Yes, friends, there is some real news coming out of Washington these days (hint: it has nothing to do with Barack Obama's bowling score) and Marc Ambinder has it:
This is big news: Democrats have mapped out their legislative strategy for passing health care reform this year. According to George Stephanopoulos, Democrats will work with Republicans to build consensus around a plan, and then, if that doesn't work, they'll write the revenue-generating-and-substracting provisions of whatever health care plan they come up with into the FY 2010 budget resolution. As important: the budget reconciliation process, which circumvents moderate Democratic and GOP discontent in the Senate, will NOT be used to set up a carbon emissions credit trading system. Cap-and-trade was always the tougher sell to Congress.If this is the choice that the White House has made, I'm not surprised, as it's an instance where the economic logic dictates the political logic. When the economy slows down, two things happen. First, less carbon is emitted. Nobody likes to say this in polite company, but a global economic near-depression is probably the single best "program" one could imagine for curtailing carbon emissions. Vehicle miles traveled are down in the United States in spite of significantly cheaper gas prices; industrial production has slowed; China and India are not increasing their carbon usage as fast as anticipated. This presents one small hedge, at least, against the decline in welfare that is otherwise brought about by an economic crisis.
The second thing that happens is that tackling warming recedes as a concern in the eyes of the public. Whereas almost 60 percent of the public described the environment as a top priority a year or two ago, that number is now down to about 40 percent.
Health care problems, by contrast, tend to worsen in a down economy. The chart below indicates the percentage of Americans covered by private health insurance; recessions are indicated by yellow bars. There has been a secular decline in this number over time because of the graying of the population and other reasons (various government-run programs have made up some of the difference, but hardly all), but the problems have been particularly acute during and immediately after recessions.
(Note: this chart corrects in a change of accounting methods made in 1999).
For obvious reasons, moreover, a more robust alternative to employer-based health insurance is probably more appealing to Americans when more of them are concerned about losing their jobs. I don't want to call health care an easy sell ... but it's a fight where the White House ought to be favored.
The risk in putting off cap-and-trade, of course, is that "later" may turn out to mean "never" -- and "never" is not an acceptable alternative when we are near so many environmental tipping points. It's easy enough to imagine a scenario in which the economic recovery is slow in coming, the Dems become skittish about advancing cap-and-trade in an election year (2010), they nevertheless lose a bunch of seats during the midterms, and then Sarah Palin gets elected in 2012 and we're all burning moose dung and invading Alberta a few years later.

137 comments
"Sarah Palin gets elected in 2012" - There was no need to scare your readers like that.
I just couldn't reconcile "It's easy enough to imagine a scenario in which...Sarah Palin gets elected in 2012". That just doesn't compute.
Great Nate! You can't get this info and analysis anywhere else!
Absolutely agree. The chart should be the main talking point for Obama and the Dems.
As for cap-and-trade, we need to come up with something simpler. It's just too complex and easily attacked.
I see that the only time the fraction of Americans insured went up was during the Clinton tech bubble. It went down straight through the Bush housing bubble.
Another way to look at it is Clinton --> mostly up (1993-1999, until the bubble burst in 2000), Reaganomics/Voodoo economics under both Bushes--> down.
Given a choice between a Democratic bubble and a Republican bubble, I can only cite the Sufi story of the man who asked his camel whether he preferred the road going up or the road going down. The camel replied, "Since my master gives me the choice, I prefer the level road."
Invade Alberta? Ridiculous! Obviously if and when we invade Canada it will be via a naval assault on British Columbia. HELLO!
FiveThirtyEight clearly needs a military analyst who specializes in invasions plans for countries with which we are closely allied.
It's true that health-care plays more naturally into the concern for the economy.
However, it's too facile to say that the slow-down in the economy (resulting in a reduction in emissions) puts the global-warming/carbon-dioxide issue "on hold": the problem is that, as long as we hold off on action, we continue to build up infrastructure based on consumption of fossil fuels, thus building up more and more "momentum" for more and more CO2 emissions. Since we need to spend tons of money to stimulate the economy anyway, why shouldn't we apply a substantial portion of that towards turning the energy-production ship around: from fossil fuels to renewables?
I could actually go for replacing the delicate and fussy regime of cap & trade by a straight-forward CO2 tax (which has been initiated in Europe with some start-up problems): It would be simpler, more flexible, and easier to "tune". Everybody that's compared these approaches agrees that it's technically a better solution. The only difficulty is that it has the "t" word: tax.
There's one thing I was hoping to see mentioned, but didn't. While the number of privately insured Americans decreases during a recession, empirical evidence has shown that the total number of Americans with health insurance increases during recessions because many more Americans qualify for public insurance.
Single payer or government control of more of the health care system will not pass. Dems are already heading for the hills.
With next year being an election year, even fewer will be willing to chance there seat.
Is cap-and-trade being put off, or is it just being timed well by an intelligent administration? It seems to me like the winter or the spring are not the ideal times to debate a fairly controversial climate change bill - you would want to do it in the summer or the early fall.
there is no situation which i can see that it would be "easy" for palin to become pres
It's easy for me to envision a situation in which Sarah Palin is elected President in 2012:
The lower 48 states (and Hawaii) are all destroyed in a global catastrophe. Only the cockroaches who love Sarah Palin in Alaska (and they are less of them now than last year) are still alive. Sarah squeaks through, beating out Tom Davis by 10 votes. Unfortunately, Mark Elias is not around to litigate the election contest.
Interesting post, as usual. Three comments:
1. I'm curious what you make of Christopher Ruhm's research that recessions are actually good for us (health-wise) in much the same way they might be good for the environment.
2. It's debatable from the chart you show whether or the drop in health coverage is the result of recessions, are simply Republican administrations.
3. Re: Geoff Johnson, you've got the geography of Palin's invasion right, but not the rationale. We don't really have much in the way of oil here in BC, but Alberta's got plenty. And to that I say: Please take Alberta! Then we can return Canada to its history of relatively progressive politics...
If you follow the old rule about Presidents getting 18 months to push through a legislative agenda, then just concentrating on the economy until it is fixed is not an option. Thats how the Republicans get elected again. Healthcare really can't wait. The environment can't wait.
Its the fierce urgency of now!
Here's a more accurate way to read your graph: people lost their health insurance when a Republican was president and got it back when a Democrat was president.
Health Care is THE NUMBER ONE ISSUE, imo. The costs are just sky rocketing out of control, and the number of those afflicted has also skyrocketed. Right now, 1 in 8 women will get breast cancer in her lifetime. 1 in 8 men will get prostate cancer. Add those to the risk of diabetes, colon cancer, lung cancer, heart disease, etc., it adds up to a lot of medical care.
Our businesses like those in Detroit are going bankrupt because of healthcare. It cripples small businesses. Our government, because of Medicaid and Medicare, is going bankrupt. Our citizens, even those with healthcare are going bankrupt. It NEEDS to cost less, or it will be the destruction of our families, our businesses, and our country.
No way Palin gets elected. She has too much respect for the Special Olympics. This country is not ready for filth like Palin who doesn't see the humor in making fun the mentally disabled.
Health care reform and increasing employment go hand-in-hand. At every company I have worked at in the past ten years, the reason for not hiring new people was the cost of "benefits" (i.e health insurance). As we've also seen, the exclusion of "pre-existing conditions" means that having health care coverage through an employer does not necessarily translate into actually being able to get health care paid for.
How is that cap-and-trade idea going to keep China, India, and Africa from producing more carbon dioxide than we do in the years ahead? Cap-and-trade is stopping the problem here, but we are becoming a much smaller part of the problem...
http://www.china-profile.com/data/fig_co2-emissions_2.htm
Keep focusing on the small problem Nate (with no look at the big picture), and wrecking our economy, that way we can all become like Britain even faster...
This is the dumbest, most self serving assinine thing Nate has ever posted:
"It's easy enough to imagine a scenario in which the economic recovery is slow in coming, the Dems become skittish about advancing cap-and-trade in an election year (2010), they nevertheless lose a bunch of seats during the midterms, and then Sarah Palin gets elected in 2012 and we're all burning moose dung"
Really? Rolling out one of the most job killing things I can imagine is actually GOOD for Obama? Oh, that is just great analysis there Nate!
It is also easy to imagine a scenario where a young whiz kid from U of C ruins his reputation before he can get his book out and has to pay back a large portion of the $700,000 advance he took to write a book because he cannot seel them. The farther we get from the election, the harder it will be for Nate to sell books.
I guess it comes down to how the Democrats approach this. Obama has said more than once that the recession will mean everyone has to put off some things they want, and that's going to include Obama putting off some of his priorities. Several groups the democrats have promised to help-- immigrants, LGBTs-- have already been as good as told that their priorities will not be on the agenda until next year.
