Republican's answer to health care

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Zute
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Republican's answer to health care

Post by Zute » Wed Feb 16, 2011 10:14 pm

... deregulate everything and give people vouchers...

Health Hard-Liners To GOP: Most Americans Are 'Over-Insured'

Sounds a lot like the lame-ass plan McCain had.
Formerly known as Panamah

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Tudamorf
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Re: Republican's answer to health care

Post by Tudamorf » Thu Feb 17, 2011 1:56 pm

OK, so what if patients can't afford those market rates, even with the vouchers? The memo has got that covered:
In a free society, the moral way to help those who are less fortunate is through private charity — or failing that, through targeted subsidies — not mandates and regulations.
Why would millions of obese rednecks in the South buy insurance when they can get it for free, paid by my tax dollars?

Until you take the position that, "if they can't afford it, they should just be allowed to die in the street," any capitalist approach will not work.

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Tudamorf
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Re: Republican's answer to health care

Post by Tudamorf » Fri Feb 18, 2011 1:25 pm

And let's not forget the cornerstone of any "Republican" health care system:

http://www.sfgate.com/cgi-bin/blogs/nov ... 3353&tsp=1
The wild three-day, going into four, spending debate on the House floor reached a hot pitch last night over an amendment by Rep. Mike Pence, R-Ind. to cut off federal funds to Planned Parenthood. Reps. Jackie Speier, D-San Mateo and Gwen Moore, D-Wisc., delivered scathing rebuttals to emotional anti-abortion pleas by two Republicans, Rep. Paul Broun, R-Ga., and Chris Smith, R-NJ.

After Broun, a doctor, said more black babies were killed by abortions that white babies, Moore delivered this: "I know all about black babies. I've had three of them. I had the first one at the ripe old age of 18." She went on to describe her difficult life as an impoverished young mother and the need for what she called, in lower caps, planned parenthood.

When Smith read aloud gory details about second trimester abortions, Speier got up and tossed her notes, saying her stomach was in knots. She said she had to endure the procedure because of medical complications in her own pregnancy. She said for anyone to suggest "that somehow this is a procedure that is either welcomed or done cavalierly or done without any thought is preposterous."
Yes, the old man in the sky tells us we have to make absolutely, positively sure that no woman gets a cheap abortion, and instead tp spend a fortune on unwanted/defective babies while forcing the woman to give birth against her will.

By the way, this is probably the only time you'll ever see a middle aged white man show any concern about black babies.

Fyyr
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Re: Republican's answer to health care

Post by Fyyr » Sat Feb 19, 2011 4:49 am

Well, that's not entirely fair.

The existing EMTALA universal healthcare system is a Republican one.
That is to say that Reagan signed the law. Dems did write it.

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Re: Republican's answer to health care

Post by Fyyr » Sat Feb 19, 2011 5:08 am

I just recently had an email exchange with Ilya Shapiro at the Cato Institute. This was in response to an editorial of his in some online publication(you can probably look it up for yourself).

This is the substance of those emails.

Ilya,

You don't know what you are talking about.

Ever since EMTALA was passed, the US has had universal healthcare. Anyone in American, citizen to illegal alien, can get healthcare.
http://en.wikipedia.org/wiki/Emergency_ ... _Labor_Act

The Federal government mandates that all hospitals provide care to anyone who comes in.
Even when they have not paid into the system, or can pay the hospital.
Without a mandate for payment for those services.
Hospitals pass that cost on to the taxpayers, insurance companies, and the uninsured who do pay.
That is to say, that the whole cost is passed on to the rest of us.

It is inevitable that everyone will access the healthcare system, at least at some point in their lives(or deaths).
Insurance is a risk distribution system.
Because healthcare will be utilized by ALL Americans(and non Americans), it is is cost distribution system.

And the existing distribution system of costs is really really stupid.

If the Federal government can mandate Hospitals to provide healthcare to non paying customers, then the Federal government can mandate those who can pay for healthcare, to pay for it.

