Palin Speaks

[blackshoe]

Ayn Rand was a lot of things. Simple minded wasn't one of them. Nor did she promote simple-mindedness.

[Winstonm]

Ayn Rand was a lot of things. Simple minded wasn't one of them. Nor did she promote simple-mindedness.

I didn't say Ayn Rand was simple-minded. I said she promoted a simple-minded faith in selfishness.

 

To me an unwavering belief in any ideology without continual questioning and review of new facts is always simple-minded.

[hrothgar]

Ayn Rand was a lot of things. Simple minded wasn't one of them. Nor did she promote simple-mindedness.

maybe not deliberately....

[blackshoe]

If you get to define the words, you will always win the argument.

[RichMor]

If you get to define the words, you will always win the argument.

If you car about the writings of Any Rand, then you need a hobby. :)

[Winstonm]

The is an inherent, insurmountable problem when the determining factor in health care is profit margin. Without a single payer system or a public option there will be no substantial change.

 

The health care debate will be staged as Much Ado About Nothing.

[Winstonm]

If you get to define the words, you will always win the argument.

Amen

[Winstonm]

Here is more "change we can believe in" and the reality of hope. Can you connect dots? Can you add 1 and 1 get 2?

 

  But these days it often seems as if Mr. Daschle never left the picture. With unrivaled ties on both ends of Pennsylvania Avenue, he talks constantly with top White House advisers, many of whom previously worked for him.

 

    He still speaks frequently to the president, who met with him as recently as Friday morning in the Oval Office. And he remains a highly paid policy adviser to hospital, drug, pharmaceutical and other health care industry clients of Alston & Bird, the law and lobbying firm.

 

    Now the White House and Senate Democratic leaders appear to be moving toward a blueprint for overhauling the health system, centered on nonprofit insurance cooperatives, that Mr. Daschle began promoting two months ago as a politically feasible alternative to a more muscular government-run insurance plan.

 

    It is an idea that happens to dovetail with the interests of many Alston & Bird clients, like the insurance giant UnitedHealth and the Tennessee Hospital Association. And it is drawing angry cries of accommodation from more liberal House Democrats bent on including a public insurance plan.

 

White House backs off public healthcare option

 

Obama and officials say it is not 'essential' to the overhaul.

 

    The Obama administration signaled Sunday that it was on the verge of abandoning a government-run insurance option in its healthcare overhaul -- a bow to political reality and a big win for insurers.

 

 

And that is how things work in Chicago.....

[PassedOut]

And that is how things work in Chicago.....

Not just in Chicago. Russ Douthat has some pertinent observations on this: Don’t Blame Obama.

 

To listen to the chatter about where his administration has gone wrong, you would think that the rest of the Democratic Party had no agency — that Democratic office-holders are slaves to poll numbers that only the White House can control, and that the way a Max Baucus, a Ben Nelson or a Blanche Lincoln votes is entirely determined by whether the president of the United States twists the right arms and hits the right rhetorical notes.

 

In reality, the health care wrestling match is less a test of Mr. Obama’s political genius than it is a test of the Democratic Party’s ability to govern. This is not the Reagan era, when power in Washington was divided, and every important vote required the president to leverage his popularity to build trans-party coalitions. Fox News and Sarah Palin have soapboxes, but they don’t have veto power. Mr. Obama could be a cipher, a nonentity, a Millard Fillmore or a Franklin Pierce, and his party would still have the power to pass sweeping legislation without a single Republican vote.

 

What’s more, health care reform is the Democratic Party’s signature issue. Its wonks have thought longer and harder about it than any other topic. Its politicians are vastly better at talking about the subject than Republicans: if an election is fought over health care, bet on the Democrat every time. And for all the complexity involved, it’s arguably easier to tackle than other liberal priorities. It’s more popular than cap and trade, it’s less likely to split the party than immigration and it’s more amenable to technocratic interventions than income inequality.

 

If the Congressional Democrats can’t get a health care package through, it won’t prove that President Obama is a sellout or an incompetent. It will prove that Congress’s liberal leaders are lousy tacticians, and that its centrist deal-makers are deal-makers first, poll watchers second and loyal Democrats a distant third. And it will prove that the Democratic Party is institutionally incapable of delivering on its most significant promises.

 

You have to assume that on some level Congress understands this — which is why you also have to assume that some kind of legislation will eventually pass.

 

If it doesn’t, President Obama will have been defeated. But it’s the party, not the president, that will have failed.

Exactly right.

 

And the Sunday News compares the US healthcare system with the systems in other countries: Expensive without the results: Health care in the U.S. costs the most, not the best.

