance is any less at all.

    2 – At least with the government health care, the fraud is not (or extremely rarely) committed BY the government…whereas it wouldn’t be difficult for me to find examples of fraud perpetrated by private insurance companies – not to mention their thirteen-times-higher administrative costs.

    Next time, look at the other side of the coin of ‘strawman’ accusations.

  • http://blogcritics.org/writer/dan_miller Dan(Miller)

    Here is a link to some more conservative trash about health care savings. Applied fairly and reasonably, I think that denying extravagant medical care to the very elderly and terminally ill is reasonable. In fact, I wrote something four or five years ago explaining how it could be done fairly, reasonably and even pleasantly. Since President Obama almost certainly reads BlogCritics daily, he will probably include my suggestions in his plan, as it evolves.

    Dan(Miller)

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    It’s called triage.

  • http://thingsalongtheway.blogspot.com/ Cindy

    Dan(Miller),

    Why wait that long? Didn’t you ever see Logan’s Run? Perhaps Obama can save everyone lots and lots of money with a more radical approach. A sort of preventative Happy Enders’ Club. Why wait until people actually get old and sick and use up everyone’s money on health care?

  • http://www.republicofdave.com Dave Nalle

    You know what’s even a more ridiculous argument? That private insurance companies cannot compete effectively against the government plan – compared to like putting a frog and an alligator in the same pool.

    Roger, the concern would not be that they cannot compete, but that they will not be allowed to compete. That seems like the most serious threat.

    Dave

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Well, Dave, I kind of covered this point with Clavos – it has to do with being able to spread the risk and therefore having sufficient enough pool in order for the insurance co to be able to provide coverage.
    But the argument I heard voiced is that WOULD be allowed to compete with the government plan, except that they wouldn’t be effective.

    So my thinking was – why not have private insurance cater to those who can afford it. It is then that Clavos came up with the “spreading the risk” objection.

  • http://www.republicofdave.com Dave Nalle

    Actually, you’re wrong. Why? Because the elderly who as a whole need much more medical care also – because greatly-increased medical care demands that much more administrative processing and oversight. That, sir, is not a strawman but a FACT.

    This is not the argument I was making and you were responding to. What I said was that your attempt to equate administrative efficiency with overall cost was erroneous. Having a more efficient administrator approving a prescription does not signficantly change the cost of a drug. Going after the root problem — high costs is more important, and the problem with medicare is not the vaunted efficiency of the administrators, it’s the waste, fraud and overbilling which inflates costs and then those inflated costs are ALSO passed on to paying private healthcare consumers.

    As Roger already pointed out, the number of elderly who require higher levels of medical care is FAR greater than that of the younger ones who do – and I do have a clue about this because my home is licensed as an Adult Family Home for up to six elderly residents, whereas I also take care of medically-fragile children. This is not proof of anything other than that I have a clue about the numbers of medically-fragile elderly as compared to the medically-fragile young.

    Again, you’re attempting to sidestep the issue. The elderly DIE. Sorry, hard but true. Who do you think will cost more over their remaining lifespan, those medically fragile kids who may need ongoing care for 60 or more years or the 80 year old who needs care for a few more years? Come on, you CAN be logical if you try.

    No, Dave, the strawmen were of your own construction. Personally, I deal in fact.

    As demonstrated by the lack of any links to supporting evidence in your article.

    When a household goes bankrupt, it’s not only the family that suffers, but it’s a greater load on local and state taxpayers, not to mention the manifold problems that arise when more people fall into poverty. That is a FACT.

    I’ll accept that, though some evidence would be nice. So we should be looking at ways to make healthcare more affordable rather than looking at ways to leave costs high and forcing other people to pay for it, effectively subsidizing the bloated costs of healthcare and insurance.

    Just think, Dave – if we had universal health care as EVERY other modern democracy on the planet does, a significant percentage (perhaps even half) of ALL the bankruptcies in this past economic downturn could have been avoided.

    All that does is socialize the expense. You don’t want to solve the problem, you just want to make more people pay for it. Not a solution, a payoff.

    Bah.

    Dave

  • http://thingsalongtheway.blogspot.com/ Cindy

    Having a more efficient administrator approving a prescription does not signficantly change the cost of a drug. Going after the root problem — high costs is more important…

    I agree.

    It’s time to STOP the govt giving monopolies to pharmaceutical companies via drug patents!

  • http://www.republicofdave.com Dave Nalle

    So my thinking was – why not have private insurance cater to those who can afford it.

    That might take the form of something like the Australian system where everyone has a voucher for basic healthcare from a choice of providers and then pays for supplemental service privately if they want it. That approach is workable and relatively reasonable if you bite the bullet and accept the idea of socializing healthcare expense. But it is NOTHING like what Obama is proposing.

    Dave

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Well, that should be the way to go – to be able to accommodate the private sector without putting it out of business.

    As a matter of fact, why shouldn’t those who can well afford it be able to obtain a plan that is superior to the one that government’s how to offer.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    “has to offer.”

    Besides, aren’t certain kinds of insurance available only to the well to do?

  • Clavos

    @#33:

    You’re wrong, Glenn. First of all, private insurers are far more vigilant than the government bozos about identifying and prosecuting fraud. There’s a reason why Medican’t is targeted more than say, Humana; it’s easier to get fraud past the unaccountable bureaucrats who have no incentive to do a good job and who for the most part don’t.

    You people who are nanny staters contradict yourselves in regard to the private insurers. On te one hand, you say they get rid of all patients who might be costly to them, and on the other you say that they get defrauded as much as the government clowns. If they are keeping such a sharp eye on the bottom line that they can effectively identify and get rid of high cost patients, they’re also very much aware of and able to control fraud. They certainly have much more of an incentive (the need to make a profit) to do so.

  • Clavos

    As a matter of fact, why shouldn’t those who can well afford it be able to obtain a plan that is superior to the one that government’s how to offer.

    Exactly what I’ve said all along, but as Dave points out, none of the proposals currently on the table include that possibility.

  • Cannonshop

    I’m still trying to figure out how Government competing against private enterprise isn’t a conflict of interest.

    ’cause, you know, that’s what the plan offered is.

    Projected unintended consequences:

    1. Employers will drop their health benefits and justify it as “The Government will do it.” Especially in low-profit, hard-margin industries. The result is increased unemployment in a white-collar sector, and increased ‘loading’ on Government and Government sponsored providers.

    Notably, we’re in a deficit, and unemployed people don’t generate tax revenues-they consume them.

    2. Glenn, VA hospitals aren’t all that ‘uniform’ in quality, and some of them are downright dreadful. Medicare Fraud is documented, Clavos isn’t talking out his ass on this, and Gov’t Regulators have DEMONSTRATED inability to cope with fraud in so many different industries (including finance and medicine) that you really OUGHT to be asking how they’re going to handle an expanded list of customers.

    Finally, have you REALLY looked at Canada’s single-payer system? When a five-hour wait in the EMERGENCY ROOM is a “quick trip” you’ve got a problem. Six months to get a test is a PROBLEM.

    The last time I went through a medical, I waited twenty minutes at the walk-in, and saw a doctor using Blue Cross-and it cost me a whopping fifteen bucks co-pay, and everything was finished in four hours. Notably, this is somewhat quicker than when I was in the Army (during peacetime) doing ‘sick call’, and unlike the Army doc, I actually got treatment.

    Only fly in the ointment being that the doctor was almost unintelligible, being as I don’t have a good ear for accents and even very intelligent people with english as a second language can be tough to decipher.

    Wanna lower health-care? Get MORE DOCTORS. Americans pursuing “Doctor” as a career have been dropping in number for decades, we’ve got plenty of Lawyers, enough that I can get a Lawyer visit pretty cheap and it’s easy to find someone who’ll file the most ridiculous lawsuit a fevered brain can imagine, but we’re in a state of IMPORTING our medical professionals.

    I suspect a correlation there. I also suspect a correlation between foreign-born doctors wanting to practice in the U.S., instead of in nations and countries that have a greater share of “Public Health” laws and systems in place, and a correlation between Canadians coming “South” to deal with major illnesses rather than staying in their ‘superior’ system back home.

    Call me crazy, but I think all this is going to do, is increase (enormously) our national debt while simultaneously dropping patient-care quality into the toilet and increasing burdens on those of us who still have jobs when all these ‘reforms’ are put in place.

  • Glenn Contrarian

    Clavos –

    You’re building another strawman, claiming that HMO’s are far more vigilant than the government in detecting fraud. Not only did you give NOTHING to back up that frankly unprovable claim, but you did not address my point.

    The point is, can you point to large-scale fraud BY Medicare/Medicaid or their administrators? Perhaps, but not much.

    On the other hand, can you point to large-scale fraud BY HMO’s and private insurers? Sure can – LOTS. Just Google “list HMO fraud cases” and see what you find!

    Lots and lots and lots – and some of those cases are BY HMO’s overbilling Medicare – but is this a hit against Medicare, or is this a positive for the government-paid bean-counters who detected it and alerted the authorities?

  • Bliffle

    Clavos repeats the same lie:

    #32 – Clavos

    …the enormous costs of fraud against the government programs is not included in their “administrative costs” by the GAO,…

    There are no ENORMOUS frauds against medicare (Clavos has repeatedly refused to provide any evidence of such).

  • Bliffle

    Clavos invents a new fantasy:

    44 – Clavos

    …..private insurers are far more vigilant than the government bozos about identifying and prosecuting fraud

    Huh! Where did you get this? Citation, please. Or did you just imagine that?

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Here’s one example for our doubting Thomas, today’s story in fact.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Why I really find ridiculous, bliffle, that we all let you get away with your theorizing and offering your opinions on the state of the economy, and the nation, not to mention your interpretation of history, while you refuse to accept even the most commonsensical propositions without an array of statistical and god knows what kind of evidence.

    Are you always committed to this kind of double standard, or is it just a recent malady you’ve contracted, and hopefully a temporary as well, so that we may overlook it?

  • http://blogcritics.org/writer/dan_miller Dan(Miller)

    The solutions are so obvious that I am shocked no one has mentioned them:

    First, we tax the health care benefits provided by private employers (well, that’s been mentioned and is apparently “on the table”).

    Then, we start taxing private insurance companies based on their profits (whoops, we already do that).

    Then, we give the Government insurance company tax credits based on the taxes collected from private insurance companies and those collected from the greedy bastards whose employers provide medical benefits (whoops, I forgot: the Government insurance company won’t have to pay taxes, so I guess the best thing is just to give them the money, in the interest of having a level playing field).

    Dan(Miller)

  • Clavos

    The point is, can you point to large-scale fraud BY Medicare/Medicaid or their administrators? Perhaps, but not much.

    No Glenn, I can’t, nor did I even allege it.

    I CAN and have, pointed to large-scale fraud against Medican’t over and over again, and from a variety of sources, including FBI reports and investigative journalism sources.

    I’m not going to repeat them again; you’ve all seen them, but here’s a new one, from today’s Miami Herald. It’s a part of their ongoing series about the enormity of the Medicare fraud problem, here in Miami, and all over the country.

    There are also reports On the Kaiser Foundation’s Medical News Today website and in The Wall Street Journal.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Your first link doesn’t work, Clav. Your second covers the same story I linked to in #50.

  • http://thingsalongtheway.blogspot.com/ Cindy

    Mr. ‘Courteous to a Fault’,

    While I find your posts hilarious, I was told it’s all about self-respect or seduction or something.

    hmm, I’m probably confused, considering the case at hand, maybe it was about self-seduction.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    What I find hilarious that you keep on trying to have a one-way conversation.

  • http://thingsalongtheway.blogspot.com/ Cindy

    Yes, I AM trying to have a one-way conversation. But it’s hard to do when you won’t stop answering me. lol

    (See, I’m not actually talking TO you. Get it?)

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    But can’t get the subject of me off your mind somehow.

    Are you so impoverished that you can’t get me off your mind?

  • http://blogcritics.org/writer/dan_miller Dan(Miller)

    Jesus H. Christ! Opps, I mean “Great Zeus!” Oh, never mind; nobody listens anyway.

    Zaphod and Marvin

  • Clavos

    Dan(Miller):

    Wanna have an online spat?

    They’re all the rage* these days…

    [*Pun most definitely intended.]

  • http://blogcritics.org/writer/dan_miller Dan(Miller)

    Clav,

    Nah. I am too old and feeble and you would probably beat me up. How about a virtual pie throwing contest? I challenge you to strawberry tarts* at ten paces.

