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November 06, 2009

Judaism And Healthcare Reform: GOP Bill Penalizes Sick And Elderly

Medical Symbol Should government sponsored or government regulated healthcare charge sick people and old people more than young healthy people?


GOP Anti-Obaman Healthcare Protestors

On sick list: Elderly and the ill pay more under GOP health care reform bill
BY MICHAEL MCAULIFF • New York Daily News

WASHINGTON - Republican leaders are pleased their health reform plan would lower premiums on average up to 10% - and shave $68 billion from the federal deficit.

But the nonpartisan Congressional Budget Office found an odd feature in the 230-page bill: Coverage would be more expensive for older people and folks who are sick.

And it would not bar insurers from excluding preexisting conditions.

Republicans spent months crafting the plan to compete with the Democrats' 1,990-page proposal, which includes a government-run insurance option.

The congressional analysts found the GOP effort would lower costs by bringing in more young, healthy people who need fewer services while raising rates for older, sickly people.

"Some provisions of the legislation would tend to decrease the premiums paid by all insurance enrollees, while other provisions would tend to increase the premiums paid by less healthy enrollees," the CBO analysis says.

"The pool of people without health insurance would end up being less healthy, on average, than under current law," the CBO says.

The GOP plan would add 3 million people to the insurance rolls by 2019, but the overall percentage of uninsured would stay the same.

What does Judaism say about this?

Here's the way I view it:

1. Judaism requires doctors to heal even if patients cannot pay anything.

2. In the same way, it requires patients to pay as much as they can based on need.

3. Insurance is a bridge that allows doctors to provide very expensive healthcare and still make a living. And it allows patients to get healthcare without going bankrupt and then needing to rely on public assistance and charity. 

4. If that insurance is government sponsored or controlled, it means society has taken responsibility. As such, society can do either of the following:

a. It can charge sick people more money, elderly people more money and exclude preexisting medical conditions. But, if it does so, it must also:

1) make sure all medical and pharmacological needs are completely and swiftly met, even when the patient has no more money left to pay, and,

2) It must completely meet the housing, food and other needs of the impoverished so that each person impoverished by paying for healthcare is sustained at his former standard of living. That means if he ate steak for dinner 7 days a week, we must give him equal or better quality steak dinners every day. The same is true for housing, clothes and transportation.

b. it can structure a system where everyone has equal access to and pays an equal cost for healthcare (unless they are unable to pay) through national health insurance or something similar, perhaps even public-private partnerships.

5. But what society cannot do is what the GOP is now advocating, while at the same time it tries to further cut welfare and other safety net programs.

6. I do not see how Jews can support Republicans on this issue. 

Comments

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I agree with the above mostly.

Funny it is the ultra orthodox who are against the health care bill, and for the republication health care bill. Hence, the ultra Orthodox are not Jewish or do not follow Torah lae

The Torah has never advocated government-run health care. "Government-run" being the key words.
I personally happen to think that health care is a right, however, government-run healthcare never works, and this government will turn it into a Darwinian monster in order to make profit. There will be no controls because the foxes will be guarding the chicken coop.

>> Should government sponsored or government regulated healthcare charge sick people and old people more than young healthy people?


Firstly, the Republican solution to adding competition to the health insurance industry would be to allow health insurance companies to compete accross state borders and this will definitely drive down costs for everyone in the health insurance market.


This would be better than giving the private sector the government as an inherently unfair competitor since


government agencies don't have to worry about making a profit.


government agenceis don't have to worry about paying for expenses with gross income.


except for police and military government agencies are usually less efficient than private companies.


with a government health insurance plan you run the risk of causing the collapse or near collapse of the private health care industry because companies need to cut costs and if they can get their employees on more affordable government health insurance. This means, you may end up with little to no competition.


As for sick people, while sick people should be helped, the constitutionality of forcing insurance companies to take preexisting conditions seems a little bit grey don't you think?


Another way the Republicans want to cut health insurance costs is tort reform. This will lower the cost of health insurance because doctors will not have to worry about bull shit lawsuits when something goes wrong that's not the doctor's fault. Doctors won't have to do sooooooo many superfluous tests to cover their asses.

Don't expect the Democrats to do tort reform because guess who are big donors to the Democratic party? TRIAL LAWYERS!!!!!!

There are also two other big reasons why people should run away from the Democrat plan.


The first issue is freedom. The Democrat plan will force people to buy health insurance even if they don't feel a need for it. Also, it would put the government in a bigger position to regulate everyone's lives. 'You like McDonalds? Oh well, your costs will increase' Don't think it can't happen.


The second issue is the national debt. The Democrat's health reform plan will cost $1.6 Trillion dollars. Repeat after me: iiiiiiiiiiiiiiinflaaaaaaaaaaaaaaaaaaaaatioooooooooooooooooon.

Well said!

The first issue is freedom. The Democrat plan will force people to buy health insurance even if they don't feel a need for it.

You know, I don't feel like I need auto insurance - I think I the govt should not force me to carry insurance since I drive carefully and think I won't get into an accident.

The problem with Comrade Pelosi's bill is that it will be funded by 0.3% of the population -- those with adjusted gross incomes over $1,000,000.

Now everyone needs healthcare, and I agree that everyone should have insurance. This, more than anything else, will bring costs down. I'm also not necessarily opposed to the public option. But everyone who can afford it should contribute to the costs, not just 0.3% of the population.

Fortunately, even the Democrats in the Senate don't like Pelosi's bill, and if we get a healthcare package, it'll look very much like the Senate Democratic version.

>> You know, I don't feel like I need auto insurance - I think I the govt should not force me to carry insurance since I drive carefully and think I won't get into an accident.

People are not cars. People can't be made to pay just for existing of which this is tantamount to.


>> Now everyone needs healthcare, and I agree that everyone should have insurance

Individuals should decide that, not the government.

Harold, what you said is the best possible argument for mandatory auto insurance. Think of what your premiums would be if only bad drivers got insurance.

I am 60 years old and this is the first time that I have had health insurance. I could not afford it until now. It was that or pay for my kids yeshiva education.
Medicaid will pay for the truly needy, and perhaps the guidelines should be lowered slightly, but the obligation is on the individual to pay for his own Doctor. Under our system, I am required to pay for maternity benefits, which I do not want and will NEVER use.
Simple reforms. Make premiums tax deductible to the individual as well as the corporation. Stop allowing the states to control the required coverages. Make available any policy that is legal in one state to any State. Encourage plans that do not pay for ordinary expenses but only pay for major expenses. And do not think you can tax Doctors by controlling the entire market and limiting the fees of the Doctors. Those over 60 will retire and the young students will not enter the field.

How does Geico get away with charging some people more than others for car insurance? Seems that they discriminate on age, sex, where you live, and a lot of other things.

If Car insurance can do it, why not medical insurance?

Harold, what you said is the best possible argument for mandatory auto insurance. Think of what your premiums would be if only bad drivers got insurance.

My point exactly - Good shabbos to all.

That's what I thought. Good Shabbos to you, too.

Reader,

'The Torah has never advocated government-run health care. "Government-run" being the key words.'

This is a straw man. The health care reform bills proposed by Democrats in Congress do not establish a government-run health care system. Democrats propose a government-run health insurance plan that people will be free to choose, but only if they prefer it to the private plans available. And further, this is only a relatively minor part of the proposals.

"I personally happen to think that health care is a right, however, government-run healthcare never works, and this government will turn it into a Darwinian monster in order to make profit. There will be no controls because the foxes will be guarding the chicken coop."

Since the Democrats do not propose anything remotely like a government-run health care system, this a red herring. But anyway, you are quite wrong about this. The UK, for instance, has what you can call a government-run health care system. The Commonwealth Fund found in a study that the UK performed better than the US on most (though not all) quality measures. And quite remarkably, in 2004 the UK spent only 8% of GDP on health care while the US spent 15% of GDP.


"1. Judaism requires doctors to heal even if patients cannot pay anything.

2. In the same way, it requires patients to pay as much as they can based on need"

First of all, if you're going to make broad generalizations about what "Judaism requires..." please provide a source.

Secondly, if a patient is paying as much as they can, they would be paying for services they utilized when they got sick. This is the same thing as charging more for people with pre existing conditions, or smokers, or the elderly, or anyone more likely to get sick, for insurance.

If "Judaism" really agreed with what you said, you would find something said like, "The Malchut should universally impose a collection and distribute it to doctors to provide refuah for all of society whenever someone requests..." What you described sounds like patients should pay doctors for what they use, as much as they can, and that doctors should be charitable.

