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Liberal super majority: The ramifications

Liberal super majority: The ramifications

Good article at the WSJ discussing the likely results of the upcoming election.

- Medicare for all. When HillaryCare cratered in 1994, the Democrats concluded they had overreached, so they carved up the old agenda into smaller incremental steps, such as Schip for children. A strongly Democratic Congress is now likely to lay the final flagstones on the path to government-run health insurance from cradle to grave.

Mr. Obama wants to build a public insurance program, modeled after Medicare and open to everyone of any income. According to the Lewin Group, the gold standard of health policy analysis, the Obama plan would shift between 32 million and 52 million from private coverage to the huge new entitlement. Like Medicare or the Canadian system, this would never be repealed.

The commitments would start slow, so as not to cause immediate alarm. But as U.S. health-care spending flowed into the default government options, taxes would have to rise or services would be rationed, or both. Single payer is the inevitable next step, as Mr. Obama has already said is his ultimate ideal.

- The business climate. "We have some harsh decisions to make," Speaker Nancy Pelosi warned recently, speaking about retribution for the financial panic. Look for a replay of the Pecora hearings of the 1930s, with Henry Waxman, John Conyers and Ed Markey sponsoring ritual hangings to further their agenda to control more of the private economy. The financial industry will get an overhaul in any case, but telecom, biotech and drug makers, among many others, can expect to be investigated and face new, more onerous rules. See the "Issues and Legislation" tab on Mr. Waxman's Web site for a not-so-brief target list.

The danger is that Democrats could cause the economic downturn to last longer than it otherwise will by enacting regulatory overkill like Sarbanes-Oxley. Something more punitive is likely as well, for instance a windfall profits tax on oil, and maybe other industries.

- Union supremacy. One program certain to be given right of way is "card check." Unions have been in decline for decades, now claiming only 7.4% of the private-sector work force, so Big Labor wants to trash the secret-ballot elections that have been in place since the 1930s. The "Employee Free Choice Act" would convert workplaces into union shops merely by gathering signatures from a majority of employees, which means organizers could strongarm those who opposed such a petition.

The bill also imposes a compulsory arbitration regime that results in an automatic two-year union "contract" after 130 days of failed negotiation. The point is to force businesses to recognize a union whether the workers support it or not. This would be the biggest pro-union shift in the balance of labor-management power since the Wagner Act of 1935.

Read the whole thing: http://online.wsj.com/article/SB122420205889842989.html

55,093 views 105 replies
Reply #26 Top

http://www.foxnews.com/story/0,2933,439607,00.html

Hawaii Ending Universal Child Health Care After 7 Mos.

HONOLULU —  Hawaii is dropping the only state universal child health care program in the country just seven months after it launched.

Gov. Linda Lingle's administration cited budget shortfalls and other available health care options for eliminating funding for the program. A state official said families were dropping private coverage so their children would be eligible for the subsidized plan.

"People who were already able to afford health care began to stop paying for it so they could get it for free," said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. "I don't believe that was the intent of the program."

State officials said Thursday they will stop giving health coverage to the 2,000 children enrolled by Nov. 1, but private partner Hawaii Medical Service Association will pay to extend their coverage through the end of the year without government support.

"We're very disappointed in the state's decision, and it came as a complete surprise to us," said Jennifer Diesman, a spokeswoman for HMSA, the state's largest health care provider. "We believe the program is working, and given Hawaii's economic uncertainty, we don't think now is the time to cut all funding for this kind of program."

 

Hawaii lawmakers approved the health plan in 2007 as a way to ensure every child can get basic medical help. The Keiki (child) Care program aimed to cover every child from birth to 18 years old who didn't already have health insurance — mostly immigrants and members of lower-income families.

It costs the state about $50,000 per month, or $25.50 per child — an amount that was more than matched by HMSA.

State health officials argued that most of the children enrolled in the universal child care program previously had private health insurance, indicating that it was helping those who didn't need it.

