After another year of domestic turmoil and political shenanigans, a year of watching President Obama in office rather than out on the campaign trail, I find myself frequently having the thought “if only McCain had been elected President instead.”
The thought came again today but unlike previous times I feel like sharing what would likely have happened in a McCain administration to this point.
If McCain had been president he would not have received the Nobel Peace Prize and Justice Souter would not have retired so he would not likely have named any justices to the Supreme Court by this point in his presidency. As far as issues that he would have dealt with that Obama has been dealing with I would like to address health care legislation, auto bailouts, stimulus, and Iran.
Obama took over a year to get any health care legislation to his desk. McCain would have dealt with the issue much more quickly. There are three possible outcomes that we might have seen. One is that Congress sent another piece of sausage like a scaled down version of what Obama got and McCain would have signed in a less expensive bill that, like the current bill, would have done little if anything to alleviate the problems we see. Another possibility is that Congress would send him a bill that was “too socialist” and McCain would then veto it. The final possibility is that Congress would conclude that they could not pass a bill that McCain would sign and they would abandon the issue and focus on other priorities. In any of the cases we would have less debt and as large of problems as we now have but the issue would have been over no later than Thanksgiving.
On the auto bailouts McCain would have grumbled more than Obama did about how undesireable it was for government to take over these large institutions. Then he would have “grudgingly” done almost exactly the same thing as Obama.
When the issue of a stimulus package was on the table McCain would have acted as quickly as Obama but the package might have been marginally smaller and there would have been a lot less verbiage about “green jobs.”
The biggest difference between the Obama presidency and a McCain presidency (besides the Nobel Peace Prize of course) would be on the issue of Iran. Obama is now talking about international sanctions whereas McCain would have done that before most of the rest of us had even become aware of the outcome of their elections last year. By now he would have us at war (more than offsetting any pittance we might have saved on smaller health care and stimulus legislation) unless, simply by the fact of his election, the anti-war wing of liberals had remained fired up. Instead, now that Obama is talking sanctions, it is the right move rather than being a code for ramping up for war (as it would have been viewed had McCain done the talking).
My point, of course, is that who we elect as President has surprisingly little bearing on what challenges we face or how badly our mangled political culture mishandles them. It’s definitely time for a change and I hope that the American people will soon be able to recognize the difference between real change and a change of posture.
Sounds about right to me. I doubt a health bill would even be discussed under a McCain presidency so nothing would be done. Frankly I’m glad Democrats now know that their party and their President are liars and undeserving of their votes.
As for the Iran situation, I have no doubt that McCain with his notorious short fuse would be much further along toward confrontation than Obama is at present. I commend this article on Glenn Greenwald’s Salon blog that lays out the deceptions we are hearing about Iran.
Your conclusion is clear – our political culture is badly mangled. I fail to see how voting for anyone, Republican or Democrat, is going to fix this problem. We have systemic issues that must be addressed and no one who benefits from the current system is likely to bite the hand that feeds him.
I think the health care issue was big enough (as evidenced by the fact that all the candidates were talking about it in 2008) that it would have been discussed by a McCain administration. It would not have been pursued as doggedly by McCain as Obama but it would have been discussed.
As you say, our systemic problems will not be solved simply by replacing office holders. We need to promote change at every level in the way things work.
We need multiparty reform. This is one area i think a lot of people actually agree on. Effectively getting their tho seems to be a difficult thing to pull off tho. single transferable voting would be good for house and senate seats.
publicly funded elections would help as well.
Single trasferrable voting is a new concept for me. I’ll have to look into that and see what I think of the idea.
If McCain was President then Jimmy Carter and LBJ would have been blamed for all the mess he inherited, Phoenix would have not got the Olympic Games, the Czars would all be Republican cronies, and Israel would be builing more condomiums in Jerusalem.
