In my occasional series on health care, I have argued that most of the arguments for a "public option" in the provision of health care either don't withstand scrutiny or are based on questionable assumptions. What doesn't withstand scrutiny is the claim that a public option is needed to "introduce" competition or to keep private insurers "honest" (i.e., an argument that competition among private insurers somehow can't do what competition does in the provision of every other good and service we buy), the assertion that insurer companies (through things like policy rescission) somehow have an ability to avoid their contractual obligations that no other provider of goods and services does, the notion that "profit" is rent and of no value and that administrative costs are irrational and gratuitous expenses that accomplish nothing, and the belief that the state would not ration care. The questionable assumptions are that it is possible for a centralized determination of what is and is not good practice and that such determinations are "better" when made by politicians as opposed to business people.
But, we are told, even if all of this is true, a public option will only be one choice among many. No need to fear it because we can simply ignore it.
That strikes me as unlikely. For it to even have a chance to be true, the public option would have to bear the following characteristics.
It must charge participants the cost of their insurance. You can't simply fund a public option by imposing a tax on employers who don't provide private coverage. If the current proposal for an 8% tax is less than what it costs employers to insure their employees, they will drop coverage. Unless someone other than the taxpayer bears the cost of that, there will be little incentive to do otherwise. Employers don't drop coverage now because it will harm them in the labor market. Unless employees forced into the public option bear the burden of the hidden subsidy (i.e, the government charges you $4000 and undertakes the $10000 obligation that such coverage really costs), the private market will be decimated. Even if the public option turns out to provide inferior service, there will few or no competing private options left.
The public option cannot be allowed to lose money. If its costs exceed its revenues for - or in - any given year, it could not be permitted to ask Congress for money. It would have to go into the private market and borrow money. Indeed, as the President himself has acknowledged, it ought to be required to borrow its startup costs at competitive rates.
The public option cannot be backed by the credit of the federal government. Any law establishing a public option would have to expressly state that under no circumstances will the federal government guarantee the obligations of the public option. If that doesn't happen, we will wind up with something like Fannie or Freddie. It will be able to undercut the private market by borrowing at a preferred rate not based on its own financial capability but by the expectation that the government will bail it out. This type of arrangement, as we have come to see, has moral hazard written all over it. In fact, the mere possibility may be reason enough to oppose a public option since Congress could always "take back" its promise not to back up the public option's obligations. Remember there was no commitment to back up Fannie and Freddie, but everyone assumed it would happen. (And they were right.)
The public option cannot be too big to fail. A corollary of the foregoing is that it must be made clear that the public option will be permitted to fail. In other words, the law cannot create a "right" to enroll in the public option that it is independent of its ability to survive as a going concern, i.e., the law can create a public option; it can't create an individual right that it continue to be available.
Subsidies cannot be gamed in favor of the public option. Any system of reform - heck, my system of reform - would provide subsidies to purchase insurance. They cannot be weighted or designed in a way that makes them more valuable for use in purchasing insurance that approximates the public option.
Regulations cannot make private insurance impossible. A prime example would be guaranteed issue at community rates. If that is not combined with a mandate or an extremely strong incentives to insure, it basically destroys the concept of health insurance. That will run private insurers out of business and, although the public option will also bleed money, it will survive as the only game in town.
If a public option does not have all - and, I suspect, other - features, we don't have a truly competitive system. Off hand, I can't think of any public provision of goods and services in competition with private providers that have been structured i this way, so I am skeptical that ObamaCare will be.
But even if it is, there is a further danger with a public option. Supporters of things like public options and single payer systems like to talk about Medicare. Medicare is a prime example of a monopsonistic player throwing its weight around. It pays whatever it wants whenever it wants and gets away with it because it has a lot of insureds. As a result, it worries little about what it's paying for. Good for Medicare but not as bad for our health care system as it might otherwise be because not everyone is eligible for Medicare and costs can be shifted to other patients. Thus, you subsidize Medicare through your taxes and your insurance premiums and what you pay for health care.
But everyone will be eligible for a public option and it will have more bodies than Medicare. When it throws its weight around, there will be less opportunity for cost shifting but what cost shifting does occur will increase the costs of private plans while lowering the costs of the public option, thus driving patients into the public option. As private plans lose patients to the monopsonistic purchaser, their costs are further increased. This is classic monopolization of a market.
