"So I'm using Blue Cross's postage to send MY message. Thanks Blue Cross for the postage." - April Buchheit from Bookmarklet

The postcard says "Postage will be paid by addressee", which implies it's the senator who will be paying the postage. Of course, the senator's franking privileges may make it so that the taxpayers pay the postage. - Gabe

True. But why is it that the Senator Hagan/taxpayers should be paying for Blue Cross' message? - Christopher Chung

My friend did this, too. I hope I get one in the mail. - Ayşe E.

They haven't sent me one of these, but when they do, I'll be sure to mail it in unmodified (or with a big "NO ON PUBLIC OPTION" written on it, perhaps). The very notion of government run health insurance is a travesty that will end up bankrupting this country. - Otto

So you don't think Medicare or the Veterans Health Administration is going to pan out, even after all these years? - Mark Trapp

Medicare and the VA system are living proof of my statements. They offer crappy service and are continually costing more and more as time goes on. They are unsustainable in the long term, and basically expanding these failures to cover everybody is only going to accelerate the problem. - Otto

What's long term? The VA system has been going since 1778, and Medicare since 1965. Are you thinking at the 300 year mark, they'll finally collapse? - Mark Trapp

Right on! Good for you! That's a great idea - Ciaoenrico

Our Canadian single-payer health care has been going strong for some time now with no risk of bankruptcy. I'd like to see some evidence that our system is unsustainable. - Matt M (inactive)

The VA system is garbage, ask any veteran who has to use it on a regular basis. And medicare is on the verge of bankruptcy, and has been for at least decade now. Last I checked, medicare was the biggest drain of tax revenue that exists. Predictions I've seen give it 10 more years, tops, even with restructuring. - Otto

What Matt said. - Nathalie

That's awesome! - Jan Ole Peek

Of course, the assertion that government-run health insurance is unsustainable (whether Medicare, the VA, the Canadian system, or any other) raises the question of what system is more sustainable than government-run insurance. It's certainly not the current American one. ... I love April's use of the mailer. - John (bird whisperer)

Don't get me wrong, I'm all in favor of health care reform... But insurance reform is unnecessary. The problem is not the insurance companies, their reactions and bad-behaviors are created by the high cost of medical care to begin with. Fix the health care system to not cost so damn much, and the problems with insurance will solve themselves. Strike at the source of the problems, not at the consequences of them. - Otto

Otto: Insurance causes high prices of medical care. Since you don't pay, the hospital can set its prices arbitrarily high and the insurance company pays whatever its maximum is. Since the insurance company pays so much, they have to have high insurance rates, which makes insurance expensive to buy. If the government had their own insurance, they would be big enough to demand low prices, which would allow people to afford insurance -- even if it is the government's insurance policy -- and create competition that would lower prices for everybody. - Gabe

That's insane. The existence of insurance does not cause the high price of medial care. You have it exactly backwards. Furthermore, the idea of a government-run-insurance plan would not solve that problem, if it was at all the truth, because you're dealing with a supply demand situation. The government run plan could say they weren't going to pay above $X, at which point the medical industry just says "fine, then we won't treat people" at which point the people themselves rise up and kill all the politicians for lying to them about the government run insurance. - Otto

The truth is that most of the waste in medical costs comes from two places: administrative overhead and fraud. Both of these are primarily caused by Medicare and the bureaucracy surrounding it. - Otto

Otto: Why is that you keep ignoring all the evidence from other countries that support national health care (e.g. http://www.yesmagazine.org/issues...) and you also keep ignoring the facts that show that medicare has lower costs that private insurance (e.g. http://www.cms.hhs.gov/Nationa... ) - Robert Felty

@Otto - why do you think there is so much administrative overhead? To deal with all the different insurance companies and the reems of paperwork to get a claim approved and avoid malpractice suits. That means more people have to be hired and trained just to deal with all that stuff and more systems and processes have to be put in place to handle it all. Insurance companies make more money by imposing this stuff on people so that fewer claims will be handled... it's a mess. You must work for a health insurance company or something to be defending them when they obviously are a big part of the problem with health care in this country. Medicare is a small part of the health industry compared to all the private segments combined and is not primarily responsible for overhead and fraud. There's probably less of that in Medicare cases than regular insurance. - Lindsay

@Lindsay: I know several people who work in administrative roles in hospitals. Not one of them agrees with you. The problem isn't the insurance forms and such, those are fairly standard. Almost all of the administrative overhead is due specifically to Medicare. And no, I do not work in the health insurance industry, so your ad-hominem attack makes no sense whatsoever. Why is it that people always resort to that sort of thing when they cannot adequately defend their opinions? You don't see me talking about what anybody who disagree with me does for a living, do you? You know why? Because I have a valid reason for my opinion, I've done actual research into the problem, and I'm not just pulling made-up facts out of my ass like you are. - Otto

@Robert: I'm not ignoring evidence from other countries, I'm discounting most of it based on facts that contradict the ones you are linking to. And Medicare has lower costs than private insurance because it rarely pays for anything. How many people who have medicare must also have their own insurance in order to get proper medical treatment? Have you looked up the numbers on that? - Otto

