Forget what I said about people hating on David Brooks. That was nothing next to this:
An article called for John McCain to “just … die already.” A GOP official responded: “Amen.” https://t.co/tCgejDfaun
— Washington Post (@washingtonpost) July 18, 2017
FYI, John McCain is the only guy in Washington calling on the parties to drop the partisan posturing and try to draft healthcare legislation that will benefit the whole country:
“One of the major problems with Obamacare was that it was written on a strict party-line basis and driven through Congress without a single Republican vote. As this law continues to crumble in Arizona and states across the country, we must not repeat the original mistakes that led to Obamacare’s failure. The Congress must now return to regular order, hold hearings, receive input from members of both parties, and heed the recommendations of our nation’s governors so that we can produce a bill that finally provides Americans with access to quality and affordable health care.”
So of course he’s hated. That’s how it works.
Of course, the stupid woman who did this is trying to walk it back. But there is no explaining away something that hateful. It just is what it is…
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McCain is Arizona’s Strom Thurmond.
He should have retired a decade ago, he’s no longer doing his legacy any favors.
There is one very interesting aspect of Mccain’s ailment. I saw one estimate that this will cost upwards of $70,000. Of course Mccain’s generous health insurance will foot most of the bill. If this happened to an uninsured person they’d be ruined. This illustrates how valuable insurance is when you need it. Seems obvious doesn’t it? Health care should be a right, not a privelage.
A right for those who smoke 2-3-4 packs of cigarettes a day? Those who drink a 12-pack of beer or 5th of booze every night? How about a drug test for those receiving free treatment, if you test positive you pay the bill.
“Health care should be a right”
No, it shouldn’t. No matter how many trite bumper sticker statements you make about it, health care is not a “right”. It is a service with a finite supply and associated costs that have to be met. It’s no different from electricity. You don’t have a “right” to electricity. If it were a right, people would have the choice to pay for it or not – not have a mandated expense under the threat of government punishment. If it were a right, doctors could choose to charge whatever they’d like for their services. If it were a right, Americans could purchase prescription drugs from anywhere they choose.
What you want is the right to force people (bad rich people) to pay for the health care of others.
If you do stupid things like smoke, drink excessively, take drugs, eat unhealthy, purposely harm yourself or just treat your body like a toilet you really don’t deserve health care. If you want it bad enough then you should be forced to pay more than those who take care of themselves. Regulate health insurance premiums like automobile premiums, with annual reviews and mandatory checkups.
Ok then when someone shows up at emergency room with no money then they (he?) should be allowed to die. That’s your 2 choices.
That’s never been the case in this universe. Doctors treat people who show up at the ER, even people with no money. Then they send them a bill.
I’m not sure about the “That’s never been the case in this universe” part.
Seems like the law that requires ERs to do that was enacted sometime during my adult lifetime.
I doubt that many doctors would have turned away people dying of acute causes, but apparently there was a thing called “patient dumping” that this was designed to address. I can’t speak to whether it was prevalent, rare or what. But it does seem that “never been the case in this universe” may go a bit far…
What they do is treat the immediate, acute symptoms. For example if an indigent person collapses in the street with a heart attack, they will diagnose and treat his immediate problem, tell him what he should do, and release him. They don’t provide a way for the person to get meds or any follow-up. This is part of what makes our system the most expensive, least efficient in the world. We don’t provide any means for the indigent to get the preventive care, drugs, treatments, or follow-ups that prevent more expensive medical emergencies from occuring.
Ok. I’ll amend my previous statement to: “People in acute medical distress aren’t refused treatment by doctors, and even people in less than acute situations probably haven’t been refused since at least 1986.” I would also challenge someone to provide an example of a patient at an ER with an immediate life-threatening situation who did not receive treatment.
ER doctors don’t ask severe trauma cases questions about their insurance. If you’re bleeding to death and you’re about to die, they don’t ask you to fill out paperwork. They treat the patient in front of them. If someone gets wheeled into an ER with a gunshot wound, or a collapsed lung, or some other immediate, life-threatening situation…they treat that person. Then they send that person a bill for saving their life.
