Ricky, you are putting words into my mouth that I've never said, and you are moving goal posts on me. I'll have to wait until I have more time to reply.

In the meantime, do yourself a favor. Look at what I've actually written, and then your extrapolation of what I've written. It would be a helpful intellectual task for you.

rickyp wrote:Steve

I have not refused to believe other countries have positive experiences with socialized medicine.

Not the impression you've given, but okay.
But you have refused to beleive that they could be applied to the US.
Even though they have..With popular acceptance, from, one can only conclude, generally postiive experiences.

Again, not what I have said. If you can quote me saying it cannot be applied here, feel free.

What I have consistently said, and you have refused to acknowledge, is that socialistic medicine has not been seriously proposed as a national solution. I mentioned Schakowsky by name. I said it was the fringe who support this.

You simply have been writing what you believe I believe without reference to anything I've said.

I've also said that when Democrats controlled the House, the Senate, and the Presidency, they did not push for a specifically socialistic plan. To now carp about conservatives not embracing Switzerland's plan (or whatever country you care to name) is entirely disingenuous. Liberals had the freedom to propose whatever they wished and they never even (edit) proposed such a plan.

danivon wrote:OK. So an incompetent doctor. Do incompetent doctors not exist outside VA? Is he incompetent because he is in VA? Is there more about systemic failure that you can't find at the moment that might flesh this out? Or do we have to keep teasing it out.

Well, if you read the whole article it referenced VA centers being closed in 2 or 3 other states for similar bad service. As I mentioned it was the first article in the series that mentioned the ended up establishing a nation-wide problem. Unfortunately, I haven't had time to sus out the others yet.

danivon wrote:If so, then we are back to the point about the Constitution not being the blockage, and if not,

No because I was specifically saying the Constitution was a blockage to the plans you were specifically proposing nothing else.

[quote=Danivon'] what would you actually accept and will you press your party to do so?[/quote]

Jesus Christ, how many times do I have to tell you. This will be the 3rd time I have specifically mentioned what I would support directly to you.

Open medicaid up to purchase to all people regardless of income levels, open sale of healthcare insurance across state lines, tort reform and stronger penalties against attorneys that bring frivolous lawsuits.

Danivon wrote:My point was not that the rich in the US do so well, it was that everyone else does so poorly.

Really? I do pretty well by healthcare and I am by no means rich.

Figures are from the CBO - Congressional Budget Office. Numbers are in Billions and don't cover TARP or the 2009 Stimulus. Some figures (specific military breakdowns) come from the Pentagon Operational Budget Document. Both the Federal and Pentagon budgets can be described as deliberately obfuscatory.

VA Benefits - 70
Military Facility Maintenance - 228
Military R&D - 21
Military Equipment Costs - 171
Military Operations Costs - Afghanistan: 191
Military Operations Costs - Iraq - 66
Military Operations Costs - Korea - 7

Total Military: 785 billion

Social Security - 615
Health, Hospitals - 284
Medicare - 396
Disability - 7
Cash and Food Stamps - 6
Social Services - 132
Housing - 41
Unemployment - 37
Police, Fire & Corrections - 31
Education - 104

Total entitlement budget: 1,622 billion. If you remove Social Security (because you believe the fairy tale that it's self funding), you're at 1,007 billion.

I went to the CBO cite and saw these actual expenditures for 2010:

3,456,000,000,000. This is about a trillion higher than your number. Any thoughts on why that is? Here's the link

http://www.cbo.gov/ftpdocs/121xx/doc121 ... Budget.pdf

It's page 24 of the PDF.

ray

Ricky, you are putting words into my mouth that I've never said, and you are moving goal posts on me. I'll have to wait until I have more time to reply

.
I wrote you've "Essentially said". You havn't. What I should have written was that attacking medicare specifically (Medicare is bankrupting the country) suggests that medicare is viewed as the key problem. But before you decide that Medicare is The problem consider what the original goals were....

