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Patrick
Sleepless Sonneteer


Joined: 05 Nov 2006
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Location: Arkansas, USA

PostPosted: Sun Sep 20, 2009 6:58 pm
Post subject: healthcare reform
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...it's currently the big topic of debate in the United States. So, what do y'all think? Do we need reform? If so, what do we do? Scrap the insurance industry altogether? Give it more regulation? Make a public option insurance? Get rid of the whole system and start over with a single-payer one?

I'd prefer the latter but don't think it's ever going to happen in the U.S., so I'll go with the White House's current public-option-including plan.

So...how 'bout y'all?
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Jade
Seven of Jade


Joined: 05 Nov 2006
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PostPosted: Sun Sep 20, 2009 10:12 pm
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I think it would be best to completely scrap everything about the current system and redesign it from scratch - if such a thing was possible. I think despite the bizarre protests about public health care from certain voices in the right, it's by far a better option than the craziness we currently have. And I've had serious surgery and other procedures done in several countries, so I have a pretty good idea what the real differences are in the both the care and the cost.

Unfortunately, I don't think it's practically possible to eliminate the current system or implement a single-payer system. And knowing the way politicians work, whatever bill does get created by Congress and the Senate is going to be a total mess. I think something needs to be done, but I'm highly skeptical they'll really improve anything.

Here's the cynic in me talking - I think the US health care system is hopelessly messed up, and no matter what happens over the next year or two, I don't think it will come out much better. A public option would be an improvement, but implemented within the current framework I suspect it will be very expensive for the taxpayer. (medicare and medicaid costs are $7000 - $10 000 per person each year, which is totally absurd). Regardless of whether a public option is available, health care costs in this country are way higher than they should be, and that needs to be fixed more urgently than trying to mandate insurance coverage for everyone, in my opinion.

Quick statistics quote from a wikipedia page, for what that's worth:
Government spending on health care was $2120 per person in 2004 in Canada, while it was $2724 in the US. That's government spending only, which is pretty ridiculous for a government that only provides public health care for a small fraction of its population.

Total cost in 2006 is $3678 per capita in Canada, and $6714 in the US. I believe Canada has the highest per capita health care expenditure after the US, or close to it. And in Canada, all medically necessary procedures and doctor's visits are paid for 100% by the government. I think most of the difference between total cost and government cost comes from dental, optometry, and drugs - but all doctor's visits, surgery, emergency rooms, etc. are completely free.

Anyway *shrug* I'm about ready to consider US health care a hopeless lost cause. When people ask me if I'll go back to Canada when I'm done my degree here, health care is a large factor in the decision that has me leaning toward Canada - even though there are probably more limited jobs with lower pay in my field. I'm not saying that I've made that decision, or that there aren't lots of other variables, but it definitely deters me from wanting to continue living here.

Jade

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LunaRaven



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PostPosted: Tue Sep 22, 2009 5:35 am
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What I want to know is, will I still get cartoon bandages and lollipops when I go to the doctor?
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Dudde
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Joined: 26 Nov 2008
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PostPosted: Fri Sep 25, 2009 12:56 pm
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argh this topic has pained my politics talks - not that I'm against conservatives, but the crazy freakin right winged crazy people are getting on some pretty consistent nerves!

I think we should punch the insurance industry in the face until they lower the cost - since we can't use violence, let's punch them in the wallet somehow...hmmm...if only we had someone to compete with them, then we'd have the private industry competing for the lower prices, instead of "sweet monkey's give me your children and I'll give you a flu shot"

oooooohhh wait. Mwahaha, +public option FTW

unfortunately, I don't see a huge likelihood of the bill being passed efficiently, though I'll give credit to our current president for weathering the crap they throw at him. If we can get some changes done for the better before 2012, I'm totally hoping he gets voted back in. He's already made a huge difference in a tiny amount of time.
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Rhodric
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Joined: 19 Sep 2007
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PostPosted: Fri Sep 25, 2009 4:16 pm
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I have faith that the government can even frak health care up more than it already is. I really don't think the White House even has a plan. The whole time Obama was going on the speaking circuit, the only concrete thing they had was HR3200-Pelosi's bill. I'm sure the public option will be the holy grail to end all our troubles just like "the stimulus" was. I guess I'm pretty cynical. The only way any kind of total reform would ever happen is if a president couldn't get reelected, or if it was just after an election, you'd have to bulldoze too much and make far too many enemies.
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Dudde
The Monster at the end of this Post