The Republican governor signed Keiki Care into law in 2007, but it and many other government services are facing cuts as the state deals with a projected $900 million general fund shortfall by 2011.

While it's difficult to determine how many children lack health coverage in the islands, estimates range from 3,500 to 16,000 in a state of about 1.3 million people. All were eligible for the program.

"Children are a lot more vulnerable in terms of needing care," said Democratic Sen. Suzanne Chun Oakland. "It's not very good to try to be a leader and then renege on that commitment."

The universal health care system was free except for copays of $7 per office visit.

Families with children currently enrolled in the universal system are being encouraged to seek more comprehensive Medicaid coverage, which may be available to children in a family of four earning up to $73,000 annually.

These children also could sign up for the HMSA Children's Plan, which costs about $55 a month.

"Most of them won't be eligible for Medicaid, and that's why they were enrolled in Keiki Care," Diesman said. "It's the gap group that we're trying to ensure has coverage."

End of quote

I guess the abysmal failure of exactly such an initiative in hawaii wasn't enough (and neither the failures of it in europe and canada etc...), oh well...

 

I think the funniest part is their suprise at this:

"People who were already able to afford health care began to stop paying for it so they could get it for free,"

 

 

Reply #27 Top

neither the failures of it in europe and canada etc
End of quote

Oh, it's a failure in Canada? Never noticed it, silly me. I only lived there 22 years of my life.

Sure, it just happen that everybody, down to the last person can go freely to a doc and not have to be worried about the bill. Or go to the hospital with your kid and only (and only) be worried about your kid's health, and not how your premium is going to get higher - nor the basic franchise you'll have to pay. Or the amount you will exceed on your contract's limit. Damn it, your doctor is telling you that it would be way healthier to stay in observation for 3 additionnal day, but you're insurance company won't pay for it? Sucks to be american then. Not so over the 49th parallel

It's not perfect - what is?!?! - but it's not a failure. Not by a long shot. My personnal beef with the system is that in many area, it is illegal to pay for an additional private insurance if you don't want to go into the governement-administrated hospitals. Which means those who want to pay for an additional premium to have the choice are not allowed. (You are still allowed to pay cash/credit card if you want to go to a 100% private clinic).

What you people don't understand is that there is not "free healthcare". Nada. No way. We pay more tax than you, simple as that. Hawaii just didn't thought of the consequences of providing an universal free healthcare system to it's citizen's children.

Reply #28 Top

Oh, it's a failure in Canada? Never noticed it, silly me. I only lived there 22 years of my life.
End of quote

Well it is kind of hard to keep up with events half a world away.  You should go home more often. ;)

Reply #29 Top

Quoting Dr, reply 3

Oh, it's a failure in Canada? Never noticed it, silly me. I only lived there 22 years of my life.


Well it is kind of hard to keep up with events half a world away.  You should go home more often.
End of Dr's quote

Na. Only been 3 months away, and I heard it actually improved since I left.

Reply #30 Top

Na. Only been 3 months away, and I heard it actually improved since I left.
End of quote

Be it ever so humbel, there is no place like home. ;)

Reply #31 Top

In the US if you need treatment and you don't have insurance / your insurance wont pay, you get it for free (medicaid / medicare).

Also... I quickly searched for the bane of all socialized health care... wait times. "Wait times canada" in google quickly revealed this site:

http://www.health.gov.on.ca/transformation/wait_times/wait_mn.html

Where you can look up your wait times for various operations... I quickly searched some, some simple things had a wait time of only a few weeks, then again, heart bypass had a provincial target of 185 days wait time. that is half a year.

If you need serious surgury, waiting months to years to have it is a failure. If there is something I am missing here, please inform me of it.

Reply #32 Top

Sigh... the health care thing again... 

If you need serious surgury, waiting months to years to have it is a failure
End of quote

I live in Canada, and have friends and family members that have had life-threatening conditions requiring operations. They recieved these operations very promptly with no problems.

