CDC Director Gerberding and Republican talking points

Their tax cut meme always starts with the idea that "the people" know better what to do with their money than "the government" (if it's the Bush government I am inclined to agree, but they are a special case)

So you think the government actually does know better what to do with the money than the people?

Hmm. What about social structure and behavior - is the government also more qualified to judge how people should act than the people are?

Caledonian: No, I think that some things can only be done on a social, not individual, scale. Framing it as "knowing what to do with our money" is the wrong way to put it.

http://www.globalresearch.ca/index.php?context=va&aid=7321
Neoliberalism underlies the evil that denies health care to those that need it, and destroys our public health system.
The neoliberal philosophy insists those who have accumulated wealth have a right to keep it. The moment an individual with wealth is taxed, and the money is redistributed to others, is the moment the person with wealth has been deprived of her or her freedom. The state, through the power to tax, takes away one's freedom. Therefore the state must be reduced to the exclusive function of protecting its citizens through the police and the military. All other functions should be privatized. In that way, the citizens will not be deprived of their freedom through taxation. Taxes will only be paid to support the police and the military.
Bush has stated those who need health care can go to the emergency room of the local hospital. And the public health system is being destroyed through lack of funds.
The idea of the commons, which was an area in the town cared for by all citizens, has been destroyed. Those without health insurance have a higher mortality rate than those that do.
Sadly, neoliberalism will destroy public health like it destroys all that is good and decent. To forget the welfare of the poor, the sick, and those in need is a crime against humanity.

If you give everyone $5,000 and tell them it is to spend on their health care, I suspect some of them would instead spend it on crack cocaine. Is that appropriate? No, but it is guaranteed to happen. So how do we reconcile that fact with the notion that "the people" know best?

Sure, you could impose restrictions on how people spend it, but then you are substituting one governmental control for another.

Joseph,
"Well, today more people don't have insurance and more people are paying out of pocket."
As Revere has specified, the concept of each person using the $5000 individually is illogical. It is not even a question of what they would spend it for. It is only when the money is combined, and treatment shared, that it is effective.
Please note the reference above. More people today do not have insurance, and more are paying out of pocket.
This is because funding has been reduced for health care.
And it has been reduced to reduce the tax burden. If Guiliani becomes president, these reductions will appear small in relation to what he plans to do. Guiliani may win through voter fraud, just a Bush won through voter fraud in Florida.
Ideally, this administration, and probably the next, would reduce funding for public health to zero, or as close to zero as is politically acceptable. The neoliberal philosophy insists private charities should be responsible for caring for those who need health care and public health services. That means tax payers have no responsibility for providing these services, and it is not the responsiblity of the citizens to provide health care for anyone in the US. If you have a job, you have money to pay a doctor for these services. If you have no money, taxpayers will not help you to pay for these services. You will have to go to a private charity, or use the emergency ward in your local hospital.

How many of us need to pool our $5000 to buy a doctor?
How about a full shift of doctors, staff, and an office?
How many of us need to pool our $5000 to buy a hospital?

Now, how many of us need to pool our $5000 to buy a politician?

What do you mean, they're not for sale?

The issues:

1) Some people (1% or 5% or 10%?) for whatever reason (stupid, addictive, other) seem to not appropriately spend money in their own (or family) interest.
2) There are needs that can only be managed by communal action. With only his own $5,000 Revere "can't buy better schools, a better health care system, better police protection, a clean environment.".

It does not follow that biggest brother should take all the money out of everyone's hands and look after everything.

One size don't fit all.

Consider education. Infant education is probably best dealt with at community level. Primary education at Village level, secondary at Town level, tertiary at State or National level. Similarities exist for health, police & environment.

Introduction of UHC meant doctors always got paid. Other factors (e.g. the Dr. Kildare factor) caused the Alphas to supplant the Florence Nightingales in the medical profession and drove up the cost of education. Damage claims made medical insurance hence fees more expensive, hence the vicious cycle of costs.

That said, UHC was a benefit in OZ, and by extension (probably) anywhere. UHC provides the necessary minimum of insurance cover that everyone needs, while at the same time helping to contain the costs for the insured events.

If the customer wants extras, like a pretty nurse or physician with a bedside manner, or tooth implants instead of a denture, or laser surgery rather than spectacles, then the customer should pay extra or buy insurance.

As for the argument concerning addictive or stupid behaviour, rather than punish the whole class, find the culprits and cure them.