Judaism requires that you respect the property rights of individuals... I believe a husbands assets can be taken to provide healing for his wife, maybe his young children as well, but beyond that, I don't think so.

SJ,

"Firstly, the Republican solution to adding competition to the health insurance industry would be to allow health insurance companies to compete accross state borders and this will definitely drive down costs for everyone in the health insurance market."

This will effectively abolish regulation of the health insurance industry, which is probably why Republicans like it. But it would also be quite wasteful and harmful.

"This would be better than giving the private sector the government as an inherently unfair competitor since ... government agencies don't have to worry about making a profit."

If for-profit health insurance companies cannot provide any useful function to consumers that justifies their profits, then they are useless to society and we should all rejoice when the goverment puts them out of business.

And if they do provide a useful function to consumers that the government cannot provide that justifies their profits, then it's hard to understand why they would have difficulty competing.

"government agenceis don't have to worry about paying for expenses with gross income."

I don't understand what this means.

"except for police and military government agencies are usually less efficient than private companies."

If you do some research on health care systems in other countries, you will see that health insurance (and arguably health care in general) is another area where government is far more efficient than private companies. You can start with this Commonwealth Fund study.

"with a government health insurance plan you run the risk of causing the collapse or near collapse of the private health care industry because companies need to cut costs and if they can get their employees on more affordable government health insurance. This means, you may end up with little to no competition."

No, the only way to get into a public plan would be through the health insurance exchange. And if your employer is eligible to participate in the exchange, the decision of which plan you choose will be your decision alone. Your employer will not be permitted to choose for you.

"As for sick people, while sick people should be helped, the constitutionality of forcing insurance companies to take preexisting conditions seems a little bit grey don't you think?"

How so? Anyway, many states already ban discriminating based on pre-existing conditions, including New Jersey and New York. It is called community rating. But it is not really sufficient without mandates and subsidies.

"Another way the Republicans want to cut health insurance costs is tort reform. This will lower the cost of health insurance because doctors will not have to worry about bull shit lawsuits when something goes wrong that's not the doctor's fault. Doctors won't have to do sooooooo many superfluous tests to cover their asses."

I don't think anyone has studied this more comprehensively than the CBO. And the CBO found that some tort reform proposals typically made by Republicans seem to reduce health care spending a little, while others seem to increase spending a little. It is perfectly reasonable to support some tort reform proposals, but it is not reasonable to use this as an excuse to oppose any legislation that does not include them.

"The first issue is freedom. The Democrat plan will force people to buy health insurance even if they don't feel a need for it."

The moral argument for this is that when you end up in the emergency room with no health insurance and incur a $200,000 bill that you are unable to pay, it is not fair for that burden to fall on the rest of society.

The economic argument (which I find more persuasive) is that a health insurance system with community rating and guaranteed issue but no mandates leads to high premiums at best, and collapses from instability at worst.

"Also, it would put the government in a bigger position to regulate everyone's lives. 'You like McDonalds? Oh well, your costs will increase' Don't think it can't happen."

Private insurance companies on the individual market can do this already. And they do do this indirectly by discriminating against people with pre-existing conditions, in states where the government does not prohibit this practice. And the reason why we are not all on the private individual market is because of tax-subsidized employer-based insurance, Medicare, Medicaid, the VA, etc.

"The second issue is the national debt. The Democrat's health reform plan will cost $1.6 Trillion dollars. Repeat after me: iiiiiiiiiiiiiiinflaaaaaaaaaaaaaaaaaaaaatioooooooooooooooooon."

No, the recent bills cost the federal goverment around $800 billion to $1 trillion or so over a 10 year period to expand coverage. To put this in context, economists project total health care spending in the United States will be around $40 trillion over the next 10 years.

And further, after cost-cutting and taxes, the recent bills reduce deficits rather than add to them.

SJ,

"Firstly, the Republican solution to adding competition to the health insurance industry would be to allow health insurance companies to compete accross state borders and this will definitely drive down costs for everyone in the health insurance market."

This will effectively abolish regulation of the health insurance industry, which is probably why Republicans like it. But it would also be quite wasteful and harmful.

"This would be better than giving the private sector the government as an inherently unfair competitor since ... government agencies don't have to worry about making a profit."

If for-profit health insurance companies cannot provide any useful function to consumers that justifies their profits, then they are useless to society and we should all rejoice when the goverment puts them out of business.

And if they do provide a useful function to consumers that the government cannot provide that justifies their profits, then it's hard to understand why they would have difficulty competing.

"government agenceis don't have to worry about paying for expenses with gross income."

I don't understand what this means.

"except for police and military government agencies are usually less efficient than private companies."

If you do some research on health care systems in other countries, you will see that health insurance (and arguably health care in general) is another area where government is far more efficient than private companies. You can start with this Commonwealth Fund study.

"with a government health insurance plan you run the risk of causing the collapse or near collapse of the private health care industry because companies need to cut costs and if they can get their employees on more affordable government health insurance. This means, you may end up with little to no competition."

No, the only way to get into a public plan would be through the health insurance exchange. And if your employer is eligible to participate in the exchange, the decision of which plan you choose will be your decision alone. Your employer will not be permitted to choose for you.

"As for sick people, while sick people should be helped, the constitutionality of forcing insurance companies to take preexisting conditions seems a little bit grey don't you think?"

How so? Anyway, many states already ban discriminating based on pre-existing conditions, including New Jersey and New York. It is called community rating. But it is not really sufficient without mandates and subsidies.

"Another way the Republicans want to cut health insurance costs is tort reform. This will lower the cost of health insurance because doctors will not have to worry about bull shit lawsuits when something goes wrong that's not the doctor's fault. Doctors won't have to do sooooooo many superfluous tests to cover their asses."

I don't think anyone has studied this more comprehensively than the CBO. And the CBO found that some tort reform proposals typically made by Republicans seem to reduce health care spending a little, while others seem to increase spending a little. It is perfectly reasonable to support some tort reform proposals, but it is not reasonable to use this as an excuse to oppose any legislation that does not include them.

"The first issue is freedom. The Democrat plan will force people to buy health insurance even if they don't feel a need for it."

The moral argument for this is that when you end up in the emergency room with no health insurance and incur a $200,000 bill that you are unable to pay, it is not fair for that burden to fall on the rest of society.

The economic argument (which I find more persuasive) is that a health insurance system with community rating and guaranteed issue but no mandates leads to high premiums at best, and collapses from instability at worst.

"Also, it would put the government in a bigger position to regulate everyone's lives. 'You like McDonalds? Oh well, your costs will increase' Don't think it can't happen."

Private insurance companies can do this already on the individual market. And they do do this indirectly by discriminating against people with pre-existing conditions, in states where the government does not prohibit this practice. And the reason why we are not all on the private individual market is because of tax-subsidized employer-based insurance, Medicare, Medicaid, the VA, etc.

"The second issue is the national debt. The Democrat's health reform plan will cost $1.6 Trillion dollars. Repeat after me: iiiiiiiiiiiiiiinflaaaaaaaaaaaaaaaaaaaaatioooooooooooooooooon."

No, the recent bills cost the federal goverment around $800 billion to $1 trillion or so over a 10 year period to expand coverage. To put this in context, economists project total health care spending in the US will be around $40 trillion over the next 10 years.

And further, after cost-cutting and taxes, the recent bills reduce deficits rather than add to them.

Yabed,

"How does Geico get away with charging some people more than others for car insurance? Seems that they discriminate on age, sex, where you live, and a lot of other things.

If Car insurance can do it, why not medical insurance?"

Good question. I will explain why.

1. A driver with a history of repeatedly causing accidents is probably a reckless driver, and probably could have controlled their driving better if they had tried. It is therefore morally fair to punish these people for their reckless driving by charging them high premiums. In contrast, if a person has a pre-existing health condition, it is always at least partially based on genetic predispositions and/or bad luck. These factors are no fault of their own. But denying these people coverage or charging these people premiums they cannot possibly pay is punishing people for factors that are not their own fault.

2. We can expect charging reckless drivers high premiums to have the effect of either encouraging them to take more care to avoid accidents or making their premiums so high that they cannot afford to drive. These are positive outcomes from society's perspective. In contrast, we can expect that denying health insurance to people with pre-existing conditions will tend to have the effect of causing them to avoid treatment and prematurely die. These are not positive outcomes from society's perspective.

