Culturally, Americans value freedom over social justice -- at least traditionally.  As a result, Americans don't tend to rely on their government to express their moral or ethical beliefs - separation of subjective morality (i.e. church) and state runs deep here.

So, for instance, the US, on a GDP basis, gives less than some countries in foreign aid at the government level but when you add in private charity, the US dominates, by far, the overall charitable giving internationally. 

Historically, transferring wealth or property from one individual to another has been done voluntarily on a per person level and has resulted in a great deal of generosity.  Americans, after all, aren't going hungry, quite the opposite.

But with freedom comes responsibility. American governments - state and local, are much more vigorous in enforcing laws than other countries. And what I mean by that, before anyone gets their hackles up, is that a lot of crimes in the US result in jail time where in other countries they would be ignored.  For example, a huge portion of the US prison population is in there for drug related charges.  In Europe or Russia those same charges would likely be at the equivalent of a misdemeanor.

Regarding rationalization of the confiscation of property:

I'm not hinting at communism at all.  What I am saying is that when people advocate for welfare programs paid for by taxes in which the beneficiaries are not some small group but rather nearly half the population what they are really doing is making it easy for people to rationalize supporting the government confiscating other people's property (money is property after all) to give to them.

For example, on the issue of health care, a tax-payer based system means that 40% of the population would suddenly be getting something paid for by the other 60% (because of the way tax credits and deductions work on US federal income taxes, anyone who earns less than around $35,000 pays little or no taxes, especially if they have a child).

Most people would feel shame going from house to house in their neighborhood begging for money to pay for their pills or doctor visits but when we start to frame health care as a moral "right" suddenly these same people can accept supporting programs that are really about them getting something from someone else -- and even demonize those who object to paying up.

Whether you use the public "option" or not you will still be taxed to pay for it. The public option is paid for by taxes. The people who would, for starters, be getting that public option are, by definition, people who fall into that 40% of the population who pay no net federal income taxes (or virtually none).

It'll be like public schools where you pay taxes for it whether you use it or not.

Match girls already qualify for Medicaid.

HR 3200 isn't about providing health care to poor people. They already get it today. It's called Medicaid.  

A lot of people who debate this tend to be non-Americans so they don't realize that the United States already spends BILLIONS a year providing health care the poor (not just hospitals but prescriptions, doctor visits, etc.).

HR 3200 presently would cover those who don't currently qualify for Medicaid which is largely those who could easily afford it, illegal aliens, and around 10 million of people who, due to pre-existing conditions, would have to pay what most would consider an unreasonably high amount for health insurance.

 

 

Incorrect.  You've been lied to.  Malpractice has come way down in Texas, the ratio of doctors to patients has gone way up, and cost changes are way down from the national average.

 

The brain drain from the surrounding states has been quite substantial.  Rates are still dropping too.  TMLT, a mutual(most malpractice insurance is through mutuals), has been paying historically massive dividends back to their policy holders as they keep dropping the premiums from year to year without managing to break even.  For those of you that don't know, a Mutual is non-profit, and pays the excess revenue back to the policy holders, that's the above mentioned dividend.  They've dropped rates around 30% so far, and are still paying out dividends around 20%.

 

On the opposite end of the equation, health insurance premiums have increased 25% over the last six years.  That's well below the national average of 33%.  In the stupid states, where they haven't even done half witted tort reform, it's around 45%.

 

As far as the new policies bit goes, if they have to conform to a set of requirements on what goes in a policy, there isn't any private insurance.  Having multiple people sell you the exact same policy the government has, at a higher cost thanks to the insurance companies not having a tax payer subsidized price, isn't having an option.

 

They've been trying to kill them for decades, anyone that believes they wont use this framework to take them out at the first opportunity is deluding themselves.  As long as they've shifted enough of the population onto the public dole first, it wont even hurt them politically when they do it.

Rather than quoting lots of text here, I'm going to reference a few posters:

Frogboy: Thank you for pointing out the reality of healthcare spending, the nature of American politics, and the context of HR 3200. It seems that much of this debate, especially the arguments of foreigners, is heavily derived from misinformation.

psychoak: You understand that doctors will follow quality of care and better rates. Many physicians would relocate in order to avoid frivolous lawsuits, poor working conditions, and state regulations that interfere with medical decisions. If we make our states, or rather, our nation, less attractive to doctors, they will practice elsewhere. A medical education is taxing in both time and money, and medical training is miserable. Do not expect physicians to go through so much to receive so little.

Daiwa: I appreciate your perspective. You are a physician, and you have experience with government-funded care. You speak to the dysfunctional reality of VA hospitals and the like.

Obscenitor: I may not agree with your opinions on this topic, but you attempt to justify your beliefs, and generally do so with sound reasoning ability. Thank you for contributing a meaningful, challenging voice.

Leauki: In an age where common sense is lost, you employ it to counter sophism. Well done.