 

Last year, a study comparing preventable deaths in 19 industrialized countries placed the U.S. dead last. France was first, followed by Japan and Australia.

 

In the U.S., one in three chronically ill patients says the health care system needs to be rebuilt completely. Only one in 10 feels the same way in the Netherlands and the United Kingdom.

And you don't have to be chronically ill to figure this out. Just run a business with employees who need healthcare insurance.

[Winstonm]

If it doesn’t, President Obama will have been defeated. But it’s the party, not the president, that will have failed.

 

If once more our elected leaders negotiate a sellout of the national interests in favor of a small group of powerful private interests then it will not be the party nor the President who will have failed but the country that will have lost.

[kenberg]

I have come to somewhat dread the word "reform". By the time the lobbyists finish massaging it, it usually means that they get more and I get less. Nonetheless, even a dodo should be able to grasp that smoehting needs to get done here.

 

Michael Steele, the chairman of the Republican National Committee, has an op-ed piece in the Post today. He presents a "Senior's Health care Bill of Rights" which reads as a proclamation that Republicans will do their very best to block any action whatsoever.

 

http://www.washingtonpost.com/wp-dyn/conte...9082302036.html

 

The opinions of the ex-governor of Alaska were recently dismissed even by such conservatives as Charles Krauthammer. Forget her. But Steele speaks for the Republican Party as whole. I am most sorry to say that they intend to do nothing constructive. Many of you can say "What took you so long" but I do think Republicans have a useful role that they could play here. Apparently they plan to not do so.

 

With regard to the Democratic plan, I feel like the fabled Christian Scientist with appendicitis. Every spending plan I can recall has always been explained as "we will finance this through cutting waste". The spending happens, the cutting of waste doesn't happen. Some serious principled leadership is badly needed, and quickly.

 

Just as a side note, as a senior I resent having Mr. Steele announce that he is hoping to scuttle health care reform as a favor to me.

[Winstonm]

Steele uses the wingnut methodology of appeal to irrational fears, an application of McCarthyism in more subtle form.

[PassedOut]

But Steele speaks for the Republican Party as whole. I am most sorry to say that they intend to do nothing constructive. Many of you can say "What took you so long" but I do think Republicans have a useful role that they could play here. Apparently they plan to not do so.

This is as sad as it is infuriating. I know for a fact that some republicans hate what is going on now, but they seem powerless against the know-nothing group.

[Winstonm]

From Yahoo News:

 

The GOP principles also include preventing government from "interfering with end-of-life care discussions." That is a reference to a provision in a bill by House Democrats that would allow Medicare to pay for voluntary counseling sessions about living wills and other issues. After critics seized on the provision and charged it could lead to "death panels" and euthanasia, administration officials said it would not likely be included in any final bill.

 

I believe the Democratic response is the completely wrong way to handle this idiotic attack on end of life discussions. Rather than cowering to the lies - which then gives then a aura of respectability - the Dems should be explaining and fighting to keep this provision in order to show how utterly stupid and disingenuous is the criticism from the right wing.

[Winstonm]

This reminds me of working for the Boyd corporation in Las Vegas a few years ago after that had gone public - every year thereafter they would announce "we have improved your benefits", and every year we got less health coverage and it cost each of us more.

 

Here is the only change we are likely to see:

 

http://www.latimes.com/news/nationworld/na...0,6925890.story

[kenberg]

My principle stipulation about end of life discussions is that no one whose last name is Bush is allowed to have any say in it. Other than that, I think that the provision is somewhat insulting to the medical profession, or at least I hope that it is.. When my father was dying thirty some years ago the doctor did not expect an extra fee for engaging in frank discussions of the options. Afterward the hospital had folks who helped me to make some of the arrangements and put me in touch with a funeral home. I am pretty sure that there was no charge for that either. Do some doctors really insist that they be paid to engage in such a discussion? I am at times critical of the medical profession, but such a fee would shock me.

[mike777]

Listening to MSNBC and others I get the impression the real and really only goal is to get the uninsured...insured.....but the health plan is never presented that way.....not even on MSNBC

 

We get all this side garbage and lies.......

 

Just simply say the goal is to get the uninsured ...insured....damn the costs.....or etc...

 

Or I think a better way to say it....to get everyone basic health carecoverage.....paid by taxpayers if need be......

 

if that is the best goal I still like my idea .........everyone is covered by medicare by july 4th 2009...sort out the details later....

 

 

 

side note.....as I commented in other threads getting info on the Canada health care plan is very difficult........as far as I can tell.....everyone calls it a single payer system but it is far from a single payer system........