SJ,

"Firstly, the Republican solution to adding competition to the health insurance industry would be to allow health insurance companies to compete accross state borders and this will definitely drive down costs for everyone in the health insurance market."

This will effectively abolish regulation of the health insurance industry, which is probably why Republicans like it. But it would also be quite wasteful and harmful.

"This would be better than giving the private sector the government as an inherently unfair competitor since ... government agencies don't have to worry about making a profit."

If for-profit health insurance companies cannot provide any useful function to consumers that justifies their profits, then they are useless to society and we should all rejoice when the goverment puts them out of business.

And if they do provide a useful function to consumers that the government cannot provide that justifies their profits, then it's hard to understand why they would have difficulty competing.

"government agenceis don't have to worry about paying for expenses with gross income."

I don't understand what this means.

"except for police and military government agencies are usually less efficient than private companies."

If you do some research on health care systems in other countries, you will see that health insurance (and arguably health care in general) is another area where government is far more efficient than private companies. You can start with this Commonwealth Fund study.

"with a government health insurance plan you run the risk of causing the collapse or near collapse of the private health care industry because companies need to cut costs and if they can get their employees on more affordable government health insurance. This means, you may end up with little to no competition."

No, the only way to get into a public plan would be through the health insurance exchange. And if your employer is eligible to participate in the exchange, the decision of which plan you choose will be your decision alone. Your employer will not be permitted to choose for you.

"As for sick people, while sick people should be helped, the constitutionality of forcing insurance companies to take preexisting conditions seems a little bit grey don't you think?"

How so? Anyway, many states already ban discriminating based on pre-existing conditions, including New Jersey and New York. It is called community rating. But it is not really sufficient without mandates and subsidies.

SJ,

"Another way the Republicans want to cut health insurance costs is tort reform. This will lower the cost of health insurance because doctors will not have to worry about bull shit lawsuits when something goes wrong that's not the doctor's fault. Doctors won't have to do sooooooo many superfluous tests to cover their asses."

I don't think anyone has studied this more comprehensively than the CBO. And the CBO found that some tort reform proposals typically made by Republicans seem to reduce health care spending a little, while others seem to increase spending a little. It is perfectly reasonable to support some tort reform proposals, but it is not reasonable to use this as an excuse to oppose any legislation that does not include them.

"The first issue is freedom. The Democrat plan will force people to buy health insurance even if they don't feel a need for it."

The moral argument for this is that when you end up in the emergency room with no health insurance and incur a $200,000 bill that you are unable to pay, it is not fair for that burden to fall on the rest of society.

The economic argument (which I find more persuasive) is that a health insurance system with community rating and guaranteed issue but no mandates leads to high premiums at best, and collapses from instability at worst.

"Also, it would put the government in a bigger position to regulate everyone's lives. 'You like McDonalds? Oh well, your costs will increase' Don't think it can't happen."

Private insurance companies can do this already on the individual market. And they do do this indirectly by discriminating against people with pre-existing conditions, in states where the government does not prohibit this practice. And the reason why we are not all on the private individual market is because of tax-subsidized employer-based insurance, Medicare, Medicaid, SCHIP, the Veterans Health Administration, etc.

"The second issue is the national debt. The Democrat's health reform plan will cost $1.6 Trillion dollars. Repeat after me: iiiiiiiiiiiiiiinflaaaaaaaaaaaaaaaaaaaaatioooooooooooooooooon."

No, the recent bills cost the federal goverment around $800 billion to $1 trillion or so over a 10 year period to expand coverage. To put this in context, economists project total health care spending in the US will be around $40 trillion over the next 10 years.

And further, after cost-cutting and taxes, the recent bills reduce deficits rather than add to them. It is hard to imagine how this could cause inflation, even if we get out of this economic crisis within the next 10 years. (As a consequence of the economic crisis, we are currently suffering from deflation. Some inflation would be nice.)

"A driver with a history of repeatedly causing accidents is probably a reckless driver, and probably could have controlled their driving better if they had tried. It is therefore morally fair to punish these people for their reckless driving by charging them high premiums. In contrast, if a person has a pre-existing health condition, it is always at least partially based on genetic predispositions and/or bad luck".....

and/or to many quarter pounders with cheese for the Goyim...or 3 Shabbas meals with 7 courses each for the Yiden. Along with a lack of exercise on everyone’s part. In addition to the last cigarette before Shabbas and using the Havdala candle to light the first. Which leads to obesity, diabetes, heart disease, etc.

So I think it could be compared to a habitually bad driver!

BUT.....

This is America and we were founded, thank God, with both the Freedom of Religion and the Separation of Church and State!

I for one do not wish to have Jewish Halacha in our Government any more than I wish to become a Christian Nation!

I know....I'm a Radical.

Americans compared to other first world countries pay more for health care than other countries yet on the whole (statistically) have the worst outcomes compared to countries which have government funded "insurance" Look at health care in Canada and Australia
Even though there may be problems urgent treatment does get done

For those who are in favor of a public option, look at France, Germany, and Belgium, and forget Great Britain and Canada.

The British system is abysmal.

Americans compared to other first world countries pay more for health care than other countries yet on the whole (statistically) have the worst outcomes compared to countries which have government funded "insurance"

Absolutely untrue.

>> This will effectively abolish regulation of the health insurance industry, which is probably why Republicans like it. But it would also be quite wasteful and harmful.
This is nonsense. Federal regulations will exist.

>> If for-profit health insurance companies cannot provide any useful function to consumers that justifies their profits, then they are useless to society and we should all rejoice when the goverment puts them out of business. And if they do provide a useful function to consumers that the government cannot provide that justifies their profits, then it's hard to understand why they would have difficulty competing.
If there is a sector of patients that are too small for private insurance to handle then sure the government should step in. This already happens with pharmaceuticals. It does not mean that the government should compete with private insurance with stuff that private insurance is able to handle.

>> If you do some research on health care systems in other countries, you will see that health insurance (and arguably health care in general) is another area where government is far more efficient than private companies. You can start with this Commonwealth Fund study.
I'm not reading all that crap. Make the points yourself dude. Sometimes I link to other pages to make my point but not stuff that's soooooo long to read. That being said, private companies are always more efficient than government. Obama himself said it best when he said that UPS and FedEX are doin fine and it's always the post office that's having problems. http://www.youtube.com/watch?v=LS12Z-MJpvw

>> No, the only way to get into a public plan would be through the health insurance exchange. And if your employer is eligible to participate in the exchange, the decision of which plan you choose will be your decision alone. Your employer will not be permitted to choose for you.
This is the first time I heard baout "Health Insurance Exchange" because noone seems to talk about it. After googling it, it appears that Health Insurance Exchanges aren't magic button to solve everything. http://voices.washingtonpost.com/ezra-klein/2009/06/health_insurance_exchanges_the.html

>> How so? Anyway, many states already ban discriminating based on pre-existing conditions, including New Jersey and New York. It is called community rating. But it is not really sufficient without mandates and subsidies.
Genius, just because it's done in some places does not mean it's not constitutionally grey.

>> I don't think anyone has studied this more comprehensively than the CBO. And the CBO found that some tort reform proposals typically made by Republicans seem to reduce health care spending a little, while others seem to increase spending a little. It is perfectly reasonable to support some tort reform proposals, but it is not reasonable to use this as an excuse to oppose any legislation that does not include them.
More stuff that takes too long to read. -.- And there's people who disagree. http://www.politicsdaily.com/2009/10/12/tort-reform-could-save-health-care-54-billion-says-cbo/ http://www.washingtonpost.com/wp-dyn/content/article/2009/07/30/AR2009073002816.html http://politicalticker.blogs.cnn.com/2009/10/12/tort-reform-could-save-54-million-report-says/

>> This will effectively abolish regulation of the health insurance industry, which is probably why Republicans like it. But it would also be quite wasteful and harmful.

This is nonsense. Federal regulations will exist.


>> If for-profit health insurance companies cannot provide any useful function to consumers that justifies their profits, then they are useless to society and we should all rejoice when the goverment puts them out of business. And if they do provide a useful function to consumers that the government cannot provide that justifies their profits, then it's hard to understand why they would have difficulty competing.

If there is a sector of patients that are too small for private insurance to handle then sure the government should step in. This already happens with pharmaceuticals. It does not mean that the government should compete with private insurance with stuff that private insurance is able to handle.


