I am, of course, happy that the Democrats' plans for our health care system are not doing well at the polls. But my happiness is tempered, perhaps even erased, by the fact that many of the people opposing it are grievously misinformed. Good policy shouldn't need to be sold by wacked-out lies. (I'm looking at you, too, Democrats--who was it who told granny she was going to lose her social security during the last big Republican reform effort?)
As I've said, I think the underlying worry is valid. It's odd to me that people settled on an obscure provision about end-of-life counseling to call "death panels", when of course, the actual proposal you have to fear will cut off your too-expensive care is IMAC. Old people know they have it very, very good in this country, and they are reasonably afraid that a system which attempts to get costs under control--and yes, Obama did say he was going to finance this by cost-saving in Medicare!--will tell them to, well, take a painkiller instead of getting a pacemaker at age 99.
But you can say that you're worried about where this is all going without claiming that the healthcare reforms are going to send death squads out to round up Trig Palin. There are enough actual problems with the bills on the table. You shouldn't need to go making them up. And if you do have to . . . well, in a democracy, you kind of deserve to lose.
Copyright © 2010 by The Atlantic Monthly Group. All rights reserved.
If anyone had cared about CPSIA, would you have thought it silly for opponents to make a big deal about the law mandating "burning children's books"? Not technically true, but the law does outlaw the sale of a large number of older children's books. I'm sure the sponsors didn't intend for that to happen, either.
So, a line like:
"Some 45% said they believe the plan is likely to include such a provision that has become known as “death panels” despite bipartisan efforts by President Barack Obama and the provision’s author, Republican Georgia Sen. Johnny Isakson to dispel the idea."
Depends on how they asked the question. If the government will take over a large portion of insurance, and intends to cut costs, it will ration care. Assuming the same people in powerful positions in the administration end up determining the rationing, it will be based on quality of life.
There is no final plan on the table yet, so whether or not the final version has such provisions isn't a factual question. The large amount of people believing that the final bill will contain such provisions isn't an indication of delusion, but of distrust--a distrust that Washington has amply earned.
"the government ... will ration care."
I don't understand this argument about government rationing care. Care is rationed now. We do not live in a world of unlimited resources. Care must be rationed one way or another. It's better if the rules are explicit rather than implicit as they are now.
If you do not like how the government rations health care for you, then buy additional insurance or pay out of pocket.
The argument about rationing assumes 1) that medical insurance should cover all medical expenses no matter how little value they actually provide and 2) that there are no other medical options besides government. Both assumptions are half-baked.
This argument about rationing comes from conservatives and libertarians who otherwise believe people should be self reliant. Except, apparently, when it comes to health care.
Talk about inconsistency.
I understand your point, but do you see the counter point? You're telling someone to "buy additional insurance/care" that is likely already paying extra tax dollars to fund -someone elses- insurance/care.
"Let's take from you to give to someone else, and if you want to get what you need you have to pay more for it."
The whole mindset of "If you do not like how the government rations health care for you...."
The issue is the government is proposing taking -my- money and giving it to someone else and then likely rationing what I can get.
That philosophy is consistent with one thing, and it's not a democratic society that values individual liberties.
1. Not the point--the question was whether or not it's plausible to believe that the government under an Obamacare reform would ration care.
2. There's a very strong argument--so strong that all economists except for a few who have given up their intellectual honesty to become partisan hacks (e.g., Krugman)--that a public option tied to the regulations in Obamacare would crowd out private insurance for around 100M Americans in the first 5 years.
3. At the moment, I don't buy $30 steaks every night because that would be too expensive. We would not call this rationing. We would call it rationing if the government said, "You can only have steak one night a week". There is a difference between my being priced out of the market and government forced rationing. If you can't see that, you're the one who's being irrational and ignorant.
But you must admit that it was a wonderful allegation that Stephen Hawking would never have survived under the British NHS.
Yes, that was foolish. It also wasn't part of the attached poll.
That was also a foolish claim because Stephen Hawking is a special case who would receive top quality care no matter what country he called home. Becausw he's Stephen Hawking. But what about some regular schmo who got ALS? What quality of care would he get under the British system? That's the real question the unfortunate choice of Stephen Hawking allowed people to dodge.
Megan, "Death Panels" does not refer to end of life counseling. That's the characterization of a media overwhelmingly in favor of reform. That what supporters of the bill want you to believe it refers to. In fact, it refers to government boards deciding coverage and exclusions. Which they obviously will.
The prevarications of O and company are more outrageous ie. claims that the plan won't impact people's existing plans and doctors; or that there is no idea about transitioning to single payer.
Or that he's going to provide coverage for 40 million people without spending anything extra.
The blogosphere is chock full of editorials pointing out that there *is no* real "plan" behind the Health Care bill. That's why the opposition is so successful as referring to is simply as "Obama Care," and pulling up (real) quotes from Obama from the past few years - particularly when they contradict what he is claiming now.
Where are the specifics?
Like the "stimulus bill," this is nothing but a mash up of old crap, vested interests, special interests, and socialist ideals. It is as coherent as a rugby scrum.
Time and again during the election people pointed out that Chauncey was an empty suit. Slow talking, yes. Well metered and disciplined? Yes. Tenaciously on point, particularly when the teleprompt-r's were running? Absolutely.
But experienced? Nada. Not even as a Senator. His record is pitiful...
and now, to quote one of his spiritual advisors, "those chickens have come home to roost." It's as if Obama hadn't even passed a High School civics class.
"Chicago Politics?" Oh, on that he's a Ph.D. But DC? We've never seen anyone less capable or competent in the Oval Office. He's a train wreck.
The "lies" are simply filling the gaps. What's more interesting, in an academic and comical way, is the almost complete lack of substance in this "bill."
From a comment on one of your posts below: "there is a limit in the UK of GBP 45,000 per patient per year excepting extraordinary cases" - I see what you mean about being grievously misinformed.
That was from Nat Hentoff in the Jewish World Review, and refers to the number of TB cases the UK will treat.
Is there some basis on which to claim the allegation is false?
Oops no, different article. It was actually by Matt Holzman.
Nat Hentoff is a Republican shill teabagger insurance lobbyist.
Right?
TallDave is purple and 17 feet tall. Is there some basis on which to claim the allegation is false?
There are allegations that are so completely batshit crazy that its very difficult to find references to cite against them. Whether you realise it or not, this is one of them. The NHS does not have online resources documenting how much money they'll spend on a TB patient because there is in fact no such limit - that's not how it works.
It's not batshit crazy to suggest the NHS rations care.
It's quite a lot crazier to suggest they don't.