Here's the twist. While the public option operates as a monopsonistic buyer, it will also - as it is successful - operate as a monopolistic provider of insurance. The resulting equilibrium will be a noncompetitive - or much less competitive - one. It will probably mean - as it does in single payer and public dominated plans abroad - less care more evenly distributed. The new equilibrium might be more "fair" but far less effective for those who are sick. This is why I would rather facilitate competitive markets with subsidies for those who can't afford to participate.
Of course, there are other possible scenarios. Opponents of strict enforcement of antitrust laws to avoid the creation of monopolies and oligopolies generally argue that, if the noncompetitive equilibrium is less than optimal, new entrants will come in as long as there are not insurmountable barriers to entry. Thus, even if the public option pushes out private providers, they can come back should the public option not meet the needs of the market. That could be the case here and the pushback against the Canadian system might be seen as an example of that.
The problem is that the high degree of regulation and extensive mandates that seem to be contemplated in ObamaCare are barriers to entry.
The other possibility is that the public option is almost immediately seen as inferior. That's the irony of President Obama's reference to the Post Office. FedEx and UPS survive because the Post Office is so bad that it can survive only with massive federal subsidies. (In fairness, there is probably a certain amount of subsidy to rural areas in play here.) Is Obama suggesting that the public option will that be bad? Not intentionally.
That people are concerned about the possibility of a public option destroying the private sector is, of course, borne out by the statements of candidate Obama and so many others that a public option is how "we get to" single payer. It is difficult to see how what Obama and Tammy Baldwin offered as an argument for this plan are "phony" and "dishonest" "distortions" when noted by its opponents.
I guess someone has "gotten wee-wee'ed up."
50 comments:
I'll bet you a cup of coffee that one or more of the usual suspects will soon post a comment averring that "employers will NOT drop their current plans."
That's possibly true, but only in the cases where there is a union contract--and then, only until the contract is up for negotiation.
You can't simply fund a private option by imposing a tax on employers who don't provide private coverage.
I'm assuming you meant 'fund a public option.' That said, the 8% tax would be something that's required to subsidize the uninsured, something you've advocated for on this blog, not to fund the public option. To be sure, some sort of tax would exist regardless of the existence of a public option. Beyond that, if the labor market provides incentive for employers not to drop coverage now (though an increasing number are doing it each year, anyway), I'm not sure why that same incentive wouldn't be there w/ an 8% tax in place; in fact, wouldn't the addition of the 8% tax create more incentive not to drop coverage since there's a direct cost associated w/ it plus the labor market reaction?
The public option cannot be allowed to lose money.
Fine.
The public option cannot be backed by the credit of the federal government.
Fine.
The public option cannot be too big to fail.
Fine.
Subsidies cannot be gamed in favor of the public option.
Fine.
A prime example would be guaranteed issue at community rates. If that is not combined with a mandate or an extremely strong incentives to insure, it basically destroys the concept of health insurance.
Sure, community rating should come with an individual mandate. Works for me.
Medicare is a prime example of a monopsonistic player throwing its weight around.
and
When it throws its weight around, there will be less opportunity for cost shifting but what cost shifting does occur will increase the costs of private plans while lowering the costs of the public option, thus driving patients into the public option.
This is a straw man. House Dems already agreed not to tie a public option to Medicare pay structure and make rates based on direct negotiations with providers.
The problem is that the high degree of regulation and extensive mandates that seem to be contemplated in ObamaCare are barriers to entry.
The regulation and mandates would be the same for the public and private plans. If the points you laid out in bold are adhered to, requiring the public and private options adhere to the same regulation and mandates shouldn't be a problem.
borne out by the statements of candidate Obama and so many others that a public option is how "we get to" single payer.
Got a direct quote we can see? Links are especially handy.
I'm not sure why that same incentive wouldn't be there w/ an 8% tax in place; in fact, wouldn't the addition of the 8% tax create more incentive not to drop coverage since there's a direct cost associated w/ it plus the labor market reaction?
Told ya, Rick. There's a phrase to describe this sort of person having to do with "shoe size"...