Joined: 26 Nov 2008
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PostPosted: Fri Sep 25, 2009 5:16 pm
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It's good to be cynical, just not the far right version of cynical, which is..different... so you = good, the crazy versions = bad. Cynicism is what drives the hammering out of the bill that will give it stability, it's why the bill is taking so long - you can't necessarily fix a car that's been sitting in your yard for 10 years in a week, it's gonna take a bit of work. Especially if you let your wife agree with what you're doing (or husband, dog, mother-in-law, etc.)

Quote:
you'd have to bulldoze too much and make far too many enemies.


agreed, but I've seen Obama's numbers drop tremendously in the last few months, especially after all the stupid rumors being stirred up. There are also a lot of spouting how the Healthcare system is going to be crap and have death panels and stupid things like that - I've only read like 250 pages of the proposed bill and I can pretty much /facepalm at a lot of the stuff coming out. The thing that irks me is that the ones crying against the bill are just crying, they have no proposed solution, but everyone seems to agree the system sucks =c

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don't think the White House even has a plan.

Rhoddy my love,

Proposed Bill

it's all definitions and table of contents until page 14.
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julie
Wicked Wisdom


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PostPosted: Fri Sep 25, 2009 5:59 pm
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Dudde, you just deserve a great big ole hugsmooch for that. *hugsmooch*
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Rhodric
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PostPosted: Fri Sep 25, 2009 6:36 pm
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Ah death panels. Was joking with my co worrker that the death panels were going to veto his hip surgery and get him one of those power chairs instead. I'll read the whole thing sometime. No time before nov though. Guess I'll rely on fox news to tell me what I need to know til then.
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Patrick
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PostPosted: Fri Sep 25, 2009 9:30 pm
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Realized I didn't post my own thoughts here. *l*

As might be obvious to those of you who've known me for a while, I have a lot of good reasons to be all for healthcare reform, and so I am. I wouldn't shed a tear if the insurance industry was entirely dismantled and a nationwide, comprehensive single-payer system put in its place. Sadly, I don't think that will ever happen. Certain elements have harped and ranted long enough that too many people think anything remotely smacking of government-run healthcare is *gasp!* Socialism (though most of the older ones happily cash their social security checks every month without a second thought) and, well, we can't have that in America!!

(Even though we haven't had anything other than a mixed socialist/market system since the 1930s).

So, I'm going with the White House's plan. Of those out there now, I think it's the best one. Not perfect by any means, but looking for perfection from government is like trying to squeeze orange juice out of a rock.

The opposition to healthcare reform is driving me bonkers. If it were just a bunch of fear-mongering right-wing nuts I might not be so upset...nuts of all political stripe are always doing nutty things, from claiming the CIA invented AIDS and crack to kill black people (or that 9/11 was an inside job, the modern successor to the great left-wing nut conspiracy theory), to claiming the UN is coming to take your Bible away and shut down your church, from believing that Proctor and Gamble is run by Satanists to believing that Obama isn't actually a U.S. citizen and thus was illegitimately elected president.

But...I think it's pretty obvious that many, if not most, of the disruptive protesters and "omg death panels!!" crazies are getting marching orders from "mainstream" elements in the Republican Party. The same party, you may note, which accused the Democratic Party of engineering anti-war protests and irrational hatred of Bush back in 2004 and 2006. The Republicans were once masters of actual, honest grass-roots campaigning on a national scale (e.g. the 1994 "revolution") that was based on genuine conservative issues and arguments (small government, lower taxes, social issues, etc.). Although I'm no longer a conservative, I can still respect that. But I cannot respect a party that brazenly sends out its most moronic elements to seize the microphone and repeat idiotic and patently false accusations in an attempt to scare people away from healthcare reform. Are there legitimate concerns about a government-instituted healthcare reform program? Of course. But the voices of those airing genuine and reasonable concerns are being completely drowned out by the nuts.