From the article:
I haven’t followed this particular issue that closely but I seem to recall reading something about an amendment being offered which was defeated that would prohibit illegal aliens from being covered. Unless there is language in the bill to the contrary, I think it’s a fair criticism, particularly since so many of the proponents of the bill throw out the mythical “47 million Americans don’t have health insurance” number which includes about nine million or so non-citizens.
Actually there is for all intents and purposes a proposed complete government takeover of health insurance. It comes in a combination of the “exchanges” and the “public option.” The “exchanges” would require that every private health insurance policy (if you have an existing one it will still happen but you might have five years before it goes into effect) cover the same benefits and limit how much of the cost the patient is responsible for (e.g. co-pays, deductibles, co-insurance). By limiting the amount the patient is responsible for in terms of co-pays, deductibles, and co-insurance, the result is higher premiums (a sharp contrast to Obama’s earlier promise that consumers might save up to $2500 on their premiums) which would price even more patients and smaller employers out of the private health insurance market.
The “public option” combined with an employer mandate (and possibly an individual one) would likely cause millions of people who have health insurance to get dumped onto the public system. This would happen because the new “exchange” would make private policies even more expensive and the “public option” would likely be exempt from many of the same regulatory and taxes that private plans have to pay (in addition to likely being able to borrow at cheaper rates and receive extra infusions of cash from the federal treasury).
So yes, I would say that this amounts to a federal takeover of health insurance even if some of the proponents don’t like to owe up to what they’re proposing.
Note that he says that this is a “tradition” but he doesn’t promise or state that he feels any obligation to honor said tradition. During the campaign Obama said that he favored repealing the Hatch Amendment which prohibits direct federal funding of abortions, would include “reproductive health care” as part of the “public option,” and his proposed “exchange” would require private plans to offer the same benefits at the “public option.” I also seem to recall that there was an amendment to prohibit abortion coverage which was defeated as well.
It should be pointed out that Obama’s home State of Hawaii has an ERISA exemption and an employer mandate to buy health insurance for employees. Hawaii does in fact require that employers provide health insurance coverage for abortions and limits the amount that the employee is responsible for.
So yes, based on Obama’s public stance favoring federal funding of abortion (by supporting the repeal of the Hatch Amendment), his call for covering “reproductive health” and his party’s defeat of language that would specifically prevent abortion coverage, and his support for requiring private plans to cover the same benefits as the “public option” as his home State requires, I think the people who believe that this bill will require them either directly (through taxes) or indirectly (through health insurance) to pay for abortions are probably correct.
Regarding illegal alien care, I would be shocked if the courts didn't mandate it regardless of the language in the bill. I'd bet my last dollar on that.
Correct.
Also correct. The last version of the House bill I saw did not mandate that all plans cover abortion, but it did mandate that at least one health plan offered in each exchange cover abortion.
So some of these mistaken ideas are based on at least half-truths, and people are committing their own half-truths in falsely dismissing them.
Speaking of CPSIA, it reminds me of snopes going too far in dismissing the concerns of thrift stores and others about the effect. Snopse essentially said that, "OK, maybe the bill says that, but the politicans have promised waivers and that they won't read the bill as written, so people who claim it will happen are all liars."
I'm actually surprised more right-wingers aren't bringing in the lessons of CPSIA, because it's a really powerful example of unintended consequences from large bills that no one bothered to read.
Over at the Volokh conspiracy they've had a number of posts regarding some of the unintended consequences of the Consumer Product Safety Improvement Act of 2008 (CPSIA) and I know Megan has done at least one post on the topic.
You beat me to it. All you left out was mocking Megan for saying that it has to go out and "round up Trig Palin" in order to count as a "death panel".
A government panel that decides what's "appropriate care", that decides who will, and won't get treated, that gets to say "yes, we could help you, but we don't think it's worth the cost" is a "death panel".
So, Megan, what do you say about a side in a debate that can't even do an honest "fact check"? That, in a democracy, "they deserve to lose"?
No one was going to put Trig Palin in front of a panel to determine whether he was productive enough to live. QALYs are tied to subjective perception of life-quality, not your tax contribution. Trig would have been fine--Downs kids are not left to die in Britain. It's old people who have to worry, because they just don't have that many years left to amortize a treatment.
Megan, your response as I understand it boils down to, Trig and everyone else with Downs will pass the test, which isn't to say that they won't be subject to scrutiny.
Megan,
Why don't you defend your statement that opponents of the government health care takeover are "claiming that the healthcare reforms are going to send death squads out to round up Trig Palin."
Death squads? Really? Are opponents trumping up false charges that Obama wants squads of assassins roaming the countryside to round up disabled people to kill them? Is that what health takeover opponents are doing?
Defend this lie.
And if you can't, in this democracy, you deserve to lose.
Megan,
1) YOU DON'T KNOW THIS. You've pointed out yourself that most of the policies (once all healthcare flows from the government) will be handled by bureaucrats. They don't have to say "Trig dies" in order to approve payments for care that amounts to the same thing or results in a mother feeling pressured to have an abortion.
2) The "death panel" clause is in a measure explicitly designed to control costs. How could anyone think the purpose of these panels might be used to ration expensive life-saving care?
3) Palin (in a facebook post) put in two words what WaPo took two paragraphs to say and a dozen paragraphs to work up to. The Palin-haters trumpeted the "death-panel" term to discredit her. They under-estimated her (again).
4) You drastically overstated Palin's position. Just what you are criticizing others for. Is it really necessary for you to trash Palin for doing God's Work in gutting this proposed bureaucratic nightmare in order to gain credibility for your positions?
Remember back in 1995-1996 when the GOP Congress tried to reduce the rate of growth of Medicare? In other words, almost precisely what Obama is saying he will do to finance half of the reform package? The Democrats and AARP screamed to high heaven, and scared seniors into believing the evil Republicans were attempting to "repeal Medicare". It wasn't true, but no one on the left cared. All that mattered was the political effect.
And that's the top priority for everyone in Congress and the special interest groups (and more than a few in the media)--political theater. The actual ramifications of legislation and policy take a decided back seat to the political spin cycle. Few Members of Congress have actually read much of the health care bills or pondered their potential effects. Same for cap and trade. What's worse, they don't intend to. Because by far the only thing that counts, the only thing that matters to them, is who's winning and losing in the political game. And if it takes lies to get an advantage, so what? A good bit of the public will buy it. And the media will breathlessly cover "the controversy", because that's what the media does. That's it's a sideshow, and total horseshit and puffery, is irrelevant.