    Dan(Miller)

    *Clinton, Edwards and Sanford might join the fun; let’s bring lots of tarts.

  • Clavos

    Tarts!!!

    Oooh, what fun!

    I’m off to South Beach instanter to find some.

    Delicious!

  • http://thingsalongtheway.blogspot.com/ Cindy

    Now that would be fun to watch.

  • http://thingsalongtheway.blogspot.com/ Zaphod Beeblebrox

    Watch?? I’m gonna pray, Man!

    Know any good religions?

  • Clavos

    Hey, Zaph,

    When did you change yer name??

  • Glenn Contrarian

    Clavos –

    You posted: “I CAN and have, pointed to large-scale fraud against Medican’t over and over again, and from a variety of sources, including FBI reports and investigative journalism sources.”

    Ah, so it’s BLAME THE VICTIM, huh? You’re blaming Medicare for fraud committed AGAINST Medicare, and ASSUMING that it’s somehow Medicare’s fault!

    Doesn’t work, Clavos. Blame the PERPETRATORS, not the victim.

  • http://thingsalongtheway.blogspot.com/ Zaphod Beeblebrox

    Dan(Miller),

    I was once in a spelling bee on Jaglan Beta, which is the second planet in a star system near the Axle Nebula. (just in case you needed to know that)

    Anyway, one of the words I got was ‘oops’. There was an earthling entered and he spelled it ‘opps’. As soon as he did, he disappeared into thin air*.

    There was an announcement…something about ‘opps’ meaning, “please tele-transport me directly to Panama, and make it snappy.”

    *It’s some sort of a diet thing, don’t ask. I much prefer fat air, myself.

  • Clavos

    Sorry, Glenn that argument doesn’t wash.

    First of all, as custodian of taxpayer funds in amounts in the billions, it has a fiduciary duty to safeguard those funds, a responsibility it obviously can’t handle in light of how ridiculously easy it is to pull the wool over their eyes.

    Victim, schmictim. If the mendicants weren’t such inept bozos, Medican’t wouldn’t be such a pushover to steal from.

    Medicare, however, does more than simply be a “victim.” It’s purchasing agents are downright stupid when they do such things as pay $5K for a wheelchair anyone off the street can buy from the same manufacturer for $2.5K. I have that documented, because, when I told the bozos that I could save the taxpayers $2.5K by buying the chair myself, their bureaucrat answer was, “No, you can’t, we have to use authorized suppliers.”

    Like most government agencies, they’re inept bumbling, and stupid failures.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    #66,

    But Glenn. Frauds committed against Medicare are a reflection, are they not? of the vulnerability of the system. It does need strengthening up.

  • http://blogcritics.org/writer/dan_miller Dan(Miller)

    Zaphod — Alas, you are mistaken. “opps” is philosopher shorthand for “I think not.” You will recall what happened to Descartes when he said those words.

    Dan(Miller)

  • Clavos

    Did anyone ever find him after that?

  • http://blogcritics.org/writer/dan_miller Dan(Miller)

    Clav,

    No, sad to say, he wasn’t; he was promptly declared persona a gratin and was never heard from again. You will have to ask Zaphod whether he wound up in the good place to which all lost fountain pens boldly go. I don’t no … o
    p
    p
    s

    Damn! It’s dark here.

  • Glenn Contrarian

    Clavos –

    No, YOUR point doesn’t wash. Why? Because it was YOUR boys who passed legislation that prohibits Medicare from negotiating better prices. THAT, sir, is why Medicare – unlike the VA – winds up paying a LOT more than they should.

    And again, like it or not, you’re still blaming the victim – and you are still ignoring the FACT that the administrative costs of Medicare are one-thirteenth that of private companies.

    And wait for my NEXT reply in a few minutes, where you’ll get a clue on how pervasive corruption is on the private side.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Do tell!

  • Clavos

    Because it was YOUR boys who passed legislation that prohibits Medicare from negotiating better prices.

    I have no boys, Glenn, I’m not even sure who “my boys” are supposed to be.

    But in any case I wasn’t talking “negotiating prices,” Glenn. If Medcrummy just paid street prices like all the rst of us, I would be happy, but no, they pay premiums for goods (and so does the VA, BTW. I have a blood pressure machine from them that they paid twice as much as I would have had to, buying at retail from my local pharmacy.

    The whole shit-ass government does that, and you know it.

    Just for the record, I belong to no political party, and I have never given so much as a dime to any politician – ever.

    And I never will. Bad enough they steal my money on April 15th.

    the FACT that the administrative costs of Medicare are one-thirteenth that of private companies.

    I guess you believe that if you say something often enough, people will buy it. One more time: only because they don’t count the fraud, waste and overpayments.

  • Clavos

    And I have never argued that there is no fraud within the private insurers, I’m sure there is, but they aren’t spending taxpayer money.

    If their stockholders and B of Ds don’t dtop it, shame on them, but it’s not public fucking money, which, if Bam has his way, the bozos at Medicrap will soon have hundreds of billions more to piss away needlessly.

  • Glenn Contrarian

    Clavos –

    They pay PREMIUMS because they are REQUIRED BY LAW (passed by the Republicans during the Bush administration) to pay WHATEVER the posted price may be.

    Your local pharmacy, which paid HALF the price, is a company that can NEGOTIATE prices and DOES negotiate prices like any other good company.

    And NO, the whole government does NOT do that, because the VA negotiates prices and gets meds and equipment for far LESS than Medicare does!

    But you don’t want to hear that, do you?

  • Glenn Contrarian

    In an interview with the now-communist/socialist/nazi (according to the conservatives) ABC News, “All it takes is one illness or accident among employees at a small business to prompt an insurance company to hike the next year’s premiums so high that the employer has to cut benefits, shop for another carrier, or stop offering coverage altogether,”

  • Glenn Contrarian

    Let’s see who’s REALLY corrupt!

    Just today, a retired health company senior executive who worked for both Cigna and Humana said that insurance companies deliberately confuse policyholders and attempt to dump sick patients to plump their profit margins. He said that companies routinely drop seriously ill policyholders so they can meet “Wall Street’s relentless profit expectations.”

    In an interview with thenow-communist/socialist/nazi (according to the conservatives) ABC News, “All it takes is one illness or accident among employees at a small business to prompt an insurance company to hike the next year’s premiums so high that the employer has to cut benefits, shop for another carrier, or stop offering coverage altogether,”

    And this is a retired SENIOR EXECUTIVE who worked at two of the largest private health insurance companies! But I’m sure that Dave, Clavos, C-shop, and the other conservatives here know better than he would, huh?

    Note – I’ve tried five straight times to post this reply. I’ve cut out the a-href tags, so let’s see if it works this time.

  • Glenn Contrarian

    At the rawstory.com link in #79, also included was a news article from the AP:

    “Congressional investigators said Wednesday two-thirds of the U.S. health insurance industry used a faulty database that overcharged patients for seeing doctors outside their insurance network, costing Americans billions of dollars in inflated medical bills.

    The flawed database is operated by Ingenix, a subsidiary of health insurer UnitedHealth Group, which agreed in January to pay $350 million to settle allegations that it deliberately kept rates low to underpay doctors, driving up expenses for patients.”

    Two-thirds of the private health insurance companies use – NOW – a faulty database that allows them to underpay doctors and overcharge patients? But WAIT! According to the conservatives, it’s MEDICARE that’s so rife with corruption – and it’s MEDICARE’s fault that people (and HMO’s) submit faulty claims to them!

    But wait – there’s MORE!

    “In one case, Aetna allegedly eliminated the highest 20 percent of medical charges before sending the data to Ingenix, according to expert court testimony cited by congressional investigators. Once the data was handed over to Ingenix, officials there “scrubbed” the numbers again to further curb charges, according to the testimony.”

    By removing the top twenty percent of the reported charges, Aetna was able to skew the data to show a LOWER average price paid…and Ingenix (owner of the database that TWO-THIRDS of the private health industry uses!) scrubbed it even further to reduce the amount the insurance companies would pay doctors…and guess who would be making up the difference?

    YOU, the customers! And ALL of us, the TAXPAYERS!

    Yeah, but this is STILL better than any government plan, huh?

    You know what the sad part is? The conservatives will only ignore this and continue to hide their heads in the sand.

  • Clavos

    They pay PREMIUMS because they are REQUIRED BY LAW (passed by the Republicans during the Bush administration) to pay WHATEVER the posted price may be.

    “Posted price,” not a premium Glenn. As I said, they paid twice the “posted price” for the wheelchair, when with no negotiation they could just have gone on the mfr’s website and paid what anyone else can get it for, without negotiation.

    And NO, the whole government does NOT do that, because the VA negotiates prices and gets meds and equipment for far LESS than Medicare does!

    Bah. I’m tired of this. You worked for the government too long, you’re way too enamored of it.

    Your government sucks, Glenn, and you’re too blind to see it.

    You deserve it.

    Yeah, well that ain’t saying much, since Medicrap pays double or more, but even the VA pays too much.

    And the VA isn’t getting ripped off by fraud like Medicrap is, either.

  • Glenn Contrarian

    And let’s see who defrauds Medicare!

    On this page is a list of for-profit companies charged with defrauding Medicare. On the page are:

    Hospitals

    In 2006, Tenet Healthcare (America’s second largest for-profit hospital chain) settled DoJ suits for $900 million after allegedly false billing of Medicare and other federal programs. The alleged conduct included: “upcoding” patient diagnoses (billing for more expensive treatment than was done or called for), unreasonable inflation of charges, and illegal kickbacks to doctors.

    In 2005, Health South settled DoJ suits for $327 million after allegedly charging for false claims for outpatient physical therapy, over-billing Medicare for hospital costs, and billing Medicare for un-allowable costs (like employee travel, entertainment, and an administrator’s meeting at Disney World).

    By 2003, HCA (America’s largest hospital chain) had agreed to pay $1.7 billion to settle DoJ suits. The alleged conduct included: falsifying hospital-cost reports, charging Medicare for unallowable costs, and giving doctors illegal kickbacks for patient referrals. Some of the alleged conduct dated back to the 1980s.

    Drug Companies & Pharmacies

    In 2005, GlaxoSmithKline settled a DoJ suit for $140 million after allegedly submitting false claims to federal programs by falsely reporting inflated drug prices — “knowing that those prices would be used by federal programs to set reimbursement rates.”

    Retail pharmacies Wal-Mart (2004) Rite Aid (2004), Eckerd (2002), and Walgreen (1999) settled unrelated DoJ suits for a combined $23.4 million after allegedly charging federal healthcare programs full price for partially filled prescriptions. Federal programs including Medicare, Medicaid and TRICARE (military health) were affected.

    In 2003, AstraZeneca settled DoJ suits for $280 million after, among other things, allegedly conspiring with healthcare providers to charge federally funded insurance programs for free samples of a prostate cancer drug.

    Laboratories

    In 2003, Abbott Laboratories settled DoJ suits for $382 million after getting snared in a federal undercover investigation called “Operation Headwaters.” Apparently, a division of Abbot had offered kickbacks to federal agents to buy the company’s products, then “advised them how to fraudulently bill the government for those items.”

    In 2002, four individuals in Florida were sentenced to prison and ordered jointly to pay a total of $11.7 million after conspiring to defraud Medicare and Medicaid by submitting false claims for laboratory tests that were not actually performed.

    In 1997, SmithKline Beecham laboratories settled a DoJ fraud suit for $325 million after allegedly over-billing Medicare and other federal programs by: double billing for tests for kidney dialysis patients; paying illegal kickbacks to doctors; and billing for tests that weren’t done, weren’t medically necessary, or weren’t ordered by a doctor.

    HMOs & Insurance Companies

    In 2002, General American Life settled a Medicare-fraud case for $76 million after allegedly failing to perform its contractual duties to the Centers for Medicare and Medicaid Services (CMS). The duties included assessing eligibility and processing claims submitted by Medicare beneficiaries and healthcare providers. General American allegedly failed to process claims, submitted false information to CMS, failed to report errors, and disguised true error rates by deleting claims selected for CMS-review.

    In 2002, PacifiCare Health Systems agreed to pay $87 million to settle allegations that it (and its predecessor companies) had inflated insurance claims while contracted to provide government-employee benefits under the Federal Health Benefits Program.