Of course, they have been doing it for years now, mostly in regards to the so-called Culture War. Which is why I am no longer a Republican. The Party used to stand for something...something I now disagree with, obviously, but positions and policies that were built on a coherent and well-thought-out ideological framework. Since about 1998, though, it has degenerated into a free-or-all mishmash of abject jingoism, gleeful paring of civil liberties in the name of Homeland Security, Culture War nonsense, and blatant race-baiting used to scare white folk in believing all manner of nonsense.

Blech. That's enough out of me.
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Dudde
The Monster at the end of this Post


Joined: 26 Nov 2008
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PostPosted: Sat Sep 26, 2009 4:35 am
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Quote:
sends out its most moronic elements to seize the microphone

Holy cow like the town halls? Man I'm glad I don't go to those

Quote:
*hugsmooch*

w00t!

*HUGSMOOCH*

/confused

I've actually heard people say that they don't want the government interfering with their medicaid and medicare ... because obviously the only response to that happening is A) Socialism or B) /facepalm

Quote:
squeeze orange juice out of a rock

bet they can do that on mars...it's where they get their water
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connor
the thief catcher


Joined: 10 Sep 2009
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PostPosted: Tue Sep 29, 2009 4:50 pm
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To be fair, I think Obama is actualy leaning more into socialism then the conservative side of the lib dems, which is good in my opinion. But whats annoying me (as im English) is all this bullshit about Americans calling our healthcare crap, I mean atleast EVERYONE has healthcare in our country. The people who are saying no to the new healthcare regime which Obama wants are not taking into account the millions of people who need, not want, it.

Sorry for that rant; just needed to be said. Also Gordon Brown is better then Obama because Brown looks like a teddy bear.
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Dudde
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PostPosted: Tue Sep 29, 2009 7:06 pm
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Quote:
The people who are saying no to the new healthcare regime which Obama wants are not taking into account the millions of people who need, not want, it.


I don't know what's up with the whole 'regime' thing, but I agree- most people I know opposed to the bill are already covered under healthcare. Most people I know fully in support are not covered under insurance of any kind.
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TPM



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PostPosted: Tue Sep 29, 2009 8:46 pm
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Dudde wrote:
Quote:
The people who are saying no to the new healthcare regime which Obama wants are not taking into account the millions of people who need, not want, it.


I don't know what's up with the whole 'regime' thing, but I agree- most people I know opposed to the bill are already covered under healthcare. Most people I know fully in support are not covered under insurance of any kind.


Well, it's typical human tendency, I think. This reminds me of the school voucher initiatives that tried to take root in my state. All the parents who lived in crappy school districts loved the idea while those who had access to good school districts screamed bloody murder.

And all the people who didn't have school aged kids were asking, "can my property tax be directed to something I can actually directly benefit from?"
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Patrick
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PostPosted: Tue Sep 29, 2009 11:18 pm
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I agree, it's just typical selfish human nature. If you want for something, in general you are all for getting what you're in want of; if you don't want for something, in general you're opposed to "unworthy" or "lazy" people getting undeserved "handouts" at the expense of "working people."

Yeah, so I get a little agitated about this. It's one of the three main reasons why I am no longer a conservative...I got real sick and tired of various conservatives (in both parties, mind you...for I started getting into politics way back when there was still such a thing as a liberal Republican and a conservative Democrat) pontificating from on high about how bad and dumb it was to have welfare and healthcare programs and a minimum wage when, really, what all those poor people truly needed was motivation to work harder, go to school (but not with student loans, cause those are also bad), and get a better job. If they did these things, somehow, magically, they'd have income and healthcare and everything else they needed!

It's nonsense, and it comes from the mouths of people who have, almost to a man, never been poor, never literally been starving and without food, never lived in a sleazy motel for two years because they couldn't qualify for decent housing or get approved to rent an apartment, never been without proper healthcare while suffering from chronic and severe health conditions. I've been all these things at one time or another.

Back in the bad old days when I needed help and sought it (and generally didn't get it) I wasn't looking for a handout so I could be lazy and not work and lay around watching tv laughing at all the dumb, rich schmucks who were subsidizing my unproductive lifestyle...I was looking for things I needed so I could be a productive member of society. That's what these jokers don't ever seem to understand...it's not a handout, it's a leg-up. It's hard to work and be productive when you're sick, malnourished, have no decent place to live, and are constantly harassed by collection agencies and on the verge of bankruptcy for medical bills. It's a vicious, killing cycle.