We seem unable to admit a very sad and problematic truth. Electronic behavioral conditioning works. The less education you have, the better it works. The prototypes developed by the Reich Ministry of Propaganda have been further advanced by our own chubby Goebbels, from Rove to Rush. Through sheer party discipline and repetition, simple word associations have structured many policy debates around specious terms, such "free" + "market" or "rich + "liberal" + "elite" or "government" + "waste" or the "death tax" and "death panel."
For a fearful, TV-soaked population with little time or money for advanced education, with poor analytical skills and historical illiteracy nearing the Alzheimer's stage, such rhetorical conditioning is now the primary instrument of organization and collective certainty. (And everyone said the Frankfurt School critics were too pessimistic!)
Electronic demagoguery works. It works for the right wing, it works for the Republican Party, it works for the plutocracy. It works for the Democrats too, but not as consistently and not for the same purposes. And yes, this is an "elitist" argument, which is why it is rarely voiced. Television is constantly reminding Americans of how smart and talented they are, and they are enraged by any "elitists" who think they know better. I do not expect a rational dialogue on healthcare.
Per P.J. O'Rourke, the three coequal branches of the US government are Money, Television, and Bullshit.
Oh please, as though the righties have a monopoly on being stupid and easily brainwashed by electronic media.
Meghan, how come when you oppose health care reform because you believe whatever passes now is just the camel's nose under the tent for further gov't healthcare meddling - and you're a smart policy wonk, but when "a majority of Americans (55%) believe the bill will extend health insurance coverage to illegal immigrants even though no proposals currently under negotiation would do so. An equally high number (54%) believe the overhaul will lead to a “complete” government takeover of the health care system, although there is also no actual proposal for that, either" they are rubes for believing in grievous lies?
Why is OK for elite-class wonks to worry about what will come, even if's not in the bill, but not for the rest of us?
Those are good questions, from what I can tell (see my above comments) a lot of the “myths” regarding coverage for illegal aliens, being forced to pay for abortions and a takeover of the health insurance system seem to have quite a lot of truth to them. If there’s ignorance in this debate, a lot of it seems to be coming from members of the MSM like the reporter for NBC who wrote the underlying article either didn’t read and understand the underlying bill or just decides to believe whatever it is that Obama sounds like he’s saying now over whatever anyone says to the contrary (including Obama at an earlier event).
The Politics of Prevarication deserves to lose.
"Deserves" ain't got nothing to do with it.
In a democracy, a decisive slice of the electorate,
say 1/3, lacks the wit to understand the issues,
the will to face the facts, and the motivation
to vote; They need a little nudge, and they
respond well to conspiratorial lies, so
good people end up saying the wrong
thing for the right reason.
Megan -- You're right, it really is a shame that we didn't let Grandma put more of her retirement money in the stock market in 2005.
The plan would not have covered grandma, since people close to retirement were grandfathered in. The rest, dollar cost averaging, would have been fine.
You're right, my 401k, which lost half its value last year due to the stock market, is fine, if you dollar cost average -- WTF?! I think the point is that social security, if put in the stock market like Bush wanted, would be decimated now.
I think the point is that social security, if put in the stock market like Bush wanted, would be decimated now.
Who said you had to put your money in stocks - have you heard of bonds?
Anyone over 45 should have a large chunk of their 401K in bond funds or other lower-risk vehicles.
IF you are approaching retirement and had your 401K lose half its value, then you need to read "Investing for Dummies" or something similar.
You're right, my 401k, which lost half its value last year due to the stock market, is fine, if you dollar cost average -- WTF?!
It lost half its value after gaining a lot in previous years, and has since recovered quite a bit, unless you did something silly like panic and sell at the bottom. Long term, dollar cost averaging works. If it doesn't, that implies the economy has completely imploded and you were going to be screwed regardless.
I think the point is that social security, if put in the stock market like Bush wanted, would be decimated now.
Um, no. No plan has ever called for dumping huge amounts of money into the market at a single point in time.
Wait a second, the whole point of this comment thread was about privatizing social security. You're saying that the solution to avoiding the stock market drubbing millions of people took and would have taken -- is government bonds?! Isn't that a long way around to get the money back to the government?
You're saying that the solution to avoiding the stock market drubbing millions of people took and would have taken -- is government bonds?!
No. High-quality corporate bonds and foreign bonds are also good. There's also stock funds for low-risk investors that buy utilities etc.
And millions of people who are not approaching retirement should take the drubbing because they are in it for the long term.
"But you can say that you're worried about where this is all going without claiming that the healthcare reforms are going to send death squads out to round up Trig Palin. "
Here's what won't happen Megan: You won't be allowed to set the terms of the debate.
Nobody, (and I have followed this issue just as closely as you have) has suggested there would be "death squads" rounding up the disabled.
"Death Panels" however, are part and parcel of what the Democrats are proposing. Obama is proposing them. That he doesn't call them "death panels" is beside the point.
That is in effect and in practice what they are. They are panels of government bureaucrats deciding who can and cannot receive health care based on government standards. They are death panels, and they scare people, and we're going to make sure elderly voters know it. And you won't be allowed to stop that.
When Obama tells stories about his grandmother's hip replacement, he out and out says he believes that society should not have provided her a hip replacement. If the government is allowed to deny people hip replacements, then it will be able to deny people other types of care.
Death Panels is the inevitable result of that and that's why the Demcorat plan to take over health care is going to fail.
"When Obama tells stories about his grandmother's hip replacement, he out and out says he believes that society should not have provided her a hip replacement. "
That sounds very definitive. Where, specifically, does Obama say that he believes that society should not have provided her hip replacement? Please provide the exact words in which he "out and out" makes that definite judgement.
Do you read the NY Times?
Here, the New York Times, in a guest-editorial, agitates for death panels and cessation of Medicare for the elderly:
http://www.nytimes.com/2009/08/17/opinion/17dooling.html?partner=rss&emc=rss&pagewanted=all
I quote: "One thing’s for sure: Our health care system has failed. Generational spending wars loom on the horizon. Rationing of health care is imminent. But given the political inertia, we could soon find ourselves in a triage situation in which there is no time or money to create medical-review boards to ponder cost-containment issues or rationing schemes. We’ll be forced to implement quick-and-dirty rules based on something simple, sensible and easily verifiable. Like age. As in: No federal funds to be spent on intensive-care medicine for anyone over 85."