>> If you do some research on health care systems in other countries, you will see that health insurance (and arguably health care in general) is another area where government is far more efficient than private companies. You can start with this Commonwealth Fund study.

I'm not reading all that crap. Make the points yourself dude. Sometimes I link to other pages to make my point but not stuff that's soooooo long to read. That being said, private companies are always more efficient than government. Obama himself said it best when he said that UPS and FedEX are doin fine and it's always the post office that's having problems. http://www.youtube.com/watch?v=LS12Z-MJpvw


>> No, the only way to get into a public plan would be through the health insurance exchange. And if your employer is eligible to participate in the exchange, the decision of which plan you choose will be your decision alone. Your employer will not be permitted to choose for you.

This is the first time I heard baout "Health Insurance Exchange" because noone seems to talk about it. After googling it, it appears that Health Insurance Exchanges aren't magic button to solve everything. http://voices.washingtonpost.com/ezra-klein/2009/06/health_insurance_exchanges_the.html


>> How so? Anyway, many states already ban discriminating based on pre-existing conditions, including New Jersey and New York. It is called community rating. But it is not really sufficient without mandates and subsidies.

Genius, just because it's done in some places does not mean it's not constitutionally grey.


>> I don't think anyone has studied this more comprehensively than the CBO. And the CBO found that some tort reform proposals typically made by Republicans seem to reduce health care spending a little, while others seem to increase spending a little. It is perfectly reasonable to support some tort reform proposals, but it is not reasonable to use this as an excuse to oppose any legislation that does not include them.

More stuff that takes too long to read. -.- And there's people who disagree. http://www.politicsdaily.com/2009/10/12/tort-reform-could-save-health-care-54-billion-says-cbo/ http://www.washingtonpost.com/wp-dyn/content/article/2009/07/30/AR2009073002816.html http://politicalticker.blogs.cnn.com/2009/10/12/tort-reform-could-save-54-million-report-says/


>> The moral argument for this is that when you end up in the emergency room with no health insurance and incur a $200,000 bill that you are unable to pay, it is not fair for that burden to fall on the rest of society. The economic argument (which I find more persuasive) is that a health insurance system with community rating and guaranteed issue but no mandates leads to high premiums at best, and collapses from instability at worst.

You can argue until you are blue in the face. It is wrong to make people pay for existing and making people pay for health insurance is too much like that. I have a link on my blog that says Nancy Pelosi wants people to go to jail if they don't pay for health insurance. That's crazy.


>> Private insurance companies can do this already on the individual market.

It's different when the government regulates and when private companies offer products with terms and conditions.


>> No, the recent bills cost the federal goverment around $800 billion to $1 trillion or so over a 10 year period to expand coverage. To put this in context, economists project total health care spending in the US will be around $40 trillion over the next 10 years.

To say that this kind of spending will not worsen inflation is silly. The Democrat's health care plan is not the plan of a Clinton Democrat. At least Clinton Democrats valued balancing the budget, even though these putzes did it on the back of the military.


>> And further, after cost-cutting and taxes, the recent bills reduce deficits rather than add to them. It is hard to imagine how this could cause inflation, even if we get out of this economic crisis within the next 10 years. (As a consequence of the economic crisis, we are currently suffering from deflation. Some inflation would be nice.)

Will cost-cutting mean quality-cutting? O.o Also, i'd like to paraphrase Ann Coulter a bit, 'Riiiiiiiiiiiiight. Adding 40 million uninsured Americans to government health insurance will not increase the debt. And I want my 40 million layered chocolate fudge cake that does not put on weight.'

>> This will effectively abolish regulation of the health insurance industry, which is probably why Republicans like it. But it would also be quite wasteful and harmful.

This is nonsense. Federal regulations will exist.


>> If for-profit health insurance companies cannot provide any useful function to consumers that justifies their profits, then they are useless to society and we should all rejoice when the goverment puts them out of business. And if they do provide a useful function to consumers that the government cannot provide that justifies their profits, then it's hard to understand why they would have difficulty competing.

If there is a sector of patients that are too small for private insurance to handle then sure the government should step in. This already happens with pharmaceuticals. It does not mean that the government should compete with private insurance with stuff that private insurance is able to handle.


>> If you do some research on health care systems in other countries, you will see that health insurance (and arguably health care in general) is another area where government is far more efficient than private companies. You can start with this Commonwealth Fund study.

I'm not reading all that crap. Make the points yourself dude. Sometimes I link to other pages to make my point but not stuff that's soooooo long to read. That being said, private companies are always more efficient than government. Obama himself said it best when he said that UPS and FedEX are doin fine and it's always the post office that's having problems. http://www.youtube.com/watch?v=LS12Z-MJpvw


>> No, the only way to get into a public plan would be through the health insurance exchange. And if your employer is eligible to participate in the exchange, the decision of which plan you choose will be your decision alone. Your employer will not be permitted to choose for you.

This is the first time I heard baout "Health Insurance Exchange" because noone seems to talk about it. After googling it, it appears that Health Insurance Exchanges aren't magic button to solve everything. http://voices.washingtonpost.com/ezra-klein/2009/06/health_insurance_exchanges_the.html


>> How so? Anyway, many states already ban discriminating based on pre-existing conditions, including New Jersey and New York. It is called community rating. But it is not really sufficient without mandates and subsidies.

Genius, just because it's done in some places does not mean it's not constitutionally grey.


>> I don't think anyone has studied this more comprehensively than the CBO. And the CBO found that some tort reform proposals typically made by Republicans seem to reduce health care spending a little, while others seem to increase spending a little. It is perfectly reasonable to support some tort reform proposals, but it is not reasonable to use this as an excuse to oppose any legislation that does not include them.

More stuff that takes too long to read. -.- And there's people who disagree. http://www.politicsdaily.com/2009/10/12/tort-reform-could-save-health-care-54-billion-says-cbo/ http://www.washingtonpost.com/wp-dyn/content/article/2009/07/30/AR2009073002816.html http://politicalticker.blogs.cnn.com/2009/10/12/tort-reform-could-save-54-million-report-says/


>> The moral argument for this is that when you end up in the emergency room with no health insurance and incur a $200,000 bill that you are unable to pay, it is not fair for that burden to fall on the rest of society. The economic argument (which I find more persuasive) is that a health insurance system with community rating and guaranteed issue but no mandates leads to high premiums at best, and collapses from instability at worst.

You can argue until you are blue in the face. It is wrong to make people pay for existing and making people pay for health insurance is too much like that. I have a link on my blog that says Nancy Pelosi wants people to go to jail if they don't pay for health insurance. That's crazy.


>> Private insurance companies can do this already on the individual market.

It's different when the government regulates and when private companies offer products with terms and conditions.


>> No, the recent bills cost the federal goverment around $800 billion to $1 trillion or so over a 10 year period to expand coverage. To put this in context, economists project total health care spending in the US will be around $40 trillion over the next 10 years.

To say that this kind of spending will not worsen inflation is silly. The Democrat's health care plan is not the plan of a Clinton Democrat. At least Clinton Democrats valued balancing the budget, even though these putzes did it on the back of the military.


>> And further, after cost-cutting and taxes, the recent bills reduce deficits rather than add to them. It is hard to imagine how this could cause inflation, even if we get out of this economic crisis within the next 10 years. (As a consequence of the economic crisis, we are currently suffering from deflation. Some inflation would be nice.)

Will cost-cutting mean quality-cutting? O.o Also, i'd like to paraphrase Ann Coulter a bit, 'Riiiiiiiiiiiiight. Adding 40 million uninsured Americans to government health insurance will not increase the debt. And I want my 40 million layered chocolate fudge cake that does not put on weight.'

We DO pay more because we LEAD THE WORLD in medical medicine and technology. Then we use this technology to help other countries improve their health care.

Is there a problem with that?

Our healthcare is not better than Germany's nor France's, yet Americans pay double their share of GDP in healthcare costs, 14% vs. 7%. This, despite the fact that Germany and France have older populations than we do, and a much higher percentage of smokers.

One thing that would drastically lower healthcare costs would be to limit malpractice suits, and we can start by going back to the way it used to be, prohibiting malpractice attorneys from advertising on TV.

I agree, I think the way to solve our health care problems would be through a series of small changes gradually implemented.

Not this drastic, quickly, nor with this much risk at once.

I responded to Avian30 on my blog because my comments weren't going through for a while.

Ordinarilly I respond on the blog where the debate takes place.