Yeah, I survived, and here I am today in law school, but my health has suffered far more than it should have, the ill effects I'll be dealing with many years down the road, possibly forever...my credit is forever ruined and I'll be facing horrendous debt probably for the rest of my life. And all because I was poor and couldn't get health insurance and couldn't afford to go to school without getting $8,000 in loans every semester.

Meanwhile those rich, handsome, well-dressed Ivy League types in government (who, by being elected officials, get all of their healthcare paid for by the taxpayers and never want for housing or food) who went to school on the backs of trust funds and legacies want to dictate to me, and millions of others like me, why welfare and government healthcare and increases in the minimum wage are wrong?

Yeah, I'm bitter and angry about it.

So...that's enough out of me. *l* Back to writing this memo....
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Jade
Seven of Jade


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PostPosted: Wed Sep 30, 2009 1:57 am
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I hear you, man. I may come from a pretty privileged background myself, but I've never understood that attitude. Yeah, I'm sure there are some people who take advantage of welfare and use it to slack off. There will always be someone who takes advantage of the system, I guess. But I don't believe it's the majority, or even very large percentage. I think the people with that attitude have lived in privilege their entire lives, and had never had any seriously bad sh*t happen to them. And they have this ludicrous belief that they are somehow invincible to bad sh*t, that being smart and hard-working is somehow a magical bullet-proof vest to anything that might come along. But in this system, bad accident or illness leads to medical bills and ongoing health problems, which can lead to losing your job, which means losing health insurance, which leads to more debt, which leads to worse health problems, which leads to inability to get a job, and so on.... (Pat, I think you're familiar with this cycle - I've actually used bits of your story as an example when I get into arguments with conservatives about this). Maybe it sounds unlikely to some people, but I think it is a remarkably easy thing to happen, and remarkably difficult to ever escape it.

I have yet to be in a financial situation as bad as what you've been through, Pat, mainly since my family is reasonably well off, so I guess I always feel like I have a cushion. But my back problems have given me plenty of perspective - without the benefit of my education, I'm not sure what the hell I'd be good for. Under no circumstances am I remotely capable of a job as a waitress, sales/retail clerk, supermarket check-out chick, or any other number of jobs that require you to stand on your feet for hours. (Spending much time on my feet causes me a ridiculous amount of pain) Nor am I capable of any serious manual labor, apparently. And let's face it, that's most of the jobs that are available for people without a lot of education. I'm likely to be a burden on whatever medical system I'm in, at least for a while longer - and luckily for me, I'm in a graduate program where my insurance premiums at least are paid for. Luckily for me, my adviser had no problem with me taking the time off work, as much as I needed, and he didn't put any pressure on me (and I was still being paid).

My $4000 surgery bill (not to mention what is probably a couple thousand more of additional expenses incurred since then, and still rising), on the other hand, came out of years of savings, and some generous gift money from my grandparents. Again, had my situation been different, I guess I would have taken out student loans... had I not been a student, what the hell would I have done? I have no clue.

Luckily, I'm headed toward a job in engineering/research... And I can manage this type of job despite my back problems, I guess. Plus I should always be in a good financial position. But I feel like I've been very lucky at least as far as my education and work experience and career track have gone. Without that, living here in the US, I think my future would be pretty crappy. Even with that, the health system is leeching a lot of money from me.

*sigh* Anyway, enough of this.



Jade

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Dudde
The Monster at the end of this Post


Joined: 26 Nov 2008
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PostPosted: Wed Sep 30, 2009 1:25 pm
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So essentially what you guys are saying, is that low times, and then fighting, and then some slips, and an earthquake, and you PWNED IT'S FACE!!

congrats!

I personally probably won't use the healthcare system anyway, the only thing I need is optical and dental, cause the stupid doctors when I was a baby took my right lense (so it sees 1000/20) and I grew up without really taking care of my teeth until I was like 18... but I still feel there should be the option for those who need it, and I'm completely happy to pay whatever taxes to back the dumb system until we get it stabilized

I seem to have a knack for electronics though, because everytime I fall on hard times, I fall back to it and works pretty okay. I DO happen to have 20k in stup/ I mean student loans, but there's not many I can blame for that =\
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Kheltan
Silky Smooth Since Seventeen


Joined: 24 Nov 2006
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PostPosted: Mon Oct 19, 2009 11:20 am
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Wow. Where to begin?

