View Full Version : Obamacare Architect States On Morning Joe That He Advocates Death By Age 75
This is so troubling on so many levels that it's hard to know where to begin. Ezekiel Emanuel, the brother of fan favorite Rahm and chief designer of Obamacare, states clearly and adamantly that humans have essentially outlived their usefulness by age 75. At a time when liberals especially talk about taking care of yourself and staying healthy in this age of longevity, here is one of their heroes, a doctor no less, advocating something straight out of Soylent Green. A Final Solution of sorts.
While he is clear that he is not in favor of euthanasia, he also makes the term "death panel" seem not nearly as outrageous as it once appeared to be. Reading between the lines one can only assume this means that once you're over a certain age you're no longer worth saving and a needless expense to both society and your own family, therefore expect that your medical care will be limited accordingly.
I'd suspect some here will possibly agree because older people do often, but not always, require extra care. Care that as rates and deductibles skyrocket we all must now pay for. However keep in mind that were it not for Obamacare this burden would be far less than it is today let alone five to 10 years from now. Such incredibly important personal decisions should be decided largely based upon one's means and specific scenario, not a computer or bureaucrat.
Beyond that numerous relatives of mine have lived into their 90's and while they had setbacks remained relatively healthy and active until shortly before they passed. My grandmother is 94 and her mind is about as clear as they come, just one of countless examples of such people. I really shouldn't have to clarify this but if some tough talking robot wants to support this maniac's view I'd ask they think again for a host of reasons both legitimate and moral.
Still the bottom line is that it really does appear that the government seeks to ration our healthcare in a way bureaucrats see fit and that to me is about as bad as it gets, something out of a twisted futuristic movie such as the one mentioned above.
This is he himself stating it on live TV. Amazingly while Mia clearly seemed irked Scarborough has little contradiction to offer, almost coming off as complacent with the idea. Was never a big fan of his but now I've lost all respect.
http://www.realclearpolitics.com/video/2014/09/22/obamacare_architect_ezekiel_emanuel_75_an_ideal_age_to_die.html
Also here is a CBS article that too appears remarkably complacent with his assessment.
http://www.cbsnews.com/news/why-one-prominent-doctor-hopes-to-die-at-75/
Is it me or is this incredibly bad? And is this clip not something that the right should seize upon and replay over and over until people are sick of seeing it? I know if I were in charge of a campaign I'd run this baby until I got every last drop out of it.
Wow! Perhaps he's seen Logan's Run too many times...
CarlosDJackal
09-22-14, 20:52
So can someone come up with a Birth Certificate for one Mr. Ezekiel Emanuel that definitively proves that he was born before September 21, 1939?
Although I disagree with most of his positions on health policy, I didn't hear him say anything too inflammatory in the interview. He was not calling for people to die at age 75, only that he was going to stop going to the doctor at that time.
I say consume as much healthcare as you desire, just don't expect me (i.e. the government) to pay for it.
Well, seeing how Ol' Zeke is 74 1/2.. He can be the first to step up to the plate and show us how it's done.. If he wants to spew this shit, fine. The day after his 75th birthday, I want to see his obituary on the news...Myself, I'm 60,and I plan on living as long as I possibly can.
The problem is that it should be a personal choice. But Obamacare increasingly limits what you can opt out of or add without major additional expense. Govt mandated healthcare decisions is diabolical.
Although I disagree with most of his positions on health policy, I didn't hear him say anything too inflammatory in the interview. He was not calling for people to die at age 75, only that he was going to stop going to the doctor at that time.
I say consume as much healthcare as you desire, just don't expect me (i.e. the government) to pay for it.
An airsofter shooting at a dime from a mile away couldn't have missed the mark any worse. Is this what the medical profession has morphed into? I ask because you overlook a host of immensely critical points and since you're a smart guy I have a hard time believing it could possibly be accidental.
Maybe try reading it again. While doing so remember that as bad as this current scenario can get single payer was the ultimate goal. If you really need me to clarify I guess I will but that shouldn't be necessary especially in your case.