When people are in car accidents, the ambulance shows up and takes them to the hospital. The ambulance drivers don’t have someone with a bunch of broken bones fill out paperwork before they put them in the ambulance. They give you care immediately…because that’s their job.
Now, if you roll up to the ER because you’ve got a little tummy ache, you might have to fill out some paperwork and wait awhile until the ER docs finish treating the life threatening cases. Then, you’ll probably still get checked out in a basic manner…and then they’ll send you a bill.
It galls me to hear people whine and moan about how medical treatment costs money, and that it should be provided to them for “free”. Doctors go to medical school for years and years to become doctors. They save lives. Modern medicine is a miracle compared to what existed a hundred years ago.
Health care is not a right. Health care is an economic activity like any other. Everyone has the right to life, and that is why people in emergency situations are (appropriately) given treatment without respect to their ability to pay. However, all health care is a service provided by people. No one has the right to someone else’s labor. No one has a right to demand that someone else do for them on an involuntary basis.
Let me fix that for you:
“Health care is an economic activity UNlike any other.”
There…
Ok, I’ll allow that it is unlike a vast majority of other goods and services.
More than just the vast majority.
It’s pretty much the only commodity where the sales pitch is, “Buy this or die.”
Except, of course, for those “insurance policies” sold by the Mob…
You are relentless, aren’t you? 🙂 I keep conceding and you keep pushing. I surrender, I surrender! 🙂
Have you struck your colors?
Always seize, and maintain, the initiative. When I have the weather gage, I don’t back away…
It also differs from other economic activities in that it generally doesn’t lend itself to comparison shopping. Just try getting a quote for an annual physical from a doctor’s office. And when your having a heart attack, you don’t start Googling hospitals to see who can treat it most cheaply…
“It also differs from other economic activities in that it generally doesn’t lend itself to comparison shopping. Just try getting a quote for an annual physical from a doctor’s office.”
But that has nothing to do with the essential nature of health care, does it? The reason it’s hard to comparison shop is because of the convoluted insurance system that has been created and layered onto the system.
[you’re]
Certainly it’s that way because of the complex insurance system we have. Single payer will correct that when we finally get there (and we will).
In the meantime, shouldn’t I be able to get a straight answer from my doc about how much something is going to cost beforehand? I can with pretty much everything else I buy.
“In the meantime, shouldn’t I be able to get a straight answer from my doc about how much something is going to cost beforehand? I can with pretty much everything else I buy.”
You would be able to but for the Byzantine “insurance” system we have right now.
Norm, the problem is that there is no single price to quote. No one inside the system ever knows what anything “costs.” The answer is always it depends – on what is included, who is paying, what is added, what is negotiated, where one is, etc., etc.
Medicare and Medicaid have fairly standardized rates for service, I believe; but everything else is a complete black box. I think the federal tax code might be simpler than the medical billing “system” we have to burden ourselves.
Healthcare is most assuredly NOT like other economic activities. If you go to a car dealer and say I want that beautiful sedan the salesman doesn’t say sure, I’ll send you a bill. Healthcare is different. We should recognize that it is different and stop pretending it’s just a commodity like anything else.
It’s certainly not a commodity. A commodity is a raw material like copper, or sugar, or wheat.
Health care is a mix of goods and services. Fixing a broken leg takes a skilled person performing a service and some actual, tangible goods.
See, now, I thought you had surrendered…
Jagiello helped me escape.
He’s such a fine fellow, sometimes one can forget that he’s only a foreigner…
Healthcare is a combination of goods and services.
Yep, that’s one of the definitions of a commodity. 🙂
“Healthcare is a combination of goods and services.
Yep, that’s one of the definitions of a commodity. ”
Uh, no, it isn’t. It may be the start of a definition of a commodity but it’s everything that comes AFTER “goods and services” that defines a commodity. A commodity is indistinguishable by the supplier. Sure, some minor components of health care are commodities (aspirin, bandages) but the vast majority of healthcare require special skills or technology to produce. Capitalism drives pretty much all the improvement you see in health care.. developing new techniques, devices, drugs, etc.