As far as Healthcare Reform is concerned I’m in full agreement with most of you on two points:
    It needs to happen; and,
    Any reform that finally passes will likely only make matters more complex and ultimately worse.

That being said I think the only way we’ll see true improvement in healthcare will be to truly improve the state of government, our country, and our society. It is the year 8510 as far as I’m concerned: time to “…tear it down, and start again.” (Zager and Evans. “In the Year 2525 (Exordium and Terminus)” 1969 RCA Records). See, the problem isn’t just the healthcare system. The healthcare systems problems come from the usurpation of authority from the People by the very Representatives we have chosen to speak for us. The Republic is failing under the strain of the power mongers and governmental elitists that have permitted capitalist ideals to determine law. I am for a semi-regulated free market, don’t get me wrong. What I do not like is money deciding politics. The First Amendment saw fit to remove the possibility of a state sponsored religion and vice versa. What it failed to do was prohibit state sponsored business and vice versa.

The problem as I see can be best described as such: our entire system is a bridge that was meant to get us from the founding ideals of the nation to the promise of those ideals. In the 220 years since the Constitution was ratified that bridge has been re-designed, added to, braced, redirected, braced again, diverted, and loaded. If I were a political cartoonist I could draw it out for you and you’d see it resembling something between a Rube Goldberg device and a pile of cartoon furniture. Every time the system faces crisis we add a few more braces to the structure even while loading it down further with new bureaucracies. Our financial system has already broken several times, just to be craned up and re-braced in a slightly altered position.

We need to stop artificially supporting the system. Let it collapse as it will. I would rather we suffer through a generation of pain, hunger, and strife while we rebuild a stable system than leave it for our children, grand-children, or great-grand-children. These bailouts over the last year will ultimately perpetuate the status quo; a status quo which has already shown its failures. With healthcare being such a massive portion of GDP in this country there are too many economic reasons to make only small adjustments to the system. Rather, there is too much short term risk in dismantling the current system.

Until the American People are ready to suffer short term pain for the long-term gain we will never be able to put in place a fully satisfying system of any kind be it healthcare, welfare, education, or transportation. Here is where our society has propagated its own failure. We truly look for instant gratification and many Americans are either unable or unwilling to look beyond their own immediate desires for greater long-term success of the group.

For the record: I am for capitalism. I just don’t like the idea of basing a government on any economic theory. The meshing of political and economic theories in either direction (anarcho-capatilism on one side / full communal socialism on the other) seems to create problems. Now, I’m realistic enough to understand that they are indelibly tied: for as long as governments issue currency a nation’s economy and government will be symbiotic. However, symbiosis is not hybridization. There have to be some levels of separation between the two that will allow them to work with each other without tying each other down.

Hmm…I seem to have got on a tangent. Still, I hope you get my gist with this. I do have ideas on how I would like a system to work, maybe I’ll expound on those at a later time.

Kheltan

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Patrick
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PostPosted: Mon Oct 19, 2009 11:47 pm
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Hmm.

I would be the first to agree with you that the system (as a whole) is broken. Never let it be said that I don't love our republic or the legacy of our Founders (well...most of it), but if there's one thing I learned from way too many political science courses it's that the government we have now and the society it underpins/overrules are well and truly nothing at all like that the Founders envisioned.

The Constitution, far from being the brilliant divinely-inspired master plan as some these days like to claim, was merely the least offensive compromise the framers were able to produce, a mish-mash of eighteenth century political theory and regional rivalries that, in the long run, has lasted this long by having been enshrined into an object of almost religious reverence. Like the bridge you described (a very apt metaphor, if I may say so), it was a thin and bare skeleton upon which have been affixed more than two centuries' worth of extraneous stuff.

The problem is, if the skeleton itself is broken, adding things to it will never solve the underlying problems, namely that the governmental system we have is unsuited to holding together an urban, industrialized, technologically advanced twenty-first century nation of 350,000,000 people that spans literally from sea to shining sea. It might have worked well once, when we were small, geographically limited, and agricultural, but even then, problems inherent in the system as formed started appearing as soon as the new institutions came into play (electoral college, anyone?).

