Obama asks the question.............

[Mashuri]

Re: Obama asks the question.............

I agree with Munger on all points.

Republicans provide socialisn for the rich, large corporations, and defense.

Demcrates provide socialism for the middle class and lawyers.

Those are your ONLY choices unless you vote for a Ron Paul and vote OUT all current senators.

Obama's plan is no more "socalist" then our current health care. The only difference is that under Obama's plan middle class America gets the benefits rather then big insurance firms.

A free market would be great, but America has not seen a free market in 80 years.

It really bothers me when people listen to TV news (CNBC, FOX, ..) and then start complaining about "Obama's Socialism" - Who do think pays for the news? Big corporate interests that fund the Republicans mostly.

Do you like seeing our country go bankrupt? I view both parties (Ron Paul being the exception) with equal disdain as they are both running our economy into the ground. What good is socialism for the middle class, or anyone else, when our entire economy collapses? California is a good preview of things to come.

[MulaMan]

Re: Obama asks the question.............

Munger, again, the author fails to address why we are in the situation we are in now.

Why do the economics of health care provide incentives for doctors to provide expensive procedures instead of other less expensive ones?

Why are health care costs vastly outpacing inflation?

These issues remain unaddressed.

Same reason finance was "de-regulated" - Health Insurance companies bought off congress and local governments and "de-regulated" health care.

"de-regulation" is the code word for screw America and pass laws to benefit a few special interest groups.

[cindykimlisa]

Re: Obama asks the question.....FIRE - Immigration- Healthcare

I am 58 years old and have always lived in USA

When I was a child in the 1950's some people had "hospitalization." this covered going to the hospital only: You paid your doctor and for your medicines directly. These professionals worked only for you and managed your care without third party interference.

Over the next two decades "hospitalization" expanded to include paying for your doctor and paying for your drugs and paying for any test or specialist you might want to go to or to whom you doctor sent you. Herein, in my opinion is where the wheels began to come off in our medical system !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! !!!!!!!!!!
An additional "profit" center was added to health care costs and that was corporate insurance companies.


Besides the unseen costs associated with the insurers there is another problem in my opinion. THE INSURANCE COMPANY CONTROLS HEALTHCARE, not the patient and not the doctor in some cases. Based on their requirements the insurance company often tells me the type of medication which they "approve." When my doctor says I need a test, the insurance company has to "preapprove it." When I need to see a specialist I have to get a "pre-approval" from the insurance company.

In my opinion if you really want to "reform" healthcare then go back to the fifties type system. Everybody (excluding medicare and medicaid) pays for the doctors and for drugs. If you need a test: pay for it. And if you need to go to the hospital then get hospitalization. If I had a choice, this would be my plan: even though I have a chronic illness, take meds and get tests. I would rather pay for them myself and take out the middle man insurance company and I want more control .Nevertheless, I would like to "insure" against trips to the hospital.

[cindykimlisa]

Re: Obama asks the question.....FIRE - Immigration- Healthcare

I am 58 years old and have always lived in USA

When I was a child in the 1950's some people had "hospitalization." this covered going to the hospital only: You paid your doctor and for your medicines directly. These professionals worked only for you and managed your care without third party interference.

Over the next two decades "hospitalization" expanded to include paying for your doctor and paying for your drugs and paying for any test or specialist you might want to go to or to whom you doctor sent you. Herein, in my opinion is where the wheels began to come off in our medical system !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! !!!!!!!!!!
An additional "profit" center was added to health care costs and that was corporate insurance companies.


Besides the unseen costs associated with the insurers there is another problem in my opinion. THE INSURANCE COMPANY CONTROLS HEALTHCARE, not the patient and not the doctor in some cases. Based on their requirements the insurance company often tells me the type of medication which they "approve." When my doctor says I need a test, the insurance company has to "preapprove it." When I need to see a specialist I have to get a "pre-approval" from the insurance company.

