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Health Care Costs Have Skyrocketed June 21, 2009

Posted by geoff in News.
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…since 2000, so the administration has stated we absolutely must increase the government’s role in providing coverage to our citizens. Simply study this comparison of the effective cost controls of Medicare vs. private health insurance, and I’m sure that you’ll be forced to agree (from Table 13):

Medicare-vs-Insurance

Comments»

1. Lipstick - June 21, 2009

Wow. Yes, I can see now that the government is so much more efficient than that shifty private sector.

2. Tushar - June 21, 2009

Geoff,

I saw the PDF and my eyes glazed over. Is your chart derived from Table 13? You may want to mention that. Nothing like using the Govt’s own data to counter their argument.

3. Tushar - June 21, 2009

Also, are those figures constant dollars, or actual dollars? I couldn’t find that in the PDF.

4. geoff - June 21, 2009

Yes – Table 13 is what I used. I’ll mod the post.

5. geoff - June 21, 2009

Oh great – now I lost the link completely. It may take me a while to find it again.

6. geoff - June 21, 2009

There. All better.

And Tushar – all the other tables were in 2007 dollars, so I assume that is true for Table 13 as well.

7. Tushar - June 21, 2009

Be prepared for crap arguments about how private insurers are selective and Govt is not.

And then be prepared when in an effort to control costs, the Govt starts denying end-of-life and other expensive care to undesirables like the elderly, republicans etc.

8. Health Care Costs Have Skyrocketed - June 21, 2009

[…] Go here to see the original:  Health Care Costs Have Skyrocketed […]

9. PattyAnn - June 21, 2009

Might as well put an “www.InnocentBystanders.net” credit on it right now.

♬ Graph Man ♬

10. Anonymous - June 21, 2009

The percentage increase seems about the same for both lines on the chart, the only difference is their starting position. With Medicare having (I assume) many more older and poor people (and thus sicker) their higher costs per person are to be expected. Is there some startling fact where a direct comparison, apples to apples reveals some major difference?

11. Tushar - June 21, 2009

>>many more older and poor people (and thus sicker)

Does poor automatically translate to sicker? How?

12. Lipstick - June 21, 2009

Anonymous, dude, they started out at $2,000 difference and ended up at $6,000 difference.

13. Tushar - June 21, 2009

I calculated YoY increases for both Medicare and Private Insurance, and then compared which grew faster in what years. Medicare grew faster under Clinton, and then slowed down when GOP took over. Medicare shot up again when President Bush signed the Prescription Benefit turd.

14. Mrs. Peel - June 21, 2009

Hmm, well, poor people are more likely to abuse substances like alcohol and tobacco, so maybe they have poorer health overall?

15. Edward Von Bear - June 21, 2009

more likely to abuse substances like alcohol and tobacco,

Abuse? But booze loves me back!

16. Edward Von Bear - June 21, 2009
17. Mrs. Peel - June 21, 2009

I just noticed an odd discoloration on my ceiling. It’s rust-colored and appears to be right where the pipes leading to my second bathroom are.

The old, rusty pipes.

Shit.

*checks balance in bank accounts*

18. Rosetta - June 21, 2009

Happy Birthday, Michael.

19. Michael - June 21, 2009

Geoff, hope you don’t mind, but I took out the break. I don’t think we should hide the chart below the fold.

Happy Birthday to you too, Rosetta.

20. Tushar - June 21, 2009

BTW, are the figures for private insurance costs only, or do they also include the rapacious/capitalistic/republican/unpatriotic/exploitative/McBusHitlerBurtonRoveJew profits too?

21. The All Barack Channel & The Government-Run Healthcare Sales Pitch « SOYLENT GREEN - June 21, 2009

[…] via Innocent Bystanders, a chart from […]

22. geoff - June 21, 2009

Geoff, hope you don’t mind, but I took out the break

I put it in there because I didn’t want to push Eddie’s post down too much. The events in Iran deserve pretty prominent placement.

23. doc - June 21, 2009

Watch the determined liberals spin, spin, spin. That’s why I love these charts and graphs. Facts! right there for all to see – even those ignorant proles, those that the left believe need the narrative shaped and spoonfed to them, can reach their own conclusions. Rock on, Mistah Geoff!

24. Lipstick - June 21, 2009

Peel, Mr. L says you have a leak and you’ll have to get someone in to cut through the ceiling , seal the pipe and then repair the ceiling.

Sorry 😦

25. Mrs. Peel - June 21, 2009

Cut a hole in the ceiling? Wouldn’t it make more sense to go up into the attic and replace the pipe from there instead of making holes in the ceiling?

I knew my pipes needed to be replaced and had already called a plumber for an estimate. I’ll have to dip into the rainy day funds, but that’s what they’re for, I guess.

26. Lipstick - June 21, 2009

Mr. L says, “Attic, sure, absolutely, if you can get to the pipes from there, that’s the way to go.”

27. Mrs. Peel - June 21, 2009

Does Mr. L have an opinion on PVC vs. copper?

28. Lipstick - June 21, 2009

(We don’t have an attic, so that’s why he said to go through the ceiling.)

Keep us informed, advise for our loved ones is always available!

29. Mrs. Peel - June 21, 2009

aw, thanks 🙂

My dad is going to help me negotiate the plumbers and insurance agent (we have the same agent). I hate making phone calls.

30. Lipstick - June 21, 2009

It’s so helpful to have a man when negotiating things like this. There is such a tenancy to rip off single females.

Mr. L said that copper is more expensive but may be best for indoors. Outdoors, PVC is fine, because copper will rust.

31. Lipstick - June 21, 2009

Does copper rust or just get that green stuff on it?

32. xbradtc - June 21, 2009

Copper rusts.

33. xbradtc - June 21, 2009

The “green stuff” is usually referred to as a “patina” but is in fact, oxidized copper. A slight patina is no problem, but copper can corrode fairly quickly, with sometimes catastrophic results.

34. CCPhysicist - June 21, 2009

For someone who says that a video promoting gay rights and an anti-war agenda “precisely captures my attitude towards Obama’s socialist agenda”, you sure picked an interesting followup. See how flat Medicare costs were during the last half of the Clinton administration, and how they jumped even more at the midpoint of the Bush administration? Did you attack “W” as a socialist when he pushed through the prescription drug plan? 😉 Tushar seems to have missed that the slope for Clinton 1 is the same as for that noted socialist “41”, and that the growth rate was negative during Clinton 2.

More importantly, have you read the article in The New Yorker a few weeks ago about the contrast between $15,000 and $7000 per patient in two similar border towns in Texas? It neatly captures the heart of the problem with Medicare, which transcends politics.

My less snarky observation is that the “private” graph has to be for group coverage for persons from 0 to 65. Since I know the rates my employer pays for group health insurance and the rates I paid some years ago for individual private coverage, there is no way a person at age 65 could buy individual private comprehensive health coverage for $4000 per year with no exclusions for pre-existing conditions. No way. This is an apples-and-oranges comparison.

But if it is true that group plans will provide the same coverage to persons over 65 at a fraction of the cost of Medicare, then the proposal to offer federally structured “group” plans like I have to individuals and small businesses or as an alternative to Medicare sounds like a great idea.

However, it could be that I am being fooled by the “per enrollee” scale, which might imply that the average cost for a family of four would be $16,000 per year. If so, that is stunning compared to what my employer’s program costs but not unlike private plans I have seen.

PS – If you really want to know what it costs to get old and sick, be sure to factor in the part of Medicaid that pays for nursing homes. The high cost of Medicare (and Medicaid) is directly related to the spectacular cost of the last year of someone’s life.