Thank you for you time

>>Shapiro's Response...
Thanks for writing. You present a policy argument, which may or may not be the correct way to look at the economics of the matter (probably not because health insurance is different than health care) but in any event is a separate question from what the Constitution allows. “Good” or utilitarian policies (in health care or otherwise) may be unconstitutional – to use an absurd example, if the government kills all sick and old people, spending on health care will decrease – and not all constitutional policies are desirable. Here, neither the Commerce Clause, the taxing power, or anything else, allows the federal government to force you to buy something.

Note, by the way, that state car insurance mandates are different for two reasons: 1) states have general police powers while the federal government is limited to those powers listed in the Constitution; and 2) driving is a choice (the law on this is indisputable) so there's a difference between having to buy insurance of you choose to drive (on public roads) and having to do so by don't of being alive.

By the way, for a sketch of a better way of reforming health care, see for example For a sketch of a better solution, see for example http://www.cato.org/pub_display.php?pub_id=10646.

Hope that helps. Best wishes.

Ilya Shapiro
Senior Fellow in Constitutional Studies,
Editor-in-Chief of the Cato Supreme Court Review
Cato Institute
1000 Massachusetts Ave. NW
Washington, DC 20001
tel. (202) 218-4600
cel. (202) 577-1134
fax. (202) 842-3490
ishapiro@cato.org
http://www.cato.org/people/shapiro.html

>>Shapiro's Additional Response...
I meant to add the following:
The requirement that hospitals care for anyone who present themselves (EMTALA) is different from the requirement that people buy health insurance. Hospitals can choose to go out of business (put enough onerous regulations on them and they will). Individuals can’t opt out of government-imposed mandates (other than by committing suicide, I suppose).



My Response to Mr. Shapiro's email(to which I received no response)...

Ilya Shapiro,

First off, thank you for responding to my email.

"Thanks for writing. You present a policy argument, which may or may not be the correct way to look at the economics of the matter (probably not because health insurance is different than health care) but in any event is a separate question from what the Constitution allows."

I would say that even though healthcare is not enumerated in any of the sections or amendments, for healthcare as we know it did not exist at the writing. It is mentioned in the Preamble.

"We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America."

Considering the intentions of the Framers, I would find it unlikely that they would support our present day modern military(common defence), and not include modern healthcare(general Welfare); if the Constitution were written today.

For example, Article 1, Section 8, Clause 8 sets up protecting the rights of poets, artists, and inventors. Not to protect those actual poets, artists, and inventors per se, but "To promote the Progress of Science and useful Art" for the rest of us. If the Framers had this kind of intention, a micro management of social engineering, then certainly they would have, if it existed, set for a whole Section just for healthcare. Of course this is hypothetical, but looking at the intentions of the Framers, it really is undeniable that they 'would have'.

"“Good” or utilitarian policies (in health care or otherwise) may be unconstitutional – to use an absurd example, if the government kills all sick and old people, spending on health care will decrease – and not all constitutional policies are desirable. Here, neither the Commerce Clause, the taxing power, or anything else, allows the federal government to force you to buy something."

That is true that it does not force(or coerce) one to BUY something, but it does force and coerce people to pay for something. When one thinks of insurance, one thinks of a product. An insurance policy is a product. But healthcare is not. Most insurance is based on the actuaries that you will not ever use it. Car insurance, fire insurance, home insurance, etc. But healthcare today is completely different, everyone alive has accessed it(by being born) and will inevitably use it during their lifetimes; or at the time of dying.

Now there are exceptions to this, for example if your mother decided to have your birth at home, with a friend midwife who took a cake or chicken as payment for her services. And there is the very odd exception of dying at home or outside of a hospital setting, never accessing the healthcare system during your life. But these exceptions are so exceedingly rare as to not even mention(other that to mention that there may be exceptions).

Every American will access the healthcare system. Many of my poor friends access it by way of the ED doors at local hospitals.

"Note, by the way, that state car insurance mandates are different for two reasons: 1) states have general police powers while the federal government is limited to those powers listed in the Constitution; and 2) driving is a choice (the law on this is indisputable) so there's a difference between having to buy insurance of you choose to drive (on public roads) and having to do so by don't of being alive."