Insurance companies want everyones medical and insurance records in one place so they can easily deny claims or manipulate people.
On the other hand, people do not have one source they can view insurance company records of denying claims and complaints.
People should know what kind of company they are insured by before it's to late.
I don't know why Shark assumes that for a public option to be pro-competitive, it must have each of the six characteristics he describes. Let's take higher education as an analogy, since it is that part of the economy that employs the Shark. And education is like health care in many ways. It is a service that, centuries ago, people paid for from their own pockets, but increasingly view as a right, or something that at a minimum should be subsidized by government for those who cannot afford to pay full boat. Like health care, higher education has public benefits.
We have a highly competitive system of higher education in this country, and one of the best in the world. It is, in fact, one of our leading "exports": students come from all over the world and pay to study in American universities. Yet public higher education, massively subsidized by the government, coexists successfully with private higher education, even without satisfying each of the Shark's six criteria.
So maybe we should ask whether the public option would be more like UW.
>>> "Told ya, Rick. There's a phrase to describe this sort of person having to do with "shoe size"...
Hey guys, one of you MUST have said something Dad didn't agree with. Shame, shame.
Anon 9:20 your question is a good one but it’s not quite appropriate. UW, like the Post Office, can choose which customers it will serve. A kid is not guaranteed service at either institution – at UW he must be admitted and find a way to pay the tuition, at the Post Office he must pay for the stamp and not try to mail any C-4. Public education and, I would assume, the public option, would not be able to choose their customers. Any American citizen who shows up would be legally entitled to receive coverage, regardless of their ability to pay, the cost to treat them, their intelligence, their sanity, etc.
By the way, public education’s inability to choose their customers is the one factor its main critics never take into account when they make their simplistic claims that private schools are better and cheaper. Private schools can, and must, choose which students they will admit. Sure they take on hard-luck cases but only up to a point they can afford (I believe this is known as rationing). By definition a child who shows up at a private school has parents or family who care on some level about their education, the same cannot be said for certain about a public school child, another general reason achievement will be better at private schools. I’ve never seen an anti-public school person acknowledge these factors.
Anyway, back to the topic at hand, since Shark’s central argument in all five of these posts have been centered on the damage a public option would do to private insurance companies, I’d like to ask him a question. It’s a false choice, but then Shark himself asked a similar question so I think it’s fair: If God himself appeared before you and said, before you get into Heaven, you must answer this question: which would be your greater priority – the private market system and the health of private insurance companies, or patients?
Certainly this topic has significant moral implications that go beyond our fidelity to the free market, just like with a lot of other issues. Banning gay marriage means the wedding ceremony industry loses profits, but for Shark there are larger issues to consider on that topic. Same with legalization of drugs, locating strip clubs in residential neighborhoods, and so on. Even Shark and (hopefully) most conservatives don’t advocate purely laissez-faire policies when it comes to health insurance, because we all know that no private company could make money covering my 89 year-old grandmother who is blind and has heart problems, and therefore would not cover her at reasonable rates.
That’s why I think, Shark, that your efforts on this topic would be better spent explaining why your preferred alternative (I think there is one, though you’ve been vague about it) would be more cost-effective at providing medical care to our Nation’s citizens without bankrupting them or the treasury, without resorting to death panels, and without “rationing” anymore than the system already does.
Because frankly, five posts of varying length full of economic arguments about why the public option will bankrupt corporations or why it’s not consistent with free-market ideology falls flat on this issue, especially with a voter like me. I like the private sector, but if it cannot or will not solve a problem I deem morally necessary to solve (such as this one), I’m willing to accept a government monopoly. I don’t care if CIGNA goes out of business if it means this doesn’t happen.
I've wondered if employees should fear losing there job if they fight a claim denial by their employers insurer?
Tosa, are you suggesting that Rick is amoral, or merely immoral?
As it is now, either private charity, Medicaid, Medicare, or health-system writeoffs assure treatment for the indigent or semi-indigent. (You could call "writeoffs" charity, by the way...)
All parties to the discussion agree that the current system is imperfect, but only Lefties make the argument that Gummint HealthCare will be 'perfect,' or at least MORE 'perfect' than the extant system.