In my opinion if you really want to "reform" healthcare then go back to the fifties type system. Everybody (excluding medicare and medicaid) pays for the doctors and for drugs. If you need a test: pay for it. And if you need to go to the hospital then get hospitalization. If I had a choice, this would be my plan: even though I have a chronic illness, take meds and get tests. I would rather pay for them myself and take out the middle man insurance company and I want more control .Nevertheless, I would like to "insure" against trips to the hospital.

[Starving Steve]

Re: Obama asks the question.............

Whether it's nice or not doesn't change the fact that our Veteran health care system is hugely cash-flow-negative. It's eroding capital and is unsustainable.

Govn't-run healthcare is not profitable, nor should it be profitable. The question is: Does everyone in the country get served; does everyone get access to healthcare? And the answer is YES.

That taxes would have to be levied is not in dispute. A general sales tax across the country for healthcare would work best in sustaining national healthcare (Obama care), and a national sales tax would also help the federal govn't pay-down its deficit.

Forget everything Ronald Reagan and Arthur Laffer preached. There is simply no way for the nation to do anything but pay-down on its deficit and to bring-in universal healthcare. The day of reckoning has come.

And forget about more defence spending. There has to be less and less and less. No more space-shuttle adventures. No more trips to the moon..... Let the Russians go to the moon or Mars, wherever.

[MulaMan]

Re: Obama asks the question.............

I've lived in both America and Canada. Care in Canada is by far better than the USA.

In America doctors seem to only focus on - run a test - prescribe drugs, run a test - prescribe drugs, run a test - prescribe drugs, ...

Scary. I actual travel up to Canada when I need to talk with a doctor regarding a health issue, the response is often 100% different.

[Mashuri]

Re: Obama asks the question.............

Govn't-run healthcare is not profitable, nor should it be profitable. The question is: Does everyone in the country get served; does everyone get access to healthcare? And the answer is YES.

That taxes would have to be levied is not in dispute. A general sales tax across the country for healthcare would work best in sustaining national healthcare (Obama care), and a national sales tax would also help the federal govn't pay-down its deficit.

Forget everything Ronald Reagan and Arthur Laffer preached. There is simply no way for the nation to do anything but pay-down on its deficit and to bring-in universal healthcare. The day of reckoning has come.

And forget about more defence spending. There has to be less and less and less. No more space-shuttle adventures. No more trips to the moon..... Let the Russians go to the moon or Mars, wherever.

You don't understand. If it is eroding capital then it is unsustainable. The system will eventually collapse. This applies to health care, defense and everything else. Government needs to stop destroying wealth everywhere.

[ViC78]

Re: Obama asks the question.............

This thread has been quite interesting and enlightening. The takeaway, for me, from this thread is that facts and sensible explanations for the current mess we are in all point towards the theory that the health insurance is not suited to be be a for-profit industry just as the way national defense is not.

The Wendell Porter interview was particularly eye-opening. When health insurance companies are answerable to Wall St and are forever in the process on increasing "shareholder value", the interests of the populace are secondary. It does not make sense for a for-profit enterprise to offer insurance to people who are more likely to fall sick, and hence creates a huge problem. Even though, they have a larger risk pool, they will try to maximise their profits by eliminating those who are more risky and will avail of the insurance.

Munger - Thanks for all the articles and the explanations. You put it much better than a lot of people I have read. The opponents only seem to have talking points culled from their neighborhood Fox News outlet and do not offer a credible and well thought opposition to all the ideas you posited.

[Mashuri]

Re: Obama asks the question.............

The Wendell Porter interview was particularly eye-opening. When health insurance companies are answerable to Wall St and are forever in the process on increasing "shareholder value", the interests of the populace are secondary. It does not make sense for a for-profit enterprise to offer insurance to people who are more likely to fall sick, and hence creates a huge problem. Even though, they have a larger risk pool, they will try to maximise their profits by eliminating those who are more risky and will avail of the insurance.

Since Medicare now has unfunded liabilities of almost 90 trillion dollars (yes, it's 90,000,000,000,000 in the hole), how long do you think an all-inclusive health care system can persist? You may think profits are evil but that tells me you simply don't understand their purpose. Let me temper this, however, with the assertion that price, profit and loss lose a lot of their benefit to society the more coercive interference from government distorts a given market.

