We were told we had to do it because of the however many millions of uninsured, yet this bill will leave some 25 million Americans uninsured. On the other hand, millions of young fit healthy Americans in their first jobs who currently take the entirely reasonable view that they do not require health insurance at this stage in their lives will be forced to pay for coverage they neither want nor need. On the other other hand, those Americans who’ve done the boring responsible grown-up thing and have health plans Harry Reid determines to be excessively “generous” will be subject to punitive taxes up to 40 percent. On the other other other hand, if you’re the member of a union which enjoys privileged relations with Commissar Reid you’ll be exempt from that 40 percent shakedown. On the other other other other hand, if you’re already enjoying government health care, well, you’re 83 years old and, let’s face it, it’s hardly worth us giving you that surgery for the minimal contribution you make to society, so in the cause of extending government health care to millions of people who don’t currently get it we’re going to ration it for those currently entitled to it.
Looking at the millions of Americans it leaves uninsured, and the millions it leaves with worse treatment and reduced access, and the millions it makes pay significantly more for their current health care, one can only marvel at Harry Reid’s genius: government health care turns out to be all government and no health care. Adding up the zillions of new taxes and bureaucracies and regulations it imposes on the citizenry, one might almost think that was the only point of the exercise.
Uncharacteristically, I think that Mark Steyn is too optimistic.
On the other hand, millions of young fit healthy Americans in their first jobs who currently take the entirely reasonable view that they do not require health insurance at this stage in their lives will be forced to pay for coverage they neither want nor need.
Some of them do need it, we (and they) just don’t know which ones or when. Which is precisely the problem insurance is meant to solve.
On the other other hand, those Americans who’ve done the boring responsible grown-up thing and have health plans Harry Reid determines to be excessively “generous” will be subject to punitive taxes up to 40 percent.
The handful of Americans who have these plans have had their health care subsidized (by the rest of us) up to now, regardless of their actual need.
if you’re the member of a union which enjoys privileged relations with Commissar Reid you’ll be exempt from that 40 percent shakedown.
No, the exemption is for unions of workers in dangerous industries, where higher-than-average medical bills are the norm.
On the other other other other hand, if you’re already enjoying government health care, well, you’re 83 years old and, let’s face it, it’s hardly worth us giving you that surgery for the minimal contribution you make to society, so in the cause of extending government health care to millions of people who don’t currently get it we’re going to ration it for those currently entitled to it.
This part is completely made up.
Adding up the zillions of new taxes
Actually, the CBO has added up the taxes and they don’t amount to “zillions”. They amount to less than $50 billion per year. E.g. less than what we spend in Iraq. Does Steyn say “zillions” because he doesn’t know the the real number, or because he realizes it isn’t all that much?
Some of them do need it, we (and they) just don’t know which ones or when. Which is precisely the problem insurance is meant to solve.
The term is “self-insurance”, Jim.
The handful of Americans who have these plans have had their health care subsidized (by the rest of us) up to now, regardless of their actual need.
What is the subsidy? And why aren’t these “handful of Americans” already paying for their health insurance?
No, the exemption is for unions of workers in dangerous industries, where higher-than-average medical bills are the norm.
That’s still no reason to make an exemption for them. They work there by choice. They can pay the consequences.
This part is completely made up.
Yes, it hasn’t happened yet. So it currently is “completely made up”.
Actually, the CBO has added up the taxes and they don’t amount to “zillions”. They amount to less than $50 billion per year. E.g. less than what we spend in Iraq. Does Steyn say “zillions” because he doesn’t know the the real number, or because he realizes it isn’t all that much?
How many times do we need to repeat this? The CBO has to use whatever fantasy assumptions it is directed to use by Congress. The CBO is not a reliable source. Please stop treating it like one.
No, it’s not “made up,” Jim. The plan is to cut $500 billion from Medicare. Where do you get that kind of money, huh? There’s only once possible place: you have to stop paying for stuff that people and doctors, left to their own devices, would consume. There is no other way, and if you think there is — some stupid mantra about “waste and fraud” — then you’re delusional, or unworthy of having graduated sixth grade.
Oh, it won’t be called “rationing.” It never is. It will be called something nice and warm and fuzzy, like “enhancing the quality of life for old people” (rather than the mere grubby quantity of life). Just like the British “Liverpool Path” euthanasia program is supposedly all about “easing suffering” during one’s “last” days, and just sort of incidentally contains some…er…advice from government which — ha ha! — turns out to be actually mandatory, about how to decide when someone’s “last” days are upon him. (Hint: you don’t ask him, or his family.)