[PassedOut]

Nicholas Kristof's piece yesterday reminded me of Dr. Jeffrey Wigand, the cigarette company whistleblower. An insurance executive For 20 years, Wendell Potter worked as head of communications for Humana and later Cigna. He quit when he could no longer face himself in the mirror: Health Care Fit for Animals

 

Opponents suggest that a “government takeover” of health care will be a milestone on the road to “socialized medicine,” and when he hears those terms, Wendell Potter cringes. He’s embarrassed that opponents are using a playbook that he helped devise.

 

“Over the years I helped craft this messaging and deliver it,” he noted.

Potter testified before a Senate healthcare committee this year.

 

Mr. Potter says he liked his colleagues and bosses in the insurance industry, and respected them. They are not evil. But he adds that they are removed from the consequences of their decisions, as he was, and are obsessed with sustaining the company’s stock price — which means paying fewer medical bills.

 

One way to do that is to deny requests for expensive procedures. A second is “rescission” — seizing upon a technicality to cancel the policy of someone who has been paying premiums and finally gets cancer or some other expensive disease. A Congressional investigation into rescission found that three insurers, including Blue Cross of California, used this technique to cancel more than 20,000 policies over five years, saving the companies $300 million in claims.

 

As The Los Angeles Times has reported, insurers encourage this approach through performance evaluations. One Blue Cross employee earned a perfect evaluation score after dropping thousands of policyholders who faced nearly $10 million in medical expenses.

 

Mr. Potter notes that a third tactic is for insurers to raise premiums for a small business astronomically after an employee is found to have an illness that will be very expensive to treat. That forces the business to drop coverage for all its employees or go elsewhere.

Much of the acrimony about healthcare reform reflects starkly different philosophical viewpoints. According to healthcare reform opponents, all of these tactics make good business sense (no doubt about that) and are therefore acceptable. The reformers feel quite comfortable with having the government step in to stop business practices that have negative effects on society. The chasm between philosophies seems unbridgeable.

 

So there will be hard feelings in one camp or another no matter what happens. If nothing happens to fix at least some of this, I will be furious.

[Al_U_Card]

The conflict of interest stems from the influence that the corporatocracy exerts over the government by PAC funds (for re-election) as well as cronyism (revolving door of government to corporate to lobbying etc.).

 

When those flying pigs take away the troughs and make government unassailable by the special and moneyed interests, then and only then will you stand a chance of the government for, of and by the people that it is supposed to serve and represent.

[mike777]

Socialized medicine for me would mean that the economic and political power of health care were in the same pair of hands.

 

At what point that occurs and whether that is a good thing or a bad thing is another thread.

[mike777]

"When those flying pigs take away the troughs and make government unassailable by the special and moneyed interests, then and only then will you stand a chance of the government for, of and by the people that it is supposed to serve and represent"

 

 

 

This is not logical. I think you do not understand the definition of special or moneyed interests or what an interest group is. By definition all interest groups are special and all interest groups have some level of money behind them. By definition if you cut off access or influence to government by interest groups you cut off access of the people they serve.

[blackshoe]

My understanding of the insurance business generally may be flawed, but it is this:

 

People would wish to undertake risky actions - for example, sailing to the East Indies from England in order to buy spices and other things at a relatively low price there, in the expectation of selling those things for a higher price back in England. The risks involved are many, but just one example is that the ship might sink on the way back, with the loss of all those spices. So people were found who were willing to make a bet with the entrepreneur. The bet worked like this: the entrepreneur put up some cash, in effect betting that his ship would sink. The insurer(s) agreed to pay some larger amount of cash if it did, in effect betting it wouldn't sink.

 

Carry that on to "health insurance". The insured is betting he's gonna have some medical problem in the future for which he won't be able to pay out of his own pocket. The insurance company is betting he won't. Given people are living longer, while being more sedentary and doing "unhealthy" things like smoking (although granted there's less of that than there used to be) it seems a very bad bet on the part of the insurance companies. So they're trying to "hedge" their bets, and their customers are viewing many of the ways they're doing that as cheating (I agree with them, btw).

 

It seems to me that given the current state of medical technology, the cost to any nation-sized group of people of complete, universal health care for everyone in the group is always going to far exceed the money available to pay for it. So I'm not sure there's any solution, given the current state of the technology. Certainly, given the paradigm above, insurance is not a viable mechanism. In the long run, the best answer is to improve the technology. Unfortunately, we need a short term answer, particularly those of us (like me) who are reaching the point where we are almost certain to win our side of the bet relatively soon. I don't know what that answer might be, but as I said I don't think the insurance paradigm qualifies.

