American Elephants


There Are Some Really Sneaky Provisions in the House Health Care Bill. by The Elephant's Child

Planning a baby?  Looking forward to bringing your first child home from the hospital?  The 1,018 -page health care bill introduced by House Democrats has all sorts of bad policy ideas, and many of them are not even about health care.  One very annoying provision calls for a home visitation program that would bring state workers into the homes of young families to improve “the well-being, health, and development of children.” How intrusive can you get!

Section 440 of the House bill —Home Visitation Programs for Families with Young Children and Families Expecting Children — would provide grants to states to establish home visitation programs to educate parents on child behavior and parenting skills.  The “well-trained and competent staff” will:

…provide parents with knowledge of age-appropriate child development in cognitive, language, social, emotional, and motor domains..modeling, consulting, and coaching on parenting practices; [and] skills to interact with their child…

Did I mention that Progressives are Control Freaks? Aside from the very, very questionable role of the federal government, the specifics of the bill are troublesome.  The home visitation policy says that the state will “prioritize serving communities that are in high need of such services, especially communities with a high proportion of low-income families or a high incidence of child maltreatment.  It is described as “voluntary” but that may be just until the time the parent-trainer arrives.

The federal government doesn’t know diddly-squat about parenting success, but the home visitation would further increase the federal role in preschool education and child indoctrination.

That takes care of the babies.  At the other end of life, the Congressional dimwits have written a provision (House bill, p. 425-430) that compels seniors to submit to a counseling session every five years (or more often if they become sick or go into a nursing home) about alternatives for end-of-life care.

Sessions cover things like whether to receive antibiotics and “the use of artificially administered nutrition and hydration.” You can imagine the abuses that this provision invites.  In Oregon, a man with terminal cancer was refused drugs that could have given him additional life as too expensive, but he was offered assisted suicide if he wanted it.

If you are diagnosed with cancer, you have a better chance of surviving it in America than in any other part of the world. The World Health Organization ranked the U.S. as number 1 out of 191 countries for providing timely treatment, a choice of doctors and for being responsive to patients needs. Pity the Progressives want to change all that in the name of getting control of your health care and you.

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14 Comments so far
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Did you mention that your characterization of the program to fight child abuse is wrong? Oh, no — you didn’t.

Did you mention that the home visits are voluntary? Did you mention that this is based on pilot programs that have reduced child abuse? Oh, no — you forgot.

Did you mention that we have a child abuse problem in this nation? Did you maybe throw a scare by talking about the woman in San Antonio who butchered her baby last month?

No.

Instead you invent a few exaggerations about what’s in the bill — or maybe worse, you repeat exaggerations you’ve heard but you don’t bother to check them out yourself.

And why not? The kids who die from child abuse, they’re not your problem. At least they’ll die knowing that you wouldn’t want socialism to save them.

What kid in his right mind wouldn’t want that?

Am I being too harsh? Is this just a case of you didn’t bother to read the bill, you thought it would be funny to try to make jokes about “liberal” programs?

Or do you really defend child abuse? We’ve had laws against child abuse generally for less than 100 years in this nation. Preachers defended it — “spare the rod,” you know.

In our rush to turn back the clock, let’s leave the laws against child abuse alone, and let’s work to reduce child abuse as a problem. Can we agree on that?

Because frankly, if you don’t agree that we need to reduce child abuse, spending money on health care programs that don’t work isn’t the most serious problem we have.

Comment by Ed Darrell

i am confused by the posters comments, this is to help fight child abuse, but is voluntary??

Man i hope all these abuser will allow someone into their homes to see what monsters they are.

Get a clue, this is nothing more then a way to try and tell parents how to raise their children

Comment by Darryl

Ed, let me be blunt. You are about to be blocked. You accuse everyone who disagrees with your command and control dictatorial policies of being wrong, and stupid, and/or lying, yet when they provide you with the evidence backing up their claims, you don’t even bother to read them. (Our blog records when people click on links, so we know you don’t) Neither do you provide any evidence backing up your claims. That makes them less than worthless.

Moreover, you are apparently unfamiliar with the United States Constitution which strictly limits the powers we have allowed the federal government to have over us, and child care is not among them.

You also don’t seem to appreciate the difference between local, state and federal government. The Constitution does. If a program really works as you claim it does, why shouldn’t that be handled at the local level, where individual states or communities can decide if the program is right for them? Where government is both more responsive and more accountable to the people? as the Constitution makes clear it should? You really ought to check it out sometime, it’s a brilliant document that is apparently thoroughly lost on you.

Now, I want to be clear. Your rudeness has come to an end. One syllable more of it, or accusing others of lying without proof, and you will be blocked from posting here permanently.