The horror story that you hear about wait-times are mostly over blown and almost always misunderstood. If you have a serious, life-threatening condition you get priority and you will certainly not be waiting half a year with nothing stopping you from dying until then.

But, the proof is in the pudding, which is that per capita Canadians have a lower infant mortality rate, longer lifespan, and pay less for healthcare (through taxes) than you do in the U.S!!!!

There is a good reason why ALL of the other G8 nations (with exception of the States of course) have a form of universal healthcare.

In the US if you need treatment and you don't have insurance / your insurance wont pay, you get it for free (medicaid / medicare).
End of quote

hhmm, that's interesting. There must be some pretty big holes in that system that folks can slip through as I have some friends from the States who almost cried when they moved to Canada and realized the difference between your healthcare system and ours- namely, they had a litany of friends and family who had to take out second mortgages or declare bankruptcy to pay for medical bills...

Also, a co-worker of mine was working in the States and he collapsed on the job. They rushed him to a hospital where it turned out he needed an operation to remove one of his organs. Price tag in the U.S- approx $ 100,000 once all was said and done, or, he could go to Canada and have it done for free. He asked the docs to stabilize him and he had the operation done in Canada, almost immediately after he arrived back in country

 

Reply #33 Top

Price tag in the U.S- approx $ 100,000 once all was said and done, or, he could go to Canada and have it done for free. He asked the docs to stabilize him and he had the operation done in Canada, almost immediately after he arrived back in country
End of quote

Cost was about the same.  You just footed the bill for him, without any way to 'know the figgers,' as they say.  'Free' is a fantasy.

Reply #34 Top

I love the term "non life threatening"... sure it is non life threatening.. and by the time you get it your health is severely deteriorated...

In theory some people can fall through the cracks in the USA, on the other hand some people have to wait longer in canada... both systems have their flaws... BUT!:

1. Bankrupcy is not PAYING for an operation, it is saying you cannot pay so the bill just goes away... if I have 50k in assests that i worked hard to get, but then i need some expensive operations to live and it costs 500k, i can just get the operation, declare bankrupcy, and start again from scratch, really it is no big deal. (and that is assuming i did not have insurence to begin with! in which case how the fuck do I have 50k in assests?). Your crying friends were just ignorent of the systems and full of fear, so they chose what SEEMED like a better plan...

2. As daiwa said, the COST is the same, it still costs 100,000k... you only make other people pay for it, so instead of taking a second mortgage, the healthier tax payers pay for it, like the ones who didn't smoke, eat healthy, and excercise regularly, yea, they are paying for your mistakes...

Ofcourse it COULD be something completely random and beyond your helping, such as genetic factors, in which case bad genes are subsidized to permiate through society...

And before you bring accidents / attacks, incedents are covered by the insurence of the place of incedient (got shot somewhere? the store insurence pays, etc...)

And at the end of the day, both systems limit how much you can get. Once your health goes south you can get infintely expensive treatments... But I doubt cadana pays millions per person on anti aids drugs or other such insanely expensive operations.

Reply #35 Top

Everything Artysim just said
End of quote

Amen brother

Reply #36 Top

2. As daiwa said, the COST is the same, it still costs 100,000k... you only make other people pay for it, so instead of taking a second mortgage, the healthier tax payers pay for it, like the ones who didn't smoke, eat healthy, and excercise regularly, yea, they are paying for your mistakes...
End of quote

Hum, false. You know why? the Market.

The market is, in theory, a marvelous thing to set the "proper" value of a thing, based on who is ready to offer how much, and who is ready to supply for how much. That way, there is the most economical efficient production available.

So, in the US, hospitals have to turn a profit. They are an industry, right? The cost they charge for their operation is defined by the market, not the situation. While in Canada, it is always "at cost", since no one is looking for a profit in the universal healthcare system. So, that 100K operation might have become... 80K? 60K? Who really knows how much costed the staff, the doctor and the operation room? When you take out the "hunt for profit" of the equation, you might end up with much lower costs.