    In 2004, Lovelace Health Systems, (a Cigna-owned hospital and HMO) settled a DoJ suit for $24.5 million after allegedly falsifying Medicare cost reports for ten years. Among other tactics, the company reportedly shifted the costs of its HMO patients to Medicare.

    Equipment Suppliers

    In 2000, an Ohio medical supplier was ordered to pay $15.1 million and sentenced to 70 months in prison after pleading guilty to defrauding Medicare by billing for urinary incontinence supplies that were not provided and by falsifying paperwork to hide the schemes from Medicare.

    In 1997, Olympus of America settled a DoJ suit for $22.8 million after allegedly overcharging the Department of Veterans Affairs (VA) for medical-imaging equipment. After the VA negotiated to receive the best discount that Olympus offered to private businesses, Olympus reportedly told the VA that it gave no discounts to private businesses (when Olympus did give discounts), thereby overcharging the VA according to the contract’s terms.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Well, yes Glenn. They do because they can. Again, the system needs tightening.

  • Glenn Contrarian

    Clavos –

    You’re talking about the POSTED PRICE at the PHARMACY!

    Do you know so little of business (I am a business owner too) that you think the posted price at your pharmacy is what that pharmacy is paying for it?

    Do you know so little of business that you don’t think that pharmacy will not NEGOTIATE the lowest price?

    Do you know so little of business that you think a major corporation will charge the SAME price for the same item for all customers?

    Do you know so little of business that you think a corporation will not charge a higher price for a customer who is REQUIRED BY LAW to pay whatever price the company sets – even when someone else gets to pay a lower price?

    THAT is the system the Republicans set in place, Clavos – but you’re blaming Medicare for it.

  • Clavos

    Thanks for proving my point, Glenn.

    Everybody rips off the government!

    So let’s turn over the entire medical system to the government! Let’s have Medicare provide ALL the health insurance for everybody!

    Typical government thinking.

    Gawdamn…

  • Glenn Contrarian

    Clavos, all you’re doing is spewing talking points, but you’re NOT doing research to see if those talking points are true.

    Worst of all, you’re acknowledging that there is corruption in the private health insurance industry (although you don’t seem to realize how pervasive it is), but you BLAME Medicare for being defrauded, even when the fraud is often committed by the private health insurers you’re defending!

    That, sir, makes NO sense.

  • Clavos

    You’re talking about the POSTED PRICE at the PHARMACY!

    No, Glenn. I clearly said the posted price on the wheelchair manufacturer’s website.

    And I’m not blaming Medicare for whatever you allege the GOP put in place.

    I AM saying the entire government, but especially Medicare, is incapable of properly handling the medical insurance for the whole country.

    And I’m saying it from multiple years experience as a Medicare client.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    I’d have to agree if we’re go by the present record – the ease with which it’s being defrauded.

    You’ve got to concede this point, Glenn.

  • Glenn Contrarian

    Clavos –

    You posted: “So let’s turn over the entire medical system to the government! Let’s have Medicare provide ALL the health insurance for everybody!”

    Well, gee, if we did that, then we’d be just like ALL the other modern democracies on the planet. We’d be doing what the TOP TWENTY-SEVEN countries on the life-expectancy list are doing – and like those twenty-seven top countries, we’d be spending less than sixty percent of what we’re ALREADY spending!

    Ah, but it’s SOCIALIST to do what helps the population as a whole live longer, and it’s SOCIALIST to be able to do that for not much more than HALF what we’re already paying, huh?

    Clavos, in many issues there’s right and wrong on both sides – but in this one, ALL the numbers are against you. It’s not a matter of right and wrong – it’s what is best for the American people and the American taxpayers. Patriotism is doing what is best for the nation as a whole – and continuing with the system we have that gives less quality for a FAR greater price…is not patriotic.

  • Glenn Contrarian

    Ah, now it’s not Medicare, but it’s the entire GOVERNMENT that’s to blame?

    Okay, Clavos – then HOW is it that the TOP TWENTY-SEVEN countries on the life-expectancy list ALL have government-run health care of one sort or another? And HOW is it that ALL of those countries pay less than sixty percent per capita of what they’re already paying?

    If government is SO incapable and SO inept, then explain how the above are possible.

    And I should warn you – don’t try to toss the blame on strawmen like illegal immigrants, diet, wars, violence, terrorism, whatever – for all of these are easily debunked.

  • Clavos

    you BLAME Medicare for being defrauded

    One more fucking time, Glenn:

    I’m not blaming Medicare for anything but stupidity and ineptitude, which I suppose is unfair, since the entire Federal government is riddled with those deficiencies at virtually all levels.

    My argument is that the amount of fraud being gotten away with is proof positive that the government is incapable of properly handling UHC.

    And I’ve given plenty of evidence for it on this and other threads for months now.

    I have defended no private insurers; I have attacked the federal government, which richly deserves it.

  • Glenn Contrarian

    Roger –

    I disagree. Yes, Medicare gets defrauded – but look at the plethora of cases against those who defrauded them! Is that really something against Medicare, or is that effective enforcement against the mindset that “it’s easy to get away with it”?

    If it were so easy to get away with it, then would we be seeing so many cases?

    Clavos’ point – and yours – is akin to blaming Wal-Mart for allowing shoplifters to get away with it, even though they strictly prosecute those they catch.

  • Glenn Contrarian

    Clavos –

    “My argument is that the amount of fraud being gotten away with is proof positive that the government is incapable of properly handling UHC.”

    What you have NOT done is said how the TOP TWENTY-SEVEN COUNTRIES on the life-expectancy list could do it when they ALL have some form of government-run health care.

    You know what this is going to boil down to? Your whole argument is going to be, “We can’t do it because we can’t do it!”

    Because that’s all you’re left with by saying that the top twenty-seven countries on the life-expectancy list can do it, but we can’t.

  • http://blogcritics.org/writer/dan_miller Dan(Miller)

    The Government is in such incredibly good hands that I don’t know of any reason why everything shouldn’t be turned over to it. With mature, sensible leaders such as these, things are just bound to be better with the Government running everything.

    Dan(Miller)

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Glenn,

    You have to consider the opposition argument. They are legitimately concerned about good money disappearing into a hole. There’s always be thieves and opportunists, can’t do nothing about it. But what you can do is to tighten the system so as to prevent potential abuses. It’s the only responsible thing to do.

  • Clavos

    We’d be doing what the TOP TWENTY-SEVEN countries on the life-expectancy list are doing…

    Read this.

    Our sorry life expectancy has far more to do with lifestyle issues than our medical system, Glenn. it’s no accident that the rich of the world flock to the USA when they get REALLY sick — the US is one of the top medical tourism destinations in the world.

    If government is SO incapable and SO inept, then explain how the above are possible.

    That doesn’t make sense, Glenn. The government as yet, thankfully, is in charge of a very small portion of our health system.

  • Clavos

    …is not patriotic.

    Screw patriotism, it’s for scoundrels.

    Like Michelle Obama, I’m hard-pressed to even be proud of being an American some of the time.

  • Glenn Contrarian

    Clavos –

    What a WONDERFUL strawman! FYI, Clavos, the U.S. is NOT one of the top destinations for medical tourism. It’s not even in the top seven. Google “top destinations medical tourism” and see what you find!

    Again, you’ve been listening to the right wing for so long that you can’t even check their facts – so I’ll do it for you. Next year, more than SIX MILLION Americans will travel abroad for medical care they can’t get or can’t afford here.

    Do six million travel here for such care? I think you’d be hard-pressed to show even ONE HUNDREDTH of that figure – sixty thousand – coming to America for medical treatment.

    I know something about this, too, Clavos – because that’s my newest business. The website will be up in late July, and operations begin in August – and my business model is at least as good as any of the others I’ve researched.

    You say, ‘screw patriotism’. I guess you don’t know that patriotism – like any sort of pride – is essential, but only when used for the right reasons. This particular retired Navy man knows something of that, too.

  • Glenn Contrarian

    Clavos –

    Considering your reference that tries to make the case it’s America’s lifestyle that is largely to blame for our lower life expectancy. I beg to differ. Here’s why:

    Your reference said: “The most enduring lesson here is that broad metrics like infant mortality and life expectancy are heavily influenced by behavioral factors for which no health-care system can take the credit or blame. But if a serious disease like cancer is threatening your life, there’s still no place on earth you’d be better off than the United States.”

    If a serious case like cancer is threatening your life, YES, there’s NO PLACE ON EARTH that has health care as good as America’s…IF YOU HAVE GOOD HEALTH INSURANCE!!!!!!

    Nearly fifty million Americans don’t. In the study referenced by your source, were any uninsured Americans – and the millions more of UNDERinsured – asked whether they were satisfied with the quality of their care? Did they ask any of the Americans whose claims had been denied (or their insurance canceled outright) by their insurance company?

    Probably not – it’s hard to be satisfied with health care when you can’t have any.

    THAT, sir, plays a larger part in our lower life expectancy…and places a big strain on our economy as well.

  • Clavos

    You say, ‘screw patriotism’. I guess you don’t know that patriotism – like any sort of pride – is essential, but only when used for the right reasons. This particular retired Navy man knows something of that, too.

    Well, this two year draftee who got his ass shot at in Vietnam, but thankfully didn’t come back in a box, is smart enough to see the wisdom in Dr. Johnson’s aphorism and has learned not to have anything to do with self-styled “patriots.”

  • http://jeanniedanna.wordpress.com/ Jeannie Danna

    My God Clavos, I have to lean left to keep you from falling over…

    We will get the changes we need in this country with or without ya!

    You of all people here should want affordable health care for all!

    shouldn’t you?

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    That’s nicely put, Jeannie. “Leaning more to the left so as to keep Clavos from falling over.”

    You’re showing the writer’s imagination.

  • http://thingsalongtheway.blogspot.com/ Cindy

    Clav,

    If you come back to these parts and you feel inclined and have time, can you translate this for me? It looks like something I’ll like, but babelfish isn’t doing it justice.

    “Escúchame, que yo te escucho, pero escúchame. Déjame que te pueda hacer dudar, y yo te dejo que me hagas dudar. Eso es”. Ramon Sampedro

  • Clavos

    Cindy,

    He was a poet who also wrote elegant prose, so it’s interpretive, and I’m not familiar with his poetry. Someone else might give you a better interpretation (Babel fish definitely won’t cut it), but here’s how I read it.

    “listen to me, for I listen to you, but listen to me. Let me make you doubt, and I’ll let you make me doubt. That is it.

    You’ve instilled in me a desire to read some more of his stuff, and also to see the movie.

  • Glenn Contrarian

    Clavos –

    You posted “Well, this two year draftee who got his ass shot at in Vietnam, but thankfully didn’t come back in a box, is smart enough to see the wisdom in Dr. Johnson’s aphorism and has learned not to have anything to do with self-styled “patriots.””

    Patriotism is also holding one’s leaders accountable – something that was verboten over the past two presidential administrations. You, then, of all people should be foaming at the mouth for the lives of young soldiers and Marines wasted to satisfy the hubris of the then-occupant of the Oval Office.

    Don’t think for a moment that I’m so naive that I don’t know our nation’s faults – but neither am I so bitter and cynical that I can’t believe in something greater than myself.

  • http://biggesttent.blogspot.com/ Silas Kain

    Patriotism is also holding one’s leaders accountable – something that was verboten over the past two presidential administrations.

    Amen, Glenn. Now I’m going to be the fly in the ointment.

    Frankly, I’m getting tired of veterans who say “I fought here” or “I went to ‘Nam, blah, blah, blah.” Let’s put the cards on the table. In the 60’s, there was a draft. I would venture to say that the vast majority who served in the military did so reluctantly but under the terms of the law governing this land at that time.

    Now, don’t get me wrong. I’m grateful to all who have served, and a part of me mourns the loss of every soldier that has fallen for the flag. However, service to country was a fact of life. Congress and the President did away with the draft and all of a sudden the importance of service has been diminished.

    Patriotism begins at home. And from the kitchen table it is carried into schools, communities and across the land. Sounds good in theory, doesn’t it? So, to put it into a logical sequence – it is up to parents to encourage patriotism. It falls upon educators to continue the encouragement. And all of this should culminate in a mandatory service program for all our youth who are capable at some point between the end of high school and the Master’s Degree. I’m not saying that it should be military, but every child citizen should be raised and prepared to serve his/her country in the best way that they can out of a sense of patriotic duty.

