Public Option dead!

[Cali Coug]

Originally Posted by MikeWaters

the strategy is 1) increase access, 2) wait for costs to implode, and then 3) trot out single payer as the only possible solution.

Liberals aren't trying to win in just one step.

No, the strategy now is to incorporate something akin to the Dutch system, which works pretty well.

[Archaea]

Originally Posted by Cali Coug

Do yourself a favor and read the links above (or at least some of them). If you are actually interested in this topic (other than just to fight against) I am confident you will have a more reasoned view afterwards.

I did read some of them. Color me unimpressed.

Until we focus upon quality, coordination and medical cooperation, health care will not be improved. I am not upset about access to care and frankly don't know anybody other than Democratic pundits who are. It is NOT important to me that our country provide universal access to medical care, as I do not perceive access to be a fundamental human right. I simply reject that assumption. OTOH, I know I may have to be pragmatic in my battles, but this battle is not something positive IMHO.

Mike's nailed the strategy. It's all part of a long range strategy to undermine private systems, as Mike noted: "the strategy is 1) increase access, 2) wait for costs to implode, and then 3) trot out single payer as the only possible solution."

And humor me, what do you believe is the "Dutch System" and why do you believe it has worked on a small scale?

The two cultures are not identical at all and trying to follow the Dutch will fail miserably.

[MikeWaters]

Care for the indigent/uninsured won't change all that much in Texas given that the bill doesn't address illegal immigrants.

Dems know they can't take care of that on the first pass-through. Will wait til later.

When it becomes clear that some of these taxpayer-based charitable hospitals are essentially only in place to serve illegal immigrants (which is not that far-fetched if everyone else has insurance of one kind or another), I wonder what the public reaction is going to be.

We may very well find out.

[Archaea]

It's that Cali's cronies believe government can create healthy markets with adequate service.

Here's a quote from one of the articles:

This is what the health insurance exchange is designed to do. It is arguably the single most important element of health-care reform, because it is the bridge between the system we have and the system we want. But amid the clamor over public insurance options -- which, incidentally, would be housed on the exchange -- and employer tax exclusions and all the other points of controversy, the health insurance exchange is hardly being discussed. And there are signs that it, and thus the long-term promise of reform, might be in danger.
Compared with the crazy-quilt system we have now, the idea behind the health insurance exchange is almost weirdly simple: It's a single market, structured for consumer convenience, in which you choose between the products of competing health insurers (both public and private). This is not a new idea. It is how we buy everything from books to socks to soup. Everything, that is, except health insurance. The benefits of reversing that bit of accidental exceptionalism are obvious to anyone who has ever stepped inside a Target: Consumers will benefit from more choice, from direct competition between insurance providers hungry for their business, from regulations meant to protect them from deceptive products, from efficiencies of scale, and from the sort of purchasing power that only a large base of customers can provide. They will benefit, in other words, from an actual, working market -- something health insurers have managed to avoid for far too long.

So the Reformers want to shift the insurance forcibly.

And great, just what we need, another government concocted marketplace.

As Mike aptly analyzed, the structure of the Exchange is artificial so it will skew normal economics, destroy the insurance companies "compelling" Congress to pay for it all. The plan is brilliantly cloaked but devious and disastrous nonetheless.

[Cali Coug]

Originally Posted by Archaea

I did read some of them. Color me unimpressed.

Until we focus upon quality, coordination and medical cooperation, health care will not be improved. I am not upset about access to care and frankly don't know anybody other than Democratic pundits who are. It is NOT important to me that our country provide universal access to medical care, as I do not perceive access to be a fundamental human right. I simply reject that assumption. OTOH, I know I may have to be pragmatic in my battles, but this battle is not something positive IMHO.

Mike's nailed the strategy. It's all part of a long range strategy to undermine private systems, as Mike noted: "the strategy is 1) increase access, 2) wait for costs to implode, and then 3) trot out single payer as the only possible solution."

And humor me, what do you believe is the "Dutch System" and why do you believe it has worked on a small scale?

The two cultures are not identical at all and trying to follow the Dutch will fail miserably.

Then what did you read? Because the cites I gave you are about cost cutting while retaining high quality care (AND expanding coverage).

[Archaea]

Originally Posted by Cali Coug

Then what did you read? Because the cites I gave you are about cost cutting while retaining high quality care (AND expanding coverage).

But their arguments were unpersuasive. They were summary in natural.

And they were polemical.

One of them assumed a 4 to 5% administrative "cost" savings. I find the thought of government saving costs administratively laughable.

I know a real life example which just completely undermines the concept, and know of no contrary anecdote.

We have a small county hospital in our state which lost 500,000 per month and was staffed with forty administrators. A private entity came in, fired the lot, relying instead upon 2 administrators, and turned it around, not that it generated huge profits, but that it survived.

The assumptions of the models are ludicrous.

[MikeWaters]

Originally Posted by Cali Coug

Then what did you read? Because the cites I gave you are about cost cutting while retaining high quality care (AND expanding coverage).

Sure, all we need is to curb the rampant fraud and waste in Medicare (which is a wonderfully administered program, well, er, except for the rampant fraud and waste), and oh yeah, these cuts will have no effect on care, well, er, maybe it will affect home healthcare visits, but those were overrated, and um, yes, we will expand this program to those 55 and over, and worry about the medicare bankruptcy later.

Yeah, lots of confidence in this.

[Tex]

Originally Posted by Cali Coug

And I thought we were actually talking about whether the bill really was improving, not whether people generally perceived it to be improving. Perhaps there is a reason for the disconnect:

http://voices.washingtonpost.com/ezr....html#comments

Heh. That poll question uses weasel words like "confidently" and "exactly". What a shock that people find it hard to be "confident" and "exact" about a target which is still moving.

If in truth 65% of people don't understand the public option (which I doubt), then the Democrats can count their blessings. The more people learn about it, the more they hate it.

[ChinoCoug]

Originally Posted by Archaea

But their arguments were unpersuasive. They were summary in natural.

And they were polemical.

One of them assumed a 4 to 5% administrative "cost" savings. I find the thought of government saving costs administratively laughable.

I know a real life example which just completely undermines the concept, and know of no contrary anecdote.

We have a small county hospital in our state which lost 500,000 per month and was staffed with forty administrators. A private entity came in, fired the lot, relying instead upon 2 administrators, and turned it around, not that it generated huge profits, but that it survived.

The assumptions of the models are ludicrous.

Administrative Costs as % of total costs:

USA 20%
Canada 6%
France 4%
Japan 2.5%
Taiwan 1.5%

Which one of these have government-run systems?
http://www.washingtonpost.com/wp-dyn...2101778_2.html

[MikeWaters]

There are a lot of inefficiencies in the US system.

Like difficulties in sharing medical information between doctors/hospitals/systems.

USA also deals with a difficult medico-legal environment. Lawyers are skimming off the top.

Americans also have access to a much wider array of services.

We have people complaining that adminstrative costs are too high, and everything is too helter-skelter with so many insurers--but then we get the other complaint that the industry is too consolidated with only one, two, or three insurers in some states!!!

Here's the deal: if you look at those other countries, what do they have that we don't? Rationing. I think if you have uniform rules on the rationing of medical care (i.e. someone chooses the winners and losers), then things become easier administratively.

Is America ready for Washington-based medical rationing?