Correct. But car insurance and healthcare are two different things. Only linked by analogy because healthcare was once only paid for when one bought insurance for it, or paid straight out of pocket. But a large percentage of healthcare today is not paid for(by the consumer), and large percentage of healthcare is paid for by taxes. It is only through a historical defect in logic of economics that businesses were encumbered with the onus of paying for it for their employees. It is a service not like car insurance, but like the public roads that you mention. Built either by mandate on contractors, the roads around your home for example, or the roads that connect cities and states that are built by public entities. And there are plenty of people who do not access the public road system directly, who pay for that service; justified because even if they themselves do not have a car they, benefit from it socially and economically. And they are forced to pay for it.

Many people confuse healthcare and health insurance. Some people confuse the two intentionally, to enact policy for example. They are two separate things. You, as an American are entitled to, and will receive healthcare(thanks to Ronald Reagan, and EMTALA), without ever having to pay for it. You don't even have to be an American, you can be an illegal alien, here in America for a week. If you come into a hospital, you will be treated, for whatever you have wrong with you; with no exceptions. And you will receive the treatment as if you had been paying into the system all your life, even the same treatment as a doctor who works at that same hospital. Someone has to pay for this. Americans demand this level of service, they have to pay for this level of service. They don't presently.

As Libertarians, it is against our nature for things received not being paid for. We view that as theft. So it is really a Libertarian argument, that if Americans are going demand the level of service that they do, to benefit from a service/entitlement which is healthcare that they do, that they should also be responsible and pay for it.

"I meant to add the following:

The requirement that hospitals care for anyone who present themselves (EMTALA) is different from the requirement that people buy health insurance. Hospitals can choose to go out of business (put enough onerous regulations on them and they will). Individuals can’t opt out of government-imposed mandates (other than by committing suicide, I suppose)."

Correct as well. One of the objections to EMTALA before it passed was that hospitals would just close their ERs. And it was a real objection. Or that hospitals would go out of business, and many did. We did put onerous regulations on them, and look what happened. If memory serves me correct, 1600 ERs nationwide closed. It was the spawning of the Med 7, Acute Care type businesses of the 80s and early 90s. Some still do exist. But the real hospitals kept their ERs open, and just dealt with the aftermath. They increased the costs of ER visits and services to account for unpaid consumers. And they passed the costs on to the other departments as well. You don't actually believe that ER healthcare cost all that much more than other healthcare today do you. Everyone who works in ER makes the same as everyone else in a hospital. The doctor makes the same as a, or just a little more, than a GP. ER costs more because it is open all day, of course. But per hour costs are really not that more than say, a clinic. It costs more because many of their consumers don't pay, and the costs were inflated to cover those who don't pay. Thus increasing all costs to paying consumers, insurance companies, businesses, and to government agencies which do pay for healthcare. It is cost distribution, like I said in my first email to you. Normal insurance(like car insurance) is risk distribution, current healthcare insurance and payment methods are merely cost distribution.

There are still a few hospitals which exist, which don't have ERs nationwide. But they are the extreme exception. Even Kaiser hospitals accept MediCare and MediCal patients, they don't like anyone to know that, but they do. And uninsured patients are definitely treated at them.

Those same individuals that you say can't opt out, will still access the healthcare system in their lifetimes. If they attempt suicide, more than likely they will come into a hospital somewhere and receive treatment and healthcare. And even if they are found dead, they will still activate the EMS(which still costs a lot of money). They can't opt out of the healthcare system if they choose to, and most choose not to. Those costs are still all passed on to you, distributed to you(and me). Those Americans who never access the healthcare system are such statistical fliers, that if you find them it would be remarkable. Healthcare is not like car insurance.


Again, Thank you for your reply.
It is an interesting discussion.


Perhaps I should have been more polite.
Last edited by Fyyr on Sat Feb 19, 2011 5:24 am, edited 1 time in total.