Aroddo: You've been a good sport, even when your logic is questionable. Thank you for keeping this debate respectful.

I'm curious as to how many of you have heard of Wendell Potter. He formerly had the top PR job at CIGNA until he retired recently. He testified before the senate about the motives of the for-profit insurers:

http://voices.washingtonpost.com/ezra-klein/Potter%20Commerce%20Committee%20written%20testimony%20-%2020090624-%20FINAL.pdf

 

I would strongly encourage anyone who is interested in the health care debate to read his testimony.

 

Comments on it?

 

Lots.  None of the major insurance companies would exist today without the government regulations that created them.

 

Needing a national company to compete with a national company is a product of the competition restrictions barring the selling of policies across state lines.  This is unconstitutional by the way, a restriction on interstate trade.  To compete in another state, you must set up an entirely new, separately funded branch, which will lose astronomical amounts of money on the massive beaurocratic requirements until it reaches maturity.  This rarely happens, as can be seen by the complete lack of new insurance companies.  It's very, very expensive, and they aren't making much money.

 

Just starting a company to begin with is ridiculous.  It's not a simple matter of going to your hundred employees and saying hey, lets start our own insurance?  We'll all pay into the pot and get rid of all the bullshit ourselves.  That's how insurance was started to begin with, it's illegal now.  Major multi-national companies can afford to do it.  The local super market chain can't even get close.

 

All of these massive insurance companies that spend 40% of their budget on administrative costs would have been wiped out by corporate raiders before they got anywhere near that high.  Anyone anywhere near that high would have been a gold mine for a take over.  The profit potentials from doing some minor cost cutting in management are ridiculous.  You could double your money without even trying.  Corporate raiding has been thoroughly hamstrung.  Corporate raiding doesn't happen anymore.

 

Limitations on new competition plus removal of optimizing agents equals really fucked up industry.  A free market works just like any other organic system.  When you stop minor fires from burning away the brush and dead wood, forests become a mass of fuel that turns into a blazing inferno at the drop of a match.  When you spray the bark beetles to keep old, sick spruce trees alive, you get the same thing.  We are preventing the natural order of things, and then complaining when the shit hits the fan.  We need to let it burn, the longer we wait to get out of the way, the worse the pain when it goes.

He's dead on.  I've had happen to me exactly what he describes - our small group health plan was 'purged' late last year and we were 'lucky' to get any coverage for our employees - we were 'bare' for 3 months and ended up paying nearly twice as much (and had to pony up 'first & last' premiums, to boot) for much less in the way of benefits when literally the only other option was telling our employees, sorry - we can't offer you health insurance.  It wasn't entirely altruistic that we bit that bullet: we were over a barrel, too - we couldn't get any coverage for ourselves otherwise.

I'm not a proponent of UHC and, given a limited choice of two, would prefer, even with my experiences and knowing what I know about large insurers, a Wall Street-run plan to a government-run plan.  I'd rather identify and prohibit the egregious practices highlighted by Potter, setting equitable rules of the game with suitable consumer protections, than throw out the baby with the bathwater.

One of the (many) ironies is that Cigna, United and several of the other big players got big thanks to government subsidies to incentivize HMO development.  HMO's were always intended to be field trials of top-down 'managed care' - mini single-payer experiments, if you will.  The government consciously sought to use 'stockholder interests' in for-profit HMO's as a way of holding down expenditures - low and behold, they inevitably succeeded, as Potter eloquent confirms.  By the time the HMO model fell somewhat out of favor, the companies were big enough to apply those principles to commercial indemnity insurance.  They had learned that heavy command-and-control bureaucracies were more expensive than simply binging and purging.  Now that success is being used as a club against them.  The way of the world in big-league politics.

psychoak is also quite correct - the big insurance companies are the Frankenstein creatures of the governmental & regulatory climate of the last 30 or so years.

True, but let's put taxation "principles" in perspective;

Income brackets already use a pro-rata variation based on deductibles which can lower their participative effects when tallied in a number of different ways.

1- Capital gains off-shooted as investment growth owned & kept.

2- Percentages relative to actual taxable incomes... not in a sense that maximums can be reached but rather if such maximal ratios carry stable (or consistant) value when paid up.

3- Capacity to share outside the scope of business stability concerns IF cash-flow is obtained from necessary risk reserves. In which case, the taxable incomes must be obtained before protected liabilities rather than within gains mentioned in #1.

4- All of this, presuming personal assets are solvable "values".

Then the fair share you introduced is more about responsabilities than probable lackthereof if justified by any economic "laws & regulations" that protect (without which growth and innovations wouldn't exist, btw) such values as stated in #2 or made available by #3.

Zyxp -

You should apply for a job writing healthcare legislation.

It would be easier to understand if he did it, but not by much...