The goal posts were set in the 60's when Medicare was established. The goal was to provide for a dignified old age free of the insecurity of bankruptcy from medical costs and the indignity of suffering from medical conditions but not being able to afford the care.
Has that goal changed?
The word being used here is entitlements. Okay. Are the aged entitled to what the nation decided they should be entitled to when medicare was brought in or have they suddenly become less worthy?
If not, then how is Medicare to become more efficient? The private sector in the US hasn't displayed an abilioty to provide serices more efficiently. Or effectively. The primary evidene might be to look at how good a job was done before Medicare came into being.

steve

What I have consistently said, and you have refused to acknowledge, is that socialistic medicine has not been seriously proposed as a national solution

.

So when it is proposed you'll be the first in line to support its adoption, because you'e seen how well it works around the world?

rickyp wrote:So when it is proposed you'll be the first in line to support its adoption, because you'e seen how well it works around the world?

I don't stand in lines.

I would support it IF the free market option is tried first.

rickyp wrote:What I should have written was that attacking medicare specifically (Medicare is bankrupting the country) suggests that medicare is viewed as the key problem. But before you decide that Medicare is The problem consider what the original goals were....

Richard, you have a problem. It doesn't matter what the goals were. What matters is this: was the original funding plan sufficient for all that Medicare has become?

Richard, the answer is a resounding "NO!"

Whatever its efficiencies are/are not, whatever promises were made, the simple truth is this: we don't have the scores of TRILLIONS of dollars we need to fulfill what was promised nearly 5 decades ago without some kind of adjustment. What the Republicans have proposed is changing the program for those 55 and under. It would not change a thing for those who are on it or are approaching being eligible.

Why? Is it because they're heartless?

No. It's because if we don't do something, the entire government will go broke. Everyone knows this.

What are the Democrats proposing?

*chirp*

steve

Richard, you have a problem. It doesn't matter what the goals were.

Why not? Were the goals wrong?
Is it wrong that Americans should have less security from medical bankruptcy or medical calamity in their old age then swedes?

steve

Whatever its efficiencies are/are not, whatever promises were made, the simple truth is this: we don't have the scores of TRILLIONS of dollars we need to fulfill what was promised nearly 5 decades ago without some kind of adjustment. What the Republicans have proposed is changing the program for those 55 and under. It would not change a thing for those who are on it or are approaching being eligible

Yes, they want to create two classes of citizens. One who were born before 1955 and one born after... How does that work in your constitution Archduke?

I agree with the fundamental point that the program is too expensive. But so too is private care. And if history serves, those aged 56 who get sick will run out of their savings using private care, just as their grandparents did prior to medicare...

I''ve stated that the answer is to study what has been learned elsewhere about collaborative regulation that has more effectively produced lower medical inflation costs, resulting in far more cost effective care. With medicare that would be easy to institute. As you;'ve pointed out, every year Congress fails to cap reimbursements to doctors when it has the legislative power to do so now...
Somebody has to be able to say no. You have a choice of saying no to medical sevices demanding higher fees every year or saying no to Big Pharma doing the same and demanding longer patent protections as well...and so on.
You put in place the mechanisms that can say no to the suppliers so you don't have to say no to the 55 year old with heart problems.

Now, perhaps by responding to the heated rhetoric, I've overstated what Ray said. He has suggested, as has Archduke, one or two minor fixes to the private health care system. And I don't disagree that each would likely have minor benefit, though there's no conclusive evidence offered that shows any of them to be certain to have the desired effect. And even then the estimates of savings by the experts are not huge. But what good is a minor benefit Steve, when the problem is as large as you state? Surely Concrete examples of systems that cover all their population more efficiently and effectively have more meaning then estimates of incremental savings from minor fixes.
And I say that because I think the goal does matter.