Fyyr
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Re: Republican's answer to health care

Post by Fyyr » Sat Feb 19, 2011 5:11 am

All that is to say, is that if you word your argument correctly, you can present a Libertarian argument, and a valid one at that for Universal Healthcare.

Maybe it needs some work, and it certainly does not fit on a bumper sticker. But it can be done.

Or at least make a Cato Institute Jew Lawyer shut the fuck up.

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Tudamorf
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Re: Republican's answer to health care

Post by Tudamorf » Sat Feb 19, 2011 1:39 pm

Fyyr wrote:Here, neither the Commerce Clause, the taxing power, or anything else, allows the federal government to force you to buy something.
A ridiculous argument.

The Commerce Clause has been used to justify just about everything, from federal registration of sex offenders to civil rights laws.

And unlike those situations, health insurance companies have a huge effect on interstate commerce.

Every time I pay my health insurance's enormously EMTALA-bloated premium, that money gets spread to rich old white men all over the nation.

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Re: Republican's answer to health care

Post by Fyyr » Wed Feb 23, 2011 6:20 pm

It's not just EMTALA.
But additionally the Lawyer tax as well.

An easy third of what I do is merely lawsuit prevention work, with no direct connection to patient care or outcomes.
That translates to a third of nurses are not necessary.

That's not at all including past, present, or future payments to the lawyers, lawsuits, or insurance companies. That is additional system overhead.

Other countries' healthcare systems don't have this lawsuit overhead.

Comparisons to other countries systems, that is per person or per outcome costs are not legitimate unless that overhead is accounted for.

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Re: Republican's answer to health care

Post by Tudamorf » Thu Feb 24, 2011 5:27 pm

Wait, there is one area where "Republicans" are concerned about the quality of health care:

http://www.sfgate.com/cgi-bin/article.c ... .DTL&tsp=1
Va. OKs bill to likely close most abortion clinics

Virginia took a big step Thursday toward eliminating most of the state's 21 abortion clinics, approving a bill that would likely make rules so strict the medical centers would be forced to close, Democrats and abortion rights supporters said.

Gov. Bob McDonnell, a Republican and Catholic, supports the measure and when he signs it into law, Virginia will become the first state to require clinics that provide first-trimester abortions to meet the same standards as hospitals. The requirements could include anything from expensive structural changes like widening hallways to increased training and mandatory equipment the clinics currently don't have.

While abortion providers must be licensed in Virginia, the clinics resemble dentists' offices and are considered physicians offices, similar to those that provide plastic and corrective eye surgeries, colonoscopies and a host of other medical procedures.

Democrats and abortion rights supporters said the change would put an estimated 17 of the state's 21 clinics out of business. Most of the clinics also provide birth control, cancer screenings and other women's health services.

"This is not about safety for women. This is about ideology, and this is about politics," said Tarina Keene, executive director of NARAL Pro-Choice Virginia. "The women of the commonwealth are going to be the ones left to suffer."

Abortion rights supporters warned of legal challenges while supporters heralded it as a way to make the procedures safer.

"It is not about banning abortions," said Sen. Jill Vogel, R-Winchester. "It is simply caring for women who are about to have an invasive surgical procedure and creating an environment for them where they have the opportunity to do that in a place that is safe."
That's right, they so concerned about the quality of health care women get when they go for an abortion, that they're willing to close down most of the abortion clinics. :roll:

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Tudamorf
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Re: Republican's answer to health care

Post by Tudamorf » Thu Feb 24, 2011 5:35 pm

Fyyr wrote:It's not just EMTALA.
But additionally the Lawyer tax as well.
True, but how does that really compare to the Christian tax?

Impeding a cheap abortion (see above), or lying to a pregnant mother about a fetal defect to force her to give birth (which, by the way, was also legal under the Bush rule), can cost millions in hospital expenses. And if not hospital expenses, then later expenses in terms of welfare and/or incarceration.

Not to mention, Christians are so fat that it almost seems to be an 11th commandment with them. Fat people are the most expensive to treat.

Some objective third party needs to do a study, to see whether Christians cost us more than lawyers do, all things considered.

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