Two Polarized Ideological Views in America

[Serafina]

for the third time yes, absolutely they should receive coverage. I thought i was pretty clear in listing what I felt should be done.

The difference between you an I is that I believe that the system can be reformed without me taking it up the ass every week to pay for it. While I will happily pay a little extra to keep the raft afloat, and I recognize the need for timely, yet measured and sustained reform, what i don't buy is the "Anything less than full UHC is fucking the poor" rhetoric. Lets get done what we can get done now, help the millions of people we can help now, and keep the ball moving gradually. Measured and Sustained reform focused on continuous improvement.

thank you yet again for showing how right of center and left of center ideas are attacked by the wingbats and strawmanned into oblivion. What a delightful microcosm of of national heath care debate.

You know, that position about gradual change seems pretty rational.

The problem is, it will not happen that way.
A reform will be passed, and that will be it for several years.

And Universal Health care should always be the goal. It's a given that there will be some gaps and problem with it, since no sytem is perfect. But even if you can not reach 100%, you can still strive for it.

Now, WHY should UHC be the goal?
Simply, it's the only way to guarantee that everyone has a health care insurance.
These serve to protect you from physical harm
And that is a basic human right.

Can you do it with other systems?
Well, that would be your burden of proof. UHC certainly can do it, and i have yet to see any other system that can.

Regards
Fina

[erik_t]

for the third time yes, absolutely they should receive coverage. I thought i was pretty clear in listing what I felt should be done.

The difference between you an I is that I believe that the system can be reformed without me taking it up the ass every week to pay for it. While I will happily pay a little extra to keep the raft afloat, and I recognize the need for timely, yet measured and sustained reform, what i don't buy is the "Anything less than full UHC is fucking the poor" rhetoric. Lets get done what we can get done now, help the millions of people we can help now, and keep the ball moving gradually. Measured and Sustained reform focused on continuous improvement.

thank you yet again for showing how right of center and left of center ideas are attacked by the wingbats and strawmanned into oblivion. What a delightful microcosm of of national heath care debate.

It's my experience that government action happens in leaps and bounds. The idea that gradual change can happen is completely antithetical to my experience with any govt (and indeed any large corporation); rather, it must happen in (relative to gradual change) power spurts. A large body of old jackasses tend not to agree on change every day; rather, they must be pressed into doing much of anything.

If you accept this claim as I have stated, what is your maximum "spurt-change", and what is your acceptable final result? This is an honest question, not a lead-in to a flaming.

[Guardsman Bass]

Ok, I'm confused. Are you for UHC or against UHC?

I'm in favor of government insurance ONLY for those who are unemployed or disabled.

We've already tried that, with Medicaid and Medicare. All it does is take the most costliest segments of the population in terms of medical costs and stick them on programs that, not surprisingly, show high cost. Those without political clout (usually the poor and the like on Medicaid) get shafted whenever a recession hits and they need it the most. Those with it (aka the elderly) become interest groups who them oppose anything that might affect the program that doesn't involve throwing more money at it. Conservatives them proceed to bitch about the costs of such programs.

To put it bluntly, it doesn't work well. It certainly doesn't guarantee security from financial devastation due to health care costs, if the 62% bankruptcy study (of which more than 75% had insurance) is any indication (found here) - which is the whole fucking point of having health insurance in the first place. It's also led to a patchwork of different bureaucracies and programs, because rather than simply having a single federal or federal-state program, we get stuck with a mix of programs with different mandates lest we create "socialism".

Mandating that all employers (within reason) offer insurance and regulating health insurance providers like banks (like back when that actually meant something).

The employer system has its advantages (for one thing, it spreads the cost and allows companies greater clout in negotiating with insurers, or in setting up their own PPOs), but it also led to the current system.

[ThomasP]

I'm pro UHC, but I can understand how the average American - and this is disregarding the uber-right loons - would have worries.

I've been living outside the US for a few years now in countries that have public or two-tier systems, and frankly I just don't see the things that the fear-mongers in the US have been saying would happen. The people I speak with are more than happy with their system and don't understand why the US is so hesitant.

The thing is I don't get the impression that many "true Americans" travel much even within the country let alone internationally, and as a consequence they may not actually have any source of information besides, well, all the screaming.