And that's something which you cannot prove, period. To posit that 'because it's Gummint means there will be LESS mistakes' is inane on its face, because believe it or not, mere mortals will also run the Gummint system.
Profits are NOT the question: efficacy IS the question.
And on that question, ObamaCare has lost in the court of public opinion, obviously.
How about Medicare for all with a public option?
The new Medicare would include basic coverage, co-pays, and deductibles designed within the current or slightly higher revenue level. Private supplemental insurance would be available for additional coverage chosen by individuals or groups.
Umnnnhhhh...JP, I think the point is that MORE Gummint insurance is NOT desirable.
Spoken like a true American ... that currently has a job, with a company that currently offers insurance, and doesn’t have a loved one with health problems and no insurance. My advice is, don’t lose or change your job, don’t get sick, and hope like hell that one of your kids or grandkids aren't diagnosed with diabetes while under a high-deductible policy. Because even if you think you have insurance, the industry has this little thing called rescission that let’s them cancel your insurance retroactively. Sorry.
Jack: On Dad's blog, he describes himself as "old" and "nasty." Do you think it's possible that, rather than company-provided health insurance, Dad has that Gummint-provided Medicare?
Good point Anon... and I think he's one of those "compassionate conservatives" too. You know, from the "values" crowd.
Dad no, I am not suggesting Rick is amoral or immoral. I’m sorry I phrased my post in such a way that you could not understand it.
What I said was that, if Rick is going to critique a policy proposal on an issue with the moral implications of health care, he’d be better served by explaining how alternative proposals could be more effective instead of spending his time complaining about the effect on private industry.
Dad said,
“only Lefties make the argument that Gummint HealthCare will be 'perfect,' or at least MORE 'perfect' than the extant system.”
This statement contains two strawman logical fallacies. First, I have never seen a lefty say seriously that government health care will be perfect, nor even “more perfect”. Better yes, perfect no. Second, none of the current proposals would create government healthcare. They would create government insurance.
I imagine you’ll want to pursue the slippery slope logical fallacy at this point.
”And that's something which you cannot prove, period.”
Nor can you prove the opposite. Frankly whether either system is “better” or “worse” will be subjective. For you, any additional government involvement would be worse regardless of any objective criteria because of your emotion-based position on the issue. For most other people, longer waits might make it “worse” in their opinion even if uninsured or under-insured no longer face the problems they do today. No matter what, it will be “worse” for some and “better” for others.
“To posit that 'because it's Gummint means there will be LESS mistakes' is inane on its face, because believe it or not, mere mortals will also run the Gummint system.”
Don’t mere mortals run government and private health insurance companies? If so, they’re all equally incompetent so we’re all screwed.
“ObamaCare has lost the court of public opinion, obviously.”
Not really:
Regrettably, almost all of the polls on the public option succumb to one or more of these sins. However, there are two exceptions. One is the Quinnipiac poll, which asks:
Do you support or oppose giving people the option of being covered by a government health insurance plan that would compete with private plans?
This is a perfect question. It makes clear that the public option is an insurance program, rather than a program to provide health care services. It uses the less ambiguous phrase "government" rather than the more ambiguous phrase "public". It makes clear that the public option is a choice. It avoids leading the respondent by comparing the public option to Medicare. And it asks in unambiguous terms whether the respondent supports or opposes the proposal.
62 percent of people support the public option in Quinnipiac's August 5th poll, versus 32 percent opposed.
I think they put the public option in mainly to generate public support, and unfortunately the public does not fund their elections. The public option likely will not survive, but HR3200 will, and that will be a travesty.
Its 1000 pages is going to require a massive bureaucracy to administer, and should be shot down in is totality or vetoed by Obama. The most sensible bill of all is HR676 Medicare-for-all that extends first-class Cheney-care to 100% of our people and saves the country $400 billion in the process. But as well it removes the cost burden from our businesses and reduces their need to terminate or outsource jobs.
Yea, it transfers the 31% of insurance bureaucracy waste and instead spends it on health care for the 47 million uninsured. And the industry hates that, and so do even some right wingers.
"On Dad's blog, he describes himself as old and nasty."
The only things there that aren't lies.
Dear Dad;
How many people are on public insurance such as Medicare, Medicaid, SCHIP, Badger Care, and whatever?
