I don't get why Obama doesn't Just Say it.

[Skeptic]

Look, the health care bill will insure lots of people who cannot get insurance now. This means raising health care costs for everybody else.

Now, if Obama had just said: "we need to take care of those who are sick or otherwise cannot get insurance. This costs money, and must be paid for by other people. But it's something I think society should do" that would be one thing.

Many might disagree. But many would agree. I think a health care bill would have a good chance of passing then. Even if it didn't, it would be a disappointment for Obama but not reflect badly on him. He could continue to work quietly on a revised bill, for instance, and come back in two years saying (in effect): "look, you say it would be nice but cost too much. How about plan B?"

Instead, Obama is trying to convince everybody of the blatantly untrue, indeed of something that could not possibly be true: that the bill somehow will not raise taxes, will not cost the average American more money, and so on.

Why?

And don't tell me it's a politicians' usual way of working towards a goal by lying. Don't tell me it is deep strategic thinking based on considering likely opposition from the republicans. That would work if he were running in, say, a district, or perhaps a state, election.

But he is president of the USA for God's sake. He is precisely the one man who is supposed to be open and represent the people in general and tell them the truth, let the chips fall where they may.

Why doesn't he do it, I don't undestand. It seems not just the morally correct thing, but the practically correct thing -- perhaps not for Joe Schmoe who is running for his third term as representative of district 17 in New York; yes, for the POTUS.

[dudalb]

I am in favor of the Health Care Bill simply because we cannot keep on going the way we are, but I agree that I wish they would be more honest about how they are going to pay for it.

[Lurker]

Originally Posted by Skeptic

Look, the health care bill will insure lots of people who cannot get insurance now. This means raising health care costs for everybody else.

Now, if Obama had just said: "we need to take care of those who are sick or otherwise cannot get insurance. This costs money, and must be paid for by other people. But it's something I think society should do" that would be one thing.

Many might disagree. But many would agree. I think a health care bill would have a good chance of passing then. Even if it didn't, it would be a disappointment for Obama but not reflect badly on him. He could continue to work quietly on a revised bill, for instance, and come back in two years saying (in effect): "look, you say it would be nice but cost too much. How about plan B?"

Instead, Obama is trying to convince everybody of the blatantly untrue, indeed of something that could not possibly be true: that the bill somehow will not raise taxes, will not cost the average American more money, and so on.

I agree with the idea that it is a moral imperative to cover everyone even if we have to pay more for it. I am willing to pay more.

However, there is a fly in the ointment here:

Total spending on health care, per person, 2007
United States: $7290
United Kingdom: $2992
Italy: $2686
Spain: $2671
Japan: $2581 (2006)


If we went to a single payer system like they have overseas, is it unreasonable to think we might pay less consider the statistics above?

[geni]

Originally Posted by Skeptic

Look, the health care bill will insure lots of people who cannot get insurance now. This means raising health care costs for everybody else.

Nope. Countries with nationalised healthcare tend to spend less of their GDP on it.

Quote:

Instead, Obama is trying to convince everybody of the blatantly untrue, indeed of something that could not possibly be true: that the bill somehow will not raise taxes, will not cost the average American more money, and so on.

Err if you had even a basic knowlage of statistics you could see how it could end up costing the average american no extra.

[Careyp74]

Originally Posted by geni

Err if you had even a basic knowlage of statistics you could see how it could end up costing the average american no extra.

I had a theory that the effects of everyone having healthcare would lower the overall spending of healthcare, but I don't see what this has to do with statistics. Is there something else I am missing?

[WildCat]

Originally Posted by Lurker

If we went to a single payer system like they have overseas, is it unreasonable to think we might pay less consider the statistics above?

Yes, because the reasons for high costs here have little to do with who is paying.

And there is nothing in the current bill that will bring down costs, in fact it's likely to increase them.

[quixotecoyote]

Originally Posted by WildCat

Yes, because the reasons for high costs here have little to do with who is paying.

Oversimplified to the point of being wrong.

Quote:

And there is nothing in the current bill that will bring down costs, in fact it's likely to increase them.

Most likely correct. The current bill looks like a mess of half-measures and half-assery that probably won't get us close to the point of our European counterparts.

[Whiplash]

Originally Posted by geni

Err if you had even a basic knowlage of statistics you could see how it could end up costing the average american no extra.

