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Civil Debate via the NYT

By Chelsea O'Brien

There are a lot of problems posed in this well-written article about the problems with the proposed health care reforms

“There are serious questions that are associated with policy aspects of the health care reform bills that we’re seeing,” said Gail Wilensky, a veteran health care expert

Dr. Scott Gottlieb...his critique is based on related fears that the plans being discussed would inevitably lead to increased government involvement in personal medical decisions and eventually affect vital services.

But, starting out with a general distrust of government solutions, even conservatives who agree that tens of billions of dollars are wasted annually are dubious about the government’s ability to find significant savings without eventually affecting care negatively.

In the meantime, Mr. Goodman said he hoped his side could do a better job at making clear it had genuine misgivings about Mr. Obama’s proposals.

“I think the critics have approached this in the wrong way; saying there’s going to be a death panel is not the right way,” he said. “The right way to approach it is to put the burden of proof on the administration — tell us how you’re going to do that without denying care to people who are really in need.”

So someone explain to me how problems will cease to exist when the government takes over? Money needs to come from somewhere and then choices need to be made on whom and what to spend that money on. That means some people will not get the medications and treatment that they need, and may end up dying because the government chooses to not fund their treatment. In the current proposed reforms this question is not and has not been answered.

Tony Ferrando

We currently pay for over 60% of the US medical system without health care coverage- that's a fact. Money already exists within the budget, as has been explained at length. The deficit will go down over the first 10 years. And if we learned anything from Ronald Reagan, it is that deficit spending does not matter. Further, a switch to prevention based health care, instead of treatment based health care, will further increase savings - as people that view health care as "free" will not be afraid of the cost to seek these preventative measures.

As far as rationing goes... that is a desirable and needed part of any system. Abortion, for example, is not covered- therefore it is rationed by the very definition of it. Rationing creates value. If you invest money in something, you want a value return. You don't walk into Tops and see a limitless amount of Cheerios in the cereal aisle, there's only so many boxes of them - therefore, they can charge you for it, and you feel like you've acquired something of value after purchasing it.

As far as denying your treatment, in what fantasy land do you think that will happen? Legislators, lawmakers, presidents, senators... they've all got a very real threat if it does not function as intended. Insurance companies do not. So you switch providers? That's your biggest threat? Oooooo, I bet those CEOs will shake in their booties at that threat. If a public insurance option is fundamentally flawed in that it starts denying coverage claims for procedures and treatments that are promised to be covered, then they lose their jobs. Politicians answer to us who want what we are promised. CEOs answer to boards, who want their profits. You buy insurance because you think you may get sick. Insurance companies sell you insurance betting you *won't* get sick. That's the difference.

Besides, this is proposed to function exactly the same as Western European countries, a two-tiered system, where you can buy private insurance. Which not only spend far less on their health coverage as a % of their GDP, but produce considerably better results.

Sep 5, 2009, 12:47pm Permalink
Lorie Longhany

If you think for a second that people aren't dying because of lack of insurance or at the hands of the insurance companies by way of denials you are living in a fantasy land, Chelsea. According to the Institute of Medical Analysis' methodology and subsequent Census Bureau estimates of insurance coverage, 137,000 people died from 2000 through 2006 because they lacked health insurance, including 22,000 people in 2006.

I'm baffled that most of us trust the government with our interstate highway systems and national defense, but we are debating furiously on the health security of our citizens. Improvements in public health and sanitation, especially better water supplies and sewage disposal (which by the way is one of the single largest contributing factor for the huge jump in mortality rates since the 19th century) can be attributed to very progressive public laws which have changed our lives substantially for the better. The Rural Electrification Act (another Democratic and progressive piece of legislation) brought power to the countryside. I'm sure most of us are pretty happy that we have power (otherwise no blog comments). Why would we not consider health care as much human infrastructure as our roads, defense and electrification?

And how can something as precious as our health be placed in the hands of for profit entities with little to no regulations? At least if the government option is my choice of health care options I can redress via the voting booth or petition my representatives with my grievances. I do not have that luxury with Excellus.

Another point -- if you think that the lack of health care by say the person making your lunch at the corner diner doesn't effect you, after all as it's been stated by many right here -- "it's not up to me to be concerned about those that aren't insured". Think again. Without adequate health insurance your neighborhood short order cook may pick up say the H1N1 virus and because he or she can't go to the doctor (let alone take off work) because of lack of health care insurance -- the results may be lots of potentially dangerous germs on your BLT. Hence, now the problem of the uninsured becomes your problem.

Sep 5, 2009, 9:00pm Permalink
Howard B. Owens

Lorie, some of us have grave concerns about Interstate highways and standing armies, so I'm not sure that is a solid argument in favor of nationalizing medical care.

Sep 5, 2009, 9:06pm Permalink
Lorie Longhany

Howard, without those roads how do we get to our jobs, visit Grandma, go to the shore for a vacation?

My own experience living four years of my adult life as a United States Marine's spouse, the military that I witnessed ran like a machine. At least from my perspective of Headquarters Battery, 5th Battalion, 10th Marines, 2nd Marine Division. Camp LeJeune NC

Sep 5, 2009, 9:56pm Permalink
Howard B. Owens

Lorie wrote: "Howard, without those roads how do we get to our jobs, visit Grandma, go to the shore for a vacation? "

I commuted for a year from Pittsford to Batavia and back and rarely took the Thruway. I did taken an Interstate (490), but would have happily stuck to county and state routes if more readily available.