My desire is to insure those who cannot afford private insurance and do not qualify for public insurance.
Dear Dad;
I,m anon 11.52 a.m.
government health care will be perfect, nor even “more perfect”. Better yes
You, too, have reading-comprehension problems, Teacher...
Frankly whether either system is “better” or “worse” will be subjective.
Not so. There is VA, Medicare, and (to an extent) Medicaid. So there IS a track record.
They would create government insurance.
Yup, I erred. It's the INSURANCE which will be "better." So sorry.
Don’t mere mortals run government and private health insurance companies? If so, they’re all equally incompetent so we’re all screwed
And only an ideologue would conclude that 'adding a Gummint program' would, therefore, be an improvement, Teach.
Q'piac: ...that would compete with private plans
Deceptive, precisely as Rick argues at much more length. How Q'pac and the respondents define "compete" is obviously critical. But a nice try!
My desire is to insure those who cannot afford private insurance and do not qualify for public insurance
See Wyden/Bennett or the Ryan plan.
Dad: You didn't answer the question: are you getting that Gummint-provided Medicare?
And, sure looks like time to write Greatgrandson29 out of the will, doesn't it?
Uh, Dad, I suggest you take the VA off your dart board:
The Best Care Anywhere
Ten years ago, veterans hospitals were dangerous, dirty, and scandal-ridden. Today, they're producing the highest quality care in the country. Their turnaround points the way toward solving America's health-care crisis. See http://tinyurl.com/6rasu
Yea, its been overworked lately because of Bush's (and now Obama's) wars, but it's pretty good.
And Medicare? I see the same doctor as before and I don't have some yokel CEO pulling the plug to increase his profits and salary.
And that said, I'm glad to see that you intend to opt out when you retire (which doesn't sound too far off).
Excellent point, Jack. I always find it entertaining to watch Fix News Sunday and have Chris Wallace and panel discuss the parade of horribles of a public option for health insurance and then at the end see, as the "Power Player of the Week," somebody from the Walter Reed Medical Center. It seems like every other week someone from Walter Reed is the Power Player of the Week.
Unhhh...nope. I put VA/Medicare/Medicaid up there because they ARE comparo points.
Unlike Obama, who lies by nature, I think the discussion should be fair and accurate.
Now shall we talk about Medicare/Medicaid cost-shifting, which is also called "rationing"?
It is incorrect to call Medicare "rationing" or even "cost shifting." As a Medicare provider for over 20 years I was always reimbursed slightly over costs, which represents a slight profit. All Medicare reimbursements provide a slight profit.
But it isn't exorbitant as the privates are (sometimes 400% of costs). But I'll give you that Medicaid is under cost and as a result cost shifting and rationing (denial of care) occurs. But under the Medicare-for-all system that those wild left wing liberals support, there'd be no more Medicaid or cost-shifting or rationing. Hopefully we'll get the compassionate conservatives to sign on.
there'd be no more Medicaid or cost-shifting or rationing
Yup, Jack, and the Easter Bunny will personally deliver babies as well as hardboiled eggs and candy.
When one proposes to add 46 million people to "free healthcare" rolls AND states that there will be "savings" as a result, one should be categorized as a loon.
But you are correct: there will be no cost-shifting under ObamaCare. There will be cost-reductions instead. Just like in England and Canada.
Maybe you want your daughter to give birth on the sidewalk, Jack.
I have a helluvalot more compassion than you do.
Dad, your statement above that "cost-shifting" is the same as "rationing" tells me that you have absolutely no expertise in health care. Just another political hack.
One has nothing to do with the other. Cost shifting is "increasing private bills to offset losses in charity work." With Medicare-for-all there are no losses to shift.
"Rationing" occurs today, but more so with private insurance than with Medicare. Remember the 17-year-old girl in California that was denied a kidney transplant and DIED? That was Cigna, not Medicare. Now, THAT is what we in the industry call rationing. But it's by the for-profit insurance executives whose salaries and bonuses are affected by the amount of expensive care they can get paid for but not provide. The parents had paid their Cigna premiums, they just got denied care.