Comment by American Elephant

Here I’ve only referred to the bill. Are these draconian provisions you claim in the bill? Give us the citations, please.

The bill number is H.R. 3200. You can get the entire text here.

Show us the “sneaky provisions” in Sen. Bond’s amendment. Show us how fighting child abuse will lead to involuntary socialism. Cite the language, show us the provisions from the real bill. These are not amorphous provisions that might be read badly by a megalomaniac in HHS running the grants to states who can then command the U.S. Army to teach people how to be good parents at the point of a gun. These are, instead, programs and procedures that are tried and proven. You claim them to be “sneaky” and, I suppose, evil.

Show me.

Am I wrong and strident? Show me, I’ll apologize.

Will you do the same?

Excuse me for being passionate in my love for my country. I fear for our democratic traditions — and I gather you’re new to them, if not new to the nation, young enough that you don’t remember even as far back as the Reagan administration. Back then we fought to keep America on the correct path — I in the Reagan administration.

You have some errors in this post. I can’t apologize for that. But if I am wrong, show me.

Pointing out errors is not rude. It’s how we keep this nation strong. I regret you find that so bothersome.

I accuse those who misstate the law of misstating the law. I accuse those who misstate the proposal of misstating the proposal. I accuse those who misstate history of misstating history. If I am in error, you should have no difficulty showing my error since these things are all on the record.

The program your post indicts is a local program. Under the bill it would remain a state-run program. Those are the provisions of the bill — am I in error? Where?

This bill provides federal support to states who lack the financial resources to run such a local program. Is that evil? Show us — show us the evils from the programs that have run awry.

Come to my blog. I don’t censor anyone. Discussion is polite, generally — but it is based on the facts. Can you hold your own?

Well, hold your own here. Show me how I’m in error on section 440.

Show us the language in the bill that compels seniors to submit to end of life counseling.

I’m rude? To my mind, you’re shooting holes in our flag. You’re spreading disinformation about our nation’s crises, to get patriots to run the wrong way.

Is that rude? Not if I’m right. It’s the patriotic thing to do.

Am I wrong? You’ve got the bill. Show me the horrors you claim.

Comment by Ed Darrell

I regret the “close link” issue in the previous post. Tough to miss the text of the bill, though.

Comment by Ed Darrell

Ed, You are missing the point. Senator Bond and Rep.Davis undoubtedly mean well. But home visitation and improving the well-being, health, and development of children, however well meant, are not the business of the federal government. We send these folks back to Washington to work in the Capitol building, give them plush offices, large staffs and call them “the honorable” and they feel really important. Any sense that they are our servants is long gone. Since they are so important, they want to fix everything. The federal government does few things well, and that includes appropriating money. Check the Constitution and see the limited tasks that the founders assigned to government.

I would urge you to read a book called “The Dream and the Nightmare” by Myron Magnet (former editor of City Journal–the lovely magazine from the Manhattan Institute) available from your local library or from Amazon. He argues that the radical transformation of American culture in the ’60s, and the honorable intentions of liberal do-gooders produced tragic consequences, and created the urban underclass.

You can see it in England’s underclass –”do-gooders” have created a permanent underclass that lives on the dole and perpetuates the dysfunction. No hope, no expectation of better lives. The Brits have gone so far as to put video cameras in dysfunctional homes so that the miscreants can be watched at all times. They mean well, but this will not work either. Mona Charen has a recent book called “Do-Gooders,” that would also be worth your time.

The language of the bill does not, in either case, say that the Federal Government IS going to intrude. But having established that such things are the concern of the government, it will soon lead to more intrusion. If you were an advocate of the Reagan administration, you should remember that he pointed out that government is not the solution to problems, but government IS the problem. This is why.

Free people in a free economy can have hope for bettering themselves and for their children to do even better. People who have something to look forward to besides the next drunk are less likely to beat their children.

You are not”wrong”, just being too literal. You accept the word “voluntary” as being meaningful. I see it as temporary, until the next well-publicized instance of child abuse, when they will tweak the bill some more. Liberals are always “well meaning.” They just have no understanding of liberty nor of the consequences of their mandates. Note my more recent post about Cuba.

And by the way, I’m older than you are, and apparently more passionate about liberty.

Comment by The Elephant's Child

A thought experiment: What is the largest stadium you have ever been in? The largest holds about 150,000 people, the smaller around 40,000 t0 50,000. So visualize a stadium, filled –then fill up the field with people. All individuals, with different lives, different expectations, different minds. So a good progressive will want to fix everything for those people. Make things equal, so nobody suffers.

How does that work? You have PhDs, Doctors, janitors, fast-food workers. Our founding documents guarantee equality of opportunity and equality under the law. Progressives want to guarantee equality of outcome. How do you do that for the stadium full of people that you have visualized? What do you force them to do so that they will all be equal? How do you manage them? What do you take away from A, and if you give it to B will that help? You obviously cannot make everyone rich. Will making everyone poor work better?