So combine a lack of exposure to UHC in practice, lack of historical precedent (or even negative connotations, like the things Crackpot mentioned), and then all the right-wing loons shrieking as loud as they can and I can see why someone otherwise rational (if uninformed) would look at this and think "wait a minute".

Doesn't mean it's the right position, mind you, as anyone taking a few minutes to review even some of the basic facts, like rescission or the bankruptcies that result from medical bills, would pretty quickly realize something is wrong. But I don't give most people that benefit of the doubt, either.

I'd think that the progressive side of the argument should make more effort to discount the rantings - or better, sell the benefits - on a larger scope, but that's easier said than done.

[D.Turtle]

If the Democrats wanted to win this debate all they would have to do is give everyone the ability to go on Medicare if they want to.

It was an incredibly stupid decision to immediately give up the single-payer system and only go for the weaker public option - a solution that should have been the final resort only if single-payer wasn't possible. Instead they started with the public option, and now they have to desperately defend that position, as a reform without a public option is more or less useless.

If they had simply started with a "Medicare for All" approach, they would be in a much better position - everyone in the US wants and loves Medicare - even Republicans. The debate could have been quite different with such an approach.

Now everything hinges on Obama's speech this week - and looking at the information that has come out so far it doesn't look like he will push the public option.

[Col. Crackpot]

The employer system has its advantages (for one thing, it spreads the cost and allows companies greater clout in negotiating with insurers, or in setting up their own PPOs), but it also led to the current system.

Massachusetts is in the midst of this mandate now. I'm curious to see how it plays out in the intermediate term so we can work out the kinks and apply it on a larger scale. To me it sounds better than the ideological line in the sand of UHC or nothing and we end up with nothing just like we did in 1993.

[Gil Hamilton]

$$$ How much of my money will be wasted by this taht could be better spent elsewhere

See... you provided a clear example of the lack oflogic in this debate. Someone says something somewhat left of center or right of center and the wing bats from the opposite camp screech like vultures and attack.

Actually, the notion that the government would do health care by definition more inefficiently that private health care is actually a myth that is largely perpetuated by private health care providers themselves. There was an EXCELLENT Bill Moyers interview with a gentleman who was the head of public relations for a health provider that detailed very specifically why this notion is false. I leave it to you to do a simple search of the board to locate the transcript, it is freely available here, but the major point was thus:

Government health care programs that exist already, such as Medicare, have an administrative overhead of somewhere around 4%. That is, of money that goes to the program, only 4% goes to managing the program, salaries for employees, et cetera. And the system works, as witnessed by how tooth and claw people on Medicare fight to keep it. Medicaid, which is for impoverished people who can't possibly afford care on their own, has similar amounts over overhead.

Now, for your average private health insurance provider the number for administrative overhead is around 20-25%. The reason is two fold; one, marketing is roughly half of that and of the money that comes from people paying their premiums, alot of it simply goes into promoting the provider.

The second one, which the Bill Moyers interview explored in significant detail, was the Profit Motive. Like any private company, these companies are beholding to their executives and to their shareholders. As it works out, every dollar of a person's premium that actually goes to paying claims is considered by the company a dollar of profit lost. Actually paying claims is costing them money that they could otherwise pocket. So the goal actually becomes one of calculus; maxmize overhead and minimize payments made on claims. Shareholders in such companies actually become upset when the amount of overhead only grows a percent; after all, that means they aren't making money as hand over fist as they might if the health care provider squeezed harder.

As the gentleman pointed out to Bill Moyers, government run health programs simply don't have this efficiency problem; there exists no motive for it. In the end, a UHC system might be TREMENDOUSLY more efficient than a private health care provider, which is exactly why those providers are spending all that marketing money on propaganda against a UHC.

[Guardsman Bass]

The employer system has its advantages (for one thing, it spreads the cost and allows companies greater clout in negotiating with insurers, or in setting up their own PPOs), but it also led to the current system.

Massachusetts is in the midst of this mandate now. I'm curious to see how it plays out in the intermediate term so we can work out the kinks and apply it on a larger scale. To me it sounds better than the ideological line in the sand of UHC or nothing and we end up with nothing just like we did in 1993.

Massachusetts has an individual mandate, not an employer mandate - and the Health Connector agency they set up mainly helps individuals to find coverage..