Seriously, health care would have been debated, the idea of disconnecting health insurance from payroll would have been discussed and defeated by Congress. Some health care legislation would have been passed that addressed portability and a methodology for not allowing insurance companies to drop coverage would have been passed, but would probably only cost $50 billion over 10 years. Also, the Cairo speech would not have been an apology, he would not have apologized to the world for all the evils this country has done to keep them safe from tyranny, Europe would have been embraced, there would still be plans for a missile defense system in Poland, and there would have been no trip to Copenhagen. George Bush would have been given some credit for listening to his commanders to achieve the Iraq results. I don’t think we would have heard Sarah Palin telling the country that she would not let her family fly on airplanes because of swine flu. There would not be a pay Czar going back to companies that repaid government loans and trying to retroactively invoke pay restrictions. The US would not own GM and Chrysler, Senator Dodd would not be trying to overtake and over-regulate the banking system. Terrorists would not have been granted civilian trial status and the Christmas bomber would be in the hands of the military at Guantanamo.
The jobs bill would not have been passed, but government would be working to stimulate demand for goods and services–probably through the continuation of the Bush tax credits–and that would have generated jobs. Also, there would have been no need for an Executive Order to restrict federal monies for abortions. There would have been no Louisiana Purchase, no Cornhusker Kickback, no new $100 million hospital in Connecticut.
McCain may not have done much, but he would not have done long-term damage to the country.
I think you give McCain too much credit. For example I’m confident that we would either own GM as we do now or he would have continued the Bush policy of perpetual bailouts accompanied by hollow theats to end the giveaways.
The description you suggest indicates a McCain that is more conservative than I believe him to be and it also implies that either we had a Republican Congress or else a president who could command Congress neither of which agree with reality. Any health care bill that McCain would have signed would still cost at least $500 Billion and we would be told that it was a good bargain. (Compared to this bill it would have been but it still would have been very bad legislation.)
I was not trying to give McCain too much credit rather I was trying to make the point that Obama has done a lot to take the country in a dangerous direction. Good points you make on GM and my hope for a $50 billion health care adjustment is way too hopeful. With respect to McCain he would not have been able to drive too much legislation (if any) through Congress; the flip side of which is Congress would probably have not been able to drive some of its nonsense through either (e.g., cap and trade). They would have been in a stalemate that would probably be best for all of us. I still think we would be better under McCain on an international front–more assertive attempts to reign in Iran, and a better relationship with Israel.
What your question ultimately highlights is how poor our options were when voting in 2008. I am being forced to reluctantly change my view of the Bush Administration. I did like Mr. Bush’s bravado to the terrorists, but in the end, too much cowboy and relatively little substance in domestic matters.
Neither party, their leaders or the majority of representatives are doing anything other than building their own empires. Neither party has any real vision for the future or understands the reality of taxes, spending, economics, or what really matters to the people.
If any good comes out of the past few months hopefully people will be more energized in holding their representatives and the government they create responsible.
You caught exactly what I was trying to highlight – and I completely agree that a stalemate between Congress and the president is generally a good thing for the nation in our current political climate. The solution, as you have suggested, is for voters to hold their elected officials accountable for good government rather than partisan rhetoric or the propensity to score political points or pork money for the district.
P.S. I don’t believe that more assertive attempts to rein in Iran would be a benefit to us, nor do I believe that our relationship with Israel is hurting in any meaningful way.
Whoops, I missed the spelling error–then again, maybe would should try to “reign” in Iran. With Israel my concern is more of what I see as an attitude of disrespect, maybe, especially in light of the comments at Cairo and a sense of embracing the Palestinians and chastizing the Israelis. Just my view. Of course, sometimes the Israeli’s need to be pushed on, but they’re within range of an Iranian missle strike so their nervousness may be more acute than ours.
The last time a Republican president messed with health care we got an extremely expensive giveaway to the drug companies. With a Democrat we got an extremely expensive giveaway to the insurance companies. Both parties are so corrupt and so out of touch with the people that differences become more about style than substance.
When Bush talked about cuts to Social Security and Medicare, they got nowhere but Obama is likely to push them through. Part of the craziness of our system is that Democrats are actually better at passing conservative legislation – NAFTA, welfare reform, etc. The health care bill is a good example. This is a plan similar to the one Nixon proposed to counter Ted Kennedy’s single-payer proposal 40 years ago. It is almost identical to the plan pushed through in Massachusetts by Mitt Romney. It avoided all the ideas Democrats were pushing (single-payer, public option, no mandate) and put in Republican ideas like being totally dependent on private insurers, mandates, and taxes on “cadillac” plans.
