Ray Jay wrote:So, this begs the question: what is Utah doing that works so well? Basically they have the same hodgepodge health care system that the rest of the US has.

How about having the youngest population in the country by a very, very large margin?

bbauska wrote:Why is there no "war-weariness" when it comes to the War on Poverty that LBJ started? We have been fighting that war for 40 years, and things are not getting better according to those on the left. t.

Actually, it's closer to 50 years. Johnson announced it in 1964.

Not quite 50, but just the estimate. I thought it was '66 from memory, and I did not have time to look.

I guess the difference is that I am making the best decisions I can for my family, and expect others to do the same.

If you were making the best decisions for your family, I'd assume you would include current and future generations?
If so, why are you saddling yourself and your descendants with a sytem that costs so much for services delivered no better than most other western systems. (Seldom the best and often significantly less than the best for all the parsing of performance indicators).
The US hodge podge includes elements that include the UK system (VA hospitals) and the Canadian System (Medicaid and Medicare) (And the UK and Canadain systems are fairly crappy compared to many others) and private insurance system ...
And your family ends up paying more when you combine taxes (that go to Medicare etc) and for insurance and direct costs than a family in any other western nation. You don't have the security of families in other nations who know that, should they lose their job at least their health isn't at risk. Or their savings at risk if their health is stricken.
Is the best decisios to saddle your family with a medical cost inflation rate that outstrips anywhere else on the planet ?
I think you are rationalizing the idea that you are supporting a free market system. You aren't making a rationale decision based on the best for your family, you're being ideological.
First you should disabuse yourself of the notion that any part of the US system is really a free market system. It exists as it does because the internal stakeholders that benefit the most from its ineffficiencies maintain a constant PR battle to sustain their lucrative streams of revenue...
If you set aside your ideology and simply looked at the best value for the dollar with at least the same effectiveness you'd be campaigning for major changes to the system. Becasue that would be the best decision for your family. (especially your grand kids and their offspring.)

rickyp wrote:

I guess the difference is that I am making the best decisions I can for my family, and expect others to do the same.

If you were making the best decisions for your family, I'd assume you would include current and future generations?
If so, why are you saddling yourself and your descendants with a sytem that costs so much for services delivered no better than most other western systems. (Seldom the best and often significantly less than the best for all the parsing of performance indicators).
The US hodge podge includes elements that include the UK system (VA hospitals) and the Canadian System (Medicaid and Medicare) (And the UK and Canadain systems are fairly crappy compared to many others) and private insurance system ...
And your family ends up paying more when you combine taxes (that go to Medicare etc) and for insurance and direct costs than a family in any other western nation. You don't have the security of families in other nations who know that, should they lose their job at least their health isn't at risk. Or their savings at risk if their health is stricken.
Is the best decisios to saddle your family with a medical cost inflation rate that outstrips anywhere else on the planet ?
I think you are rationalizing the idea that you are supporting a free market system. You aren't making a rationale decision based on the best for your family, you're being ideological.
First you should disabuse yourself of the notion that any part of the US system is really a free market system. It exists as it does because the internal stakeholders that benefit the most from its ineffficiencies maintain a constant PR battle to sustain their lucrative streams of revenue...
If you set aside your ideology and simply looked at the best value for the dollar with at least the same effectiveness you'd be campaigning for major changes to the system. Becasue that would be the best decision for your family. (especially your grand kids and their offspring.)

so why didn't Obama fix it? I think that you are rationalizing that this is the Republican's fault.

If I care about my family throughout the future, I would think that is more reason to not saddle them with a huge debt.

That would be caring much more than having a health care system that is not needed by my family (as I think I can decide best which system fits my family's needs the best).

Ricky:

If you set aside your ideology and simply looked at the best value for the dollar with at least the same effectiveness you'd be campaigning for major changes to the system. Becasue that would be the best decision for your family. (especially your grand kids and their offspring.)

I've figured out why this discussion is so frustrating for me. It's all bait and switch. Four years ago (and years before that) we endlessly discussed how expensive the US health care system is ... we elected a president partially on that basis ... he was going to bend the cost curve down ... he was going to take the best ideas from both parties ... if we didn't do this we would go bankrupt ... he then made the health care system more expensive. So now, reformers are going to talk about how we are spending too much per person ... and how we should reform our health care system because we are spending ourselves into bankruptcy (which we are), but then they will put it all in the sausage machine and we will be spending even more at the other end.

Boy I'm grumpy this morning, but at least now I know why I'm grumpy.

Brad, they already have a huge debt - or rather a share in one that at some point will be due.

How do you know that your family will never need anything over and above what your insurance can provide? None of us have the foresight to predict. If (and I hope this never happens to you or yours) things change drastically all your good decisions may count for nought.

