The Progressive Pulse

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James 17 Oct 2007 3:32 pm

Well said.

But don’t hold your breath waiting for anything even remotely resembling an apology. I suspect the free-market fanatics would just as soon boil the kid in oil to defend their point. Their arguments on this issue remind me of Bush’s arguments for invading Iraq. The minute you dismantle one, they make up another.

Same applies to climate change, their latest high horse. It’s not real. It’s not affected by humans. Taking steps to reduce pollutants won’t make a difference. And even if it did make a difference, it wouldn’t be worth doing because rich guys might suffer. Oh yeah, and it would actually require planning . . . and we all know that planning = communism.

Sometime I don’t know why I bother.

“If boiling people alive best served the interests of the American people, then it would neither be moral or immoral.” Max Borders, Civitas Institute

Evelin B. Brinich 17 Oct 2007 5:44 pm

Well, and there was Secretary of State Albright’s 5/1996 comment on CBS 60 Minutes when asked about the devastating impact the sanctions were having on the children of Iraq (half a mil killed) “..we think the price…is worth it.” Let’s boil the kids as long as it serves our financial interests.

Joseph Coletti 18 Oct 2007 8:35 am

This is not about Graeme Frost or his sister. It is about the irresponsibility of the parents who could have purchased insurance before the accident for much less than $1200 a month, purchased insurance instead of commercial property, purchased insurance instead of three cars, or found some other way to set aside the money. Graeme Frost was used as an example of what SCHIP does and his parents qualified with their $45,000 a year income for a family of six, but his parents are an example of how government programs create moral hazard and bad choices.

I have always made sure my children were privately insured to avoid the pre-existing condition problem that the Frosts now face, even when I was trying to start a business and had no income. The Frosts chose not to.

If you want to talk policy Adam, we can talk about eliminating certificate of need (CON) regulations on medical capital investment, tax credits for individuals who purchase insurance, regulation of naturopaths and nurse practitioners, non-compete clauses in insurance company contracts with doctors, procedure-based payment in government and private insurance, mandates on insurance not purchased by large firms, tax code discrimination against individuals and small companies who purchase insurance, delinking HSAs from specific types of insurance policies, the inability of consumers to choose health insurance products that are legal in other states, and a number of other policy ideas.

Let’s talk about unintended consequences and the true costs of government-paid health insurance. I don’t defend the current system. Individuals don’t have enough freedom to choose their own doctors or treatments that work for them. But if you think having the state or federal government pay doctors makes the most sense, then let’s look at how doctors get paid in Medicare and Medicaid. Let’s talk about how unwilling your friends in the state legislature were to find less than $10 million in the General Fund to pay for a high-risk health insurance pool and how much you wanted to raise taxes (assessments) on the insured.

Call Frank Stasio at the State of Things. Call Bill LuMaye. Call Scott Carr.

Joseph Coletti 18 Oct 2007 8:37 am

This is not about Graeme Frost or his sister. It is about the irresponsibility of the parents who could have purchased insurance before the accident for much less than $1200 a month, purchased insurance instead of commercial property, purchased insurance instead of three cars, or found some other way to set aside the money. Graeme Frost was used as an example of what SCHIP does and his parents qualified with their $45,000 a year income for a family of six, but his parents are an example of how government programs create moral hazard.

I have always made sure my children were privately insured to avoid the pre-existing condition problem that the Frosts now face, even when I was trying to start a business and had no income. The Frosts chose not to.

If you want to talk policy Adam, we can talk about eliminating certificate of need (CON) regulations on medical capital investment, tax credits for individuals who purchase insurance, regulation of naturopaths and nurse practitioners, non-compete clauses in insurance company contracts with doctors, procedure-based payment in government and private insurance, mandates on insurance not purchased by large firms, tax code discrimination against individuals and small companies who purchase insurance, delinking HSAs from specific types of insurance policies, the inability of consumers to choose health insurance products that are legal in other states, and a number of other policy ideas.

Let’s talk about unintended consequences and the true costs of government-paid health insurance. I don’t defend the current system. Individuals don’t have enough freedom to choose their own doctors or treatments that work for them. But if you think having the state or federal government pay doctors makes the most sense, then let’s look at how doctors get paid in Medicare and Medicaid. Let’s talk about how unwilling your friends in the state legislature were to find less than $10 million in the General Fund to pay for a high-risk health insurance pool and how much you wanted to raise taxes (assessments) on the insured.

Call Frank Stasio at the State of Things. Call Bill LuMaye. Call Scott Carr. Let’s go.