But you dodged my question. If Obama (or President Palin) comes out with a copy of the Swedish ot Norwegian or French systems....you'll be the first in line, right? Think of that, only 10% of your GDP on Health care! And everyone, not just the 55 year olds, gain security that was the goal of Medicare when it wa started. IS 10% of the GDP affordable?

Archduke Russell John wrote:Well, if you read the whole article it referenced VA centers being closed in 2 or 3 other states for similar bad service. As I mentioned it was the first article in the series that mentioned the ended up establishing a nation-wide problem. Unfortunately, I haven't had time to sus out the others yet.

It mentioned it, but it was vague as to whether there was a pattern and if so what it was.

No because I was specifically saying the Constitution was a blockage to the plans you were specifically proposing nothing else.

And now I'm confused because you also said that there were changes that could be

[quote=Danivon'] what would you actually accept and will you press your party to do so?[/quote]

Jesus Christ, how many times do I have to tell you. This will be the 3rd time I have specifically mentioned what I would support directly to you.

Sorry, but you also seem to be saying that the Republicans won't actually do them?

Open medicaid up to purchase to all people regardless of income levels, open sale of healthcare insurance across state lines, tort reform and stronger penalties against attorneys that bring frivolous lawsuits.

I think all of these are good ideas. I'm not sure how much they'd end up cutting costs (or rather reducing the rate of cost increase), but it's worth a try.

Danivon wrote:My point was not that the rich in the US do so well, it was that everyone else does so poorly.

Really? I do pretty well by healthcare and I am by no means rich.[/quote]Well, by 'pretty well', I'm also including the factors such as how much it costs you (or your employer), what happens if you need to access it, how subject you are to the needs of an insurer to manage costs, what the likely future will be for a period when you are more likely to need healthcare (old age), etc. Mine is also pretty good - better than commentators in the USA will be prepared to tell you.

rickyp wrote:steve

Richard, you have a problem. It doesn't matter what the goals were.

Why not? Were the goals wrong?
Is it wrong that Americans should have less security from medical bankruptcy or medical calamity in their old age then swedes?

No Richard, what is wrong is if we don't change things this will be the first generation to tell the next, "You're hosed." The US has been a country that did things FOR the next generation, not TO them.

It doesn't matter what the goals were because no matter how laudable they were, they are not affordable. Can you grasp the difference? We ought not imagine ourselves as forced to drive the car (to borrow the President's well-worn analogy) over the cliff.

Medicare is financially unsustainable in its current form. What part of that are you incapable of grasping, Richard?

Whatever its efficiencies are/are not, whatever promises were made, the simple truth is this: we don't have the scores of TRILLIONS of dollars we need to fulfill what was promised nearly 5 decades ago without some kind of adjustment. What the Republicans have proposed is changing the program for those 55 and under. It would not change a thing for those who are on it or are approaching being eligible

Yes, they want to create two classes of citizens. One who were born before 1955 and one born after... How does that work in your constitution Archduke?

I fall into the "second class" (an erroneous distinction, but I'm playing along). I am perfectly fine with having less. Why? Because I don't want my kids, grandkids, great-grandkids, etc. to have to foot the bill for me when I can prepare for whatever slack I have to pick up myself. I am not so self-indulgent that I think I have the right to destroy the country.

I agree with the fundamental point that the program is too expensive. But so too is private care. And if history serves, those aged 56 who get sick will run out of their savings using private care, just as their grandparents did prior to medicare...

Imagine if you will, that the Ryan plan is passed. I'll tell you what will happen. For starters, companies would begin offering those in the 55 and under some supplemental insurance--the sooner you buy it, the cheaper it is. When some reform is made, people will adapt. Will there be some who don't? Sure--and they'll wind up on Medicaid in nursing homes, just like they do now.

America has never been a place where the government provided cradle to grave entitlements. It's just not in our DNA. If you can't handle that, it's fine. Feel free to remain in Canada.

I''ve stated that the answer is to study what has been learned elsewhere about collaborative regulation that has more effectively produced lower medical inflation costs, resulting in far more cost effective care.