If $500 billion really is to be cut from Medicare, then care will be rationed, just as Steyn says.
But I believe that you don’t think it will be. Indeed, I don’t think the Democrats think it will be. Nobody really does. The Democrats just put that “cut” in there as part of their Kabuki theater pretense that they give a damn about the bill not costing a huge fortune. They assume, as any reasonable person would, that there is no way it will ever happen — that well before it threatens their re-election hopes among 55+ voters, Congress will restore the cuts, or fail to enact them in the first place.
And then — oops! — looks like that original Obamacare bill was actually $500 billion more than was promised at the time! But who cares? Not the Democrats. Indeed, this is part of the plan, which is Steyn’s point: if Medicare can’t be savagely cut, and of course we have this wonderful new national health plan that can’t be cut either — think of the children! Tiny Tim, dead, because Scrooge didn’t care enough! — well, then, the only solution is a truly staggering tax raise, enough to transform the US at long last into a Eurosocialist state where 40% of the wealth of the country passes through government (i.e. Democrat) hands. I can see them salivating already.
Jim,
Are you hoping some combination of these bills becomes law? How do you think it will improve your life? More money, better health care, or comfort in knowing that more people will get care?
It’s a wonder Jim can stop fellating Obama long enough to be as prolific a correspondent as he is.
Whatever their genuine actuarial needs are, they will not, in aggregate, come close to the premiums they will be required to pay under this monstrosity.
(continued) This abomination will be a textbook case of the socialist calculation problem: the creation of vast shortages and surpluses. Some glaringly obvious ones being visible from jump street — a shortage of coverage for the elderly, a surplus for the young.
I remember Moe, Larry, Curly, Shemp, and Joe.
When was there a Stooge named “Jim?”
They don’t care about who or what or how. They just want to get their legislative foot in the door so to speak on this particular issue. Once they plop their ass down on your proverbial healthcare couch that’s when the real “improvements” will be made. If your health were your house they will have all sorts of grand ideas about how to make living in the house so much easier, enjoyable, and efficient. Then, one day the time will come when you say, “Okay can you get off the couch now and help me try some of those things seeing as you’ve been living on my couch this whole time?” You’ll get a grimace and sympathetic sigh, “Oh, I’m sorry I just remembered I got this really important thing to do and stuff, see ya later.”
Adding up the zillions of new taxes
Actually, the CBO has added up the taxes and they don’t amount to “zillions”. They amount to less than $50 billion per year. E.g. less than what we spend in Iraq. Does Steyn say “zillions” because he doesn’t know the the real number, or because he realizes it isn’t all that much?
The CBO is only looking at federal taxes. It doesn’t consider how much the states will have to raise their taxes to meet the increased Medicaid obligations. Except Nebraska, apparently. Their senator whored himself to get them exempted from that requirement, one of many examples of political prostitution in the legislation.
young fit healthy Americans in their first jobs who currently take the entirely reasonable view that they do not require health insurance at this stage in their lives Actually, this is completely unreasonable, unless they expect to never get in car accidents, develop a non-lifestyle related cancer or disease, or fall victim to a violent criminal. The odds of one of these things happening may be low, but they are nowhere near zero.
Also, unless you are Bill Gates, there is no such thing as “self-insurance” for health care. Dealing with serious medical conditions can result in hundreds of thousands of dollars in costs. If you can’t cover that out of pocket, you are not “self-insured” you are un-insured.
Oh don’t be silly, Chris. First of all, if you get racked up in a car accident the ER is not going to refuse to treat you. So it’s not like you’re going to die in the streets. Indeed, the medical care you get will be just as good as Bill Gates gets (provided he goes to the same ER). So your fantasy worries about your lack of insurance leading to lack of care are nonsense.
Secondly, the result afterward, after you run up a few tens of thousands of dollars of care, is that you’ll be billed for it. What do you do then? You call up the hospital and doctors, you tell them you don’t have insurance, and they then give you a certain percent break on the bill and set up a payment plan for the rest. So then you pay the bill off, in installments. If you’re responsible about the whole thing, there’s no reason why it should be a problem. They won’t even charge you interest.
And why is it such a big deal to pay off $20,000 in medical bills from a bad car accident? Young people pay that much to buy a new car all the time. They pay far more in college student loans, typically. If you have a good job it’s an annoyance — you might have to cancel the cable TV and gym memberships, maybe even the cell phone! — but it’s hardly crippling.