I think the way to solve our health care problems would be through a series of small changes gradually implemented.

I heard someone else propose an incremental plan as you suggest. Start out with those who are uninsured. And by uninsured, those who can't afford or obtain it. Not those who don't want to pay for it. See how it works first. This massive overhaul is nuts.

>> This will effectively abolish regulation of the health insurance industry, which is probably why Republicans like it. But it would also be quite wasteful and harmful.


This is nonsense. Federal regulations will exist.

>> If for-profit health insurance companies cannot provide any useful function to consumers that justifies their profits, then they are useless to society and we should all rejoice when the goverment puts them out of business. And if they do provide a useful function to consumers that the government cannot provide that justifies their profits, then it's hard to understand why they would have difficulty competing.


If there is a sector of patients that are too small for private insurance to handle then sure the government should step in. This already happens with pharmaceuticals. It does not mean that the government should compete with private insurance with stuff that private insurance is able to handle.

>> If you do some research on health care systems in other countries, you will see that health insurance (and arguably health care in general) is another area where government is far more efficient than private companies. You can start with this Commonwealth Fund study.


I'm not reading all that crap. Make the points yourself dude. Sometimes I link to other pages to make my point but not stuff that's soooooo long to read. That being said, private companies are always more efficient than government. Obama himself said it best when he said that UPS and FedEX are doin fine and it's always the post office that's having problems. http://www.youtube.com/watch?v=LS12Z-MJpvw

>> No, the only way to get into a public plan would be through the health insurance exchange. And if your employer is eligible to participate in the exchange, the decision of which plan you choose will be your decision alone. Your employer will not be permitted to choose for you.


This is the first time I heard baout "Health Insurance Exchange" because noone seems to talk about it. After googling it, it appears that Health Insurance Exchanges aren't magic button to solve everything. http://voices.washingtonpost.com/ezra-klein/2009/06/health_insurance_exchanges_the.html

>> How so? Anyway, many states already ban discriminating based on pre-existing conditions, including New Jersey and New York. It is called community rating. But it is not really sufficient without mandates and subsidies.


Genius, just because it's done in some places does not mean it's not constitutionally grey.

>> I don't think anyone has studied this more comprehensively than the CBO. And the CBO found that some tort reform proposals typically made by Republicans seem to reduce health care spending a little, while others seem to increase spending a little. It is perfectly reasonable to support some tort reform proposals, but it is not reasonable to use this as an excuse to oppose any legislation that does not include them.


More stuff that takes too long to read. -.- And there's people who disagree. http://www.politicsdaily.com/2009/10/12/tort-reform-could-save-health-care-54-billion-says-cbo/ http://www.washingtonpost.com/wp-dyn/content/article/2009/07/30/AR2009073002816.html http://politicalticker.blogs.cnn.com/2009/10/12/tort-reform-could-save-54-million-report-says/

>> The moral argument for this is that when you end up in the emergency room with no health insurance and incur a $200,000 bill that you are unable to pay, it is not fair for that burden to fall on the rest of society. The economic argument (which I find more persuasive) is that a health insurance system with community rating and guaranteed issue but no mandates leads to high premiums at best, and collapses from instability at worst.


You can argue until you are blue in the face. It is wrong to make people pay for existing and making people pay for health insurance is too much like that. I have a link on my blog that says Nancy Pelosi wants people to go to jail if they don't pay for health insurance. That's crazy.

>> Private insurance companies can do this already on the individual market.


It's different when the government regulates and when private companies offer products with terms and conditions.

>> No, the recent bills cost the federal goverment around $800 billion to $1 trillion or so over a 10 year period to expand coverage. To put this in context, economists project total health care spending in the US will be around $40 trillion over the next 10 years.


To say that this kind of spending will not worsen inflation is silly. The Democrat's health care plan is not the plan of a Clinton Democrat. At least Clinton Democrats valued balancing the budget, even though these putzes did it on the back of the military.

>> And further, after cost-cutting and taxes, the recent bills reduce deficits rather than add to them. It is hard to imagine how this could cause inflation, even if we get out of this economic crisis within the next 10 years. (As a consequence of the economic crisis, we are currently suffering from deflation. Some inflation would be nice.)

Will cost-cutting mean quality-cutting? O.o Also, i'd like to paraphrase Ann Coulter a bit, 'Riiiiiiiiiiiiight. Adding 40 million uninsured Americans to government health insurance will not increase the debt. And I want my 40 million layered chocolate fudge cake that does not put on weight.'

If for-profit health insurance companies cannot provide any useful function to consumers that justifies their profits, then they are useless to society and we should all rejoice when the goverment puts them out of business.

And if they do provide a useful function to consumers that the government cannot provide that justifies their profits, then it's hard to understand why they would have difficulty competing.

Good point. If the govt entry is abysmal then they will fail against the privates. What people fail to realize is that the govt is already in the healthcare business so the infrastructure is already in place. What is being suggested is to open it up so that more people can opt into it. If their coverage is sub par then the market forces will kick them out and the privates will prosper. If the privates do nothing but siphon off money to line their pockets and offer nothing to further health care then let them fail. Let the market decide.

Repeat after me: There is no such thing as a free lunch. There is no such thing as a free lunch. There is no such thing as a free lunch.
Medical expenses are real. Someone must pay for them. The government can theoretically open up it's printing press and pay all Doctors, Hospitals, Lab Fees and drugs out of the treasury, No tax increase necessary, just add all costs to the already hugh deficit. Quick quiz, can anyone tell me why that is not a good idea?

Or the government can nationalize all the Doctors and pay them. What's a fair salary? $75,000? $150,000? Whatever. Of course the doctors are already deep in debt from Student Loans and their malpractice insurance costs them over $200,000 per year, but what the hell, the Doctors have an obligation to heal, don't they? We aren't talking about capping lawyers fees because they are necessary, as opposed to Doctors who are not. So next time you have a heart attack, don't call a doctor for help, call a lawyer.Doctors are currently refusing to see Medicare patients because the compensation from the government is not adequate. Now the government wants to lower it. Since when are doctors exempt from the 13th amendment? And who do you think are going to be the Doctors of tomorrow? The Indians and Pakistanis who do not speak English well. Whaat is that going to make of the quality of health care?
Or we could make some modest changes in todays system, see how that goes and move on from there. We could make the premiums tax deductible. We could allow the people to tailor there health insurance to their individual needs, rather that having the States mandate Cadillac coverage for people who can barely afford a used Hyundai. There are very few people who are completely uninsurable, most can be insured at subprime rates. Perhaps the government can subsidize imsurance costs for the poor.
This is much better than the Government setting up a system of its own. That will undercut the current system by dictating fees and treatment. It will undercut the Doctor/patient relationship. It will set up, willy nilly, a rationing system that will be accused of being subject to politics as there will always be waiting lists and those who want to move to the top of the list.
In short, there is a major revolution being planned with no real justification and no real idea of how it will work. Tamper at the edges, don't break the system. The First rule of medicine is "Do No Harm." That is a good rule for politics as well.

When I said that Ameicans have the worst first world outcomes I only meant statistically I should have added that paradoxically some of the best health care for individuals occurs in the USA.
The problem with reform is that there are tremendous built in costs that are in the system and also health care is capable of absorbing all the money thrown at it.

formerpostvillian and effie,

The health care reform bills proposed by Democrats in Congress do not constitute a "massive overhaul." On the contrary, I would consider it quite incremental.

The bills make no substantial changes to the health care delivery system. The bills preserve employer-based insurance, Medicare, Medicaid, SCHIP, and the VHA with relatively minor adjustments. The only "massive overhaul" is with the individual market, which currently covers only 5% of Americans (see page 2 of this report). May I suggest you read PolitiFact's "Health care reform: A simple explanation"?

>> This will effectively abolish regulation of the health insurance industry, which is probably why Republicans like it. But it would also be quite wasteful and harmful.


This is nonsense. Federal regulations will exist.

>> If for-profit health insurance companies cannot provide any useful function to consumers that justifies their profits, then they are useless to society and we should all rejoice when the goverment puts them out of business. And if they do provide a useful function to consumers that the government cannot provide that justifies their profits, then it's hard to understand why they would have difficulty competing.


If there is a sector of patients that are too small for private insurance to handle then sure the government should step in. This already happens with pharmaceuticals. It does not mean that the government should compete with private insurance with stuff that private insurance is able to handle.

