Health Care Reform

[Griffon64]

River, an in-depth study by McKinsey also found the same thing. The number being touted by the white house is that only 5% of the costs are due to malpractice suits. But those are from actual suits. The threat of suits raises the costs much higher (I've forgotten the exact number, it was greater than 10%). This problem really should be fixed. I don't know if the current bill does do that.

I think a lot of it is a vicious cycle. The threat of malpractice raises costs, but why IS it that the Americans are so likely to sue? Part of it, of course, is culture, greed, whatever. But also it is because there is no social safety net for these things.

If a doctor makes a mistake, which results in the patient needing longer, more expensive treatment, now the patient is on the hook for all that money. Not only medical costs, but time out of work, transportation, time out of work for whoever is taking care of the sick person. It is all coming out of patent's pocket, and is it really so unfair that the person who made the mistake should be responsible for fixing it?

Frelga and Mahima, that is an enormously interesting perspective on things. Thank you! That's the kind of thought and ideas that I feel I'm missing when attempting to discuss health care.

As far as the more expensive treatment & costs goes, that can possibly be covered under universal health care. But what about the other part? The living expenses? How can that be reduced under universal health care? Can it? How is it covered in other nations like Canada and the U.K.? Do they have different social nets that catch those things?

Second, we've been discussing a lot about insurance companies not achieving companies of scale, and hence higher insurance costs. In the past we also discussed why there aren't national health insurance firms (like auto insurance). Well, apparently, insurance firms can be national, and spread the risks. But they don't, because each small insurance state firm loves its little kingdom. But 20 leukemia patients can shatter the potential profits of north NJ insurance company, which leads to increasing premiums, and all the pre-existing condition stuff.

That's an interesting truth, and a good argument for national coverage - the risk pool.

So, perhaps a good chunk of "wasteful" health care costs is because everybody is hedging against disaster: doctors hedge against malpractice suits, insurance companies hedge against ruinously expensive expenditures on patient claims, and so on.

Then the argument is that a larger scale will spread these risks around sufficiently that coverage can be expanded. That's certainly true.

I still wonder about those malpractice suits, though. Surely Canadian and UK doctors butcher patients about as often as USA docs do. What happens in such a case?

[halplm]

I have not called anyone evil... I don't think... If you think what the democrats are doing is evil, well, that's your opinion. Please refrain from putting words in my mouth, though.

You're right, you only said that dems are trying to destroy and enslave. I merely assumed you would think such things are evil. Apologies.

Is it extreme rhetoric if you actually believe it to be true?

Of course. I would not, for example, be allowed to say racially derogatory remarks on this board regardless of whether I thought I was factually correct.

Why should I think it evil? The democratic leadership doesn't. They think they know what's better for all of us than we do, so they're doing good.

If YOU think it's evil, so be it, but don't dodge the issue by claiming I am saying they're evil, and thus I can't rationally discuss the issue, which is what you were doing.

[halplm]

Is it extreme rhetoric if you actually believe it to be true?

I am shocked! shocked! and astounded! that the Democrats would use the same legislative method Republicans have used in the past.
No truly, I am a little disappointed that the bill will probably be passed by a majority vote on a rule rather than on the bill itself.

So let me get this straight: you're saying that because the Republicans have done something similar (and make no mistake, it is not the same), that makes it OK?
LOL! That is about the worst argument possible you can make. Rather, you should be outraged it was done in the past, and further outraged it is being done now, in a way that will cripple this country for all time.

I'm not outraged that the same exact procedure has been used 36 times before by the Republicans and 48 times before by the Democrats. Apparently you should have been; doubtless you can link to past examples of your outrage at its use.

Since you seem to have very specific information about each and every time things have been done this way (which liberal blog did you get it from?)... perhaps you can expand on it, and discuss when of those 84 times you have cared to highlight... did the majority not have the votes they needed?

I'm genuinely interested, because I would consider it a colossal failure of our media to highlight the constitution being completely sidestepped.

[River]

I have not called anyone evil... I don't think... If you think what the democrats are doing is evil, well, that's your opinion. Please refrain from putting words in my mouth, though.

You're right, you only said that dems are trying to destroy and enslave. I merely assumed you would think such things are evil. Apologies.