Otto, how does limiting the pricing result in providers refusing service? In Canada, the Federal Government sets the pricing schedule, but the private providers are still here, providing us good service for a set fee. More info on our system: http://en.wikipedia.org/wiki... I would say that our health care system is an excellent counterpoint to "if you fix the fees at a certain point, providers will stop providing service". - Matt M (inactive)

Otto - would you care to share some references which contain the facts that contradict those which I shared? I am open-minded, but I need to see actual data from credible sources to form my opinions. - Robert Felty

How does Otto make the claim that insurance isn't even part of the problem when medical loss ratios in the health insurance business have dropped from 95% to 80% in just 15 years? (and if you don't know what that means, you don't have an informed opinion about health care reform.) - Andrew C (✓)

I am always amazed at the ignorance of those arguing against public health care services when practically the entire world is doing it and they always have their facts wrong about Medicare and every other system. They'll become advocates when they or their loved ones are being evicted or foreclosed upon while they are dying an excruciating and untreated death. - Brad Nickel

Otto, just exactly how many veterans have you actually talked to? The VA definitely has flaws, but all the veterans I've talked to seem to like the service provided, and often compare it favorably to the private sector. And why are all those people out there so opposed to changing Medicare if it's so terrible? Since you've stated you haven't seen a doctor in decades, how could you possibly have any experience with any health care system whatsoever? - Victor Ganata

FFS... @Matt: Canada has a lower doctor to patient ratio than anybody else does, and it's decreasing all the time. @Robert: You have Google. Use it. I wouldn't believe links you provide me, so why should you believe links I provide you? Do your own research and make up your own mind. I'm not trying to convince you or anybody else, and I frankly don't care what you believe. @Andrew C: You're making an invalid assumption by assuming that a greater profit ratio means that they're getting it by doing bad things. The existence of bad things being done by a few doesn't mean that bad things are done by everybody. Outlaw/prevent the bad practices instead of condemning the entire enterprise. @Brad: http://en.wikipedia.org/wiki... is a fallacy. You lose. @Victor: Your anecdotal evidence does not beat my anecdotal evidence, so we're on even ground there. :-P - Otto

*shrug* I'm supposed to be swayed by second-hand anecdotal evidence from someone who doesn't have any recent direct experience with any health care system? If you don't care, why do you continue to post? - Victor Ganata

*shrug* I'm supposed to be swayed by somebody who actually has a vested interest in the health care system (ie, a doctor)? See, I can use fallacious arguments as well as you can, Victor! ;) Also, I post to express my opinions and ideas. Why else would anybody post anything? - Otto

Otto, your facts on doctor:patient ratio are incorrect. Our ratio is 2.2 per 1000, versus 2.4 per 1000 in the USA. In fact, our ratio has improved from 2.1 in the 1990s. While our doctor:patient ratio is not as high as other public health care systems, it isn't far off that of the USA. - Matt M (inactive)

Here's my reference: http://www.oecd.org/dataoec... "Between 1990 and 2007, the number of doctors per capita remained relatively stable in Canada" - Matt M (inactive)

Otto, but, fair is fair, so long as you don't pretend your anecdotes are generalizable truth, I won't pretend mine are either. It is clear that you do have quite a grasp on fallacious arguments. :) And I do agree that it's important to consider the source of your evidence. - Victor Ganata

Otto, the dropping medical loss ratio specifically means an increasing share of premiums isn't going towards paying for health care; that is /by itself/ inherently bad! In an actual working market, advances in efficiency, if any, would be passed along to the consumers in the form of lower premiums. Instead, prices are getting jacked up even faster than health care inflation because the health care insurance industry exploits monopoly power. - Andrew C (✓)

@Matt: According to the WHO: http://nofearsingapore.blogspot.com/2007... the numbers are slightly different. Close, admittedly. However, the important thing to note is that Canada's ratio is the lowest among almost all industrialized countries, which was my point. I was not comparing to the US, specifically. - Otto

@Andrew C: I understand what "medical loss ratio" means. I understand what "profit" and "premiums" are. What I don't understand is why you think a company should not be allowed to make a legitimate profit? Insurance is gambling. If you don't like the bet, then don't gamble. Or, if you really want to see the loss ratios decrease, then ALLOW COMPETITION. Currently there is virtually no competition for health insurance. People can often only get it via their employer, you can't buy insurance across state lines, insurance companies don't compete on either benefits or price... You're right that it's a monopoly situation, but the solution is to eliminate the monopoly, not to make it into a government-run monopoly. - Otto

You make no sense. A company should certainly be allowed to make a legitimate profit, but indefinitely extracting rent at this level is a clear symptom of market-setting power. Trying to call one the other doesn't actually make them the same thing. Also, people can only reasonably get it from their employer _because that's the only affordable option_. Individual insurance exists; it's just priced out of reach for nearly everyone. Insurers don't offer individual insurance at reasonable prices because of adverse selection, which is yet another point of market failure that government should fix. - Andrew C (✓)