Let’s say that A is a venture capitalist who makes $1.500,000 a year (in a good year). Obviously nobody needs that much — just tax him until he’s equal to everyone else. But what do venture capitalists do? They provide the start-up money for the little companies with a good idea, that grow into tomorrow’s giant employers. They create the jobs.

So multiply your stadium by enough more stadiums to get to 330 million people. Visualization fails. What laws are you going to make, what mandates, to manage 330 million people to make them do what you want?

The free market only recognizes the impossibility, and tries to keep some kind of order so that citizens don’t kill each other in fits of temper, and you see how well that works. At least, most of the time, we get people to drive on their own side of the road and obey traffic lights.

So what does work? Competition keeps quality up and prices down. Competition helps kids to succeed in school. When competition is properly encouraged the kids that lose pick themselves up and compete again. Progressives don’t want any losers. They want to make rules against losing.

Life is hard. Free people struggle to make it better. For 230 years, Americans have not only made our country “a shining city on a hill” but helped a rather large number of other peoples to find freedom as well.

Comment by The Elephant's Child

Ed, You are missing the point. Senator Bond and Rep.Davis undoubtedly mean well. But home visitation and improving the well-being, health, and development of children, however well meant, are not the business of the federal government.

You’d lose a discussion under the necessary and proper clause on this, but it’s becoming increasingly clear to me that you’re not reading the bill. Section 440 doesn’t set up a federal program to do anything. It funds local initiatives.

Read the bill, please. Go look at the Missouri program, and tell us where there is excessive federal involvement. It’s been in operation 26 years — long enough for all the harms you claim to show up. Where are the harms?

We send these folks back to Washington to work in the Capitol building, give them plush offices, large staffs and call them “the honorable” and they feel really important.

Bond set up the Missouri program 26 years ago, long before he got to the Senate. The issue was that kids in Missouri were being abused. He took action to stop it.

You have criticized a program designed to aid that and similar local programs, though such programs are proven to reduce health care costs.

That’s a lose lose, to me. I’m against child abuse, and I’m against high health care costs.

On what basis can you oppose a program to stop child abuse that also reduces health care costs?

Any sense that they are our servants is long gone. Since they are so important, they want to fix everything.

You do a disservice to Kit Bond and dozens of other Members of Congress. At least they don’t share your cynicism, and that’s hopeful for the nation.

The federal government does few things well, and that includes appropriating money. Check the Constitution and see the limited tasks that the founders assigned to government.

The federal government runs our nation’s largest health care programs, serving more people with full health services for less spending per capita. Some things the federal government does not do well. Thousands of things it does very well, and health care delivery is generally one area where civilian programs lay it all over private enterprise.

I would urge you to read a book called “The Dream and the Nightmare” by Myron Magnet (former editor of City Journal–the lovely magazine from the Manhattan Institute) available from your local library or from Amazon. He argues that the radical transformation of American culture in the ’60s, and the honorable intentions of liberal do-gooders produced tragic consequences, and created the urban underclass.

It’s an old argument, and there is some truth to it.

But it is also true that the Social Security changes wrought in the Johnson Administration all but completely abolished poverty among our aged. It is also true that the dramatic prosperity we experienced in the 1970s, 1980s, 1990s and 21st century were in great part due to the boosts federal funds gave education, especially the GI bill.

It is also true that those who tried to dismantle those programs rather than fix them did a lot of damage. We had measles all but wiped out from the U.S. in 1980, but the Reagan administration cut the $3 million annual expenditure to finish the job. Measles came roaring back, killed a few hundred, and cost us millions. Multiply that by a few dozen diseases, and you can begin to see the problem with NOT being “do-gooders.”

But the real problem is this: Private health care doesn’t work. In the U.S. we pay more than $6,000 per person to provide health care, double the per capita cost of any other nation. The tragedy is that we pay that cost for each of the 50 million people who are shut out of the health care system.

Nowhere else on Earth is private enterprise so wasteful and inefficient as the U.S. health care system.

If Myron Magnet says that’s good, he clearly doesn’t have a clue what he’s talking about. You don’t have to be an economic genius to know that paying Maserati prices for Yugo-quality health care that doesn’t even cover one of every seven people (two of seven under the statistics you gave earlier) isn’t smart.

You can see it in England’s underclass –”do-gooders” have created a permanent underclass that lives on the dole and perpetuates the dysfunction. No hope, no expectation of better lives. The Brits have gone so far as to put video cameras in dysfunctional homes so that the miscreants can be watched at all times. They mean well, but this will not work either. Mona Charen has a recent book called “Do-Gooders,” that would also be worth your time.