So in the end we have the worst of both worlds – an expensive plan that funnels billions of dollars from lower and middle income Americans into the wallets of the wealthy insurance corporations yet does nothing to actually meet any of the alleged objectives like universal, comprehensive coverage or lowering of costs.
I agree that we ended up with the worst of both worlds. I am curious however at your claim that taxing “cadillac” plans was a republican idea. I was under the impression that that was a democratic idea that was opposed by unions.
Their have been republican and democrat proposals to get rid of the health care benefit tax deduction for employers for eons now. This particular deduction costs around $300 Billion per year (as of 2007), And at a 6% growth rate is a scary thing for the few that give a rip about the budget. If you include individual deductions for health benefits as well its closer to $450 billion, give or take.
Now their has been bipartisan agreement between the far ends of both party’s, both Ron Paul and Dennis Kucinich have wanted to get rid of this, But(theirs always a but) the middle ground of both party’s(you know the guys they get a free ride to blackmail their party in the senate) are very against removal of the deduction, The Cadillac tax is a sale out position that was arrived at by the Democrats when Republicans opt’ed to exit the health care/national debate entirely to score a few political points. This is the result of allowing President Joe Liberman and the cabinet of small State conservative democrats to run things in the effort to obtain 60 votes in the senate after the republicans left for a spot of tea. I blame provisions like this in the bill ENTIRELY on republicans exiting the discourse.
The fact that we got as much as we did is a real testament to Harry Reid and Obama, 100% agreement of any Caucasus especially one as ideologically spread out as the democrats is just amazing and its an even bigger feat considering the size of the bill.
The Cadillac tax protects big business’s ability to deduct the costs of health benefits while leaving most of the burden on plan holders for the costs of the health care law. This tax also has the advantage to helping the insurance company’s slowly force everyone into more profitable high deductible plans. With the growth rate of costs the Cadillac tax will likely hit every plan within 20 years or so of it going into effect.
I hope that the Cadillac tax will be repealed and the revenue replaced by rolling back and eventually removing the health benefit deduction.
Either way that’s $450 Billion dollars subsidizing the health insurance industry every year, Bloody waste of money putting it their if you ask me consider we would get a lot better bang for the buck directly paying for health services with it(aka single payer). Also this is a big part of the Tax inequality problem we have in the united states, it greatly benefit’s mostly big business and subsidizes an industry running on a very broken business model while at the same time allowing big business to get out of paying their fair share of the tax’s. When I hear the actual tax that some of these business’s pay it makes me angry, Goldman Sachs payed less then 1% income tax in 2007, When these guys don’t pay their fair share everyone else gets to pay it for them.
I find it interesting that when the far right and the far left agree on something as being good for the nation that are usually (possibly always) right but those ideas are always torpedoed by the “moderate” (Charles would say “corporate”) middle.
Blaming the republicans entirely for walking out is convenient coming from a democrat. It ignores the fact that while they were happy to leave for the sake of scoring a few political points there was no serious effort made to work with them. Pelosi and Reid preferred bullying tactics and cornhusker kickbacks rather than an actual discussion of policy ideas.
I disagree, their where long and consented efforts to have bipartisan ship, the gang of 6, the work with Olympia Snowe who’s only objection to the HELP commite bill was the public option and that was a much more liberal bill.
The bill looks much like the 1992 Republican Health care bill in the first place.
So They dump the public option and does that win her vote NO. They increase restrictions of abortion at the request of many republicans and do they win any votes NO. They lower the medicaid increase from 150% of fpl to 133% of fpl and increase the fed match to 90% does that win any votes NO. they loosen community rate rules a bit at the request of republicans does that win them any votes NO. Obama increases the funds for state tort reform programs by $250Million dollars(5x increase) does that win any votes NO.
The Republicans support most of the provisions in the health care bill, insurance exchanges, community ratings, guarantee issue, tax credits for small business’s to buy health insurance with, etc.
Voting against a bill because you can’t place all of your favored policy’s into it and keep all of your opponents policy’s out of it when you are the super minority is absurd.
I can guess you are against the Medicaid expansion, the exchange subsides, the tax’s?, do you have a list of items in the bill you are against? I really haven’t heard many conservatives propose an alternative that would actually work, beyond the libertarian position of individual responsibility and every man/women/child for themselves.