When Billie and I drove to Amherst, MA last summer, our wheels didn't touch an Interstate once.

Our small towns would be in much better economic shape without Interstates.

I was in the military. There's no doubt that a military life is a good life, and the military is full of heroes and admirable men and women, but we could reduce federal expenditures by $600 billion if we brought all the troops home from all the foreign lands. Without a standing, nationalist army, we would be more secure and would be less capable of misadventures such as Iraq.

I'm just saying, these are arguments alternative to the "conventional wisdom" that Interstates and Standing Armies are good things. They aren't unalloyed goods.

Big government is not an unalloyed good. A radical change such as moving all of health care into the nationalist government confines will have a multitude of consequences, some of which can't be imagined.

And given the national government's track record for screwing things up and not thinking through consequences, I'm not optimistic.

Think about it this way: Eventually, the Republicans will be in power again. Would you want the next President Bush running your health care?

We need health care reform that decentralizes power to protect us all, not concentrates it into the hands of nameless nationalist bureaucrats.

Sep 5, 2009, 10:50pm Permalink
Lorie Longhany

Howard, I have to agree with many of your arguments to a point. I hate imperialism and nation building and believe that our military should be used strictly for national defense, so we're together on that one. But I was talking about the efficiency of the military not how that efficiency is put to use.

I also love the scenic country roads and prefer them over any interstate but it would take a helluva long time to drive to Florida, which we do every Thanksgiving, if we mapped out all local roads. Besides, governments build the local roads, too. There are local, state and interstate highway systems -- all built and maintained by some government entity.

When I worked in Rochester I never drove 490, I preferred Scottsville Rd and my husband works in Lancaster and travels Rte 5 and then 33.

I've always wanted to travel the entire length of Rte 66, eating at all the great diners along the way.

Howard said
Think about it this way: Eventually, the Republicans will be in power again. Would you want the next President Bush running your health care?
Eeek -- don't scare me!

Sep 5, 2009, 11:27pm Permalink
Howard B. Owens

Lorie, I get your point about the efficiencies or not, but I'm talking about the consequences.

The more narrowly focused power is, the more easy it is to misuse. That's why I oppose large national and state governments and favor smaller governments.

You wrote, "There are local, state and interstate highway systems -- all built and maintained by some government entity."

My argument isn't with local government. I have a strong distaste for state government and an even stronger distaste for the national government. They are the ones who do the most to screw up people's lives, and take the most money for the least return.

Sep 6, 2009, 9:54am Permalink
Howard B. Owens

Let's put it this way: I would be less concerned about a single-payer/universal plan that was entirely Genesee County's, where all of the money was collected here, all of it spent here, and all of it controlled here, controlled by a local board of governor's, than I am about a nationalized system. And I certainly wouldn't want it run out of Albany, either.

Sep 6, 2009, 9:56am Permalink
Bea McManis

Posted by Howard Owens on September 6, 2009 - 9:56am
Let's put it this way: I would be less concerned about a single-payer/universal plan that was entirely Genesee County's, where all of the money was collected here, all of it spent here, and all of it controlled here, controlled by a local board of governor's, than I am about a nationalized system. And I certainly wouldn't want it run out of Albany, either.

...and it would be nice if we lived in a country where people got along and were civil to each other. We both know it isn't going to happen.
So, let's look at reality.
Your perfect form of self rule isn't going to happen to our country tomorrow. You have said that you find yourself musing how and if it could work. The question begs to be answered, what is the solution NOW - not in some warm and fuzzy idealistic muse?

The "I don't trust the government" is also growing old. Why not? If this government is so atrocious then why are those, who don't trust it, still here? Why haven't they found another country who's government they can trust?

Sep 6, 2009, 4:21pm Permalink
Chelsea O'Brien

Due to lack of critical thinking skills, furious following of party lines, and idiot comments I may have to leave the Batavian soon.

I may not trust the government, but the only way to fix things I don't like is to keep fighting for it. If you don't like people saying that they don't trust the government, without stating reasons why they should, leave the conversation. Being ridiculous and never taking part in the debate is what I'm growing tired of. Peter's side may sound a bit outlandish, but at least he can defend himself. I'm not so sure of the other side (and I have lived in one of the most liberal areas of the country without getting so upset as I have on this site).

Sep 7, 2009, 8:23pm Permalink
Howard B. Owens

Bea wrote, "The "I don't trust the government" is also growing old. Why not? If this government is so atrocious then why are those, who don't trust it, still here? Why haven't they found another country who's government they can trust?"

That's a red herring. It sounds a lot like the Republican "love it or leave it" of the 1960s. Did you have one of those bumper stickers on your car in the '60s, Bea? I bet not.

You can love the Constitution and the ideals of freedom that sparked a revolution and still distrust and dislike the government that has violently trampled on those ideals and freedoms. You can believe in the principles of the Constitution and believe that the government has evolved into an imperial power bent on its own self-serving lust for ever more control over the lives of people at home and abroad.

"Love it or Leave It" was a red herring in the 1960s and it's a red herring today.

Sep 7, 2009, 9:43pm Permalink

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