>> If you do some research on health care systems in other countries, you will see that health insurance (and arguably health care in general) is another area where government is far more efficient than private companies. You can start with this Commonwealth Fund study.


I'm not reading all that crap. Make the points yourself dude. Sometimes I link to other pages to make my point but not stuff that's soooooo long to read. That being said, private companies are always more efficient than government. Obama himself said it best when he said that UPS and FedEX are doin fine and it's always the post office that's having problems. http://www.youtube.com/watch?v=LS12Z-MJpvw

>> No, the only way to get into a public plan would be through the health insurance exchange. And if your employer is eligible to participate in the exchange, the decision of which plan you choose will be your decision alone. Your employer will not be permitted to choose for you.


This is the first time I heard baout "Health Insurance Exchange" because noone seems to talk about it. After googling it, it appears that Health Insurance Exchanges aren't magic button to solve everything. http://voices.washingtonpost.com/ezra-klein/2009/06/health_insurance_exchanges_the.html

>> How so? Anyway, many states already ban discriminating based on pre-existing conditions, including New Jersey and New York. It is called community rating. But it is not really sufficient without mandates and subsidies.


Genius, just because it's done in some places does not mean it's not constitutionally grey.

>> I don't think anyone has studied this more comprehensively than the CBO. And the CBO found that some tort reform proposals typically made by Republicans seem to reduce health care spending a little, while others seem to increase spending a little. It is perfectly reasonable to support some tort reform proposals, but it is not reasonable to use this as an excuse to oppose any legislation that does not include them.


More stuff that takes too long to read. -.- And there's people who disagree. http://www.politicsdaily.com/2009/10/12/tort-reform-could-save-health-care-54-billion-says-cbo/ http://www.washingtonpost.com/wp-dyn/content/article/2009/07/30/AR2009073002816.html http://politicalticker.blogs.cnn.com/2009/10/12/tort-reform-could-save-54-million-report-says/

>> The moral argument for this is that when you end up in the emergency room with no health insurance and incur a $200,000 bill that you are unable to pay, it is not fair for that burden to fall on the rest of society. The economic argument (which I find more persuasive) is that a health insurance system with community rating and guaranteed issue but no mandates leads to high premiums at best, and collapses from instability at worst.


You can argue until you are blue in the face. It is wrong to make people pay for existing and making people pay for health insurance is too much like that. I have a link on my blog that says Nancy Pelosi wants people to go to jail if they don't pay for health insurance. That's crazy.

>> Private insurance companies can do this already on the individual market.


It's different when the government regulates and when private companies offer products with terms and conditions.

>> No, the recent bills cost the federal goverment around $800 billion to $1 trillion or so over a 10 year period to expand coverage. To put this in context, economists project total health care spending in the US will be around $40 trillion over the next 10 years.


To say that this kind of spending will not worsen inflation is silly. The Democrat's health care plan is not the plan of a Clinton Democrat. At least Clinton Democrats valued balancing the budget, even though these putzes did it on the back of the military.

>> And further, after cost-cutting and taxes, the recent bills reduce deficits rather than add to them. It is hard to imagine how this could cause inflation, even if we get out of this economic crisis within the next 10 years. (As a consequence of the economic crisis, we are currently suffering from deflation. Some inflation would be nice.)

Will cost-cutting mean quality-cutting? O.o Also, i'd like to paraphrase Ann Coulter a bit, 'Riiiiiiiiiiiiight. Adding 40 million uninsured Americans to government health insurance will not increase the debt. And I want my 40 million layered chocolate fudge cake that does not put on weight.'

Are we talking about the Republican Health care bill, which is going nowhere and is a joke, or the Democratic Health Care Reform bill, being voted on this weekend. You people don't seem to know, do you.

And oh yeah, keep using Judaism to justify capatilism, that's real smart. Almost as smart as using Judaism to justify colonialism.

I can't believe we can be so dumb.

First of all, if you're going to make broad generalizations about what "Judaism requires..." please provide a source.

I'm sorry. Me bad. The source is the Shulkhan Arukh.

NOTE: Cross-posting from SJ's blog.

SJ,

"The only reason why I am responding on my blog and not on Failed Messiah is because Failed Messiah seems to be having technical problems (which happened before) and my comment isn't going through."

I had problems too. I found the solution was to split my one large comment into two smaller comments.

"This is nonsense. Federal regulations will exist."

OK, I should have been more precise and said state regulations. I was referring in particular to community rating and guaranteed issue. You can see in the Krugman articles I provided why abolishing these regulations in the states that have them would be wasteful and harmful.

"If there is a sector of patients that are too small for private insurance to handle then sure the government should step in. This already happens with pharmaceuticals. It does not mean that the government should compete with private insurance with stuff that private insurance is able to handle."

Private insurance is "able to handle" the employer-based market in the sense that they operate with profit margins and relatively high administrative costs that gets passed down to the consumers.

And private insurance is "able to handle" the individual market in the sense that they refuse to provide health insurance to the people who need it most.

"I'm not reading all that crap. Make the points yourself dude. Sometimes I link to other pages to make my point but not stuff that's soooooo long to read."

I made the point, and provided a reference to support it. Anyway, if you are too lazy to read the entire report, you can simply read the Executive Summary or even just look at the table on page 8.

"That being said, private companies are always more efficient than government."

You are being inconsistent here. You said earlier that "except for police and military government agencies are usually less efficient than private companies." And if you think government-run health insurance is less eficient than private insurance companies, why are you afraid that private insurance companies will have so much difficulty competing?

"Obama himself said it best when he said that UPS and FedEX are doin fine and it's always the post office that's having problems. http://www.youtube.com/watch?v=LS12Z-MJpvw"

Obama is not an authority on this subject.

Incidentally, 89% of Americans have a very favorable or somewhat favorable opinion of the Post Office.

"This is the first time I heard baout 'Health Insurance Exchange' because noone seems to talk about it."

Perhaps this indicates you should do more research to improve your understanding of the health care reform bills before vehemently opposing them?

"After googling it, it appears that Health Insurance Exchanges aren't magic button to solve everything. http://voices.washingtonpost.com/ezra-klein/2009/06/health_insurance_exchanges_the.html"

Did I claim it was? And it is hard to see how you view Ezra Klein's article as an argument against the Democratic health care reform bills.

NOTE: Cross-posting from SJ's blog.

SJ,

"Genius, just because it's done in some places does not mean it's not constitutionally grey."

You have provided no evidence whatsoever that it is constitutionally gray.

"More stuff that takes too long to read. -.- And there's people who disagree. http://www.politicsdaily.com/2009/10/12/tort-reform-could-save-health-care-54-billion-says-cbo/ http://www.washingtonpost.com/wp-dyn/content/article/2009/07/30/AR2009073002816.html http://politicalticker.blogs.cnn.com/2009/10/12/tort-reform-could-save-54-million-report-says/"

The first and the third link do not represent disagreements at all. This is $54 billion for the period between 2010 and 2019. You can see on page 6 of this report that the White House projects Medicare and Medicaid spending for this period to be $9,954 billion! $54 billion is around 0.5% of that.

You can see for yourself in the CBO report this estimate comes from.

The second link cites some surveys and anecdotes that suggest that defensive medicine is a huge fraction of our total health spending. But the fact is that when we review the most comprehensive studies to study the real world effects of the malpractice reforms typically proposed by Republicans, we find that their proposals do not reduce health spending that much.

"You can argue until you are blue in the face. It is wrong to make people pay for existing and making people pay for health insurance is too much like that."

I have some news for you. All modern civilizations make people pay for existing. We call those payments taxes.

"I have a link on my blog that says Nancy Pelosi wants people to go to jail if they don't pay for health insurance. That's crazy."

Not likely.

"It's different when the government regulates and when private companies offer products with terms and conditions."

The point is that private companies are already committing the kind of practices you are opposed to, and they would be committing these practices on a much larger scale if not for government tax subsidies, regulations, and programs. If you truly oppose these practices, you should be in favor of Democratic health care reform, which will prevent private insurers from committing these practices on the private individual market too.

"Will cost-cutting mean quality-cutting? O.o"

Not likely.

"Also, i'd like to paraphrase Ann Coulter a bit, 'Riiiiiiiiiiiiight. Adding 40 million uninsured Americans to government health insurance will not increase the debt. And I want my 40 million layered chocolate fudge cake that does not put on weight.'"

You don't have to take my word for it. Read the CBO studies of the recent House bill and the recent bill from the Senate Finance Committee.