What other approach can we take that you wouldn’t object to?
Their efforts to gain bipartisanship on the bill were aimed at buying one Republican vote or another so that they could claim bipartisanship. They had already made it clear that they were not interested in slowing down and having an open and honest debate. Admittedly most of the Republicans weren’t too keen on having a real debate. I freely admit that obstructionism and a lack of well develped ideas were rampant among the GOP.
You are asking for what I would want so here goes. I don’t care how much it is like the Republican proposal of 1992. I want an open debate, not a series of backroom deals. I want small pieces of legislation addressing specific issues rather than a 2700 page monster. I want an end to a tax favored status for employer provided insurance. I want a focus on controlling costs, not on federal oversight. Even the CBO predicts a double-digit increase in insurance rates due to this bill.
The whole debate was about how to massage the structure of federal control without any consideration of alternatives to federal control.
Republicans had the opportunity to pass smaller single issue health care bills for the last 30years, they haven’t and now are well way to far down the rabbit hole to fix the problem with small simple fix’s. 6% growth rate is a national disaster by 2020 well over 50% of Americans won’t have any health coverage(without reform), just adding a national exchange and a few minor regulations or deregulation’s will not substantively change that. The cost shift from the uninsured is a gross disaster that is bankrupting hospitals in the big states already, causing even higher rates on the insured and has a cost amplification effect when conditions are not caught when they are cheaper to treat.
And all of this is going on while we are subsiding the insurance company’s to the tune of $450 Billion per year through the employer health benefit write off, and substantial tax benefits to the health industry in general that far exceed most industry’s.
Roll back the employer health benefit write off without doing something substantial to keep people insured and you will accelerate the the cost shift from the uninsured because many employers will stop providing health benefits. In the end the damage to public health from lower tax revenue from the productivity loss and increased costs to public health programs, and hospitals will be incredible to say nothing of what will happen to insurance rates.
Don’t get me wrong I am not big on Obama’s plan, I think throwing more money at the insurance industry is a waste of time, and I don’t think they will behave in an ethical manor that reflects the intent of the law. But I will still take his plan over the fat load of nothing the republicans have offered. Obama’s plan will keep the uninsured rate down, improve public health, and has double digit increase in health premiums that are still LOWER then the double digit increases without reform. I actually predict that their we will be a few years after it all goes into effect where the increases are small due to decreases in cost shifting from the uninsured.
And above I only talk about the direct costs to the government and health care industry, add in the cost shift from higher bankruptcy rates, lower productivity, etc and the true cost is just staggering.
We are well passed the simple solution option being practical.
First off, I have never held up the congressional republicans as a model of what should be done or as a source of good ideas. Secondly, democrats have controlled congress for 18 of the last 30 years so I think you had better slow down in arguing that republicans have wasted such a massive opportunity.
As for the ramifications if what i would like to see, if we roll back the employer health benefit and employers stop providing health insurance what happens to all that money? If they simply take it as profit it will be taxed – that’s higher tax revenue. More likely they will reinvest that money in salaries or other investment. Increased salaries would make self-selected insurance more affordable and other invesments would help grow the economy. If insurance companies can no longer depend on companies to buy group policies they will find ways to serve the individual market better and there would be less occurance of people losing their insurance when they lose their jobs.
I can’t figure out why you are so intent on defending a Trillion dollar piece of legislation that is so obviously dysfunctional and riddled with naked giveaways. I guess it goes back to your belief that government has the right and ability to give away what it wants and that anything they do is legal.
“It’s definitely time for a change and I hope that the American people will soon be able to recognize the difference between real change and a change of posture.”
The American people don’t want *real* change anymore than Utahan want *real* change. The only real change will come when we set aside partisanship but the American people, in general, and Utahan, in particular, eat up partisanship. Utahan give Limbaugh, Hannity, & Glenn their biggest following and most listeners eat up the rhetoric without any serious thought or analysis because its full of divisiveness and criticism of those they love to vilify, whether its reasonable or not. I’d love to challenge all the talking heads, and even bloggers, to spend one week pointing out only the positive. That would be a *real* change.
