HEALTH REFORM: The Cost Of Doing Nothing
It's something that doesn't get the attention it deserves in this health care debate, in large part because the true cost of health care is hidden from most people. (Though those of us fortunate enough to have employer-provided health coverage do get an eye-opening, jaw-dropping reminder during our annual open enrollment period, which we happen to be in here at TIME. I think I'm speaking for all my colleagues when I say, it's not pretty.)
But Rob Shapiro, who was a top economic adviser during the Clinton Administration, puts the cost of doing nothing in a perspective that is easy to understand. According to Shapiro, if things keep going the way they are headed, the typical middle class family could find itself paying one-third of its income for health care within five to six years. Here's how Shapiro does the numbers, based on analysis by Urban Institute economist Eugene Steuerle:
According to the CBO, the average family will earn $54,000 a year in 2016, when a moderate-priced family policy will cost $14,700. Employers will pay much of that insurance bill for most middle-class families; but that's just a mask, since those employer payments come out of people's wages, not a company's profits. In real effect, a middle class family's earnings in 2016 will come to $68,700 ($54,000 + $14,700), of which $14,700 or 21.4 percent will go for health insurance. And that won't be their only health-related costs. Their co-payments and other uninsured expenses, on average, will come to another $5,100. They'll also be paying taxes to help cover other people's health care — 2.9 percent of their cash wages for Medicare ($1,566), plus perhaps $750 more in federal and state income taxes for Medicaid and for Medicare costs not covered by the 2.9 percent payroll tax. Add up all of that, and it comes to $22,116, or 32.2 percent of the middle-class family's adjusted income of $68,700.
While Steuerle is concerned — rightly so — about provisions in health care reform that will treat people with the same incomes differently, depending on the rules the legislation applies to employers, I'm more incensed about the current, raw deal for middle-class Americans. Why should an average family expect to pay one-third of its income in 2016 on a health care system which, in that same year, should claim 16 percent of our GDP? The biggest part of this puzzle lies in the fact that most of the costs are roughly the same for most people, regardless of their income. The worker earning $68,700, a manager who makes $100,000, and the company's CEO who earns $1 million will all pay the same $14,700 for their families' health coverage. Their out-of-pocket expenses do rise with income but not by very much; and while the manager and CEO pay more Medicare taxes than our average worker, they all pay at the same 2.9 percent rate. There also are other factors which reduce the burden on other groups — and so tacitly increase it for those middle-class families. For example, people on Medicare and Medicaid bear much lower insurance costs, although they also pay relatively more for their out-of-pocket expenses; and families without children pay relatively less for both insurance and out-of-pocket expenses.
Whatever the causes, the data show clearly that health care costs have become a core economic issue for middle-class Americans. Unless we can contain them, and over time even reduce them, realistic prospects of upward mobility for most middle-class families will simply slip away. . Health care, in short, has to be an essential part of a new economic strategy.
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1
Thank you, KT, for getting this up. With all the bickering about what reform will cost, I'm glad we have something to compare the costs of reform to.
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KT, thanks for this. I'm working on a thought here but OT, I just read your tweets. Is today your mom's b-day? Happy Birthday to her! Actually, I would've guessed it was over the weekend – thus your trip. Certainly the High Chiefs can let you go home during the week. You ARE among the TWX Empire's primetime media starlets, so they should cut you some slack already.
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2.1
Thanks, decon. It is actually today, but we celebrated on Saturday night. However, she announced yesterday that she has decided to count backward from here on out, so I guess she's 78.
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2.2
Counting backwards is a great idea. If we could literally reverse aging (resveratrol?) we could really revisit our happy childhoods.
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..."within just five or six years, the average middle-class family will have to devote nearly one-third of its income to health care costs.
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That's right: one-third. According to the CBO, the average family will earn $54,000 a year in 2016, when a moderate-priced family policy will cost $14,700. Employers will pay much of that insurance bill for most middle-class families; but that's just a mask, since those employer payments come out of people's wages, not a company's profits.
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In real effect, a middle class family's earnings in 2016 will come to $68,700 ($54,000 + $14,700), of which $14,700 or 21.4 percent will go for health insurance. And that won't be their only health-related costs. Their co-payments and other uninsured expenses, on average, will come to another $5,100.
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They'll also be paying taxes to help cover other people's health care — 2.9 percent of their cash wages for Medicare ($1,566), plus perhaps $750 more in federal and state income taxes for Medicaid and for Medicare costs not covered by the 2.9 percent payroll tax. Add up all of that, and it comes to $22,116, or 32.2 percent of the middle-class family's adjusted income of $68,700.".
I am sorry to regurgitate what you have written above, but again I ask, "Where is the outrage from the liberal left"?
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I also asked in the previous thread that Republicans step up to the task of REALLY going in-depth, and analysing costs. Not just the cost of health care insurance, which is what this article is all about, but the actual costs of healthcare.
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To me, something is majorly wrong here. I am in contact on an almost daily basis with Hospital Administrators and the like who are in charge of expenses and profits within hospitals. Their comments to my questions on profits are that "there are none". Very little with the cost of wages for health care staff, and the cost of drugs and up-dating of medical equipment, etc. Factor in all the other expenses of running a business, such as the case for hospitals, un-insured pass throughs due to those who do not have insurance.
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The cycle goes on.
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The winners:
1. Big Drug Companies
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Losers:
1. American taxpayers if this "bill" is passed.
2. People who think they will get insurance after this bill is passed, then to find out in a few short years the cost of the insurance will put them further into the poor house than they already are right now.