So if the Democrats specifically step forward and say, cap and trade is off the table but we're going to make a push for it next year? OK, fine. The democrats have a lot on their plate and not everything can come all at once. I can live with that. If the Democrats just kind of drop the subject or imply they'll get to it "later" without making any real commitments, I for one will not be happy.
As for cap-and-trade, we need to come up with something simpler. It's just too complex and easily attacked.
We have something simpler, it's called the carbon tax. Somehow I don't think the Republicans will like that any more...
The real story of AIG and how it was brought down. Essentially, they gave away a large part of the money on these swaps up front, and the folks who did it took none of the downside risk.
We might see an MCI-like criminal probe soon.
http://tpmmuckraker.talkingpointsmemo.com/2009/03/the_rise_and_fall_of_aigs_financial_products_unit.php?ref=m2
Obama, Geithner, Dodd, Congress... they all authorized the AIG bonuses in the simulus bill. The same bill that was rushed through Congress so quickly that no one had time to read it. And then Obama goes on Leno and talks about personal responsibility and blasts the mentally retarded. Are you kidding me? And these are the guys the left wants to run healtcare, the education system, and nationalized banks?
What the frak?
1. Governor Palin will never be President of the United States. She got as close as she's ever going to about six months ago.
2. The Pacific 10 goes 5 and 1 in round one.
It makes sense for the Obama admin to focus on health care for another reason. Among its three top priority areas it has identified as in need of fundamental change (in addition to addressing the financial crisis) -- health care, energy, and education -- heal policy is the only one that involves mainly a federal governmental initiative, though it engages the health care and insurance industries as well as state government. And a transition could be brought about in just a few years if the decision is made and the political will is there.
In contrast, energy independence requires a lot more effort and fundamental investment, a relatively limited federal government role, mainly a provision of incentives. And the transformation will require decades of investment and the development of new technology -- mainly by private enterprise.
Education is a tougher issue than health care for the federal government to address. It remains fundamentally a local and state government policy area. While the federal government can play a role, a lot of that is as advocate and standard setter. The "will" to improve education -- especially public education -- has to come from below. And a lot of the opposition comes from people who just don't believe in science, much less the distinction between science and religion (or politics).
So health reform is logically the most immediate target. Supporting this prioritization is that with the economy being in such a funk, and America's competitiveness depending in part on cutting the wasteful way our health system operates, a lot of "forces" are aligned to change the system. And the moral shame of having 50 million people uninsured is pretty compelling.
I don't know if you were a debater in high school, but if you were, I predict that this will be a very exciting bit of news to you: I have just cut this blog post into a card to use in a politics DA for a debate tournament tomorrow. Thanks!
The bonuses were actually enabled by Paulson in the Bush era. Dodd failed to get a provision in that would stop the bonuses (this was before the changeover, he was overridden by guess who?!). Twisting that to claim he caused them is perverse.
And just because polls say US is deluded on climate change, thanks to lots of industry PR, lobbying, poor education, and lots of anti-science in the last 8 years, doesn't mean it's not a problem. Climate is not driven by polls. The doubt creation machine (see cigarettes, good for you, creationism/intelligent design, etc. origins) has been quite successful.
Thankfully, we have some people in now who have some regard for truth and expertise.
And isn't it cute that Obama's excellent and lengthy summary of what's up was trumped by a missed phrase in one sentence in the press? Sure, he should have known, but the rest of it was important.
@Mr. Riddles: Nate was indeed a (state champion) debater in high school, according to Wikipedia.
I suppose it's every debater's dream to have other debaters cut cards using their stuff.
"Sarah Palin gets elected in 2012"
Dude that wasn't even a funny joke. The thought of that truly scares the shit out of me
It's not just economics, it's immediacy. Global Warming seems like a problem most Baby Boomers will not live to see manifest itself. These soon to be geriatric patients see health care as a problem they need to worry about right now, since the period of biological fragility is already upon them.
Global Warming resonates more with my generation. Barring serious injury or some surprise medical disorder, I'm young enough that it's unlikely I'll need to visit a doctor for anything more than routine physicals for a decade, maybe two. The effects of Global Warming are likely to manifest in my lifetime-so to me it seems more serious than it would to my parents when compared to health care.
I predict Obama will still see Global warming as a priority because of who his base is- he won by a large margin because his GOTV machine targeted young voters in a way no previous campaign ever has. He's very conscious of that, and the fact that young people aren't as stupid as the Boomers would like to think-if he screws us, we may not show up at the polls in November 2010 or 2012.
i tell you what. if we can get health care done this year in a way that significantly reduce costs even if it doesn't readily expand coverage, i'll be a happy man. even if it's the only thing we get done along with economic recovery.
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the reason healthcare was so toxic under clinton was because the repubs understood that if it was done, and it was successful, people would have too close of a relationship with their government. and that would have negated everything about reducing the size of government and abolishing the department of education.
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so i say, let obama focus on making cars more energy efficient, develop alternative energy, and get a real good market-based but with public enhancements during those 4 years. then move resolutely in a cynically pragmatic way on foreign policy, establishing a blueprint for how we approach the world in the 21st century.
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In 4 years time, we'll be reelected if we're successful with these. then we can focus on global warming, immigration and what have you.
startler N Warldof, i totally agree with you (early 20s). Global Warming is a bit more urgent to our gen. But if we try to do both energy and healthcare and fail at both, tehn i just don't see us tackling these issues anytime soon within the next 20-30 years.
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it's not everyday you get a leader of the caliber of an Obama.
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i also know that if we don't deal with healthcare, a capntrade system would really saddle up small businesses. you'd see them start failing like crazy.
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so for the sake of energy and global warming, let's do healthcare.
Impressive use of the term secular to mean aperiodic!
The concern about running all these issues at once is the unspoken assumption that President/Congress/Public cannot deal with them all at the same time.
Is this really true? Are there financial reasons why they cannot be simultaneously addressed? Remember, we have a need to stimulate the economy with spending.
"...Democrats have mapped out their legislative strategy for passing health care reform this year..."
**********
very fine post sir Nate.
Not to mention many others bloggers as Juris,Statler and so on,who posted their thoughtful commentary.
And well done mister President,
taking care of your people is exactly what You have to do.
Congratulation.
said...
"Sarah Palin gets elected in 2012"
Dude that wasn't even a funny joke. The thought of that truly scares the shit out of me
March 20, 2009 9:33 PM
It is a Worldwide,globalized, feeling.
Marc Ambinder and Nate have missed the most significant part of the Stephanopoulos report:
Putting the health care reform plan into the budget resolution means that IT WON"T BE SUBJECT TO A FILIBUSTER! A majority will be sufficient to pass it.
Here is the history of this little known and little used provision.It appeared on the NY Times website but not in the printed editions.
March 16, 2009
Alternate Route: Bypassing the G.O.P.
By JOHN HARWOOD
There is an easier way.
An easier way, that is, for President Obama to achieve his huge health care and energy goals than begging, pleading and negotiating for help from Republicans. The absence of bipartisan consensus, after all, has prevented strong action on either front for decades.
The easier way would let the president negotiate with only fellow Democrats. The deal they strike could pass Congress this year by a simple majority vote — in a single budget bill with historic health and energy policy changes that Republicans could not filibuster.
Here is how: Congressional Democrats pursue Mr. Obama’s agenda under the arcane rules of “budget reconciliation.” Here is the problem: By disarming the legislative minority, that path would cause the opposite of political reconciliation with Republicans.
Indeed, Republicans warn that such a move would be a hostile act, as bitterly divisive, one leader cautions, as President George W. Bush’s conduct of the Iraq war.
“If President Obama takes a look at what happened to President Bush, he won’t want to,” said Senator Lamar Alexander of Tennessee, who is chairman of the Senate Republican Conference. “It would be very difficult for Obama to have a successful presidency.”
The White House press secretary, Robert Gibbs, responded that it was “entirely premature” for Republicans to focus on procedure in lieu of practical solutions. Without signaling any final decision, Mr. Gibbs added, “what we’re concerned about is not how we get there, but that there’s progress.”
A One-Party Push
The budget reconciliation process dates back to reforms of the mid-1970s, as lawmakers grew anxious about deficits. It streamlined procedures for action, notably banning Senate filibusters, the minority’s most powerful weapon.
The process smoothed the path for President Ronald Reagan’s economic plan in 1981. As Mr. Gibbs points out, it provided the vehicle for Mr. Bush’s 2001 tax cuts. Without it, President Bill Clinton never could have enacted his deficit-reducing tax increases in 1993 by the barest of margins.