Personally I can’t stand Limbaugh or Hannity although I can sometimes stomach Beck. Abandoning partisanship unfortunately is a little bit like disarmament – it’s great if everyone does it but doing it unilaterally is just an invitation to get hammered by the opposition.
I like the idea of having everyone focus on the positive except that sometimes the negative cannot be ignored. We get too much negative now but we need some coverage of some negative things.
I do promise a positive post on Friday but since the bulk of my ideas start from something in the media I have very little opportunity to be forever positive.
I don’t think we should abandon partisanship, but we need to abandon incivility and mindless unfounded attacks. I don’t want conservatives or liberals to change their principles, or to compromise them to gain short-term political points. I want them to confront the many serious problems that we have in this country and articulate their proposed solutions. Instead of focusing on who is scoring points or who is ahead in the polling or who made the most recent boo-boo, let’s focus on policy ideas and substance.
Our media is unwilling to do its job. There are no serious long-term investigations, no serious analysis of policy ideas, and no holding of our elected officials to account (except for sexual misbehavior of course). All those things are too expensive and don’t bring in enough revenue. Having some partisan hack shouting down anyone opposed to him or inviting a parade of other partisan hacks to spout off incoherent, uninformed nonsense is both cheap to produce and profitable. It’s time “we the people” stopped listening to this. We have a political system to fix, an economy to fix, a pointless war machine to stop. We need to learn to work together not revel in transient “victories” over our political opponents.
Thank you Charles. You have said that so well that I am promoting your comment to it’s own post.
Thanks.
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Trying to pass health reform under Reagan or either Bush would have been a waste of time, It would have been veto’ed no matter what it was. And Clinton tried the whole health reform thing it didn’t go to well for him.
Even if it makes its way into salaries it will still result in an overall reduction in the number of people with health insurance. This will cause increase cost shifting from the uninsured and will accelerate health care’s cost growth, Which is already a 6% growth rate. 6% is a national disaster do you not understand 6%? does something doubling 3 times faster then your wages sound like a healthy situation? Yes that is right health care costs will double 3 times in the time it takes for your wages to double, meaning that by the time your wages have doubled health care will cost 8 times as much.
Obama spending $78 Billion per year on a $2,500 Billion (well in 2014 it will be $3,500 Billion) problem is chump change. So no in the context of health care a $35 Trillion dollars over 10 years problem him spending $1 Trillion is nothing.
“I guess it goes back to your belief that government has the right and ability to give away what it wants and that anything they do is legal.”
I guess it goes back to your belief that “The corporation” has the right and ability to “take” away what it wants and that anything they do is legal.
Come on we can keep throwing sticks and stones at each other we can can give the numbers a good look over and understand that if this where the bacterium in the bottle growth problem that we are at 11:59am.
bacterium in the bottle growth problem
youtube bacterium in the bottle growth problem *note bottle problem at 3:33*
I sense a theme. Democratic congress and Republican president – you can’t expect Congress do do anything under those conditions. It’s the Republican’s fault. Republican congress and Democratic president – president is at the mercy of Congress. It’s the Republicans’ fault. Republican congress (bare majorities) and Republican president – you’ve got me there, six years that are undisputedly the Republicans’ fault. Democratic congress (solid majorities in both chambers) and Democratic president – don’t like the result so it’s the Republicans fault. Either democrats don’t know how to govern or you have shut your eyes to half the problem – take your pick.
I also understand 6% which is why I think something should be done about he cost curve. Obama talked about it but this bill does nothing about it. The lack of understanding here seems to be that you don’t believe that an increase in uninsured people would require and entice the insurance companies to find ways to serve the individual market in a more affordable way or else watch their revenue evaporate. Either of those should appeal to you since currently the greedy insurance industry is pure evil.
You have a point David. I for one cannot defend the health insurance bailout bill that just got signed into law. It is not reform, it does nothing to lower costs, it doesn’t provide universal coverage, it doesn’t rein in health insurance abuse to any measurable extent, and it will use the power of government to force working Americans to purchase defective products from immoral and corrupt insurance companies. Would the Republicans have done better? I sincerely doubt it.