Please elaborate, in detail. Otherwise I'm going to assume that is just some kind of blind faith. It flies in the face of reason, to me. Maybe I also lack this statistical genius. But I'm willing to be educated.

[drkitten]

Originally Posted by Whiplash

Please elaborate, in detail. Otherwise I'm going to assume that is just some kind of blind faith. It flies in the face of reason, to me. Maybe I also lack this statistical genius. But I'm willing to be educated.

There are several reasons.

The first is that expansion of the insurance risk pool will spread the risk around further. Most of the people without health insurance are reasonably healthy, simply because most people are reasonably healthy -- the medically uninsurable are a problem, but not a major demographic.

The second is that people without insurance still get medical attention (which ends up driving the costs, which in turn end up getting covered by the insurance companies). If you have, for example, an ER that costs $5000/hr to run, but half of your patients are uninsured charity cases, you'll end up charging the paying patients the equivalent of $10,000/hr. Putting the charity cases onto the insurance rolls will spread the costs out more fairly and reduce health care costs for the people who currently have insurance.

The third is that insurance companies tend to prefer paying for cheap preventative treatments over expensive acute treatments. My dental insurance company, for example, would much rather pay for a cleaning twice a year instead of a root canal. My medical insurance would rather pay for a blood pressure screening and a diet-and-exercise routine than a triple bypass following a heart attack. They'd also prefer to pay for a screening and simple outpatient surgery for stage I cancer than a full court press set of chemo, surgery, and radiation for stage III.

[theprestige]

Originally Posted by Skeptic

Look, the health care bill will insure lots of people who cannot get insurance now. This means raising health care costs for everybody else.

It doesn't even necessarily mean that.

You could completely unlink the two. Establish a welfare program for the needy (in this case, state-subsidized health care), and raise a tax from the affluent to pay for it. Deal with reforming the system as a completely separate issue.

Sure, it's government-enforced charity, and therefore not really charity at all, but if there's a net social benefit from it, I wouldn't complain.

And sure, it lacks the epic grandeur of a sweeping overhaul of the entire system all at once, an amazing feat that will cause Barack Obama's name to echo down the halls of history in stentorian tones for centuries to come... but other than that, I don't really see the problem.

[geni]

Originally Posted by Whiplash

Please elaborate, in detail. Otherwise I'm going to assume that is just some kind of blind faith. It flies in the face of reason, to me. Maybe I also lack this statistical genius. But I'm willing to be educated.

The issue is the average american. In this case we are probably talking about income. Now if you use the median income as the average (normal approach since the mean tends to produce some pretty meaningless figures) then the average american earned $41.5K in 2008.

It would be fairly trivial to set up any taxes to pay for goverment involvement in healthcare so that they didn't hit anyone earning less than $45K per year.

So statisticaly it is entirely posible for it to be true. If it is desirable to take that aproach is a seperate issue.

[Meadmaker]

I pity, in some sense, the American politician. If he tells the truth, he won't get elected.


We have met the enemy, and they are us.

[leftysergeant]

Originally Posted by theprestige

It doesn't even necessarily mean that.

You could completely unlink the two. Establish a welfare program for the needy (in this case, state-subsidized health care), and raise a tax from the affluent to pay for it. Deal with reforming the system as a completely separate issue.

Problem is that thaty would probably only work until the ecconomy got better and people elected the GOP to all the important offices and someone started calling the taxes "theft" and scrapped the program.

Quote:

And sure, it lacks the epic grandeur of a sweeping overhaul of the entire system all at once, an amazing feat that will cause Barack Obama's name to echo down the halls of history in stentorian tones for centuries to come... but other than that, I don't really see the problem.

I think the part I bolded is what bothers rightwingers the most.

[TShaitanaku]

Originally Posted by Skeptic

Why doesn't he do it, I don't undestand. It seems not just the morally correct thing, but the practically correct thing -- perhaps not for Joe Schmoe who is running for his third term as representative of district 17 in New York; yes, for the POTUS.

Because, for Obama, this, like most every other issue, is first and foremost a political issue. His support depends solely upon his long-term pulse of the electorate analysis. He isn't interested in trying to shape voter interest and perceptions, but rather, predict them and stay in step with them.

[Darth Rotor]

Originally Posted by Meadmaker

I pity, in some sense, the American politician. If he tells the truth, he won't get elected.