When Ezekiel and every other person on the planet with the same views checks themselves out promptly on their 75th birthday I'll be willing to consider their opinion.
Although I disagree with most of his positions on health policy, I didn't hear him say anything too inflammatory in the interview. He was not calling for people to die at age 75, only that he was going to stop going to the doctor at that time.
I say consume as much healthcare as you desire, just don't expect me (i.e. the government) to pay for it.
Given that it is now MANDATED, why should anyone stop using it at any age? The government sure as hell expects US to pay for Obamacare, to the point we aren't even given a choice anymore. And then they want to turn around and tell us not to use it when we reach the point in life when we will need it most?
This is what is wrong with all forms of required insurance. They want you to pay, but you aren't expected to actually use it for anything. Since Obama and his crew are so pro socialism, how about NON PROFIT heathcare insurance?
wild_wild_wes
09-22-14, 21:54
Those policies, if implemented by the government, would lead to armed rebellion.
Fine, let's start with Harry Reid and the rest of the demented geriatrics in Congress...
Those policies, if implemented by the government, would lead to armed rebellion.
Who's to say they haven't been implemented, at least to a dangerously far extent? Look at it this way:
As stated Emanuel was the chief architect of Obamacare and now by an amazing coincidence he comes out and blatantly lies by stating that he won't try to save himself when he gets critically ill, and that's giving him the benefit of the doubt since he may be trying to lie to an even greater extent by saying no medical treatment period, even for something relatively minor like a broken arm.
First thing that comes to mind is what is his motivation for stating this ridiculous lie? Could it be because at some point we'll start to see that people over 75 start to get the VA treatment? That they start to be placed at the back of this line, get inferior care or even no care at all in some cases?
So then perhaps you say "Well maybe but that's just for those enrolled through the ACA, what difference would it make to someone who has obtained insurance on their own?"
First off deliberately shorting people in such a way without absolute full disclosure is utterly immoral. Second those who have their "own" insurance still have to pay a deductible, do they not? And are we not already hearing of those same deductibles having increased substantially? And what about the the repeated warnings that they are likely to go even higher, this to support those on subsidies? When that happens then everyone but the very wealthy, specifically people like him, become hindered, so in that respect we almost all will lose out.
Now let's also say that as I now speculate his comment was geared to prepare people for this outcome but offer reasons as to why they shouldn't get upset about it. Is his new, enlightened mindset really a reflection of his knowledge that since many doctors will be overwhelmed and prices will go so high that care for all but primarily the elderly will either become rationed out of necessity or be priced out of reach for most? Or might it also be because we have yet to find out there are pending clauses that will restrict healthcare for older people in the future? If you say probably not, have you read and fully understood all 1,200 pages of the law? Has anyone but him and a small handful of others? Also tell me, because of his masterpiece what choice do any of us have?
Based upon his own words I will almost guarantee you there will be stories coming down the road of the elderly getting the healthcare shaft unless they are rich, Obamacare or not. If they'll do it to our vets by design then they sure as hell will be doing it to older folks at some point under this new unsustainable plan. Just wait and see.
SeriousStudent
09-22-14, 22:27
Let's talk about healthcare policies, and not each other. Don't make it personal about members here.
Belmont31R
09-22-14, 22:53
Given that it is now MANDATED, why should anyone stop using it at any age? The government sure as hell expects US to pay for Obamacare, to the point we aren't even given a choice anymore. And then they want to turn around and tell us not to use it when we reach the point in life when we will need it most?
This is what is wrong with all forms of required insurance. They want you to pay, but you aren't expected to actually use it for anything. Since Obama and his crew are so pro socialism, how about NON PROFIT heathcare insurance?
If you read the paper he wrote, and I didn't read every word, but the jist is they calculated our productivity to society based on ages. Its not just old people they view as unproductive. Little kids, too. Basically people of breeding age, and those who are able to work are the most desirable. A young kid with an illness isn't productive to society, and its easier to make a new kid than treat a sick one. Past about 40 you start having diminishing returns, and elderly are past the age of productivity.