Britain should have tried Bond’s program. It’s cheaper and it works.

It’s also voluntary. Parents don’t like to be child beaters. They ask for help. Why wouldn’t we help them?

The language of the bill does not, in either case, say that the Federal Government IS going to intrude. But having established that such things are the concern of the government, it will soon lead to more intrusion.

Never has before, can’t under current law. Under the Constitution, placement of cameras in private homes would require a warrant.

But in 26 years of operation in Missouri, there is not a hint of a camera in a home. Counseling to parents to ask for it works.

Please don’t claim to know the Constitution and then forget it.

If you were an advocate of the Reagan administration, you should remember that he pointed out that government is not the solution to problems, but government IS the problem. This is why.

Programs like these won approval in the Reagan administration. Reagan approved reauthorization of Head Start because the study conservatives demanded demonstrated that every $1.00 spent in Head Start prevented $7.00 in other federal expenditures to remediate problems later.

Reagan signed the Home Health Care Act because it’s stuppid to require old people to go to hospitals to die a slow, painful and expensive death, when they’d be healthier and happier in their own homes, making their own life decisions.

Reagan signed the Organ Transplantation Act and the Orphan Drug Act because the federal government is in the best position to make some health programs work, and it’s wise to do things that help people.

We discovered along the way that big government isn’t as big a problem as stupid government.

Free people in a free economy can have hope for bettering themselves and for their children to do even better. People who have something to look forward to besides the next drunk are less likely to beat their children.

You are not”wrong”, just being too literal. You accept the word “voluntary” as being meaningful. I see it as temporary, until the next well-publicized instance of child abuse, when they will tweak the bill some more. Liberals are always “well meaning.” They just have no understanding of liberty nor of the consequences of their mandates. Note my more recent post about Cuba.

And by the way, I’m older than you are, and apparently more passionate about liberty.

Comment by Ed Darrell

Progressives want to guarantee equality of outcome.

Bull feathers. No one makes that claim.

What we’re discussing now is whether the woman who cleans your toilets for $10.00/hour can get her baby inoculated against measles to avoid blindness.

We can afford that. We’re paying for it now, though it’s not being done. Take the person with the highest income in that stadium and ask him if she thinks she should continue to pay for that woman’s kid to get measles shots, and then they don’t happen.

My experience is especially those with high incomes get angry when they understand that we’re paying for gold-plated goods that are not getting delivered.

Comment by Ed Darrell

We will have to agree to disagree. The federal government runs the Indian Health Service which is a disgrace and a tragedy. They run Medicare, which is going broke from waste, fraud and abuse. They run Medicaid, ditto. And they run the VA, which has some bright spots and poor care in general, at least according to vets.

Our current health care system is the best in the world. We have better outcomes for the major diseases, and most people are satisfied with their health insurance and happy with their care. We pay more for it in general because we can afford it. Medical care has been transformed in recent years with CT scans, MRIs and all sorts of new drugs and treatments that have saved and extended life. That’s expensive, but worth it.

The health care bill before Congress is estimated by the CBO to cost $1.2 trillion over the next ten years, and another trillion over the 2nd decade. Health care costs will increase by 8% a year while revenues increase at only 5%.

Yes, I did read the bill. Medicare was estimated by the CBO to cost $12 billion by 1990. By 1990, it cost $110 billion. Government-run health care will cost vastly more than private insurance ever cost. Doctors will leave the profession — Some doctors have estimated that 20% of doctors will retire early. There is nothing whatsoever in the house bill that will reduce costs. Government health care has failed in Massachusetts, failed in Hawaii, failed in Tennessee, failed in Oregon, and failed in Maine.
To cut costs, which the government will have to do, they will have no choice but to ration. Both presidential health care advisers Ezekiel Emanuel MD, and Peter Orzag, his budget director,have pointed out extensively the high costs of end-of-life care and the need to cut back on those expenses. Pain pills for the older folks instead of hip replacements or motorized wheel chairs.

All government-run health care programs ration care. Which they do because they will not do the things that would actually reduce the cost of health care, like tort reform, increasing free market competition, offer insurance across state lines, and offer medical savings accounts, high deductible policies. These all are proven to save costs, but the trial lawyers are second only to the Unions as financial support for Democrats.

I know no Republican or Conservative who does not observe that Liberals want to guarantee equality of outcome. It’s obvious in their legislation. All kids get vaccinated, they are required to be vaccinated before they can enter kindergarten, and help is available if they cannot afford it. Silly claim.

I would challenge most of your claims, but there is no point. According to what I know to be true, you are vastly misinformed, but you probably think that of me. I simply do not have time to carry on pointless discussions.