Everyone already has the right to health care. Even if you are poor, you have access to health care.
What you are interested in is the “right” to insurance that covers every interaction with a doctor. Insurance that is paid for solely based on the income of the recipient and not on other factors like lifestyle choices and frequency of use. You believe in the “right” of the government to control what health care is provided, how much it costs, and how to collect tax revenues to pay for it. We already see how that works with Medicare, Medicaid, and the VA. That’s what we will get with single payer.
And I thought we had you on board with single-payer… 🙂
I am on board with single payer if it shuts down Obamacare, Medicare, Medicaid, and the VA. But I hold out no expectation that the care will be world class. It will be mediocre at best, reserving the best care (as always) for those who can pay for it.
So let’s you and me run up to Washington and straighten those people out!
You know, that’s the tragic irony here: As much as you and I argue about practically everything, I think if you and I were allowed to call the shots on the issues facing our nation, we’d manage to agree enough, and get so much done, that the people would want to appoint us co-consuls for life…
Except on beer. I want to be Secretary of Hops.
Doug, I think you don’t give enough consideration to the fact that insurance coverage and preventative care regimens are of societal benefit – that is, ultimately, they save us all money.
The most expensive care (for everyone not just the sick person) is the charity case that walks into the hospital ER at the 11th hour for acute care access.
It seems far better to have everyone accessing insurable coverage (and I’m on board with the necessity of reasonable but not light co-payments), especially when it includes preventative care.
Actually the most expensive care is usually in the last days of life of older people.
“According to one study (Banarto, McClellan, Kagy and Garber, 2004), 30% of all Medicare expenditures are attributed to the 5% of beneficiaries that die each year, with 1/3 of that cost occurring in the last month of life. ”
People against single payer will talk about death panels but there really should be some discussion of how finite resources are allocated when it comes to end of life. Doctor assisted suicide in terminal cases should be legal. Hooking up a person to a machine to keep him alive for months or years with no quality of life is an easy decision when insurance is paying for the true cost.
I’m ok with assisted suicide and death panels. Why shouldn’t the terminally I’ll have access to a way out of excruciating suffering. I support both healthcare and end of life options as rights.
We do agree on this.
And Brad might agree as well that relying on families in stressful end-of-life situations to be the ones who dictate care is not the best idea for anyone. Nobody wants to be in the position of having to do anything but expend heroic efforts to keep loved ones alive.
The problem here is that they should not have to shoulder that burden – and we should not tell our medical system that they have failed if someone dies. It’s life; it is unavoidable. We need to promote hospice and palliative care – both in and out of hospitals.
Medicare works great. I have several family members on it and have few complaints. Sure there are the occasional snafus but NOTHING compared with the private insurance cluster.
Here’s a good question, if Medicare is so great… why does everyone I know who is eligible for Medicare also carrying insurance policy with BC&BS or similar? Is it because there are things that Medicare refuses to pay for?
Yep. Medicare doesn’t cover everything, just like most other insurance.
Actually, I want all of us to pay for the health care of all of us. Or close enough. Sure, there will be some who can’t pay much, and theoretically people exist in the world who will never need (or never avail themselves of) medical care.
But generally speaking, all for all.
Not because I want to punish some people or reward others. That does not interest me (and boy do I get tired of arguments that center around such considerations). We do it because it’s the one rational way to do things. With a REAL mandate to participate, we can afford the system. That’s it.
But I’m with Doug on not calling it a “right.” We have enough “rights;” we don’t need to mint any new ones. Just do it because it’s practical, and because the way we’ve done it up to now is stupid….
As long as we all pay. That includes anyone who can afford a phone or cable TV, cigarettes, or alcohol. If you have to give up those to pay for “free” health care, too bad. That’s a YOU problem.
My preference would be for the Medicare tax to be increased and combined with a national sales tax. Then when the government wants more, they have to raise it for everyone – and that means people will have to value what they are getting for their dollars.
But it also means shutting down every other federal healthcare solution and requiring all government employees (elected or unelected) to be on the same program. If politicians want private insurance on top of the single payer, they have to pay for it.