[charliebrown]

Re: Obama asks the question.............

i am a simple man, there are a lot of good ideas here and a lot of hate spewed around.

Here are some things I find broken with the system.
1) To visit a doctor stick out a tongue and say Ahh, and leave costs $200.00
If you have something wrong that requires a recheck, medicine, etc. the price quickly goes up. Have a kid with a sinus infection, you're talking 200 for initial visit, $100.00 for anti-biotics, and 200.00 for a visit later to see if everything is ok. 500.00 for a sinus infection is a lot of money for a family making 50K.
That is why insurance for simple things exists.

2) Try pricing an out patient procedure, call your insurance company, provider etc. No one will commit to a price. You insurer will state that a qoute is not a gurantee of coverage. So basically I'm rolling the dice on a 10K bill? I have been misquoted by a factor of 2x before, and all you get is "i'm sorry we made a mistake". Even with a 20% co-pay. a 2x mistake is a big surprise.

3) My son had a simple out-patient procedure done. In and out in two hours.
Bill around 35K?? What's up with that?

4) I have another son with some kind of weird metabolic issue. We have gone to many doctors some don't have a clue, others have led us down a bad path.
Under a "rules" based system are we going to be able to get these tests and procedures done? I'm sure a public system will be good for those with run of the mill issues. But what about those with out-lier conditions?

The health care system i would classify as a "wicked-problem" This is a technical term from system design. With wicked problems one cannot truly predict what the final outcome of the system when a change is applied. I really think a small change needs to be done, and see what equilibrium point is
reached, then try another, go for the biggest bang for the buck first.

What about lowering the deductible floor for deductible medical expenses. Currently it is 7% of agi. Tell me how many middle class families can afford 7% cut in disposable income? Maybe lower it to 5 ... 3 etc.

Yes this employer insurance thing is not the best arrangement. As mentioned you get what your employer offers. The big stumbling block here is open enrollement. If you have a major illness, no one will insure you on a private plan. So if you have heart disease, cancer etc. without going to an employer with open enrollment you cannot buy private insurance, and of course unless you are a millionare or more, you cannot afford to pay cash for any serious illness.]

What's with in net work preferred provider discount? If I go to a doctor and pay cash, I get full retail price, go in through insurance and its half of that. Is there any other business where the cash customer pays more?

A big chunk of the increase is the advances in medical care giving people a much higher quality of life. 20 or 30 years ago if your 70 year old aunt millie had a degenerating knee or hip, she was given a cane or walker and a big bottle of aspirin. Now she gets an artificial knee or hip at a price of 100K. She may live another 5 years, or another 30.
I am, was? a theologian, and I am chicken to make a call, who is going to make the decision on deciding if the 100k for aunt millie is a good allocation of resources? Moneterally or ethically it is a very thorny problem. What if aunt millie has assets? Do we take her retirement savings to pay for her new knee? what if her only asset is her house? Do we take that and force her to live in a small apartment? If we deny her surgery we condem her to a prison of immobility.

I can go on, but i need to leave, and i'm sure all you smart folks already know this. This is from a typicall employee with a cronically ill child.

[mcgurme]

Re: Obama asks the question.............

We don't have a free market in health care right now, that's the point. How can you possibly call it one? The existence of gubment-mandated HMO's, Medicare, and Medicaid prove that.

You're also trying to tell me that hospitals were never businesses until "the neocons came in" and changed things? Right...


Munger - What is being proposed and worked on is not oversight of a free market. Not even close.

You keep saying that somehow "the government is preventing a free market in health care." But you have provided exactly zero evidence for that view. Probably because there is none.

What, exactly, is a "gubment-mandated HMO?"

Medicare and Medicaid have no relation to whether or not there is a "free market".

And, no, most hospitals were community or church owned as nonprofit organizations. Your statement of "right" adds exactly zero facts to why you think it isn't so.