3. People who do not have insurance, are not sick, and choose not to buy insurance. They will be penalized, fined and potentially thrown into jail.
4. Doctors. This group will see major cuts to reimbursements as this new entitlement grows uncontrollable, and expenses continue to be uncontrolled.
5. Seniors. This group will immediately see cuts in already existing coverage. Also with the new influx of new patients, rationing will become rampant. People in the middle class down will be fighting among each other as to who will get care. Who will get the next available hospital bed.
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I am sorry, but Obama's pipe-dream along with Nancy Pelosi, the Democrats in Congress, and good 'ol Harry Reid have or are attempting to sell us down the river.
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In my mind the only way to defeat this at this point is a complete overhaul of Congress in 2010. That is when our voices will be heard.
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When people get their paychecks an the 33% for health care insurance costs are taken out, plus the regular taxes of 28% are taken out, you are talking a whopping 61%, that is 61 PERCENT of your hard earned wages go to the Government or insurance + Government.
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We must stop now, and re-look at this entire assult on our lives.-
3.1
Obvious troll is obvious.
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3.2
"Where is the outrage from the liberal left"?
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Rusty, I know you read Stuart's commentary, and if you read more of the commenter's as well as his you would see the "outrage" has been there for a long time.
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3.3
So rusty, are you in favor of price controls on drugs? Or what are you i favor of, exactly, when it comes to health care changes in this country?
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I read this from you:
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Very little with the cost of wages for health care staff, and the cost of drugs and up-dating of medical equipment, etc. Factor in all the other expenses of running a business, such as the case for hospitals, un-insured pass throughs due to those who do not have insurance.
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And then I read your five numbered points and I think what you provide in terms of possible ways to help to begin to resolve this problem is the Republican health plan -- which amount to this:
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Zip. Zero. Nada. Zilch. Null set.
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I noted in a post yesterday that I had gone to see a presentation by Dr, Paul Farmer who runs an organization called Partners in health. Farmer and his group have built hospitals throughout rural Haiti and are now expanding their program throughout some of the most destitute parts of Africa. He gives a very compelling case why depriving people of health care simply based on economics ("They can't afford it") is one of the most inhumane things people can do to one another.
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In fact, he opened his talk with this quote from Martin Luther King, Jr.:
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“Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.”
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He also cited numerous examples of how patients can be treated with the same care and the same drugs in third world countries and achieve the same outcomes that we get with our vaunted "beast health care system in the world" (as Republican leaders in Congress repeat endlessly) at 1/16 the cost.
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The discussions of how other advanced countries generate excellent outcomes at considerably lower costs than we do is constantly met with the Republican rejoinder about "the best health care in the world" and "no one should come between you and your doctor."
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So solutions to this monumental problem are continually stifled by people like you.
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Did you know that France and Switzerland have no government-run health care? What they do have is highly-regulated insurance markets, but that idea, too, is an anathema to folks like you.
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So just what the hell is the free market answer to this monumental problem, rusty?
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I suspect you got nuthin'. Just like the Republicans in Congress. -
3.4
Rustydog:
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GOP market fundamentalism won't solve the problem, neither will centrist, Third Way Dem "industry partnerships".
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The liberal outrage has been clear and constant, against both the do-nothing-ism of the GOP, and the do-the-wrong-thing-ism of the Dem leadership.
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We're fighting two political wings that oppose liberals and liberal solutions, Rustydog.
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Some of us are so afraid of the past eight years of do-nothing-ism that we think that the best use of our efforts is to simply oppose the GOP and negotiate with the centrists for compromises like a nearly worthless public option. Folks like that support health care reform at virtually any liberal cost, because the centrist position is the only one opposing the GOP. The Dem leadership isn't liberal, but it's in power.
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Some of us are so afraid of the political and economic consequences of centrists doing the health care equivalent of voting for the Iraq war that we're primarily opposed to the Dem leadership's awful legislation, not the out-of-power, do-nothing GOP. We're getting vicious resistance from people like Rahm and Reid (and the rest of the Beltway establishment), though, because they naturally oppose us taking charge of the Democratic party. They think that we're the liberal equivalent of the Palin wing of your party, i.e. that we're stupid and nuts. They hate us worse than they hate you, Rustydog. They will at least compromise with your party.
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Believe me when I tell you that liberals are f-ing outraged, Rustydog, but we're not in control of the conversation...yet. -
3.5
Palin:
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Government regulation of the Insurance Industry is already going on from State to State. By not allowing a monopoly, or DE-regulating the insurance industry MONOPOLY of health care insurance would be a great first step.
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Can you find it in the Democrat plans? NO. Can you find it in the Republican Plan? Absolutely YES.
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So far as Drug Company profits are concerned, I am in total favor of regulation on prices on drugs. But, again due to Government favoritism with the drug companies, and the use of patents, our Government officials have all (Republicans and Democrats alike) are in bed with the Big Pharmas. Obama your illustrious leader, has also struck a major deal with Big Pharma to not only continue to rape and pillage us, but he has expanded that opportunity with his "sweetheart deal".
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Move over Big Oil/Bush, we now have Big Pharma/Obama!!!
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1. Cost control of drugs, limit time period between patents and generics. Drug costs can be controlled by limiting the time that a patent can be enforced. Also allow foreign companies to compete with domestic on the same ground without tariffs.
2. Open State to State sales of insurance.
3. Pass legitimate TORT reform.
4. Deregulate the monopolies that insurance companies have, make it similiar to the other insurances like auto, life, etc. Spell it with me Palin...C-O-M-P-E-T-I-O-N!!!