You know that the U.S. have the highest rate of unnecessary surgeries in the world? That's what happen when your hospital is more concerned about its profit margin than your health.

Reply #37 Top

Bankrupcy is not PAYING for an operation, it is saying you cannot pay so the bill just goes away... if I have 50k in assests that i worked hard to get, but then i need some expensive operations to live and it costs 500k, i can just get the operation, declare bankrupcy, and start again from scratch, really it is no big deal. (and that is assuming i did not have insurence to begin with! in which case how the fuck do I have 50k in assests?).

End of quote

That is a VERY good point. I wonder why they didn't address that in their immediate replies.

Incidentally, getting insurance is a form of voluntary socialism. And while government does indeed pick up the costs for those who (really) cannot afford the price, I do think that those who can are morally obligated to get insurance and PAY into the system that will pay for them when necessary.

 

So, in the US, hospitals have to turn a profit. They are an industry, right? The cost they charge for their operation is defined by the market, not the situation. While in Canada, it is always "at cost", since no one is looking for a profit in the universal healthcare system.

End of quote

Must be tough getting good doctors in that case. I know the differences in quality between German dentists ("at cost") and Irish dentists (fantastic profits).

 

Reply #38 Top

That is a VERY good point. I wonder why they didn't address that in their immediate replies.
End of quote

Because I really don't understand that point. Getting bankrupt is a valid healthcare plan in the USA?

What about follow-ups on the operation? What about the time in observation? What about medication you have to take afterward?

Must be tough getting good doctors in that case. I know the differences in quality between German dentists ("at cost") and Irish dentists (fantastic profits).
End of quote

Good doctors? Not that tough. Very good doctors? Yhea. They are all going into the Very Expensive Hospitals of the U.S.A., and are only providing for the very rich. So I'd say it would be just as hard for you to get very good doctor as it would be for me. Except if you have a practically limitless insurance, off course.

But then, if you have that kind of money, you can very well take a plane to go take Very Good Doctor pretty much anywhere in the world. I don't see the Canadian's system weakness here.

 

Reply #39 Top

Because I really don't understand that point. Getting bankrupt is a valid healthcare plan in the USA?
End of quote

The point is that the only difference - to the end user - between Canada and the US is who pays.  In the US, the person who can afford it pays.  In Canada, everyone pays regardless.

Reply #40 Top

They are all going into the Very Expensive Hospitals of the U.S.A., and are only providing for the very rich.
End of quote

A myth.  Just as you explode the myths of the Canadian system, I must call you on these myths as well.

Reply #41 Top

The point is that the only difference - to the end user - between Canada and the US is who pays. In the US, the person who can afford it pays. In Canada, everyone pays regardless
End of quote

But everyone needs healthcare. It's a basic human need. It's probably one of product that has the most inelastic demand curve on the supply/demand graph! It's not like a car, where you might need it less if you do not work, or if you change some parts of your lifestyle. You will always need healthcare! With or without a job!

Reply #42 Top

A myth. Just as you explode the myths of the Canadian system, I must call you on these myths as well.
End of quote

Ok. But please tell me exactly how can an hospital that is looking toward a (juicy) profit margin can pay a lot more their doctor without charging more?

Reply #43 Top

But everyone needs healthcare. It's a basic human need. It's probably one of product that has the most inelastic demand curve on the supply/demand graph! It's not like a car, where you might need it less if you do not work, or if you change some parts of your lifestyle. You will always need healthcare! With or without a job!
End of quote

Needs?  Not really.  Wants - most do.  But needs?  How did mankind survive without it for 100,000 years?  You do need (see I used it too) to be careful with words.  I will agree what MOST need it at some point. 