Comment by The Elephant's Child

Remember that this thread starts out with your savaging a program to support child abuse prevention programs.

We will have to agree to disagree. The federal government runs the Indian Health Service which is a disgrace and a tragedy.

Private health care on the Navajo, Hopi, Pine Ridge and other major reservations is non-existent. Yes, the IHS is inadequate by any rational standards. It’s also underfunded, and a key problem is that many enrolled members of tribes lack other health insurance.

The federal program may be a wreck, but it’s 1000% better than the private alternative, which in that case is nothing at all.

And this is what I fear: Without government intervention, Indians are left to die from easily preventable and easily treatable diseases. Without government intervention, 50 million other Americans are left to die from easily preventable and easily treatable diseases, and 150 million more have limited access.

For reasons I cannot fathom, you favor letting the people die rather than fixing things. Surely you’re not making that decision on the basis of any rational system of rationing, are you? I don’t think the poor and unemployed “deserve to die.” Talk about death panels!

They run Medicare, which is going broke from waste, fraud and abuse.

Absolutely false. Medicare has problems from rapid inflation by the private sector and other causes. But it is NOT “going broke from waste, fraud and abuse” by any measure. Compared to private health care, Medicare is purer than distilled water.

They run Medicaid, ditto.

Ditto. Medicaid has problems from overuse because too many people lack private insurance. Waste, fraud and abuse are significantly reduced from private systems.

Which leads me to wonder why you favor a system that is going broke from inflation, waste, fraud and abuse. The denialism runs strong in you.
(No — it’s going broke mainly from uncontrolled inflation — but if you can make wild unsubstantianted charges, I can at least point out that your favored position is worse.)

And they run the VA, which has some bright spots and poor care in general, at least according to vets.

And what does the private insurance system do for vets? Any injury due to war is excluded from coverage.

Again, you choose no coverage over some coverage. Whose side are you on? Not the vets’ side, it appears.

Our current health care system is the best in the world. We have better outcomes for the major diseases, and most people are satisfied with their health insurance and happy with their care.

Except for heart and lung disease, where Canada, France and England lay it all over us, on an epidemiological basis. Their systems do a lot fewer major procedures because there is much less heart disease, and problems are discovered earlier and treated much more effectively and cheaply.

Yes, the U.S. does a lot more heart transplants, easily by double. The problem is we have nearly quadruple the need for heart transplants. Heart disease is often preventable, almost always treatable, well before heart transplant time. It’s cheaper and better for the patient if we treat heart disease before it progresses to cripple the victim.

Yeah, we do more transplants. The tragedy you don’t name is that we need to do them.

We pay more for it in general because we can afford it.

Have you discussed this with small businesses? We can’t “afford” to pay double what every body else pays. These incredible expenses broke Chrysler and General Motors. The cost keeps small businesses from creating plans for employees.

Worse, that $6,000 per capita includes spending for the 50 million people excluded from easy access. We pay double for services, and we pay for a lot that we don’t get. Talk about waste!

Our system spends nearly 25% of every “health care” dollar in insurance administration, mostly designed to keep the minority of uninsured from getting care at all.

Don’t tell me we should spend hundreds of billions of dollars to bar the doctors’ offices doors, and then claim any system is more wasteful. There is no more wasteful system possible, and it’s a moral imperative that we fix it.

We pay double because the system is broken. We can’t afford it.

Medical care has been transformed in recent years with CT scans, MRIs and all sorts of new drugs and treatments that have saved and extended life. That’s expensive, but worth it.

Mostly unavailable to about half of Americans. Insurance plans pay for surgery that costs six to eight times a CAT scan, because it doesn’t like “expensive technology” without justification. If a CAT scan discovers no problem requiring surgery, insurance won’t pay. “Doctor error.” So doctors don’t use the technology as it could best be used.

But when that heart disease that could have been prevented ends up in the surgery theatre, Katy bar the doors on expenses!

The health care bill before Congress is estimated by the CBO to cost $1.2 trillion over the next ten years, and another trillion over the 2nd decade. Health care costs will increase by 8% a year while revenues increase at only 5%.

Without it, health care costs will continue to rise at nearly twice that rate, 15% annually.

Don’t look now, but the lousy bill you don’t like is better than the catastrophe you’re defending.

Yes, I did read the bill. Medicare was estimated by the CBO to cost $12 billion by 1990. By 1990, it cost $110 billion.

Why? Do you know?

Medicare was expanded because it worked so well. Plus, it turns out there was a much greater need than anyone had projected.

In 1994, health care inflation was estimated to run about 8% annually if the Clinton plan didn’t get passed. Instead it ran closer to 16%.

The problem you cite is doubled in private insurance. Don’t tell me you don’t like waste and then propose to double the waste.