    Perhaps then, and only then, will we spawn a generation that actually appreciates what we have achieved thus far and work to improve it for the next generation. It’s time for the citizenry to become the new special interest group in town.

  • Clavos

    …neither am I so bitter and cynical that I can’t believe in something greater than myself.

    Chacun à son goût, Glenn.

    I’m cynical, but not bitter.

    A friend said to me recently, “You live in Miami and sell boats. Your life is a vacation.

    I’m satisfied.

    Until something better comes along.

  • Cannonshop

    #47 Glenn, the basic difference between private Fraud cases, and Mediscam fraud, is that in private cases, usually someone gets fired, and the darn cases get PROSECUTION. (people, going to jail, y’know??)

    Federal Kleptocrats don’t get prosecuted, and are almost never fired, no matter how badly they screw up or screw over the taxpayers.

    In the private sector, before you give someone an increased level of authority, access to additional budget, or some combination of the two, you make certain that someone can actually perform the job. In Government, the only measure is time, and how many SEIU votes you can create to maintain your power-base.

    Before you beat the drum to expand another un-answerable, non-accountable, completely immune-to-consequences bureaucracy, maybe you should consider first and foremost working out some civil-service reforms so that you’re not just adding to the burdens while dumping the existing quality into a fiduciary toilet?

    And as for the Private insurers-yeah, a frog next to an alligator, see how long the frog lives. The Alligator IS the government.

    What, wasn’t Fannie and Freddy enough of a lesson for you? We have a gigantic number of citizens getting ready to roll into Medicare now-they’re called “baby boomers”, and notably, the age of Social Security has been pushed upward to keep THAT structure solvent. Medical bills are even more intense than retirement pensions, and Medicare, when you INCLUDE the rest of the data instead of cherry-picking your numbers to look good (what’s called “cooking the books” anywhere else, and a crime if you’re a PRIVATE insurer) is wholly reliant on deficit spending by Uncle Sam to remain in business. Expanding that to the rest of the country WILL put legitimate, actually-regulated insurers out of business as customers drop them in favour of the public system (which businesses WILL DO-they’re already paying the taxes on it, keeping private care won’t lower those taxes, Taxes only go one way now, and even if they didn’t, they won’t for businesses since it’s popular to ‘soak the rich’ even when there’s nothing to soak from.)

    You need to also ask yourself if the people proposing and pushing this, are going to be forced by circumstances or legislation to make use of it without prerogatives regular citizens don’t get. Amazing though it might seem, when a Boss has the same plan as his employees, he tends to make sure it’s adequate, whereas when he doesn’t…

    and Congress rarely sits in the same leaky boat with the rest of us on anything short of national defense.

  • http://ruvysroost.blogspot.com Ruvy

    I’m going to toss in my two cents here.

    Now I’m going to be the fly in the ointment.

    Citizenship begins at home, and it includes not only the willingness to serve one’s country, but the determined willingness to criticize the country’s policies when they ought be criticized, and the sense that one has to know enough of those policies to criticize intelligently. That’s true for the United States as it is of Israel.

    Merely screaming that “my taxes are too damned high!” doesn’t constitute criticism of any intelligent sort.

    Now to bring this round to the topic at hand. I think that there should be a system of universal health care in the United States. I always have, and considered moving to Canada 30 years ago precisely because they had universal health care – and the States didn’t.

    But….

    It appears to me that you have several times the value of your GDP floating around in currency – which means that a very nasty bout of iflation will soon set in, if it hasn’t already. It appears that your are all up to your ears in debt to foreign nations.

    A reasonable sense of FISCAL RESPONSIBILITY demands that you set your financial house in order before undertaking a program of social nets that universal health care requires; you need more than just universal health care, you need a system that provides decent treatment for all.

    So far, the American record on that stinks. There never used to be homelessness – until someone got the bright idea that closing mental institutions and releasing the patients to group homes of various kinds would save a fortune of money as well as cut out the well documented abuse that went on at mental institutions.

    The mental institutions got closed – but the sufficient number of group homes never got opened. The overflow were the nut cases who were homeless – who were fed by charity centers in cities like Saint Paul, and who sat next to me in eating soup or sandwiches, and who sat rolling tobacco into cigarettes when I was homeless myself.

    Given that Americans have already fucked up the mental health care system in order to save money, managing to create homelessness instead; given that you are all up to your eyeballs in the debt your government has contracted in your name (I can’t talk about private debt here); given that insurance companies are lining up behind “the plan” pushed by your tactically sharp but strategically retarded president, I suggest you go slow on all this. If insurance companies are lining up behind Obama’s plan, it will not save money.

    And you will get fucked over, but good.

    Meet the new boss – same as the old boss…..

  • Glenn Contrarian

    C-shop –

    “Federal Kleptocrats don’t get prosecuted, and are almost never fired, no matter how badly they screw up or screw over the taxpayers.”

    Hm. Let me see – the guy in charge of Medicare might get $200K per year. That’s it – but you call him a ‘kleptocrat’. But you think what we have with the HMO’s whose CEO’s make as high as $29M per year (more than 100 times greater) is somehow better for the American taxpayer.

    C-shop, most high-level government functionaries make FAR less than their civilian counterparts – but what they have in return for FAR less pay is (normally) better job security.

    I really don’t understand where you get off calling those who work for the government ‘kleptocrats’, because their salaries are publicly set in stone and can’t be arbitrarily changed.

    ANY human organization will have some level of corruption. You will NOT name ANY human organization ANYwhere – political, military, commercial, religious, educational – that is not corrupt to some extent. It’s all a matter of degree.

    That’s why it’s such a mistake, a strawman of epic proportions, to ASSUME that the American government is too corrupt to trust…because compared to the governments of the world, ours is among the LEAST corrupt – AND there is FAR less corruption in the Federal government than among the profit-driven health care industry.

    Why?

    A major reason is that in the Federal government, all salaries are essentially public record…and that makes it blatantly obvious when someone’s taking in more money than they should.

    C-shop, we trust the government with police, with firefighters, with military…and these are part of society which should NOT be profit-driven. That then begs the question – when police, firefighters, and military (all of whom (save the few who are corrupt) are NOT profit-driven) are trusted with protecting our lives, WHY must health-care be profit-driven?

  • Glenn Contrarian

    Ruvy –

    Excellent post! You are spot on concerning the root causes of our homelessness. The only point where I disagree is on our financial status – it does suck, badly, but we’ve still less debt, relatively speaking, than after WWII.

    But then, after WWII, we had the political will to do what was necessary. That’s why we had a 90+ percent top marginal tax rate, and a corporate tax system with FAR fewer loopholes…and you know what? Our economy became the envy of the world in the 50’s and 60’s!

  • Glenn Contrarian

    For all who are absolutely SURE that universal health care is a bad, bad thing, check what they mayor of San Francisco says. You see, they got tired of waiting on the rest of the country and started their own…

    …and you know what? It’s CHEAPER, because now the people aren’t having to spend hideous amounts on emergency-room visits!

    Of course this is in San Fran, and so most conservatives will just KNOW that one must sign up for sexual-adventurism training…

    …but wait! Republicans would qualify! Just look at Craig and Ensign and Sanford – heck, if that’s not sexual adventurism….

  • http://www.republicofdave.com Dave Nalle

    We’venow got an interesting development on this front. Finally the GOP has done something useful (unlike the plan they suggested last week). Sen. Jim DeMint (R-SC) has put forward a plan much like what I was talking about earlier with a partial voucher system — he’s getting lambasted by some fellow Republicans, but the idea is basically sound and makes much more sense than the hodgepodge of social engineering claptrap and insurance industry payoffs which Obama is offering. It’s the nucleus of a real, coherent system for health reform. I disagree with DeMint on just about every other issue he’s known for, but he actually on the right track. I particularly like his idea of tying it to ending TARP. I’d likely take it a bit farther, but the idea is much more sound than anything else I’ve seen.

    Dave

  • Glenn Contrarian

    Sorry – forgot to include the link in reply #112.

  • Glenn Contrarian

    Dave – got a link to his plan?

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Yeah, I was gonna ask the same.

  • http://www.republicofdave.com Dave Nalle

    “For all who are absolutely SURE that universal health care is a bad, bad thing, check what they mayor of San Francisco says. You see, they got tired of waiting on the rest of the country and started their own…

    Which raises the obvious question of why this sort of thing shouldn’t be handled at the state or local level rather than on the federal level. The higher the level of government at which a program like this is undertaken, the more people who will be ill-served and see the quality of their care decline rather than improve.

    Dave

  • http://thingsalongtheway.blogspot.com/ Cindy

    104 – Clav,

    Ah thanks Clav…that is a wonderful translation. I love that poem.

    I’ve never heard of Ramon Sampedro. Mar Adentro looks good. I’ll want to see that. Muchas gracias amigo. :-)

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    #117,

    It’s possible, I suppose, for the program to be administered locally, on a state by state basis, but there’s got to be some Federal guidelines and minimal standards.

    Couldn’t the Food Stamps program serve as model? (That’s in fact the direction I’ll be taking in Part III of “Rethinking Universal Healthcare.”)

  • Glenn Contrarian

    Clavos #107 –

    I do understand about life being a vacation.

    And that’s why I miss living in Hawaii so badly. From what I’ve heard, in the normal economy there a gallon of milk now costs 9 bucks – 9 bucks! – but it’s still the best place on earth to live IMO.

    One of my favorite things was to take a bus down to Waikiki or up to the north shore and walk among the tourists who paid thousands for the privilege.

    Enjoy! And be grateful…for all real happiness is rooted in gratitude.

  • http://biggesttent.blogspot.com/ Silas Kain

    It’s possible, I suppose, for the program to be administered locally, on a state by state basis, but there’s got to be some Federal guidelines and minimal standards.

    I cautiously agree. My major concern is that I can’t see how a state plan could be effectively administered in certain states where the population has the collective intelligence of a back water, inbred batch of Bible thumping jug heads. And the next concern I have is that states like Massachusetts, California and New York could very well create and administer plans that are so over the top and financially oppressive. The ones who would not be able to afford these plans would end up moving to the aforementioned back water states. At that point states like Mississippi and Alabama would look like the Gaza strip.

  • Bliffle

    Let’s take a look at Clavos’ fabulous citations in #53. (I’m shoving this into the thread because I know that lazy BC commentors are not going to read this stuff and will accept Clavos’ claims on face value).

    Miami Herald

    Federal agents have dismantled a Miami-based ring they said schemed to defraud Medicare of $100 million by filing false claims for obsolete HIV therapy across five states — although two of the suspects who posed as clinic owners have fled to Cuba.

    Notice that the criminals “schemed” to defraud medicare but were stopped and arrested.

    Medical News today

    Eight defendants were indicted in a massive Florida Medicare fraud case. The Associated Press reports: “It may be the center for Medicare fraud, but even Miami officials said Tuesday they were surprised by the breadth of a ring they say spanned five states, used 29 fake storefronts and attempted to steal $100 million from Medicare and Medicare Advantage. Eight defendants were charged in the elaborate scam authorities say billed Medicare for bogus HIV and cancer infusion drugs using dozens of storefronts in Florida, North Carolina, South Carolina, Georgia and Louisiana, authorities said. Two of the defendants and about $30 million are still missing.” The AP notes: “It shows Miami’s stepped up health care fraud task force is working. They’ve prosecuted $1.5 billion in health care fraud cases in the past three years. Miami alone has had 146 convictions since 2007 in these cases. The fact that the suspects had to move to other states and other avenues of Medicare – in this case, Medicare Advantage – signals an understanding on the streets that officials are on to their old tricks.”

    Notice that the criminals attempted to defraud medicare but were soon arrested.

    WSJ

    The federal government announced indictments of 53 people allegedly involved in a Medicare-fraud scheme in Detroit, a day after charging eight others in Miami suspected of running a similar fraud.

    The two separate cases, a joint effort by the Justice Department and the Health and the Human Services Department, reflect a pickup in the government’s pace in combating Medicare fraud.

    In the Detroit case, the alleged fraud was estimated at $50 million. Those charged included doctors, health-care executives and beneficiaries. The scheme in Miami allegedly used fake storefronts in an attempt to cheat Medicare out of $100 million.

    Notice that the criminals made “an attempt to cheat Medicare” and were arrested.

    Also notice that none of these attempted frauds suggest anything like the total amount of fraud that Clavos claims.