Is it extreme rhetoric if you actually believe it to be true?

Of course. I would not, for example, be allowed to say racially derogatory remarks on this board regardless of whether I thought I was factually correct.

Why should I think it evil? The democratic leadership doesn't. They think they know what's better for all of us than we do, so they're doing good.

If YOU think it's evil, so be it, but don't dodge the issue by claiming I am saying they're evil, and thus I can't rationally discuss the issue, which is what you were doing.

I'm looking for the rationality in this position. My own father has said similar things in very different contexts ("These people I don't like have said this thing I disagree with is okay so it must be"...Whiskey Tango Foxtrot??) and it baffles me to the point I can't put together a reasonable argument against it. It's like trying to extinguish a fire with kiddie-sized toothbrush and it's especially maddening when the person being absurd really has the education and innate reasoning powers to know better. So could you please explain, in very simple child-like terms, what you're trying to say here?

[Primula Baggins]

Hal, of course anyone who wants to destroy this country and enslave its people is evil by any rational standard. Please don't play word games. The error is not in calling such behavior evil; it's in attributing such behavior to an entire political party and its members.

Just don't. Please. Argue the issues by all means. Don't insult masses of people and thinkthat by doing so you are scoring rhetorical points or persuading anyone that you're right.

I should have edited the post in which you made these accusations rather than responding to it as I did, in an equally insulting manner. It's my fault that we've gotten off track. I hope we can return to discussing the issues. There's a lot going on right now.

[Ellienor]

I thought that was a good perspective too, Griffon. The injured person has no recourse except what they can obtain from the doctor. Another proposed system would be something analogous to worker's comp:

Workers' compensation (colloquially known as workers' comp in North America or compo in Australia) is a form of insurance that provides compensation medical care for employees who are injured in the course of employment, in exchange for mandatory relinquishment of the employee's right to sue his or her employer for the tort of negligence. The tradeoff between assured, limited coverage and lack of recourse outside the worker compensation system is known as "the compensation bargain." While plans differ between jurisdictions, provision can be made for weekly payments in place of wages (functioning in this case as a form of disability insurance), compensation for economic loss (past and future), reimbursement or payment of medical and like expenses (functioning in this case as a form of health insurance), and benefits payable to the dependents of workers killed during employment (functioning in this case as a form of life insurance). General damages for pain and suffering, and punitive damages for employer negligence, are generally not available in worker compensation plans.

from Wikipedia.

In law school we read all these horrendous cases from >100 years ago before there was worker's comp, where people had been killed, maimed, horribly injured in workplace accidents, and there was no recourse except to sue the employer.

[halplm]

Hal, of course anyone who wants to destroy this country and enslave its people is evil by any rational standard. Please don't play word games. The error is not in calling such behavior evil; it's in attributing such behavior to an entire political party and its members.

Just don't. Please. Argue the issues by all means. Don't insult masses of people and thinkthat by doing so you are scoring rhetorical points or persuading anyone that you're right.

I should have edited the post in which you made these accusations rather than responding to it as I did, in an equally insulting manner. It's my fault that we've gotten off track. I hope we can return to discussing the issues. There's a lot going on right now.

Well, you're twisting what I said. I didn't say they wanted to "destroy this country." I said they wanted to cripple it. Now, the reason I said that, is because i do not WANT to play word games. I want to call it what it is. If you and yov, and anyone else thinks that that "crippling" the country is evil, then why on earth would you support politicians that want to do just that???

The argument that you should be making is that what they are doing is NOT crippling or enslaving... but everyone here had no interest in trying to argue that (because of futility?) and preferred to take the time honored debate tactic of claiming offense and saying they're not going to "deign that comment with a response..." as it were...

You'll note, in my original response to such claims, I did try to expand on and explain my original statements, but no one has actually responded to that except Ellie, who ignored the reality of today to claim the the past was good because of the democratic policies (ignoring, of course, that California's true blueness is relatively recent).

I'm looking for the rationality in this position. My own father has said similar things in very different contexts ("These people I don't like have said this thing I disagree with is okay so it must be"...Whiskey Tango Foxtrot??) and it baffles me to the point I can't put together a reasonable argument against it. It's like trying to extinguish a fire with kiddie-sized toothbrush and it's especially maddening when the person being absurd really has the education and innate reasoning powers to know better. So could you please explain, in very simple child-like terms, what you're trying to say here?