That’s why I keep saying the system is dysfunctional. Positive health care reform that actually lowers costs and delivers universal and affordable care to all is possible – but it isn’t in the interest of those who fund political parties and campaigns and the media. I’m not aware of any problems our nation faces that are impossible to solve, but I’m not aware of any that can be solved by political expediency, or any that will provide a clear “win” for one party or another, or any that will endear the problem solver to the establishment that benefits from the problem’s existence.
I agree that we do not face problems that can’t be solved. I also agree that positive health reform is not in the interests of those who fund political parties.
Would the Republicans have done better? Not if they subscribe to the mindset that Congress can or should fix the problem.
Expecting Congress to create a solution to this is like expecting a gardener to make a tree grow taller or straighter. The gardener can foster an environment conducive to that kind of growth (just as he can impede such growth) but in the end the tree must do the growing. If the gardener tries to stretch the tree himself he will hurt or kill it unless it is exceptionally healthy and strong, in which case he will have no impact. I think we all agree that this particular tree is not healthy at the moment.
To carry your analogy a bit further, if there is a drought and an invasion of pests, your garden will not grow without attention from the gardener. Expecting the market as it currently stands to correct itself isn’t the answer either. If it were capable of doing so or if that were the goal of the market, we wouldn’t have this problem.
However, as far apart as we are politically, I would wager that you and I could sit down together and over the course of some intense discussions come up with a plan that would work. It would be politically impossible I suspect, but then everything seems political impossible.
The first thing we would have to do is determine what outcome we seek. What would a healthy health care system look like? If we could agree on that, then we would need to evaluate possible solutions to determine whether they could in fact produce that outcome. Once we find a set of solutions that are viable, we would need to find a way to pay for them, etc., etc. That’s what a good political process would do, but if you and I each have a gaggle of people paying us who are benefiting from the current dysfunctional system, there’s not much point even sitting down to talk about it.
The reason that you and I would have a chance at success if we were to sit down and discuss this is that we both agree that the garden needs attention and we are both more interested in a solution than we are in gaining power.
“The lack of understanding here seems to be that you don’t believe that an increase in uninsured people would require and entice the insurance companies to find ways to serve the individual market in a more affordable way or else watch their revenue evaporate.”
As if private industry can figure out how to pay for people that clearly can’t afford health care on any terms, let alone their terms that require them to grow their profits every year. High deductible plans drive more people into bankruptcy and many will choose to go without if their is no coverage for their basic needs as well. HSA’s only help marginally on those in income brackets that can afford such things, income brackets where comprehensive coverage makes more sense. If you make $40 grand a year (Median income in the USA) a HSA + high deductible plan still means you are 1 issue away from bankruptcy so why even have a plan.
And you are up in the night if you think we can lower the cost curv without government involvement. This is an issue well outside the bounds of private industry’s ability to solve. And part of what is diving cost growth is the uninsured, anything that helps with that will lower the curv. Efforts to lower administrative costs via bulk payments, global budgeting, national negotiation, paper work standardization are all things that are outside the ability of private industry todo anything about. Even tort reform is something only the government can do through involvement in the system.
“Either of those should appeal to you since currently the greedy insurance industry is pure evil.”
Corporations are neither good nor evil, they merely exist to function for the benefit of the share holders, And solely for the benefit of the share holders. That’s what their meant todo, I don’t wanna change that, I am merely making the argument that this is not the right model to run all things. Health care being something that is being performed exceedingly poorly by the corporation.
As to them being greedy, That’s not the term I would use, I think the term “fiduciary responsibility to their share holders” fits better. Share holders will sue if the company is not fulfilling their LEGAL OBLIGATION to make them money. Again I am not saying this should be changed, I am saying this is not the model under which to run all things, Health care being one of those things.
Whether or not comprehensive coverage makes sense for any given individual has a lot more to do with their health history than it does their income.
I’m not sure who you are debating here because I have not been arguin that goverent should have no involvement. My argument is that a government takeover is no panacea.
I’m glad to see that you understand the nature and value of cororations and their profit motive. Now if you could come to believe that a profit motive is not an intrinsic deterrent to finding ways to address health care issues then we might be Ble to have a productive dialog. I don’t believe that insurance companies will solve this on their own but there’s no need to vilify them or exclude them from the solution.