Democrats that year considered including Mr. Clinton’s health care plan in the budget reconciliation process. They did not, and under withering attacks from Republicans and businesses, the plan never even came up for a vote.
Thus, Democrats, now facing complaints that Mr. Obama seeks “too much too soon,” are exploring that option. Under the procedure, the House and the Senate would first agree on an overall budget outline. Then they would pursue legislation “reconciling” the outline with any needed policy changes.
So long as 50 of 58 Senate Democrats support the legislation — with Vice President Joseph R. Biden Jr. available to break ties — the White House would not need a single Republican vote.
“Bipartisanship is not an end in itself; health care is the end,” said Andy Stern, president of the Service Employees International Union and a sharp critic of Congressional gridlock.
Yet business leaders worry that streamlining procedures would curb their influence and cloud chances for consensus. Health insurers once financed “Harry and Louise” advertisements attacking Mr. Clinton’s agenda. Today, the Web site of America’s Health Insurance Plans urges, “Be part of health reform now.”
“I don’t want to sound like a Pollyanna,” said the organization’s president, Karen Ignagni, “but there’s a real role for bipartisan discussions.”
Democratic Congressional aides say the House, at the behest of the White House, is likely to call for reconciliation procedures in its coming budget resolution. Less clear is whether the Senate will, given warnings from Republicans and some prominent Democrats like Senator Kent Conrad of North Dakota, the chairman of the Budget Committee.
The Senate majority leader, Harry Reid of Nevada, is “exploring all options,” a spokesman said, with Democrats “a week or so from having to make a decision.”
A Backup Plan
One Senate aide outlined a compromise: a call for reconciliation “couched as a fallback” should bipartisan negotiations fail.
The smartest approach would be to use the process “to bring Republicans to the table,” the Congressional scholar Norman J. Ornstein said, embracing the fallback option. “ ‘We can do this without you, with no input and none of your ideas, or we can sit down together and negotiate to get to 65 votes.’ ”
The threat depends on Mr. Obama’s ability to deliver a Democratic deal that could withstand parliamentary objections against “extraneous” budget reconciliation provisions and draw a simple majority. Mr. Alexander predicts “massive defection” of moderate Democrats from Mr. Obama’s energy plan to cap carbon emissions, which opponents call a tax increase.
Acting with a bare majority, Democrats would lack the bipartisan cover politicians prefer for controversial changes. “They’ll own the whole thing,” the Senate Republican leader, Mitch McConnell of Kentucky, observed dryly.
Yet Mr. Obama has consistently demonstrated his desire for movement. He may ultimately decide that reconciliation as a means of enacting new health and energy policies is worth the risk of angering Republicans who almost unanimously opposed his economic stimulus package.
“He strongly believes that sustainable economic recovery depends on major action,” said John D. Podesta, who directed Mr. Obama’s presidential transition. “He’s not going to give that up to make people feel the process is somehow sweeter.”
Will the Democrats finally have the balls to pull something like this off?
@Itai -- Take a look here.
Correlation? Run this one Nate...
No sunpots today, again:
http://sohowww.nascom.nasa.gov/sunspots/
Maunder minimum:http://en.wikipedia.org/wiki/Maunder_Minimum
Little Ice Age:
http://en.wikipedia.org/wiki/Little_Ice_Age
Or do your correlation analysis only end with positive correlations when they agree with your world view and political viewpoint?
Brad,
Stop posting disinformation that has little to do with recent warming. There is absolutely *no* significant correlation between sunspots and global average temperature over the past 50 years. Nada. Nor is there any with cosmic rays. In short, natural influences can not explain the warming of the past 30+ years with the additional forcings from greenhouse gases. End. of. story.
I forgot the link that shows the increase in temperature correlates with the increase in CO2 (76% for temp. anomaly and ln CO2 for 1880-2007). See
http://www.geo-cities.com/bpl1960/Correlation.html
Oops, wrong link posted. Here is the correct one:
http://www.geocities.com/bpl1960/Correlation.html
50 years? You really think 50 year windows are relevant to climate change across the planet? Get over yourself already. Look at the long term trend - the sunspot theory makes perfect sense as a long term driver. The planet does not run on your time scale, but nice try.
Fast global temperature changes are common:
http://www.esd.ornl.gov/projects/qen/transit.html
Nice job refuting the facts in my posts by the way, the global warming folks are turning into the religious folks - it is true because they said it is true.
There is no question that the recent temperature increase is due to global warming based on carbon dioxide. The real questions are twofold:
1) Does it really matter in the greater scheme of global long term temperature change?
2) Even if we shut down our economy and decide to throw millions out of work and lower the standard of living for the entire country - will it matter because China and India will create alot more carbon dioxide than we cut?
http://ucsdnews.ucsd.edu/newsrel/international/03-08ChinasCarbonDioxideEmissions.asp
http://www.sciencedaily.com/releases/2008/03/080310155857.htm
Seems like global warming hysteria has mostly faded as teh contrary scientific evidence has emerged, except within these hallowed halls.
Like health care "reform," cap & trade is a solution that's worse than the disease.
As the huge costs of cap & trade and dubious benefit are fleshed out beyond the save-the-polar-bears simplicity, it will be untenable (and potentially suicidal legislation).
As for health care, what's really needed is a way to encourage Costco-like efficiency, not just empower more government control that only sucks money into the bureaucracy.
OOPS! China was supposed to overtake us as the primary carbon dioxode producing country in about 2015: http://www.mongabay.com/images/2006/graphs/co2_country_1990-2025.jpg
Unfortunately China overtook us last year: http://www.nytimes.com/2008/06/14/world/asia/14china.html?ex=1371182400&en=2da61e4ada46d9eb&ei=5124&partner=permalink&exprod=permalink
Rudy-
Global warming is real, I just don't think the crisis can be solved. That said, the sun has a good shot at making us very glad we have more carbon in the atmosphere, if we truly enter another sunspot minimum.
As for healthcare - you are already having your choices made for you by a large insurance company, if the government can do it and slow the rise in healthcare costs I am all for it.
I am shopping at Costco and skipping WalMart now. Who knew some Costco's are unionized, and they will support a version of the EFCA:
http://www.politico.com/news/stories/0309/20308.html
But that's just the point, Brad. The government has no history of being able to reduce costs and maintain quality. I'm for greater consumer empowerment via a more competitive insurance and health care provider market. There's no reason to believe more government control would save money beyond price controls, which would necessarily reduce access.
As far as global warming being "real," it is real well short of the hysteria level, and you correctly point out the crosscurrents, including the effect of sunspots. There is, as yet, zero evidence that what little global warming that's happening is more bad than good, The debate and scientific search for evidence has only just begun.
The models predicting doom are garbage-in, garbage-out and have been very wrong in predictive power to date, and certainly shouldn't be the basis for sweeping policy. Further, the proposed solutions are really just taxes in drag, so they would have big negative effects on the economy, and unlikely to have any meaningful positive effect.
What's scary is that some think it's a positive that economic activity has dropped because that means less energy used. Luddite thinking.
As a late boomer who should be concerned about affordable healthcare to preserve my imminent geriatric failings. I am actually far more worried now that the Obama administration will NOT be addressing climate change and other environmental threats. Sure Nate is right when he says that we don't want to talk about the reductions in GHG emissions due to a global economic recession, but the reality is that the rate of GHG increase will slip a few percent--it won't stop the continuing upward trend. You young folks (Statler-Waldorf, Nate Silver et al) should be darn well campaigining for the evironmental legislation (cap and trade or C tax -- I prefer the latter 'cos it's easier to understand!) and screw affordable health care. The more of us oldies who die young the better it will be for you in thirty years!!!
The problem with true free market healthcare - what do you do for people that really get cancer or have an immune system problem caused by genetics? Are those folks then uninsureable in the free market? Do we just let healthcare be a reason for bankruptcy?
As far as I'm aware, no one's talking about extreme free market solutions that would abdicate responsibilities of insurers -- that's a straw man thrown up by the government-control advocates.
People that get cancer or have immune system deficiencies are typically covered by their insurance, which is why the US has such a higher rate of cancer survivorship and better access to experimental therapies relative to socialized health care countries.
I've yet to see a coherent case as to why a government-controlled system would provide superior care at lower costs. Government isn't equipped for that role.
Cap and trade is just a money making adventure. EU hasn't fared better than US in CO2 reductions.
That is the reason carbon tax is gaining ground as a better alternative.
BTW, even cap & trade legislation dies in Washington - no not DC - I'm talking about WA. So what hope is there of any real global warming solution will ever be passed in Washington, DC ?
Whatever Obama does will be too little, too late. We are doomed.