And what if you don’t have a good job? What if you’re unemployed, or a single mother with two toddlers, or some other sad case where there’s not a great prospect of your being able to pay the bill, even over time? Why then, the hospital will enroll you in Medicaid, and then Medicaid will pay your bills. Because, Chris, a little known fact (apparently) is that if you are poor then Medicaid already offers you free or lost-cost comprehensive health insurance. All of this fuss about “the uninsured” consists of “worries” about people who are not poor who don’t have health insurance.
Finally, what about the case where you get some true dread awful bad-luck situation, and even though you have a good job the expenses are just spectacular, and you’ll never be able to pay the bill, even if you pay over 30 years, like a mortgage. Let’s say you find out you have some weird congenital heart defect, and you need a heart transplant at age 30, and that’s a cool million up front, plus big-time annual costs.
Well that’s a good argument for true health insurance — you know, like car or house insurance, stuff that protects you against things that are by definition both very unlikely and very expensive. But true health insurance, which only does those things, would be quite cheap for someone young and healthy. And that is exactly what the Republican plan that the Democrats hold out in contempt as a “non plan” would be. Youi buy true insurance, against catastrophes, which would be cheap, because you’re risk-pooling with millions of other healthy young people — and then you pay your own routine and forseeable emergency costs yourself. They even helped you out by creating the HSA, which lets you sock away money for your health-care costs tax free in an interest-bearing account, sort of a 401k for your health-care costs. And, note well, you get to decide what it pays for — not some insurance bureaucrat.
But of course all that sensible stuff will go away now, eliminated by Dr. Obamastein’s monster. Good job Democrats!
Carl Pham – yes, the emergency room will treat you. They will not do reconstructive surgery, rehab, or any of a hundred other things you might need to go from “not dying” to “well.” Also, the service they provide will not be free – they will pass that cost on to those with insurance.
Also, you badly underestimate the magnitude of costs – $20K for a car accident is the low end of the scale. I have an HSA. They are only good if you have a fair amount of cash in hand and are healthy when you start.
Medicaid is only for the poor. You have to expend all other assets and not have a job to qualify. In short, your prescription is to:
1) Rely on charity
2) Bankrupt yourself
Reconstructive surgery, et cetera, isn’t life and death stuff, Chris. It’s optional. I see zero reason why your wish to achieve some optimum of health is my problem to fund. Pay for it yourself, or do without. That’s the fundamental rule of adult responsibility. That’s how we treat other fundamental things. You don’t ask me to pay for your food or clothing or shelter, and I would laugh if you did. I don’t see why your rehab after a car accident is my problem.
If you want to talk about how you can fund that, how you can spread those costs out so you don’t have to accumulate a huge pile of cash for them in advance (which is particularly hard since you don’t know when they’ll hit), then, again, I don’t see why that’s my problem. Mechanisms exist, and have existed, for a long time to achieve that in the private domain. No one needs to accumulate $400,000 in cash before they buy a house, or $30,000 before they buy a house, or $100,000 before they go to college.
Nor does it need government to provide a way for people whose houses burn down to lay hands on the cash necessary to rebuild them.
In short, there is no other realm of human need where we have seen a genuine need for government to create and run a mechanism for you to pay for your own costs over time. I fail completely to see why health care costs are magically different. Enlighten me, will you? What makes the cost of rehab fundamentally different from the cost of fixing your car after the accident? What makes the cost of chemotherapy different from the cost of rebuilding your house if it catches fire?
You say:
your prescription is to:
1) Rely on charity
2) Bankrupt yourself
Balls. It works more like this:
(1) Pay for the services you demand from others yourself, out of your earnings, either past, present, or future.
(2) Rely on the historically high ingenuity (and greed) of finance people to provide a mechanism by which you can spread your sudden lump-sum costs over time, for a fee.
(3) If you are truly destitute and unfortunate, then you may assume society will, out of Christian charity, give you some help. But not enough to make you completely happy, because that would remove the motivation to help yourself. And it’s good that you are uncertain how much you’ll be helped, and that relying on charity makes you anxious. That’s why you work hard — so you don’t have to rely on the uncertain charity of strangers. I like the fact that this motivation exists, and see no reason to get rid of it.
To my mind, your final paragraphs seem to contain an underlying insanity. You seem to be implying that the average person cannot afford to pay his average lifetime medical costs, and that, therefore, it becomes necessary to subsidize them from…what? The magic money tree kept in Ben Bernanke’s basement?
Chris, if the average person cannot pay for his average lifetime medical costs, there is no solution. There is no external source of wealth. You cannot create wealth by shuffling the money around at high speed between citizen and government. (Indeed, the amount of wealth must inevitably shrink in such a process, since you have to pay government bureaucrat salaries to do the shuffling.)