    Notice what losers these fraudsters are. If you were a fraudster would you attempt to defraud Medicare?

    Many fools attempt Medicare fraud, even when they should know better. A couple of years ago the head of the state Medicare Fraud Detection unit in a southern state attempted to build a fraud gang and ripoff medicare based on her inside knowledge, and she was caught and jailed! It was quite a shock to me since I had dealt with her on the phone for several months.

    If you’re a crook, if you want to commit fraud, steer away from Medicare.

  • Glenn Contrarian

    Now now, Bliffle – you know very well that it’s patriotic to blame the victim for what the criminals do. That’s why Palin’s town was the only one in Alaska that charged rape victims for the ‘rape kit’.

  • Clavos

    Shit, Glenn, if it’s patriotic, I’ll stop doing it for sure.

    The very last thing I want to be accused of is patriotism. I’d rather be known as a pedophile.

    I’m gonna have to go burn a couple of flags in a VA cemetery tomorrow.

  • Cannonshop

    #110 I used the wrong term. What is the term for someone for whom it’s all about increasing their power, Glenn?

    We trust Police, Firefighters, and to a limited extent the Military for one simple reason-they’re accountable.

    Bad Cops go to jail when they’re caught, or get fired, or are removed (well, unless it’s a certain Alaska State Trooper with friends in the Legislature and National Media), Firefighters who ‘go bad’ are generally fired-and sometimes prosecuted (One wonders, exactly, how a firefighter might GO bad. Maybe turning into an arsonist?)

    Soldiers likewise face courts-martial, and prison time, and a dishonourable discharge wrecks your life. (Take a look at some of the penalties), further, they’re under a far, far, stricter and more strictly enforced code of conduct than ANY civilian faces.

    Now, cross that over to Federal Bureaucrats-who aren’t under NEARLY the kind of pressure that a cop, fireman, or soldier lives with day-to-day, nor are they under NEARLY the kinds of strict rules, with harsh penalties that firefighters, cops, and soldiers work under-and did you notice that cops, firemen, and soldiers are all paid CONSIDERABLY LESS than a comparable GS-rating in a non-dangerous field?

    (particularly soldiers.)

    The comparison answers your own question, the issue I, and a lot of other opponents of UHC have with the concept, is that Federalcrats aren’t accountable. They’re IMMUNE, and that’s not a good thing.

    The fraud case Bliffle posted is only the most obvious, and easily prosecuted scam out there-there’s plenty that go right on through without being noted, and worse, there’s WASTE and internal fraud going on.

    Everything you find in a major corporation-everything that makes MONOPOLIES bad, is present in Government, and the wider you extend that power, the worse it gets. Sure, a director of Medicare might only make two hundered grand, but he’s going to make a BUNCH MORE when he moves on to the Private Sector and collects on the favours he’s been dealing out for fifteen, twenty years (or his wife will, or his kids, brother-in-law, nephew, domestic partner…)

    Then, there’s the other side of it. In Canada, if you get sick and need a doctor’s note?

    well, first it’s the five hour wait in the emergency room, then, after they’ve chiseled you (because agencies always find ways to make budget-and if the budget’s strained, they’ll add ‘user fees’. Visit a national or state park sometime), it’s going to cost you ten bucks for the note to show your work. (or school, or whatever).

    Now, remember, I’m with a private insurer, (Blue Cross), it costs me…fifteen bucks, and I get in to see MY doctor, the note’s free, I GET treatment, if I need tests, I GET tests…and it’s supported thanks to a Union Contract with a Private Employer, who shells out the rest (and it’s a lot-COBRA coverage would run me six hundered a month-about what Renting a decent place in most of the country that isn’t the East or West Coast would cost-i.e. about what most folks would pay for their HOUSING-the largest part of any American’s living expenses).

    Under this “Plan”, any company that doesn’t have a “Strikin’ Union” is going to drop their Private insurers and stick the guys working for them on the Federal plan-because they’re ALREADY PAYING FOR IT, can you dig this? That puts people out of work here (’cause, you know, The Feds aren’t going to pick up all those folks who worked for places that closed shop when the customers dried up), increasing unemployment. People still get sick, so you’ve got a smaller (shrinking) pool of providers covering a larger market from a fixed budget (well, not really-the Congress is running on imaginary money anyway, they can print more, right???)

    In a Crap economy (fourteen million out of work and it’s still increasing) that isn’t generating the tax-revenue it did five years ago, and coming under a “cap and trade” programme that is also financed with funny-money that increases the costs to individual citizens without providing more than a gold-farting-unicorns promise of some mysterious ‘new industry’ that is going to give them jobs building alternative energy systems that largely don’t work.

    I reiterate: did you learn NOTHING from Fannie and Freddy, TARP, etc. etc.?

    The one thing you do NOT do in a bad economy, is hand out goodies you can’t afford while putting people who’re already on the margin over the edge.

    Sure, the “Rich” can afford this-and a large number of them and their sycophants occupy the halls of congress and are pushing this-but take the system as a whole, Glenn. We can’t afford this, Before you start talking about Government-sponsored “Health Insurance”, you need to have a functioning economy that’s producing enough that you can AFFORD to gut little office small-run outfits to hand out freebies to people who don’t have real jobs, and don’t want them.

    It’s simple: Fix the Economy, THEN you can talk about taking on additional responsibility with the taxpayer dollar-you don’t take it on before you’ve PROVEN you can generate the money to do so. (and by “generate” I’m NOT talking about borrowing half-again from China then running the printing presses ’till they shatter from metal fatigue.)

    Similarly, in a nation of three hundered some-odd million people, most of whom rely on motor transport to get to work (if they have jobs), increasing the price of fuel (or cutting production, which does the same thing) is a recipe for further disasters. It’s easier to build an alternative energy system when your existing infrastructure is flush, you don’t do it in the middle of an economic melt-down, where people are cutting back on what they eat to get to work this week.

    FIRST you increase production of what you have, increase available resources for your system, and reform your civil service so that it SERVES instead of trying to MASTER, and THEN, you start implementing alternatives-and you make damn sure that whoever you put in a position to handle the administration and enforcement is up to the task, and unlikely to get complacent, corrupt (well, excessively-this IS government we’re talking about), or too comfortably obscure to pull shit. (it’s called making them accountable, perhaps Malfeasance and Incompetence should return to the list of things that get you fired from Government service-and maybe jail time, too…)

    Further, Regulatory bodies (and the FBI) should NOT be back-burnering financial fraud cases-as they have been since…before I was born in 1973?

    Beyond that, if you want a “Universal Health Care” that works, maybe it would behoove you to consider incentives to lure young, bright people into the Medical field, and incentives to schools to admit, run, and support their science and medicine programmes at LEAST as well as they fund and support their football teams…

    More Doctors in the field means lower prices for the people that use them. Less Doctors means more demand, and higher prices. Fix the “less Doctors” problem and the rest may well take care of itself.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    I like your comment, Cannon, especially when it concerns the timing. Fix the economy first. And reforming civil service should be first priority. No one has any real conception as to the extent of waste of money and resources. I’d be willing to bet that if someone was of the mind to a real, honest-to-goodness audit, they could cut the expenses by 40 percent without compromising the scope or the efficiency.

    It is wasted money going down the sinkhole.

  • Clavos

    …before I was born in 1973?

    Damn, Cannon, you just made me spew coffee all over my screen.

    My wife and I were married in ’71, kid.

  • Clavos

    Oops! Meant to also say great comment, Cannon.

  • Clavos

    bliffle #122:

    You almost had me convinced, despite all the evidence to the contrary, including the fact that your government, by its own admission can’t interdict more than 10% of the drugs entering your country, that maybe, just maybe, it really does have a handle on Medicare fraud.

    So you can imagine my astonishment and chagrin this morning, when I opened my copy of the Miami Herald, only to find this enormous, above-the-fold front page headline:

    Crackdown on Medicare fraud a priority for Obama administration

    Perusing the article, I find some statements from highly placed government bumblers — er, officials, such as this one from Kathleen Sebelius, your Health and Human Services Secretary:

    ”The Obama administration is committed to turning up the heat on Medicare fraud and employing all the weapons in the federal government’s arsenal to target those who are defrauding the American taxpayer,” HHS Secretary Kathleen Sebelius said during a news conference at the Justice Department with Attorney General Eric Holder.

    ”But our joint efforts don’t just stop at the jailhouse door,” she said. “Every dollar we can save by stopping fraud can be used to strengthen the long-term fiscal health of Medicare, bring down costs and deliver better service to Medicare beneficiaries.”

    And the article goes on:

    The government’s job will be anything but easy.

    During the past five years, thousands of Medicare fraud offenders have shown that they can outsmart the vulnerable healthcare system for the elderly and disabled. Their weapons: cash kickbacks to Medicare patients, manipulation of medical records to justify bogus charges, and use of different billing codes to get around Medicare’s technology to block false claims. (emphasis, as always, added)

    And:

    Multiple indictments, returned by a federal grand jury in Michigan, spotlighted HIV infusion and physical therapy that have been widespread in Miami and were transported to Detroit, the latest Medicare fraud hot spot.

    The severity of the problem in Detroit prompted Holder, Sebelius and FBI Director Robert Mueller to hold the news conference Wednesday at the Justice Department.

    And finally, we have this, from your ever affable (if inept) Attorney General, Eric Holder:

    ”We will strike back [future tense, bliff] against those whose fraudulent schemes not only undermine a program upon which 45 million aged and disabled Americans depend, but which also contribute directly to rising healthcare costs that all Americans must bear,” Holder said.

    So, apparently, you’re wrong bliff. Your much-maligned and perennially inept government does not yet have things even close to under control.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    “your ever affable (if inept) Attorney General, Eric Holder”

    Why inept? Isn’t it a rather early call?

  • Bliffle

    Cannonshop does a lot of wild speculating without any basis in #125:

    Federalcrats aren’t accountable. They’re IMMUNE, and that’s not a good thing.

    Huh? Where is that written. In fact, federal bureaucrats are subject to the same las as anyone else, like fraud, thievery, etc. And some go to jail every day for crimes.

    The fraud case Bliffle posted is only the most obvious, and easily prosecuted scam out there-there’s plenty that go right on through without being noted,…

    How do YOU know? What are your sources? Your own Paranoia?

  • Bliffle

    Clavos blows hot air again in #129:

    This time he’s recycling political hot air from democrat politicians, of all things!

    No numbers, no facts, just political hot air.

    Clavos has fallen victim to the Permanent Political Campaign.

  • Bliffle

    And where does this come from:

    You almost had me convinced, despite all the evidence to the contrary,…

    What evidence?

    … including the fact that your government, by its own admission can’t interdict more than 10% of the drugs entering your country,…

    Whose government? What does the drug war have to do with medicare?

  • Clavos

    Yer whistlin’ past the graveyard again, bliffle.

    Even the govt officials are admitting Medicrap fraud is out of control.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Speculations aside, bliffle, there are some cogent ideas expressed by Cannon concerning the importance of timing and fixing the economy first, ideas to which you’re apparently as blind as a bat.

    Not everything should be decided on the basis of “mere facts,” be they numbers or figures. That’s the bean-counter’s way. Ideas count.

    You seem to be undergoing a phase of late – this obsession you seem to have to try to reduce everything to factual arguments, forgetting all the while that numbers and statistics can be used to support both sides of the argument.

    And in light of this recent conversion of yours from a thinker to a bean counter, we shall be more than justified to discount from now on all your observations as regards such sundry matters as your interpretation of history, America’s past, or any other general subject on which (if I remember correctly) you felt quite free to treat us to your esteemed opinions.

  • Bliffle

    Clavos: “Even the govt officials are admitting Medicrap fraud is out of control.”

    No, politicians are plumping for more money.

    You know, just like the hysteria Bush generated by saying Saddam Hussein was going to bomb us with his WMD.

  • Bliffle

    “How Does Universal Health Care Save Money? Easy…”

    Here’s how:

    Given that about 18% of the GDP, about $2.2triliion,
    and that insures about 200million people,
    and there are about 50 million uninsured,
    and private insurance overhead is about 40%,
    and medicare overhead is about 3%,

    then:

    converting everyone to medicare reduces total cost for 200 million to:

    $2.2T * (1 – 0.40 + 0.03) = $1.5T

    and adding the 50million uninsured adds 25%:
    Total cost = 1.5T * (1.25) = $1.9T

    a clear savings of $300billion per year.