River, I do not like what they are doing. I think it is "wrong" and will do bad things to this country. My response was to yov's assertion that I was unworthy of being engaged with in this discussion, because I had turned those I disagree with into an "evil" caricature. "Evil" is a loaded term, not to mention a moral judgment (something I like to avoid, personally), even given "any rational standard."

Certainly if some people are right, then crippling the US, and enslaving it's people will save the planet and make everyone healthier and happier... which would certainly be a good thing, if it were true.

[Cerin]

I think it's instructive for us to hear halplm's rhetoric, because this is the sort of thing Rush Limbaugh peddles constantly, and that millions of his listeners believe. I turned Limbaugh on today. He is prepping his ignorant listenership (I believe that anyone who listens to Limbaugh and believes what he says is ignorant) to believe that the Democrats are perpetrating the greatest assault on the Constitution in our lifetime. And what someone said earlier is why we need to be concerned -- belief in the kinds of lies that Limbaugh and now much of the Republican mainstream engage in could very well be the basis for violent acts by people who believe it is a patriot's duty to overthrow the government if Democrats -- who apparently want to cripple the nation and enslave its populace -- are in control.

[halplm]

ignorant and violent, eh? Now who's insulting groups of people?

How am I even supposed to respond to that nonsense?

[N.E. Brigand]

(which liberal blog did you get it from?)

This one:

However, this kind of end run by the House is not that unusual, according to congressional scholar Thomas Mann of the Brookings Institution. Mann says Congress has used self-executing rules to pass such legislation as the smoking ban on domestic airline flights, an employment verification system meant to screen out illegal immigrants and a ban on using statistical sampling for the 2000 Census.

"It's a way to manage difficult, partisan problems," Mann says.

As with reconciliation, self-executing rules have been used by both Democratic and Republican congressional majorities, Mann says. He says Congress used it 36 times in 2005 and 2006, when the GOP was in charge, and 49 times in 2007 and 2008, after the Democrats had taken control.

It is amusing that when Republicans first used this technique, Nancy Pelosi joined a lawsuit claiming that it was unconstitutional, and lost.

Since you seem to have very specific information about each and every time things have been done this way ... you can expand on it, and discuss when of those 84 times you have cared to highlight

Not really. Remember, I'm not the one outraged by the process, which requires a majority vote* by the House to pass. I think Pelosi was wrong to object in the past, and the Republicans are wrong to object now. The Constitution, as noted above, is not being subverted.

*Explanation:

Okay, so here’s how the “deem-and-pass” procedure would actually work. The House Rules committee is often called the “traffic cop” of the House – controlling what bills come to the floor and how much debate is allowed on each one. On each bill, they pass what is called a “rule” – a resolution determining what kind of debate is allowed on each bill. The whole House must first pass the rule, then the underlying legislation. In the case of “deem-and-pass,” the vote on the rule would also have the effect of passing the Senate bill. According to the CRS report linked above, the House has used this procedure at least six times between 1989 and 2005 with both parties in charge.

I don't know what explains the differences between the CRS and Brookings Institute statistics.

That said, I would prefer a straight vote whenever possible.

[halplm]

So you have no examples of getting around a vote they can't win?

That is the issue, not the rules of the house.

If a bill is going to pass, and the vote on the rule expedites the passage, in some way, I see no real problem with it. There are lots of legislative rules and processes that could be done away with, and things would be better, but they don't subvert the concept of democracy.

This bill (up until this point, of course), will NOT pass, and using a legislative trick to get it to the president's desk is very much subverting the constitution, the republic, and the entire concept of democracy.

[Ellienor]

now much of the Republican mainstream engage in could very well be the basis for violent acts by people who believe it is a patriot's duty to overthrow the government if Democrats -- who apparently want to cripple the nation and enslave its populace -- are in control.

I do think that Limbaugh's untruths such as "assault on the constitution" is best irresponsible and at worst treasonous.

As N.E. Brigand points out, this method to pass legislation has been used extensively by both parties in the past. What makes it such an "assault on the constitution" this time? Where was Limbaugh before?

Where was Hal before????