Or do you just want to call us names?

Brian 18 Oct 2007 9:30 am

Joe,
Unintended consequences? What are those?

After all, according to Stephanie Bass “There’s just no downside.”

There’s no time for rational analysis when there is a “moral obligation” at stake.

Adam – step out from behind the human props and fear-mongering (Bush’s veto will kill kids!) and publicly debate Joe on the topic. Or would that be too difficult for you? After all, public debates are “no place for the faint of heart.”

sturner 18 Oct 2007 1:22 pm

Joseph…I’ll say the same thing to you that I said to Max and Brian on their blog. You have provided a laundry list of consumer driven policy options, each of which may or may not have merit.

Here is your problem. You have had a Republican president and Republican controlled Congress for 6 years. Your own party could not be bothered to pass any significant healthcare legislation, much less implement to a meaningful degree any of your favored policies. Similar policy recommendations came out of the Heritage Foundation and elsewhere in February of 2001. You should have been asking your party leaders for the past 6 years to debate your policy recommendations, not Adam. You already had your chance in the marketplace of ideas…and your leaders passed. Take it up with them.

Now you are faced with Democratic control in both houses (with majorities likely to increase significantly in the next election cycle). It is early, but more likely than not, there will be a Democrat in the White House in 2009. Public sentiment is in favor of an increased role for government in healthcare. Why do you think your ideas are politically feasible now, when they have been largely ignored while your party was in control?

Finally, and most importantly, your list of policy options do very little, now, to cover the 47 million uninsured Americans. You want to lower costs and increase competition…great!…so does Hillary Clinton and she also has ideas about how to do it. But she has a legitimate plan to cover the uninsured immediately and you do not. Now you have an uphill battle on your hands. You’re going to have to convince Democrats how your ideas fit into their plans. Good Luck!

I won’t speak for Adam, but his concern is providing access for the millions of Americans who are under- or uninsured. Until you have a legitimate comprehensive plan on how to do so, if I were Adam I wouldn’t bother to debate you either.

PS. You do have a very legitimate point on Medicaid and Medicare reimbursement rates. I’ve mentioned it in the past and intend to blog more about it in the future.

Brian 18 Oct 2007 1:37 pm

Politically feasible idea does not equal the best idea.

So, when are you opening your free clinic in southeast Raleigh to provide immediate access for the uninsured? After all, it is your “moral obligation” and there is “no middle ground.”

Joseph Coletti 18 Oct 2007 9:16 pm

Steve, Adam’s recommendations make it harder for millions of Americans to get quality health care. All of the policies I mentioned can be handled at the state level, which is where my concern is.

As for “a legitimate comprehensive plan,” I must have missed Adam’s and yours. I don’t think single payer is legitimate and “universal coverage” will always have people who opt out so it’s not really comprehensive. On the other hand, having faith in the market means trusting that there are a few people out there who understand a small part of the puzzle enough to make money, so we don’t really need a comprehensive plan which I doubt anyone is smart enough to be able to devise anyway.

Good attempt at ducking, but your premises are wrong. Try again.

Adam Searing 18 Oct 2007 10:19 pm

You know, when I was growing up Asterix wasn’t really such a bad guy!

Anyway, Steve couldn’t have said it better. I’ve asked it before and I’ll join Steve and ask it again. Where is your plan – even one to cover 100% of kids in NC? We’ve proposed one, complete with actuarial studies and a framework. We got part of it passed in the last legislative session (sliding scale premium basic coverage for kids in families between 200% and 300% fpl) and we’ll get the buy-in at full cost for all parents in a future session.

Do you have a real plan for insuring all kids in NC? No. Much less any realistic plan for coverage for other groups. I’m open to any realistic solutions that result in broad coverage. What I have no patience for is lame proposals put forward without cost estimates or actuarial studies for the sole purpose of scoring political points.

When you aren’t addressing the realistic concerns of millions of Americans, people start to catch on. We see that with the 80% approval ratings (70% among Republicans) for the SCHIP expansion on the table. I’m happy for you to join the slide into irrelevance. Your side wasn’t for our SCHIP program when it was first proposed. You aren’t for this expansion. You aren’t for universal coverage. Well, what are you for? I’d be very afraid that question will become academic after the next election.

sturner 19 Oct 2007 8:19 am

Joseph…Who’s ducking? I’m on record for supporting an Edwards/Clinton style healthplan in 2009. If I’m right, most Americans will be covered. If you’re right, it will be a disaster and a campaign issue for the Republicans in 2012. You afraid to take that bet?