We have met the enemy, and they are us.

PJ O'Rourke's Parliament of Whores did a great job of discussing the problem, with a few good laughs tossed in.

DR

[Earthborn]

Originally Posted by Skeptic

Now, if Obama had just said: "we need to take care of those who are sick or otherwise cannot get insurance. This costs money, and must be paid for by other people. But it's something I think society should do" that would be one thing.

But he has repeatedly said that one of the major reasons for healthcare reform is specifically to save money. Abandoning that reason would not make him more honest.

[mhaze]

Originally Posted by Earthborn

But he has repeatedly said that one of the major reasons for healthcare reform is specifically to save money. Abandoning that reason would not make him more honest.

It's quite irrational: "We've got to spend more to save money".

[Earthborn]

Originally Posted by mhaze

It's quite irrational: "We've got to spend more to save money".

It would be irrational if someone said that, but nobody did.

[Eyeron]

More precisely, "we've got to spend other people's money to save money".

[tyr_13]

Originally Posted by Eyeron

More precisely, "we've got to spend other people's money to save money".

Still wrong.

[Eyeron]

That's what the government does. UHC will be paid for with other people's tax money, regardless of what form it takes. Of course those who can't pay for it won't and those who can will be charged for it. It's the same for any government program to "help" people.

[JoeTheJuggler]

Originally Posted by Skeptic

Look, the health care bill will insure lots of people who cannot get insurance now. This means raising health care costs for everybody else.

By that logic, the insurance companies all must be losing money the more customers they get.

Quote:

Now, if Obama had just said: "we need to take care of those who are sick or otherwise cannot get insurance. This costs money, and must be paid for by other people. But it's something I think society should do" that would be one thing.

In a way, I agree with you. I think it's a mistake to worry overmuch about deficit spending wrt universal healthcare. I've said elsewhere that it was a mistake for Obama to pledge not to sign any law that will increase the national debt.

However, the fact is that right now we as a nation spend much more per capita on healthcare while a substantial percentage of our capitas don't have access to healthcare, and the overall quality of our healthcare is not equal to what we're paying.

We definitely could set up a universal single payer system for less money than we as a nation are spending now. I disagree with Obama that the best solution was to preserve our current for-profit insurance-based system and try to reform it rather than replacing it altogether. In this regard, I'm more in agreement with critics of his plan who point out that his plan is more about extending coverage to as much of the population as possible than it is about reducing the overall cost we as a nation pay. (However, I'm all in favor of making healthcare more accessible to lower-income people, especially lower-income self-employed. And I'm in favor of the insurance reforms, if we're going to be stuck with private insurance anyway.)

As we've discovered, the many parts of this puzzle are inter-related, and you can't address one without addressing the other.

Just as an example, you can't really institute a universal mandate for insurance without making it possible for most everyone to get insurance. You can't remove the insurance companies' cost-saving rules (lifetime or annual benefit caps, the right to cancel coverage to high-risks, etc.) without requiring low-risk people to pay their fair share into the system.

[Earthborn]

Originally Posted by Eyeron

UHC will be paid for with other people's tax money, regardless of what form it takes.

Regardless of what form it takes? No, if it takes the form of mandatory insurance, it is not at all a given that it will be paid by tax money.

Quote:

Of course those who can't pay for it won't and those who can will be charged for it.

In most universal healthcare systems there are no people who can't pay. Everybody pays in at least something.

[leftysergeant]

Originally Posted by Eyeron

More precisely, "we've got to spend other people's money to save money".

Stop it. Those who make the most money are using the life energy of others and need to pitch in a bit to preserve that life energy.

There is no self-made man in civilized society. You ned to pay for the resources you use.

Working people are one of your resources, so pay for their upkeep and stop whining.

[Eyeron]

Quote:

Regardless of what form it takes? No, if it takes the form of mandatory insurance, it is not at all a given that it will be paid by tax money.

How so? Then where else will it come from?

[tyr_13]

Originally Posted by Eyeron

That's what the government does. UHC will be paid for with other people's tax money, regardless of what form it takes. Of course those who can't pay for it won't and those who can will be charged for it. It's the same for any government program to "help" people.

The highlighted section is self contradictory. If everyone is covered under UHC, and everyone's tax money is used, who do you suppose these 'other' people are? Are we going to tax Canada?