Is Medicare perfect? Absolutely not, and I've written about that. But it is better than the private insurance bureaucracy that drains 31% of costs from the system to offset high CEO salaries, broker commissions, actuarial costs, shareholder profits, and even their lobbying and campaign contributions that are passed on to the patient.
We don't have room here to discuss all of the right-wing lies about Medicare, but suffice to say that we spend twice the dollars than Canada and England and we won't have mothers giving birth on sidewalks. Or 17-year-old girls dying unnecessarily in California.
You are doing yourself and your family a great disservice by not becoming more educated on the issue than you are. You are shooting with blanks rather than bullets. For a full description of Medicare-for-all see http://moneyedpoliticians.net/medicare-for-all/
>>> "When one proposes to add 46 million people to "free healthcare" rolls AND states that there will be "savings" as a result, one should be categorized as a loon."
And just so you don't have to use your high-tech calculator, the 31% of administrative costs that are "saved," will offset the costs of adding 46 million people to the rolls. A more efficient way of using our money.
And NOTHING is free, though I know you right-wingers like to pretend that we don't understand math. We'd still pay for healthcare but rather than the myriad ways we are paying today --- cost-shifting, bankruptcy costs, and when employers add their costs to the price of their product and we reimburse them at the cash register --- we'd pay through our national infrastructure instead.
Yea, TAXES! But we'd save money in the process and we'd free businesses from the burden that has helped send jobs (and cash) to other countries.
An insurance company bureaucrat has an incentive to "pull the plug on
Grandma", their profiteering bonus is riding on how little (and how
slowly) hey can pay out in claims. A government bureaucrat has no such
incentive. And anyone who believes that the democrats are trying to bring
healthcare access to all Americans so that the plug can be pulled on
people's loved ones has been completely deluded.
Sean, right-wingers aren't interested in facts. They are ideological, not pragmatic.
Well Jack, one should expect little else from strict adherents to a failed utopian ideolology.
"has been completely deluded."
They're completely deluded to begin with.
We don't have room here to discuss all of the right-wing lies about Medicare, but suffice to say that we spend twice the dollars than Canada and England and we won't have mothers giving birth on sidewalks. Or 17-year-old girls dying unnecessarily in California
17-YO girls on Medicare and you call ME 'ignorant'?
I note you've reverted to form: it's all the EEEEEEEEEEEEEVIL insurance companies. Boring.
Cost shifting IS another word for rationing because when Medicare/Aid does NOT pay U&C, they are RATIONING dollars, Jack.
Geez, you are thickheaded.
A government bureaucrat has no such incentive
Umnnhhh...nope.
Just like Doyle "has no such incentive" to ration highway-rebuilding dollars in order to feed WEAC.
Oh....wait!! He did RATION highway dollars, and now the 894/94 interchange may literally disintegrate before our eyes.
Grow up, naif!
"And anyone who believes that the democrats are trying to bring
healthcare access to all Americans so that the plug can be pulled on
people's loved ones has been completely delude."
I have seen dumber statements before, but not many. When Jack called that 'factual' he lost all credibility I had attributed to him to this point.
So Sean, you think 'righties' believe Democrats are pushing public healthcare so that the plug can be called on people's loved ones? Politicians are a hell of a lot more crooked and greedy than insurance CEOs. It is all about re-election and the money needed to get there, not care for you or me.
Tuerqas
I did NOT say the 17YO girl was on Medicare. I DID say that it was Cigna that refused to pay for the transplant. Not that "evil government Medicare system" that supposedly rations all of the care.
And please, I spent 40 years in health care. I do know what "usual and customary" charges are. We called them "whatever you can get away with." They have absolutely nothing to do with "the costs of the service." Medicare pays OVER costs, leaving the physician with a PROFIT. No need to cost shift!!!
For 15 of my 40 years in the business I provided a mobile echocardiogram service in which I charged $300 per patient for a 30-45 minute test. After interpreting the echo the doctor billed and was paid $400 (less the 20% co-pay). A 33% margin.
But some doctors billed the privates $1800 for that same test and got away with it, because the stupid insurers simply passed on the costs to the policy holders. A 400% profit, sometimes needed to cost shift.
Medicaid is another story. It's one of the reasons we need to expand Medicare to all Americans. Doctors should not be expected to take a loss and have to cost-shift. Learn the system Dad, or stay out of the argument.