I find it pretty funny BTW that you have implicitly agreed with the rest of us that the health care _insurance_ industry actually is part of the problem. - Andrew C (✓)

"Insurance is gambling. If you don't like the bet, then don't gamble." It shouldn't have to be a game. Everyone is going to need medical attention at some point in their life. It's a matter of how you will be able to afford to pay for it. People pay for insurance because it's the only way they can afford to ensure that their health will be taken care of. It's not really an option if you can afford it. It's a necessity. Those who can't afford it are the ones who are gambling and don't have the option to bet even if they wanted to. Yes we need more options in health care, and I don't see why having one of those options be a government supported program is a bad thing. It would force the private insurance companies to give up their monopoly. - Lindsay

It's the conservative message: You're On Your Own. - Andrew C (✓)

For the record, I'm not a conservative. I'm also not a liberal. I'm a person, with my own opinions and ideas. Labeling people only means that you're not paying attention to what they're saying. - Otto

@Andrew C: Individual insurance is priced out of the market because of regulations limiting what kinds of plans can be offered. Why can I not a health insurance plan for, say, emergencies only? I'm healthy, I don't have any need to go to the doctor much, I never get sick, the only reason I'd need to do so would be an accident. So why can't I buy that insurance? State regulations prohibit it, the only health insurance available must be comprehensive. Allow competition based on plans and rates and there would be competition. But the state sets the rates and the plan requirements, so there's nothing to compete on. Insurance isn't the problem. Over-regulation of insurance is the problem. And socializing insurance does nothing to fix that problem, it only makes it worse. - Otto

@Lindsay: Your statements are provably false. Not everyone is going to need medical attention at some point in their lives. Furthermore, if your statement was true, health insurance would not work at all, since the entire point of "insurance" is to spread risk. If risk was 100%, as you claim, then there's nothing to spread. For the record, I do not currently have, nor need, health insurance. I am perfectly capable of affording it, but it is not a sound bet at this point in my life. Even furthermore, creating a "government program" to eliminate a monopoly is the stupidest idea I've ever heard in my life. You don't stop a monopoly by setting up a single entity to do a thing. That goes against the actual definition of the word "monopoly". - Otto

Everyone has some chance of getting hit by a bus or eating E.coli tainted food or having a tree branch fall on them. {shrug} - Andrew C (✓)

Except for the winners who have somehow divined ways not to do so, I guess. - Andrew C (✓)

@Otto, your claim about emergencies-only plans being ruled out seems incorrect to me: http://www.insurance.com/health-... - Andrew C (✓)

Otto is completely right. Insurance, not having insurance, it's all gambling. What's relevant is regulation limits choices; or forces one person's judgement and preferences on another. Big government healthcare won't work because the government can't do anything well because unlike a market it doesn't have distributed knowlege and I don't think the incentives are right. Witness the UK's NHS: they have targets, and armies of bureaucrats ensuring they meet the targets, but they never cut waiting times because if they did they wouldn't be able to clamour for ever increasing budgets. - Rob Fisher

While I don't know if we're using the word catastrophe in the same way, clearly there are policies that have very high deductibles where realistically, the only time they would pay benefits would be if you ended up hospitalized. And there are plenty of policies that don't cover preventative care at all. Even these types of policies are out of the reach of quite a few Americans. - Victor Ganata

What a silly response Otto. Its all emotional. Why do you think the argument here is so passionate? The fact that you would even dismiss it that way tells me everything I need to know about your point of view and existence. Sad. - Brad Nickel from email

If "the government can't do anything well" why do they even exist? Unless you're an anarchist, I can't see how it makes sense. - Victor Ganata

There are limited things governments might be good at. Defense of the realm; keeping the peace. They are not good at providing goods and services. When they try to provide (or control the supply of) food, for example, you get famine. That's because you need market signals to stimulate [the right amount of] supply [and demand<delete], and that information is not centralised. The same problem affects government supplied healthcare. Hence waiting lists. - Rob Fisher

We have waiting lists now. In what way are the NHS's waiting lists worse than the delays caused by having to argue with insurance companies to get coverage for diagnostic tests, procedures, and specialist referrals? - Victor Ganata

Because the latter involves the invisible hand somehow! - Andrew C (✓)

It's hard to say. I'm not arguing that you don't have a problem, just that more government isn't the solution. E.g. on the NHS you often end up paying for your own treatment anyway just so you get it in time. This is not an improvement. - Rob Fisher

So that's not really different from the current system we have now: you can always pay cash. I think "more government isn't the solution" is a bare assertion that needs a fair amount of evidence to actually prove. - Victor Ganata

Medicare and the VHA have waiting lists? Really? I haven't ever heard anyone waiting for Medicare, and it's single payer. I haven't heard of anyone in England (or Canada, or any other developed country) put on a waiting list. Do you have evidence to support that? You would write off education, food safety, the highway system, firemen, and air safety as well? Seems like you're asking for a very extreme form of government that isn't very much like what developed countries are or what they provide. - Mark Trapp