Here, in an interview with the NY Times, Barack Obama questions the wisdom of us "giving" his own grandmother a hip replacement surgery to relieve the excruciating pain she was in after falling and breaking her hip:
http://www.nytimes.com/2009/05/03/magazine/03Obama-t.html?partner=rss&emc=rss&pagewanted=all
"my grandmother got very ill during the campaign, she got cancer; it was determined to be terminal. And about two or three weeks after her diagnosis she fell, broke her hip. It was determined that she might have had a mild stroke, which is what had precipitated the fall.
So now she’s in the hospital, and the doctor says, Look, you’ve got about — maybe you have three months, maybe you have six months, maybe you have nine months to live. Because of the weakness of your heart, if you have an operation on your hip there are certain risks that — you know, your heart can’t take it. On the other hand, if you just sit there with your hip like this, you’re just going to waste away and your quality of life will be terrible.
And she elected to get the hip replacement and was fine for about two weeks after the hip replacement, and then suddenly just — you know, things fell apart.
I don’t know how much that hip replacement cost. I would have paid out of pocket for that hip replacement just because she’s my grandmother. Whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model, is a very difficult question. If somebody told me that my grandmother couldn’t have a hip replacement and she had to lie there in misery in the waning days of her life — that would be pretty upsetting.
And it’s going to be hard for people who don’t have the option of paying for it."
It's going to be hard for people who don't have the option of paying for it, Obama says, as if his twisted vision of health care reform has already passed.
It hasn't passed. And it's not going to pass.
I'm really sorry that I have to quote these in a comment replying to being called a "prevaricator." You'd think Megan would read the NY Times.
I didn't ask where Obama said that it is a "difficult question." I asked you to substantiate your claim that "he out and out says he believes that society should not have provided her a hip replacement."
You have not done so. Are you prepared to do the honest thing: acknowledge your claim as false and retract it.
Or would you care to try again to provide the specific quote to substantiate your claim?
Here is the New York Times story by David Leonhardt from April 2009. Obama's exact words, in context:
Now, he doesn't specifically make a definite judgment that society definitely should not have paid for that particular hip replacement. He says that it's a "difficult decision" for society, though he stresses that he would have paid with his own money, since he could afford it. He says that people would want to spend the money, but it's a "huge driver of cost," "potentially 80 percent of the total health care bill." He wants an independent group to give guidance about whether it is worth it for society to do so or not.
But the topic is definitely up for debate. He's certainly saying that society should not pay for some end of life care that is currently going on.
I agree -- I won't have my coverage denied by a panel of government bureaucrats. I'd much rather have it denied by a panel of insurance company bureaucrats. Because I know in my heart that deep inside the mansions where the insurance executives live, built with my $2000/month premiums that don't cover prescriptions or dental, I say deep in those mansions are the people who are REALLY looking out for me. And when those executives ration my care -- sorry, when they deny coverage based on a pre-existing condition -- then I look at the flag with a tear in my eye and think, wow, now THAT's the free-market that is guaranteed by the Constitution!
Rosser Clark:
Your satire doesn't make sense. You see, it's only if you believe in the public option that you have to believe that the government officials and politicians, deep inside their mansions, built with your tax dollars and their lobbying, REALLY look out for you.
Libertarians have no such romantic ideas about the free market, nor about government. As Adam Smith said:
Thinking that a company raises prices out of meanness and cuts them when it's feeling nice is incredibly stupid. Companies raise, lower, and keep prices the same out of the same thing-- pure greed. Companies are always greedy.
Why does individual health insurance cost so much more in NY than in VA? Are the companies just greedier in New York? Why do mutuals, co-ops, and nonprofits not charge lower premiums than the for-profit companies?
It only doesn't make sense if you think: 1) companies are always greedy, AND 2) companies are the best way to provide health insurance. If all those countries with government-run health INSURANCE are so horrible, why are we 29th in health outcomes, while paying twice what the others pay?
I don't get this: Obama and others on the left has explicitly talked about having panels of experts discuss end of life issues with the elderly in the context of cutting costs out of our health care system. In fact, Obama explicitly discussed this issue in the context of cutting costs out the health-care system in a New York Times interview just a few months back. What else would you like to call this other than a death panel?
I don't get where you're getting from this death squads; I know it proves a certain amount of hipness to a certain section of the elite to trash Palin (got to prove to the male hierarchy that you're willing to rape any women who tries to take power for herself on her own terms, after all (metaphorically, of course, sista)), but the death squad comment was written by her on a facebook page; it wasn't even given in a speech. The media trumpeted this to try to use it to discredit those who opposed Obamacare. They have only themselves to blame that it turned on them, and many believed it.
But, this goes to a deeper question: Why are so many willing to believe this of Obama? His constant lying is catching up to him. Most polls now say a majority of Americans don't trust him. And for a citizen of the world with no real past, this is very bad news.
Barack Obama doesn't believe that we should be spending so much money on what he terms the "chronically ill."
Here he is, again, describing the cost-cutting death panels in the New York Times:
THE PRESIDENT: "I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.
Interviewer: So how do you — how do we deal with it?
THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now."
Barack Obama himself just described a death panel made up of doctors, scientists and ethicists. Why would you need ethicists? Unless he himself recognizes what he's describing to be akin to a death panel.
Cite:
http://www.nytimes.com/2009/05/03/magazine/03Obama-t.html?partner=rss&emc=rss&pagewanted=all
When people describe these as death panels, it's because that's exactly how Barack Obama described them. It's not a lie to call them death panels, because that's what they are. And many people recognize it for what it is and are fighting against it.
I suspect that fight will continue until the Democrats are removed from power in 2010. And you can bet there will be a huge GOTV effort where elderly voters will get free rides to the polls by people well-versed in the "death panel" issue.
I would call it offering financial support for a routine, optional medical service that is widely used today, supported by many insurance plans, and that many people find valuable.
It is certainly true that there are circumstances in which doing the right thing will produce cost savings
It is the right thing to do to provide preventative care. It also may produce cost savings by reducing expenditures on expensive preventative diseases.
It is the right thing to do to provide people with information about how to insure that their wishes regarding end-of-life care are followed. And explaining to people how to avoid expensive, painful medical procedures that offer no real benefit and that they do not want may in some cases yield cost savings.
"I'm looking at you, too, Democrats--who was it who told granny she was going to lose her social security during the last big Republican reform effort?"
Since Social Security is a pay as you go system, where was the money for current retirees going to come from if all current workers started putting their Social Security money into private accounts? It's my understanding that mainstream media dodged this question almost entirely back when this was an issue.
I think it's a legitimate claim. Either current workers would have been forced to pay 'double social security' (deposits into accounts plus extra taxes to cover current retirees), or granny would, in fact, have faced drastic benefit cuts.