I really, really disagree with you here. Historically Americans DID go hungry and DID lead unacceptably poor lives during and after industriallization before the free market was regulated and the welfare state was established. You just act like it's a given that all of (of course it was far from perfect) the New Deal was a mistake and as though city life in the late 1800s and beyond was remotely acceptable.I disagree with this as well. America is light years beyond a number of theocratic states that I'd be afraid to even visit, but there's constantly clashes between people trying to express religious beliefs through legislation and their opponents. The Defense of Marriage Act and DADA are perfect examples. Don't get me wrong, we're way better off than a lot of countries, but compared to our hat (Canada) and most of our European peers we're not atypical in that respect.I don't agree with this either... Saudia Arabia is harder on crime than we are and they still have a fraction of our incarceration rate, as do other countries whose values are more aligned with ours. You say we're more vigorous about enforcing laws, but I think that's just a euphamism for we're waging a batshit insane war on drugs, which is a whole other can of worms (new thread time!). I also think our incarceration rate is more a testament to the strength of the prison-industrial complex's lobbying power than the values of the average American citizen.Most people would feel shame about going door to door begging for money to pay fire brigades in the days of old or to raise protection money so private security forces would investigate a burglary, murder of a family member, or whatever, and yet we still have fire and police protection which we lionize. We don't seek to make poor people feel guilty when emergencies arrive and they receive those services, but I would think that by your logic we should.

I think that opposition to health care reform is more an issue of political frustration and economic scale than an expression of a consistent political philosophy in most cases.

I ask you this: Should we seek to enable people to receive medical insurance in spite of pre-existing conditions? If not then so be it, but if so it's worth acknowledging that the whole notion of any kind of insurance is extremely similar to taxation in the first place. Everyone pays into a big pot and if the selected misfortune befalls one of the payers they withdraw from it. If you're not the unlucky one (and I assume you're not laying in a hospital bed as you read this) then you're paying for other people's health care.

If people with pre-existing conditions are allowed to get health insurance at non-astronomical rates you're going to pay for it one way or the other. If you either agree that they shouldn't be given insurance or you're fine with that so long as the government doesn't control the pot, then your beliefs are consistent, but otherwise they are not.

Yeah, because they sentence people to dismemberment, stoning, or beheading instead of jail time. Most of the drug offenses we jail people for are capital offenses in Islamic nations, and their appeals processes are sketchy at best. It doesn't take them more than a few weeks to go from arrest to chopping block.

Very well, since you can't seem to get the point: No one here really thinks people with preexisting conditions should be uninsurable, or any of the other bullshit brought up in the testamony linked to earlier. Most of us don't have much issue with paying for other people's problems with our insurance premiums. The situation we want to avoid is that the people with insurance will be paying the insurance that covers themselves AND the premiums for those the public option is going to cover (many of whom make far more than me, BTW).

What we need to do is straighten out the ratfuck that we let the insurance laws become, then get the hell out of it. The very poor are already covered with existing systems and if we fix the existing insurance system it will work for almost everyone else.

I think you're overestimating the thinning effect execution has on the prison population. China leads the world in executions and supposedly only had about 6,000 of them.

In 2008 we had about 1.6 million people in jail. We could quadruple China's execution tally in spite of our smaller population and still have the highest incarceration rate by a (not-so) comfortable margin.

Sure, but let's remember this in its political context. If the republicans had championed these things sometime in the last 30 years we wouldn't have a democratic majority threatening to shove a plan you can't stand down your throat.

It's a limitation of our two party system I suppose.

Not that I'm advocating this, but something like the Saudi drug sentences would result in hundreds of thousands of executions each year until people wised up. China also avoids long drawn out legal affairs and has some pretty severe penalties as well. And almost no country coddles inmates as much as we do. Come on, cable TV is a Constitutionally protected right for inmates.

There were just short of two million drug related arrests last year. Less than a quarter were juveniles, but still well north of one point five million adults were arrested at some point last year due to drugs. How many of those offensives do you think would have occurred if a conviction was a near certain death sentence carried out within weeks, not decades?

An actual effective death penalty had a substantial deterrence effect.

I haven't seen any proof that the death penalty is an effective deterrent. Countries which have abolished it haven't seen crime spikes and total number of executions in the US has been dropping without increasing crime rates.

In fact the states with the death penalty have consistently higher murder rates.

Impossible to say. Would crime have increased or decreased if bootlegging were a capital offense back in the days of prohibition? If the punishment for jaywalking were having your feet lopped off who's to say people wouldn't get into shootouts over incidents that are currently trivial, like parking tickets?

The whole thing is pure conjecture and completely immoral and unconstitutional by your own admission anyway.

I believe that's because we have a prison industry which is fueled by extended incarceration and a shitty cultural perspective that supports it. I think it's a perfect example of how private business has little interest in public welfare and an excellent glimpse of conservative backlash in its top form. Vote to reduce crime and improve morality, get a massive prison-industrial complex that bleeds out your state.