35. Lipstick - June 21, 2009

Thank you Xbrad. I didn’t know if the patina was harmless or not.

36. geoff - June 22, 2009

For someone who says that a video promoting gay rights and an anti-war agenda “precisely captures my attitude towards Obama’s socialist agenda”,

That was Michael, not me. And Michael explained in the first comment what portion of that video captured his attitude.

Did you attack “W” as a socialist when he pushed through the prescription drug plan?

Naw, we attacked him as a pandering spendaholic. He wasn’t as systematic as Obama, so we didn’t call him a socialist.

It neatly captures the heart of the problem with Medicare, which transcends politics.

The point is that government, not politics, is the problem.

This is an apples-and-oranges comparison.

It’s an apples-and-oranges comparison if you try to derive the wrong conclusions from the data. The point is that the gov’t has vilified the health insurance industry for rising insurance costs. They have made the point that our health care expenditures have risen dramatically over the past decade. But their solution is to increase government involvement and supplant the private insurance companies, when the government has performed no better in controlling treatment cost increases than the private sector. Even with cost controls and treatment guidance. And even with off-the-book subsidies by medical practitioners.

37. geoff - June 22, 2009

Should also mention that the periods of slower growth are attributed to Congressional action, not the leadership of the administration.

38. Mrs. Peel - June 22, 2009

@30: no kidding. When I need maintenance on my car, I always have my dad handle it, because the techs assume that I know absolutely nothing. Granted, I don’t know much, but I know enough to smash your face in if you take that condescending tone with me.

So, it’s better to let my dad do the talking.

39. Dave in Texas - June 22, 2009

Peelie. depending on the damage to the sheet rock on the ceiling, it still may have to be replaced. If it’s just discolored, then it can be treated for mildew with KILZ and repainted, but if it’s swollen or something it’ll need to be cut out and repaired.

40. OrwellianThoughtPolice - June 22, 2009

Please cease and desiste from questioning the uber liberal class. It is clear that they as the elite intellectuals now have all authority. Please note ccPhyscist name. He is obviously well-qualifed and pointed out the wrong thinking of Michael and Geoff.

If you persist in this dissent towards our Supreme Leader – Teh One – you will receive a call, a very peronsal call from the Supreme Leaders staff. Remember, what happened to the Inspector General, or to the whistle blower on ACORN, or to “Rev” “Gosh Darn” Wrong.

It is very likely you could end up in Bermuda. Consider this your last warning.

Orewllian Obama Organizers – The Big Three OOO.

Ps. ice cream is on special today, please take advantage while other people rot in hell.

41. OrwellianThoughtPolice - June 22, 2009

ccPhysicist,

On a more serious note. It was the Contract with America, started by Newt Gingrich and fellow Republican pals that revolutionized government spending and stopped the welfare ride for masses of people on the dole for decades.

Try to remember all of your history, not just the selective one-sided ideology. Clinton went along for the ride after 94. He gave into the Republicans. And the uber liberal classes were all hacked off. Cost were held down because the Budget promised in Contract To America was a simple, straight forward solution. For trhe first time, Americans were actually served by their elected leaders. I’ll give credit to Clinton for going along, but he did not think of it.

Please say hello to Comrade William Ayers while on your next stop to ThugTown Chicago. Be sure to let us all know how the failed public housing project is doing today after Obam’s planned dream came into reality. I’m sure he will do just as good a job on healthcare. Maybe he can appointe yet another failed crony from Syria.

42. Cathy - June 23, 2009

Sorry to hear about the ceiling problem Mrs. Peel that’s probably caused by plumbing.

After you get the plumbing problem fixed and let the ceiling dry out completely try mixing a simple solution in a spray bottle: 1 teaspoon laundry detergent, 1 cup bleach and 1 cup of water. Wear goggles and gloves, and cover/protect any surfaces immediately below the stain. Then SPRAY the spot on the ceiling and allow it to dry. Repeat this procedure until the stain disappears. DO NOT RUB. You might be able to completely eliminate the stain without having to patch or paint.

43. drjohn - June 23, 2009

You guys gotta cut this out. All this honesty is going to get you in trouble.

Nice work again!

44. Retired Geezer - June 23, 2009

KILZ is the Shiznit for fixing discolored ceilings. Especially a textured one.

45. scottw - June 23, 2009

As a former landlord for 9 apartments in two apartment buildings, here’s one more vote for KILZ primer, for killing wood/rust stains that tend to persistently bleed through sheetrock and paint.

FYI: If you use Cathy’s stain remedy, keep a window open with a fan going. You don’t want to be using that high a concentration of bleach without plenty of ventilation.

If you don’t have a good, effective way to vent to the outdoors in any very small room, do not use strong bleach there, ever.

46. lauraw - June 23, 2009

Uh, that was me.

Some random guy had his wordpress stuff all up against my computer.

47. Mrs. Peel - June 23, 2009

A random guy, huh? Weird. So you put tape over his mouth in a little X? Good thinking. 😉

The stain is in the entryway, near my front door, so ventilation wouldn’t be a problem. I may give the KILZ stuff a shot, though, once the plumber has been through (now that I think about it, I’m not 100% sure the attic is tall enough to access the pipes there). Thanks!

48. Will - June 23, 2009

You know, somebody better get a new post up soon, or the streak is dead.

49. Will - June 23, 2009

Definitely wait till after he’s done repairing the pipes. The odds are good he’ll make it worse, or even put a foot through your ceiling. Not that I haven’t seen that done a time or two.

50. Mark in NJ - June 24, 2009

Hey Geoff…found ya (based on a tip from Mrs Geoff) cozily ensconsed within the mutual admiration society.

Nice graph, as always. The Medicare curve is steeper, but what can we conclude from that without a lot more information (particularly the demographics of the people in the two groups)? e.g., if medicare pts are older, sicker, poorer, then the govt system might be doing a relatively great job and may be actually more efficient than private insurers?

Dude, need more data.

51. BrewFan - June 24, 2009

Hey Geoff…found ya (based on a tip from Mrs Geoff) cozily ensconsed within the mutual admiration society.

We do admire geoff around here. He is smart and offers non-partison analysis on the issues we discuss here. Of course, because you take ‘progressive’ knee-jerk positions on everything this might be hard for you to believe.

if medicare pts are older, sicker, poorer, then the govt system might be doing a relatively great job and may be actually more efficient than private insurers?

And what, exactly, leads you to believe the government runs any large scale effort efficiently? USPS? Amtrak? Social Security Administration? Should I go on?

Dude, *I* need more data.

I fixed that typo for you Mark.

As a relative of geoff’s you are let off with a mild rap with the clue bat.

52. geoff - June 24, 2009

if medicare pts are older, sicker, poorer, then the govt system might be doing a relatively great job and may be actually more efficient than private insurers?

If you think about it, that’s impossible. That could be why they start at different points, but not why they increase at the same rate as private insurers, unless you’re going to claim that Medicare patients are getting sicker as time goes on. That would be a great testimonial to gov’t-sponsored care.

53. Cathy - June 24, 2009

Ventilation is essential. Sorry I didn’t mention it the first time.

The reason why I’d try the bleach solution FIRST is because it does not add layers or weight to that area. Painting something on top of other layers can add weight that will sometimes flake away and even peel the previous layers away…this can end up being more noticeable, just sayin’.

54. Mark in NJ - June 24, 2009

Not sure I understand — looks to me like Medicare pt expenses are increasing at a *greater* rate (not same) than privately insured (~7K/15 yrs vs 3K/15 yrs).