So you really have only two choices:
(1) If you really think the average person can’t afford an average lifetime’s medical costs, then the game is up, and we have finally reached the curious point where medical care exists that not everyone can have. Some will have to do without, and the only question is who it should be.
(2) If you think the average person can afford an average lifetime’s medical costs, you have to explain why people can’t figure out how to pay those costs themselves, without having a giant clumsy stupid lawyer’s committee in Washington meddle in the process — and in particular why these are the only costs of living where this is true. You don’t need government to buy a house or send four kids to college or start a business or build a skyscraper or any number of other things that require large amounts of capital. What’s special about medical care, huh?
> The CBO is only looking at federal taxes.
The CBO is also ignoring money that people are being forced to pay under penalty of law. That’s a tax under any reasonable definition, but the CBO isn’t scoring it that way.
Here’s one other li’l tidbit, Chris. Your scare-mongering relies on people not really being clear on how much they’re already paying for healthcare, and hence can afford to pay.
Let’s take my wife as an example. She was diagnosed with breast cancer when she was 43, whcih is shockingly young. Her treatment sucked up quite a lot of money, about $60,000. Good thing she had health insurance, huh?
Well…maybe. Let’s recall she’d been working 25 years by then, dutifully paying healthcare premiums all the way. What you see deducted from your paycheck is only the tip of the iceberg. As any employer can tell you, the bulk of the cost is hidden in what your employer pays directly to the insurer. But it, of course, comes out of your pay — it just comes out before you even see it, like the withheld Federal taxes. (I once worked at a place that, once a year, showed you what they were paying for your healthcare, i.e. what your real salary was. But that’s unusual.)
Over that 25 years, let’s say her salary averaged a mere $30,000, and her healthcare premiums were 15% of her gross, which is on the low side these days. That means over that time she’d paid $30,000 * 25 years * 15% = $112,500. Subtract off a measly few thousand for pap smears and antibiotics, and then the $60,000 for the cancer — and the insurance company still made a fat $60,000 profit from offering to spread her healthcare costs over time for her. More, if you include the fact that they invested that money and earned good interest on it.
So for the average person, there’s no question you can pay for your own healthcare, and indeed are not already doing so but also paying fat profits to the insurance company that lets you spread those costs over time. The fear that, except in rare cases, the average person would go broke paying for his own healthcare is nonsense.
It’s instructional to consider who profits by keeping you afraid, however. The most obvious agency is of course the insurance companies. They make excellent money out of your fear. Who else? Why, government, of course. Your fear means you’ll surrender all kinds of liberties — including the liberty to spend your money where you see fit — to “protect” yourself from these “threats” which, to the extent they aren’t wholly imaginary, are generally the direct result of stupid or criminal collusion between government and insurers.
Government and insurance companies. And who, pray, benefits most from the new Obamacare? Which requires everyone to buy health insurance, and which also subsidizes with taxpayer money the cost of those premiums? My God it’s the biggest corporate welfare scheme ever. Utterly dwarfs the military-industrial complex.
Sold your soul to Big Insurance for a chance to skim a little tax money cream off the top for yourself. Good job Democrats!
Carl Pham – I am relying on the ingenuity of finance people to figure out how to pay for health care. They developed something called “insurance” and it works quite well. In fact, the average person can pay for their lifetime care.
Unfortunately, some portion of the population is not average, and therefore can’t pay. I refuse to live in a society that tells those who can’t pay “sorry – sucks to be you.” It’s a moral thing.
Regarding insurance profits – that’s why I wanted a public option, to provide competition and push the insurance companies to either offer a better deal or lower prices. I blame the Republicans for that plan’s failure – their refusal to govern forced the Democrats to develop a super-majority (60 votes).
I hope they aren’t counting on that money. There’s no way folks are going to pay 10-15K/year for over-insurance — they’ll just pay whatever the fine is and remain uninsured, comfortable in knowing they can sign-up in the unlikely event they get some chronic condition.
Unfortunately, some portion of the population is not average, and therefore can’t pay. I refuse to live in a society that tells those who can’t pay “sorry – sucks to be you.” It’s a moral thing.
Don’t worry, Chris. I’m sure we can get government to fix your “moral thing”. Or you know, you could move somewhere else that indulges in your moral flaws.
Regarding insurance profits – that’s why I wanted a public option, to provide competition and push the insurance companies to either offer a better deal or lower prices. I blame the Republicans for that plan’s failure – their refusal to govern forced the Democrats to develop a super-majority (60 votes).