“Whether or not comprehensive coverage makes sense for any given individual has a lot more to do with their health history than it does their income.”
It has everything todo with income, Pretty quickly here high deductible plans will be the only option of those making the Median wage or below due to simple cost growth. And the plan people need has a lot more to do with their future then it does the past, No one knows what their health care needs will be tomorrow.
“I’m glad to see that you understand the nature and value of corporations and their profit motive.”
In health care the “profit motive” does not provide value to the end product that is health care service. The profit motive leads insurance company’s to avoid paying claims, dropping customers who have the gull to get sick, force enormous cost shifts onto doctors and hospitals for administrative overhead, etc.
No other country has ever created an affordable system through private corporations, No one has presented a model to run health care by private corporations that could have long term viability. Somethings just don’t work in the one size fits all corporation model.
If health history is no predictor of future health needs then why do insurance companies waste our time collecting that information in order to determine our premiums?
I’m not arguing that there should be no government involvent but if private companies cannot at least break even providing health care and health insurance then how can we expect the government to break even?
If you think that government can afford to run perpetual deficits to provide health care simply because health care is something we would like to provide to everyone then we can end this conversation right here. Eventually someone will have to pay for the care we deliver. If nobody can pay for it the system will collapse no matter how much we demand from the government.
Health care is not something that can be provided to everyone at a profit or even break even. This is one of the reasons that the corporation model is flawed for this service.
Health care could be ran at break even if you used the administrative cost cutting ability that government could bring to the system. A single National authority for negotiating hospital and doctor rates would save $100 Billion or so per year, a program for global budgeting and bulk payment of services and nationally standardized paper work would cut costs by $200-$300 Billion per year, ending Medical bankruptcy through universal access would save another $100-$200 Billion per year, simplified billing through a payroll tax would further simplify the system saving another $50-$100 Billion per year, Their would also be savings from preventative care, early treat of diseases by being caught before their emergency room worthy, increases in worker productivity, etc.
Add in removal of the employer health benefit tax write off, existing medicare tax’s, federal medicaid money, federal employ benefit plans money, and by 2020 we can pass single payer as a TAX CUT.
Now I don’t want to remove the insurance industry like in the Canadian system, I like the model France has for their system and I think that would work wonderfully here. Their model doesn’t get all the savings of traditional single payer but they give everyone a wide variety of choices in how their health insurance is delivered by allowing people to opt out of the system and choose a private insurance company(they get to take a premium credit with them when they do this), and they have the one of the highest rated systems in the world.
“If you think that government can afford to run perpetual deficits to provide health care simply because health care is something we would like to provide to everyone then we can end this conversation right here.”
Much poorer country’s managed to provide ALL of their citizens health care without running deficits, Their is absolutely no reason what so ever we can’t.
“If nobody can pay for it the system will collapse no matter how much we demand from the government.”
If nobody can pay for it the system will collapse no matter how much we demand from the “The corporation”.
Health care is not something that can be provided to everyone at a profit or even break even.
I don’t believe that’s true because if it is the problem is unsolvable. It might be true based on our current expectations regarding health care but it can’t be ultimately true otherwise, as you said, “the system will collapse no matter how much we demand from the corporation” (or government).
The French model sounds like an interesting mix of public and private.
Much poorer country’s managed to provide ALL of their citizens health care without running deficits
Exactly what level of care do they provide? It’s probably a safe bet that most of them have a lower standard of living and that all of them that do this without running a deficit demand less in the way of services on a per person basis than we do. What we currently demand, and what Democrats imply that we can continue to demand, is unsustainable and without rationing there is nothing government can do to make it sustainable.
Part of making a system affordable is making it universal. Guaranteed access to care increases national productivity and reduces costs from preventative care, and ongoing conditions not going untreated, We lose Billions of dollars every year due to people who die from treatable conditions such as diabetes, people unable to afford their basic health needs lands them in the emergency room at 100’s of times higher cost then if they had been treated properly in the first place this is the result of a lack of access.