But if original premise that Medicare pts are older/sicker/poorer is true, then why can’t rate of “sickness” also be steeper? The older you get, the sicker you get – sad truth of life. And greater poverty is unlikely to mitigate that.

55. Mark in NJ - June 24, 2009

One more thing…BrewFan – thanks for the typo fix – nice to hear from you again.

And, for the record, I’m very fond of Geoff as well.

56. geoff - June 24, 2009

Not sure I understand — looks to me like Medicare pt expenses are increasing at a *greater* rate (not same) than privately insured (~7K/15 yrs vs 3K/15 yrs).

Overall they have increased by the same percentages based on their starting values. From 2000 to 2007, for example, they both increased by 70%. That’s simplistic, of course – it’s likely that we shouldn’t have expected the percentages to be equal, since there are some costs that don’t scale that way. My guess is that Medicare is doing a bit worse than private industry, which is a shame given the inferior care and level of government oversight.

But if original premise that Medicare pts are older/sicker/poorer is true, then why can’t rate of “sickness” also be steeper?

How to explain… Once you’ve defined the difference in costs between Medicare patients and the public at large, you’ve already accounted for the age/infirmity differences. That’s at the starting point. Then any per capita increases thereafter are based on increased costs, not population differences or sizes.

57. Mrs. Peel - June 24, 2009

mutual admiration society

HOW DARE YOU?!?! GEOFF IS THE GREATEST AND IS NEVER WRONG!!!!

Well, maybe that one time. And the other time. And…

Hmm, I may have to rethink my starting premises here.

58. geoff - June 24, 2009

Well, maybe that one time. And the other time. And…

Hmmm… Early onset of dementia or perhaps an addiction problem. So sad.

59. deb - June 25, 2009

This is great news! The private insurance industry CAN compete. I challenge them to take on our elderly and uninsured and let’s get rid of Medicare! Yippee! This is wonderful news!

60. lauraw - June 25, 2009

Well, maybe that one time. And the other time. And…

Geoff has documented all those incidents and is absolutely willing to discuss today how you were wrong about that.

*waits patiently while geoff accesses the file marked ‘Mrs. Peel- WRONG! 2002-2009’*

61. geoff - June 25, 2009

The private insurance industry CAN compete.

This comment is so poorly thought out on so many levels, I don’t know where to start. And since it’s undoubtedly a drive-by strafing from some know-nothing, I’m not going to bother.

But deb, if you really want to talk about how lame your comment was, in explicit and technicolor detail, just come on back and I’ll share a little quality time with you.

62. geoff - June 25, 2009

Geoff has documented all those incidents and is absolutely willing to discuss today how you were wrong about that.

Like I would be so petty as to remember every little disagreement I had with every person I’ve ever met.

OK, maybe I remember them, but I don’t do it pettily.

63. Dave in Texas - June 25, 2009

Public insurance will not be required to hold financial reserves, like private companies must. Public insurance will dictate allowable charges to providers, unlike private companies which must negotiate rates. It is impossible for private companies to compete with the public alternative. Which everybody on the left pushing this nonsense knows, hell we’ve all seen that idiot congresswoman telling the crowd the plan is supposed to drive them out of business.

These things are demonstrably true today, why would anyone think they’d be different with Obama’s plan? Or asked another way, if you see the truth and hear his lie, why do you believe him?

64. Dave in Texas - June 25, 2009

Also I sure could use some pie and maybe a ticklehug from some chicks today. Ladies?

65. geoff - June 25, 2009

Also I sure could use some pie and maybe a ticklehug from some chicks today.

Well…I’ll getcha a beer and do a manly high five. Will that tide you over until our resident babes arrive?

66. Mark in NJ - June 25, 2009

I feel like one of us is missing the point (and I fully accept it might be me)…Both groups of pts are getting sicker as they age – both are requiring more tests, procedures, meds this year than they did last year…so up to this point, I see that the increase in expense could be explained by increase in costs of the tests, etc. But I’m suggesting there’s a possible acceleration rate difference as well (health decline per year per year)…

Anyway, this is way into the weeds — all I meant to say was, your graph *might* show that govt insurance is less efficient, but in my biz (where we compare data for a living), no one would accept that as definitive without more information about the 2 groups of pts.

67. geoff - June 25, 2009

Both groups of pts are getting sicker as they age

No – you’re not following a cohort of people who are aging. As you follow the timeline along the abscissa, new people enter into the systems and some people drop out. But the age distribution within the groups is always about the same, even though the Medicare group gets larger each year. So aging population and getting sicker with age have nothing to do with the data.

no one would accept that as definitive without more information about the 2 groups of pts

It’s not as undefined as you seem to think. But the point was that gov’t, despite its myriad advantages, does no better at controlling increasing medical costs than the private sector, and in fact is probably worse. That fact, combined with the lower standard of care (80% of Medicare providers did not meet the minimum standards of care in one study), mean that the administration’s claim that Obamacare will save money is not grounded in reality.

68. geoff - June 25, 2009

So aging population and getting sicker with age have nothing to do with the data.

That’s a little strong. They have a secondary effect on the data.

69. Dave in Texas - June 25, 2009

Yes.

70. geoff - June 25, 2009

But the point was that gov’t, despite its myriad advantages, does no better at controlling increasing medical costs than the private sector, and in fact is probably worse.

And even that was not the main point, which was that the government has cited rising health care costs as the main long-term economic problem facing the country (which isn’t true, but whatever). And they’ve pointed the finger at the health insurance industry as part of the problem. But they’ve done no better at controlling costs, and in fact it’s the future costs of existing government programs which are the biggest financial liabilities in the health care systems.

Taxpayers won’t be able to afford to support Medicare or Medicaid because their cost increases are out of control? Then the answer must be to increase government oversight!!

Not so much.

71. deb - June 25, 2009

geoff-This know nothing has an MBA and a Masters of Hospital Administration from Georgia State University who worked in non profit hospital administration (Vice President) for 10 years. I spent a fair amount of my time shifting the cost of uncovered care or under-insured services onto private insurance companies who passed these costs onto businesses providing group coverage for their employees. I became disgusted with the whole system of dysfunctional wasteful business practices in both private and public health care insurance, and eventually retired because my job became too distasteful. So I would be happy to talk about my comment more if you would be happy to refrain from name calling. For profit private insurance companies cannot provide what medicare does, nor do they want to. Therefore the graph is contextually misleading to the vast majority of the unknowing population. Private insurers want only the best risk clientele. They want their stock price high, they want their bonuses and perks, and they want government to make it easy on them to continue to have just that. As long as they remain able to cancel policies, and book profits, they aren’t too concerned about the waste, or the disgrace that this country doesn’t currently value ALL citizens access to health care. Watch the c-span testimony of the big 3 private insurers which took place on Tuesday. If you aren’t appalled as the members of congress on BOTH sides of the aisle clearly were, then I will understand why you call me names and dismiss my comments. Now please may I kindly have your level of expertise in this industry before you reply? I do not want to be condescending if you are well versed in these matters.

72. lauraw - June 25, 2009

*sets pie on IB lunch counter*

*wiggles into Dave’s squeezy hug*

Watch the hands, buddy.

No, I meant with the pie. Here, I brought a pie server and a plate. There ya go, stud.

Sincerely Peel, when I met geoff the Friday before last, he told me that he and I had had three disagreements over the years. And he remembered what they were about.

I was completely flummoxed, of course.