5. Stop abuse and over-charges, in specific with Medicare.
6. Mandate insurance for everyone, including illegals. No more free rides to the Emergency Room.
7. Pass legislation for Castastrophic loss, and outlaw the practice of pre-existing conditions. If needed, fund an insurance exchange that would provide for Major Medical insurance.
8. If all else fails, THEN pass a government "option" for insurance plans.
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I have said all of these so many times, Palin I can recite them in my sleep. What are your plans? To simply roll over and let your Democrat Representatives screw you over? -
3.6
stuart:
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This is exactly where you and I part ways. You believe another big government entitlement program is going to solve all the problems.
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When in fact it will grow so huge, that it smothers everything else in its path. Couple that with the FACT, government for the most part cannot, and is totally incapable of running anything unless it is straight into the ground. Big government will simply "bail" it out with tax dollars, which by the way we do not have anymore of....Democrats have spent it all, its GONE!
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Free market competition is the answer. Put all players on the same playing field. It is not only unique to Democrats, but it actually works.
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That has been the Republican answer to the problems with health care, and will continue to be the answer. You simply are tone deaf stupid because of your liberal bias towards socialist solutions.
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If you do not go after the actual costs and reasons, nothing will be solved. NOTHING! -
3.7
Rustydog:
You believe another big government entitlement program is going to solve all the problems.
No, I don't, and you know that.
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Japan has a system of draconian-regulated, non-profit private insurance, and they're doing great. They just don't allow a free market for health care, because the government sets those prices.Free market competition is the answer.
That's not how the rest of the wealthy nations in the world do it, and we'll never have full "free market competition" with Medicare and Medicaid in the picture, so it's not even possible to try without killing those programs.
it will grow so huge, that it smothers everything else in its path
Listen, given what just went down with the Stupak amendment putting the government squarely between women and their doctors, quite frankly I'm scared as hell of fundamentalist Republicans taking over Congress and effectively banning private insurers from offering contraception to unmarried women through the exchange, so I'm much more receptive than ever to the idea of keeping private players in the market.
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That said, I don't care what the solution is, as long as we can stop health care price inflation from eating up the wealth of our country, the wages of middle class people, and the dreams of entrepreneurs. -
3.8
Free market competition is the answer. Put all players on the same playing field. It is not only unique to Democrats, but it actually works.
When will peolpe stop shilling this garbage. We already have a more or less free market in health care. If a doctor wants to only take cash, just see medicare patients, only do elective surgeries, et cetra, the free market allows them to.
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3.9
Poor Palin-wannabe.
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I am not talking about Physicians. I am talking about the monopolized insurance companies. You might read more closely before you declare your stupidity.
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Now to more sane and rational debate with a liberal...
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stuart says:
."Japan has a system of draconian-regulated, non-profit private insurance, and they're doing great. They just don't allow a free market for health care, because the government sets those prices."
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"The reasons why Japan has been able to constrain its health care spending are multiple, but some of the explanation lies in its record of much lower levels of expensive social phenomena compared with most other industrialized nations. Its rates of crime, divorce, teenage births, drug use, high-speed motor vehicle accidents, and incidence of human immunodeficiency virus (HIV) are all appreciably lower than comparative numbers in the United States."
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http://content.healthaffairs.org/cgi/reprint/18/3/56.pdf
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Culturally we also have this major differnce as well...
."Finally, the growth of long-term care has followed a similar pattern of weak differentiation. Although care at home by a daughterin-law has long been regarded as normal in Japan."
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How many daughter-in-laws are going to forego their careers in the US in order to take care of their mother-in-law?
."One factor is a cultural antipathy for invasive procedures and a preference for more conservative treatments. Another is that the fees paid for surgery in Japan are very low—an indication of the importance of government policy in controlling costs".
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Another major difference, there are not any drug stores in Japan...
."Japanese physicians and hospitals dispense drugs directly and profit by buying from wholesalers at a discount and selling at the fee-schedule price"
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While I am not saying that Japan does not have a good health care system in place. Even Japan has recognized faults within it's system. Cost for health care even in Japan is out-pacing GDP. A crisis for Japan looms in the very near future most notably the pressure is from its aging population.
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There are many things to learn from the Japanese or Swiss health care models, and I believe our representatives in Washington should first look at these countries for a guide, then implement the best of each.
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3.10
Rustydog:
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You make some very good points.There are many things to learn from the Japanese or Swiss health care models, and I believe our representatives in Washington should first look at these countries for a guide, then implement the best of each.
Nobody who knows the basic facts of our health care system and its issues could honestly disagree with that statement.
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Well said, Rustydog. -
3.11
"Some of us are so afraid of the past eight years of do-nothing-ism that we think that the best use of our efforts is to simply oppose the GOP and negotiate with the centrists for compromises like a nearly worthless public option."
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But, stuart. This is exactly what is wrong with it all. The compromises you are agreeing to with your so-called Centrists, are the exact things that those of us in the middle class on the right and the left will suffer from.
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If you truly believe in what you have said here in the past, then you surely do not mean this at all.
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If you truly are for limited government, but a government that limits the excesses of big business and greed. That limits unfair practices, then you surely cannot believe that joining up with the "centrists" is going to gain you any ground. A government that has limits on it's powers against the individual, with State's rights returned to its intended purpose.
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But, if you believe that joining the centrist is a much better option for you as a liberal, then you believe in the total destruction of the United States as we know it. Complete anihillation of the current economic (pre-bailouts that is) structure as we know it. Risking the potential downfall of this country, forever.