[Pablo Sanchez]

How can there be any progress with two views completely at odds with each other. I mean how can you convince the conservative side of the merits of UHC when they view it as an assault against them. One could say that the dems should just ignore the other side and push their agenda. But then when the conservatives get back into power they won't hesitate to do the same.

I don't think you have a clear view of who is actually the problem in the UHC debate; it's not really the 25-30% "total moron/authoritarian personality" bloc that is claiming that UHC will necessarily entail turning old people and the mentally handicapped into Soylent Green. The very raucousness that makes the media so keen to cover their screeching at the same time alienates the key constituency of moderates, centrists, and other people with no strong opinions. In the 1920s and 30s there was a lot of profound social and economic dislocation going on which made the middle mass of people less inclined to resist radical right wing politics; the situation now is comparatively stable, and the mere historical fact of Nazism/Fascism already to some extent inoculates most people against its appeal. The wingnuts are politically isolated and in practical terms powerless. They'll continue yelling, and probably commit some more domestic terrorism, but their ability to actually control policy is very, very marginal. It has to be remembered that this has happened before, in the 1990s, and whereas the Black Helicopter tinfoil brigade was able to effect politics in a circumspect way (since the GOP was eager to appeal to them) they didn't actually do much except tromp around the woods in camo pants pretending to fight the gummint--barring a few individuals who, for example, bombed the Olympics and a federal building.

I mean, look at the polls indicating support for health care reform, for public option, even for single-payer. There is a broad base of support in the population. The "problem" right now isn't the GOP but the Democratic Party and the D.C. system generally. A concerted push by the Democrats with Obama at the head could easily have delivered a good health care reform bill, but they aren't interested in it. It's hard to tell what the administration and congress are trying to do in this debate, but they're not trying to pass a good universal health care bill.

[Lord MJ]

More belief that people that want UHC are "selfish."

It costs more to have the best care available. Those other countries have long waiting lines for what we consider simple out patient care.

An easy solution would be to disalllow insurance companies period. Then supply and demand would take over. Get to a point where negotiations happen with your doctors.

Things will never get better if people continue to think that healthcare is a right. Your neighbor should never be forced to provide for you.

How do you argue with something like this. The first point can be countered with hard evidence, but the other two points, no amount of logic would convince a hardened conservative who views UHC as an assault on his freedom.

[ThomasP]

How do you argue with something like this. The first point can be countered with hard evidence, but the other two points, no amount of logic would convince a hardened conservative who views UHC as an assault on his freedom.

Ask him what happens if he's diagnosed with stage IV cancer and his insurance company drops him.

Or in his utopia of economic freedom, what happens when all the doctors all want to charge more than he can afford.

He'll have a response of course - they always do, usually some mumbling about at least he's free to choose to die - but that usually makes the point as well as it can be made.

[Lord MJ]

Ask him what happens if he's diagnosed with stage IV cancer and his insurance company drops him.

Or in his utopia of economic freedom, what happens when all the doctors all want to charge more than he can afford.

He'll have a response of course - they always do, usually some mumbling about at least he's free to choose to die - but that usually makes the point as well as it can be made.

This particular person has already gone through that experience having to file bankruptcy to pay for cancer treatments. He is touting that nobody should be forced to pay for his cancer treatments and that "If you are not free to fail, you are not free at all."

[ThomasP]

Wow.

I think you may be right, then. I don't know what else to do if somebody that's actually been through it still can't see the problem.

[Lusankya]

This particular person has already gone through that experience having to file bankruptcy to pay for cancer treatments. He is touting that nobody should be forced to pay for his cancer treatments and that "If you are not free to fail, you are not free at all."

Doesn't him filing bankruptcy imply that his creditors have already been forced to pay for his cancer treatments?

[Duckie]

Bankruptcy makes it almost impossible to secure credit, which makes it impossible to own a home or make any large purchases. It also prevents you from getting many types of insurance, as you get put into the 'deny this person' pile even if you're healthy because you're no longer a guaranteed profit.

Just for a few of the bad sides to bankruptcy. If it were easy, people would use bankruptcy to pay for things, and in the 2000s they made it even harder to file bankruptcy even for valid reasons, so the man in the story is actually in a way perversely lucky, assuming he actually picks up what remains of his life after a medical bankruptcy before he dies of the disease that causes it.