Its all about farming people to pay taxes and be slaves to the state. If you aren't contributing by labor or tax dollars or breeding new drones they don't want you.
Leaveammoforme
09-22-14, 22:56
Those policies, if implemented by the government, would lead to armed rebellion.
Yeah right.
We were taxed over 50 cents on the dollar a year or so back. That means we give more money to the Government than we are allowed to keep for ourselves. Since then SS rose 2%, but that doesnt count because it's going to an account with your name on it :rolleyes:. The whole Obamacare debacle came before that and slowly wormed its way in. Government has record employee numbers and welfare recipients. We are now told by someone in a position that we are worthless at 75. As 'American' as an armed rebellion may sound, If we haven't done it yet I highly doubt it will ever happen again.
We (the forum as a whole) can't even agree on what to do regarding recent events like Bundy Ranch, The stupid town in Missouri, General open carry or even if a shotgun is a viable home defense weapon. I have a very hard time believing we (citizens of US) could ever stop our bickering long enough to invoke any real change.
So what does this get us? It gets people that want change and are super pissed off. They randomly or even methodically kill citizens and LEOs. We sit back and then scream for thier blood. Then we repeat the process over and over.
Let's talk about healthcare policies, and not each other. Don't make it personal about members here.
Since that probably directed at me I'll gladly take a moment to clarify that while I'm not sure he'd say the same of me I find myself agreeing with Sensei 90+% of the time and respect his opinions for the most part. That being the case and especially since I believe he's a doctor it was rather disappointing to hear him being the only one so far who sees no issue with Emanuel's commentary.
I see right through the guy so how he doesn't is beyond me, but maybe I'm wrong and he'll set me straight. Either way my comment was a confused expression of disappointment I guess you could say and no insult was at all intended.
When the docile milk cow runs dry its time for hamburger.
Next we will hear that the mentally ill are too much burden (they probably don't vote anyway). Then meat eaters consume too much and are killing themselves anyway. Gun owners are too risky to cover just an accident waiting to happen.
They already have it planned that scarce care will be rationed according to who the govt wants to keep around. Nothing like a herd of 18-35 yr old pulling in the harnesses with less and historical memory of other times to feel uppity.
FromMyColdDeadHand
09-22-14, 23:15
Not. Gonna. Happen.
Way to many baby boomers that VOTE and want to live forever.
thopkins22
09-23-14, 00:17
The chief designers of Obamacare were employed by The Heritage Foundation/insurance companies/pharmaceutical companies. Democrats in Chicago had as much to do with the design of this law as I did. That is to say that this dude didn't design jack. The only thing they did was add a provision about pre-existing conditions(which didn't bother anyone in the industry.)
He's very happy to take the credit I'm sure, and "conservatives" are happy to give it to him. But facts is facts.
As a side note, as long as it was voluntary, I would happily sign up for an insurance plan that dropped my ass at 75 or 80. Do you have any idea how much cheaper our premiums would be if not for the hundreds of thousands of dollars that we spend on the elderly for such a small return? As government policy? Terrible. As something to think about as a way to achieve affordable insurance? Not so terrible.
Single payer was NEVER the goal of this bill. That was lip service to hard-core liberals who they still needed support from...but in reality is utter BS. The ultimate goal of this bill is that insurance companies looked at the populace and realized that they were missing huge sections of the population's business. So they literally made it against the law to not buy their products. Then they realized that some of those people weren't buying their products because they couldn't afford it, so they designed the law so that the rest of us bought their products for these people.
This isn't socialism nor steps to socialism...not even close. The laws that GWB pushed for(and signed into law) were FAR more socialist in nature than Obamacare...and awfully costly.
Belmont31R
09-23-14, 01:00
The chief designers of Obamacare were employed by The Heritage Foundation/insurance companies/pharmaceutical companies. Democrats in Chicago had as much to do with the design of this law as I did. That is to say that this dude didn't design jack. The only thing they did was add a provision about pre-existing conditions(which didn't bother anyone in the industry.)