Waste is waste whether it’s government-run or private business run, and it hammers costs either way. Greater waste hammers us more greatly.

Government-run health care will cost vastly more than private insurance ever cost.

That’s not so for programs in either Medicaid or Medicare, compared to comparable coverage offered by private companies. The record, in every other nation AND in the U.S., is that government-run systems are cheaper. Especially where government simply takes over the payment, and not the delivery (leaving private health care providers as private health care providers), government systems are vastly less expensive.

This is why the insurance companies started to squawk about how unfair it would be for the government to compete against them. Competition is the key to an effective free-enterprise system — we need to inject some into health care now.

Doctors will leave the profession — Some doctors have estimated that 20% of doctors will retire early.

Compared to the estimates of 30% of doctors are retiring early now, right? We’ve had a physician shortage for 40 years. Here in Texas nearly 20% of our counties have no physicians at all. There is a reauthorization for a 40-year-old program to encourage medical students to graduate and serve these populations — you called it “socialism.”

Or you didn’t know it was in the bill.

Either way, the sensible solution would be to pass the bill and get more doctors for less money to serve the underserved areas, thereby reducing the incredible expenses of health care and even greater expenses of delivering no health care to millions of Americans.

There is nothing whatsoever in the house bill that will reduce costs.

The single most important cost-saving step is to cover people who lack insurance. No program can reduce costs at all without that. That’s a key target in the bill.

The cheapest health care system is the one that delivers care appropriately, on a timely basis. We spend an inordinate amount of money in the last 6 months of patients’ lives — 50% by some estimates — because they lacked good health care that would have kept them more sentient and more ambulatory until death.

The most important thing we can do is move health care delivery from the old to the younger, from the hospital emergency room to the doctor’s office. We can only improve that if everyone has access to a doctor on a timely basis, for the delivery of simply preventive programs, for the delivery of early treatment of disease.

Government health care has failed in Massachusetts, failed in Hawaii, failed in Tennessee, failed in Oregon, and failed in Maine.
To cut costs, which the government will have to do, they will have no choice but to ration.

We ration health care now by cutting out one out of every seven people for no care at all (though we pay for it — they just don’t get it; the money goes to “insurance company administration” instead of health care delivery). We ration health care now by denying technology to most Americans. That rationing saves no money for the nation — it seems to double the cost.

In contrast, Medicare patients, in the biggest government-run program, are the single least-rationed group.

There will be rationing until we equalize access, which will require more doctors, more clinics, more nurses, less emergency room use and more doctor’s office visits. But that rationing now is draconian and cruel, based chiefly on whether one works for a company with a health plan or not.

That’s unfair and cruel. Worse, it multiplies the costs for everybody. (An enormous part of hospital charges to private insurance-covered people is to provide the pool of money for indigent care.) Multiplies, not “adds to.”

Non-fraudulent waste may be many times fraudulent waste. We need to stop it.

The first step is to cover everybody.

Both presidential health care advisers Ezekiel Emanuel MD, and Peter Orzag, his budget director,have pointed out extensively the high costs of end-of-life care and the need to cut back on those expenses.

Under the present system, yes. Emanuel’s paper in January talked about the rationing decisions made now, how unfair they are, and how they increase pain and suffering.

Damn straight we need to reduce those costs — to increase delivery of health care.

Don’t defend private rationing by pretending it doesn’t exist, or by pretending it’s more fair, when no study shows it is fair or cheap.

Pain pills for the older folks instead of hip replacements or motorized wheel chairs.

That’s what happens today, yes. Unless, of course, they’re on Medicare, the government run program. That’s why the advertising for carts for the immobile notes that the companies selling the carts will take care of Medicare paperwork.

God help you if you’re not on Medicare. Private insurance won’t.

All government-run health care programs ration care. Which they do because they will not do the things that would actually reduce the cost of health care, like tort reform, increasing free market competition, offer insurance across state lines, and offer medical savings accounts, high deductible policies.

Hold on — Medicare and Medicaid allow free market competition, offer insurance nationally (in contrast to private plans), and allow medical savings accounts (though that’s not a viable solution for the poor, unemployed, students and retired people).

Tort costs about 1% of health care — and to my view, it works well. I don’t think swimming pool companies should be able to suck the bowels out of children without paying for it.

We do have a tort problem with OB-GYN, but it is largely caused by the insurance companies’ refusal to defend good doctors. That’s not a tort reform issue.

You cite problems that exist now, problems that are subject to attack by H.R. 3200. We’re not going to get anything at all if yammering yahoos don’t stop fighting against all change.

Doing nothing is cruel and costly. If you want to make a case for adding something to H.R. 3200, make the case.

Defense of current incredible waste is not a rational, moral option.