Whoever up the chain said this was a lie, about sunspots, here is some science and some links.
http://www.space.com/scienceastronomy/natural_sunblock_040802.html
We have very low sunspot activity in 2008 - lowest since the space age - and that correlates with lower solar output. BTW - the last three sunspot cycles have been very active, correlating with high solar output, but that does not seem to be in the global warming models. Kinda weird.
> The government has no history of being able to reduce costs and maintain quality.
Ah yes, this silly myth. A great example is the US's market-based health care costs, per GDP, far more than other industrialized nations. Mid-double digit percent higher in fact.
Well, Dwight, what is mythical about that statement?
We do spend a high proportion of GDP on health care, and have the superior access and outcomes to show for it. Certainly, lots of money is wasted, but that's mostly because health care is viewed by many as a free good, for which there is unlimited demand.
We need greater efficiency, which requires consumer empowerment and competition. That's the antithesis of what greater government involvement would create.
If anything they should pass cap and trade and skip the healtcare -- at least their version of it.
The economy would love to recover if only Obama would clean up his act or get out of the way!
It appears that one partial solution to the "crisis of the uninsured" is to increase economic activty.
It seems to me that we would be better off attending to the economy and lifting it and then figuring out to do with the rest of health care.
Immediately their should be an expansion of Medicaid both in terms of elligibility and reimbursement. The scandal of this program is that everyone knows that if something is free it must be rationed. Medicaid does that by keeping reimbursement so low that only the greediest, most depeatate doctors will take it. It is a credit of the system that there are very few of those among the physican community and thus the victimization opf the poor by venial is lessed by ineluctable market forces.
Medicaid needs increased funding by a lot. Medicare needs means testing. Let us implement those two needed and expensive reforms and let the economy recovery and we can see where the real gaps are.
At least with Cap and Trade you can count on the resiliency of the business community --ALL THINGS BEING EQUAL-- to prosper despite the burden. One cannot say that with health care that is increasing moving from oligopoly to monopsony. The Health Care Market is Broken, unlike that of the market for good and services which remains quite rational.
Cap and Trade will rediuce the competitiveness of American Industry vis-a-via world competitors who do not impose the same penalties on themselves.
Import Tarrifs are one thing, but never in history has a nation taxed its own exports and that is pretty much what this is.
President Obama and most of Y'all and your representatives in Congress do not know what they are doing. Or perhpas they do but their motives are obscure.
There is a much simpler way.
(You can now follow me on Twitter: PeteKent01)
Rudy said...
But that's just the point, Brad. The government has no history of being able to reduce costs and maintain quality.
Really, we should also go back to private firefighting companies.
Healthcare provided by the V.A. costs 20% less than traditional U.S. care. The patients at the V.A. experience less backlog, no insurance headaches, and report significantly higher satisfaction in their medical care than the rest of us.
A comparison of medicare and medicaid to private insurance is another good example of the fallacy behind the claim that government is always inefficient and provides poor service. Both government run insurance programs are incredibly efficient, with about 3% overhead. In contrast private insurance companies typically have about 20% overhead costs. The government run programs do a much better job at keeping down costs and ultimately provide better care at significantly lower costs.
Private insurance companies are simply profit sucking middlemen. Their entire reason for being is to restrict medical access and to enrich their corporate executives and shareholders.
Rudy-
You do realize that the U.S. spends more per capita on health care than any other nation in the world right? This is despite the fact that no other nation relies so heavily on free market solutions to their healthcare than the U.S.. In other words, every other nation has has a higher degree of socialized medicine than we do, and every other nation spends less on healthcare than we do.
Moreover, your claim that we have the best quality care in the world is a complete farce. There have been numerous studies that have pointed out that by many measures (infant mortality rates, childhood diseases, obesity rates, longevity, etc.) the U.S. lags most industrialized countries. Our return on investment in terms of care provided per dollar ranks somewhere around 30th in the world.
Many countries cover more people, at lower cost, and with better outcomes. I see no reason to cling to our rather inefficient system.
Why not move toward a more synergistic approach?
The environment's health is directly linked to our health. People living close to toxic waste dumps get cancer more often and faster than people living far away from such places. Unclean air and water mean little kids with UTIs and respiratory ailments.
Global Warming has real health consequences. Yellow Fever and Dengue are diseases that you don't normally associate with the United States, and yet it's been found recently along the Texas border, as mosquitoes carrying these viruses migrate further north as the climate shifts toward conditions favorable to their reproductive cycles. Alot of people die in large hurricanes like Katrina, which grew in strength due to warmer waters int he Gulf. Drought and flooding, like what happened in Georgia last year and in Iowa earlier that same year are created when the ordinarily stable weather patterns are disrupted-and these post threats to the elderly that cannot evacuate and the poor who have no where to go.
Dude, those measures have nothing to do with the quality of care. The studies purporting to show US inferiority are invariably assembled by those with axes to grind. Infant mortality, et al, have more to do with genetics, population composition and personal behavior than quality of health care. Access and availability of state-of-the-art care are where the US system is unparalled. Those features have been uniformly ruined in socialized health care countries.
It is silly to suggest that our quality of care is inferior to that in socialized health care countries. They uniformly ration by exclusion and have far inferior access. Lengthy waiting times for life-threatening conditions are the norm.
Administrative costs are not the sole measure of efficiency, as they are a small portion of the total health care bill. If Medicare/Medicaid spent money on managing care and negotiating contracts the way the private sector does, it would have higher admin costs, but lower waste. Study after study has shown that more money expended on health care providers does not translate into superior results, but if providers cannot make money on care, there will be fewer.
We have chosen as a society to spend more money on health care. I agree we spend too much, and consumer empowerment and price drops via competition are the answer, not empowering more government control.
The reasons behind the high cost of U.S. medical care have little to nothing to do with government involvement. The reasons (as I see them) are as follows:
1) The AMA maintains a monopoly and limits the number of practicing doctors in this country, artificially limiting supply. The doctors in this country are paid more than anywhere else in the world. Not because they are better, better educated, work harder, treat more patients, or any other merit based measure. They get paid what they get paid because there are so few of them per capita, and this has nothing to do with the rigors of the profession.
2) We are an overly litigious society. Doctors pay incredible rates for malpractice insurance, and pass those costs on to customers. We all pay for that insurance, and it doesn't improve outcomes in the slightest.
3) Doctors practice far too much defensive medicine. Not only do we all pay for malpractice insurance, but we also suffer through a large number of completely unnecessary procedures designed to limit doctor liabilities. This is unsafe, inconvenient, and expensive.
4) Private insurance companies are profit sucking middlemen. See above post.
5) The Byzantine network of insurance companies that we have in this country produces a tremendous amount of wasted paperwork and man hours.
6) Because healthcare in this country is so expensive, many patients put off care until symptoms become severe. Consequently conditions are detected late, and treatments are more expensive. Investments in preventative care would likely bring down our overall costs and improve outcomes.
7) Because so many people lack health insurance, they put off care until they present in emergency rooms. Emergency care is incredibly expensive and inefficient. Many of those that lack insurance also lack the means to pay for these costs. Ultimately the rest of us pick up the tab.
BTW, Dude, I do agree that the VA is a decent model to follow, as it is much akin to the Kaiser model, which is even more efficient than VA. The VA efficiency is overstated becasue its facilities are in population centers, and it benefits from having a fairly homogenous population, i.e., mostly older men with similar issues. It also isn't run by politicians.
"Access and availability of state-of-the-art care are where the US system is unparalleled."
Unparalleled availability? Agreed. Unparalleled access? I don't think so.
If you have any remotely pressing medical condition in this country you are forced to go to the emergency room. It is neigh impossible to get a doctors appointment with less than a months notice. If you do not have gold plate insurance or a silver spoon in your mouth, good luck getting access to the state-of-the-art care that you refer to.
The exception being that our country heavily subsidizes the treatment of premies. Doesn't matter that caring for the average premie costs around $1 million, we as a society gladly pick up the tab.
The fact that the VA is not run by politicians does not mean that it is not run by the government. I thought your original point was that government run programs provide poor service and are inefficient.
If your point is that politician run programs are crappy, I doubt you would get an argument from anyone on the planet.
> Well, Dwight, what is mythical about that statement?
Because those other nations with much lower costs involve far greater government involvement in their systems. There are situations where government bureaucracy trumps free market for efficency.
Typically this is found in areas where there is a huge amount of bureaucracy to start with because of the problem being addressed, and it is something that is highly universal in need. Governments do bureaucracy relatively well. That fits healthcare's profile. A good deal of the problem right now is that the US system has a great deal of redundant bureaucracy.