But all that is irrelevant to the point.  The point being that in the US, those that can pay for it themsevles.  IN Canada and other countries, all pay regardless of the recipient's abilty to pay.  IN a way, we are more socialist in that respect than you.  We soak the rich!  And provide for the poor.  And in the US, you have health care by law.  Whether you can pay for it or not.

Reply #44 Top



Because I really don't understand that point. Getting bankrupt is a valid healthcare plan in the USA?

What about follow-ups on the operation? What about the time in observation? What about medication you have to take afterward?
End of quote


I think his point was that if you don't have the money, even in the US government will pick up the bill. But if you do have the money, you should get health insurance.

The example here of someone working in the US and going back to Canada for an operation was apparently about a person who did have an income, could have bought health insurance, and didn't. Instead he got his fellow Canadians to pay for it, from a fund he didn't pay into as he worked in the US. Is that not right?




Good doctors? Not that tough. Very good doctors? Yhea. They are all going into the Very Expensive Hospitals of the U.S.A., and are only providing for the very rich. So I'd say it would be just as hard for you to get very good doctor as it would be for me. Except if you have a practically limitless insurance, off course.

End of quote


Well, all I can say is that I saw (and felt) the difference. And I am neither very rich nor do I have limitless insurance.




But then, if you have that kind of money, you can very well take a plane to go take Very Good Doctor pretty much anywhere in the world. I don't see the Canadian's system weakness here.

End of quote


The point is I don't have that kind of money. I just have enough to buy insurance.

Reply #45 Top

Ok. But please tell me exactly how can an hospital that is looking toward a (juicy) profit margin can pay a lot more their doctor without charging more?
End of quote

You are confusing Hospitals (most profit making) with specialists.  All the profit making hospitals provide for the poor and make a profit.  How?  marking up the care for those who can afford.

Specialists do not work for hospitals.  They work for themselves and charge you for their services.  So your Great doctors do not treat the indigant (actually most do on a pro-bono basis), but can charge a lot to their clients.  But all will get that heart operation regardless of the ability to pay.  And in some cases, the ones that get it off the taxpayer dime get better service as great doctors are not created out of dust, but have to rise up through the ranks just like the mediocre ones.

Reply #46 Top

Quoting Cikomyr, reply 16


Charity are usually localised, and better endowed in areas where the economy is doing better, there are more people with more money to give.

In places generally poor, or where the economy is going down, there would be less donations, and quality of the healthcare would be greater lessened. Charity just don't fit the bill when it comes to medical coverage.

End of Cikomyr's quote

Most of the major charities are nation wide.  The United Way, Salvation Army, Purple Heart, Red Cross, American Cancer Institute, etc. are all just a few examples.

Moreover, there are a ton of charities that fit the bill when it comes to medical coverage. I think you need to research this topic a bit more.

Reply #47 Top

Quoting Cikomyr, reply 41

But everyone needs healthcare. It's a basic human need. It's probably one of product that has the most inelastic demand curve on the supply/demand graph! It's not like a car, where you might need it less if you do not work, or if you change some parts of your lifestyle. You will always need healthcare! With or without a job!
                
End of Cikomyr's quote

But not everyone needs healthcare equally.

That's the fundamental problem with "universal" healthcare.

Often times, the least productive are also the least healthy and they get their healthcare subsidized by the productive and healthy.

The reason why the issue is never really resolved in political debates is because the debate falls on the wrong issues: It's not about cost. It's about principle.  Individualism vs. Collectivism.

Americans tend to prefer individualism.  Canadians/Europeans would call it "selfishism" but whatever you want to call it, it's a different in socitieties.

Americans, including myself, fundamentally believe that those who produce more (which is generally translated into having a higher income) should have access to better health care than those who produce less through the purchasing of different levels of insurance. One person should not be paying for the insurance of another unless they volunteer to do that.

Because it's not politically correct to say it, the fact is, most tax payers do not want to be on a level playing field with the poor when it comes to access to health care. They certainly don't want to pay for the poor to have access to the same health care they do.