[kenberg]

Insurance means different things to different people. I insure against catastrophe. I don't have theft insurance on my car. If it is stolen, I won't like it but I will buy another. I have never insured my car against theft. But I do have fire insurance on my home. My home burning down would be a catastrophe.

 

Now I do have health insurance. Unlike car insurance my employer (even in my retirement) contributes to this plan so economically it makes sense. I also have medicare. And prescription drug insurance. All subsidized. I just went to the pharmacy for some prescribed lotion for my poison ivy. It cost five bucks. To say that I have insured against the catastrophe of having to pay the marked price of fifty buck is a distortion to my way of using words. It's better to say that I contribute to a subsidized health plan that allows me cheap meds and doctor visits when needed/wanted.

 

Regardless of semantics, the distinction in intent is important as we try to decide what we should do. Do we want to make sure everyone can get prescription medicine at low cost for relatively minor issues? My prescribed lotion at $5 is cheaper than a probably adequate (I am beginning to think maybe better) over the counter lotion. Or are we prepared to say "If you get poison ivy you have our sympathy but buy your own lotion, we are here to help when you have appendicitis"? And what really do we intend to do about someone who will live for maybe three more weeks but we could extend it to perhaps four more weeks if we spend enough cash?

 

The issue of what we intend to do, what we do not intend to do, what we can afford to do, what we cannot afford to do is real. The discussion seems to mostly be dominated by those who imply that there are no difficult choices that need to be made and those who fantasize about death squads. We can do better.

 

 

ALSO:

I could use help on a specific issue. My congressman, Roscoe Bartlett, was asserting yesterday that in England no one over the age of 65 can get into an intensive care unit. The thought that a 66 year old is hit by a truck and left to die because he is too old to go to an ICU is, I presume, another fantasy of the right wing. Could someone direct me to information to learn what British policy is being distorted here? I would like to call him on this, but I need facts with some precision.

[RichMor]

My understanding of the insurance business generally may be flawed, but it is this:

 

People would wish to undertake risky actions - for example, sailing to the East Indies from England in order to buy spices and other things at a relatively low price there, in the expectation of selling those things for a higher price back in England. The risks involved are many, but just one example is that the ship might sink on the way back, with the loss of all those spices. So people were found who were willing to make a bet with the entrepreneur. The bet worked like this: the entrepreneur put up some cash, in effect betting that his ship would sink. The insurer(s) agreed to pay some larger amount of cash if it did, in effect betting it wouldn't sink.

 

Carry that on to "health insurance". The insured is betting he's gonna have some medical problem in the future for which he won't be able to pay out of his own pocket. The insurance company is betting he won't. Given people are living longer, while being more sedentary and doing "unhealthy" things like smoking (although granted there's less of that than there used to be) it seems a very bad bet on the part of the insurance companies. So they're trying to "hedge" their bets, and their customers are viewing many of the ways they're doing that as cheating (I agree with them, btw).

 

It seems to me that given the current state of medical technology, the cost to any nation-sized group of people of complete, universal health care for everyone in the group is always going to far exceed the money available to pay for it. So I'm not sure there's any solution, given the current state of the technology. Certainly, given the paradigm above, insurance is not a viable mechanism. In the long run, the best answer is to improve the technology. Unfortunately, we need a short term answer, particularly those of us (like me) who are reaching the point where we are almost certain to win our side of the bet relatively soon. I don't know what that answer might be, but as I said I don't think the insurance paradigm qualifies.

Good analysis, but I disagree with some basic concepts.

 

First, the shipping thing. This is classic insurance history stuff, but the origin is simpler. Several ships left England empty, sailed to the East and bought goods. The captains would distribute their goods among the ships for the return voyage. If one or more ships were lost, everybody lost some of thier goods but nobody lost everything (unless all the ships were lost)

 

So the basic concept of insurance is loss sharing. Everyone accepts a likely small loss in order to avoid a total loss. The original insurance syndicates shared the liability for a shipping loss. Modern insurance organizations still reinsure.

 

Second, the betting thing. Health insurance is not a large series of binary 'bets' that the insured will or will not require medical treatment any more then life insurance is a bet that the insured will or will not die. Nobody gets out of this world alive.

 

So I don't agree that insurance companies try to 'hedge' an individual bet. They just try to balance their expected losses (claims) with expected gains (premium plus investement earnings).

 

RichM

[Al_U_Card]

This is not logical. By definition if you cut off access or influence  to government by interest groups you cut off access of the people they serve.

Heaven forbid that we should deny the corporate lobbyists their chance to shill for and enrich those that benefit the most at the loss of the VAST majority. That is how oligarchies function. ¢erfs and peasants pay homage and owe fealty to the noble$.