And why is 'help' in sacred quotes? Are you actually implying that health care coverage doesn't help people, or that other government programs don't help people? Or that the 'help' is really something else?

[WildCat]

Originally Posted by drkitten

The third is that insurance companies tend to prefer paying for cheap preventative treatments over expensive acute treatments. My dental insurance company, for example, would much rather pay for a cleaning twice a year instead of a root canal. My medical insurance would rather pay for a blood pressure screening and a diet-and-exercise routine than a triple bypass following a heart attack. They'd also prefer to pay for a screening and simple outpatient surgery for stage I cancer than a full court press set of chemo, surgery, and radiation for stage III.

Once you go beyond things like vaccinating entire populations the cost savings of "preventative treatments" is a myth.

Fom NPR:

Quote:

MICHELE NORRIS, host:
A central question in the debate over the health care overhaul is how to pay for it. Many politicians, including the president, have said that increasing preventive care will save a lot of money in the long term. But the Congressional Budget Office has consistently said preventive services won't reduce costs.

Commentator Douglas Kamerow is a former assistant surgeon general and preventative medicine specialist. Here's how he sees the debate over money and preventative care.

DOUGLAS KAMEROW: Not only do many politicians believe that prevention reduces health care costs, but so do most Americans. In a recent survey, 77 percent of Americans agreed that prevention will save us money. It's only logical - find a disease early in its course, treat it and you not only prevent illness and suffering, but you also save the money you would've spent treating it later.

Except that usually it's not literally true. Here's the dirty little secret: most prevention doesn't save money any more than treatment saves money. The question to ask is not whether it saves money, but whether your money is buying good value in health.

...
Now, it turns out that some preventive medicine does actually save money. For example, the cost of vaccinating an entire population against some diseases is actually less than it would've cost to treat those diseases if they developed in some of the people.

But most types of prevention don't literally save money. The reason for this is that you have to screen a lot of women with mammography, for example, in order to find one breast cancer. So, if it doesn't save money, how do we decide what prevention is worth doing? That's where value comes in.

As Dr. Steven Wolf and others argued in a recent paper on this subject, the question of whether prevention saves money and thus can help pay for health care reform misses the point. What does matter, and this matters both for prevention and treatment services, is value - the health benefit per dollar invested.

[corplinx]

Originally Posted by tyr_13

The highlighted section is self contradictory. If everyone is covered under UHC, and everyone's tax money is used, who do you suppose these 'other' people are? Are we going to tax Canada?

Due to the Bush and other tax cuts, we have a lot more people who pay zero federal income taxes or are tax negative. Everyone's tax money will not be used.

http://money.cnn.com/2009/09/30/pf/t...axes/index.htm

According to that, 53 percent of us are paying for the other 47 percent. Now we'll be paying their healthcare too.

[tyr_13]

Originally Posted by corplinx

According to that, 53 percent of us are paying for the other 47 percent. Now we'll be paying their healthcare too.

You do realize that we're already paying for their healthcare right?

[theprestige]

Originally Posted by tyr_13

The highlighted section is self contradictory. If everyone is covered under UHC, and everyone's tax money is used, who do you suppose these 'other' people are? Are we going to tax Canada?

It's not self-contradictory at all. It's how the government funds all its welfare programs: Everybody gets taxed.

Except those that can't afford to pay taxes and still have enough left over to live on. Instead, everybody else gets taxed more, to pay for those who can't afford to pay taxes.

[Meadmaker]

Originally Posted by mhaze

It's quite irrational: "We've got to spend more to save money".

EXACTLY! The rational thing to say is "If we cut taxes, we'll collect more money!"

I heard the President say today that this bill will pay for itself and lower the deficit.

Please make sure to hold him accountable to that when you get the chance, or if it happens to be true, give credit where credit is due.

[mhaze]

Originally Posted by Meadmaker

EXACTLY! The rational thing to say is "If we cut taxes, we'll collect more money!"

I heard the President say today that this bill will pay for itself and lower the deficit.

Please make sure to hold him accountable to that when you get the chance, or if it happens to be true, give credit where credit is due.

hahahha...

I know you is smarter than that.

Da Prez says this will pay for itself and lower the deficit -

"Ya, like Social security, medicare and medicaid". Yeah, riiiiigggghhhttt."

[Earthborn]

Originally Posted by Eyeron

How so? Then where else will it come from?