I don't want to be in line to get a procedure (life critical or not) with someone who hasn't themselves contributed to the system.

We know, deep down, that healthcare is not an unlimited resource. It's a shared resource.  I think quite secretly, most tax paying Americans would love it if tax payers got preferential treatment when using roads.  I imagine there's not a few people sitting in a traffic jam even in California wishing that they had alternative routes to take that only tax payers could make use of.

On health care, it's not just a matter of convenience like roads. It can be a matter of life or death.

Not to put too fine a point on it but why should my son wait an extra nanosecond for treatment in favor of someone else's son who has the same ailment if I'm paying for the healthcare for both? You want to talk about fairness, that is what I find fundamentally unfair about "universal" healthcare.

I look at the 40+ million "uninsured" and think of that as a feature, not a bug, of the system. 

And because of that fundamental difference in outlook, you'll never be able to get agreement on the issue because the two sides are coming from drastically different points of view on what the goal is.

Reply #48 Top

Often times, the least productive are also the least healthy and they get their healthcare subsidized by the productive and healthy.
End of quote

This is true, depending on how you look at it. My follow up question however is what about the old and retirees? By and large, it is this group that is and will be putting most of the strain on your healthcare system with the retirement of the baby boomer generation.

A retiree needing dialysis, hip replacement or even precscription drugs...there's a nice side business for U.S seniors coming to Canada to buy the same drugs at significantly cheaper costs...most likely is not going to be a very productive member of society. Even though they've worked a lifetime, if they don't have good medical coverage or are dependent on an inadequate fixed income (a pension that's stayed the same over the years and has fallen way behind compared to inflation) what should happen to them?

Should they be penalized for no longer being productive, and not having an adequate retirement plan? Should maybe we just euthanize them? That is, after all the most efficient and cost-effective solution.

Not to put too fine a point on it but why should my son wait an extra nanosecond for treatment in favor of someone else's son if I'm paying for the healthcare for both? You want to talk about fairness, that is what I find fundamentally unfair about "universal" healthcare.
End of quote

Because the value of a life cannot be pegged to how much money you do or do not contribute to society. Not to put too fine a point on it, but the decision of who gets treated first should be based on who needs it more and the seriousness of the condition.

Because if you go the route of biggest contributor gets first bids, you kill democracy and might as well go back to the middle ages with a feudal system where those without are beholden to those with.

Again, let's use the fire department analogy.

A fire starts in your town. The Fire Department, being a branch of the municipality, gets more of it's funding from the nicer houses in town and the property taxes and moreover, business taxes, of the people who live in the biggest houses and probably own a couple shops locally.

So, when the fire hits, what would happen if the fire department ignored the less well off houses and ran around to different parts of town to douse the nice houses to ensure that they couldn't be touched by fire? Meanwhile, since the biggest contributors are getting "first dibs" there's no co-ordinated response to the fire or if there is it's an afterthought.

Again, you are correct this is an ideological thing. What kind of society do you want to live in? That is the question. I believe in the concept that we're all in it together. I'd rather live in a system in which no one is left behind, than a dog-eat dog world in which the motto of the day is "screw you, I'm fine!!"

Reply #49 Top

I'd rather live in a system in which no one is left behind, than a dog-eat dog world in which the motto of the day is "screw you, I'm fine!!"
End of quote

The only problem is, our system is not as you characterize it - 'a dog-eat dog world in which the motto of the day is "screw you, I'm fine!!"'.  That is pure propaganda, not to mention fiction.  And your characterization of the Canadian system as not leaving anyone behind is not quite accurate, either - simply defining it as so doesn't make it reality.

Reply #50 Top

Because the value of a life cannot be pegged to how much money you do or do not contribute to society.
End of quote

What are you going to peg it to?  Seriously, you have 2 people dying - all things being equal, how would you decide?