P. Kent: "The economy would love to recover if only Obama would clean up his act or get out of the way!"
Wow, you actually made me laugh out loud. Here are the facts: The economy became an unmitigated disaster when the Shrub and the Republicans were in charge. They failed miserably. Easily the worst administration foreign and domestically in the modern era, bar none. We now know that that trickle down economics is an utter failure. And that the Repubs have absolutely zero credibility when it comes to fixing the economy. What we also know is that the economy desperate needs more investment and purchasing. Which is *exactly* what Obama is doing. Of course the Republicans have nothing to offer except saying "no". Which is why their approval ratings are abysmal.
Once again, thank you for making me laugh out loud. That was definitely one of the most clueless, unsubstantiated in facts posts I have read anywhere in quite a long time.
PeteKent said...
(You can now follow me on Twitter: PeteKent01)
March 21, 2009 11:23 AM
***********
Yes Petey,
We are coming...wait.
Todd Dugdale,
I think you probably don't know how pre-existing conditions coverage works in group health plans. If you have had coverage with a plan for 18 consecutive months, there is no pre-ex (creditable coverage) regardless of your or your dependents' conditions. If you did not have the creditable coverage, then the payment for pre-existing conditions is limited to some dollar amount for 12 months. After 12 months, they are treated like any other illness.
Pre-ex isn't forever in group health plans.
Hey, GROG:
What's worse: Making a joke that obliquely referenced the mentally non-neurotypical and then apologizing for it, or slashing funding for those people the way Sarah Palin has done in the past and is doing today?
Coleman Attorney concedes defeat-Coleman himself is still mum, but his attorney is giving up
Yes folks, it's true. J. Friedberg, the guy that won Bush v Gore for Bush, has publicly announced two startling things: 1) that Coleman will most likely lose the case currently awaiting a decision by the three-judge panel and 2) no matter what the outcomes is, Freidberg is done with the case and will not be defending Norm Coleman should Coleman decide to appeal.
This doesn't mean Coleman will not appeal however. I propose that we all work together to find the most incompetent Public Defender in Minnesota to plead Coleman's appeal case.
Would anybody here have a suggestion?
Statler N Waldorf said...
I propose that we all work together to find the most incompetent Public Defender in Minnesota to plead Coleman's appeal case.
Would anybody here have a suggestion?
March 21, 2009 2:13 PM
********
I'll take the bait:
Why do not assign the case to Petey ?
Lost in all the blather and the ad hominem attacks is that there is a simple and viable alternative to the universal healthcare/single payor solution that seems in vogue.
Consumer driven health care.
The real problem with healthcare today is that marketplace is not working right.
The ultimate consumer is largely cut out of the financial equation by his purchase of insurance. Any payor -- government or private insurance company -- will be motivated to use some form or rationing to limit expense.
This becomes necessary when the consumer lacks a stake in the economics of his care, but turns that over to his paying source.
Consumer driven healthcare suggests another way where we return the market discretion to the patient and with transparent pricing allow him to make choices based on his own sense of cost-benefit like we do with virtually every other thing we buy in society.
One element of the Plan: Give everyone a healthcare tax credit and eliminate the deductibility of employer provided health care benefits.
This will give each individual a stake in selecting whatever health insurance and healthcare that makes sense for them and does not tie them all together because of an artificial association like employment.
Studies are now showing both wide acceptance and success for High Deductible Insurance plans coupled with Healthcare Spending Accounts (HSAs). Consumers like them as they reduce costs for both the patient and employers.
Those who have HSAs tend to take more advantage of wellness programs like smoking cessation, stress management and weight loss.
In many ways the results we are seeing with are the very ones that Obama promises under his more "command and control" vision of healthcare.
It is the sort of thoughtful debate over different policies that gets subverted when we rush things through using the reconciliation process.
It is anti-Democratic and undermines the legitimacy of government.
(You can now follow me on Twitter: PeteKent01)
no sunspots today :(
http://sohowww.nascom.nasa.gov/sunspots/
Pete- you do know that noone reads those long, wordy, repetitive, poorly argued posts, right?
Brad,
That's okay if they don't read them. I come here to hone my arguments.
The one above is mostly about consumer driven health care as an alternative to Obama's single payor system.
I don't think i have ever written about that at length. Also, while I admire brevity (follow me on Twitter -- PeteKent01), some things require some more in depth exposition.
I am pleased to put it out there to see if it attracts interest or intelligent opposition.
> I am pleased to put it out there to see if it attracts interest or intelligent opposition.
Hint: "Intelligent opposition" tends to avoid conversations where the other person is willing to adamantly proclaim that white is black and the sun is the moon. The first step to honing your arguments, if you actually do want intelligent conversation, is to stop resorting to blatant buffoonery.
PeteKent said...
"...Consumer driven healthcare suggests another way where we return the market discretion to the patient and with transparent pricing allow him to make choices based on his own sense of cost-benefit like we do with virtually every other thing we "buy" in society...."
March 21, 2009 2:40 PM
PeteKent said...
"...I am pleased to put it out there to see if it attracts interest or intelligent opposition..."
March 21, 2009 2:57 PM
*********
Petey,
#1-
People MUST NOT "buy" health care,they OWE and DESERVE that,mostly in the richest country in the World.
And please, don't say this is socialism,read the Gospels,Jesus said that:
" I was sick and you visited me. In truth I say to you:
Every little thing you made behalf the poorest of these brothers of mine,you did it straight to me."
#2
"intelligent OPposition" needs "intelligent POsition" in order to develop.
Agree Dwight-
He also needs to hone intelligent discourse - e.g. the ability to listen.
Stat-
No,Friedberg isn't quitting.
He claims his case was built for the Minnesota Supreme Court and that he'll win there
A much better report on this story is here.
Sorry,I can't get the link to work.You'll have to go to:
http://www.startribune.com/politics/national/senate/41606392.html?elr=KArks8c7PaP3E77K_3c::D3aDhUxWoW_oD:EaDUiD3aPc:_Yyc:aULPQL7PQLanchO7DiUr
They are betting on a Bush v Gore US Supreme Court political decision - Ithink the chance of the Supremes taking cert on this case is close to zero.
Recall, Matador, that our Lord did his preaching among the people. He rarely harangued the Roman government; he treated it respectfully but more or less as an irrelevancy.
That should tell you something right there.
Had Jesus seen government as the way, the truth and the light, he certainly had a lot to work with with the Bureaucracy of the Roman Empire. But he ignored government in favor of private initiative as imprinted on each human heart in equal measure and without limit, each of us infinitely blessed with His Love!
Logic, Matador, logic!
Is Jesus Christ running for office?I thought he dies long ago, and clearly his religion became the scandalous shithole right around the inquisition.
Religion = government = corruption
PK,
are you sure you want to invoke Jesus Christ on your side of the healthcare debate? And does it ever occur to you that maybe the faults of America today have more to do with the party that has been in control for the last 8 years rather than the one that has been in charge for barely 2 months?
One of the most ridiculous things about healthcare in the US right now is it ignores the hypocratic oath that doctors have taken immemorium. The sick/ill/ injured don't even get as far as the doctor though. And if they do and can't afford the premiums they end up bankrupt. How does that reflect the morals and teachings of Jesus Christ?
Come on Pete - I just called out Christ. If he has the power he will smote me! God is powerless to smote anyone - as he does not exist.
Damn, guess I am still here. Take the religion to another board.Pete has no idea what Christ really taught, he has never actually read the bible. He only knows that it supports his position, no matter what that may be. Of course, that is true right????
HAHAHAHAHAHAHA!!!!!!!!!!!!!!!
PeteKent said...
Recall, Matador, that our Lord did his preaching among the people. He rarely harangued the Roman government; he treated it respectfully but more or less as an irrelevancy.
That should tell you something right there.
Had Jesus seen government as the way, the truth and the light, he certainly had a lot to work with with the Bureaucracy of the Roman Empire. But he ignored government in favor of private initiative as imprinted on each human heart in equal measure and without limit, each of us infinitely blessed with His Love!
Logic, Matador, logic!
March 21, 2009 4:02 PM
**********
Petey,
First of all:
I am from Italy ,so please,please,please,avoid to try to teach me about Roman Empire...
second:
Not all was blessed by infinite love.
In fact ,the men whom sentenced Him to be nailed on the Cross were the ancesters of the modern,greedy Republicons.
good-night.
fred said...
Pete has no idea what Christ really taught, he has never actually read the bible. He only knows that it supports his position, no matter what that may be.
**********
@Fred,
You have the right to not have faith.
It is ok for me.
and let me apologize to have brought Jesus during the discussion.
My Bad.
But let me tell the last thing:
Jesus would NEVER support Republicons'position.
good-night.
:)
Logic, Matador, logic!
LOL. So give it up Pete. You are trying to do a "Colbert", aren't you? No, no, don't answer.