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I honestly do not know how much more our economic structure can take of all the government intrusion. I fear the weakening dollar as it has drop drastically over the past few months is a clear signal, that if it is not stopped now, the entire thing is going to collaspe or implode upon itself.
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But, perhaps that is the goal. Let it all fall like a house of cards, then start all over again. -
3.12
Rustydog:
You seem to have misunderstood:
Some of us are so afraid of the past eight years of do-nothing-ism that we think that the best use of our efforts is to simply oppose the GOP and negotiate with the centrists for compromises like a nearly worthless public option.Some of us are so afraid of the political and economic consequences of centrists doing the health care equivalent of voting for the Iraq war that we're primarily opposed to the Dem leadership's awful legislation, not the out-of-power, do-nothing GOP.
I (and a significant chunk of the liberal blogosphere) am in the latter category. These are two separate blocs of liberals, not a single "some of us".
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Sorry for not making that more clear, Rustydog.
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Don't worry, though, tort reform will fix everything.
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Just my random thoughts: fixed prices on a large public scale might help, though when private cos. do that as a group – read collusion – it often means we get screwed. Individually we have little power to say "we won't pay any more"; we can shop around and find the selection that sucks least but that's it. Together though, we can fight back, such as letting Medicare, etc. bargain for cheaper drugs. Or we can look at other public services such as police and fire (bringing up old idea, sorry KT). There aren't many screaming headlines about soaring police costs – falling budgets, yes, but not people / equip. costs. If some HC services (medicine, not insurance) were publicly run like the cops, both fixed pricing and open bidding could work, e.g., haggling over supplies or let private hospitals bid to join the local public network. And why would Private Companies do this, RW's snarl? Choose between a steady stream of payments from fed / local coffers for treatments (even at lower profits) OR fight insurance cos. daily over every GD pill and procedure, then try to make up for it by “bleeding” patients even more. Easy call (esp. for publicly traded HC companies. The Market loves steady incomes, even small, NOT volatility). I'm done, finally.
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5.1
...so much for serious thoughts, pfffft.
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KT:
Whatever the causes, the data show clearly that health care costs have become a core economic issue for middle-class Americans. Unless we can contain them, and over time even reduce them, realistic prospects of upward mobility for most middle-class families will simply slip away.
Weird silliness like "Whatever the causes" aside, this isn't an argument against "Doing Nothing", it's an argument for doing primarily that which reduces the price of health care in the US.
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The question reporters should be asking about the current bills under consideration is:By how much will this legislation reduce the price per person per year of health care in the US --not the price of insurance, mind you, but the price of health care goods and services?"
Doing "something" about the wrong thing isn't good enough.
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When Rob Shapiro saysI'm more incensed about the current, raw deal for middle-class Americans. Why should an average family expect to pay one-third of its income in 2016 on a health care system which, in that same year, should claim 16 percent of our GDP?
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Why are we Americans getting a raw deal? Not just on health insurance, although that's certainly a waste of money, too, but on health care! What does health care reform legislation do about the price of health care in America?
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Shapiro correctly notes:The biggest part of this puzzle lies in the fact that most of the costs are roughly the same for most people, regardless of their income.
Right!
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The costs are roughly the same because the price of health care in our country is too high! It's not that wealthier people are paying fifty cents per health care apple, and the rest of us are paying two dollars, it's that health care apples cost two dollars in the US, and only one dollar in the rest of the developed world!
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So, KT, if the cost of doing nothing about hyper-inflationary US health care prices is the bankrupting of the middle class --the vast majority of Americans-- then what do any of the bills being voted on in Congress do about that?
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Given what we know about the White House's negotiations with PhRMA to structure high pharmaceutical prices into health care reform, isn't doing nothing, i.e. "not doing that" better than doing something, i.e. "continuing to raise prices"?-
6.1
Thank you stuart for pointing this out as well.
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6.2
“Whatever the causes” IS a huge deal, nothing to brush aside with a Wintour-like “that's all”. What are the causes? Other countries do have price limits / fixed prices, yes? (Is Japan among them?)
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6.3
I am beginning to think that all the snark that Rep Grayson claimed.
."The Republican Health Care Plan: Die Quickly
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Die quickly is really not that far fetched of an idea. If you get sick enough, You and your family WOULD be better off under the Democrat plans to simply DIE QUICKLY.
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The other alternative, pay out all of your money to Big Government entitlement programs, Big Pharma, and all the other Lobbyists in DC (AARP and AMA).
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Thank you KT for stepping away from your journalistic cynicism long enough to highlight an article that shows what's at stake for all those who mistakenly, yet predictably think reform is just about poor black and brown people that will once again cost them money to support. Now, if you could focus some attention on the fanatical games being played by the GOP on the hill to thwart, delay, and frustrate the system. that would be helpful. Lately it seems that the media narrative has totally focused on the Dems as if that's the only reason it might be delayed in the Senate. At the very least could there be one story about all of the folks that lost their unemployment while the GOP played games knowing full well they were going to vote for it in the end. Making the hardship for all those people who didn't get a check morally reprehensible since it didn't have to happen.
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It appears Steurele equivocates health care insurance costs with actual health care costs. If Congress passed a law that froze insurance rates at today's levels, out of pocket expenses to consumers would rise. He also seems to have an issue with tax policy as well which again he somehow equates to HC insurance.
What he really does is raise the question as to the competence of the government to run 16% of the economy given the abysmal track record of fraud, abuse, cost underestimation and overspending in the Medicare/Medcaid programs. To believe it will be different this time is a fool's errand. It is also a foolish belief to assume that the "public option" will not be government run. If it were not the need for a 2000 page document of rules and regulations of penalties and costs would not be needed.