73. geoff - June 25, 2009

I’m just a lowly hybrid scientist/engineer who likes crunching numbers, so I look at the statistics. I was condescending to your comment because it was both snark-laden and constituted a strawman response to the post. If you can’t address the point of the post, then I don’t really care how qualified you may be.

So here’s the point of the post: Health care costs are increasing rapidly. The administration claims that more government intervention will help control costs. Does their past record justify this claim?

Therefore the graph is contextually misleading to the vast majority of the unknowing population.

I’ve already been through this twice before on this thread, so forgive me if I’m a little testy by now. Has the health of patients accepted by Medicare declined dramatically over 2000 – 2007 timespan? Has the health of patients covered by private insurance improved dramatically over the same period?

No? Then the relative increases in costs are a perfectly valid measure of the cost control competencies of the two approaches.

74. geoff - June 25, 2009

he told me that he and I had had three disagreements over the years.

There were only 2, dear.

75. Dave in Texas - June 25, 2009

YESSSSSSSSSSSSSSS

life is good.

76. lauraw - June 25, 2009

See what I mean?

77. Mrs. Peel - June 25, 2009

he told me that he and I had had three disagreements over the years.

There were only 2, dear.

Well, NOW it’s three.

78. lauraw - June 25, 2009

I think he started to tell me right there what one of the disagreements was, but I was already at three Indians so all I heard was bzzzz bzzz bzzt and then somebody interrupted and I was saved.

79. lauraw - June 25, 2009

I think. Tequila might have wiped some of the data.

80. geoff - June 25, 2009

and then somebody interrupted and I was saved.

Only a reprieve, I assure you.

81. deb - June 25, 2009

Thank you for your honesty about your number crunching expertise vs real life business experience with this issue. That earns my respect. You do answer questions as an expert in health care, though. The relative increase in costs as illustrated in this graph are related more to the following: an aging population receiving extreme end of life care vs a privately insured population who have been risk managed to remove a large segment of “uninsurables” due to pre-existing conditions or because the individual was not completely factual as to their insurability (often through cumbersome and misleading applications.) There are more factors in this equation which make the chart less than the final word. Is the population healthier-NO-we have more chronic disease than ever. Many statistics show we do not have the best care in some areas, and in others we are far above the rest of the world. We operate on insured 97 year olds with cancer instead of offering palliative care-yet an uninsured 30 year old has to pay for their own surgery. There is something fundamentally wrong with this beyond the rising costs of providing government insurance to an aging population which the private insurance industry would NOT TOUCH. If you don’t get that, and you refuse to watch the c-span testimony, then perhaps you don’t really care about anything but being right. This is too complicated to put up a graph and conclude government sucks and private industry does it right. I am not in favor of universal government managed insurance, for the record. But I am opposed to for profit healthcare. Non for profit healthcare is a worthy goal, combining private/public options where everyone is in the system. If it were all private non profit, that would be even better-but I laugh at the thought that any of the for profit guys would even want that business. As long as for profits put profits first, and government grows, we got problems.

82. geoff - June 25, 2009

an aging population receiving extreme end of life care

No, that’s not true. That is indeed why there’s an initial difference in the two plots, and why they end up in different places. But the rate of increase is independent of the differences in population. I.e., if an average elderly person cost twice as much to care for in 2000, unless something odd happens, they’ll cost twice as much to care for in 2007. The only question is: does government cost control reduce the cost increases compared to private industry? The answer is no: both categories saw their costs increase by 70%.

The costs themselves do relate to the differences in the health of the two populations. But the % increase in costs does not.

Many statistics show we do not have the best care in some areas

I’ve looked at those stats, of course, particularly the birth survival stats. They are not very useful.

Look – I’m not arguing at the moment that Medicare should be dissolved, even though it provides substandard care and is headed for financial disaster. And I don’t really like the way insurance companies do business. But putting the government in charge of all health care is exactly the wrong direction, both in terms of health care and government expansion.

It appears that you agree with that, so now you can see if Dave will share some of his pie.

83. deb - June 25, 2009

-something odd has happened-we have more expensive technology, more expensive drugs and more expensive everything in 7 years which extend life. The private portion of the graph does not participate in providing these ever spiraling services to the “average” client. They get rid of them instead. Private industry costs increase more proportionately in “management” areas while public management costs have maintained steady. Private costs have increased partly because CEO’s are making (in one case 1.2 billion dollars) exorbitant bank. There are a lot of reasons the “odd” you discount is relevant. Beyond that, I believe the INTENT of the graph is to make public insurance look bad and private better. You and I do agree that is a ridiculous political tool and I submit a disservice to solving the problem.

84. geoff - June 25, 2009

Oh dear. And things were going so well, too.

First let’s look at your claim that management costs have increased more in the private sector than in the public sector. Fortunately the data for those costs is included in the link in the post (though it only goes back to 2002):

Year Private Public
2002 $68.6 $35.8
2007 $94.6 $59.5

So over those 6 years, management costs in the private sector went up by 37.5%, while management costs in the public sector went up by 66.2%. So that claim is untrue.

Private costs have increased partly because CEO’s are making (in one case 1.2 billion dollars) exorbitant bank.

Which CEO was that? Here’s a list of CEOs and their compensation (from Daily Kos, so you know they’re not low):

AHIP: $1.58 million
Aetna: $24.3 million
CIGNA: $12.2 million
WellPoint: $9.8 million
Coventry: $9.0 million
Centene: $8.77 million
Amerigroup: $5.29 million
Humana: $4.76 million
Health Net: $4.4 million
Universal American $3.5 million
United Health: $3.24 million

None of them are even close to $100 million, let alone over $1 billion.

The private portion of the graph does not participate in providing these ever spiraling services to the “average” client.

No, it’s Medicare who has traditionally lagged in that area. But in any case, I’d need a citation for that claim. It sounds fanciful.

I believe the INTENT of the graph is to make public insurance look bad and private better

That I can’t help you with. I told you what the intent was. If you don’t believe that, then I’ll let you continue to make things up on your own time. But you won’t waste any more of mine.

You and I do agree that is a ridiculous political tool and I submit a disservice to solving the problem.

No, I believe that it’s a ridiculous political tool for the gov’t to blame health care costs increases on the private health insurers, when their record is no better. And I’m not attempting to solve the problem here – I’m attempting to stop the problem from getting worse.

85. deb - June 25, 2009

And by the way geoff, lest it seems we actually agree, I’ll live with government insurance over doing nothing. I’ve never heard a conservative say we should get rid of the military, medicare, or social security programs. I’ve never seen a conservative bitch and moan that we should privatize our military because of government waste and inefficiency. Do we have a responsibility to provide our citizens equal access to health care? I believe in many libertarian principles-most notably that the federal govt should get out of the business of mandating moral codes. But there are a few jobs the federal government exists to do-federal law enforcement, defense, security, and ensuring the equal access to health and education for our citizens, which all make us a stronger country. To all of you conservatives(and I am one) who claim you want smaller government, I submit you don’t want it at the expense of these services. Fight the good fight-eliminate bureaucratic programs that could be managed by states. )Orin Hatch thinks health insurance might be best managed at the state level and I rather like that idea.) Eliminate cumbersome tax laws which only create more layers of inefficiency and waste. Work on things that leave room for the greatest country on the planet to provide health care, yes probably inefficiently, just like military spending and medicare are inefficiently managed, but available to benefit us all. The “government can’t do it well so don’t let them do it,” if applied to the military would be laughed at. Shame on everyone who bitches about government ineffective management of a basic need of every citizen and yet produces ZERO good alternatives which guarantee it. The Republicans have been doing zero for years on end to produce an alternative to federal health insurance while they had a majority. Sat on their hands and took money from the industry to do so. Shame Shame on Republicans.