[Lusankya]

Bankruptcy makes it almost impossible to secure credit, which makes it impossible to own a home or make any large purchases. It also prevents you from getting many types of insurance, as you get put into the 'deny this person' pile even if you're healthy because you're no longer a guaranteed profit.

Just for a few of the bad sides to bankruptcy. If it were easy, people would use bankruptcy to pay for things, and in the 2000s they made it even harder to file bankruptcy even for valid reasons, so the man in the story is actually in a way perversely lucky, assuming he actually picks up what remains of his life after a medical bankruptcy before he dies of the disease that causes it.

I mean the creditors he had before his bankruptcy. I presume that they weren't fully paid off.

[Dark Hellion]

A thing I find remarkable in far-right thinking is the axiomatic equivocation of failure and destitution. People can fail at all kinds of things without necessitating becoming impoverished, however something in American right-wing thinking is that success and failure are wholly economic things. I find this a sad statement on the narrow-mindedness that drives the group, but I also see many connections to how they perceive of many scandals.

[Junghalli]

A thing I find remarkable in far-right thinking is the axiomatic equivocation of failure and destitution.

Remember that economic ultra-liberalism (I hate dignifying it by calling it "libertarianism"), like the Divine Right of Kings, is a legitimizing ideology for a fundamentally flawed and unjust system (unregulated capitalism). As such, a vital part of its function is to give the suffering that system generates a cloak of "natural" legitimacy, or at least inevitability. It makes perfect sense that they'd conflate destitution and personal failure, because if destitution = personal failure then obviously it's your fault that you suffer, not the system fucking you over. Now stop being a selfish commie and take it up the ass like a good little peasant.

[Bounty]

This particular person has already gone through that experience having to file bankruptcy to pay for cancer treatments. He is touting that nobody should be forced to pay for his cancer treatments and that "If you are not free to fail, you are not free at all."

His position is self-contradictory. If he couldn't afford the cancer treatment he shouldn't have bought it in the first place. He has decided to be a thief and a fraudster (making a purchase on credit he knew he couldn't repay), forcing others to pay for his treatment, rather than follow his own ideology and foregoing treatment.

If he wants the right to fail, he should fail and die, not use other people's resources to save his own life.

[D.Turtle]

An easy solution would be to disalllow insurance companies period. Then supply and demand would take over. Get to a point where negotiations happen with your doctors.

Things will never get better if people continue to think that healthcare is a right. Your neighbor should never be forced to provide for you.

Wow, this kind of thinking is stupid. These people have no idea of how expensive health care can be.

As an example, one of the smaller health insurance companies here in Germany recently had to levy an additional fee on their members because they had two cases of an extremely rare hemophilia that cost them 14 Million Euros in the last two years.

But then, the best health care system in the world would simply let the 6 year old child and the 26 year old guy die. Much better than having other people chip in in order to keep them alive.

[Bounty]

The more I think about it the more this idea of going bankrupt to dodge cancer treatment fees, and then being blasé about it, pisses me off.

If lightning strikes tomorrow and blows out my TV, can I walk into a store and take a new one? If some jackass totals my car, can I walk into a dealership and just steal a new one? Of course not. So if a guy gets cancer, why is he allowed to take cancer treatment (essentially, buy a few extra years of life) without paying? What makes him entitled to live at someone else's expense?

Yeah, he could say he's not staying alive for his own sake, that he needs to provide for his family, if he has one. But his wife can get a job herself, no? Maybe she won't have enough money left over to send the kids to college but that's something he should have thought of before he got cancer. Kids can work when they hit their teens, too. Hell, they can work at home as soon as they can be taught to stitch or iron.

Once he knew the cost of the treatment and knew he couldn't afford it he should have stuck to his principles, walked out of the clinic, settled his affairs and waited for death. What he did - stealing health care - is taking the fruits of a universal health care system (care when you need it, not when you can afford it) without ever doing one iota to support that system. Even a communist "gives what he can" before "taking what he needs" - this guy just steals. It's sickening.