The solution does not have to be 'more' government, by the way. A better system of insurance with a compulsory level (see Switzerland) can be less wasteful with good coverage and people can easily top it up with extra cover if they wish.

What it actually comes down to is that the US system is dysfunctional. The last attempt to fix it has been a fudge and a compromise, and is not likely to have a drastic effect. Obama was not a proponent of single-payer when he was campaigning (Edwards and Clinton were on that side of the debate during the primaries) so I'm not shocked that he and the Democrats shied away from it in 2009.

Which is why Ray is also right that there has been some 'bait and switch' in the debate. He's just forgetting that saying the US system was and is flawed and supporting a national solution should not be equated with supporting the last set of reforms.

ray

so why didn't Obama fix it? I think that you are rationalizing that this is the Republican's fault.

Obama is a political pragmatist. Period. He isn't the radical the right makes him out to be... He tries to do what he thinks he can.... His one outrageous ideal, that he could change the political discourse, failed him.
He isn't committed enough to any idea to try and ram it through any and all opposition. He'll make incremental change and compromise. And he obviously has on this issue.
I also don't think, that Obama, or anyone can make a change to your health care system without a major change in the over all attitude towards solving problems. Your political system is byzabtine and complicated and subject to out size influence from stakeholders with money.
Right now those on the right will reflexively take the opposite position of those on the left. In the health care debate that leads to engaging in counter factual arguement on minor points, (like whether the US is 15th or 4th in the world on some individual performance indicator) in order to ignore the large point that the system is crap and needs a change.
It leads to folks like B who beleive that their noble motivations (for the good of their family) somehow support the notion that the continuation of the status quo is appropriate. Those who'd like a change probably have exactly the same motivations... .
B, part of the reason you have acquired the debt level, and is that 5 to 7% more of your nations GDP goes to health care than those nations who'd chosen more pragmatic methods of managing the sector. Digging out of that debt means cutting expenses. If the way to cut those expenses is taken off the table because it doesn't fit with ideological notions ....thats a horrible burden to place on your family for your inflexibility.

okay, so when there is a Democratic majority to the left and in excess of what Obama had in 2008, this will become relevant.

Danivon,
Try this on for a 10 day spread in my life:
Paralysis/Ruptured spine surgery on me, followed by physical therapy
Caesarian Section my wife had
Heart condition for my child just born that required transport to nearby major city and treatment for a few days.
Associated meds for all of above.

I know how difficult medical conditions can be. Do I know what life will bring? No, but I know my values do not include dependance upon the government. I had to depend on family and my decisions that I made before I was ever injured. (insurance/savings/economic lifestyle).

So, because my position is not popular with the Sell-outocrats, it's not worth even thinking about?

I know there's a snowball in hell that decent healthcare reforms will come out of Congress given the way that it's populated, but that does not stop the system being broken.

I'm not sure that the 2009 reforms make much difference, although some of it is only coming into effect now, so it's early to be definite on the outcomes - all we have is guesstimation on both flanks.

Brad - glad to hear you were covered and/or found ways to cope. Do you believe that your entire economic wellbeing is solely a result of your own decisions, and that the decisions/actions of others and that elusive lady known as 'Luck' play no part?

On ARJ's studies, I have also drawn a blank. The nearest I got was an article written by two guys from the Discovery Institute which listed countries and their alleged different methods but did not quantify the effect on IMR comparisons, and a load of op_eds derived from it.

My own decisions.

I had assistance from my church and family, I planned ahead with employment insurance, retired military health care insurance. The only difficulty I had was for the ambulance costs that I asked the local government for a payment schedule to pay this over time. They were the only one who was unmoving in their decision. They would give assistance to those in need, but because I had a job and made a certain amount of money, I was not eligible.

Does that seem fair? No, and that is why I don't want the government to do anything for any citizen, unless it does the same thing for ALL citizens. That is why I expect the same tax rate or the same tax fee. I don't trust the government to be fair, because I lived it.

I don't trust the government to be fair because I lived it. (repeated intentionally)

green is not a flattering colour, Brad.

you seems to be arguing for less healthcare for others because you are too well off to qualify for some.

and as for your first answer, you clearly underestimate luck. And forget that military benefits are paid for by government.

Envious? Hardly.

I am arguing for EQUALITY. All men are created equal. It says that in our founding documents. If some get support from the government, it should be available for everyone. To pick one economic strata over another is wrong and discriminatory.

As too being too well off, hardly. I am debt free because I am austere with my finances. I am not rich by any US Standard.

I don't see what luck had to do with my decisions. It was my decision to pay for 4 years of employment disability insurance at my job at that time. It was my decision to work for 20 years in the military and be away from my family for the benefits of a later lifestyle. It was my decision to pay the entire ambulance bill and have a crappy Christmas because we did not have the money to pay it all at once.

Envious? Puhleeze.
Responsible? Definitely.
Lucky? Not at all.