    Any high school graduate who was actually awake in math class should be able to figure this out.

  • Glenn Contrarian

    Clavos #123 – I did laugh out loud at that one. Good riposte….

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Glenn,

    I think you should re-read Cannon’s #125 which our bean counter has so summarily dismissed. Apart from the dollars and cents argument which you folks are so enamored of/with (take your pick, Clavos, which preposition fits better?) – and I’m sorry, I can’t get excited about the accounting aspect(s), so I shall leave these matters for you to decide – Cannon does make some valid points as regards the importance of timing and fixing the economy.

    In a typical dismissive fashion, so characteristic lately of once “Bliffle the thinker,” the aforementioned individual pays it no heed. But Cannon’s points still stand and at the very least deserve to be answered.

    Now, I don’t expect Bliffle to be able to do that, because apparently he’s no longer capable to process ideas. But you should re-read Cannon’s remark and at least try to respond.

    In fact, I’d like to hear your response.

  • Glenn Contrarian

    C-shop –

    What, you don’t think there’s federal bureaucrats in the police force, the firefighters, the military? Are you KIDDING?

    And if you think that doctors don’t face danger, why don’t you go talk to one about what they and nurses face with MRSA, C-DIFF, AIDS, and a plethora of other mircrobes that will kill you and feast on your bones?

    Why don’t you read about how many doctors and nurses (and medical researchers) died doing their duty in the 1918 influenza? Check what they go through every day in inner-city emergency rooms!

    I could write a book on all the errors in your post, all the prejudices against government that you’ve inherited from Reagan’s greatest blunder, and PARTICULARLY about your erroneous paradigm about government corruption.

    YES, there is government corruption, as with ANY other human organization bar none. BUT what you are NOT UNDERSTANDING is that there is FAR MORE corruption in the private health insurance industry!

    ALL OTHER MODERN DEMOCRACIES ON THE PLANET have government-run health care of some form or another for their ENTIRE populations, and NONE OF THEM pay much more than half PER CAPITA than what we ALREADY do…AND most of them comprise the TOP TWENTY-SEVEN on the list of nations by life-expectancy!

    ALL your bitter bombast cannot negate those facts!

    The experience of ALL the free world outside America’s borders should tell you that you pay FAR LESS TAXES if you have universal health care!

    If the rest of the world’s democracies can do it, then why can’t we?

    If most of the rest of the world’s democracies can provide BETTER care overall for their populations for FAR LESS TAXES, then WHY can’t we?

    I’ll tell you why – it’s the old saying, “Can’t never could”. As long as the right wing (financed by those who would lose money with UHC) keeps saying, “we can’t, we can’t, we can’t”, then you’ll be RIGHT – we CAN’T.

    BUT if you’d pull your head away from Faux News and realize that those federal bureaucrats you hate so much are JUST LIKE YOU, that those who can’t afford health insurance are JUST LIKE YOU, that we liberals are JUST LIKE YOU, then maybe, just maybe we might get somewhere.

    Twenty-seven nations have proven that universal health care is not only better, but costs FAR LESS TAXES. It’s PROVEN, C-shop. It’s a FACT.

    If they can do it, so can we.

    Let me introduce you to the obvious corollary to “can’t never could” – it’s “can, CAN”…and as much as you want to scream otherwise, “Yes, we CAN!”

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Well, let me provide at least one example of which Medicare is being bilked – in a matter of regular checkups.

    I have one every 3 months, and it consists of nothing but taking the blood pressure (which I can take at home and properly monitor it without the doctor’s checkup)and a stethoscope to check the lungs.

    It’s a five minute affair for which Medicare is charged God knows what. And the MD makes it a point to process as many as 200 perhaps a day. So however little the MD gets from the government for each such appointment and check up, he still ends up with raking in the money.

    This is just one example of how the present system does NOT work.

  • Glenn Contrarian

    Roger –

    That’s a classic case of not seeing the forest for the trees.

    Keep your eye on the big picture – the top twenty-seven nations on the life-expectancy list ALL have UHC of one form or another. ALL of them pay less than sixty percent per capita for UHC than we ALREADY do.

    We can, Roger – there will always, always be corruption. If there’s one instance of corruption in a hundred people, than that means there’s three million cases of corruption in three hundred million people.

    Don’t ignore the bad that the right wing wants you to see…but remember that in the big picture, twenty-seven nations have proven that UHC provides better overall care for FAR less taxes.

    Big picture, Roger – it’s sometimes hard to see when the trees are in the way.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    OK, Glenn. I know it’s anecdotal (though true). And BTW, I didn’t mean to use the example as any kind of counter-argument.

    Just a slice of life, if you like, as to the kinds of things people do when they can get away with it.

  • Clavos

    It seems that Glenn’s one point with any meat to it is the mantra of 27 nations.

    But the wrong conclusion is being drawn from the data, it’s not their UHC which results in their greater life expectancies, it’s their healthier lifestyles, especially as regards nutrition.

    Though you may not think lifestyles have anything to do with the life expectancy of a cohort, they do, and here in the USA we have one of the worst in terms of nutrition. We are, after all, the fast food nation par excellence. Our obesity is a major factor affecting life expectancy, which is why the food police are already maneuvering to either tax the shit out of fast food or eliminate it altogether, as the systematic building of the new nanny state by democrats and independent liberals proceeds apace.

  • http://www.republicofdave.com Dave Nalle

    Keep your eye on the big picture – the top twenty-seven nations on the life-expectancy list ALL have UHC of one form or another. ALL of them pay less than sixty percent per capita for UHC than we ALREADY do.

    Glenn, the fundamental fallacy in this oft-repeated canard is that because UHC is so widespread, far more than 27 countries which ALSO have UHC have LOWER life expectancies than we do. Does that mean that our system is better than all UHC? No. Just as your figure doesn’t mean that UHC is automatically better than our system.

    The truth is that as Clavos pointed out, UHC and life expectancy are largely unrelated.

    Dave

  • http://www.republicofdave.com Dave Nalle

    Bliffle, your #122 can’t be serious. Surely even you realize that if they are arresting and indicting that many people it’s just the tip of the iceberg of how many more fraudsters there are and that the crimes they are indicted for are just a fraction of what they likely did.

    Case in point, a local doctor was indicted for medicaid fraud after 30 years of practice. He processed thousands of fraudulent claims every year during that time, but the indictment was only for a handful that were well documented in his final year of practice. That would appear to be a typical pattern for this kind of fraud.

    Dave

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    It’s a common occurrence, Dave. They’re all doing it because they can. The little episode I cited it but a drop in a bucket. It is a prevalent practice.

    I sort of conceded the point to Glenn, but in a sense, I shouldn’t have. There has got to be controls put in place before making Medicare the model for UHC. The way things stand, it’s a milk cow. And there is no way that you’re going stop unscrupulous people from taking advantage. There are just too many of them.

    I’d say, the system needs a serious overhaul from ground up before expanding it to encompass the totality of medical services to be provided.

  • Clavos

    In a very interesting opinion piece published on Real Clear Politics today, Tom Bevan notes that the much-touted comparison between Medicare’s administrative costs and those of private insurers is specious because it is expressed as a percentage of total medical expenditures, and since Medicare exclusively serves patients requiring a great deal of the most expensive care (the disabled and the elderly), it gives the appearance of being lower in admin costs, when in reality, just the opposite is true.

    When one compares costs on a per capita basis, the picture presented is radically different, as shown in this graph.

    In fact, in 2005, the latest year for which there is data, the actual per capita administrative costs are: $509 per patient for Medicare, versus $453 for private insurers.

    Bevan writes:

    So, contrary to claims of Alter, Krugman, and President Obama, moving tens of millions of Americans into a government run health care option won’t generate any costs savings through lower administrative costs. Just the opposite.

    This confirms two things most Americans already know: 1) government is rarely, if ever, more efficient than the private sector, and 2) if something sounds too good to be true, it almost always is.

  • Clavos

    The pandering by the politicians marches on.

    We learn from Bloomberg that:

    Senate Finance Committee Chairman Max Baucus, the chief congressional advocate of taxing some employer-provided benefits to help pay for an overhaul of the U.S. health system, says any change should exempt perks secured in existing collective- bargaining agreements, which can be in place for as long as five years.

    The exception, which could make the proposal more politically palatable to Democrats from heavily unionized states such as Michigan, is adding controversy to an already contentious debate. It would shield the 12.4 percent of American workers who belong to unions from being taxed while exposing some other middle-income workers to the levy. (emphasis added)

    And the beat goes on…

  • http://twitter.com/tolstoyscat Cindy

    Interesting point army an army physician:

    NEWSFLASH: 9.2 Million people already insured by a single payer system in this country

    I am struck however that nobody has brought up the simple fact that the government already provides free healthcare in a single payer model to over 9 million of its population. While this system is not perfect, I believe I provide that same quality of care, offering empathetic, evidence based (one more time for good measure) care as any other physician who practices at any hospital in the country.

  • Bliffle

    Roger lets himself be fooled by a Red Herring:

    135 – roger nowosielski

    Speculations aside, bliffle, there are some cogent ideas expressed by Cannon concerning the importance of timing and fixing the economy first, ideas to which you’re apparently as blind as a bat.

    It’s a classic red Herring, Roger, designed to distract the weak-minded from the actual case. And it worked with you, apparently.

  • Bliffle

    Dave advances a couple interesting ideas, novel because no one else brought them up, which is surprising since they are obvious rejoinders. But they are also easily dealt with:

    #
    146 – Dave Nalle

    … Surely even you realize that if they are arresting and indicting that many people it’s just the tip of the iceberg of how many more fraudsters there are and that the crimes they are indicted for are just a fraction of what they likely did.

    Oh yeah? Sez who? Where do you get your facts and figures? Or are you just scandalizing again?

    What do YOU think the percentages are, and why? All you’ve done so far is claim they’re enormous without knowing SQUAT!

    Case in point, a local doctor was indicted for medicaid fraud after 30 years of practice. He processed thousands of fraudulent claims every year during that time, but the indictment was only for a handful that were well documented in his final year of practice. That would appear to be a typical pattern for this kind of fraud.

    Dave

    All that suggests is that fraud-catching methods are getting better. 20 years ago fraud detection was skimpy and ineffective.

    And notice that anything you’ve suggested about Medicare is also true about private insurance.

    Do you really think that private health insurance is immune to fraud? Do you think that somehow they have methods that stymie fraud? If so, why not get medicare to use private insurance methods?

    Or do you suppose that you haven’t heard about fraud in the private sector because they keep it quiet to avoid bad publicity? After all, the Medicare system is PUBLIC and required by law to have open books, whereas private healthcare is not.

    Remember that the 1945 McCarran-Fergusson act EXEMPTS insurance companies from Federal regulation, leaving only weak State regulation, which has allowed them to form their Oligopoly.

  • Bliffle

    Re; #149:

    Why should company provided health insurance be untaxed? Other perks are taxed, like stocks and options. If an employee gets a company car he’s taxed for it.

    All that Baucus is doing is phasing the tax in with a slight time tilt to unions (probably a small financial exposure but a big voting block for a democrat).

  • Bliffle

    #148 represents dumb and dumber.

    “Real Clear politics” is a rightwing opinion rag and their article is sourced at the “American Heritage Foundation”, another like it. You’re reading an echo chamber.

    Dumber is comparing per capita costs between systems, which is basically immaterial since it’s overall costs that are of interest.

    then there’s this oft-stated belief:

    This confirms two things most Americans already know: 1) government is rarely, if ever, more efficient than the private sector, and 2)…

    That’s only ever been true when the private sector is truly competitive, i.e., antitrust is rigorously enforced, otherwise, the private sector forms a monopoly or oligopoly and systematically loots everyone by dominating the market.

    And the insurance companies have a solid oligopoly.

  • Clavos

    “Real Clear politics” is a rightwing opinion rag and their article is sourced at the “American Heritage Foundation”, another like it.

    Oh I forgot, bliffle, rightwing sites, unlike leftwing sites are not to be believed.

    What horseshit. You don’t like the message, so you attempt to kill the messenger.

    Dumber is comparing per capita costs between systems, which is basically immaterial since it’s overall costs that are of interest.

    Yet more horseshit. Given the differences in client bases, both as to size and illnesses, between the private and government insurance programs, it is, as the author so cogently argues, the only relevant comparison.

    Your final “point” in that comment doesn’t merit a response.