I actually pretty much agree with Doug.
Remember a few years ago when I proposed a 4 tier healthcare approach. I’ve never seen anything quite like that but it seems like that would be an interesting approach.
Why four tier? I thought the goal was to have one equal coverage program.
Bud? Can you dust that off and share?
I was afraid someone would ask. As best I can remember it went something like this:
Tier 1 – Urgent and sudden care like heart attacks, allergic reactions to insects, serious injuries from accidents etc. would be covered 100% for everyone without questions. There are no decisions to be made. No “competition” elements involved. You are treated. What is the point of ANY paperwork in these cases.
Tier 2 – Chronic conditions like diabetes that require treatment but are not immediately life threatening would be covered at some % say 80%. Price could be a consideration for these conditions that could be incentivized.
Tier 3 – Preventive care like mammograms, colonoscopies etc. would be covered to the point that they would be useful in preventing future complications but not to the extent that money is wasted. A small copay would apply.
Tier 4 – Semi-optional procedures such as hip replacements, fertility treatment. Patients could do without these but would likely have significant life enhancement. These would be mostly paid for by patients but some government help may be available depending on a life enhancement score. Purely cosmetic procedures like breast augmentation would not be covered whereas skin grafts to treat a serious facial burn might be covered up to 90%.
I’m good with Doug’s plan. I’m all for a national sales tax as long as there are no exemptions except for used items (the tax has already been collected on the initial sale). As long as they cut income tax completely.
That’s ALMOST what Fritz Hollings kept pushing his last years in office. Except he would have used it to eliminate the 35 percent corporate tax, not the personal income tax. Here’s his argument…
This person refers to herself as a “journalist.” I differ.
I don’t know about this being the most hateful thing I have ever seen in politics. Both sides have engaged in some rather awful and hateful rhetoric over the past two decades. Unfortunately this is becoming more the norm than the outlier comment. And once said, the person who said or posted it will almost always take down the quote or post and offer sincere apologies for their unfortunate choice of words. To that I say “bull$h!t”.
After it is out there, all they are looking to do is cover their behind the best they can when they are excoriated on social media. Generally the first words said or typed and put out for public consumption are the words that express how they really feel about a person or subject. If you said or posted it, own it when called out about it. That is the one thing I do like about bud, when he posts a comment, he will stand by it and own it. I don’t agree with everything bud posts but at least he is willing to stand up and defend what he has to say.
I appreciate your comment Bart. I try not to be such an ideologue that I won’t change my mind when confronted with contradictory facts. There is one issue that I will admit to great ignorance. Why does Trump’s base continue to support him so stridently? I’ve heard all the explanations but they just don’t make sense. Mostly they boil down to the notion that Trump speaks to their needs. Typically these are white, blue collar workers who see little hope for advancing economically. I can certainly relate to that having come from a working class upbringing. But Trump never did. In fact he’s spent his life cheating people like that, I.E. Trump University. Yet they remain fiercely loyal. I guess the true test will come whenever we have a big recession.
Just throwing this out there.
http://www.ar15.com/media/mediaFiles/92687/Twain-politicians-257773.JPG
Actually, the most hateful thing this week may have been the House Appropriations Committee voting to permit the genetically brain dead British baby and his family permanent residency the same day too many in the GOP were calling for repeal without replacement of the ACA.
Everyone wants to sympathize with the helplessness of a genetically condemned newborn. However, usually the issue is several hundred thousand dollars of medical care expenses squandered on an inevitable death. But here we had Congress looking to purge tens of millions of people from the rolls of the insurable – thereby condemning how many millions of families to needless suffering of all kinds?
Hypocritical doesn’t even begin to describe it. There were (and still are) moral failings of a magnitude we have not seen for a long time in American politics. I understand Paul Ryan’s philosophical position on self reliance and limited government; what I do not understand is how he and much of the GOP seem so intent to plunge these like a bayonet into a significant percentage of our most vulnerable citizens? Somewhere along the line the Obama hatred poisoned good people and caused them to lose track of the actual human costs involved in implementing their theoretical political goals. It is a moral and ethical failing of America as a whole and I hope we begin to consider this in our deliberative political process.