Otto: The way that discourse works in research-based journals is that one person makes a claim, and backs that up with either data, and/or references to other research. I would happily read any references you give. I don't understand why you wouldn't look at references that I give. - Robert Felty

Rob Fisher: if government controlled healthcare doesn't work, then why does Canada spend less on health care per person, but have lower infant mortality rates, and longer life expectancy? In addition, these numbers have improved since they started their single payer system, while our numbers have basically remained flat. http://www.yesmagazine.org/issues... - Robert Felty

Victor: What can I say? You probably won't be impressed by my Austrian economics theory. You could come and live in the UK and get sick, and see what it's like. :) I do hope the USA manages to avoid the worst of it. Maybe look around at what many other countries do; I don't think anyone gets it quite right. Singapore seems to have good healthcare; but their statistics look good partly because sick, poor immigrants just get kicked out of the country. In the UK my favourite example is opticians: you can walk into any one of any number of franchises on the high street and been seen instantly and leave an hour later with new glasses. Why can't all healthcare be like that? As for Canada: I've heard they have waiting list problems and people go to the USA to get treatment. I don't know too much about it, though. Anyway, it is late here, so goodnight all. - Rob Fisher

I also think it's fallacious to believe we're actually arguing about a completely government controlled system. The public option is not even close to a true single-payer system, and nowhere near a nationalized health care system. It is quite similar to Medicare, except with different eligibility criteria, and as far as I can tell, Medicare doesn't seem to have destroyed the private health insurance industry, no matter how many people try to argue that slippery slope. - Victor Ganata

Part of the reason all healthcare isn't like that is because not all health procedures and exams are as simple as eye exams. - Andrew C (✓)

@Rob Fisher - the number of Canadians who seek treatment in the US is not very large: http://content.healthaffairs.org/cgi... - Andrew C (✓)

You probably can't get a new liver in an hour and expect to have a good outcome no matter where you go. - Victor Ganata

But you should be able to get simple scans and tests quickly and cheaply. You can't on the NHS. The point about this not being about an NHS-like system is taken, though. - Rob Fisher

If you are insured by a private insurer in the US your health fate is decided by insurance underwriters and doctor panels whose sole mandate is to save and make money for the company- not to keep you healthy or prevent you from getting sick or sicker. A doctor's intuition on what a patient may need, even in terms of preventative/investigative testing is hooey as far as they are concerned. You can forget about any treatment that is experimental or costs above average. They criticize Canada and France saying people wait and wait - but they wait here, too. They wait until it may be too late. because the doc could not follow through. The industry made such record profits this year they were actually forced to refund some premiums. I did not hear that it was a record year for battling illness or improving the mortality rate for infants or adults. - Karma Martell

How do we get to a point where you can make money by keeping people healthy? People want to be healthy, so it must be doable. - Rob Fisher

The prescription drug cos would fold, Rob. That is not what they want. - Karma Martell

i wish i could do more than "like" this. oh, and while i'm here loving this, @Rob Fisher -- my answer is, make money doing something other than "keeping people healthy" -- putting profit and human life in the same objective is bound to have some horrifying conflicts of interest, no matter how pure the "health" motivation is. and with $$ involved, it will never even be close to approximating pure. - (dot)lizard kelly

@Rob - you can make money by keeping people healthy, but as (dot)lizard kelly just said, you can make _more_ money by not... for example, by collecting premiums from healthy people and denying coverage to your sick customers. - Andrew C (✓)

@kelly - I wouldn't mind people profiting by keeping people healthy. Hospitals and doctors do that. The trouble with insurance companies is that they profit by denying people care. - John (bird whisperer)

Karma: As long as *someone* can make money at it, doesn't matter who. (dot)lizard kelly: food is important to be healthy; people make money at providing food; no conflict of interest there. I'm not convinced there's anything so different about healthcare. I'll sleep on it and let you know if I have thought of an amazing business plan in the morning. And if it doesn't work, I'll be looking for regulations that stop it working. - Rob Fisher

(I suspect the reason is you can't switch insurance companies easily.) - Rob Fisher

Simple scans and tests frequently lead to incidental findings that are almost always benign but lead to literal million dollar workups. I actually don't think easy access to everything is always the right answer. - Victor Ganata

The food example may not be a good counter-argument here in the U.S., where farmers have actually been paid not to grow things in order to artificially keep prices up. - Victor Ganata

Evidently you and others that spout this free market gobbldy gook have never worked for corporate America and the absolute incompetence in those organizations. Hello , can you say mortgage, banking, savings and loan, energy, etc etc etc. It is a lie and a myth and you folks have gotten away with it for far too long! Thanks, Brad - Brad Nickel from email

I have worked for corp America. As Brad says, free market is never free. The wealth is not distributed. There needs to be accountability and standards. As Obama says, an insurance co should not be able to come between a decision made by you and your doctor. And Victor, it's about fair access, not just access if you have the money and you can override the system. - Karma Martell

The problem is that access is controlled by two forces: actual medical need, and the need to generate a profit, and lots of times these forces end up opposing each other. As the costs of medical care continue to increase, I think we're going to have to decide as a society which is actually more important. - Victor Ganata