Avian30, SJ, etc:

TypePad's spam filter is grabbing comments like crazy. If this happens to you again, please email me.

TypePad is a buggy, expensive, poorly managed system.

I notice my earlier attempts at commenting generated a lot of duplicates. Sorry about that.

Shmarya: You can delete the duplicates if you want.

Shmarya, the Shulkhan Arukh does not require caplitalism, socialism or communism. It requires the individual to care about the poor. It does not require that we play Robin Hood, stealing from those who we think may have more money than us and giving it to anyone who claims to need it. Give out of your own pocket. If you reach your hand into my pocket, I will cut it off.

If I get time, I will. I had to pull all of those out of the spam filter.

The spam filter even grabs MY comments.

And TypePad support is pretty much worthless.

Shmarya, the Shulkhan Arukh does not require caplitalism, socialism or communism. It requires the individual to care about the poor. It does not require that we play Robin Hood, stealing from those who we think may have more money than us and giving it to anyone who claims to need it. Give out of your own pocket. If you reach your hand into my pocket, I will cut it off.

Really?

The Shulkhan Arukh REQUIRES the doctor to heal, even if the patient has no money, and it REQUIRES the patient to spend what money he has money on healing.

The Shulkhjan Arukh REQUIRES you to pay for a communal mikva, school or shul – even if you do not want one and you do not need one.

The problem with Orthodoxy is that most of its adherents have never really learned.

Does the Shulkhan Arukh require the doctor to work 24 hours a day? 12 hours a day? 8 hours a day? 6 hours? 4 hours? Does it require anyone to become a doctor? Or can anyone sit home in his mother's basement and play with his computer and require a personal physician to be at his beck and call?
Exactly which doctor do you require to heal you? Do you even know which specialist you need? And how much money does the patient have to spend? If he truly has no assets he is eligible for medicaid. If he has assets, what percentage does he have to give the doctor? Does he have to sell his house to pay the doctor bills? Most young people have no assets and figure they can go bankrupt if they get a substantial medical bill and decide not to purchase insurance. That is why young people do not have insurance.
The Shulkhan Arukh is not stating practical law, either about doctors and patients or contributing to mikvaot and Yeshivot. They are stating individual goals. Not enforceable laws.
But since you are quoting shulkhan Arukh would you perhaps like to quote the source, chapter and verse, rather than, "it's in their somewhere and you are an ignoramous if you do not know where." I do not have the entire Shulkhan Aeukh at my fingertips, but I do not recall any special law about physicians. It is a mitzvah to feed the hungry but does not give you the right to go onto the neighborhood supermaket and swipe food for your lunch.

Incidentally, 89% of Americans have a very favorable or somewhat favorable opinion of the Post Office.

That is an excellent point. Here we have a case where public and private can co-exist without driving themslves out of business. The post office does an admiral job, yet if you want that special service then there is UPS or Fedex you can go to. Public and private side-by-side.

Maybe the private insurance industry can morph themselves to supplement and pay for what the public insurance doesn't cover. Isn't that what is going on with medicare? Private options to fill in the gap not covered by the public option. Again, the best of both worlds.

avian30: Don't tell me a 200 page bill that is going to cost anywhere from 1.8 to 3 trillion dollars is not a massive overhaul.
Go sell crazy to some one else.

And yes, the bill makes substantial changes. It's designed to eventually force everyone into a public plan. If your employer plan doesn't meet the gov. standards, it's terminated and you forced into a public plan. If you leave your employment, you are forced into a public plan.

And no, you may not suggest Politifact. I've read that site before and it is misleading and biased.

More damn paperwork and more damn taxes and higher premiums for insurance coverage I don't want. I'm very satisfied with my insurance plan and I'm going to lose it because of people who don't know what they are talking about who think they are going to get something for free. Ha!

Did I say 200 pages? Whoops! I meant 2000 pages.

The majority of Americans rarely use the post office. Those of us who use it often for business, think it sucks.

The Shulkhan Arukh is not stating practical law, either about doctors and patients or contributing to mikvaot and Yeshivot. They are stating individual goals. Not enforceable laws.

Nope. Halakha l'ma'ase.

I'll try to find the source for you. But if you have access to Nishmat Avraham, you'll find it there easily.

The problem with Orthodoxy is that most of its adherents have never really learned.

And, I should add, this is a problem that originates with Brisk and its toldot. The Brisker method is a bit weak on practical halakha.

effie,

"Don't tell me a 200 page bill that is going to cost anywhere from 1.8 to 3 trillion dollars is not a massive overhaul. Go sell crazy to some one else."

No, the CBO says the cost to the federal budget is more like $800 billion to $900 billion for the provisions to increase coverage. See the CBO reports for the recent House bill and the recent Senate Finance Committee bill.

If we are talking about health care costs added to the economy as a whole, $1.8 trillion is plausible but I have no idea where the $3 trillion number comes from.

Further, these are the costs over a 10 year period. If you look at page 3 of this report, you can see that the Center for Medicare and Medicaid Services projects that total health spending for the 2008-2018 period will be around $35 trillion. If we consider the $1.8 trillion number, we are talking about a 5% increase over 10 years. But CMS projects health care spending to grow on average 6.3% every year between 2008 and 2018, and Republicans don't seem to be outraged about this.

"And yes, the bill makes substantial changes. It's designed to eventually force everyone into a public plan. If your employer plan doesn't meet the gov. standards, it's terminated and you forced into a public plan. If you leave your employment, you are forced into a public plan."

This is complete nonsense. And if you disagree, then I will ask you to provide some evidence for this claim.

"More damn paperwork and more damn taxes and higher premiums for insurance coverage I don't want."

We have the most bureaucratic health care system in the world. If you consider paperwork to be such a problem, you should support a single payer system like the one in Canada, which has one third of our administrative costs.

"I'm very satisfied with my insurance plan and I'm going to lose it because of people who don't know what they are talking about who think they are going to get something for free. Ha!"

Can you provide any evidence for this?

The majority of Americans rarely use the post office.

You mean most Americans use UPS, Fedex or DHL over USPS? I would just love to meet someone who Fedexs their electric bill or pays their mortgage via UPS or goes to DHL to pay their phone bill.

++...I'm very satisfied with my insurance plan...++

Many Americans are not. Many Americans, when they are suddenly faced with a serious illness, discover that their private insurance plan screws them. Have you ever, G-d forbid, had to deal with your wonderful insurance plan when you discover you need cancer chemotherapy and/or major cancer surgery with reconstruction? You will then discover how really satisfied you are with your insurance plan.

If you are against any government insurance plan, then please tell your parents to get off Medicaire.


My son recently graduated college. He is being offered jobs that pay $30-35,000. No health insurance is offered. An individual bare bones BC/BS policy will cost him about $7,000 per year, here in the NY/NJ area. Do the math please, and tell me how he should pay for this.

Selfish people who have good insurance, or think they do, don't want anyone else to have it. Guess what- most Americans aren't as lucky as you.

The shulchan aruch is not "Judaism" it is one opinion....

I can't believe that you are arguing something based on Jewish values and basing those arguments on the shulchan aruch when you clearly do not regard shulchan aruch as definitive or even valid Judaism (from what I've seen of your posts)

Secondly, as I pointed out before, it seems from those statements that the shulchan aruch states that the sick should pay for their healing- as much as they can afford. The idea that those who are utilizing medicine should pay for those services is more in line with the Republican view point. The Democratic view point is that all of society should pay for the healing of the sick, not simply that doctors should heal free of charge as the shulchan aruch says.

WSC - So not everybody is happy with their employer sponsored health care. I guarantee you that far more people would be unhappy with their govt. run healthcare program. I hope we never find out.

The simple solution, damn it, is to be able to purchase insurance across state lines. I believe in a free market system, not socialism.

We are not the land of opportunity, we have become the land of entitlements.

Wow, you have such faith in the government.
You can put your life in the hands of Pelosi, Reed, Boxer, and Obama, but I would rather not. What the hell, Obama has fired the CEO from G.M., we have a large stake in private companies, and now we'll control the healthcare everyone receives.

As for your comment regarding people with good insurance being selfish and not wanting others to have it, that is a silly comment and you know better. Whatever the govt. sponsors in terms of healthcare won't be good at all. It has nothing to do with selfishness. Let's screw the 85% so that we can give the other 15% lousy healthcare.

Bleeding heart liberalism is destroying this country from the inside out.