Jesus would never support republican positions? Really?
I think gay marriage is a dead ringer constitutional issue - and it is allowed and protected. Does Jesus believe that?
Rudy posted the following:
"[...]The studies purporting to show US inferiority are invariably assembled by those with axes to grind. Infant mortality, et al, have more to do with genetics, population composition and personal behavior than quality of health care.[...]"
And you know this because? Answer: You know no such thing, but are merely making it up. And why is that? Because you refuse to accept an obvious statistical truth. And I have to wonder why. What is so different about American genetics than genetics in Canada or European countries? I can think of one thing: More people of recent African descent. Which makes me suspect you are motivated by RACISM, as well as classicm.
Why you think affordability of healthcare has no effect on the degree to which uninsured or poorly-insured people use non-emergency - and, therefore, preventative - health services, only someone as illogical and apparently prejudiced as you could possibly manage a convoluted answer to.
I'm glad that repugnant, illogical, prejudiced thinking like yours is so clearly out of the mainstream now. People who blame untold thousands upon thousands of victims for being bankrupted by sudden or cumulative health emergencies are hateful.
smite/smote/smitten
Not sure J supported marriage at all, or family values. He was a maverick, though, hung with lots of extremely admiring guys, and was not known as a babe magnet, despite the fact that his Dad made the first one.
Mary Magdalen--legalized prostitution? No stones, please.
Q: Why is J's origin story similar to several involving Zeus (thunder god, later DBA Jehovah) and human females? What is it with male deities and human females? I guess Hera was a handful.
I'm just saying...
> Not sure J supported marriage at all,
"What therefore God has joined together, let no man separate."
Although I don't recall any specific reference by him [that made it into the modern collection of the books that make up the New Testament] to homosexuality by Jesus, I don't believe he ever contradicted the Jewish laws about Christian marriage = man + woman.
P.S. Not that this particularly relevant to the US laws since marriage isn't limited to [traditional] Judaic-Christian definition. Just saying it is more likely than not where Jesus himself would come down on what constitutes marriage.
Agreed that J didn't argue against the prevailing definition of marriage, but the general message was a call to revolutionary spirituality rather than to any conservative status quo.
Hard to picture him appearing at a GOP function except in a subversive capacity. Not that he'd be a card-carrying D either. ACLU maybe :-)
And then Obama goes on Leno and talks about personal responsibility and blasts the mentally retarded.
Once again the troll proves he is mentally retarded.
Obama blasted the mentally retarded? You would have to be a fucking retarded troll to think that.
Obama, Geithner, Dodd, Congress... they all authorized the AIG bonuses in the simulus bill.
That is a neat trick given they were authorized last fall
Anyone got some troll-b-gone spray?
Pre-ex isn't forever in group health plans.
12 months with next to no coverage when someone has cancer is forever. As is they are going to either:
1. Die
2. Completely bankrupt themselves just to get the care they need
In Bush's America this is acceptable.
It is not acceptable now.
I am pleased to put it out there to see if it attracts interest or intelligent opposition.
What you don't understand is that to attract intelligent opposition, you need to make an intelligent argument.
You are incapable of intelligence.
Neither the President nor anyone else will be able to reduce the cost of medical care until we at least double the number of places in American medical schools.
Contrary to what the AMA would have us believe, anyone with an MCAT score of 25 is fully capable of being trained to be an at least serviceable physician. Maybe not good enough to be a super duper subspecialist whose work product is only affordable by the very rich, but good enough to treat what ails most of the rest of us most of the time.
As the Soviets and Cubans discovered long ago, the practice of medicine in most cases really isn't rocket science.
fred said...
Jesus would never support republican positions? Really?
I think gay marriage is a dead ringer constitutional issue - and it is allowed and protected. Does Jesus believe that?
March 21, 2009 6:10 PM
********
@Fred,
looks like you didn't accept my apologize.
Anyway,
I wrote Republi-CONS position,
not Republi-CAN position.
...probably you didn't get the difference.
Furthermore,inside the Gospels there ARE NOT specific position about gay marriage.
That's means that for Jesus this issue is not so rilevant.
And for me either:
I am favoureble to gay marriage.
Is it enough ?
bye.
:)
Yes.
Beavis said:
"You would have to be a fucking retarded troll to think that."
You're a class act. I hope you're not a true representation of the left in this country.
You think Bush, Cheney, and Palin are dumb? None of them are dumb enough to say what Obama said about the Special Olympics.
Grog,
Really I think the right are jumping over what Obama said in an over the top manner. Two reasons for this- the intent of what Obama said was to be self deprecating, he wasn't saying anything overly bad about the Special Olympics (at least in intent). Was it crass- absolutely. Thats why he apologised so quickly. The other point is that I wonder if the right would have jumped all over this if a Republican had said exactly the same thing. After all Trent Lott said in all seriousness that the country would have been better if Strom Thurmond won in 1948, and hardly a Republican batted an eyelid. I think there is a lot of fake moral rectitude coming from the right about now.
> Furthermore,inside the Gospels there ARE NOT specific position about gay marriage.
Red herring, since there is implicit support against it via the support of OT version of marriage. In fact he takes it further talking down divorce (which under the OT was fully allowed). Of course the Bible represents a good deal of filtering and editorial control by those since then. But that line is very misleading.
Re: Special Olympics
I have one child on the autism spectrum and another with LD/DCD, and I think it's much adieu about nothing. Probably because it is something I might have said conversationally.
At least it's nice to see a President talk to people, in a largely articulate and informed manner. Something that's been missing for a while.
P.S. I don't think you really want to play the "what Sarah Palin is dumb enough to say" card. :D And Cheny only poked up his head now that he's out of office...and has a book he'll be flogging soon?
newyorker2874999 said, "Neither the President nor anyone else will be able to reduce the cost of medical care until we at least double the number of places in American medical schools."
As I indicated in an earlier post, I agree that this is one of, if not the most significant, reasons we overpay for healthcare in the U.S.. There are simply too few doctors.
Hell, why stop at doubling the number of medical school slots? Why not quadruple them? That and open up the possibility of allowing for the immigration of foreign trained doctors.
If you are a foreign trained research scientist, engineer, computer programmer, economist, or just about any other professional, you can immigrate to this country and find work. If you are a foreign trained doctor, you are S.O.L..
Bottom line, if we want to bring down medical costs, we need to increase the number of doctors in this country 4-5 fold. They are grossly overpaid in this country. Doctors in other parts of the world make between 10-50% of what U.S. doctors make, while in many cases treating more patients per year.
I still haven't figured how health care costs can go down by increasing the number of people that don't pay for it! Don't believe it's a "right" either.
Actually Dwight, there is a specific proscription against basing laws on Biblical principles int he New Testament. "Give to Caesar what is Caesar's and to God what is God's"
Therefore, no matter what the OT says, that is not intended to be the law of the land. It's intended to be a private matter between the believer and God. The state is not God's representative on Earth, tasked with the enforcement of his will. The state is a manmade institution.
Now, I personally feel that the Bible is a manmade institution as well. No eyewitness accounts of Jesus' birth exist-all four gospel writers wrote decades after he lived and died. They're inconsistent on major details of his life-only two mention the virgin birth, and the resurrection was left out until centuries after he died. To this day, his childhood is completely absent. He pops out of Mary's vagina and disappears until he's 30 years old. If you were to apply the same standards to a biography of anyone else, it would never be accepted as historical fact. Imagine if we had an account of George Washington's life, written by four authors who made no reference to sources predating the mid 1800's,. half of whom describe a ridiculous story of his birth and the other half refuses to discuss his birth at all, the circumstances of his death are not added to any of the biographies until the late 1990's, and the whole subject of his first thirty years of life are completely absent from any account. It would be garbage. Nobody would look at that as history.
Further, the US is not and never has been a theocracy. The Constitution has specific proscriptions against a religious test for candidacy to high office, and the First Amendment bars official recognition of any religion by the government. Nowhere in the Constitution is any name of God mentioned. This is government by man, not by church.
So no matter what the OT says on homosexuality, it doesn't matter. 1) the Bible itself says it is not to be used as a basis for secular law 2) The Bible is not something that can be taken literally as the word of God, because it was written with human hands and human errors abound throughout it 3) The United States has distanced itself from theocracy since its inception. We are a democracy, not theocracy demos meaning of the people and theosmeaning of religious institutions.
The decisions as to how this country is run are to be made jointly by the majority of the people of this country and the Constitutional restraints against mob rule-we do not take our orders from the Vatican in this country. The Pope is not our King.
@Rick - interesting, albeit snide, talking point.