[jhurt]

Re: Obama asks the question.............

I skimmed your article...the ABC poll I'm sure was "scientifically" conducted and unbiased (forgive the sacrasm but even Obama will joke that the major networks are in the liberal tank so to speak...we all know it's true). What's amazing is that it showed medicaid recipients as more satisified than private payer insured patients. How could this be true? I know for a FACT how difficult it is for medicaid patients to get seen by any MD, much less a specialist! The only rational explanantion is that it's free. In fact, I almost believe the article is accurate b/c most Americans do see healthcare as a "right". They chaff at having to pay co-pays of $30 and believe me, if you don't get the surgery co-pay before surgery the amount of "drive-offs" you would get are staggering (it's hard to repossess a surgery). No, people believe they should get this care for free...regardless of what it cost to develop the technology, to develop the skill, to pay for the malpractice/schedulers/nurses/xray techs/custodians/billers/collectors...you get the point. John Stossel (sp?) did a special a month or so ago which spot lighted the attitude of current medicare recipients towards the overspending. Many of those interviewed enjoyed going to the doctor b/c it was a nice outing (never mind that they didn't have to pay anything). When confronted with the fact that the current younger generations were paying for their care...that is was in fact a Ponzi scheme they laughed and basically said "too bad." So sure, they like it...it's free...well, it's free for them. Someone always pays...nothing in life is truly free. As long as that someone is someone else then you Munger and everyone else is OK with whatever plan comes along. America used to be the land of opportunity...now it's becoming just another failed socialist experiment nanny state.

[mcgurme]

Re: Obama asks the question.............

Do you like seeing our country go bankrupt? I view both parties (Ron Paul being the exception) with equal disdain as they are both running our economy into the ground. What good is socialism for the middle class, or anyone else, when our entire economy collapses? California is a good preview of things to come.

Hey, would you rather have economic collapse with healthcare or without healthcare?

Because healthcare is not going to cause the collapse nor will it prevent it. $239 billion spread out over 9 years (the cost for Obama's plan according to the CBO) is mere chump change. We've given more than that to banks in the last six months. So all this whining about the costs and "economic collapse" is a mega straw man.

So, I say, give us health care.

[jhurt]

Re: Obama asks the question.............

"Its top executives are now saying that the USPS will default on a $5.4 billion payment to prefund future [FONT=Helvetica,Arial,Verdana,'Trebuchet MS', Sans-serif]retiree health benefits[/FONT] on September 30, 2009. And its government affairs representatives are now telling Congressional staff that the Postal Service may not be able to make payroll in October and will be forced to issue IOUs instead."
http://thenexteconomy.blogspot.com/2...issue-iou.html

THE US GOV CAN'T EVEN DELIVER THE MAIL WITHOUT GOING BANKRUPT...YOU THINK THEY CAN RUN HEALTHCARE?!!!!! I CAN'T BELIEVE RATIONAL THINKING INDIVIDUALS CAN REALLY BELIEVE THIS STUFF. IT'S MIND BOGGLING! THE EMPEROR HAS NO CLOTHES!!!

[santafe2]

Re: Obama asks the question.............

I've lived in both America and Canada. Care in Canada is by far better than the USA.

In America doctors seem to only focus on - run a test - prescribe drugs, run a test - prescribe drugs, run a test - prescribe drugs, ...

Take no offense, as I don't mean to attack you directly but this is complete nonsense. I've had the unlucky occasion to be the father of a near terminally ill child. And by all accounts, we live in the back waters of the US medical system. The care we received from our child's primary physician to the care and attention from the staff of specialists that saved her life, while consulting with the CDC were astounding to me. It is the only time in my life I've felt out of control and in the hands of experts.

My youngest daughter is an important part of who we are as a family and we have at the macro level, the US health care system to thank. Our pediatric physician is the hero for not pushing past his limit of knowledge, but I'm not sure he could or would have made the hand-off if he didn't trust the system.

I know it's not perfect but the people in the US health care system care about how they do their jobs and the people they care for. The system is secondary.