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8.1
I've yet to hear any useful ideas from you or rusty on how to fix health care. You two only seem capable of saying how poorly the Democrats are doing. Criticism is useless without construction.
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8.2
hotbbq
Isn't that the job of the opposition? Demos ran on having the absolute answers for everything. What they are quickly finding out putting together a cogent plan is quite different than voting present
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8.3
The current role of the minority party is to obstruct at all costs. The Republicans in Congress are intellectually bankrupt on health care reform. They provided a laughable attempt at an alternative bill when they realized that sending out the tea bagger mobs to scare people wasn't going work. You, rusty, and the rest of the Republicans have every right to fall on your collective swords (or assault rifles), but I suggest you wait until after a bill gets signed into law.
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8.4
hotbbq
Contrary to the continuous whining here from the left, the problem with passing a health care bill is not the Republicans or even some Democrats. It is the left-wing nut job, not unlikely many who appear here. 39 Democrats voted with Republicans.
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8.5
Contrary to the continuous whining here from the left, the problem with passing a health care bill is not the Republicans or even some Democrats. It is the left-wing nut job, not unlikely many who appear here. 39 Democrats voted with Republicans.
Yes, it is definitely the extreme liberals who are crazy in this scenario. Imagine the cojones of people to demand a public health care system that has been proven in a myriad of other countries to be at a minimum to be as effective as our own system for less money. Your arguments are as pathetic as your platform. I wouldn't trust your ilk to run my Facebook mafia.
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Democrats must not be "hoodwinked and fooled" into an abortion fight that does not really exist! We should be smarter than that... We must keep our "eye" on the Prize -- the long awaited and wished for Goal of healthcare for all Americans and lower premiums for those who are already insured. Democrats have a chance to lead by actually doing something good for Americans -- like health care, which is tied to the deficit and the bankrupting of businesses and families. We must keep our "eye" on the Prize and not be labeled with the title of another "do nothing Congress"!
GOP politicians and operatives continue to dishonestly and deceptively say that they cannot support a public option, they claim that they want to keep costs down for the American people! Really? This they claim all the while knowing that a public option/competition is the only way to really control cost and to bring about true reform thereby putting a definite Halt to the “out of control” medical costs and premiums crippling people and businesses today, making it harder and harder for average Americans and young people to realize and take advantage of the slowly, slipping away American Dream. One could ask themselves, If you happen to lose your job today or tomorrow in these unstable economic times and at a time when we currently do not have healthcare reform for all, who would pay you or your familiy's health care costs, that is, if you are lucky enough to be able to see a doctor without insurance? This American Dream, now being called Socialism by the GOP has slowly been slipping away, and is in the last throes of dying, if we do not forge a new path onwards toward inclusion and cooperation for all. This dream of America will die to be replaced with just another third world country -- only to go by the wayside and into the history books as another failed experiment.
(FYI: The Conservative blog "Powerline" barred me from commenting on their blog because my ideas were opposite theirs. This is something a Liberal blog would never do -- censor free speach because it did not agree with theirs!)
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9.1
bacalove:
a public option/competition is the only way to really control cost and to bring about true reform thereby putting a definite Halt to the “out of control” medical costs
In the spirit of honest discussion, I must ask you:
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How so?
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How will a public health insurance option reduce health care prices in the US from twice that of the rest of the developed world?
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Doesn't Medicare already pay more for hospitals, medical procedures, prescription drugs and laboratory tests than every other OECD country?
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Even if the public option were to reimburse at Medicare + 5% (which is not in any current legislation), how would that "control costs", except to slightly slow health care's already wild inflation rate?
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Before we hear the automatic response ("Big Pharma needs huge profits to fund R&D") let's note the reality – Big Pharma will focus its considerable resources on maximizing the bottom line, often by creating a market for new products of dubious public benefit but significant net profit.
Just how many variations on the boner pill does society need, particularly when more calamitous but insufficiently profitable medical issues go unaddressed?
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10.1
So true, FO:
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Big Pharma will focus its considerable resources on maximizing the bottom line,<b? often by creating a market for new products of dubious public benefit but significant net profit.
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One of the many anti-consumer, anti average American changes instituted by the Clinton administration (in addition to the repeal of Glass-Steagall and the Telecommunications Act of 1996) was permitting pharma giants to directly advertise prescription drugs to consumers.
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Ask most self-respecting doctors how that law has worked out. It has created a virtual industry of Big Pharma-created demand for drugs that many people may not even need. -
10.2
I actually saw my first commercial for a female boner pill this morning on network TV. What struck me is that they didn't sound sure it actually worked. It was like "The lab rats looked a little more frisky when we used this to cure their hemorrhoids so give it a shot".
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I wonder what the Blue Dogs and other Dems are going to think when, after compromising the crap out of any and all reform of anything, the independents and progressives stay home while the teabaggers throw them into the streets come 2010. -
10.3
centfan:
I wonder what the Blue Dogs and other Dems are going to think when, after compromising the crap out of any and all reform of anything, the independents and progressives stay home while the teabaggers throw them into the streets come 2010.
They'll try to scare us by pointing out how radical and liberal-hating the right-wing is, and then they'll blame us for being "ideological purists" and not "pragmatic" like them -and for whatever losses happen on their watch.
.
That's what centrists have always done since they took over the Democratic party from us. -
10.4
…centfan, with stuart answering the second half of your reply, I'll address the more serious first half. What was the pill company called? If they don't get sued or seized by the FDA or FTC, this could be something to stay on top of, a huge untapped market still lying on its back.