Wait, what?
It is more hateful to want to go back to the status quo of insurance law circa 2010, than it is to specifically wish for the death of a person?
Do I have that right? A policy preference regarding insurance law is more hateful than specifically wanting John McCain to die?
The thing about Obamacare that resonated with people across the board is the idea that we could vanquish the cancer of “pre-existing conditions”. This has been a huge boon the country in many senses. To return to what you call the status quo 2010 would significantly burden millions of people – and their families. That is a hateful act – especially when done simply out of political pique.
Wishing John McCain to die is hateful thought and speech.
So yes, actions that negatively impact millions of people to prove a (asinine) political grandstanding point is more hateful than a few words uttered about one person.
Normally I do not think of politics in terms of hate (or even of any real sense of animosity); but this conclusion to the GOP’s long vapid promises of the party out of power came crashing down to reality the last few months. The willingness to cause actual suffering to millions of people – with no apparent regard for that reality – was morally repugnant to me. And hateful. As you say, your mileage may vary; but that is my take on the situation.
Media outlets are reporting McCain had an aggressive brain tumor. I wish him well.
I am very saddened by this. It is a glioblastoma. I also wish him well.
Okay I’ll be the one to say it, he’s 80 years old and aggressive cancer of the brain… if he’s like my grandfather he’ll be dead in 2-3 months (maybe longer with his level of medical access and slightly improved medical treatments since then) with obvious daily degradation. Wake up and can’t talk, wake up the next day and can’t walk, wake up the next and don’t remember anyone… fact is he’s a dead man walking. This is the same cancer Ted Kennedy had, and he deteriorated fairly quickly.
Or maybe he’ll be like Jimmy Carter who miraculously beat Melanoma of the brain at 92.
Two completely different animals. Melanoma doesn’t branch off like glioblastoma, that’s like comparing an allergy sneeze to pneumonia. Given the choice 100 out of 100 knowledgeable people will gladly take melanoma.
It’s a completely different form of cancer. More aggressive with a median survival duration of 14 months. 5% survival rate after age 55. He should quit the Senate and focus on his family and his treatment.
So I decide to go without insurance for decades and then get diagnosed with cancer I should be able to just sign up, pay my $500/month and get treatment? Then when it goes into remission or am cured I can drop my insurance coverage again… until the next medical crisis. Is that they way you think it should work? Because there are people out there that will deal with it… why pay for insurance when I’m healthy? If I get into a car accident on the way home tonight, I’ll just get someone to sign me up as I’m on the way to the hospital.
No, I don’t think anyone would be crazy enough to say that’s how it should work. Because it can’t possibly work that way.
The way it should work is the opposite. Everyone must be required to be insured, and the requirement must have teeth. Not signing up can’t be an option for anyone, for a system to work…
So health insurance will be a requirement… what if I refuse? Will I be thrown into prison and then fall under the prison health care system?
Yes, a requirement. Like we already have with auto insurance here in SC.
And of course if you prefer to be treated in the prison system, that would be up to you… 🙂
There are 52 members of the House Appropriations Committee. Of the 52, 22 are Democrats and 30 are Republicans. The vote was unanimous, no dissenting votes. This was not a partisan vote but bipartisan vote and a humanitarian gesture by the committee. Your point is not a valid criticism of the GOP in this instance.
As for ACA or Obamacare if you wish, repeal and replacement is dead in the water and Republicans/GOP who were hell bent on repeal and replace are now limping away, trying to curtail the damage, and spinning their defeat in the best manner possible. This lame, hair brain attempt was at best a fool’s errand and at worst, a demonstration of the ineffectiveness of GOP leadership and a revelation of the division within the party.
For once I agree with Trump. Let ACA, aka Obamacare, complete its course and wait for the who, what, when, and where that is inevitable to take place. I for one did not agree with ACA and the way it was handled but the Republican attempt was even more pathetic and all they accomplished was a bloated version of Pelosi’s comment, “we need to pass it to find out what is in it”.