At one level you are correct. Increased demand for healthcare may potentially increase costs both at the individual and aggregate level. Individual prices would likely go up, unless there is a matching increase in supply (see above). And aggregate costs may go up because a greater amount of healthcare would be provided.
However, this whole supply/demand dynamic would be true regardless if everyone paid out of pocket or if no one did.
Are you arguing that no one should have health insurance because insurance obscures the true cost of care? Are you arguing for the nonsensical position that people that pay the full price for their insurance are more prudent in their use of medical services compared to people that receive subsidized policies? If so, do you think that employers should be allowed to provide insurance as a component of employee benefits?
One can debate if healthcare is a fundamental human right or not. Of course it is a right in most countries in the world, even some of the most impoverished and or authoritarian. I tend to think that a society that does not ensure the basic health of its population is rather petty, pathetic, and cruel.
Beyond fundamental human rights, there are obvious economic benefits to ensuring access to basic healthcare for all citizens. The sick and injured are much less productive than the healthy. Our current system forces many families into bankruptcy, which not only saps the time and resources of the affected families, but it also produces negative ripple effects throughout the economy - think foreclosures. Those without coverage put off basic care and present with advanced symptoms that are much more expensive to treat. And many without the means do not ultimately pay - instead you do.
Actually Dwight, there is a specific proscription against basing laws on Biblical principles int he New Testament. "Give to Caesar what is Caesar's and to God what is God's"
That's an, um, interesting interpretation of that passage. *cough*
Okay.
Under the current system of insurance in the US (which is really a non-system), people who are likely to become ill or suffer injury self-select into programs that offer low deductables and copays. People who are not likely to become ill or injured (myself, for example) opt for no insurance or for something with low premiums and we don't care that much about copays or deductables.
The insurance carrier has a problem. The first group is costly-their risk is so high that the insurance company is more likely than not to have to pay out beaucoups bucks, so they have to recoup that cost by charging a very high premium. The second group is only profitable if the sign up for insurance at all-unless a state law like Massachusetts' forces them to, they're better off not having insurance since they're more likely to pay into the system than get anything out of it.
So the insurance carrier cannot distribute the risk. If they had just as many likely to become sick people as they had people who were unlikely to become sick, the risk could be distributed evenly-the total payments coming into the system would be equal to or greater than the total payments going out, therefore allowing for a very low premium for everyone.
A universal single payer health plan would allow for extremely low premiums for all members since the risk distribution is such that there would be no need for a high premium to cover the likelihood of paying out more than comes in from copays and deductables. The low premium means employers don't have the burden they now carry of having to pay the large part of the premium.
In other words, a universal single payer system is good for business, good for people on limited incomes as well as people on better incomes, since the low cost is the same for everyone rich or poor in the system, everyone benefits.
If you are worried about the possibility of waiting lists and rationing, allow me to make two points. 1) If you cannot afford insurance at all, then you're not getting medical care at all, and a waiting list for elective surgeries would seem like a luxury. That's how it is for the majority of Americans today. 2) We have existing government bodies whose job it is to recruit and entice people to practice medicine and nursing in the United States, namely the HRSA. If we improve the quality of our secondary education in the United States so that more American kids are qualified to enter medical school upon completion of their bachelors programs, and we beef up the HRSA's existing mandate to recruit more of these qualified Americans to study and practice medicine, we can meet the new load of patients quite easily. There are already laws on the books which direct the government to see to it that there are hospitals and clinics within close proximity to most Americans-no new legislation would need to be passed to meet the new load. We would just have to enhance the existing departments' ability to do the job they are already tasked to do. The hard part of meeting the new load is already done- all that is missing is legislation creating the universal single payer system itself.
Dwight,
And how do you interpret it? As a call for a christian version of Sharia?
> And how do you interpret it? As a call for a christian version of Sharia?
You clearly do not understand what was on the coin (the prelude to that passage) and the context of that situation. :/
Just stick to "civil unions for the same tax benefits and legal protections afforded to marriage" and steer clear of any mention of theology. If you frame it as a theology debate you haven't a hope in hell of winning. You'll just end up looking silly and undermining the goal ... which are those legal and tax benefits, right?
Dwight said
Actually Dwight, there is a specific proscription against basing laws on Biblical principles int he New Testament. "Give to Caesar what is Caesar's and to God what is God's"
That's an, um, interesting interpretation of that passage. *cough*
------------------------------
I have to say I am with Dwight on this one. Without wanting to go to far down a theological conversation, its not at all a passage that is about seperation of church and state, its about obeying the laws of society AS WELL as the laws of God. Actually its a wider point about the hypocrisy of religious rulers at the time.
And actually plenty is written about of Jesus' early life. Many of the Apocryphal Gospels include details of Jesus' early life.
http://en.wikipedia.org/wiki/New_Testament_apocrypha
Incidentally I have never really understood the arguement that inconsistencies in the New Testament make that document as a whole worthless. Plenty of modern histories, written with much more intellectual rigour (in modern terms) than the bible, have inconsistencies with each other, and we don't just through those out. The New Testament is not designed as a historical account (in modern terms) more an attempt to learn meaning from Jesus' life.
Incidentally I should add that I do kind of agree with WnS's larger point that the Bible is not a good starting point for direct influence on law making. Even the commandments are not designed to be laws as such. The Bible is about personal responsibility, laws are by definition almost, about collective responsibility, how we act as a society, and an agreement of how we interact with each other.
I think much of the current dissatisfaction with Federal Healthcare is the inadequate performance of Medicaid system, the system for the indigent. Unlike Medicare, the system for the elderly, Medicaid reimbursement has been cut to the bone.
Obama is willing to spend billions to fix healthcare in general. The poor of this country are suffering desperately; it is time to increase Medicaid reimbursement to assure available treatment to all Americans regardless of payor source.
Unless you want a Cuban style system, as portrayed so unrealistically in Michael Moore’s “Sicko”, you do not want a single payor system even if you move to universal healthcare. Only the free market can assure competition and adequate distribution of resources. It seems to do it so well everywhere else, so why not in Healthcare?
One of the current problems with Medicaid is that reimbursement rates are so below market standards that few doctors if at all will serve this community, especially given the geography that many of the indigent find themselves in – either remote rural or urban / ghetto -- that it is very hard for them to attract doctors.
Given the President’s laser-like focus on reforming healthcare you have to wonder why he continually recites that a central problem with high healthcare costs is that the uninsured are using emergency rooms for care, when Medicaid patients are also choking the ER. Medicaid patients who cannot otherwise find a practitioner to treat them. Naturally, treating this population in the ER is as expensive as any other and much more wasteful given the availability of government healthcare insurance to pay for their care.
I heard an anecdote once of a cardiologist in the South being given a check for less than $2.00 for performing heart surgery on a Medicaid patient. This was 10 years ago. The situation has only gotten worst so consequently only the most desperate, least qualified doctors and a handful of do-gooders (many associated with religious groups and the rest mostly doctors donating their services) ten d to the needs of one of the most vulnerable populations.
You would think that the President who is such a fine orator and was once a law teacher would want to teach the people about Medicaid and let folks know that there is a basic problem: no one wants to serve the segment.
Now that Obama controls the army, I suppose he could use some tanks to force the docs to treat the folks in the Hood.
Or he could raise reimbursement and make it attractive for doctors and medical facilities to situate or otherwise serve where the indigent are and there might be a chance in doing a fair amount of good.
It’s an incremental step, and in these hard times it certainly an apt one. Even spending on doctors is stimulus.
You have to wonder why this has not been more of a short-run focus.
(You can now follow me on Twitter: PeteKent01)
Mark and Dwight,
The passage refers to the need to obey the laws of man which are distinct from the laws of God-pay your taxes to the Roman empire even though Rome is not a christian state.
Neither is America.
And our laws are also distinct from those of the church. You must obey our laws, even the ones that contravene your religion. Your religion's laws are not greater than those of the state. For instance, if you were to commit murder and tell the judge God commanded you to do it, you would still be guilty of murder, no matter if you can find justification for it in the OT, the NT, the Book or Moron or the Koran. Your religion simply does not trump the laws of the state.
The argument for Equal Marriage is not about the tax benefits so much as it is about equality. Whether you want to accept my way of life or not, the fact remains that we are equals before the law. I personally find christianity to be loathsome. Does this mean I have the right to discriminate against christians? Despite the fact that your religion is more of a choice than my sexuality, and therefore something one could make a far stronger argument in favor of legalizing discrimination against, such a thing would violate the constitutional protections of the minority who are considered equal to the majority.
Therefore, marriage is equal no matter whether it is heterosexuals or homosexuals being married. As such, asking me to accept a civil union would require you to do the same.