No, they wouldn't. Current workers are going to have to pay out the money to retirees regardless; the partial privatisation plan just made an unfunded liability explicit. Anyone who is not already retired will pay in more than they get out. It's the same thing--it just feels different because the cost is buried and most people aren't very good at math.
Yes, they would. Under Bush Social Security, if current retirees were still to receive benefits at the same level, current workers would have to pay the same Social Security taxes that they have been paying. In addition, they would have to deposit money into their private account.
Compare this to the current situation, in which current workers pay for current retirees, and then receive benefits from future workers. They really would have been paying double under the Bush plan.
No. There will be fewer workers and more retirees in the future.
...Megan, continuing. To simplify, suppose C is the parent of B and B is the parent of A. Currently, C receives benefits from B's taxes, and B receives benefits from A's taxes. Every generation except the first (who are already long gone) pays one persons taxes and receives taxes from one person.
Under Bush, C would have received benefits from B's taxes, and B would have received benefits from B's own account contributions (C would pay no SS taxes, and receive benefits from his own account). C's generation pays once and receives once, but B's generation pays for C's benefits and for B's benefits. With A's generation, we return to everyone paying for their own retirement. (I'm ignoring the fact that different generations are of different sizes and life expectancy is not constant, these are equally important, but separate, issues.)
...edit (**A** would pay no SS taxes, and receive benefits from his own account)
This is true. But actuarially, there is no difference in the cost to the workers. The difference between what the workers are putting in now, and what they will eventually be taking out, must, as an accounting identity, be equal to the transition cost of the program. Either way they pay . . . but with the partial privatization, they had some chance of actually earning a market return on their money.
Either way, the generations are too small and the beneficiaries are living too long for B to support C to any reasonable extent, and things get even worse for B once it has to rely on A. It just isn't possible for each generation to keep relying on the next anymore. With properly structured debt, however, it should be possible to spread B's cost through multiple successive generations, guaranteeing B something close to the retirement enjoyed by C and only hampering generations A-? [it would have been better if your generations went in the opposite direction] by a slowly decreasing fraction. B will have to pay some amount extra to keep C in Depends and Ensure, but that's going to happen regardless.
If you do nothing, every generation starting with the back half of B would be facing benefit cuts and/or every generation starting with A would be facing tax increases to pay them off. With a partial reform, the tax increase/benefit cuts would only need to happen once, rather than repeatedly with each new group. Thereafter every generation pays its own way, with the exception of the slow, lingering B payment. The sooner you reform the system, the lower the extra payment would be and the sooner we can transition to a long-term manageable plan.
@Megan. I think you are still not understanding the point. If you switch from pay-as-you-go to advance-funded, it is as if social security is ending at the end of the current generation.
The current workers would pay SS for current retirees and receive ***NO*** benefits later on. All they have is a special account that can be thought of as a substitute for ordinary saving.
The next generation of workers after the current would pay ***NO*** SS taxes at all, and would just have their own account.
With ordinary SS, on the other hand, the only difference for the current workers is that they will receive benefits from SS taxes of the ***next*** generation of workers.
@Mario. You are raising a different problem from the one I was discussing. I will note that there is no way to solve the demographic part of the crisis with either a pay-as-you-go system or an advance-funded one. Even in an advanced funded system, you still have many retirees fighting over scarce resources, namely the goods and services produced by the small workforce of scarce young people. This pressure is likely to severely erode the real value of their retirement assets.
Not to go too far OT but I think you raise a fair question about the transition costs which were an issue (although not as big of an issue as Social Security’s unfunded liability). There were several bills that would have addressed this either by changing the formula for benefit increases (which overstated inflation), phasing in a higher retirement age (which would have protected current retirees), removing the cap on FICA, or some other combination.
Me, I preferred a combination of means-testing, phasing in a higher retirement age, and possibly changing the formula for benefit increases.
Means testing sounds good, but it's actually a terrible idea. Consider the effect of means testing on the incentive to save for retirement.
Of course, something like raising the eligibility age needs to be done because the retiree/worker ratio is rising. Fortunately, we have Japan, South Korea, and Europe to watch how they deal with the problem before we have it.
Means testing sounds good, but it's actually a terrible idea. Consider the effect of means testing on the incentive to save for retirement.
It wouldn't necessarily be any worse than the disincentive caused by taxation in general. As long as you avoid stupid situations like the effective tax rates of over 100% that many working poor face when their benefits go immediately to zero once their wages cross a threshold.
@Brain 2. I disagree. Ordinary income tax can actually increase the incentive to work, because it isn't as easy to build up a nice retirement nest egg in a few short 'fat' years. Means testing SS payments would by definition produce no such result because it penalizes people for accumulating a nest egg.
...continuing. to put it another way, with means testing, people would have an incentive to retire early and burn up their savings so that they run out of money just when SS kicks in, so that they pass the means test.
burn up their savings so that they run out of money just when SS kicks in, so that they pass the means test.
Well, if it's done right (yes, huge if) there wouldn't be a hard cutoff where if your assets are $X you get substantial benefits and if they're $X+epsilon you get nothing.
It doesn't matter if there's a hard cutoff, for anyone wanting to maximize lifetime spending with the minimum necessary amount of work, there would still be an incentive to burn their savings down to the point at which they would receive maximum benefits. Having the means test phase in would only lessen this effect, not eliminate it.
Means testing would be the biggest swindle in history. I've paid into Social Security my entire life on the promise of collecting when I retire. It's my money, damn it.
You know I understand the feeling behind this line of reasoning but legally/morally I think it's on shaky ground. Doesn't the Social Security Act contain a provision to the effect that Congress can modify the plan any time, including doing away with it? If so I think anybody who's "paid in and ready to cash out" has been swindled to some degree. But as a person in his early 30s it's not obvious to me why people my age should be forced to be left holding the bag just to fulfill a bargain that we weren't really even a party to. I mean even the Madoff "screwees" gave their money to him voluntarily, it's not like the government is forcing new people to "invest" with him now that the jigs up just to pay off those who got swindled first. I'm sympathic, but you all did have a say in this while it was going on while folks like me had no say by virtue of being unborn.
Legally it isn't, and I don't think it is morally either. The entire point of Social Security is to reduce poverty among retired people, i.e. welfare. Its structure is ridiculously convoluted to try to hide that fact, but fundamentally it's just a tax and a stream of benefits. Complaining that you don't get "your" money back doesn't make any more sense than saying you should get food stamps because you pay taxes for them, or that you should get a ride in an F-22.