I guess the Republicans aren’t completely useless after all. And I don’t buy the strained claim that a “public option” will improve competition in any way. The problem, just in case you haven’t thought it through like so much other stuff you claim to believe in, is that a public option will be heavily subsidized compared to private options. It’ll have to be or it won’t get used. The competition won’t be there.
Carl Pham – if it is a “moral flaw” to be concerned about the well-being of my fellow man, it’s a “flaw” that I am both proud to have and profoundly grateful for.
Your assertion that the public option would be heavily subsidized is just that – an assertion unfounded on the bill or any other evidence.
The bill already mandates a 90% loss ratio — meaning that only 10% of premiums can be used to pay the administrative costs, advertising, and “obscene” profits. How much cheaper do you want it?
it’s a “flaw” that I am both proud to have and profoundly grateful for.
That’s what happens when feelings trump doing what is right. I don’t know why you feel proud or grateful in screwing hundreds of millions of people in order to exclude hypothetical “sucks to be you” cases, but I really can’t be bothered to ponder it greatly. Some delusions transcend understanding.
If everyone consumes more health care than they pay for, it’s not going to work, no matter how much you hate “sucks to be you” situations.
Your assertion that the public option would be heavily subsidized is just that – an assertion unfounded on the bill or any other evidence.
If the public option is to be in any sense competitive with private insurance, it has to be subsidized. Any claim otherwise ignores the well-known greater inefficiencies of government services. And once it is subsidized, there’s no natural upper limit to how much it can be subsidized except the tax payers’ unwillingness to keep paying for it.
feelings trump doing what is right. So it’s not right to want your fellow American to get adequate health care? Apparently compassion is not a conservative virtue.
if it is a “moral flaw” to be concerned about the well-being of my fellow man, it’s a “flaw” that I am both proud to have and profoundly grateful for.
It’s all well and good that you’re concerned about your fellow man (and presumably woman). What I object to is your demand that I get sucked into a massive government program against my will and forced to pay dearly in taxes so you can feel good about your self-righteousness. If you’re so concerned, pay for it yourself.
So it’s not right to want your fellow American to get adequate health care? Apparently compassion is not a conservative virtue.
At whose expense? If you’re forcing the US to pay for it, then yes, it is a wrong thing to want. And what do you mean by “adequate”? That weasel term can mean a lot of things.
Here’s my take. Nobody has a right to health care or affordable health insurance. And it’s not clear to me how US society is going to pay for this “adequate” health care. Finally, until you (and the politicians you support) show some interest in getting the low lying fruit (such as malpractice reform, reducing regulation and artificial barriers that restrict supply, permitting health insurance companies to compete across state borders), things that don’t require us to squander our future, your moral arguments are pathetic and not worth my respect.
Finally, who said anything about conservatives or compassion? The “compassionate conservative” has never been my thing.
The irony of course is that “conservative virtues” like self-reliance, hard work, thrift, moderation of vice, etc. are those which built Western civilization. These are the virtues that created surplus wealth for weasels to wet themselves over how they’re going to redistribute it all; that they take for granted and spit on anyone who doesn’t immediately acquiesce to their petulant childish foot-stomping demands.
Here’s my take. Nobody has a right to health care or affordable health insurance
Well, you’re welcome to your take. You’re wrong of course, but that’s hardly a new experience.
And still I wonder how every other industrial country manages to afford to do it…
Like with banking, power utilities, public transportation, infrastructure and a dozen other things I’ve noticed since moving over here – I am left wondering why it is that the United States finds so many things so much harder than many other countries.
It’s almost as if you took all the good bits of the Calvanist Protestant work ethic and liberal theory and then wrapped in up in bad bits of Germanic conservatism and intransigence.
No, he is correct. Conventional rights are just that — arbitrary. Thus the right does not exist before it is created by the society at large. For example, children here have a conventional right to education. People cede their rights via law, and in turn the government has a duty to provide for those rights.
It’s worth noting that the bills in Congress do not create any right to health care per se, and the government will have no new duty to provide health care. The “utilitization” analogy is the most correct one: you have no right to electricity or trash service, just the opportunity to purchase it (even if it’s 100% subsidized by taxpayers). There is a difference.
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In related news, Hugo Chavez is ready to create public option fast-food and retail stores to “compete” with the evil private sector:
“We’re going to defeat speculation. Private individuals in sales can still sell, but they’ll have to compete with us and with a people who is now fully aware,” Chavez said.
Progress!