You made the comment about your son several months ago, almost verbatim. Around my parts, it is out of the ordinary to be offered jobs requiring degrees which don't include access to free or greatly subsidized by the employer healthcare. What gives by you?

By the way, everyone, please notice that the "blue" states are far worst off financially than the "red" states. This is not a coincidence, not at all. However, just like Muslim terrorism, people just refuse to see the facts, even though they are crystal clear.

Why is it that these states with super-high taxes are hurting. I thought higher taxes meant more revenue for the government. Actually obama doesn't even say that - he says rich people should pay higher taxes to be given to the poor because it's fair and good neighborliness.
Yes, he used the word "neighborliness".

What is fair is to let the wealthy create jobs with their money and to encourage the entreupenerial spirit.

I fail to see how bigger government is better government.

Gut voch

Secondly, as I pointed out before, it seems from those statements that the shulchan aruch states that the sick should pay for their healing- as much as they can afford. The idea that those who are utilizing medicine should pay for those services is more in line with the Republican view point. The Democratic view point is that all of society should pay for the healing of the sick, not simply that doctors should heal free of charge as the shulchan aruch says.

Like I wrote above, too many people who are 'Orthodox' or Orthodox-affiliated never really learned.

As I wrote in my post, just as the patient must pay, the doctor must heal if the patient can't (or won't) pay.

And, if a patient does go bankrupt, society is obligated to sustain him at the level he was at before his illness.

So there's the flip side to the halakha that you ignore.

The Shulkhan Arukh requires residents of a town to pay for a mikva, a synagogue and other communal needs. If a resident says he won't use the shul, or he doesn't need a mikva because his wife is no longer halakhicly obligated to use one, he is still forced to pay.

What this means is Jewish law recognizes the concept of communal good and taxation to support that good.

This is discussed by poskim with regard to schools, libraries – even hospitals.

My post is about the Jewish view of healthcare reform.

It seems clear that view supports such reform and universal coverage.

And, so far, nothing anyone has written here brings any halakhic source to the contrary.

With regard to Shmarya and Rabbidw's exchange, I would think that Judaism is capitalist because in Judaism there's:


private ownership

rules for fair competition in business

and there's nothin against the profit motive. XD

looks capitalist if you ask me.

Despite all the arguments, I agree with universal care, HOWEVER, at this point in the development phase, I think the outlay of money needs to be devoted SOLEY to quality control over our existing programs. Billions in healthcare fraud is currently being siphoned off, only adding to the budget strain. I would wager a guess, if the current healthcare system was run as initially intended, enough money would be freed up to insure everyone equitably with minimal additional expenditure. The biggest complication while weeding out the violators, is that smaller organizations that are actually operating legitimately would be penalized for minor infractions resulting in care being compromised/going bankrupt, while the big violators would only become more creative in covering their tracks. Impose pricy new legislation on top of that, and yes we do have a problem. Beam me up Scotty!! NOW!!!

and there's nothin against the profit motive.

But there are halakhic caps on how much profit can be made and restrictions regarding competition.

But there are halakhic caps on how much profit can be made

I will never forget the time that my wife had a procedure called Gamma Knife. The doctor agreed to take what Blue Cross pays since he was out of network. On the day of the procedure I took my wife in at 9am and picked her up at noon. A few weeks later I get a bill for $40,000 - that’s right 40 grand. I called the Dr and asked him what is going on and he said that his record shows that the check for the procedure was mailed to me and that the money was coming to him. Of course I never received any check so I called up Blue Cross, they had a laugh and said that if he was in network they would pay $2,000 for the procedure. I told the doctor’s secretary that I was in the wrong field and asked if he gets this kind of payment and she says sometimes he does.

I don't know how much he finally got but the spread between the $2,000 that Blue Cross would pay in-network and the $40,000 that he was asking makes me realize that there is a big problem with our healthcare system.

effie,

"Don't tell me a 200 page bill that is going to cost anywhere from 1.8 to 3 trillion dollars is not a massive overhaul. Go sell crazy to some one else."

No, the CBO says the cost to the federal budget is more like $800 billion to $900 billion for the provisions to increase coverage. See the CBO reports for the recent House bill and the recent Senate Finance Committee bill.

If we are talking about health care costs added to the economy as a whole, $1.8 trillion is plausible but I have no idea where the $3 trillion number comes from.

Further, these are the costs over a 10 year period. If you look at page 3 of this report, you can see that the Center for Medicare and Medicaid Services projects that total health spending for the 2008-2018 period will be around $35 trillion. If we consider the $1.8 trillion number, we are talking about a 5% increase over 10 years. But CMS projects health care spending to grow on average 6.3% every year between 2008 and 2018 without health care reform. It is odd that Republicans seem to be outraged at an 5% increase over 10 years to give health insurance to people who cannot currently obtain it, but don't seem too bothered by a 6.3% average increase every year under the status quo health care system.

"And yes, the bill makes substantial changes. It's designed to eventually force everyone into a public plan. If your employer plan doesn't meet the gov. standards, it's terminated and you forced into a public plan. If you leave your employment, you are forced into a public plan."

This is complete nonsense. And if you disagree, then I will ask you to provide some evidence for this claim.

"More damn paperwork and more damn taxes and higher premiums for insurance coverage I don't want."

We have the most bureaucratic health care system in the world. If you consider paperwork to be such a problem, you should support a single payer system like the one in Canada, which has one third of our administrative costs.

"I'm very satisfied with my insurance plan and I'm going to lose it because of people who don't know what they are talking about who think they are going to get something for free. Ha!"

On what basis do you believe you will lose your health insurance as a result of the reform?

harold,

Your experience was not an anomaly. The way hospital services are priced in the United States is truly bizarre.

You might be interested in the health care economist Uwe Reinhardt's article on the subject.

Shmarya,
You presented one view as a highlighted article, with a heavy partisan, non-objective stance. For the sake of equal presentation of the issues, would you post the Wall Street Journal article on the Pelosi healthcare plan at the same level as this article?

http://online.wsj.com/article/SB10001424052748704795604574519671055918380.html

Please.

You ask me to post an OPINION piece from the WSJ? Why?

Past that, the point of the post is clear. 1. What does Jewish law say about healthcare an dhow does that impact the current debate? 2. What does the CBO say?

You can't answer either point.

Shmarya, please,
You present a position where the House plan is better for seniors than the alternatives. This distorted position is the foundation for your argument and you expect the reader to accept that as true. One of the biggest concerns raised by multiple physicians I have spoken with is the diverting of Medicare Advantage funds to politically motivated inner-city projects (think of Acorn for healthcare). Many of my elderly relatives use Medicare Advantage, and will see a reduction in healthcare benefits if this bill is passed. This will impact their longevity.

I quote the Wallstreet Journal article,

"Sec. 1161 (pp. 520-545) cuts payments to Medicare Advantage plans (used by 20% of seniors)."

One of my associates, a physician that has worked in the private section, VA, and DoD believes that this will lead to rationing and severe restrictions on care for the elderly in the future. After all, if less care is offered to the elderly on the House health plan, it will also solve the social security problem. The elderly, unless wealthy or former members of Congress, will simple live shorter lives when presented with reduction in healthcare and rationing of services to the elderly under the House plan.

In summary, some segments of the population will benefit from the House plan. However, seniors that use Medicare Advantage will be hurt by the House plan! You can not argue this point, and it runs counter to your premise that the House plan will be better for seniors.

Jerome

Please.

I posted an article that QUOTED THE CBO – which is actually an authoritative source, as opposed to an op ed article you quote, which is not.

Past that, as I noted above, you need to address the halakhic issues.Try doing that.

Jerome Soller,

I wrote a long post, but the spam filter ate it. I'll post a summary.

Betsy McCaughey has a long history of making false claims about health care, and there is no reason to take anything she says seriously.

In regard to the Medicare Advantage issue: Medicare Advantage plans are run by private insurance companies. Republicans, who are so convinced that private insurance companies are more efficient than government, decided in 2003 to setup a bidding process in which the taxpayer can end up paying private insurance companies more per beneficiary than the cost for traditional Medicare. And the consequence of that is that the taxpayer now pays 14% more per beneficiaries of Medicare Advantage plans than to traditional Medicare plans. MedPAC has been recommending to Congress for years to stop overpaying these private insurance companies. Democrats are now saving the taxpayer around $170 billion over 10 years by following these recommendations. That is the context of these supposedly devastating cuts to Medicare Advantage.

I'll provide sources to any of the above claims upon request.

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