And Oh, you're "bored" about hearing about those bad insurance companies. Tsk, tsk. That must mean they're no longer a problem, or the problem went away, or YOU are not affected by them. Thus we should now just let them off the hook. Quit talking about it.
Duh!!!
Geez, you are uninformed. But I'm sure fat with insurance.
Tuerqas, No the Dems are not trying to pull the plug on granny, and neither are the R's. But the R's ARE INDEED making wild claims against the dems, unless you've been AWOL over the last month. So please, consider me one of those wackos that believe the R's are being absolute scaremongers and liars on the issue. And in Dad's and your case, uninformed.
We called them "whatever you can get away with."
Gee, Jack! That sounds like you just might have been a rapacious, EEEEEEEEEEEEEEEEEEEEEVIL capitalist swine.
Are you sure you weren't in the insurance industry?
Your problem, Jack, if you choose to accept it, is this: you found that there are some people in the system who are rotten bastards.
What you adamantly refuse to accept is that rotten bastards will continue to be in the system, regardless of who's running it.
But if anyone will challenge the bastards, it is PRIVATE INDUSTRY, not the Gummint--as shown over and over, and over again with 'waste & corrpution' scandals in Pentagon, Medicare/aid, Social Security...ad nauseam.
Yea Dad, I'm a capitalist. I was a business owner in competition with other business owners. But I did not have the luxury of charging for services and then denying them retroactively, after collecting money to pay for them. You can look up the definition of "rescission".
Rescission: Private insurers can cancel a policy retroactively if they find any minor flaw in the application, such as the failure to report acne when you were a teenager. Even if you have major surgery scheduled.
Yea, there are rotten bastards that bribe our politicians to block any reform that benefits the public. And those politician bastards perform as expected. Do you really want your country governed by bribery?
And if "private" was so much better than "public," why do private Medicare plans cost the taxpayers 17% more than traditional Medicare?
Oh, here's your PRIVATE INDUSTRY efforts.
You all seem to be getting all wee-weed up.
I still want to know if Dad has Gummint-provided Medicare. But he's not telling.
Well, he may or may not have it now, but when he turns 65 I can assure you that he will be on Medicare. And he'll love it.
In addition, he will be able to purchase privately any additional coverage he desires.
Sean wrote: "An insurance company bureaucrat has an incentive to "pull the plug on
Grandma", their profiteering bonus is riding on how little (and how
slowly) hey can pay out in claims. A government bureaucrat has no such
incentive. And anyone who believes that the democrats are trying to bring
healthcare access to all Americans so that the plug can be pulled on
people's loved ones has been completely deluded."
Jack responded: "Sean, right-wingers aren't interested in facts. They are ideological, not pragmatic."
You are calling Sean's word fact. Now I guess you could read his text in such a way as to believe that no one is deluded because no one believes that Democrats are trying to pass healthcare with the intent to kill Grandma, but that is clearly not the way he meant it. So you seemed to believe that right wingers (a somewhat vague term to me) think that Democrats are trying to pass health care with intent to injure, and since your response was to call me uninformed, not to retract, I can assume you to believe it to be fact.
All I had said was that politicians are a lot more crooked and greedy than insurance CEOs. I believe I can defend that statement. Crooked goes hands down to politicians, CEOs can stay within the law to make their millions. While you could argue that they are equally greedy, I will point out that CEOs are hired to make money. It is their job.
Politicians are hired to serve us, it is not their job rip us off and take money knowing that it will specifically and directly hurt the people who 'hired' them. You want Government to take over healthcare? I say first prove you can handle it. Pass tort reform that was your responsibility in the first place. We all know how likely that is and how incomplete it would be if they did do it due to the special interest money thrown from many lobbies at every politician. If the Government can't even admit their part in the mess, much less fix their own portion in the first place(a portion that no one else can legally fix) why would anyone want them to take it all over?
And I am deluded and uninformed?
I believe Government should first clean up their part in today's healthcare morass before takin over the whole project. You believe 'right wingers' think Dems want to pass healthcare to kill Grandma? I ask: Who is the idealogue between you and I Jack?
Tuerqas
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