He's very happy to take the credit I'm sure, and "conservatives" are happy to give it to him. But facts is facts.
As a side note, as long as it was voluntary, I would happily sign up for an insurance plan that dropped my ass at 75 or 80. Do you have any idea how much cheaper our premiums would be if not for the hundreds of thousands of dollars that we spend on the elderly for such a small return? As government policy? Terrible. As something to think about as a way to achieve affordable insurance? Not so terrible.
Single payer was NEVER the goal of this bill. That was lip service to hard-core liberals who they still needed support from...but in reality is utter BS. The ultimate goal of this bill is that insurance companies looked at the populace and realized that they were missing huge sections of the population's business. So they literally made it against the law to not buy their products. Then they realized that some of those people weren't buying their products because they couldn't afford it, so they designed the law so that the rest of us bought their products for these people.
This isn't socialism nor steps to socialism...not even close. The laws that GWB pushed for(and signed into law) were FAR more socialist in nature than Obamacare...and awfully costly.
Pretty much. Any business would be absolutely drooling at the prospect of being in such a regulated market that there isn't much competition, and having an actual law that says its illegal to not buy your products.
The socialist nature of Obamacare is the subsidies, and basically not allowing elderly to be charged more based on a ratio to younger people to spread the cost around. But thats doesn't change the total income the insurance companies get.
Its all about farming people to pay taxes and be slaves to the state. If you aren't contributing by labor or tax dollars or breeding new drones they don't want you.
And rest assured it's mutual. I think Congress is the number one over paid non contributor in the entire country. Sadly, we didn't even get true socialized healthcare. Socialism is bad enough when it's obligatory, but at least in many places once they pick your pocket they actually provide a genuine level of care for your money.
Obamacare is the worst combination of socialism and capitalism. It's mandatory like the socialist version but profit motivated like the capitalist version. But because it is mandatory, there is no motivation to be cost effective or provide quality care.
thopkins22
09-23-14, 01:12
It's mandatory like the socialist version but profit motivated like the capitalist version.
This is essentially Mussolini's definition of fascism.
Not. Gonna. Happen.
Way to many baby boomers that VOTE and want to live forever.
And most of them voted FOR Obama and FOR Obamacare and will refuse to accept the truth all the way to their deathbed.
This is essentially Mussolini's definition of fascism.
Exactly. The new paradigm is the govt provides the iron fist to make us subservient to the few global corps. Fascism.
We will ALL be there some day (unless you relish an early demise), as will your loved ones........remember that.
You won't be in your 30's forever. Easy to form an opinion on matters such as this when you're decades away, but really it's just around the corner.
And rest assured it's mutual. I think Congress is the number one over paid non contributor in the entire country. Sadly, we didn't even get true socialized healthcare. Socialism is bad enough when it's obligatory, but at least in many places once they pick your pocket they actually provide a genuine level of care for your money.
Obamacare is the worst combination of socialism and capitalism. It's mandatory like the socialist version but profit motivated like the capitalist version. But because it is mandatory, there is no motivation to be cost effective or provide quality care.
That's Facism by definition.
The_War_Wagon
09-23-14, 06:36
You're ONLY worth to libtards, what you can pay in taxes to support them. Once you STOP paying them, you've outlived your "usefulness" to THEM...
The chief designers of Obamacare were employed by The Heritage Foundation/insurance companies/pharmaceutical companies. Democrats in Chicago had as much to do with the design of this law as I did. That is to say that this dude didn't design jack. The only thing they did was add a provision about pre-existing conditions(which didn't bother anyone in the industry.)
He's very happy to take the credit I'm sure, and "conservatives" are happy to give it to him. But facts is facts.
Speaking of facts how about we stick to them? Check the title of the RCP video again or try the link below. Can find dozens like it and have seen him on TV numerous times described as "architect", "key figure", etc and it wasn't on FOX news. Why you would make the statement above I have no idea but unless you were present for the designing there's a lot of evidence out there blatantly contradicting you.