UHC is not a universal panacea. But taken in small doses it has a beneficial effect.

http://www.commodityonline.com/news/specials/newsdetails.php?id=3723
bar,
Universal Health Care will never happen in the US. How much has your gasoline, heating, and food bill increased recently? How much does a barrel of oil cost?
What does the price of oil have to do with public health?
The answer is plenty. Please take a second to finish reading this.
The world in 2006 reached peak oil. That means the era of cheap oil is over. The global demand for oil is now higher than the supply. Global supply of oil in 2007 is 85 million barrels per day and demand is 88.2 million barrels per day. The situation can only get worse, since world oil production may never exceed 85 million barrels per day, and may actually start to decline at 3% per year, starting in 2008.
This means US citizens will resist any tax increases to pay for Universal Health Care or public health; because they will be paying more and more for food and energy.
What does the price of food have to do with oil? It takes 10 calories of energy from oil to produce 1 calorie of food. That includes the fertilizers, made of oil, the insecticides made of oil, the diesel for the tractors to plow the fields and the trucks to transport the food to your local store.
The world consumes oil at 5 times the rate new discoveries of oil are being made. The city of Portland Oregon is now studying what the impact of peak oil will be on public health services. The government of the United Kingdom has has a group studying the problem.
In 1900 there were about 1.6 billion people living on the planet. Oil has provided the energy to produce the food to allow the world population to increase to about 6.5 billion.
Once oil productin goes into permanent decline, it is estimated 4 billion will starve to death, because there will not be sufficient oil to produce the food.
Please read the above referenced article for more information.

Bar and Herman cover a lot of this. UHC is a talking point with the Democrats. They know we cant afford it especially if we go eco nutz in the US without everyone else on the planet being forced to do it too. UHC would swallow more money than the DoD has in 10 years than in 75. Limited UHC for those who CANT pay for it is in my book but full blown mandated UHC is a disaster and will never work.

This is a socialism/communism thing and anyone supporting it is just that, one or the other. Healthcare is not a right and anyone willing to sit in the ER or even in a doctors office can get healthcare in the US. Healthcare and health insurance. There are 40 million without health insurance in the US but if you asked them when they went to the doctor last, most will tell you they have been to one in the last year. This will put all of the money you make into the governments pocket and not in yours. When that happens, kiss your job goodbye because everything will collapse around our ears. No spendable income. Cant buy fuel because you dont have it in your pocket (but hey you can go to the ER and get it right), cant eat out (but you can drive 80 miles to see a doctor to try to get into their practice for care as they do in the UK), cant go to WalMart and buy clothes (but hey, they'll have a doctor in a kiosk...you can see him). You get the drift.

Bottom line is that healthcare will DECLINE under UHC and its really already there as 50% of the healthcare is already UHC (Medicare/Medicaid/VA). Those are such shining examples of inefficiency that its just incomprehensible to me that anyone would want to even try this. Once in, as with TennCare it will eat every dollar taken in and hasten the demise of Social Security by 12 years. Raise taxes? Oh no, not in a global economy. Interest rates would have to double to pay for this as government spending would create runaway inflation. Taxes would have to also go up by 25%. This is a concept cause and one that ensures the complete and total destruction of the US and its economy in a fast hurry.

But there are those that just dont get it. Iraq is their sticking point, their lightning rod. This would ensure that we WOULD go to war with Iran and Venezuela as the economy shuts down from costs. This is the most destablizing idea that the Democrats have ever come up with. Instead of employer provided insurance, the government provides it thru taxes. Its another cash flow scheme like Social Security became. They stole it and they will steal from this too. It will ratchet up taxes in increments just about every year until you have nothing to live on. Then they'll say we have to have more government subsidized housing.. Might be a fair statement because you'll have no money to pay for ever rising costs that support UHC for electrics, house, fuel, equipment. As those costs accelerate the economy will accelerate in reverse as jobs move to places that dont have the cost basis we do. Remember what the CARTER gas tax created? The Department of Energy... Can anyone tell me what particular energy it has created to date? It does grants and things like that just as the HHS does, but what has either created but problems in what is supposed to be a free market society. Add in the fact that the illegals will bomb the system from across the border and you have recipe for total economic collapse.

This is a permanent government control thing. Fewer doctors, less care for some, but care for all? Depends on what you consider to be care. Driving for miles just to see a doctor? They polled all of the doctors here in town some 300 and not a one of them said they would be UHC. My dentist said he couldnt make it if it was imposed. He would have to raise his prices by twofold to the UHCS to get by.