86. deb - June 25, 2009

Look geoff clearly I’m not an expert on statistics, and wouldn’t presume to out argue you. I made my point about why the graph itself is producing a false overall sense of righteousness by the right. You seemed like you kind of got that when you admitted you weren’t a fan of private industry on this issue either. As far as the 1 billion dollar man, his name was protected in the testimony for privacy reasons, but it was presented as fact, probably via stock options rather than direct salary. If you aren’t appalled by those salaries you list, then once again, you are part of the problem. Finally I have already provided the citation for the game private industry plays to reflect the nature of that line on the graph. Watch the cspan testimony. Dismiss me all you want, but I am quite sure you have a better understanding of the pitfalls of do nothingism that has defined Republican majorities for decades as a result of my comments.

87. geoff - June 25, 2009

I’ve never heard a conservative say we should get rid of the military, medicare, or social security programs.

Almost all conservatives say we should get rid of Medicare, Medicaid, and Social Security. You should get out more. I’ll say it right here: “We should get rid of Medicare, Medicaid, and Social Security.”

I’ve never seen a conservative bitch and moan that we should privatize our military because of government waste and inefficiency.

A private military is kind of a silly notion, don’t you think? A better comparison would be the Post Office, and there have certainly been calls to privatize that.

ensuring the equal access to health and education for our citizens,

No, the government was never formed for those purposes. It was deemed advantageous to provide public education, but it was never a right of the citizenry or a duty of the government to provide it. It may be advantageous to society to provide health care as well, though I think that case is weaker. But it’s certainly not a required role of our government.

The Republicans have been doing zero for years on end to produce an alternative to federal health insurance while they had a majority. Sat on their hands and took money from the industry to do so. Shame Shame on Republicans.

Hey!! We agree again!! In fact I wrote a post making that very point almost 3 years ago.

88. geoff - June 25, 2009

If you aren’t appalled by those salaries you list, then once again, you are part of the problem.

They’re kind of standard for CEOs in general. Yeah, it sucks, but so do salaries of sports stars, entertainers, actors, etc. And the CEO salaries don’t really move the needle as far as the overall costs go.

I think there are real issues with health care in this country, but I think that the current plan to address them will degrade both health care and the economy for decades to come. I’d rather stick with what we’ve got and make incremental changes than revolutionize it in another case of hurry-up massive spending and submarine legislation.

89. deb - June 25, 2009

Okay Republicans SAY it, they just don’t DO it. Only libertarians MEAN it. I stand corrected. We have in some cases privatized military armies working in Iraq and Afghanistan, so no I don’t think it is a silly notion to war profiteers. Silly to me, absolutely, but relevant to the point—– that “just because something is inefficient” argument is a red herring as a reason to be against it..If you are arguing the constitutionality of government services argue that. Continue to reveal that to conservatives. I have no problem with that. ( The post office was specifically mandated as a function of federal government in the constitution, btw.) But to put up this graph and then get the “I told you so” undereducated audience of readers to say HELL NO and fight for the sake of fighting is not productive. I challenge anyone here to produce a plan that might work-I have written one. You want it? It’s complicated and revolutionary unlike what the dems are proposing which is anti-revolutionary, theirs is just more medicare.

P.S. when you say their salaries suck are you agreeing that profiting via health care is wrong? Otherwise their salaries are competitive and just, no? Some solution.

90. geoff - June 25, 2009

We have in some cases privatized military armies working in Iraq and Afghanistan

No, those are security forces, not armies – they were not hired to perform combat missions. Privatizing the US military would place your national security in the hands of an MBA, and would make a coup inevitable. That’s why no nation would ever consider privatizing their military.

But to put up this graph and then get the “I told you so” undereducated audience of readers to say HELL NO and fight for the sake of fighting is not productive.

This is not the first post I’ve ever written on the subject, and it certainly won’t be the last. It’s not intended to be an all-encompassing solution for health care – it’s just a critique of one of the administration’s talking points. If people are deriving their stance on health care from this little post, then no amount of exposition will help.

when you say their salaries suck are you agreeing that profiting via health care is wrong?

Running hospitals and insurance agencies as profit centers has advantages and disadvantages. So far the disadvantages of massive government intervention outweigh the disadvantages of being treated like a cost/profit unit in the current health care system. I don’t think that profiting via health care is inherently wrong, but it’s very damaging when the profit motive complete overwhelms the desire and moral obligation to provide a good service.

91. Dave in Texas - June 25, 2009

The profit motive is not inherently evil. Choice creates competition. As I pointed out above, there can be no competition between private and publicly subsidized health care. It’s a false choice.

Pie?

92. deb - June 25, 2009

Just for the record, I was clumsily trying to say that management costs as a percentage of total expenses (on the budget) are much lower. Do your stats show otherwise? If so, I’ll look up my source again, as I’m going by faulty memory. I have still yet to engage anyone who offers a plan to counter the dems. All that is done is bash the dems, no real comprehensive solution to offer the dems as a counter to their proposal. I hope we at least get your gradual approach since revolution is not possible in a bought and paid for congress. It would make me appreciate our current President for pushing hard and forcing Republicans to do SOMETHING>at least moving us forward unlike past administrations.

93. deb - June 25, 2009

Dave what’s your experience with the for profit based healthcare industry? There are “not evil” people who are incentivized to make some pretty destructive choices. And again, if you watch the c-span testimony, you’ll see what I mean. I don’t understand the false choice argument. Non profit competes with for profit competes with government NOW. For-profit just won’t take anyone. They will NEVER agree to cover every citizen. They are very selective. Imagine a system built around that model alone. Then bash government some more.

94. geoff - June 25, 2009

I was clumsily trying to say that management costs as a percentage of total expenses (on the budget) are much lower.

That is true, but doesn’t change the message of the graph. There are some indications, however, that the Medicare administration’s claims of low costs are not entirely honest. I’ll be looking at that in a future post.

I have still yet to engage anyone who offers a plan to counter the dems.

I don’t have a plan, but I do believe that society has a legitimate interest in providing meals and health care to minors. Giving them a healthy upbringing will improve their educational performance and reduce downstream health problems. After they’re 18, though I think the responsibility for obtaining health care lies with foremost with the individual.

95. wiserbud - June 25, 2009

no real comprehensive solution to offer the dems as a counter to their proposal.

Yep, not a one.

http://www.reuters.com/article/healthNews/idUSTRE55F7HR20090616

Click to access PCAsummary2p.pdf

96. Dave in Texas - June 25, 2009

>> Dave what’s your experience with the for profit based healthcare industry?

Ah, appeal to authority. You know, for someone with all that experience, you don’t seem terribly knowledgeable, or did you even notice the negative government influence on costs you yourself described.

My experience is I can think.

97. deb - June 25, 2009

Now that’s a false choice.
Promote guarantees then because that isn’t the way it works today, thanks to the Republicans. If you’ve had one of about 2000 diagnosis, you are un-insurable if you leave your group employer. If you can afford the temporary Cobra coverage and get employed by another group within one year, then portability clauses protect you. Otherwise the individual often cannot get coverage. If you self employ or retire early, good luck getting reasonable coverage. Via “heavily lobbied for” state law, private companies can cancel you within 2 years of accepting you as a private payer IF during that time period you see a doctor for anything more than a minor acute issue and find your initial application at all imperfect. This happens a lot as a way to improve the risk pool. Take all sides of the issue and comment on the horrific behavior of the for profit industry and then we’ll be on the same page. Remove medicare and you have a disaster because private insurance will NEVER cover the majority of that risk pool or give every individual a chance at securing health care. Nice ideal, but DOA

98. deb - June 25, 2009

Above I was speaking to geoff, to Dave in Texas, I only wanted to know if you have a solid understanding and what it is based on-no offense or appeal to authority intended. Are you deflecting by attacking my knowledge level?