SnW,
Just on gay marriage (how did that ever get into a thread about healthcare and the environment btw?) Its a tough one. I still think that the best way to argue the case is not the rights path you take. I think a far more worthwhile route is the financial road that Dwight suggests. I think the rights path is dubious at best, as it requires a leap of faith in the moral view of a judge on what marriage should be defined as, and is easily over trumped by a definition of marriage law (which would be tough to turnover constitutionally, however unfair that might be).
But I think Obama is right when he says that most Americans can agree that a gay partner should be allowed death benefits. I think it would be hard to argue legally that someone cannot chose who should receive benefits when they die, and I think that civil partnerships are not to be sniffed at, as you seem to. Its a big step forward, and sometimes in the US these things have to be done one step at a time.
Mark,
Given that you have stated nothing but opposition to Equal Marriage in the past, I don't think taking advice from you would be wise on my part, any more than I would take advice from the RNC if I were running for office as a Democrat.
There's no need for the judge to consider morality-the letter of the law as well sas its spirit will suffice. The Equal protection Clause is the thrust of my argument, not the Bible, which is the opposition's. Interestingly, my basis for argument is in the Constitution-and theirs is not.
SnW,
I don't believe I have voiced any opposition to equal marriage in the past. (My view is that the state should only deal in civil partnerships, and they should be open to all, let religions define what marriage is for them). But I don't believe that right now it is a major priority, worthy of risking political capital on. (Though i understand why you feel differently than I do on this issue).
Where I say a judge may have to use a level of moral judgement is because right now there is no 'letter of the law' about what Marriage is. I thought a socially conservative judge would have no difficulty in defining a marriage as being between a man and a woman, and there would be little to change that view. In deed if a case came to a court where the lack of a definition was a problem, then I think that might force congress' hand on a law defining marriage, and even with a Democratic majority, I wouldn't bet my house that a congressional definition of marriage would allow for gay marriage. The equal protection clause only goes so far on this one. It would only force Alabama to recognise a couple married in California as married, not to offer Gay Marriage to its own residents.
This is one of those times that taking the wrong direction could put back your case 50 years. (Roe v Wade has been around for 35 years without a hint of Christian Conservatives managing to overturn it after all). I think it is a time when careful footsteps are required.
There is however a legal argument defining what equality is-and that is really the goal here. The Equal Protection Clause states that whatever standard you apply for what marriage is defined as, you have to apply it equally-I can't pass a law that would require a poll tax, for example, since this would unfairly prevent those unable to pay the tax from voting. Nor could I discriminate against uneducated Americans by requiring a test to access the polls. Likewise, you cannot define marriage as heterosexual as this would de facto exclude homosexuals from marrying.
The Tenth Amendment says anything that is not in the Constitution or the Amendments is reserved for the States to sort out. As the 14th Amendment says whatever standard for marriage must apply to all citizens equally, Alabama would have to either downgrade everyone to a civil union or to allow me to marry, much as Alabama not only has to recognize the Senator for California as a Senator, but also cannot exclude impoverished residents from voting for their own Senator.
You seem to confuse the popular will with the law. They are not one in the same, nor have they ever been; were they, there would be no need for a Constitution at all- all matters would simply be handled by whatever the majority declares on a referendum at any particular time. We don't do that in this country-if we did, miscegenation laws would not have been struck down by the SCOTUS in Loving vs Virginia. The rights of the minority are respected in a democracy such as our own, no matter what the howling mob outside the courtroom may think.
If you would rather live in a lawless anarchic state where whoever can rally the most troops decides who has rights and who does not, move to Somalia.
Incidentally, the majority of Americans have recently voted Democratic. Should we therefore hold a referendum on whether Republicans should be allowed to vote, since they comprise a despised minority at this particular moment?
There's as much justification for denying Republicans the vote as there is for denying me the right to marry.
We should come up with a minority name for Republicans-I'm thinking we could call them 'Evil-Americans'. It's a little derivative, though. Inhuman Slime has more of a ring to it, although I'm not sure it would catch on as well as EA would.
> The passage refers to the need to obey the laws of man which are distinct from the laws of God-pay your taxes to the Roman empire even though Rome is not a christian state.
Which has f*ck all to do with what you were talking about. You were trying a huge bullshit stretch at best. It'll only serve to enrage the vast majority of those that strongly don't agree with you (whom you aren't going to win over anyway) and have you coming off as a either an two-faced blowhard or a babbling nutcase to those that are on the fence (which you WILL require). None of which is going to help you out.
Stop reaching into/bringing up the Bible/Jesus to try make your case. It only makes it harder for us that ARE trying to help. :/
You know Dwight, the thing I love most about you is your ability to attack the argument and not the person making it. You're such a pillar of calm strength, someone who never flies off the handle into an irrational rage.
Well, fuck it, if you're going to bullshit me why shouldn't I bullshit you?
I've repeated myself a dozen times-our government does not apply the laws based upon the whims of an angry mob, soc who cares if you're enraged or not? It's the Constitution, stupid.
Oh, and one more thing? I neither need nor want your help.
What does God or Gay have to do with health care. You let this idiot sidetrack you.
When it comes to large scale endeavours that require long term planning, the federal government is more efficient. It beats the private sector and that's just the facts Jack.
If it works for the DOD why can't it work for healthcare.
What does God or Gay have to do with health care. You let this idiot sidetrack you.
Larger cycle, he's been doing this for a while. So I thought I'd get it over with and bite.
Well, fuck it, if you're going to bullshit me why shouldn't I bullshit you?
... I'm not but I guess I should get ready for you to really cut loose with the bullshit now?
I've repeated myself a dozen times-our government does not apply the laws based upon the whims of an angry mob, soc who cares if you're enraged or not? It's the Constitution, stupid.
Oh, and one more thing? I neither need nor want your help.
Yup, there it is. That is patently false. Otherwise why are you here thread after thread impatiently shaking an angry fist at Obama for "doing nothing"? Tossing out doomsaying about the Gay Vote is going to abandon him.
If it was all about the Constitution you could just STFU and sit back at ease. But that isn't the case, is it? No, debate and public opinion matter, too. Something you are handling in a ham-handed manner, something that you are proving decidedly bad at. Part of it is trying to get into theological arguments about gay marriage. But every time you bring up the Bible you LOSE. You lose in public opinion because while people are likely to be convinced that the Constitution is on the side of civil unions, there is only a very small slice of the public that could be swayed to consider that the Holy Trinity is down with it, or even neutral on it. You want this all framed in the Constitution. You DO NOT want the Bible to come into this, you don't want that forefront in people's minds when making this decision. Because right or wrong, that's going to go poorly for you.
So tone down the bullshit, stop talking about the Bible, concentrate on the Constitution when discussing this, focus on what the law does (meaning being flexible on wording of "civil unions" over "marriage", if you aren't already), and when you feel your panties getting in a knot stare at this picture till you feel the panic subside. :P
SnW,
If your reading of the constitution is correct, and frankly I think its a stretch at best, why is it a congressional matter at all? Why isn't the issue before the SCOTUS? And as such it doesn't need to be a political issue for Obama.
But your idea that popular will has not affect on the law is frankly naive at best. In an ideal world then maybe it would be ok, BUT we all know that all laws are subject to popular will. The court only deals with issues that popular will pushes upon it and the legislative branch is not going to stretch popular will beyond a certain level. So to seperate popular will from the law is just a silly point. (If you doubt this then compare Plessy vs Freguson and Brown vs School Board of Topeka.)
To: Saint Dude, SnW, and PeteKent,
Increasing the number of people in the pot receiving healthcare will not by itself lower costs for all. Supply and demand economics will only work to lower costs if the population increase comes from those people who only use it infrequently, which is probably just the opposite of what would happen. Also without more doctors those already in practice will be in the position of being able to charge more for their services not less due to supply/demand.
Before any meaningful reduction of costs can occur there must be changes to our society other than just giving everyone care. We could make healthier lifestyle choices. All schools could offer classes on good nutrition and its health benefits. Courts awarding megabucks to patients could be eliminated except in obvious cases of malpractice. Someone said earlier that Medicine is not an exact science. Patients, lawyers, and juries must come to understand this fact. As stated there must also be a substantial increase in the number of available doctors to care for these new people who will seek treatment. Once we have more doctors hospitals can stop seeing non-emergency cases in ER's. More medical personnel and hospitals will also mitigate long waiting lists for elective surgery.
Even if we successfully lower costs are you really interested in Government controlling another healthcare system? I'm not! It hasn't been able to effectively administer the Medicaid, Medicare, and Social Securtiy programs. I don't want them now telling me what type of healthcare I'm entitled to and which doctor is going to treat me. Given a choice I am in favor of less Government in my life, not more.
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