But...having said all that, I don't really see it changing. That our form of government is "unique" and "special" has become an object of faith, a civil religion if you will, ingrained into the American psyche. Questioning the system is thus tantamount to blasphemy. Our founding documents are like Holy Writ, and if you try to change Holy Writ, you get religious wars. Heck, when was the last time the Constitution was amended in a way that well and truly changed part of the original system? Me, I'd say the 17th back in 1912, that provided for direct popular election of Senators. All subsequent ones changed things, but didn't fundamentally alter part of the system. Because the system is, more or less, sacred to so many.

So...I don't know. With the system we have now, I think something drastic has to been in regards to healthcare, and it has to be done now.

Don't get me started on transportation. :P
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Kheltan
Silky Smooth Since Seventeen


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PostPosted: Tue Oct 20, 2009 9:17 am
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Oh, I agree that it won't change. I was only saying that if we want a truly good system, it should--nay, has to--change.

*depressed sigh*

Personally, I'd like to see hospitals and clinics follow the Mayo model. Doing so would create a drastic decrease in the cost of medical care and, I suspect, ultimately increase its quality. A non-profit that pays its staff, including doctors, a fixed salaray that isn't dependant on patient volume. The private practice Doctors out there would probably end up taking a pay cut on a system like this, but the advantage would be lower overall costs for the patient, and the providers would be less financially motivated and more motivated by their own desires to be a doctor. The choice of becoming a doctor in this system would be a more personal one driven by one's desire to heal rather than one's desire to be comforatably rich.

If we can do that and lower the costs of our healthcare to an adequate level the question of insurance becomes less intense. Instead of >17% of GDP being spent on healthcare say it we could drop it around the 10-12% mark at first with a ptential steady decline as the quality and effinciency increase over the decades. If that chunk of change can be brought under control, the insurance companies' bottom line will already be declining and they will be more ready to accept a series of reforms in their industry so long as it is done gently.

As for a government option...that's a tricky one for me. See, I believe in personal responsibility and am vehemently opposed to handing over additional controls or systems to the federal government. However, the private system has spiraled out of control and innocents that haven't an option are paying the price. I'm speaking of children here. I guess the compromise I'd be most ready to support would be unniversal healthcare for minor dependants and full time dependant students to age 21. At that point (18 without being a full time student; 21 if going to college) they are adults in the adult world and should have adult resposibilities. This means they have to face the pain of medical insurance, etc. Of course, I would only support this with changes in the private industries to make medical care and insurance more affordable. I like the single payor concept, but I would need to see a detailed plan of how it would work to be fully behind it.

One thing I am definately not behind is a government mandate that all people have to have insurance. I can see where they are coming from with the idea as such a large expense for those with insurance is paying for those without; but, I feel that can fixed other ways. The reason I don't like forced health insurance is philosophical more than anything: I don't think the government should have the ability to dictate things like this. At least not on the fedral level. If a local or state government does it, I may be ok with that. A person who disagrees can always move. But the federal government getting their hands into the daily lives of people is not, in my opinion, what they are for.

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Joined: 17 Nov 2009
Posts: 65
Location: Southern Oregon

PostPosted: Fri Nov 27, 2009 12:42 pm
Post subject: Healthcare Reform
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Because I am middle-aged, I guess it would be fair to say that there's way more chance of my becoming old than young; therefore I believe that I can lay claim to some objectivity regarding my opinion:

Something like 80% of America's medical budget is spent on "last illness." In America the average life expectancy at birth is 78 years. Therefore something like 40% of all medical expense goes to folks over 78. (I know, the math isn't pure here).

What if healthcare dollars were allotted more on a per capita basis? Or at least, what if healthcare dollars were allotted more or less evenly by age group? Then, rather than the focus of expenditure being on kidney dialysis for 80 year olds, there would be a much fairer use of healthcare cash, a precious and limited resource. Preventive care, weight loss, smoking cessation counseling, pre-natal care, cancer screening, cholesterol-lowering drugs...and many other younger-in-life therapies would be cheaper and would have vastly greater efficacy than the heroics that we currently lavish upon our elderly.

Medicare was a fine piece of 1960's legislation, but it caused a 180-degree turn in healthcare policy. No reasonable reforms are possible until we abandon the fiction that people can be kept alive forever.

-WB
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