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10.5
palinatowel:
"Ask most self-respecting doctors how that law has worked out. It has created a virtual industry of Big Pharma-created demand for drugs that many people may not even need."
This is the typical view of big corporations through the twisted liberal lens. I am sure even the planet you may reside that for any consumer to receive a drug it must be prescribed by a licensed physician. A consumer can't self-prescribed, a drug company can't prescribe, only a doctor.
What have is not the evil corporation, who by the way is in business to make a profit, but the whiny consumer who wants to live, have sex, be germ free and wrinkle free forever. And they don't care what it costs somebody else.
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10.6
centfan:
.
...and then they do things like this: link to centrist Dems in action again.
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11
I guess we finally have an answer to the question "How many times does SZ have to ask about the total cost of health care before anyone at Swampland takes notice?"
I did find it amusing that KT tries the blame the media's general inability to provide perspective on the public ("in large part because the true cost of health care is hidden from most people.")
Of course! The public is unaware that their premiums are skyrocketing. That explains the focus on CBO scores and PAYGO.
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12
Thanks so much, KT.
You're one of the few reporters in the MSM that constantly bring up real info, as opposed to offering nothing but political sound bites, heavy on the "fair and balanced".
CNN has been particularly horrible in the way it has covered the health-care debate, making it seem like nothing more than a political contest. Rarely have they dug deep and reported why health-care reform, real reform, is so important to all Americans, especially the middle class who believed they are covered now.
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13
Thanks for posting this important story, Karen.
.
When in fact [the big government entitlement program] will grow so huge, that it smothers everything else in its path.
.
So following a story about how completely unsustainable the predominately private health insurance market is, which will smother everything else in its path if left unaddressed by government action, the right-winger can't help imagining some terrifying future effect of government intervention. I point this out to highlight another key feature of the authoritarian following mind: their intensely irrational inculcated hatred of everything government (except the military, of course) and the inability to hold conflicting or otherwise complex ideas, e.g., government can be inefficient and wasteful but the for-profit marketplace is impossibly worse. It really is a mental disorder.-
13.1
shepherdwrong:
.
Please name me one government entitlement program that isn't going broke?
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Please define for me what you believe to be the insurance / big business / "private health insurance market" as it currently exists? Do you understand that through very strict State regulations, private insurances are granted virtual monopolies?
.
If you agree that they are monopolies, then in past history what has been best for the consumer? Allowing monopolies to continue or to break them up and offer more choices?
.
If you believe the Democrats, and their claim that the insurance "market" is not monopolized, then tell me why I can't buy a health insurance policy that will meet my needs from the State of Maryland, when I live in Pennsylvania? -
13.2
"Please name me one government entitlement program that isn't going broke?"
.
Why should I? Government programs aren't designed to make money. Is the DoD "going broke"? They keep running out of money every few months, no matter how many $trillions we shovel at them.
.
"...tell me why I can't buy a health insurance policy that will meet my needs from the State of Maryland, when I live in Pennsylvania?"
.
The short answer is because that's the way the insurance industry likes it (actually, that's the short answer to every question about why the system is the way it is). And the $trillions wasted by the for-profit insurance industry aren't caused by state insurance regulations and neither are the monopolies. Besides, I'm doing exactly what you claim you can't do so it must be you that's the problem...and we're back to my original point. -
13.3
Rusty:
.
How about Government subsidies for Rural America?
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That particular entitlement will never go broke because I have to pay for it every year... -
13.4
"Why should I? Government programs aren't designed to make money. Is the DoD "going broke"? "
Wow, stamping your feet and holding your breath?
Government programs are not designed to make a profit but the program must reside inside a budget. Every entitlement program has had an unlimited budget and they have exceeded it.
And in the case of the DoD, it is not an entitlement but is actually one of the duties of the government that is constitutionally expressed unlike Social Security or Medicare or Amtrak or Post Office. But then agian the constitution is one of those inconvenient documents liberals hate
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13.5
'And in the case of the DoD, it is not an entitlement but is actually one of the duties of the government that is constitutionally expressed unlike Social Security or Medicare or Amtrak or Post Office. But then agian the constitution is one of those inconvenient documents liberals hate'
.
Wrong again.
Article I, Section 8: 'To establish post offices and post roads'
.
To paraphrase the freeper:
'But then again, the constitution is one of those inconvenient documents freepers are too busy mouthing off about to actually take the time to read.' -
13.6
"And in the case of the DoD, it is not an entitlement but is actually one of the duties of the government that is constitutionally expressed unlike Social Security or Medicare or Amtrak or Post Office. But then agian the constitution is one of those inconvenient documents liberals hate..."
.
You never tire of embarrassing yourself with your ignorance and false beliefs, do you? The DoD is no more enshrined in the Constitution than the government's responsibility to "promote the general Welfare" of US citizens - affordable access to health care, anyone? In addition, the Founders granted war-making power only to Congress and abhorred the notion of a standing army. It's war, (authoritarian)-executive-power and corporate interest-loving "conservatives" like you who have done the most to destroy the US Constitution. You don't even know what it means.
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14
"If you agree that they are monopolies, then in past history what has been best for the consumer? Allowing monopolies to continue or to break them up and offer more choices?"
The case for a single-payer system if I ever heard one.
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14.1
That the Dems let the Stupak amendment through, and that we can imagine a Republican Congress should give us pause about single-payer, shouldn't it?
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15
Thanks for this KT.
.