This is not to say that I don't think people who actually provide the care shouldn't be compensated for their labor. (In my case, that's just self-interest.) But there's a huge difference between fair compensation and outright profiteering. - Victor Ganata

So who is paying for the "Public Option"? - Brett Veenstra

And who here does not know Blue Cross is a private company. - ۳۰ مرغ Loves Y'ALLLLL

If you go by what's in the House bill, the public option will initially be financed by seed money from the federal government that is supposed to be paid back in 10 years. In the long run, it's supposed to be funded entirely by the premiums of people who choose to participate in the plan. - Victor Ganata

Otto: it is not the existence of insurance companies that keep prices high (auto insurance's existence doesn't make auto repairs artificially inflated), it is how the system works. If I am a healthcare provider and you are a patient who will only pay $100 no matter how expensive the treatment is, I can set the price as high as I want. Your insurance might only cover $500, but somebody else's might cover $1000 or $5000, so there's no reason I shouldn't set my price at $5000 for the treatment. - Gabe

Furthermore, let's say that there's a 1% chance that you'll need another $5000 test (an MRI perhaps). If you do need it and I don't give it to you, there's a chance you'll sue me and my malpractice insurance goes way up. If I give it to you and you don't need it, you don't care because you're not paying for it. You end up getting lots unnecessary tests just so I don't get sued. In Canada they prevent this problem by not having enough MRI machines to satisfy every doctor's whims. Some facilities will give you preference if you really need a scan, but others will let you die waiting. - Gabe

I dunno, didn't Japan solve the MRI problem by providing lots of them and driving the cost-per-exam down? ( http://www.pbs.org/wgbh... ) - Andrew C (✓)

And besides, the insurance companies in the States deal with that problem by denying procedures. - Andrew C (✓)

It might be instructive to look at the US airline industry before and after deregulation. It used to be that prices were fixed, so airlines competed on service. This meant that service was good, and profits were built-in so airlines weren't constantly in bankruptcy. It also meant that flying was a luxury that most people could not afford, which made it not so crowded either. After deregulation, airlines have to compete on price, so service is for shit and airlines are always bankrupt, but everybody can afford to fly (which is only good if you're among the unwashed masses). It's also less fair because you could be paying 10 times what the guy next to you paid for the same seat. - Gabe

Unless you intend on repealing EMTALA, access to emergency care regardless of ability to pay is in fact a guaranteed right in the U.S. - Victor Ganata

Hmmmm... Unless Crutis you think they fall within Life, Liberty, and the pursuit of happiness! Thanks, Brad - Brad Nickel from email

What of someone is happiest if they choose not to acquire health care insurance? It would seem to me that the imposition would thwart their pursuit and remove their liberty. - Mattb4rd

When are we going to learn that the cake really is a lie? Re: Washington D.C. - I say we take off and nuke the entire site from orbit. It's the only way to be sure. - Mattb4rd

Civilization is impossible without some form of government. The idea that we can live without it is the lie. - Victor Ganata

No, the lie is that government is somehow required in all aspects of daily life. Civilization does need government, but mostly it needs it to stay as small as possible and leave people alone as much as possible. You are not a child. Grow up and deal with your own problems instead of expecting the rest of society to take care of you. - Otto

BTW, a "public option" doesn't actually bother me provided you use absolutely zero tax money to pay for it. Make it paid for entirely by the premiums of the people who opt-in to it, and I have no further argument against it whatsoever. (Also, eliminate the part of the current plan that imposes tax penalties on those of us who choose to not have health insurance, as that is simply flat-out wrong. If I choose to cover my own risk, then that is my business, not the governments.) - Otto

Yeah Otto, that works well. For example banks, mortgage companies, savings and loans, toys from China, Enron.... The naive Libertarian view of the world that somehow everything will work out in the end and all will be well makes me laugh every time I hear it. Greed, perversion, violence, and chaos don't go away when the government goes away. Human run institutions are all equally flawed whether governments, families, charities, or corporations. For the most part government serves us very well and has accomplished amazing things in this country including this frigging technology you use everyday of your life. It also does a decent job of protecting us from greed as much as possible until a Republican gets controls of government and deregulates us to death - literally. - Brad Nickel from email

Brad: I don't know what world you're living in, but it's not the same one I am. Government has done very little good in the world, and is in fact responsible for the vast majority of evil in it. Perhaps you forget who's waging wars, eh? A few people inconvenienced by a bank or who signed bad mortgages doesn't really much compare to millions and millions of dead people. Also, "this friggin technology" you use was not developed by governments, it was developed by private companies and corporations in a free market environment. Technology has progressed *despite* government, not because of it. - Otto

Sure, because the US Department of Defense had absolutely nothing to do with the Internet whatsoever. But I agree. To believe that the government is either completely virtuous or always evil is delusional. - Victor Ganata