99. deb - June 25, 2009

wiserbud thanks for the links…
this is far from comprehensive. I never said NO plan, I said comprehensive one. Address those who are unininsured and creating a HUGE burden on business and the rest of us, address the end of life expenses creating huge deficits to extend life an average of 3 months (I know every minute counts, blah ,blah) and I’ll call the republican plan comprehensive. Republicans are getting closer to doing something, thanks to Obama. For that I am happy. I’ll take the Republican non comprehensive plan over nothing.

100. Michael - June 25, 2009

I was completely flummoxed, of course.

The look on your face was pretty funny, actually. And I think Geoff went on to cite some dispute that was about six years ago.

101. wiserbud - June 25, 2009

>>>this is far from comprehensive.

The reason there will never be a plan to provide insurance to each and every single person in this country is that some people do not deserve it and some people do not want it. And unless you put people in jail for not getting it, that will never change.

As for controlling costs, or NOT creating a huge burden on business and the rest of us (which is what I assume you meant) please, that is exactly what Geoff’s graph addresses. The government is no better at reducing costs than anyone else. In fact, once they get total control of this sector, you can be positive that costs will balloon completely out of control while the quality of care will diminish rapidly.

For a perfect example of the failures of socialzed medicine, we have to look no further than our neighbors to the North. The only thing that keeps their system from completely imploding is that they have the US to act as the fall-back option for people who have to choose between coming here for care or waiting years at home, probably to die while sitting on the waiting list. What happens when that same system is implemented here? Who is our fall-back?

This attempt to nationalize the healthcare has nothing to do with fixing the actual problems that exist. It is simply about taking control of the entire industry, which is the standard, par-for-the-course wet dream of every socialist everywhere when it comes to any private industry.

You want comprehensive. I prefer intelligently address in the actual problems and leave what actually works alone. But that’s not what Obamacare offers. Hence, I am against it.

And, before you ask, I have worked in and around the outpatient healthcare industry for the last 30 years. I have quite a bit of experience in how the system works.

102. geoff - June 25, 2009

And I think Geoff went on to cite some dispute that was about six years ago.

4. Sheesh. And then 2. So I guess they add up to 6.

103. geoff - June 25, 2009

The look on your face was pretty funny, actually.

That was true. I don’t actually remember every discussion, but I do remember most of the red-on-red battles. And I definitely remember the ones where I’m not confident that I’m in the right.

The paramilitary shutdown of the rave concert was a story that I followed for several years after the post, to see if the lawsuit the ravers were preparing was going to go anywhere. It never did. That probably means that lauraw was about 80% right. Dang it.

The Jehovah’s Witness child-neglect case is an issue I still struggle with. Logically I should side with the Jehovah’s Witnesses: I can’t come up with a self-consistent logical construct to respect the right of religious practice and the right of parents to raise their children that allows for the state to intervene and force the child to be treated medically. But I’d sure like to.

I hate not having a logical construct that makes things like I want them to be.

104. deb - June 25, 2009

wiserbud-The reason there will never be a plan to provide insurance to each and every single person in this country is that some people do not deserve it and some people do not want it.-
People who do not want it should be designated as self insured then. This is addressed in a more detailed way in my plan. To continue to absorb the costs of people who opt for this and then use the system without the ability to pay is madness. To those who do not deserve it, why do they get it? Fix that.
-the govt is no better at controlling costs- this is stipulated by me as to my statement earlier that I do not support single payer govt insurance. However, I have been attempting to explain, obviously poorly, that the conclusion you and geoff and others make that costs would spiral out of control–is misleading. Costs would spiral out of control if the same people were covered by private insurance and there was no govt program-turn this over 100% to the private sector but mandate no one loses coverage and geoff’s argument still applies. The quality of care issue is also being misrepresented. Many people on medicare get excellent quality of care, but the hospital/dr doesn’t get paid for the full cost of this care. This is a huge distinction. Many people on private insurance get kicked out and have zero care if they can’t self pay because they got cancer or 2000 other diagnoses. The quality of care for some suffers more under the private insurance system. There are inconsistencies on both sides when it comes to quality, but only private insurance cancels people. The Canada story also is misleading but I would bore you with a very long explanation if I tried one. The “attempt to nationalize” conclusion you make is an opinion, not a fact. Again, I’m against single payer govt insurance. -leave what actually works alone-this IS the bottom line-private insurance doesn’t work for the vast majority and you just believe it works but don’t understand how heavily subsidized it is by business, individuals and taxpayers. Wish geoff could figure out how to show a graph of how private insurance takes money from everyone for profit motive and turns what’s left over to politician’s campaign coffers. Meanwhile hundreds of thousands, perhaps millions of people who want private insurance, would pay for it but can’t get it because of some health condition are left in the cold with the Republican plan. Lucky you, this doesn’t apply to you. You may not be paying higher taxes with this system but you are paying indirectly.

105. Dave in Texas - June 25, 2009

>> Are you deflecting by attacking my knowledge level?

Sugartits, you’re the one who keeps asking about everybody’s experience level and waving your own. I’ll use the Jack Swigert explanation for the basis of my understanding, “I can add”.

106. wiserbud - June 25, 2009

To those who do not deserve it, why do they get it? Fix that.

You tell me why? When the incessant refrain of “46 million uninsured is a crisis!!!” is bandied about, it is never mentioned that approx 12 million of those uninsured are illegals. The Republican plan addresses that by not giving them insurance. Next step is to stop providing free healthcare to them at hospitals and emergency rooms. Then maybe we wouldn’t have to work so hard to secure our borders because people wouldn’t keep flocking here for their already-provided free healthcare (another little factoid that always seems to be overlooked.) Tough solution, I know, but much better than the alternative, in my opinion.

The “attempt to nationalize” conclusion you make is an opinion, not a fact.

Based on recent events in other industries, an opinion that is well-supported by the facts.

-leave what actually works alone

So you haven’t read the Republican plan, but you know you already disagree with it?

Meanwhile hundreds of thousands, perhaps millions of people who want private insurance, would pay for it but can’t get it because of some health condition are left in the cold with the Republican plan.

bzzzt! Wrong. As long as someone is willing to pay, there is always someone willing to insure them. Your point seems to be that if these people decided they don’t want to pay, others should be forced to pay more for them.

From each according to his ability, to each according to his need, huh? Now where have I heard that before?

What happens when no one wants to pay? How long before companies start to drop their private plans and simply tell every to get on the government’s plan? How long before the cost of the free healthcare completely bankrupts this entire country, because no one can afford to pay the taxes required to support such a system?

In fact, some studies have shown that the Dem plan may reduce some of that dreaded 46 million uninsured, but it will also cause another approx 19million who currently have insurance to lose it. Hmmm, sounds like this isn’t gonna work as well as they say.

You may not be paying higher taxes with this system but you are paying indirectly.

Can I get the government to give me free life insurance too? ‘Cause as it turns out, I don’t qualify for that without paying outrageous premiums. (I won’t bore you with the reasons why.) I think we all have the RIGHT to have life insurance and I think the government is responsible for giving me that insurance! Even if those who have their own life insurance policies and ability to properly plan for their heirs have to pay higher taxes. Because, honestly, don’t their families become a burden on society when the primary breadwinner dies?