Someone is just making assumptions. All of those previous cites for UHC countries are not fluff they are real time and real stories of how each and everyone of them have had to come to grips with the facts. Those facts are that the costs rise, the service is low, the lines intolerable and you above all have to SUBMIT to government control of your body. Hey, want to get into a debate about the first government paid for abortion under UHC.

Remember what I said about the South? We said Ta-ta before, we can do it again and for a whole different group of reasons.

Herman and MRK:

Over here in Australia, and in Europe, the price of a barrel of oil has remained fairly constant or fallen over the past few months. During that time the US dollar has been depreciating, probably because of the sub-prime thing, which might make oil look more expensive to US customers. The situation is probably not helped by the people who do not want refineries in their backyard.

Peak oil is not a new concept to me. I explained why it is not a problem nearly a year ago. http://barvennon.com/spin/?p=12

Both you guys are thinking like, well, liberals, which is to say you do not seem to realize that the dynamics of a situation move interactively when you make a change.

Introduction of a minimalist UHC such as I described in the post above does not just add on to what is there. It isn't all extra.

Instead it CHANGES THE WAY THAT YOU PAY for what is already there. Minimalist UHC would incorporate the existing health care system, and properly designed, would reduce the overheads and the cost of what is currently being paid for by existing insurance schemes.

MRK stated that 40 million people were not covered by medical insurance in the USA, and also that everybody uninsured got treated. So worst case is 13% of the US population would be the extra charge for UHC on the US medical system. And that worst case would be if UHC gave the same cover as the existing insurance scheme.

A minimalist scheme such as that in OZ pays only about 70% of the doctor's fee.

1) So you are not going to get a flood of penurious patients, because they still have to pay something, and at least the physician does not have to work on emergency cases for charity.
2) Competitive pressures would force existing insurance schemes to reduce their rates proportionally to adjust for the partial refund of fees provided by the minimalist UHC.

In fact, after the gains from synergies and from improved community health, it could well be that introduction of such a proposed UHC might be revenue neutral. And to maintain cost control, I would suggest that the UHC contributions be included as a separate charge on the income tax form.

You blokes really should ignore all that advertising by the insurance companies about the "Horrors of UHC". Those insurance companies are making a very nice living thank you very much, and they most certainly would fight tooth and nail against anybody who proposed introducing any UHC system whatsoever that might take any of their profits away.

I suspect that people from countries that have UHC would probably agree that UHC seems to get bad press in the USA.

"MRK stated that 40 million people were not covered by medical insurance in the USA, and also that everybody uninsured got treated."

Yeah, well, he didn't cite any evidence of such. In an emergency condition, you may be able to get help at an emergency room, but there is no guarantee.

People with cancer, kids with brain tumors or in need of heart transplants don't automatically get the treatment they need on the taxpayer's dime, no matter what Randy may believe. And without insurance, there is simply no way the average American could pay for that treatment out of pocket. Most of us couldn't amass that kind of money in a lifetime.

As it stands now, my visit to my Family Physician costs me a ten buck co-pay. In the future, my insurance may be switched to a "Traditional Plan", where all non-hospital treatments are paid for by me. I'll still be covered for the really major stuff, but each office visit will jump to $80-$120 bucks. It's worth it to me to see my doc for some persistent problem, but it's likely I'll opt for self-care unless it gets worse.

What really scares me is what I don't know at the moment: do I pay each time I go for "additional tests" or is any of that covered? In the last month, I have gotten my annual mammography, which led to a core-needle biopsy, which is in turn leading to an excision biopsy. With any luck, that will be the end of it, but if that were all charged to me, it would get expensive fast! That's not even counting the "routine follow-up" visits that most thorough docs want to schedule.

The entire business model of for-profit health insurance is that money is made by selling the policies and then denying payment for procedures. Some companies actually do a decent job of providing care, but this is obviously not the case for many Americans at this point.

wenchacha:

Apologies, I misrepresented what MRK actually said. He said:

"There are 40 million without health insurance in the US but if you asked them when they went to the doctor last, most will tell you they have been to one in the last year."

The following link is a web site by Physicians for National Health Proram. Supposedly 14,000 physicians are onboard.

http://www.pnhp.org/news/press_releases.php

The fact of the matter is that today 2 trillion dollars are being spent each year on health care in the US, or 7000 dollars per person, far more than any other country.

Who pays under the current system? Individuals and corporations (50% via taxes, the other 50% via direct payments or through insurance premiums). Who pays under a UHC system?. Individuals and corporations via taxes.