Actually Otto, religion and greed are responsible for most of the wars. Whether a government fights them or not is irrelevant and these days its private corporations that are fighting much of our wars and doing a piss poor job of it as evidenced by the debacle that is Iraq. That there is a fine example of where we should have let government run things, but we had to privatize things at the expense of our soldiers, Iraq, and the world. Deregulation kills a lot of people in the United States and all over the unregulated world. This is especially true in unregulated Asia where millions are dying creating products to fulfill our free market demand in their polluted, unsafe countries. Greed would be killing millions of people if Libertarians were allowed to destroy government. Its fascinating to me that anyone can believe and espouse a philosophy that is incapable of dealing with the fact that human beings are greedy and will kill, abuse, and run over other people to get what they want without government regulation. The examples I gave you resulted in destroyed lives, and sick and dead children. Have you been watching the news for the last few years? The Internet was developed by the government. Incredible technological advances have been developed by orders of the government and then that crazy government has released them to the world for commercialization. Wow! Who would have thought that government could create so much and see the value in commercialization. It boggles the mind! You can't get through a day without utilizing government funded, developed, and managed projects and you would be living in the dark ages without it. Stay off the highways, mass transit, etc. etc. etc. and then tell me about the evils of government. Of course you can't ever answer the point I originally made about the incompetence of corporations matching the incompetence of government. The difference is that corporate incompetence will kill us all if allowed to run unfettered by government and driven by greed. - Brad Nickel from email

@Victor: The DoD had very little to do with creating the internet, short of funding it. They paid for it in order to connect universities together (whom they were funding for other projects as well). It's not like they sent over a bunch of engineers to lay some cables or actually wrote any of the protocols or anything. Vint Cerf didn't actually go work for DARPA until 1976. The first pipes were laid when he was still in school. - Otto

@Brad: It's amazing to me that anybody can espouse a philosophy like yours, which enables governments to control the population and do basically anything they like, including killing millions of innocent people through senseless wars and immoral legislation. Corporations didn't bomb Iraq and Afghanistan, the federal government did. Corporations didn't lie to us about the non-existent WMDs.... What you advocate is basically totalitarianism, and the fact that you don't want to live in a free country just means you should go somewhere else, IMO. Government *CAN* do good works. It simply usually does not. - Otto

Yes, because ordinary people with no funding or government backing whatsoever can always complete large scale worldwide projects if they just work hard enough, without any assistance. Rugged individualism FTW. - Victor Ganata

@Victor: Why must everything come down to "large scale" and "worldwide" in your view? Are you so incapable of taking care of your own problems that you want to a) take care of everybody else's and b) have yours taken care of by everybody else? We're talking about health care. Why must "health" be a worldwide problem, to the extent that you want to take away individual rights in favor of putting them within the government's purview? Take care of your own health, and let me deal with mine on my own terms. Where do you or anybody else think that you get the right to dictate terms to me when it comes to my personal health decisions? - Otto

Otto, where are we talking about taking away individual rights? I'm talking about HR 3200, not some fantastical single payer system or some nationalized health care system from your paranoid nightmares. Don't be a fool. Look around you right now. Clearly health can be a worldwide problem. And it's disingenuous to believe the Internet would have been built if some government hadn't been around to provide funding. - Victor Ganata

Silly Otto... Its obvious that an informed conversation with you is impossible, since you are unable to defend your actual philosophy or arguments and rely upon distortions and extremely silly exaggerations to try and make a point when the question being asked can not be answered with the truth. This happens every single time I debate a Libertarian. They can't explain themselves or how things in the real world will work with their philosophy, so they resort to name calling rather than answer the very logical concerns of those of us living in the real world. No wonder Libertarianism is sweeping the globe. Sadly for you, you've been debating someone that believes that government should stay out of bedrooms, drug laws, etc. etc. etc. and we probably agree with each other when it comes to reasonable civil liberty protections, but you chose to resort to extreme name calling rather than a true discussion you can back up with facts. Tells me theres not much to back it all up. Best of luck to you. - Brad Nickel from email

Because we'll have to pay for your silly self to keep you alive when you are sick and dying and don't have coverage. - Brad Nickel from email

@Victor: HR3200 takes away my right to choose my own health insurance (in my case, none) by imposing additional taxation and penalties for my choice. It also uses tax money to finance the "public option", which I'm firmly opposed to. And it's disingenuous to believe that the internet would have NOT been built if the government had not provided the funding. It would have happened regardless, because it was initiated by the universities, not by some magical government agency that can create things from thin air. - Otto

@Brad: I'm tired of listening to your socialist and communist rhetoric. (See? I can apply incorrect labels just as well as you can! I'm not a "Libertarian".) Anyway, if you want the government to control your life, keep it to yourself, I'm not interested. Also, if you can find anywhere I called you anything other than "Brad", I'd be very interested. Note: Saying your ideas amount to "totalitarianism" isn't name-calling when it's true. - Otto

You are a funny guy Otto and I mean that in all the ways it can be interpreted. - Brad Nickel

Fine. Welcome to my block list, Brad. If you ever grow up and decide that you want to have a real conversation instead of trolling, then I'll be happy to oblige you. Until then, just rant incoherently to somebody else, eh? - Otto

