The biggest problem with the healthcare reform

[MikeWaters]

did you all notice the semantic difference now? I heard it this morning in an audio clip. It's not "Healthcare reform." Now it is "Health Insurance Reform."

[Tex]

Originally Posted by Cali Coug

Whether or not that is true is irrelevant to your argument, which is that he SHOULDN'T pass healthcare reform at this point, not that passing it will be a political liability. If you take the position he SHOULDN'T pass healthcare reform, as you appear to do, then my question remains unanswered: why? Do you think he must follow the polls, particularly given they show 40-50% support the healthcare reform efforts? You vaguely answered with a "continuum" argument, but how is the actual 2008 election weighted in your continuum?

It's not just "follow the polls." There is a palpable public distaste for this bill. Why else, with a 10-seat advantage in the Senate, and a 70-ish seat advantage in the House, has this thing still not passed yet? Why do you think each member of Congress is exacting his pound of flesh in exchange for his vote? Why does losing a single Senate vote and less than a fingerful of House votes jeopardize the whole process?

I don't expect Obama, or any other politician, to boot up PPP.com and Rasmussen.com and make all their decisions on that basis (ala Bill Clinton). Obama was elected with a wide margin, and it was to be expected that he'd spend that political capital.

I think the lesson of 2008 ... how its "weighted", as you put it ... is that people are getting a different Obama than the one they thought they voted for, both on the left and in the "center." The only people not surprised are those of us on the right.

Originally Posted by Cali Coug

A "discussion," Tex, requires a two way conversation. In that conversation, yes- you can expect to get questions. You almost never actually respond to those questions, especially (in my opinion) when you sense that the answer will expose a flaw in your logic. If you want a "discussion," then respond to questions. Otherwise, you are just having a soliloquy interrupted from time to time by loud comments from the audience.

That is just so absurd.

[Cali Coug]

Originally Posted by Tex

It's not just "follow the polls." There is a palpable public distaste for this bill.

As measured by...

Why else, with a 10-seat advantage in the Senate, and a 70-ish seat advantage in the House, has this thing still not passed yet?

It has- just two different versions of it. Merging the two is the challenge, primarily due to the 60 vote "requirement" the Republicans are forcing. Remove the filibuster and it passes almost immediately (which is why reconciliation is now on the table).

Why do you think each member of Congress is exacting his pound of flesh in exchange for his vote?

Because they can and because they view it politically favorable to do so (and when it ceases to be politically favorable, they won't do it- ask Nelson).

Why does losing a single Senate vote and less than a fingerful of House votes jeopardize the whole process?

You already know the answer to this. It has nothing to do with the House and everything to do with the filibuster.

I don't expect Obama, or any other politician, to boot up PPP.com and Rasmussen.com and make all their decisions on that basis (ala Bill Clinton). Obama was elected with a wide margin, and it was to be expected that he'd spend that political capital.

Good. Then that is what he is doing and it sounds like you agree there is nothing wrong with it- which seems contrary to your original point, but so be it.

I think the lesson of 2008 ... how its "weighted", as you put it ... is that people are getting a different Obama than the one they thought they voted for, both on the left and in the "center." The only people not surprised are those of us on the right.

No, they are getting precisely the Obama they voted for- the pragmatic leader, which is precisely why health care has advanced this far (further than ever before), and which is why I believe it will ultimately pass.

That is just so absurd.

No point in arguing it, but if you ask around my guess is you will hear the same sentiment echoed.

[Archaea]

Cali:

You apparently believe some "health insurance" reform is necessary. Why?

In the past, you believe the percentage of GNP expended is too high? Why?

If I am divining your answers, have you ever considered this as a primary reason for the significant amount of GNP expended on health care to be lifestyle and consumption related?

What I mean is, American are consumers. We want everything now. Is it possible that our conspicuous consumption also creates high health care costs?

Do you believe our unhealthy lifestyles contribute in any amount to the high cost of health care in our country?

[Cali Coug]

Originally Posted by Archaea

Cali:

You apparently believe some "health insurance" reform is necessary. Why?

Two reasons: 1) because far too many people do not have health insurance right now, which cripples them economically or even costs people their lives, and which is a heavy burden on society at large when those individuals can't pay their costs; and 2) because the current rate of spending on health insurance is simply not sustainable.

In the past, you believe the percentage of GNP expended is too high? Why?

About 1/6 of our spending goes to health care, and it is increasing rapidly. That isn't sustainable, and it is hurting us economically and competitively.

If I am divining your answers, have you ever considered this as a primary reason for the significant amount of GNP expended on health care to be lifestyle and consumption related?

What I mean is, American are consumers. We want everything now. Is it possible that our conspicuous consumption also creates high health care costs?

Sure- consumption of fatty foods and a lethargic lifestyle are obviously contributing to high costs, but that isn't even close to the entire answer.