How is that any different than your argument?

private insurance doesn’t work for the vast majority and you just believe it works but don’t understand how heavily subsidized it is by business, individuals and taxpayers

Oh, I am fully aware of the burden being carried by all the taxpayers for the already free healthcare that is being provided by our government. And you want to increase that?

I’m curious, what is your opinion of the Dems idea of totally overhauling the healthcare industry, but ignoring tort reform? Do you not feel that this the current legal system may also be a huge part of the overall problem in healthcare. But the Dem plan refuses to address it at all. Doesn’t sound too comprehensive to me.

Wish geoff could figure out how to show a graph of how private insurance takes money from everyone for profit motive and turns what’s left over to politician’s campaign coffers.

Oh, stop this please. Non-profits are some of the biggest lobbyists and contributors to politicians of all. In fact, there are sitting Senators who are actively working to close down one of the most cost-effective and safest healthcare delivery models in teh entire industry who are wholly owned by the hospital and their lobbyists, both for- and non-profit. Don’t even try to play this sanctimonious “evil profit-taking capitalists pigs” argument on this one.

107. deb - June 25, 2009

wisebud on illegals I agree 100% dems are stoopid on this issue.

-So you haven’t read the Republican plan, but you know you already disagree with it? – I didn’t say I disagreed with it, I said it was not comprehensive based on the articles you cited. I’m especially in favor or curtailing lawsuits-drs make mistakes, and unless there is intent to harm through fraud or gross incompetence, we shouldn’t be allowed to sue.

–As long as someone is willing to pay, there is always someone willing to insure them.–I implore you to watch the cspan testimony, this is a critical point and there is significant evidence to the contrary. Significant. Seen it with my own eyes many times. Uninsurable-many

I agree the dem plan is comprehensive, but is not my preference. I don’t know why you and others keep insisting I do. I only meant to show that the pitfalls of an all private industry plan are just as massive as the pitfalls of an all public plan. I am a capitalist pig, I trade derivatives since I left health care. This is not about bashing private industry, it’s about understanding the bigger picture, which I believe geoff could be more impactful doing. Hey, I’m a Republican who wrote my congressmen against TARP and auto bailouts, but I want solutions that address points I believe my party is ignoring. I hope we get the Republican plan, but I doubt we will, because they don’t make arguments which take into account the horrors of of Americans kicked out of the system because they got sick. You’ve got to get the people on your side, and denying or bashing all people who point out the for profit pitfalls doesn’t grow our party.

108. Lipstick - June 25, 2009

Republicans know how to make paragraphs. Sheesh.

109. wiserbud - June 25, 2009

I agree the dem plan is comprehensive,

Who said that? I pointed out two areas where this plan is NOT comprehensive. Yet, you still think it is and support it? Lemme guess… You also just couldn’t make yourself vote for that stupid rube Sarah Palin either, so you were left with no other choice but to vote for Obama, as much as it pained you, right?

Quite the hard-core, rock-ribbed conservative you are….

denying or bashing all people who point out the for profit pitfalls doesn’t grow our party.

Not bashing you….disagreeing with you. Also pointing out the flaws in your arguments. There’s a difference.

110. deb - June 25, 2009

dave in texas-I know you are passionate about this issue and assume that’s where your intention comes from. I’m sure in real life you are a consummate gentleman and this forum sometimes allows us to be less than polite. Because the blogoshere is heavily anonymous, I often feel it helps some people to be open about one’s experience and background. I do have some expertise in this area, but I don’t claim righteousness about any of it. And I’m not here to bash political parties or ideology. I simply thought the graph warranted airing both sides and geoff has clearly articulated the pitfalls of govt takeovers. As you noticed my first comment to geoff was fairly viewed by him as a drive by strafe, so I had to start over with my own intention being declared. I meant zero disrespect in asking you. Peace.

111. Dave in Texas - June 25, 2009

>> I’m sure in real life you are a consummate gentleman.

You’d be wrong about that too. Ask around.

Your first comment on the thing was snarky bullshit and since then you’ve shotgunned the barn, crawfished, and just plain nonsense. You tried using your expertise to defend your silly comments and (remarkably, I know!) no one deferred.

I doubt your veracity.

112. deb - June 25, 2009

wiserbud-Sarah had a lot to learn, she may be better prepared in 2012. No intelligent person really believed she had a detailed grasp of the issues, the supporters voted her ideology. She is more socially conservative than McCain, and she is certainly rabidly pro Alaskan oil and gas, and has considerable expertise in this area. I also note that the party has been heavily co-opted by the religious right who are far from libertarian. I have voted Republican for years, but voted for Ron Paul until that choice was removed. I am sick of my party continuing to spout an ideology that they do not practice. Republican majorities have been growing government non stop for 30 or more years. At least the dems admit they like big government and don’t really mind socialism sometimes. Full disclosure, more than most people give. Republicans have not been honest to their core values and I want that to change. For the last time, I don’t support any plan which simply expands medicare like coverage to a wider population. It’s been roundly and appropriately criticized, but it is a one sided argument. I only hoped to present the pitfalls of private insurance, nothing more. The fact that not many on this board want to indulge these huge private insurance problems lest they be seen as not honest to their ideals, is fascinating, but not surprising.

113. wiserbud - June 25, 2009

So you are jump from supporting a man who’s main reasons for being are “limited constitutional government, low taxes, free markets, and a return to sound monetary policies” (from his web site) to being okay with a “comprehensive” Dem plan that:

A) Nationalizes 1/6 of the private sector
B) Is going to cost the taxpayers untold trillions (estimates I’ve seen run from $2 – $6 TRILLION!),
C) Incredibly increases the tax burden on all Americans
D) Puts this country so far in debt it will probably never recover from it

And let’s not forget that nothing…NOTHING in the Constitution provides for the right of free healthcare for all US citizens. So there’s that, which flies in the face of anything Ron Paul has said.

Well, thanks for playing, but as Dave said, I strongly doubt your veracity. And even if you are a Ron Paul supporter, you are obviously not a very good one.

114. wiserbud - June 25, 2009

Republicans have not been honest to their core values and I want that to change.

This from a person who has decried the profit motives of the private insurance vendors as “evil” and morally bankrupt.

How exactly do you want the Republicans core values to change, Deb? By adopting the Democrats’ values?

115. Dave in Texas - June 25, 2009

Puzzling ain’t it? It’s like me saying I’m a Steelers fan.

116. Lipstick - June 25, 2009

When it’s clear that I’M the real Steelers fan.

117. deb - June 25, 2009

Okay I will answer your questions fully if I am still welcome here. I do not want to overstay it and have begun to unintentionally monopolize the board by having several people respond to my comments. I decry the for profit health insurance industry because I know it is a failed model from experience. I do not decry capitalism or private industry in general. I do not think that is contradictory, but I believe health care is a different animal when cost containment is so important to the success of the delivery system. I do not wish to see them abolished necessarily, but I do prefer a non profit model, more in tune with not for profit hospitals and cooperative health insurance models.