Literally, hundreds of times.

With medicare that would be easy to institute. As you;'ve pointed out, every year Congress fails to cap reimbursements to doctors when it has the legislative power to do so now...

Why is that? I mean can't government just mandate 30% less in payments and tell the doctors to "stuff it." After all, that is the law, so why bother with the "doctor fix?"

Really. Answer that.

Somebody has to be able to say no. You have a choice of saying no to medical sevices demanding higher fees every year or saying no to Big Pharma doing the same and demanding longer patent protections as well...and so on.

That's right! Who are doctors to expect to make a decent living! Preach it! There's no reason for an internal medicine doctor to make more than someone who gathers tolls on the Pike!

But what good is a minor benefit Steve, when the problem is as large as you state? Surely Concrete examples of systems that cover all their population more efficiently and effectively have more meaning then estimates of incremental savings from minor fixes.

Richard, really well put. Let's see if we can get a groundswell of support for the Swiss system before the debt limit has to be raised. That seems doable.

And I say that because I think the goal does matter.

If I have a goal to own a Lamborghini, but I can afford only $400 a month in car payments, does my goal matter?

But you dodged my question. If Obama (or President Palin) comes out with a copy of the Swedish ot Norwegian or French systems....you'll be the first in line, right? Think of that, only 10% of your GDP on Health care! And everyone, not just the 55 year olds, gain security that was the goal of Medicare when it wa started. IS 10% of the GDP affordable?

I answered it. I don't stand in lines. That's what makes me so opposed to socialism.

Let me know when Obama proposes the Swedish system.

steve

It doesn't matter what the goals were because no matter how laudable they were, they are not affordable.

And yet most other western nations meet those goals and more..... Do you see the juxtaposition? That the wealthiest nation in the world can't manage to meet a half assed goal?

Medicare is financially unsustainable in its current form. What part of that are you incapable of grasping, Richard?

Firmly. Which is why it should be run like the nations that actually achieve the goal (plus evryone from 0 to 55 as well) who run similar systems. I have no faith that tinkering with it, or improving it by increments will work. Thats why I think Obama has failed here. Even though his increments are better than caving in the way Ryan wants to..

But I understand this reason. Its the kind of thing Fareed Zakkaria refered to in the quotation at the begining.

America has never been a place where the government provided cradle to grave entitlements. It's just not in our DNA.

Yeah,. That makes sense.

steve
Imagine if you will, that the Ryan plan is passed. I'll tell you what will happen.

It already wsa tried on Medicare Part D and costs went up 20%. Why will it work this time?

danivon wrote:And now I'm confused because you also said that there were changes that could be

What is there to be confused about? You suggested using something similar to the Swiss and/or Dutch systems. Both of those systems rely on an mandate that every individual purchase health insurance. The U.S. Constitution does not give the Federal Government the power to impose such a sweeping mandate. Period that is the end of the Constitutional argument.

Danivon wrote:Sorry, but you also seem to be saying that the Republicans won't actually do them?

Well, I don't speak for all Republicans. You asked me what I would support. That is what I would support.

Danivon wrote:I think all of these are good ideas. I'm not sure how much they'd end up cutting costs (or rather reducing the rate of cost increase), but it's worth a try.

Well, you never know till you try.

Danivon wrote:]Well, by 'pretty well', I'm also including the factors such as how much it costs you (or your employer), what happens if you need to access it, how subject you are to the needs of an insurer to manage costs, what the likely future will be for a period when you are more likely to need healthcare (old age), etc. Mine is also pretty good - better than commentators in the USA will be prepared to tell you.

Well doesn't the article I referenced and you found kind of prove that the not rich are subject to the same problems in your country.

Besides with Medicare, our old people have little to no problem.

http://pnhp.org/blog/2011/05/06/part-d- ... are-costs/

citation for medicare part D cost claims