Do you believe our unhealthy lifestyles contribute in any amount to the high cost of health care in our country?

Obviously.

[MikeWaters]

If we are spending too much on healthcare, that means we need to buy LESS healthcare.

And that's the rub. How do you buy less healthcare, and who are the winners and who are the losers.

They will talk about efficiencies, fraud, waste, etc. But we all know what less healthcare means. Rationing. That might mean only getting less expensive medicine. Forgoing expensive procedures. Not spending as much in futile care. There's any number of ways to get there. But no one wants to talk about it.

The state of Oregon has experimented with rationing. It's been a long time since I have heard about it however.

Really, none of Obama's stuff flattens the curve, as they like to say. Increasing coverage, allowing pre-existing conditions, not allowing people to lose their healthcare, etc. None of that changes costs. In fact, it increases cost. Preventative medicine? Increases cost.

The reason we dont' have an answer is because the American people are far, far, far away from wanting to make these choices. And in fact, Americans would probably say we don't need to make those choices. Yet.

[Tex]

Originally Posted by Cali Coug

As measured by...

It has- just two different versions of it. Merging the two is the challenge, primarily due to the 60 vote "requirement" the Republicans are forcing. Remove the filibuster and it passes almost immediately (which is why reconciliation is now on the table).

Because they can and because they view it politically favorable to do so (and when it ceases to be politically favorable, they won't do it- ask Nelson).

You already know the answer to this. It has nothing to do with the House and everything to do with the filibuster.

Good. Then that is what he is doing and it sounds like you agree there is nothing wrong with it- which seems contrary to your original point, but so be it.

No, they are getting precisely the Obama they voted for- the pragmatic leader, which is precisely why health care has advanced this far (further than ever before), and which is why I believe it will ultimately pass.

You're not hearing me. You're wallowing in the minutiae of parliamentary procedure while I'm talking rhetorically. If this legislation is really what the people want, if Obama's 7-pt victory was to affirm American support for just this sort of health care reform, then it should be wildly popular. Democrats--and maybe even some Republicans--should be stepping all over each other just to get their names associated with the bill. Congressmen should be coming home to cheering crowds of adulation from fawning constituents.

It's not happening. Far more people dislike it than like it, and those who dislike it, dislike it a lot. You croon about 40% support like it's something to be proud of, when in reality that's a political disaster. A candidate who gets 40% of the vote in an election is considered to have been slaughtered.

Everything about how this bill has moved through Congress reflects its unpopularity. There's no way for you to dance around that.

Originally Posted by Cali Coug

No point in arguing it, but if you ask around my guess is you will hear the same sentiment echoed.

This is the sound of me caring:






.

[Cali Coug]

Originally Posted by Tex

You're not hearing me. You're wallowing in the minutiae of parliamentary procedure while I'm talking rhetorically. If this legislation is really what the people want, if Obama's 7-pt victory was to affirm American support for just this sort of health care reform, then it should be wildly popular. Democrats--and maybe even some Republicans--should be stepping all over each other just to get their names associated with the bill. Congressmen should be coming home to cheering crowds of adulation from fawning constituents.

Um, no. That is almost never the case with any legislation. Can you think of any legislation that has passed with "Congressmen coming home to cheering crowds of adulation from fawning constituents?" The process of legislating is messy. The minority party frequently plays the role of demagogue (and Republicans last year more than any other), and people take unnecessarily extreme (and dishonest) positions on legislation (again- Republicans last year more than others). Some bills when enacted are relatively popular, some aren't, but none get the reaction you describe.

Again, however, you seem to be suggesting that not only is it politically dangerous to pass a bill with 40-50% popularity (polling is hard to gauge on issues), it is inappropriate. Is that your argument or not?

It's not happening. Far more people dislike it than like it, and those who dislike it, dislike it a lot. You croon about 40% support like it's something to be proud of, when in reality that's a political disaster. A candidate who gets 40% of the vote in an election is considered to have been slaughtered.

Everything about how this bill has moved through Congress reflects its unpopularity. There's no way for you to dance around that.

You are arguing as if the polls have been static on the question. Should the Congress have passed health care reform on January 12, when polling was at 49% in favor of passing the bill compared to 46% against? On your continuum, polling was in favor of passing the bill, and the electorate had spoken strongly in favor of health care reform. Did you favor passing the bill on the 12th, then? We all know the answer, so why not? How about in October 2009 when support for passing a bill was at 51% to 41% opposed? Did you favor reform on that date? Or is Gallup the wrong pollster to ask? Should we have only gone by Rasmussen Reports (which showed lower support)?