I do not want republican core values on fiscal responsibility to change, I want republicans to return to these values which have not been practiced in more than a generation. I think each of you would agree that Republicans as a whole in the leadership of congress have not lived up to a creed of balanced budgets. They have been able to reduce taxes but exploded the deficits in the process. I would like what have become core Republican values on social issues to moderate-they have taken to legislating morals, just like the dems have, and I think this is something that should be left to the states. I also would like dems to explore Orin Hatch’s model of state oversight of health care legislation. I don’t believe this will happen because the Republicans are not willing to budge on fixing the problems with the for profit insurance industry which causes the dems to be intransigent-they are responding to the vast majority of Americans who find great fault with private insurance. I point out flaws in reasoning when I see them, but hold no need to be right. Someone present me with evidence instead of attacks and I am more than open, Hatch is a reasonable man who I think gets it. I don’t see anyone of the left who really gets it. Obama is a communicator, I think we needed that in this time in our history. While I find great fault with many of his policies, others I like. This is democracy. I preferred his approach to foreign affairs and think he was right years ago on Iraq. He has been able to bring conservatives into his administration, he has let them lead on our foreign wars, he has somewhat dissipated the looking back on torture grandstanding of the dems. He ain’t perfect but I see him as better than McCain would have been. I’m not a party loyalist anymore.

118. Dave in Texas - June 25, 2009

>> but hold no need to be right.

Or coherent, apparently.

119. deb - June 25, 2009

Finally, you keep stating that I support the dem health care plan. I said repeatedly I do not. I do however, believe that if Republicans don’t wise up quickly, that’s what we will get, and I accept that as the potentially inevitable consequence of Republicans losing and losing big. I do not see it as the end of the world should it happen, but again it is not my first choice. I think Ron Paul sometimes goes too far, but not always. I think we would have had all out depression had his policies all been implemented but in 20 years a cleaned up balance sheet. I was prepared for that. I do not see the costs of dems federal plan the same way you do because I factor in other things, which I’ve tried to explain. I want health care rationing of the extremely elderly. I want any American who has accomplished wealth by hard work or inheritance to be able to pay for cadillac care and insurance. I want every legal citizen to have the opportunity to purchase insurance. I the shedding of high risk clients to stop, as federal law mandated, but state law gave loopholes to. I want those who choose to be uninsured rather than purchase insurance in order to save money to be excluded from taxpayer bailouts. They should be designated as self insured and ineligible for government assistance. I want illegal aliens to be excluded. I want lawsuits to be dramatically curtailed. I want a non for profit private industry model. I want states to take control of this issue. These are my preferences, I make no claim to certitude or political allegiance. I want what works best for the country and remain open to good ideas.

120. Dave in Texas - June 25, 2009

>> Finally

I doubt that too.

Michael - June 25, 2009

18 comments, mostly voluminous, from 5:36 a.m. to 4:31 p.m.

You gotta give Deb some credit for stamina.

121. Edward Von Bear - June 25, 2009

^also, she avoided the rank anti Semitism, thus I doubt she really is a Paulbot

122. geoff - June 25, 2009

You gotta give Deb some credit for stamina.

I’m sure that our charm and winning personalities kept her coming back for more.

123. Dave in Texas - June 25, 2009

Ninja please.

It was your mantissa.

124. Mrs. Peel - June 25, 2009

Wiserbud: The reason there will never be a plan to provide insurance to each and every single person in this country is that some people do not deserve it and some people do not want it.
deb: People who do not want it should be designated as self insured then.

So, deb’s plan is to resolve the uninsured “problem” by redefining them as insured? Works for me!

Also, there’s a little thing called the Enter key. Look into it.

125. geoff - June 25, 2009

It was your mantissa.

Oops. I didn’t know it was showing.

126. nirumi - June 26, 2009

Good blog! I

127. wiserbud - June 27, 2009

rather low standards there, nirumi, don’t ya think?

Say, you wouldn’t happen to be from Tuvalu, would you?

128. steve2 - July 4, 2009

Interesting blog. Should have priced out what it would cost to insure a 70 y/o with private insurance. Do it and you will have a bit of a surprise. Also, the writer appears to be comfortable with stats and should understand that it is not valid comparing two such disparate groups. Too many variables.

Steve

129. geoff - July 4, 2009

Also, the writer appears to be comfortable with stats and should understand that it is not valid comparing two such disparate groups.

The reader should note that we are not comparing the two groups – we’re comparing the rate of increase of the two groups. Having normalized the two groups by their cost baseline in 2000, most of the disparities disappear.

130. Mario the Magician - July 4, 2009

Pardon the intrusion, but I don’t think you are comparing the rate of increase as you assert in your last post, Geoff. Comparing the rate of increase would show a lower rate of increase in private sector spending, despite the overall larger number.

The overall rate of increase reflected in chart 13 of the link shows an increase of 2600% for public spending and 3400% for private outlays. Necessarily so, since the increase in demand created by public sector programs inflates the price, while public price control ability allows it to spend less.

No doubt this was part of the original plan, first to create a system that was too expensive to be privately maintained and then provide the only affordable option.

What is constantly ignored by many in the arguement, is that increasing access to insurance does not at all increase the access to health care. All it does is put a greater demand on an already inadequate supply, which, as anyone who has had elementary level economics taught to them will tell you, increases the price.

Any policy which intends to curb the inflation of health care costs must start on the supply side, that is, putting more providers in the field. It is in this area which the present proposed legislation is utterly lacking. I expect this is because it is easier to fit “we insured america” into a campaign slogan than it is to fit “We provided adequate numbers of health professionals to effectively cause the decrease of health care costs by providing the incentive to be in health care, particularly in the underserved area of primary care specialties.”

Moreover, supply side economics is the hallmark of Reagan economic policy, and Democrats can’t do that lest it be construe as enriching the already rich.

131. geoff - July 4, 2009

The overall rate of increase reflected in chart 13 of the link shows an increase of 2600% for public spending and 3400% for private outlays.

Start with 2000 as the baseline, not 1990. That’s what the post is about – the administration’s claim that skyrocketing costs since 2000 are a threat to the economy.

Over the history of the program between 1976 and 2006, the per capita cost increases of the two approaches are comparable.

132. Mario the Magician - July 4, 2009

I see I was confused. I thought based on post 129 that you were comparing the rate of increase of the two.

Even using the arbitrary “since 2000” baseline Mr. Obama does, the rate of increase would still favor public spending if not for the Medicare prescription drug benefit. As it stands, they are still only 2% different. In short, the public expenditures have not increased at the same rate based on the numbers, regardless of what the Medpac asserts for reasons I stated previously.

Comming back to your original argument, though, it seems that before you can refute Mr. Obama’s claim, you first have to define “skyrocketed.” Since this, like most of his rhetoric, is ambiguous at best, there is no way to refute his claim, even with statistical evidence.

A far more convincing line of attack is what I proffered earlier, that access to insurance is not the same as access to health care. The proposed legislation does not address the dearth of primary care providers that it will inherently create. Obama’s claim that health care costs have skyrocketed is one I happen to agree with. Unfortunately, his method of combating the conflagration is to add gasoline.

133. geoff - July 4, 2009

Even using the arbitrary “since 2000″ baseline Mr. Obama does, the rate of increase would still favor public spending if not for the Medicare prescription drug benefit.

Yet the private health insurers have had to cope with pharmaceutical costs throughout.

it seems that before you can refute Mr. Obama’s claim, you first have to define “skyrocketed.”

I’m not arguing that point – just his claim that the gov’t is in the best position to control those costs.

A far more convincing line of attack is what I proffered earlier, that access to insurance is not the same as access to health care

A point made on earlier posts, and hopefully again in an upcoming one.

The proposed legislation does not address the dearth of primary care providers that it will inherently create.

Absolutely true, and again, planned to be included in an upcoming post.

Unfortunately, his method of combating the conflagration is to add gasoline.

Yes, and that’s the point in the “Atlas Groans” post above.


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