Hi Brian! I saw 28 patients yesterday; hopefully I made a small difference in the lives of at least few of them. And you? Have you freed anybody today from the coercive actions of the state from your cubicle at the Institute of Irrelevant Magical Big Ideas?

Joseph Coletti 19 Oct 2007 8:31 am

You’re starting from the wrong premises. It’s not about “coverage,” it’s about care.

Michael Cannon of the Cato Institute laid out the following principles that explain the club’s opposition to “universal coverage”:

1. Health policy should focus on making health care of ever-increasing quality available to an ever-increasing number of people.

2. To achieve “universal coverage” would require either having the government provide health insurance to everyone or forcing everyone to buy it. Government provision is undesirable, because government does a poor job of improving quality or efficiency. Forcing people to get insurance would lead to a worse health-care system for everyone, because it would necessitate so much more government intervention.

3. In a free country, people should have the right to refuse health insurance.

4. If governments must subsidize those who cannot afford medical care, they should be free to experiment with different types of subsidies (cash, vouchers, insurance, public clinics & hospitals, uncompensated care payments, etc.) and tax exemptions, rather than be forced by a policy of “universal coverage” to subsidize people via “insurance.”

Brian 19 Oct 2007 10:32 am

Hi sturner!
28 patients, eh? I’m sure you made quite a difference in their lives with the 90 seconds you spent with them. Perhaps you should spend more time with each patient rather than devoting so much time pecking away at your laptop blogging personal smears against people you’ve never met.

I’m still waiting for you to back up your “moral obligation” talk by opening up that free clinic.

To piggyback Joe’s comment, the focus on “coverage” for everyone is a distraction. The reality is “coverage” does not equate to health care.

http://redclaycitizen.typepad.com/redclay/2007/10/universal-healt.html

“In a world in which resources are limited always and everywhere, single-payer “coverage” cannot guarantee health care, and “universal coverage” is a mirage.”

sturner 19 Oct 2007 11:01 am

Joseph…again your ideology rears it’s ugly head. Your operating premise has nothing to do with coverage or care…it has everything to do with minimizing government intervention.

Let’s analyze your points.

1. We agree. How to get there is where we disagree. I would submit that France has equal or better quality than the US, with much better access. At half the price.

2. Pure anti-government boiler-plate ideology. You’re entitled to your opinion, but don’t state it as fact. Particularly when there is ample evidence to suggest otherwise (again France, Canada, UK, Veterans Administration…all operate much more cost efficiently than private sector US).

3. In a free country we acquiesce everyday to things our government has deemed valuable ( public education, mandatory vaccinations, defense spending, etc). Why draw a line in the sand over health insurance?

4. I’m not against experimentation to try to determine the best way to deliver healthcare efficiently (as long as it’s part of a comprehensive universal coverage plan). Again, though, you need to ask yourself why the Republicans didn’t experiment with any of the ideas you mention when they had the chance. If they really cared about “ever-increasing quality available to an ever-increasing number of people” they were free to experiment with every idea you have mentioned. Why didn’t they? And why should Democrats, assuming they consolidate political power, experiment with your ideas when they have different ideas of their own?

Joseph Coletti 19 Oct 2007 12:46 pm

Steve, my four points were statements of principles, not of facts. Explain why your principles of government-provided “coverage” does a better job of improving health care.

Government already pays for half of health care costs in the U.S., so it is misleading to say our system is private.

People have a right to refuse public education and “mandatory” vaccinations, they should also have a right to refuse insurance — national defense is a public good, not in the same category as the other items.

Why do you keep going back to partisan politics instead of debating the policy itself?

There are about ten of us who read this blog. Seriously, let’s have this debate in front of a bigger audience.

sturner 19 Oct 2007 1:27 pm

Joseph…No thanks to the debate. Any increase in government intervention is a non-starter for you. I don’t see any way to cover the uninsured without it. We have different goals. So be it. My time, and yours, would be better spent trying to elect candidates who share our values.

So, you should go back to your echo chamber and we will keep our lonely vigil at the Progressive Pulse. I’m willing to invest my time here because I believe that the country is moving towards an increasingly progressive agenda. If I’m correct, the policies we advocate here will become more relevant, while yours will become less so. We’ll see.

As to partisan politics…I have definite opinions on that subject. None of which you will like, but I’ll share them soon anyway.

Adam Searing 19 Oct 2007 1:48 pm

Actually Joe, there are thousands of people who read this blog every month.

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