Should we care that many of those opposed (13% in December) were opposed because the bill wasn't liberal enough?

http://i2.cdn.turner.com/cnn/2009/im.../21/rel19a.pdf

http://www.fivethirtyeight.com/2009/...alth-care.html

Given the overwhelming passion people on the left and the right have on the issue, is it even possible to get a bill, any health care bill, to a high level of support? If, as in December, 42% favor the bill and 56% oppose the bill, but 13% oppose because it doesn't go far enough, and 39% oppose because it goes too far, where do you expect to see significantly more support for any proposal on health care? If you make it more conservative, you will definitely lose people who currently support it now, and certainly won't get anyone who already thinks it isn't liberal enough. If you make it more liberal, you lose more who support it now and won't get any of the 39% who think it is too liberal. Honestly- what is your target poll percentage before you favor passage? If polls are what you find important, then there must be a number at which you would support the bill. What's that number? And why the number you pick?

My guess is you don't care at all about the polling, other than you think it supports your opinion today. If it were to change, I am quite certain you would jump off board with it as your benchmark.

The fact that the polling has shifted so much from month to month is precisely why politicians should just be working for the best possible bill they can support, let the polling fall where it may.

This is the sound of me caring:

I already knew that. If you cared, I assume you would have changed by now.

[Tex]

Originally Posted by Cali Coug

Um, no. That is almost never the case with any legislation. Can you think of any legislation that has passed with "Congressmen coming home to cheering crowds of adulation from fawning constituents?" The process of legislating is messy. The minority party frequently plays the role of demagogue (and Republicans last year more than any other), and people take unnecessarily extreme (and dishonest) positions on legislation (again- Republicans last year more than others). Some bills when enacted are relatively popular, some aren't, but none get the reaction you describe.

It was a bit of playful hyperbole to make a point.

Originally Posted by Cali Coug

You are arguing as if the polls have been static on the question.

Um, no, I haven't. Or have you already forgotten this scatterplot I showed you just a week ago? There is a clear trend against this bill. I also noted back then that there's a distinct difference in polling between this bill, and a bill--a difference you apparently failed to notice when you posted that Gallup link.

Originally Posted by Cali Coug

Given the overwhelming passion people on the left and the right have on the issue, is it even possible to get a bill, any health care bill, to a high level of support?

No idea. But if you're going to re-architect 1/6 of the American economy, you'd better damn well have some level of consensus on how to do it, rather than pounding it through with parliamentary tricks.

Originally Posted by Cali Coug

My guess is you don't care at all about the polling, other than you think it supports your opinion today. If it were to change, I am quite certain you would jump off board with it as your benchmark.

Then you would be wrong, as usual. It's hard to fault politicians who are listening to popular opinion. That's what they're there for. Indeed, I don't blame Obama and the Dems for wanting to tackle health care (their poor timing notwithstanding), since "generic" health care reform gets popular support. But this bill is a disaster. The American people know it, have communicated it in numerous ways, and the thick skulls in DC refuse to listen.

Originally Posted by Cali Coug

I already knew that. If you cared, I assume you would have changed by now.

Then as I said at the beginning, stop whining about it.

[Archaea]

Originally Posted by Cali Coug

Two reasons: 1) because far too many people do not have health insurance right now, which cripples them economically or even costs people their lives, and which is a heavy burden on society at large when those individuals can't pay their costs; and 2) because the current rate of spending on health insurance is simply not sustainable.

Okay, now you're mentioning specifics.

Why do you believe the number is far too high?

Secondly, what do you believe the number is? Working in the health care industry, at least incidentally, I don't believe the big numbers politicians quote.

But a follow up question, what portion of whatever the number is attributable to choice, i.e., college kids risking it to save a few bucks, versus those who are uninsured because of uninsurability or unaffordability?

Now, if you're honest, you'll have to admit we have no idea what the number of uninsured is who are uninsured by choice versus the other subcategory. And if we can't determine what the number is with any reasonable degree of confidence, how can we say it's too high?

But let's move another step, let's assume that the number of uninsurables for cost or coverage is 8 million persons, a lot of persons.

Originally Posted by Cali Coug

About 1/6 of our spending goes to health care, and it is increasing rapidly. That isn't sustainable, and it is hurting us economically and competitively.

And you know where costs outstrip demand, costs are reigned in, so why the alarm?

These are two assumptions which liberals make but I don't see proof of it. I see many factors in our international competitiveness, but health care? In many of the countries, such as Brazil, China and India, which are hurting our economic base, they don't grand social contracts for health care.

You'll have to make a good argument that is hurting us.

Originally Posted by Cali Coug

Sure- consumption of fatty foods and a lethargic lifestyle are obviously contributing to high costs, but that isn't even close to the entire answer.

Obviously.

I never said it was, but it's not even part of the liberal equation to "remedy" health care. Why not?

What if this is the primary reason, combined with the impossible to satiate appetite for health care on demand?

Nobody even studies these lifestyles angles, because they don't yield political results which give more power to politicians. Politics is about gaining power and if one can't get power from an issue then you ignore issues such as the ones highlighted.