The answer should be pretty obvious; if it takes the form of mandatory health insurance, the money comes from health insurance premiums.

[tyr_13]

Originally Posted by theprestige

It's not self-contradictory at all. It's how the government funds all its welfare programs: Everybody gets taxed.

Except those that can't afford to pay taxes and still have enough left over to live on. Instead, everybody else gets taxed more, to pay for those who can't afford to pay taxes.

Ohhhh, so people who can't afford to pay taxes don't get to be part of our society and can just die.

Understood.

Hyperbole aside, do any other programs that are tax supported fail for this reason? Roads? Schools? Defense? Law enforcement?

It's a non-reason that has **** all to do with health care.

[corplinx]

Originally Posted by tyr_13

You do realize that we're already paying for their healthcare right?

And what does that have to do with my correction of your incorrect statement?

[Just thinking]

Originally Posted by leftysergeant

Stop it. Those who make the most money are using the life energy of others and need to pitch in a bit to preserve that life energy.

They already do ... they pay the workers wages (as per their job description and competitive wage levels and benefits). They pay the highest level of income taxes ... assuming they are indeed of the wealthiest. And the companies pay business taxes. They also in many cases support public programs of the arts and sciences through grants.

Quote:

There is no self-made man in civilized society. You ned to pay for the resources you use.

Just what do companies get for naught? Resources do cost money ... which help keeps other companies and their employees prosperous. They pay, trust me --- it's called Accounts Payable.

Quote:

Working people are one of your resources, so pay for their upkeep and stop whining.

And at just what level do those workers take on any responsibility for their own livelihood?

[Meadmaker]

Originally Posted by mhaze

hahahha...

I know you is smarter than that.

Da Prez says this will pay for itself and lower the deficit -

"Ya, like Social security, medicare and medicaid". Yeah, riiiiigggghhhttt."

It seems unlikely to me that the plan, by itself, will pay for itself or lower the deficit.

On the other hand, it won't be by itself. It will be part of a program that encompasses more health care reforms, other spending, and other taxes.

It really doesn't matter whether we think it will work or not. In the last elections, the Democrats won big, and earned the right to impose their will on the American agenda. If we don't like the results, we should throw the bums out when we get the chance. If we do like the results, we should reward them with re-election.

So far, I'm unimpressed with the President. I thought he would be more aggressive with the national debt. He hasn't been, and it seems to be getting even worse than what he inherited. Part of that is plans like this one with the Democratic form of Voodoo Economics, in which more services are provided, but they somehow result in less cost. If it works, I'll give him credit. If the debt is still rapidly climbing, or if the currency collapses as a result of the debt we already have, I'll vote for someone else in 2012.

[mhaze]

Originally Posted by Meadmaker

It seems unlikely to me that the plan, by itself, will pay for itself or lower the deficit.

On the other hand, it won't be by itself. It will be part of a program that encompasses more health care reforms, other spending, and other taxes.

It really doesn't matter whether we think it will work or not. In the last elections, the Democrats won big, and earned the right to impose their will on the American agenda. If we don't like the results, we should throw the bums out when we get the chance. If we do like the results, we should reward them with re-election.

So far, I'm unimpressed with the President. I thought he would be more aggressive with the national debt. He hasn't been, and it seems to be getting even worse than what he inherited. Part of that is plans like this one with the Democratic form of Voodoo Economics, in which more services are provided, but they somehow result in less cost. If it works, I'll give him credit. If the debt is still rapidly climbing, or if the currency collapses as a result of the debt we already have, I'll vote for someone else in 2012.

Yes, we are on the same page on the basic issues.

Except I've already formed an opinion of where the printing press economy is headed, and some other people have a "wait and see" attitude.

[a_unique_person]

Originally Posted by dudalb

I am in favor of the Health Care Bill simply because we cannot keep on going the way we are, but I agree that I wish they would be more honest about how they are going to pay for it.

They are all terrified of the sound bite out of context. Once it is in circulation, it can mean political death.

[tyr_13]

Originally Posted by corplinx

And what does that have to do with my correction of your incorrect statement?

My statement is still 'correct' in that there is no 'other' group to be taxed. It's all tax money from Americans. The fact that some Americans don't pay taxes is a separate issue.

Your 'correction' is also just plain wrong, which I pointed out in saying that we already pay for it. That isn't changing.