[Ellienor]

This bill (up until this point, of course), will NOT pass, and using a legislative trick to get it to the president's desk is very much subverting the constitution, the republic, and the entire concept of democracy.

Why didn't you care the other 84 times it was done, Hal???

The correlary to this argument is that if it's been done 84 times before, and the Republic is more or less intact, then perhaps it's not so destructive to "the entire concept of democracy" then, hmmm???

[Griffon64]

*Tries to read around all the bickering.*

Ellienor - that's interesting! However, it also reminds me that my doctor wants me to sign a binding arbitration waiver thingy every year - basically, sign away my right to sue if she messes up. Is this standard practice, or no? If it is, why is the malpractice insurance still factored into health care costs?

I absolutely believe that there should be solid recourse for people who suffer from medical mishaps - but it should be done in a way that isn't excessively costly. A kind of a one on one resolution to that kind of thing doesn't seem cost-effective. Something like the worker's comp model could work.

[halplm]

now much of the Republican mainstream engage in could very well be the basis for violent acts by people who believe it is a patriot's duty to overthrow the government if Democrats -- who apparently want to cripple the nation and enslave its populace -- are in control.

I do think that Limbaugh's untruths such as "assault on the constitution" is best irresponsible and at worst treasonous.

As N.E. Brigand points out, this method to pass legislation has been used extensively by both parties in the past. What makes it such an "assault on the constitution" this time? Where was Limbaugh before?

Where was Hal before????

So now, they're not just ignorant and violent, but also liars and traitors.

Lets not hold back now, what do you guys really think?

I already answered your assertions.

[Ellienor]

*sigh* some people can dish it out, but they can't take it.....

I have never heard of doctor's offices requiring people to enter into mandatory arbitration to receive services. Although a brief google showed that this is becoming more common. I do know that there have been legal issues of whether such agreements are truly binding for being contrary to public policy...the right to sue for redress being a pretty ingrained right for U.S. citizens.

[halplm]

This bill (up until this point, of course), will NOT pass, and using a legislative trick to get it to the president's desk is very much subverting the constitution, the republic, and the entire concept of democracy.

Why didn't you care the other 84 times it was done, Hal???

The correlary to this argument is that if it's been done 84 times before, and the Republic is more or less intact, then perhaps it's not so destructive to "the entire concept of democracy" then, hmmm???

No, actually, you make a good point. Those 84 times, have very much undermined things, as they set a precedent that is now potentially going to be used to pass a bill that wouldn't normally pass.

Where was I? Unfortunately I can't know everything.

[halplm]

*sigh* some people can dish it out, but they can't take it.....

I have never heard of doctor's offices requiring people to enter into mandatory arbitration to receive services. Although a brief google showed that this is becoming more common. I do know that there have been legal issues of whether such agreements are truly binding for being contrary to public policy...the right to sue for redress being a pretty ingrained right for U.S. citizens.

Can't take being called an ignorant lying violent traitor? When I have I exactly "dished that out?"

I clarified that my statements were aimed at the leadership of the democratic party, not every democrat. Your comments, as well as Cerin, are attacking many many conservatives as a group.

[Inanna]

*Tries to read around all the bickering.*

Ellienor - that's interesting! However, it also reminds me that my doctor wants me to sign a binding arbitration waiver thingy every year - basically, sign away my right to sue if she messes up. Is this standard practice, or no? If it is, why is the malpractice insurance still factored into health care costs?

Griffy, that is SO right. I never thought of that. Isn't that only for major procedures though? I know my cousin had to sign a load of stuff as he was being led into the operating room from the ambulance.

Need to dig deeper here....

EDIT: Cross-posted with Ellie (on the same topic...)

[JewelSong]

No, actually, you make a good point. Those 84 times, have very much undermined things, as they set a precedent that is now potentially going to be used to pass a bill that wouldn't normally pass.

84 times is more than "setting a precedent" and on its way to "business as usual." IMHO.

Isn't that how this strategy has ALWAYS been used? To potentially pass a bill that "normally" wouldn't pass?

Where was I? Unfortunately I can't know everything.

I guess the real question is - why are you (and other Republicans) so bent out of shape THIS time - when this very same thing has been done by BOTH parties so many times before?