LOL. See what I mean. You are funny. - Brad Nickel

Are you kidding me about the Internet, Otto? http://en.wikipedia.org/wiki... Note that 2 of the original nodes were UC schools--government funded public schools. With HR 3200, it's obviously going to take money to get the public option up and running, but it's supposed to be paid back in 10 years. As for the mandate, it's not ideal, but I don't see how else it will work. Otherwise, that means that you're totally cool with the idea that if someone gets hit by a bus tomorrow, and the liquidation of your assets isn't enough to pay for your prolonged hospitalization, then the hospitals and health care professionals providing your care should just eat the cost. - Victor Ganata

No, I think they are supposed to let him die. - Brad Nickel

@Victor: No, I'm not kidding, and that link backs up every word I just said about it. As for the public option paying for itself, are you joking? Medicare is continuously in the red (average benefit per person in Medicare is $11,000 per year!) , and you think making a bigger version will somehow magically work? As for the mandate, that's an absolute deal-breaker, because it it is inherently anti-freedom. IMO, the very idea is unconstitutional. And quite frankly, I'm totally cool with the idea that if somebody runs out of money and cannot get charity or friends/family to pay for their treatments, then they don't get any treatments. You get what you pay for, and if you can't pay for it, you don't get it. On the other hand, private insurance might be a damned good bet, if you can't pay for it. Which brings me back around to why can't I buy emergency insurance only? I know about "catastrophic health insurance", but no company I'm familiar with offers such a thing. State law outright prohibits it in most places. If there was some way for me to buy "hit by a bus" type insurance, I'd probably buy it. Instead, the only insurance available to me is more along "comprehensive" lines, meaning that I'd have to waste money to insure against things that I don't need to insure against. This is why we need deregulation and competition among private insurance carriers, so that I *can* buy insurance which fits my needs. - Otto

That's how government projects almost always work: they award private companies contracts to do the work. Even HR 3200 is structured that way. - Victor Ganata

If you actually look at it, HR 3200 isn't structured like Medicare. And why is it that state laws that mandate you to carry auto insurance if you drive haven't been struck down by the Supreme Court if it's so unconstitutional? If you're totally healthy there are policies with $10,000 annual deductibles that cost like $50 a month. Obviously, the health insurance companies would rather you pay for a more expensive plan if they can get you to. - Victor Ganata

Why in the world is a high deductible insurance plan not what you want, Otto? - Andrew C (✓)

"Medicare is continuously in the red" - regular people who aren't on Medicare either lose benefits or coverage entirely or get outrageous rate hikes, so I'm not sure why you seem to keep claiming private insurance is any better... - Andrew C (✓)

My goodness, a single-payer plan in BC costs ~$54/person/month and the deductible is way lower than $10K. And what I lose in 'freedom', I gain back in peace of mind and more money in my pocket overall. (and isn't the glibertarian definition of freedom money?) (Amazingly, the US actually spends as much _government_ money on health care per capita as Canada, and then of course far more in private money on top.) - Andrew C (✓)

@Victor: a) State laws don't require you to carry auto insurance. They require you to carry auto insurance *OR* post a bond for some fixed amount, in case you hit somebody else. and b) Auto insurance is about liability (protecting other people from you), while health insurance is not (it's about about protecting you from other things, people included). - Otto

@Andrew C: I fail to understand the question. A high deductible insurance plan is not what I want, because it is not what I want. What I want is a health insurance plan that will only cover me from, say, accident. Something that doesn't cover routine crap which I won't be needing anyway, or which I can pay for myself. In cases where there is an accident, I don't want *any* deductible, but in cases where there is not, I don't need coverage. Why can't I cover only the specific events that I need to cover? Also, as much as $54 a month is *too high*. It's quite likely that I won't see a doctor for any reason for the next, say, 20 years, and even then very likely won't be for anything major. I'd be better off investing that money and using the result to pay for whatever problems I'd incur. This is *insurance*. It's supposed to cover an event that is unlikely to happen. - Otto

A high deductible plan effectively only covers you for catastrophes, because you're on your own for the first $5K or $10K, so all "routine crap" will be out of pocket. - Andrew C (✓)

BTW, not seeing a doctor even for routine checkups is also gambling. Good luck with that. - Andrew C (✓)

"Effectively" is not the same thing as actually. And if there was some kind of major incident, I'd still be on the hook for the $10k, which is still problematic. Basically, a high deductible means that you're getting no real coverage at all, it's not disaster coverage. - Otto

The $10k outlay doesn't sound problematic to me; you've been investing your money, right? - Andrew C (✓)

Andrew C: No, it's not. There is no actual need for "routine checkups" in a healthy human being. You'd free to disagree, but I'm just going to say you're wrong, and that is that, so there's no point in arguing it. And whether I can afford $10k or not is beside the point, it's still not the type of coverage I actually need or want. - Otto

Otto - You have a valid point that insurance is designed to cover catastrophes. It turns out that preventative medicine helps to avoid catastrophes though. So it is in the best interest of insurance companies to encourage their customers to get preventative care. One way to do that is to pay fot it. Another way to do it would be to give people discounts for getting regular checkups, just like you get discounts on auto insurance for having a good driving record. - Robert Felty