Another mystery is your statement that only conservatives call him such. Quite the contrary and so again I'm lost as to your motivation for popping in only to create confusion.
http://www.phillymag.com/news/2014/09/22/penns-ezekiel-emanuel-wants-die-75/
Seems a decent solution to our Social security problem too.
Honestly if our health care system becomes single payer I would support this. I also feel strongly about a single payer system not treating lifestyle induced chronic disease, like diabetes, heart disease, and even some forms of cancer (lung cancer).
It is our only chance of having a mildly affordable system. After all we will be paying it as tax payers.
Don't want to pay for some one who lived on McDonalds and never exercised to be medically taken care of? You wouldn't have to.
Many countries with single payer systems also have private health insurance people can buy to supplement the public health care. Want health care past 75? want health care to take care of your ailments from sitting on your porch eating friend chicken and smoking cigarettes? you can buy it yourself.
Its the type of single payer health care I would be much more apt to embrace.
My biggest issue with a single payer system is helping people who don't help them selves and don't contribute to society.
But in the end it will be a mess no matter what, there for I would rather stick with the mess we have now. Honestly the best thing we could do with our healthcare system is reform it so things are not so ridiculously expensive. You see bills posted online of hospital visits, there is no way it should cost as much as it does. You are paying for freeloaders and law suits that did not involve you every time you go to the hospital.
The other thing that crosses my mind is the hypocrite oath. I have heard an argument for single payer health care that goes like this: People go to the hospital with out insurance, they get treatment because of hypocrite oath. Argument is that since they are getting git free anyway lets just make it free for all. My idea is that the hypocrite oath applies to doctors, not security guards outside the hospital. No insurance card?, thats easy no entrance, take your ailment elsewhere. Doctors want to help people for free? They can volunteer and do it on their own dime.
I'm sure this sounds very cold to some, and it is. But people need to taking care of them selves. Modern health care has created a mentality that is not sustainable, and only truly has existed for the last 50-75 years.
brickboy240
09-23-14, 10:42
If all the liberals would start offing themselves at age 75...our kids might indeed have a bright future.
...one can hope
Seems a decent solution to our Social security problem too.
Honestly if our health care system becomes single payer I would support this. I also feel strongly about a single payer system not treating lifestyle induced chronic disease, like diabetes, heart disease, and even some forms of cancer (lung cancer).
It is our only chance of having a mildly affordable system. After all we will be paying it as tax payers.
Don't want to pay for some one who lived on McDonalds and never exercised to be medically taken care of? You wouldn't have to.
Many countries with single payer systems also have private health insurance people can buy to supplement the public health care. Want health care past 75? want health care to take care of your ailments from sitting on your porch eating friend chicken and smoking cigarettes? you can buy it yourself.
Its the type of single payer health care I would be much more apt to embrace.
My biggest issue with a single payer system is helping people who don't help them selves and don't contribute to society.
But in the end it will be a mess no matter what, there for I would rather stick with the mess we have now. Honestly the best thing we could do with our healthcare system is reform it so things are not so ridiculously expensive. You see bills posted online of hospital visits, there is no way it should cost as much as it does. You are paying for freeloaders and law suits that did not involve you every time you go to the hospital.
The other thing that crosses my mind is the hypocrite oath. I have heard an argument for single payer health care that goes like this: People go to the hospital with out insurance, they get treatment because of hypocrite oath. Argument is that since they are getting git free anyway lets just make it free for all. My idea is that the hypocrite oath applies to doctors, not security guards outside the hospital. No insurance card?, thats easy no entrance, take your ailment elsewhere. Doctors want to help people for free? They can volunteer and do it on their own dime.
I'm sure this sounds very cold to some, and it is. But people need to taking care of them selves. Modern health care has created a mentality that is not sustainable, and only truly has existed for the last 50-75 years.
First its smokers and the obese. Eventually it's some risky behavior of yours. Then EVERYTHING is risky, then 24/7 monitoring with all these devices out there. That's a VERY slippery slope. No thanks.