Then again, I'm an apparently weird form of libertarian in that I don't mind limited redistribution for the sake of actually helping those who are worse off; I'm much more concerned about government interference in the larger economy. I'm fine with the welfare part of SS; it's the forced-savings-with-negative-return-rate obfuscating shell around it that really annoys me.
Every Congress is a new Congress. You can't make legislation binding on successive office holders, so it really doesn't matter what the act says - unless it's a constitutional provision Congress can change it.
Yep. It wasn't obvious to me when I was 30 either. But I paid in because I didn't have a choice, even though the train wreck was on the horizon. The system needs to change, but means testing isn't the answer. If they're going to reduce payments, reduce them for everyone.
Yes, but under the current system, the status quo defended by the Democrats, there's going to be a sudden benefit cut of 24% in 2037. See the SSA's own website:
Plenty of informed Democrats said that that was absolutely no problem, but that cutting the rate of growth of benefits very slowly, by .5% per year, was completely horrible. I don't understand why a sudden and drastic cut in benefits would be preferable. I suspect that they realize that suddenly dropping benefits by 24% would be politically impossible, and actually prefer the alternative of raising taxes to pay for it.
This issue is separate from what I was talking about. You are referring to the problem resulting from having too many retirees and not enough workers, while I was referring to the inherent problem with switching from a pay-as-you-go system to an advance-funded one.
I agree that there are problems looming in the coming decades due to demographic shifts. These are inherent with any system though. Even an advance-funded system may suffer when security prices plummet as members of a baby boom retire and sell off their assets en masse.
In looking beyond the news stories to the actual poll, the poll question does not indicate that people are informed or misinformed about the proposals that are on the table. Here is question #15 from the NBC poll
"Let me read you a number of criticisms that town hall protesters have made about the proposed health care plan. For each one, please tell me whether this seems to you to be likely to happen or unlikely to happen.
Will give health insurance coverage to illegal immigrants ............
Will lead to a government takeover of the health care system .....
Will use taxpayer dollars to pay for women to have abortions .....
Will allow the government to make decisions about when to stop providing medical care to the elderly"
The way in which this question is worded is very future oriented and calling for an opinion as to whether or not something is likely to happen. To state that respondents are grievously misinformed for believing that the unspecified health care proposal is likely to allow the government to make decisions about when to stop providing medical care to the elderly seems like a huge leap. Perhaps respondents recognize that the logic of the plan in question has a significant chance of leading to a situation in which government guidelines will indeed require that grandma should have an analgesic rather than an operation.
Perhaps the real misinformation and ignorance lies in the selective interpretaion of poll results and the willingness to rely on media interpretations of poll results rather than reading the actual poll questions and relying on critical thinking to understand how reasonable people could answer in the manner in which they did.
Though I suppose that wouldn't support the "stupid country" meme.
Regards,
Neil
Nice catch on the wording of the poll questions. It really wasn’t about “what do you know about the specific language of the bill” but rather “what do you think will happen if the bill becomes law and it gets put into effect.” Law professor and blogger Ann Althouse (who like Megan was also an Obama supporter) started turning against Obama on this issue precisely because she understands that concerns about how a law might be implemented are every bit as important (if not more so) than the specific language in the bill or the professed intentions of its supporters.
The wording is actually designed to get a less-than-majority response on these. That's the point of referring to the "town hall protestors" instead of the more typical "some say".
Thanks for the kind words. The divergence between poll questions and stories reporting on poll results is one of my pet peeves.
Neil,
You're exactly right. This poll is being spun to make respondents appear that they're stupid morons.
Well, Megan, we're not stupid morons. We are able to read; we're able to extrapolate from our experiences with out government; we're able to take Barack Obama at his word about what he wants to do (eliminate private insurance).
Obama is out-and-out lying by claiming he can extend health care to 45 million people and it not exacerbate the budget deficit. He's out-and-out lying when he claims his aim is not a single-payer health system. His own words have been recorded, so we don't have to debate whether he's lying or not, since he's on videotape admitting that's his goal.
We don't need a poll to figure out whether Obama is lying. It's on videotape.
How about a nice long post about the lying going on in the White House on the health care takeover.
The poll didn't ask about or refer to "death panels"; it simply asked whether people thought that under the "reforms" the government will decide when to stop providing medical treatment to senior citizens. And, reasonably, many answered yes. Savings have to come from somewhere, and one of the places that Obama has suggested they could come from is not providing medical treatment to certain seniors.
The poll asked whether they thought the "reforms" would extend health insurance to illegal immigrants. And, reasonably, many answered yes. We provide public services, including health services, to illegal immigrants today, and it is incomprehensible to me that we wouldn't provide insurance coverage (and subsidies) as well.
The poll asked whether they thought the "reforms" would lead to a complete government takeover of the health care systems. And, reasonably, many answered yes. It's clear that the public option is meant to be a waystation to single payer, and it isn't hard to imagine a combination of single payer and regulation of coverage outside single payer that is, in effective, a government takeover of the health care system.
The poll asked whether they thought the "reforms" would mean that federal tax dollars are used to fund abortion. And, reasonably, many answered yes. It's "unclear" whether the final bill would do that only because we don't have the final bill. All the contending bills, in one way or another, provide federal funds for abortion.
It seems to me that a majority of Americans have a pretty good feel for what the resulting system would look like. That's why they're opposed.
But to Megan, they're all just lairs who are "grievously misinformed."
No, Megan ... they're all too well informed, methinks. Much more informed than certain columnists who can't be bothered to read the actual poll questions before opining in error.
I have to fear Install Move Add or Change?
That's the last time I call the help desk...
Plenty of thoughtful comments already here to counter Megan's characterization as Obamacare opponents as "grievously misinformed."
People are less stupid than you may think, and are capable of looking down a slippery slope with the same clear eyes that the public-option-as-Trojan-horse-for-single-payer progressives can.
http://www.prospect.org/csnc/blogs/tapped_archive?month=08&year=2009&base_name=the_history_of_the_public_opti
Am I more or less grievously misinformed than the Congressmen who haven't read any one of the several bills floating around that no one has decided how or when to reconcile? Or than Obama who hasn't really settled on what he will claim as his own in the not-yet-settled-on plan, and who also hasn't read any of it?
Pray tell, who represents the gold standard of the INFORMED? I'd like to know. I have some questions answered. Until then, I'll believe anything people tell me may or may not be included in this mess. These are, after all, the folks who came up with the stimulus bill. I'm supposed to just nod and smile and get walloped again? My God. It's Harry Reid and Nancy Pelosi. I'd sooner trust the Manson family to come up with decent policy.
That should be: I have some questions I would like answered.