What is inevitable is a version of single pay within the next 10 years or maybe less. ACA was the first step toward the inevitable. Even the original architect of the plan made the comment it was not going to work the way the daydreamers in Congress believed it would. Ask Romney about his version for Massachusetts and the myriad of problems it created.
A little factual information about the Heritage plan, Romneycare, the ACA and how they significantly differ. http://www.lawyersgunsmoneyblog.com/2017/03/heritage-plan-paul-ryans-wet-dream-nothing-like-affordable-care-act
Thanks. Make it a little shorter and simpler and maybe even the president would understand it..
“For once I agree with Trump. Let ACA, aka Obamacare, complete its course and wait for the who, what, when, and where that is inevitable to take place.”
Would it truly be inevitable if Trump’s administration was not actively trying to sabotage it and make it fail through the leeway they have in how it is implemented through health and human services?
Not saying it doesn’t have problems. It does and we should try to fix them.
But I find it extremely disingenuous to listen to Republicans and members of the Trump administration talk as if they want to improve health care for everybody beyond the current situation while at the same time proposing plans that would significantly reduce care beyond the current situation and also at the same time taking direct action to sabotage the implementation of the ACA, which will have direct harmful effects on the American people they claim to care about and be working to help.
If the ACA fails in spite of everyone working together to try and make it work, that’d be one thing, and it may well be, that it would. But if you claim to care about people and claim you want to help them, you don’t try to shoot the legs out from under the table they are standing on when it’s all they all have left just because it’s not the table you built and you couldn’t manage to get a new one.
I heard an expert talking about this on the radio.
There’s no such thing as passively letting it fail, according to the guy I heard. The executive branch is constantly making decisions and taking actions that affect the course of the ACA going forward. Choices are made. So the Trump administration would have to deliberately make choices to help it fail.
The guy, who was one of the architects of the ACA, sounded like he knew what he was talking about. But I don’t know how to follow him that far into the weeds. Too complicated for me to be sure…
There you go listening to NPR again…
You can hardly find a more reliable, in-depth source of information…
Point of clarification on the comment you highlighted. I have heard predictions from both sides that ACA in its present form will not succeed. It is my contention and has been all along it was cobbled together too quickly and without proper vetting or projections of failure on a couple of key elements. One being the anticipated participation of the young, healthy, and just getting started young women and men, families in particular. While it may be an admirable expectation, the hard truth is that disposable income for young people just starting out in life is not very much and to spend a disproportionate portion on health insurance that in turn goes toward assisting people who don’t take care of their health, make bad health decisions, and the older citizens who have more health problems as they age.
The second is the insurance companies dropping out to the point some states have only one provider participating in ACA and more are planning to drop out. What then? Who steps up and fills the void?
The third was the promise that if you liked your health insurance, you could keep it was not realistic.
Basically there were not enough “what ifs” accounted for based the information available at the time it was introduced and passed. Doug or anyone who is or has been involved in developing a flowchart for a complicated system like ACA knows for it to be successful, you do have to account for almost every contingent and what to do if a variation should occur. Without getting into any sensitive areas where both of our children work, one is working on implementing a change over for a large corporation with several locations across the country. They meet every week and work on the new system and have been doing so for three years and it won’t be completed until around 2020. It is nowhere as complicated as ACA and some of the best talent and minds the corporation can find are working on it as a team. ACA is not different in reality, just the application is geared toward healthcare and not industrial. I know from personal experience when developing an inventory, accounting, payroll, and production system the difficulties involved in producing a working program that is reliable and accountable.
I stand by my original observation, ACA never met one of the benchmarks of a well planned piece of legislation. It may work in government but an inane comment like Pelosi made may fly in Washington politics but not in the real world.
I don’t disagree we need a good plan or bill that allows more people “access” to our very good healthcare offered in the US but politicians and academics are not the best choice to put it together. And at some point, people who practice unhealthy lifestyle choices need to accept personal responsibility and if they continue to live an unhealthy lifestyle knowingly, why should you or I pay for it?