I cannot understand the republican stance of "the free market will solve everything!" We have a free market now and look where it's got us? I also do not understand why I should have to shell out 20 cents of every health care dollar to cover corporate profits, advertising and overhead.
.
Screw the private companies - they add nothing of value to the equation. They're no better than than the mafia types who demand a percent of the take.-
15.1
"Screw the private companies - they add nothing of value to the equation."
This is quite possibly the dumbest statement uttered by someone walking upright. Although it goes a long way to explain the lefts inability to grasp the consequences of this idiotic HC bill.
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15.2
Oh please do share your genius (this shouldn't take long) and explain what insurance companies contribute to the delivery of health care in this country, compared to the government collecting premiums and paying health care providers directly in an open market of health care services.
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15.3
shepherdwong
You are starting to arrival IQ 53 for ignorance. The statement was private companies add nothing.
The comment was made in regard to health care costs which every liberal has translated to mean insurance companies. That by itself is ludicrous. Now lets add hospitals, drug companies and medical supply companies that are private and add to the cost of health care. So they add nothing of value -- well then health care would be free because you need nothing of value from them according to that brillaint statement.
Here is a hint: the premiums that are paid to health insurance do not drop straight to the bottom line. And contrary to the stupidity of the liberals, the profits of insurance companies is much lower than most industries. But that's a inconvenient argument when you are trying to scare up a bill.
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15.4
Hmmm..took even less time than I thought. Though, if I'd wanted disjointed nonsense, I would have asked for that instead of what insurance companies add to the delivery of health care services, which you obviously couldn't answer.
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15.5
shepherdwon
You really need to stop playing with the home lobotomy kit. You can chose to ask what you like but as usual your question had nothing to do with the discussion at hand.
But since your mind is made up already continue to impress yourself with your mindless twaddle
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15.6
health care costs which every liberal has translated to mean insurance companies
.
That's a lie. -
15.7
SZ:
"That's a lie"
Oh pleaseeee! It may be an exaggeration but bit by much if you read the posts on this site.
Obama's rhetoric has transformed overtime form HC reform to demonizing heath care insurers. Anything else is at the margin
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16
The problem is that the argument that health care reform "costs too much" is simply a convenient out for opponents; centrist and GOPers alike. Can we really put a price tag on this?
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16.1
"Oregon JC. I could be wrong, though. Maybe liberals are the chickensh*ts that the rightists say we are, and the centrists count on us being. Maybe we are smug, incompetent narcissists in love with self-defeating academic theories afforded us through undeserved affluence."
.
Did you leave out arugula eating vegetarians by mistake or a simple omission? -
16.2
OOps, missed the correct comment section, sorry.
.
-
-
17
SZ @ 1:57 = excellent!
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17.1
Thanks, Oregon JC.
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17.2
But my ? would be how to go about changing that dynamic (of centrists sh!tting on their base repeatedly). From w/in or w/out the dem party institution? Do you see progressives being as likely to push their party base-ward (as the rightist base has recently done to the GOP), espec. given media hysteria over anything remotely liberal/populist?
.
I mean, getting played by the centrists repeatedly, it tends to get old doesn't it? There are either consequences or... -
17.3
Oregon JC:
Do you see progressives being as likely to push their party base-ward (as the rightist base has recently done to the GOP), espec. given media hysteria over anything remotely liberal/populist?
Yes, if we have the balls.
.
The rightists even created their own anti-media (AM talk radio), and then created their own competing mass media (Fox, etc).
.
There's more of us than there are of them. We live in the future, they live in the past.
.
The thing is, though, before the centrists f*ck up the country as badly as the rightists, we must destroy centrist rule in this Democratic party.
.
The centrists have pulled a huge blanket over the eyes of liberal Democrats, which is that they are necessary to intermediate between us and the voting public. We are the voting public, though. The rightists appeal to the voting public, Democrats appeal to a donor base. The rightists are self-organizing, the left is following the centrists in search of updated mass-marketing techniques.
.
"The American public just isn't liberal," they say. For too long we've stood by and let other Americans like ourselves forget just how liberal we are. When centrists define liberalism to be the dirty word that rightists use, of course people who we know agree with our deeply American values won't identify with that word.
.
Americans believe in progress, we believe in a better future, we believe in meritocracy, we believe in freedom, we believe in self-government, we believe in great public works, we believe in the little guy's dreams, we believe in ourselves as a nation.
.
The centrists would have us believe that we somehow need them and their focus groups and Mad Ave campaigns and machines and backroom deals with "stakeholders".
.
We don't need them, they need us.
.
The evidence?
.
Answer this question:
.
If the American people are all closet rightists, and rightism isn't really just the cultural currency of regional and religious minorities, and liberalism is an elite phenomenon sneaking forth to corrupt the young from degenerate elites and academics, then how did Barack Obama get elected with the kind of leftward populist messaging his campaign exploited? How did that f*cker carry Iowa in the general? How about Maine? How about Colorado? How about Oregon?
.
What was it about "Yes, we can!" that was so powerful, Oregon JC? Why does it speak to so many Americans, if we're all such village-bound rightists, terrified of change?
.
Liberals can speak directly to our fellow Americans with which we have so much in common, Oregon JC. We can inspire confidence in our strength of principle, in our dedication to our country, in our fidelity to the Constitution, in our faith in our neighbors. We can remind them how powerful we all are together, and that the inheritance of this beautiful land is ours. Yes, we can.
.
If we have the balls to do what needs being done, that is.
.
That means remaking the Democratic party in our image. That would be the party that doesn't compromise with the rightists, but defeats them, the party that speaks for the people it represents, not the interests that exploit us.