  • http://www.republicofdave.com Dave Nalle

    Bliffle, have you even looked at Obama’s proposals? They’re just going to strengthen the stranglehold of private insurance on the public’s pocketbook and will do nothing to break up your ‘oligopoly’.

    Dave

  • Cannonshop

    #140
    “…it’s “can, CAN”…and as much as you want to scream otherwise, “Yes, we CAN!”

    And you will. And the rest of us will be screwed over by it.

    It’s like Moon-shots, Glenn. You don’t do Moon-Shots when your economy is in the toilet and going downward, you don’t assume you can buy a thing on the earnings of the future, when you can’t make your bills in the PRESENT.

    UHC is nice, it’s well-intentioned, and frankly, we’re (censored) broke-flat broke and digging deeper. This is the sort of thing you buy when you are NOT BROKE, because it’s a fundamental change to about 7% of a shrinking GDP, Glenn.

    (Gods, I want to reach out and scream sometimes…)

    Flat out, we Don’t have the money. Can you process this into your equations? Health-Care costs Money. People don’t work for nothing, they don’t work for free, buyers when presented with a system they are already paying for, don’t buy discretionary supplementals that are taxed-and pvt. Health Care IS taxed (called Payroll taxes, Income taxes, Business Taxes, Property Taxes, Taxes on Inventory, and soon, special taxes on employer-provided Health Coverage thanks to your friends who say “Yes We Can”.)_

    This means MORE people out of work, on the same system. Expanding the responsibilities of that system when it fails to manage those responsiblilities adequately (and that’s what the Fed does), with an already shrinking pool of revenue (which will only get SMALLER under the current regime of proposals in Congress, many of which are supported by the President) Is mind-blowing in its stupidity-there’s no “America” out there to soak the other costs and burdens the way we did for Europe and those other 27 countries during the Cold war era and after. We’re It. Everything has been bought on credit right to the red-line and now beyond, Glenn.

    It’s stupid, and self-indulgent, and self-destructive to go about making things worse when they’re already going bad, even in the name of making things better for a few individuals who, during their working lives, couldn’t be bothered to be involved enough to understand how the things that they did to feel good about themselves have fucked the rest of us for the next few decades and beyond.

    I’m thirty-six, in the prime of my working life, and I am compelled by law to pay into a social-security system that will be bankrupt by the time I’m forty. I will never see a dime of that when I’m too old to stay in the traces (assuming I can still FIND work by then). In that tiny span of life, I’ve watched my country go down a toilet of debt, failure, and ignorance, I’ve seen it lose most of its industries, watched the middle class become the Serf class, and seen people I am ashamed of being related to game the system in preference to working.

    I know the fraud is there, because I’ve SEEN IT, Glenn-and reporting it does exactly jack-shit, because the way budgeting works for government agencies is that if they don’t have ‘enough clients’ they get the budget cut..only it doesn’t get cut, it just doesn’t increase.

    This takes that flawed, destructive system and that flawed, destructive, corrupting paradigm and puts a fucking supercharger on it.

    Before you expand ANY system, you must first make certain it works as it is, and then make certain it can handle the expansion, and finally, you have to put in safeguards to make certain it does neither melt the rest of your system down, nor turn into something that will have to be replaced/supplemented/added to because it has failed in its fundamental mission.

    More=/= better, Glenn. Frankly, “Do it NOW” thinking is what got us INTO this mess (in more ways than one), the culture of Instant-Gratification is largely responsible for issues ranging from American Obesity to the financial crimes and frauds (separate-some of those are LEGAL, but still fraud in practice), to drug abuse, the whole stupid abortion debate, and the essential collapse of Education (with the attendant pseudo and anti intellectualism that saturates our so-called culture.)

    The problem: Pay for it, without adding to either the debt, or choking what’s left of the economy. Assess your impacts Realistically, including the ones you don’t want to acknowledge because it might knock your house of cards over, plan for the worst-case scenario FIRST, that’s what you prepare for if you want to survive LESS than the worst-case.

    Optimism is for salesmen, mechanics work on Pessimism. Good mechanics do the work once, and it lasts for years without major changes and without doing damage to the customer, bad ones have to replace everything multiple times and it never works correctly.

    Medicare hasn’t worked correctly since it was first instituted, Neither has Medicaid, nor Social Security, nor any of the other European-inspired “Social Service Reforms” pushed since LBJ altered existing programs with his “Great Society”.

    The War on Poverty is a failure-now we just have lots of “Slightly less uncomfortable” people in Poverty, and this won’t work any BETTER. (especially formulated in the manner in which it has been formulated, in a back room, with no time for congressmen to actually read the actual bill they’re voting on…kind of like Carbon Trading in that.)

    We’re already so deep in the red as a country that we’re borrowing from people that used to borrow from us, and more than we ever loaned out. This is living on bad credit, Glenn.

    It’s like “How do I lose weight?” (answer: Stop eating the goddamn twinkies the way you wanted to eat them when you were six and your dad said NO. There’s no Dad to say No when you’re an adult, you’re supposed to be responsible… same thing here. It would feel ‘good’ and be ‘nice’ if everybody was insured, but can you actually pay for it and provide a decent standard of service? Probably NOT-that shit costs money, that shit requires people to work.)

  • Cannonshop

    OH…and here

    It’s not just Right-wing AMERICANS who have a problem with this…

  • Cannonshop

    Fundamentally, the problem is akin to having a car.

    Do you really worry that much over rips in the upholstery or a leaky muffler when you’ve got a spun bearing or a rod knock?

    If so, You’re likely a democrat, or a Left-Republican. The problem is the American Economy is like a car with a spun bearing AND a rod knocking. It makes a lot of noise, and it crawls slowly along, but it’s more likely to crap out when you NEED it, than to suddenly run like a champ because you added some muffler tape and a new ignition module.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    #151,

    [Personal attack deleted by Comments Editor]

    We’ve been without UHC for all this time, and waiting extra six months or so if it means doing it right ain’t gonna kill us.

    Rather than dumping the money into a system that is far from foolproof and subject to all kinds of abuses, fix the goddamn system first, revamp it, clean it up, whatever it takes. Such an action would not only command a wide public support but it would also ensure successful passage. Haste makes waste, remember, but apparently you’ve forgotten.

    But no, you’re so fixated on getting it done right here and now that you throw all caution to the wind.

    So yes, I’m going to repeat what I said: you’ve become a bean counter rather than a thinker. [Personal attack deleted by Comments Editor]

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Well, I kind of think what you said earlier how expediency has become the MO behind every government policy and action. And we continue along that road, then I really don’t see how we’ll ever be able to come up with viable solutions to the problems facing us. It’s only going to get worse despite best intentions and contrary to all appearances. But the average Joe ain’t gonna see past the gloss that’s being put on things. Perhaps it will take nothing short of a total collapse of America as we know it before the realization sets in. And by that time, mark my words, it will be too late.

  • http://www.republicofdave.com Dave Nalle

    Going back to the issue of medicare fraud vs. fraud in the health insurance system, Bliffle once again made a bogus argument when he claimed that both are being defrauded equally.

    I’m sure there are figures out there which I could get if I had a decent internet connection right now, but in the absence of the figures, just apply simple logic. Bureaucrats working for the government have only the incentive of their own sense of right and wrong to ferret out medicare/medicaid fraud. On the other hand private insurance companies hire people who are paid specifically to find fraud and that’s their entire job. The profit motive naturally makes them more efficient in this area. It is the same mindset which causes them to disallow certain benefits and cut those with preexisting conditions, and the left will freely admit that private insurance does those things — well, doing those things goes hand in hand with pursuing fraud and having very little of it as a result.

    Another inherent benefit of private insurance over UHC.

    Dave

  • Bliffle

    Dave says:

    Bliffle once again made a bogus argument when he claimed that both are being defrauded equally.

    I’m not sure I said ‘equally’, but given lack of solid data about either private or medicare fraud, what can we assume?

    I’m sure there are figures out there which I could get if I had a decent internet connection right now,…

    I look forward to seeing those figures.

    … but in the absence of the figures, just apply simple logic. Bureaucrats working for the government have only the incentive of their own sense of right and wrong to ferret out medicare/medicaid fraud. On the other hand private insurance companies hire people who are paid specifically to find fraud and that’s their entire job.

    Medicare also hires private fraud-sniffers who are similarly motivated.

    The profit motive naturally makes them more efficient in this area.

    True. Sometimes Medicare folks even go over to the enemy to make the money they are frustrated at not making simply by doing good fraud-sniffing (“it’s your JOB! No, you don’t get a bonus for ferreting out a $100million fraud!”. You can hear the boss saying it.) But there are higher levels of fraud-sniffing to catch that, they just operate behind a curtain.

    Most of the fraud-sniffers keep a low profile to avoid being hacked. That would be bad: getting hacked by fraudsters. In fact some use Real Private Networks (like ISDN) that assure private communications instead of VPNs.

  • Bliffle

    The health insurance companies are NOT the solution to the problem, they ARE the problem.

    Because of the special privileges they have accumulated over the years, the immunity from regulation, and the de facto oligopoly.

    Right now healthcare expenses consume 18% of the GDP and in a few years it will be 30%, because of the unregulated monopoly they have.

    We either have to get rid of the insurance companies or bring them under regulation. Otherwise they will consume the entire USA economy and there will be an explosive crisis.

  • Bliffle

    The health insurance companies are NOT the solution to the problem, they ARE the problem.

    Because of the special privileges they have accumulated over the years, the immunity from regulation, and the de facto oligopoly.

    Right now healthcare expenses consume 18% of the GDP and in a few years it will be 30%, because of the unregulated monopoly they have.

    We either have to get rid of the insurance companies or bring them under regulation. Otherwise they will consume the entire USA economy and there will be an explosive crisis.

  • Zedd

    What is at the core of this issue is the outdated fear of Communism. The “conservatives” are simply making outdated arguments because they are stuck on notions that don’t apply to our world today.

    Actually the reason that they are so ineffective is because their position is irrelevant.

    Gen X perspective…. Hold on to your hats geezers

    No one cares about making government big. Can we move on.

    Big or small the point is whether we are prosperous as individuals and if would civil liberties are in tact. The point is whether it works for ME. Not whether it almost looks like communism.

    If a small government is in place and everyone is dying of starvation and the streets are littered with trash, what’s the point? Answer: There is none. You just have a small ineffective government.

    Conversely, if the government is big and the people are starving and the streets are littered with trash, what is the point? Answer: There is none. You just have a big ineffective government.

    The point is whether the government insures the health and security of it’s people. Is it run well? Is it fair and smart? Big or small.

    The nit picky minutia ridden comments that are based on outdated ideological arguments must end. We need to FIX health care. Focus.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    The well-being of the people, whether in terms of healthcare or physical, material well-being, should be the priority. And the dominant political and economic idea should be to spread this well-being beyond our shores – so as to encompass the entire globe if possible.

    Improving material conditions, eliminating hunger and poverty, must come first before ideological consideration. Only then can education properly kick in, not before.

  • Zedd

    Especially when there is no opposition to your ideology.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Well, I’d say that’s an example of the kind of new thinking that’s required.

    Is it ideology trying to eliminate poverty and hunger in the interest of worldwide prosperity? I should think it ought to be the goal of all our leaders, not to mention all right-thinking people.

    “Imagine” by John Lennon comes to mind.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    Imagine there’s no heaven
    It’s easy if you try
    No hell below us
    Above us only sky
    Imagine all the people
    Living for today…

    Imagine there’s no countries
    It isn’t hard to do
    Nothing to kill or die for
    And no religion too
    Imagine all the people
    Living life in peace…

    You may say I’m a dreamer
    But I’m not the only one
    I hope someday you’ll join us
    And the world will be as one

    Imagine no possessions
    I wonder if you can
    No need for greed or hunger
    A brotherhood of man
    Imagine all the people
    Sharing all the world…

    You may say I’m a dreamer
    But I’m not the only one
    I hope someday you’ll join us
    And the world will live as one

  • http://twitter.com/tolstoyscat Cindy

    posting anarchist songs. does this mean you get it? keep listening to the lyrics. it’s the only way to do it. it’s not possible this way:

    I should think it ought to be the goal of all our leaders…

  • zingzing

    cindy, you should listen to a band called crass (english anarcho-punk band 77-84). read up on them as well. they did all their own production, recording, and artwork, started their own label, lived on an anarchist commune that they created outside of london, everything. heroes, i say.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    There is a context to this, provided by the exchange on this thread.