Now France, Germany, Switzerland, Norway, Briton, Italy, etc(many euro country’s), Japan, Taiwan, etc(few Asian country’s) all run some sort of National health care system that provides very good care. France and Japan have better systems then we do, Both have better out comes and longer life expectancy’s, Japan’s life expectancy’s being so long they had to raise the retirement age to 70. Now Japan, and Briton are bad examples to take from because they have large deficits Japan running a deficit of around 200% of their GNP(they kinda do this on purpose tho because its how they pay their retirement system out), And Briton is only a half bad example because their resent deficits are now due to their health care system their system does “ration” care however not as much as our private corps due but I guess that is hardly the point.
Japan’s health system spends around 1/4 per person that our system spends, and Frances system spends around 1/2 of what our system spends per person. So neither country’s health care system is really adding a whole lot to their deficits, in Japan its their National trade policy(heavy subsides for exports) and national social insurance program that has a massive glut of retiree’s entering while at the same time having their population shrink, for the first time in history Japan is looking at their immigration policy as a serious solution.*sorry bit of a tangent I find it interesting*
Anyway The french system uses a National rate negotiation authority which is ran by their public option, the private insurance company’s can choose to use these rates if they choose or negotiate on their own. The government runs a Adverse risk pool which all of the insurance company’s are required to pay into, this pool pays back to the insurance company’s with higher health costs so that the company’s have no motivation to cull the sick. The government also runs a third risk pool that is used for long term capital management to pay hospitals for expansions, and cover costs of things that are easy to global budget(beds for example). The government sets plan coverage minimums and pays for the basic coverage plan through a payroll income tax. The public option their receives additional money from the government for the coverage of those who are not in the system, tourists, illegal immigrants, etc.
Now France, Canada, Briton, and Japan all have quality’s of life that are just as good as our own. Two of these country’s Canada and France do it without massive deficits. I would argu that Norway, Germany, Switzerland are pretty close to our quality of life, non of these country’s have massive deficits(in fact Norway has a massive excess right now they don’t know what to do with (they got big oil reserves tho so maybe they don’t count =p))
I’m not convinced that universality of coverage will guarantee affordability of coverage.
You offer a nice lengthy list of countries with universal government run health care but before anyone gets carried away perhaps we should ask ourselves about their tax rates and whether Americans have the stomach for the corporate and individual tax rates enjoyed in France or Germany.
“I’m not convinced that universality of coverage will guarantee affordability of coverage.”
Both Canada and Briton have no deductibles or co-pays, in fact Briton has a program that pays your for going to the doctor to cover the bus fair or other travel expense to get their and back. I suppose you may be referring to the long term viability of such a social program?, Briton has been running their universal system sense 1952, Japan started their universal system in the late 1890’s and it has been running ever sense. France started universal coverage in 1999 so its hasn’t been around for the longest time. Most of the systems do have co-pays(minus above stated) averaging around $25(when converted to US $) or so, several of these country’s the doctors are allowed to waive the co-pay if they wish however.
They do have higher tax rates, but it is not as bad as you would think. Their personal income tax’s are generally higher, but their corporate rates are generally lower.
Most European country’s have a VAT tax of some sort in lue of higher corporate tax rates. A VAT tax is basically a sales tax that is set based on the amount of value added through manufacturing process on said produce, for example unprocessed food would have low or no sales tax where as a LCD TV could be as high as 30%. This form of taxation is actually very interesting, as it acts as a side car tariff equalizing the amount of tax payed by foreign made products with the amount of tax paid by domestic products. Many Many country’s do this and is one of the reasons American exports are at a disadvantage in the international market. I support replacing corporate income tax revenue with a consumption based VAT tax, I don’t support the ridiculous libertarian notion that a national sales tax can replace all income tax revenue.
You may be right tho, their are few that hate tax’s as much as Americans. I really don’t see how increased tax rates can be avoided with the deficit we are currently running however, Of course this is a deficit problem that we have been putting off for 30years now.
Obama is not doing very well for the most part with the budget deficit so far, however he has attacked a couple very controversial budget items that needed to be hit. The NASA shuttle program is a gross waste of money he has cut that,NASA Area rocket program is a waste he cut that(why can’t these guys get passed the upside down roman candle approach they should call Burt Rutan), the military’s C-140 transport plane cuts that was nice and evenly spread across 48 Senate districts to buy votes, The student loan banking subsides, The F-22 jet aircraft purchase cancellation.