Yeah, there really is no point in arguing with you, not when you just make statements and "that is that". (Good thing cancer never starts off growing in the body for years before becoming a major problem! And that arteries don't ever get clogged before they close up entirely.) - Andrew C (✓)

Robert: Preventative medicine does help to avoid catastrophe, however, it's also far cheaper to cover your own costs there instead of relying on insurance coverage to pay for it for you. It makes no sense for insurance to cover basic care. You don't pay for gasoline with your auto insurance, do you? The fact that insurance covers basic care means added burdens to the administrative overhead, higher premiums, etc, etc. It's a bad system overall. - Otto

OK, so you want catastrophic coverage that starts from dollar 1 for accidents, but no insurance for routine procedures. I think this is a little ridiculous, but you're right, I don't think insurance companies offer that. - Andrew C (✓)

Insurance companies are actively prevented from offering it, is what you meant to say. Many state laws require certain minimum levels of coverage, so the plan I want/need is unavailable to me because of over-regulation. - Otto

Preventative care isn't gasoline. Food is the analogy to gasoline. And no, health care insurance doesn't pay for food. - Andrew C (✓)

@Andrew C: Okay then, if you don't like that metaphor... Does your auto insurance pay for oil changes? My point is that health care should not pay for routine stuff *unless I want it to*. I do not want it to, I'm perfectly capable of dealing with routine stuff on my own. - Otto

Otto - this is not just about you though. It is mostly about the millions of people who don't have any insurance at all right now. Also, with the oil change analogy, that is not quite right either. Standard auto insurance does not pay for vehicle failure. It pays for vehicle damage due to accidents. There probably is a small correlation between frequency of oil changes and automobile accidents, but I bet that the correlation between regular colonoscopies and advanced colon cancer is much higher. - Robert Felty

Robert: Auto insurance does indeed pay for vehicle failure, if you have comprehensive insurance. Depends on the type of failure. On the other hand, you can get liability insurance to only pay for accidents caused by you, if you so want. You have choice of what to get. And I'd venture to bet that the correlation between colonoscopies and colon cancer is indeed quite high, but in the opposite way of what you suspect, since you have to have the colonoscopy to detect the colon cancer. Also, who the *hell* gets "regular colonoscopies"? I mean, I've got much better things to do on Saturday nights, you know? I'd much prefer to go my whole life without having a tube shoved up my ass. If that means I don't live as long, then you know what? I'm okay with that. - Otto

Otto - my dad gets regular colonoscopies, because he has diverticulosis, and I am not ready for him to die just yet. - Robert Felty

Robert: He has a medical condition. I'd hardly call that "routine maintenance", sort of thing. - Otto

Sure. The reason why health insurance companies don't offer plans like that are completely because all 50 states have strict mandates, and certainly not because the health insurance companies don't think they're profitable and would prefer that you pay for more coverage. Of course it's always the government's fault, and never the invisible hand's. - Victor Ganata

Victor: In this case, what I said was in fact true. All 50 states and even the federal government have tons of regulations on the health insurance industry. Rates, premiums, etc.. these are all fixed by the individual states. The insurance companies have to work within a very narrow window of guidelines, sort of thing. This is one reason that so many of them have tried hard to deny coverage, because their window of profitability is continually hampered by these sort of rules. So please, do your own research before making up your mind. Simply listening to political wags is not a way to form a balanced opinion. - Otto

The only regulation I see that applies to all 50 states is that insurance companies have to be solvent, capable of paying claims, and able to process claims in timely fashion. Fact is, the insurance companies have continued to make record profits despite all these regulations, so I'm not exactly going to cry them a river. - Victor Ganata

Switzerland gets by with strict regulation... Admittedly, I doubt they have the kind of catastrophe-only plans you like, but (1) the insurers there make it work, and (2) they achieve better coverage and outcomes than the current US system does. - Andrew C (✓)

I just can't get over the rhetoric. It truly makes me laugh outloud. Slave labor. It's not worthy of further debate. - Brad Nickel from email

It's hardly slavery when health care professionals take oaths to serve society in exchange for the position of privilege it puts them in. And they provide care that isn't fully compensated quite frequently: it's part and parcel of many of the contracts they sign with insurance companies. Are you going to call that slavery too? - Victor Ganata

It is impossible to be a physician without government interference, since license to practice is issued by the state. I'm not sure I'd want it otherwise, personally. Anyway, once again we're straying from the topic at hand: there's nothing in HR 3200 that says you have to accept gov't issued insurance, anymore than you have to accept Medicare or Medicaid. It will still be quite possible to have a nice little boutique practice without getting a paycheck from the gov't. - Victor Ganata

I do medical billing for a nursing home. Those of you who are in favor of a public option obviously don't understand Medicare and Medicaid. We couldn't take care of anybody if we had to rely only on what the government pays. And doctors didn't go to school for all those years and incur all that debt just to be civil servants with tons of red tape and poor compensation. There will be a huge shortage of doctors within a decade. If the bill passes the Senate, we're in for a true disaster. - Dawn