Nearly half of Americans believe that a proposed overhaul of the health care system means the government will decide when to stop providing medical treatment to senior citizens, according to the latest polling by NBC News released this evening.
It's hard to view this as a miconception when, contra Susan Davis, Obama himself said his own grandmother shouldn't have received a hip operation shortly before she died, and said such a system was "unsustainable."
Further, a majority of Americans (55%) believe the bill will extend health insurance coverage to illegal immigrants even though no proposals currently under negotiation would do so
Again, disinenguous. It doesn't need to be explicitly authorized to happen, it just needs lax enforcement. No one supports a bill giving illegal immigrants the right to vote, but Democrats have always vociferously opposed voter ID requirements, even when bills are attached to provide such IDs for free.
And not only that Dave, but Republicans put the Democrats to a test on the issue of illegal aliens receiving health care under this reform bill by offering an amendment putting it in writing.
The Democrats voted it down.
For Megan McArdle to label people who can see through the charade "prevaricators" is really libelous.
Reasons to be skeptical of the motivations of health-care reformers:
1. Q1: "What is this all about? What is the fundamental problem? Why do we need health-care reform?" A1: "Fundamentally, it is about covering all Americans with high quality medical services at a price they can afford, subsidized by taxes." Q2:"So, any plan that accomplished that goal, including plans that relied only on vouchers and the private-sector would be ok?" A2:"No - any plan without a government-run social-democratic 'public option' is unacceptable." Q3:"Hmm... your reluctance to even consider such a possibility makes me worried that what you are really working towards is for the government to take over all health care. Is it wrong for me to suspect that your true vision and motivations are other than merely universal coverage?" A3: "What nonsense! What evil-monger filled you with such vile lies?"
2. Q1: "Are illegal immigrants going to be fully covered at taxpayer expense?" A1:"Of course not." Q2:"You wouldn't mind passing this amendment that puts that in writing in the bill, you know, just to ease my mind?" A2:"No, that amendment is unacceptable - we will vote it down." Q3:"Hmm... your reluctance to even consider such a possibility makes me worried that what you are really working towards is treating illegal aliens like any taxpaying citizen. Is it wrong for me to suspect that your true vision and motivations are other than legal-resident-only coverage?" A3: "What nonsense! What evil-monger filled you with such vile lies?"
And replay with taxpayer-funded abortions, death panels, etc...
If you're claiming that people are misinformed and worried about things that will never come to pass, then surely it can't hurt to amend the bills to specifically assuage these fallacious concerns.
If, on the other hand, you spin hysterically about things "not actually, literally being in this particular draft of a potential bill", while refusing to be explicit at every opportunity to commit to a position that ensures such "hysterical delusions" will never occur, then you will not be trusted.
That's it Indy ... it's all abotu trust.
When Democrats claim today that illegal aliens won't be covered, or that abortions-for-teenagers won't be provided ... I mean what moron would take them at their word? Megan herself doesn't even believe that crapola.
They're not even plausibly denying these issues. Put to a vote, of course, they refuse to play along, revealing their true intentions.
Americans aren't morons. They know exactly what the Democrats are up to. And they're not going to stand for it. I believe it will lead in 2010 to the Democrats losing more seats in a mid-term election than at any time in history.
And they'll deserve to lose.
There’s something else that came to mind which makes me even more mistrustful of the legislation. The bill itself is over a thousand pages and very complex in the length and breadth of the topics that it covers.
The amendments however, which have largely been voted down on a party-line vote, have been pretty specific in terms of issues they address like abortion coverage, insurance for illegal aliens, rationing, etc.
I find it very hard to believe someone who says that they don’t think a particular problem is created by a very long and complicated bill but nonetheless votes against a very short and straightforward amendment that addresses that concern.
This whole post and thread is fascinating. A whole class of pundits/politicians believe one set of facts, to the point where they call anything that contradicts those facts "myths" and anyone who believes any of these "myths", "grievously uninformed".
Then we have a whole bunch of obviously intelligent posters, who present compelling evidence that the "myths" are either true, or are likely predictions of what is actually going to happen.
A major, important political debate. And two sets of people who each believe they are 'informed', and one of them has to be living in a fantasy world.
Amazing. And more than a bit scary.
And you know what's sad: Our media should be maintaining an unbiased stance and providing people with the actual facts.
But instead, as this post and the resultant comments make plain, there are many people in the media who are either too uninformed to provide accurate commentary, or are pushing the President's agenda for him.
I hang out a lot in the comments, because that's where I'm finding the real facts in this debate. Frequently, commenter such as "HandleTheTruth" and "Neil" (as proven above) are far more informed about the topic being blogged about than the blogger is.
That's a sad commentary on the capabilities of the writer here.
fyi...
I did not intend my comment as "a sad commentary on the capabilities of the writer here". I have the utmost respect for Ms. McArdle.
I was somewhat surprised as to the effort required to actually get to the poll questions, and am not surprised that a blog entry was made on a link to a tertiary source rather than to the primary source.
I do strongly object to those who crudely caricature American citizens (or particular groups of American citizens) as stupid or uniquely ill-informed...especially when the justification for doing so is a news story based on a poll.
I usually have respect for Megan's writing, until she starts denigrating people as liars and suggesting we're spreading false rumors about "death squads out to round up Trig Palin."
That's not respectful of those participating honestly in this debate and it's beneath Ms. McArdle.
OK, so the left hates Palin's "Death Panels" descriptive. And comments like this are par for the course:
But it takes an extra helping of hootspa to make those comments in a post deriding everyone else for The Politics of Prevarication.
If health care reform includes a public option paying Medicare rates, then I actually think we can achieve expanded coverage while reducing overall health care costs in the near future, and without the need for any kind of direct government rationing.
Here's how: The public option will be popular because it will be cheap. Providers will try to shift costs to private insurers, thus driving the private insurers out of business. Thus a single-payer system will rapidly establish itself. With lower payments, some current clinics and hospitals will not survive. Many doctors will leave the profession so more care will be provided by PAs and NPs.
So many more Americans will have health coverage than at present, and overall costs will go down. The bad part is that Americans will have to wait longer: in clinic waiting rooms, in emergency rooms, for appointments with subspecialists, for diagnostic tests, for operations. There is no need for any government bureaucrat to deny care. Instead, care will simply not be readily available.
So, instead of losing half of your investment in the stock market, you'd rather see none of the moneythat you put into SS?
On a side note of - What the hell is government doing sticking its fat fingers where they don't belong?
We have this from our government about the cash clunkers program:
"I know dealers are frustrated. They're going to get their money," LaHood told reporters. He said the Obama administration would soon announce how much longer the $3 billion car incentive program will last.