All health care systems ration health care. Our system rations health care on income and geography, and age. Higher incomes, big-company-employed, urban locations, and higher ages get the care.

Is that smart? It’s not cheap.

I don’t think These all are proven to save costs, but the trial lawyers are second only to the Unions as financial support for Democrats.

Those figures aren’t accurate, or they demonstrate that political giving doesn’t have much effect.

Tort cases take up the slack where government regulation ends. Should we allow McDonald’s to keep burning old ladies almost to death? (I thought you were for reducing costs, no?) Unless you will allow the Ministry of Coffee Temperature to regulate every fast-food drive through, tort cases are real money savers in the long run. (It cost less than $2.00 to fix the Pinto’s gas tank so it wouldn’t explode on impact. How many lives should we have sacrificed instead? I thought you were for reducing pain and suffering.)

I know no Republican or Conservative who does not observe that Liberals want to guarantee equality of outcome.

But none of them can show anyone who actually proposes to do it, not since Lenin abandoned the idea in 1920. I know no Democrat or Liberal or Republican or Conservative who urges equality of outcome. I’ll wager you can’t name major players who do, if you can name anyone at all.

That’s the problem with a lot of Republicans and conservatives — they’re not even tilting at windmills, they’re tilting at wind. We need action to make things better.

You propose we stick with the most wasteful and inefficient health care program in the industrialized world, one guaranteed to bankrupt the nation, or collapse soon.

Better you should tilt at windmills.

It’s obvious in their legislation. All kids get vaccinated, they are required to be vaccinated before they can enter kindergarten, and help is available if they cannot afford it. Silly claim.

All kids getting vaccinated (religious exceptions honored), is a great idea, a high ideal, compassionate, money-saving and wise.

My brother had polio, and the complications killed him early. I’m partially deaf from measles, or maybe scarlet fever. I don’t think vaccinations are bad things at all. Back when we lost 1 out of 3 babies before their second birthdays to infectious disease, the nation was not better off.

Universal health coverage keeps a population healthy, learning and working. You don’t like it? Take a look at any nation where disease is rampant — like malaria in Uganda. The lack of simple preventive measures tends to cripple a nation’s economy and destabilize its government.

That’s not good.

I would challenge most of your claims, but there is no point. According to what I know to be true, you are vastly misinformed, but you probably think that of me. I simply do not have time to carry on pointless discussions.

Who was it who observed, it’s not what we don’t know, it’s what we know that isn’t true that gets us into trouble?

Comment by Ed Darrell

Excuse me, but to claim that because I do not believe that child abuse is the business of the federal government, then I favor child abuse is such a failure of logic and so insulting, that perhaps you can fathom why I find it pointless to argue with you. You are a statist, who believes that government can do things well. I do not.
Since the government has treaty obligations with the Indian tribes , there is probably no alternative. The Indian Health Service needs to be better funded — but ideally it would be funded through private insurance companies. Private industry and competition do almost anything better than the government does. Again, you make the insulting claim that I want people to die. I want them to get better care than the government is capable of.

Heritage has a post from James Frogue and Elizaeth Noelcke from the Center for Health Transformation. They estimate the waste and fraud in Medicare and Medicaid annually at well over $ 100 billion — that’s each year! And they give examples.

The credit card industry handles over $2 trillion each year in billing involves 700 million credit cards. Their rate of fraud is below 1/10 of one percent — making fraud at Medicare and Medicaid 100 times higher. The president gave an inadvertent example when he pointed out the success of FedEx and UPS compared to the Post Office which is going broke. I wonder what would happen if the Government contracted out the post office to FedEx?

Oddly enough, I have either read comments, or heard them on talk radio, from vets who had problems that the VA wasn’t solving, or refused to solve. A visit to their civilian doctor solved the problem. Many are calling in to oppose government-run health care. Visit Blackfive and see what they have to say about the VA.

You tell me now that you are from Texas, but I thought you earlier claimed to be from Missouri where Sen. Bond has had such success with abused children. Now you claim a shortage of doctors in Texas, but I have read that Texas’ success with tort reform has brought doctors flooding to the state, large numbers escaping MassCare. An American Neurosurgeon pays $200,000 a year in liability insurance. Tort reform involves limiting awards for “pain and suffering” but has nothing to do with damages, as you seem to think, and over 30% of the “pain and suffering” awards go to the lawyers like John Edwards who sway ignorant juries by “channeling” dead babies.

Your figures on costs, on American health care, on disease outcome are simply false. Malaria has been devastating in Africa, killing children particularly, in the tens of millions. All because Rachel Carson falsely claimed that DDT was too dangerous to use. And the EPA banned it’s use, and was followed by the WHO. It is perfectly safe to spray around huts, and far more effective than any other remedy, but is still underused by countries who are sure that the WHO knows best. It has nothing to do with universal health care. Polio is, thank goodness, long gone, as are most of the diseases of childhood in this country.