  • Glenn Contrarian

    Dave –

    “On the other hand private insurance companies hire people who are paid specifically to find fraud and that’s their entire job.”

    Sounds good…except that the federal bureaucrats ALSO have no PROFIT MOTIVE, by which I mean they have no pressure on them to always make more money for the company, or save more money by denying service or canceling policies.

    The private companies DO have a ‘profit motive’. Not only that, but the conservative wisdom that enough competition will drive down prices has not done so – as can be seen by the constant rise of prices two to three times the rate of inflation over the past decade or so.

  • Clavos

    In fact, the bureaucrats have NO pressure on them, not even the pressure of “perform or you’ll lose your job,” which is the perennial problem with them, they don’t have to do a good job, so they don’t.

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    But this goes against the conventional wisdom of crediting Caesar Augustus with inventing “civil service,” or with what the British rule has been able to accomplish on behalf of their colonies, India most notably.

    To an extent, the development of Indian democracy and many of its institutions are some of the results of British rule and their rendition of “civil service.”

  • Clavos

    In fact, the bureaucrats have NO pressure on them, not even the pressure to “perform or you’ll lose your job,” which is the perennial problem with them, they don’t have to do a good job, so they don’t. Even their promotions are seniority-based, not merit-based, so they have no incentive to excel.

  • Bliffle

    I think you’re out-of-date Clavos. Public employees (around here anyhow) are scared sh*tless about losing their jobs, along with healthcare, pensions, etc. The only ones who have sweetheart deals are the police and firemen.

    Performance depends a lot on good management, and most management (both public and private) is simply horrible these days. People are made managers for the wrong reasons. Even in private companies.

    IMO, nowadays the old mantra that private works better because of profit motive simply doesn’t hold up anymore.

    For example, the coffee shop I’m sitting in right now has dreadful service, like most of them. And they lose customers because of it: I’ve watched potential customers walk out because they couldn’t place an order, and I’ve done it too!

  • http://takeitorleaveit.typepad.com/ roger nowosielski

    A Chinese guy may be the owner. It was the same with a coffee shop in Alameda a year ago. Once the new owner took over, the customers started leaving in droves. Didn’t have a concept that customer is king.

  • Clavos

    I agree with your observation about management, bliffle. It’s been that way for a long time in the private sector, and in fact is the prime reason for the failure of the American auto manufacturers — their management has been rotten for decades.

    However, my remarks about government employees were in regard to federal employees. In most places where I’ve lived, state county, and municipal employees have not had the kind of job security the feds do and the level of competence is usually much higher than in fed offices.

  • Cannonshop

    If the best argument on the fraud issue is that Medicare and Pvt. insurers suffer it equally, then that’s a strong argument against centralizing MORE of it in Medicare’s hands-private insurance is voluntary, taxation to fund government agencies is non-voluntary, and monopolies do not tend to become MORE customer oriented-they tend to be LESS so.

    One of the legitimate roles of government, is to dismantle Monopolies so that there are choices. Notably, the only examples of that in the last three decades were Ma Bell and Microsoft. Meanwhile, instead we have the meme of “Too big to fail”, and Government trying to BECOME the monopolist.

    Bear Stearns, AIG, General Motors, Enron, Fannie Mae, Freddy Mac, IndyMac, BankAmerica, Citigroup, now Health Care?

    I didn’t think, Bliffle, that when you folks on the left were shouting about “Socialism for the rich” that you meant it as a statement of intent, I thought that was a protest against collusion between abusive corporations and government.

    The proper role of government, is to establish and enforce standards, not to try to compete against private providers of goods and services (y’know, the people who generate the economic activity that provides the taxed incomes needed by government to function?)

  • Bliffle

    In fact, the insurance companies are unregulated oligopolies, able to divide up markets as they see fit, to exclude competitors, dictate prices and terms to their customers, and to legally bribe politicians with their fantastic funds. They may also freely bribe government officials with promises of high-paying jobs.

    Under current law they are excused from the limitations you mentioned by the 1945 McCarran-Ferguson statute which forbids the federal government from attempting to regulate any insurance company.

    They are, in fact, no better than a government agency, and in many ways are much worse. For example, they are able to extract higher fees from their transactions than any agency you may imagine.

    AS bad as a government agensy would be, the overhead cost would be much lower, and it would be subject to the rule of citizens.

    The fact is that the goal of every business is to eliminate competitors and control their markets. In order to reap the benefits of competition people must frustrate those goals, and, in the case of insurance companies, our hands have been tied by a 60 year old law, written in a totally different age.

  • Clavos

    In that case, it seems to me bliffle, that our goal should be to clean up what we have, starting with repeal of McCarran-Ferguson, and proceeding to and into a setup similar to that of the airline industry before deregulation (with the flaws therein corrected), rather than spending the immense fortune it will take to implement a totally new government-run and -paid health care system.

    But, I doubt that will happen.

  • http://twitter.com/tolstoyscat Cindy

    172 – zing

    thanks for that recommendation. i found a documentary, there is no authority but yourself about them. looks interesting from what i’ve watched so far.

    communes, that reminds me–i found this book in my h.s. library, Home Comfort: Stories and Scenes of Life on Total Loss Farm. it so profoundly affected me that from 14 to 19 my plan was to live on a commune, as soon as i finished college. but fate intervened.

  • zingzing

    ooer. i’ll watch that as soon as i can. thanks!

  • Glenn Contrarian

    Strawmen. All I see from the right are strawmen.

    Medicare fraud is a strawman – they can only see this and that instance of fraud, but they cannot see the larger picture.

    So I guess I’m going to have to do some research to show them that Medicare – that bureaucracy tasked with paying for the care of 97% of all the nation’s elderly and most of the nation’s disabled (like my three medically-fragile Foster kids to the tune of perhaps a half million per year (one child alone costs a quarter million)) does so QUITE efficiently – MORE efficiently than the private health care agencies do.

    But I’ve got to prove that claim. Not only do I have to use reliable sources, but I’ve also got to ensure that I’m not inadvertently drawing the wrong conclusions from the compilations of the data.

    Once I’m ready, I’ll light a fire to the strawman of Medicare fraud.

  • Cannonshop

    183: That’d be MY solution, Clavos, or at least, part of it. The other part would be to take what’s being proposed for funding a giant Bureaucracy, and use it to provide grants and ‘stimulus’ to colleges to expand/improve medical and science programmes, along with additional scholarship initiatives to bring more students into those programmes from lower and middle class backgrounds (you know, people who aren’t accustomed to buying a new BMW every five years).

    And maybe a bit to encourage effective, but low-volume drugs for rare but tragic conditions actually being produced.

    BEFORE doing the latter bits, though, instituting reforms and regulation to the Insurance Industry to fight exploitive crooks, and giving those reforms actual TEETH comes first-same for fixing the SEC and Financial industry. (Funny thing to think about- Real Estate people have to comply with strict ethical guidelines and get licensed-neither is true of mortgage brokerage, stock-brokers, or financial advisors-notice where our crisis happened? Yup…)

    We have a Congress that can’t balance their chequebooks or comply with the tax-laws they themselves write and pass-putting that as ‘oversight’ to an expanded agency is stupidity.

  • Bliffle

    Looks like Clavos and Cannonshop are preparing to lead the charge to revoke the 1945 McCarran-Ferguson act and bring the insurance companies under federal regulation so they can be broken up under federal anti-trust laws.

    I wonder what their first move will be in this noble endeavor? Shall we wait and see?

  • Cannonshop

    188 Considering that I think that would be a splendid move, Bliffle, My first move is going to be writing my “better” Senator (that’d be Maria Cantwell) with the idea as a practical alternative to loading the Government (an entity already drowning in debt) with the job of doing what insurance can’t/won’t/hasn’t been doing.

    SOME regulation is good, especially if it is written to be enforceable and the responsible agency is actually held accountable for enforcing it. NO regulation is bad, just as TOO MUCH regulation is bad.

    I don’t actually expect to GET ANYWHERE with it, mind you, but it’s what I’m actually able to DO (and still, you know, make a living and have a family and all that other shit that the media doesn’t think is important.)

    Question being: would YOU do the same with YOUR congresscritter or Senator? If so, maybe you could get some friends to do it-Conservatives are like herding cats-we may all like to go to the ‘Tea Parties’ but when it comes to unified action, we stink on ice-Leftists are FAR better at organizing, and let’s face it, this goes right into the realm of ‘moderate’ and could actually BE bi-partisan.

    (Yeah, I don’t think it’ll work either…but I’ll give it a go anyway. Nothing to lose and all…)

  • http://blogcritics.org/writer/dan_miller Dan(Miller)

    According to this article, a bill now before the Senate would impose a fine of $1,000 (more for families) on those who do not obtain the prescribed “affordable health care” insurance.

    The Congressional Budget Office estimated the fines will raise around $36 billion over 10 years. Senate aides said the penalties would be modeled on the approach taken by Massachusetts, which now imposes a fine of about $1,000 a year on individuals who refuse to get coverage. Under the federal legislation, families would pay higher penalties than individuals.

    *****

    The fines would be collected through the income tax system.

    I hope that the Congresscritters find the time to read and understand the legislation before voting. It probably won’t affect us, since my wife and I have adequate medical insurance in Panama, which costs us about $1,200 per year. Still, I think it’s a dumb idea.

    Dan(Miller)

  • http://biggesttent.blogspot.com/ Silas Kain

    Well, as a resident of Massachusetts and a beneficiary of Romney’s so-called health plan, let me tell you something — it’s all smoke and mirrors. The coverage that is “affordable” and available to residents so as to avoid the ‘penalty’ is a joke.

    Health care is a national problem and one that has to be addressed at a Federal level in order to assure ‘universal health care’. Look, I don’t like the concept, it frightens me, and I fear what we’ll get as a result. The bottom line is that we are lagging behind 30+ other countries in health care. Forget about placing blame, just fix the damn system once and for all.

  • Clavos

    just fix the damn system once and for all.

    A worthy goal, and one I’m sure we can all support.

    Problem is, nobody, including Obama, the Republicans, the Democrats or anyone in government has yet come up with a plan that will fix it.

  • Bliffle

    Cannonshop draws the wrong conclusion:

    #181 – Cannonshop

    If the best argument on the fraud issue is that Medicare and Pvt. insurers suffer it equally, then that’s a strong argument against centralizing MORE of it in Medicare’s hands-…

    Actually, quite the opposite. Private insurance fraud is hidden, the InsCos are under no obligation to reveal fraud publicly, so they hush it up to improve their image. But Medicare is REQUIRED by law to make fraud public, AND they are required to pursue fraud to prosecution. Every state is REQUIRED to have certified fraud detection systems (these are provided by competitive private companies, incidentally, not public agencies).

    Thus, by moving health insurance to a public agency fraud will be exposed and prosecuted and reduced. Public agencies are not able to sweep fraud under the rug.

    reducing fraud will reduce costs to everyone.

  • Bliffle

    “just fix the damn system once and for all.”

    That would require revoking McCarran-Ferguson. Do you think that our congressmen, saturated in insurance company bribes, have he guts to do it?

    Or do we need to outflank them with the “Public Option”?

  • Bliffle

    If Clavos and Cannonshop are desirous of cleaning up the existing system before changing things, then here’s a place they can start: the drug companies have not only been gouging us with their arbitrarily high prices, they have also been bribing the makers of generic drugs to not compete with them!

    Apparently they consider themselves above the law, namely the Sherman Anti-trust law.

    Read it and weep:

    Wall Street Journal

    The heat is closing in on the drug indsutry’s practice of paying generic manufacturers to delay competition for branded drugs.

    Companies say the practice is legal. But the U.S. Department of Justice took a skeptical view when it weighed in Monday on a pending case brought by CVS and Rite Aid. The drug stores (which make higher margins on generics) challenged a deal in which Bayer paid Barr to delay producing a generic version of the antibiotic Cipro. Here’s more on the case from Dow Jones Newswires.

    The Federal Trade Commission has been attacking the deals for a while now — witness Bristol-Myers Squibb’s $2.1 million payment earlier this year to end the FTC probe into its negotiations to delay the entry of generic Plavix.

    Meanwhile, on the other side of the Atlantic, the European Competition Commissioner is expected to release a report this week on competition in the drug industry, notes Bloomberg News. The report is likely to take a hard look at the pay-for-delay deals —