How much will a UHC system cost? Well, 2 trillion dollars a year would be the maximum in todays dollars at todays costs. In fact, the efficiencies that would be introduced into the system would mean that HC costs would be lower. Why?

Consider that the administration costs under medicare are only 3% while that of the insurance companies is 16%. Consider also the cost and manpower for HC providers in getting a multitude of insurance company approvals for treatment of each patient, billing and collection of the insured and uninsured (collecting that part not paid by the insurance company). In addition, consider that overall, 31 cents on every dollar spent on HC is spent on non HC matters. And last but not least, imagine a mega insurance company (Uncle Sams Insurance Company)with up to 2 trillion dollars to spend on the HC of 300 million people and the ability to demand the best price for it's customers, and willing to do so at no profit. Costs will certainly go down with a UHC and the USIC will be in a position to control unwarranted rising costs in future years.

Does this mean the insurance companies are out of business? No, they can still provide supplementary insurance for the well off who want better coverage and services, eg, private rooms, elective surgeries, priority services, and are willing to pay for it.

Some might say "If it ain't broke don't fix it". Dude, it is broke. Consider.

1. We had 45 million uninsured in 2006. There were 54 million who were insured for at least part of the year. up to 100 million people are uninsured at least part of any 5 year period.

2. Many of the insured are insured for only as long as they are able to work. A serious injury or illness that prevents them from working means they will no longer be able to afford insurance on their own, and inevitably leads to bankruptcy and the loss of their home. The safety net is medicaid, but you have to be dead broke to qualify, and then we still pay their medical costs after we bankrupt them.

3. Many insured folks find out the hard way they are underinsured, or insured by a bad company who denies virtually any claim and manufactures ways to cancel your coverage at the first sign of serious illness, which can lead to bankruptcy and loss of home.

4. Many uninsured seek treatment in emergency rooms. There is no more expensive form of health care. Many of the bills for these patients go unpaid, leading to higher charges that are passed on to those with insurance via higher premiums. In the case of illegal aliens, the government offers subsidies to states to offset these costs and reimburse hospitals. Still, since 1994, over 1000 emergency rooms have closed, and some that have not deny coverage to the uninsured. Try calling 911 from a hospital emergency room requesting an ambulance when you are denied treatment.

5. The government already provides health care insurance to almost 50% of the population, the old (medicare), the poor (medicaid), veterans (VA), government workers and military, prison population (2 million strong), low income children (SCHIPS), illegal immigrants (state subsidies), terrorists being detained in GITMO, etc. The healthy who are able and willing to work are left over and given over to the private insurers where they reap huge profits, since these folks HC costs are relatively small compared to the populations the government covers.

6. 30% of small and medium business do not even offer HC insurance to their employees and by next year, the average Fortune 500 firm will have a health care bill that exceeds its net income, so how long even the bigger companies can continue to operate under the current system without removing HC insurance from the benefits they provide is questionable. Since workers real income in todays dollars has been relatively stagnant over the last 20 years, asking them to absorb even more of the HC costs is not realistic.

7. Even Veterans have trouble getting HC. 1.8 million Veterans have no HC, and 3.8 million family members. Many are denied treatment because of a 2003 Bush order halting enrollment of middle income families. Support the troops at least!

Some will still argue about the need or desirability of UHC. The popular objections.

1. It's socialism. Well, democracy is simply a balance between socialism and capitalism. Too far to the left, and you have a Soviet Union, too far to the right, and you have Mussolini's Fascist Italy, and of course we have China's hybrid which can be called authoritarian (not democratic) capitalism. Corporations are driven by their shareholders insatiable demand for profits, and when they can not be trusted to provide universal and dependable essential services, democratic governments step in with a dab of socialism. Examples of socialist functions are public education, military and homeland security, health care for the old and needy, welfare, public housing, etc.

2. "It will be a disaster". Since the UK in 1948 started their UHC system, following years of war that devastated their economy and left tens of thousands of disabled soldiers requiring health care, every industrialized country, most of them democratic, has implemented a UHC with resounding success. Is any system perfect? No. But like democracy, the only thing you can really say to support it is that any other system is worse. Any government with a UHC system in place who tries to remove it and replace it with privatized HC would face a revolution, because it works. UHC is not an experiment, it is a tried and proven system.

Just wanted to state that this post and thread (or whatever you call it) justifies my internet costs for the year, topped off by one of the best comments I have ever seen anywhere, by PTodd. I have printed a copy in case some poor, unsuspecting soul asks me for my opinion on UHC. Mind you, part of the reason I liked it was that there were some contrarian opinions expressed (and discussed in a civil manner).