Liberals constantly attempt to pass laws that essentially take money from the rich to give it to the poor so they won’t be quite as poor. That is an attempt to make people equal. It doesn’t really help the poor. (I’m not talking here about the disabled who are unable to do anything for themselves, but about the able-bodied) What helps is when they are forced (with help) to go to work. The welfare-to-work program that is part of welfare reform has given people pride in providing for themselves and hope that they can improve their situation, and do better for their children. Sheltered workshops for the mentally challenged gives them pride in going to work every day and helping to provide for themselves. Welfare is demeaning and leads to all sorts of dysfunction in the poorest neighborhoods. Your assertion that people who abuse their children really want help is absurd. ‘I keep beating the kid and I just can’t stop?” Please.

Universal health care controls costs only by rationing. Rationing a hip-replacement for someone too old and frail to withstand the operation is common sense. You do what you can. Deciding that anyone over 65 cannot have knee replacement surgery simply because they are over 65 is absurd. England and Scotland are the examples of how government health care gradually fail. Massachusetts is an example of how government health care can fail in just 3 years. The federal government is having to subsidize Massachusetts to the tune of $1.5 billion a year of taxpayer money already. You do not understand private insurance, you do not understand the current health care situation in America, and you do not understand the workings of government insurance. You have lots of optimism and faith in the state, which I believe is misplaced. I would urge you to read more widely, but it is obviously useless, you are fixed in your beliefs. Go insult somebody else.

Comment by The Elephant's Child

Deciding that anyone over 65 cannot have knee replacement surgery simply because they are over 65 is absurd

I agree; luckily, that doesn’t happen on the NHS. Care is allocated according to medical need as determined by the doctor and patient.

England and Scotland are the examples of how government health care gradually fail

Got any stats to back that up, or are you just parroting talking points? Wait, no, you don’t, because the NHS performs brilliantly well, especially in comparison to the trainwreck which is the US system. The UK ranks better than the US for the following metrics: life expectancy, infant mortality and physicians and nurses per 1000 people. The percentage of national GDP spent in the UK on healthcare is 8.4%; in the US, it is 16%. The percentage of govt revenue spent on healthcare in the UK is 15.8% versus 18.5% in the US.

Furthermore, in terms of healthcare qua general practitioners (PCPs), they are almost all private practices which contract to provide services to the NHS. In other words, government paid, not government run.

In short, I would urge you to take your own advice, and read more widely; it might cure your insatiable optimism in “the market” and you might then know what you were talking about.

Comment by Mike

uh huh! As someone remarked yesterday, nothing so riles the Brits as when you quote back to them what they have been saying about their NHS. Daniel Hannan was over recently and warned us not to copy the NHS, as did Theodore Dalrymple, and all hell broke loose. We know that there are people in NHS who have received excellent care, and that there are fine doctors and caring staff in some places.

Trainwreck? You must be talking about all those dead bodies lying around in the streets. However: Yes, we spend more on the best in the world health care than you do, mostly because we can afford it.

American cancer survival rates for breast cancer –mortality is 98% higher in the UK, 52% higher in Germany.

Prostate cancer mortality is 604% higher in the UK, 457% higher in Norway.
Colorectal cancer mortality is 40 % higher for British men and women.

Americans have better access to treatment for chronic disease–56% of Americans who could benefit from statins were taking them. 36% of Dutch, 20% of Swiss, 26% of Germans and 23% of Brits.

Infant mortality is a phony statistic. Here we consider every live birth in our statistics. Very low weight babies have a high mortality rate. No other country considers a low weight baby as a “live birth.” They don’t enter the survival statistics at all, and our survival rate for very low birth weight babies is pretty good.

Our life-expectancy rates are reduced by that, and by the fact that we have a very big country where we drive a lot. Lots of auto deaths, and far too many murders — but health care, sorry, you are vastly outranked. The statistics come from NCPA, a highly respected think tank, but we have lots of think tanks studying the problems of health care. I have visited the websites of about 50 of them, but there are many, many more.

Actually, we do read rather widely, including the British and Scottish papers, and others that publish in English. We freely admit that we are deficient in foreign languages. We hear from everyone whose health care we decline to emulate, insisting that they know more about the dead bodies in our streets than we do, and insisting that anything reported about their health insurance is false. Canadians tell us that nothing in their health service is ever, ever rationed, while at the same time their government is announcing cutbacks (in this case, B.C.)so I’m glad you have had wonderful care, but I’ll believe your newspapers and other publications.

And we absolutely have faith in the free market. Proven over and over. It works!

Comment by The Elephant's Child




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