.
The centrist-dominated Democratic party betrays the American people at its peril, and gradually --and then suddenly --the peril will be upon them.
.
That's only if we have what it takes to persevere and make it happen, Oregon JC. I could be wrong, though. Maybe liberals are the chickensh*ts that the rightists say we are, and the centrists count on us being. Maybe we are smug, incompetent narcissists in love with self-defeating academic theories afforded us through undeserved affluence. Maybe we can be pushed around by snivelers like Harry Reid and piss-ant bullies like Rahm.
.
Maybe we don't deserve to be in control of a national political party, because we can't even be honest with ourselves.
.
I guess we're going to find out pretty soon, aren't we Oregon JC? -
17.4
Thanks for the response SZ. Work, diapers, etc. will not allow me to give it the full attn. it merits, but a few quick reactions...
.
One, you optimist softy you!
.
Good pt: "When centrists define liberalism to be the dirty word that rightists use, of course people who we know agree with our deeply American values won't identify with that word." Yes, liberals afraid to come out of the closet are, you pegged it, chickensh!t.
.
I agree about the rich vein of collectivism that Obama tapped into during that interminable election. The question, in our ADD/myopic culture, is whether or not that was a fleeting moment, a corrective salve to the deep wounds of Bush-Cheney (of which so many Americans seem determined to forget less than a year later). There's no doubt that you're correct about the rightists being a small reactionary sliver of the American pie, but the question is how much larger are our numbers?
.
IMHO, at the very least, if we're going to attempt such a revolutionary paradigm shift (turning back 30 years of Reaganist discourse), the term populism needs to be embraced over liberalism. Whether such a populist movement comes from w/in or w/out the democratic party. I remain doubtful that we can reshape the dem party from within the institution it's become (i.e. a corp subsidiary/"The banks own this place")
.
In the end, when you say the centrists running our party (& the nation) betray the people at their peril, I fully agree, and yes, we'll find out very soon. Sadly, that betrayal will bring a far darker correction next time. The people poised to capitalize on such betrayal are not among us, suffice it to say. But perhaps we're back to "things have to get worse before they get better." Silly me, I thought Jan. 2009, previous to the inauguration, was about as bad as things could get. If Obama continues to coddle Wall St., screw Main St., and send our sons and daughters to far flung boondoggles enriching Dick Cheney's friends...
.
I'll hand you this--the definition of liberalism you continually offer can be embraced by not only most dems but most Americans. But before we can offer that definition to the country, we have to first take back our party. Too many seem comfortable operating according to Rahm's rules, victory over the other team in a bipolar C/R construct. With inevitable losses next year, it's hard to see one step FWD, 3 steps back ever bringing us within reach of the prize, progressive empowerment in the DP. But I dig your optimism. It, smile, allows one to stay in the game, remain engaged/committed despite the bleak outlook. -
17.5
Oregon JC:
One, you optimist softy you!
Dude, my Lovely Bride is from Slovakia.
.
I've been to that country, I've seen it, I've met Slovaks living here and over there.
.
The Slovaks are a f-ing pessimistic bunch of people, let me tell you. You can't get them to change a tire without the entire village whinging and worrying about it. You say to them "But you know it doesn't always have to be this way," and they look at you like you're crazy, and go right back to working and complaining. Maybe being colonized by the Hungarians does that to a people. Maybe it's living too close to Vienna. I have no idea what makes them do it, but they eat cheese, bread and sausages, play medal-winning hockey and are brutal pessimists.
.
I'm an American, my friend, and a liberal.
.
Of course I'm an optimist! -
17.6
Doesn't it all come back to the issue of a two-party system? When you only have two parties they will both fight over the same centrist demographic and they thus gain excessive influence compared to their size.
.
The only way to solve the problem (for both Dems and Reps) is abandoning the mis-guided two-party system. At least that's the only solution I can see. -
17.7
repzak:
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I don't think that the parties fight over the same demographic at all.
.
I think that's an abstraction created by centrists in the Village.
.
The most excessive influence wielded by a comparatively tiny centrist demographic is that of the Village itself.
.
Kill the Village centrists, and they'll stop fighting over slivers of a shrinking likely voter population.
.
The reason the Republicans are out of power is because they catastrophically failed at governing, not because they don't appeal to some mystical population of centrist voters. -
17.8
Well Stuart. I agree that the Village is a major part here. And I also agree that the actual "centrist" population is tiny. But at the end of the day perceptions matter more than reality, and the perception - with or without the Village - is that this tiny center determines who is in power.
.
Now I don't really agree - the political spectrum is not a line (nor even a circle) - and actually politics is a lot more complex than this simplified view. But still - it's not a bad approximation, in the same way that Newtonian physics - while not accurate at a detailed enough level - are a useful and relatively accurate approximation at the macro-level.
.
And at the end of the day I still think the issue is the two party system. It has worked in the past because party affiliation has been relatively loose. But for the last few decades party descipline has been tightened - led by the Repubs, but (weakly) mirrored by the Dems. And when that happens you don't get any crossovers on the more complex level of politics and the overall view of the line or circle to describe political reality becomes a lot more accurate.
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18
[...] more here: HEALTH REFORM: The Cost Of Doing Nothing – Swampland – TIME.com Health, Uncategorized [...]
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19
Shame on the Dems for burying tort reform. Which do they love more, lawyers or taxes? Tough call. Now, we can look forward to spending billions of $$$ each year on defensive medicine. I guess the Dems feel we have health care money to burn. For some balance, see http://www.MDWhistleblower.blogspot.com
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