Any of you not enrolled in Obamacare?
I'm not nor is my wife nor will we ever...
If everyone decided NOT to enroll, this crap would disappear.
C'mon, let's hear from you!
Enrolled?
NOT enrolled?
Not enrolled but our employer plan went from a $200/yr deductible to $3,000/yr.
One of daughters opted for no coverage at work since the employee cost was so high and Did not enroll. She pays the penalty and its cheaper.
thopkins22
09-23-14, 12:25
Speaking of facts how about we stick to them?
http://s3.amazonaws.com/thf_media/1990/pdf/bg777.pdf
http://www.heritage.org/Research/Lecture/Is-Tax-Reform-the-Key-to-Health-Care-Reform
http://www.heritage.org/research/lecture/assuring-affordable-health-care-for-all-americans
http://www.nationalreview.com/corner/294585/history-individual-mandate-ramesh-ponnuru
http://thomas.loc.gov/cgi-bin/bdquery/z?d103:S1770:
I'm not saying that Democrats don't want him to have credit too. I'm only saying that it's not his idea, he's not the architect, and that this whole thing is smoke and mirrors. Read the text of the 1993 bill. Read the lectures and papers written and published by Heritage. The mandate is about 95% identical to the mandate that was proposed by the folks at Heritage.
I didn't come to cause confusion...but IMO opinion calling him the architect causes confusion(and I fully realize that you're only referencing the title used by RCP, and I don't mean it as a dig towards you or anything.)
Not enrolled, but I'm on my employer subsidized plan. Out of pocket has gone up but it's still better that Obutt**** care. Not sure what will happen over the next few years. I see employer subsidy going bye bye and everyone getting dumped. I also think a lot of corporate HQ will relocate and hire contractors here in the USA to save cash.
Fascism, communism or socialism; it's irrelevant. They are all about someone sticking it to you without you having a way out.
I pray that I don't live long enough to see my kids enslaved by a government or that I have the strength my parents had to say **** it and leave for a better place if it exists. Not holding my breath though as the world is screwed up as a whole.
When the docile milk cow runs dry its time for hamburger.
Next we will hear that the mentally ill are too much burden (they probably don't vote anyway). Then meat eaters consume too much and are killing themselves anyway. Gun owners are too risky to cover just an accident waiting to happen.
They already have it planned that scarce care will be rationed according to who the govt wants to keep around. Nothing like a herd of 18-35 yr old pulling in the harnesses with less and historical memory of other times to feel uppity.
You have just nailed it to the masthead!
I have insurance through my employer. Costs have gone up significantly since Omaocare was first discussed.
ramairthree
09-23-14, 17:12
My Great Grandfather fell coming down the cherry picker ladder on the back of a log truck when he was 80 and broke his hip. 6 months latter he was rolling under barbed wire fences and hauling wheelbarrows of horse shit. He was doing the same thing 8 years later when he dropped dead from a stroke.
His son, my Grandfather, is now 88 and still driving a skidder and running a chainsaw.
He got sick and his stomach was hurting and he was having trouble carrying choker chains over one shoulder while pulling the cable from the skidder winch over his other shoulder. He went home from work, was too sick to go to work the next day, and finally he let the family take him to an ER the day after that. He had a ruptured appendix. They took it out and he made them discharge him the next day instead of staying longer. He is back to his old self.
WTF people like that should be shut off,
while 50 something diabetic crack heads soak up millions in and out of the ER and dialysis clinics that have never worked a day in their lives until they kick it at 60 baffles me.
My Great Grandfather fell coming down the cherry picker ladder on the back of a log truck when he was 80 and broke his hip. 6 months latter he was rolling under barbed wire fences and hauling wheelbarrows of horse shit. He was doing the same thing 8 years later when he dropped dead from a stroke.
His son, my Grandfather, is now 88 and still driving a skidder and running a chainsaw.