[Darth Wong]

For me it is a matter of "the government fucks everything up". Lets look at FedGov's track record as of late:

War on Terror: clusterfuck
War on Drugs: clusterfuck
Immigration Reform: clusterfuck
Education Reform: clusterfuck
Bank Bailout: CLUSTERFUCK
Auto Bailout: CLUSTERFUCK
Iraq: Biblical Clusterfuck

So this means it is incompetent to run an insurance company? That's a pretty big non sequitur, is it not? It runs enterprises far more vast and complex than insurance companies already. These examples you give are not necessarily examples of incompetence to run large organizations, but rather, ideas that were widely supported by business or the public and which were stupid in the first place.

Let's look at your list:

• War on Terror: blame the collective stupidity of the American people for that, not federal bureaucrats.
• War on Drugs Which Aren't Made In the US Southern States: again, you can blame the American people for supporting it, not federal bureaucrats.
• Immigration reform: conflict between popular sentiment and business interests. Once again, not the fault of federal bureaucrats.
• Education reform: bad idea from the outset, but mostly because they were trying to "apply free market principles" to education. In other words, it was due not to incompetence, but to ideology.
• Bank bailout: Once again, ideology.
• Auto bailout: what would you have done differently? Let them drown?
• Iraq: see War on Terror.

pretty much every major initiative the government has undertaken in the past four decades has been a turd. Now the 70- 80% of the population that has decent heath care access is being asked to roll the dice and trust the federal government to do something right for a change. Not only that but we have to hold our noses and do it on an advanced timetable set by the white house? Shit No! Slow down, do this right and ignore the idiots on both sides beating the crap out of their strawmen.

Insured Americans do not have decent health care. If they ever get a serious prolonged illness, they will find themselves at the tender mercies of insurance company employees who are paid a bonus if they can figure out how to get rid of you.

[Darth Wong]

You do realize there are things the federal government does right? In fact the US has reformed education and immigration successfully before. It is just possible that we are doing it wrong- I hear there are countries that have managed to handle drugs and terrorism successfully.

Oh i'm sure there are. I'm willing to bet the success stories are the results of long processes completed over periods of years to ensuring proper implementation. Not something that is ramrodded through congress in time to appease the masses before the midterm elections.

Interestingly enough, Tommy Douglas single-handedly rammed through a provincial health insurance program in Saskatchewan, and then the entire country adopted a similar concept 10 years later. But at its inception, it was definitely done by shoving something down the throats of the industry against their wishes.

Unless you are willing to recognize that the insurance industry is a villain here, you'll never solve your problems.

[Liberty]

The Christian Right is adamantly, adamantly against government run health care. But why? The Bible doesn't say "thou shalt not have government run health care." The Bible does say to love each other, care for each other, sacrifice for each other. Hell, the early Christians gave up their earthly possessions and lived fully communal lives:

Acts 4: 32-35 And the congregation of those who believed were of one heart and soul; and not one of them claimed that anything belonging to him was his own; but all things were common property to them. And with great power the apostles were giving witness to the resurrection of the Lord Jesus, and abundant grace was upon them all. For there was not a needy person among them, for all who were owners of land or houses would sell them and bring the proceeds of the sales, and lay them at the apostles’ feet; and they would be distributed to each, as any had need.

So remind me, why is the Christian Right against a compassionate government and a sharing of resources to provide health care to all who need it? Well, let's see. Clyde Wilcox, professor of government at Georgetown University, wrote the following in his 2000 book Onward Christian Soldiers?: The Religious Right in American Politics:

"The values the Christian Right brings to the debate are but one set of religious values, of course, and I hope that others will engage movement participants in a discussion of competing values, such as social justice, equality, and personal liberation. A political scientist, Clarke Cochran, responded to a paper by Ralph Reed at a conference in the 1990s by noting: 'A lot of issues that Christians should be supporting, such things as gun control, justice in health care, protecting the vulnerable widows and orphans (to use Biblical language), dignified work for people, and property for the common good (from the Catholic natural law tradition) never appear because...the Christian Coalition...has been captured by the conservative ideological position.' Cochran's analysis is but one example of the useful debate that could be undertaken on the religious values that underlie public policy."

The Christian Right is not against government health care because of the Bible. They're against it because they have imbibed libertarian views. Can we undo this somehow? It seems like, if their opposition isn't actually rooted in the Bible (in fact, it's counter to the Bible), it should be reversible!

[ray245]

Oh please, most of those Christians don't even care about what the bible says. They are simply appealing to "authority" in any debate through the use of the Bible.

The Bible is just an excuse for them to continue to act like idiots.