Am I the only one who is completely appalled that government has its greasy, fat, intrusive fingers jammed so far into American markets that they are actually managing (and naturally screwing up) sales promotions?
I'm usually not that easy to get upset, but just the whole concept is vastly disturbing. No one in the President's cabinet, or in Congress, or state, city or local government, should be asking the question, "Gee, know what would be a great sales promotion for this business?"
Of course, they're not simply asking the question, they're forcing it, making everyone pay for it, and then screwing it all up in the process.
Keep your hands of my sales promotions!
It's not a "sales promotion."
It's a welfare program.
Obama is handing out $4,500 welfare checks so that rich people can trade up to a brand new SUV.
Meanwhile, millions go hungry in America each night, and 16 million are unemployed but can't get an extension on their unemployment insurance.
America has turned into Bizarro World.
Ah... government has been doing welfare for the rich and poor for some time. If that were the case I'd just see business as usual.
But everything this administration does reeks of micromanagement. The Presidency of the United States of America should not be bogged down in crafting and administering sales rebate (yes, that is indeed a promotion) programs.
It would be all too easy to just blame the President on this one. Most of society is to blame because we all look to the President to fix everything, so naturally he's doing the best he can to fix things.
It's still quite disgusting when you think about it.
I'm amazed-all these attacks about Obama introducing " death panels" from folks who would like to scrap Social Security and Medicare altogether-which would really cut end ogf life care to near zero, except for the rich .
What's amazing is that so many people really believe this "tinfoil hat" stuff- as if Obama asking for an honest debate on end of life care means that he is mandating cutting off end of life care in specific cases. Bizarre!
What's the point of an honest debate on end of life care, in the context of discussions about fiscal limits, but to mandate a cut off of care in specific cases? It's bizarre that you think people act without reason. Most people aren't as irrational as you.
So let's have no debate at all about end of life care issues because that's the same as sentencing Grandma Elsie, of 25 Primrose Lane, Bloomington, Illinois, to death!
Allrighty, then......
Obama never asked for an honest debate. He wants to lead a "very difficult conversation" telling us how it's going to be.
Barack Obama: "... There is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance."
He wants to tell us how an independent group is going to decide on our care. No debate. Just conversation explaining to us how grandmother isn't going to be able to get that hip replaced even though she just fell and broke it and is in extreme pain.
Here ... eat this pill.
Solid ground emerging from a stormy sea of discordant discourse;
If the authors of this legislation refuse to take a lesson from
the Constitution, and begin by prohibiting specific actions, then
it is reasonable to assume they intend to permit them, later,
either through last-minute amendments, bureaucratic regulations,
or court rulings, because they have a decades-long record of
doing just that.
Question: Has the drafting of contracts in the private sector
benefited from the computerization of writing and researching
legal documents and precedents, and the introduction of plain
English legalese ? If so, then why has Congress not adopted
the technology to the drafting of legislation ? Unless they
want the result to be incomprehensible and unpredictable. :>
There are enough actual problems with the bills on the table. You shouldn't need to go making them up. And if you do have to . . . well, in a democracy, you kind of deserve to lose.
In a democracy, you do have to. Well-reasoned argument is simply not an effective campaign technique under a system of univesal suffrage. If it were, libertarians would be running (or rather, actively refraining from running) the show. But the reality is that universal suffrage doesn't work. The median voter is not competent to evaluate the issues rationally and intelligently, so in the end everything hinges on who lies most charismatically.
For those readers who think the "death panel" smears are true or close enough, I have a question.
Do you favor the government paying for all requested treatments no matter their efficacy or value? If not, how are you not a proponent of death panels by your definitions?
In pursuit of momentary political advantage, conservatives who used to want the government to spend less on health care have adopted the position that the government not paying for everything means "death panels."
Even crazier is the implication of some of the above comments that the government not paying for a service is the equivalent of forcibly preventing patients from receiving it.
Tom
Yeah, I gotta say, I find it really implausible that either the government or private insurers currently pay out for anything and everything. Likewise, if you don't have private insurance and don't qualify for government assistance, I imagine in most cases your pocketbook sets the ceiling on your care.
Are you in favor of machine gun bans just for civilians or for the government too?
The analogy does not sync up right with this case, but the broader point does. Just because something happens in one context with private citizens does not mean it should happen with the government.
If my insurance company decides what it is willing to pay I can read the policy and decide to find a different insurance company (I in fact do use and pay 100% of the cost for different insurer than that offered by my employer).
If my insurance company screws I can at least sue them (much easier than the government) or find a new company.
Now if the government is my insurer, what do I do if treatment is not available? Get it elsewhere? Get extra insurance? That model will probably work for 1-2 years. But as has been pointed out elsewhere there is no free lunch. And you can't just shift all low-cost care to the government and dump all the high cost "bonus" care to private insurers without making private insurance really really expensive.
Not to mention government will simply crowd out competition. Ask yourself this, if the government operated a grocery store in every neighborhood of the US where prices were cheaper and you didn't have to pay tax, what would happen to the other grocery stores? They would either go out of business if they tried to compete on price, or they'd have to try to compete on costly services (for those able and willing to pay) and charge a lot more for it.
In practice, I would be amazed if anyone fully understands what their insurance company covers. In my interactions with insurance companies, the agents of the insurance company are often unaware of their own company policies on major issues, let alone the enormous number of rare situations. By the time you do discover what your insurance company does not cover something important, its usually too late to make a switch.
I find bizarre the belief that the government in the future will
a) drive out all private competitors
b) begin to stop paying for legitimate health care
If b) happens won't that bring back your private competitors. For that matter, are you unaware that there is private supplemental insurance market to Medicare today? Or that government and private suppliers exist in a fair number of markets (e.g. education)?
This still leaves me first question though - do you support the government always paying for any medical care? If not, do you support death panels?
Tom
Megan, How can you deserve to get your rights violated?
To put it another way: The masses are not fair, rational, or well informed. We have no moral obligation to offer ourselves up as sacrifices.
In what way would you become a sacrifice? Do you believe you have the right to government spending unlimited amounts of money on your medical care?
Tom
Amazing; 3/103 comments on target ! :)
Installing a pacemaker @ 99 yrs would yield a from-point life expectancy lower than not installing. Probability of death in the operation/complications outweighs any increase in life expectancy if the operation is a success. This is a treatment (given age), on net, that will decrease life expectancy. The doctor should advise against it, and insurance shouldn't pay for it. However, if someone will pay for it, a surgeon has an incentive to install it - however that incentive doesn't really align with the patient's well-being.