He got sick and his stomach was hurting and he was having trouble carrying choker chains over one shoulder while pulling the cable from the skidder winch over his other shoulder. He went home from work, was too sick to go to work the next day, and finally he let the family take him to an ER the day after that. He had a ruptured appendix. They took it out and he made them discharge him the next day instead of staying longer. He is back to his old self.
WTF people like that should be shut off,
while 50 something diabetic crack heads soak up millions in and out of the ER and dialysis clinics that have never worked a day in their lives until they kick it at 60 baffles me.
You got that right. Seriously I find it to be ridiculous when we hear this crap that I won't ever let myself need this, I should be dead before X, blah, blah, blah. Narrow minded simpleton stuff based on not the slightest shred of truth. These fools will be the very first to be running to the doctor when things go south.
Good for your grandfather. May he live even longer and continue to prosper.
I didn't come to cause confusion...but IMO opinion calling him the architect causes confusion(and I fully realize that you're only referencing the title used by RCP, and I don't mean it as a dig towards you or anything.)
Well that's a fair and cordial response but the problem is the RCP title had little to nothing whatsoever to do with my assessment. Yes I mentioned it but the basis for my statements has been out there far, far longer than this week. Emanuel's influence on the final version of the bill, this largely but not solely due to his brother's past position inside the White House, has been touted for years more so in the liberal media than that of the conservative. You seem to implicate that conservatives portray him as a strawman yet the potential basis of this theory eludes me. Can you elaborate?
Also I read though a bit of the links and understand where you're coming from in that regard. With that in mind even if he did play a 5% role, which is at least more than "jack", he still would be among the very few to understand the bill far more than others. So just factoring this detail in should clarify why I and others find his comments so alarming.
Since that probably directed at me I'll gladly take a moment to clarify that while I'm not sure he'd say the same of me I find myself agreeing with Sensei 90+% of the time and respect his opinions for the most part. That being the case and especially since I believe he's a doctor it was rather disappointing to hear him being the only one so far who sees no issue with Emanuel's commentary.
I see right through the guy so how he doesn't is beyond me, but maybe I'm wrong and he'll set me straight. Either way my comment was a confused expression of disappointment I guess you could say and no insult was at all intended.
I've now watched the interview 3 times. So far, I'm not seeing where he is calling for people to die at a particular age or that the government should prohibit people from using their own financial resources to fund their healthcare beyond age 75.
What he did say is that an inflection point of diminishing returns exists for healthcare expenditures in relation to quality outcomes across the population. This is a fact that is not in dispute - my sixty year old patients do better, on average, than my eighty year old patients. How we deal with this reality is a discussion that I'm more than happy to have (in another thread) provided that we start from the premise that the status quo is financially unsustainable.
I sent a woman for then-experimental heart procedure two months before she turned 90. She was found to be too healthy for that, and received a conventional heart surgery. She did very well, and is happy to have received that.
This wouldn't have happened in any country in the world.
Just one example, but I have tons of octagenarian patients who give me a lot of personal hope that there is a lot more to life after 75 than a decay. Even if that requires health care consumption. These people paid into Medicare all their lives; is it their fault that every player in healthcare game is responsible for bankrupting it?
Zeke is suffering from a selection bias. He's in Philly, dirty, unhealthy city with huge rates of obesity and impoverished population. He needs to come out to parts of this country where people don't have to spend two hours of their life on commute and instead exercise daily, watch what they eat and see docs for appropriate preventative care in appropriate times.
What he did say is that an inflection point of diminishing returns exists for healthcare expenditures in relation to quality outcomes across the population. This is a fact that is not in dispute - my sixty year old patients do better, on average, than my eighty year old patients. How we deal with this reality is a discussion that I'm more than happy to have (in another thread) provided that we start from the premise that the status quo is financially unsustainable.
I think it is the implications of those statements and many of the logical conclusions that are arrived at that have so many people concerned.
My solution of course is a pure free market system where insurance companies are forced to compete for customers by offering them quality of service and price packages. Doctors and hospitals also need to establish a one price system for the insured and uninsured patients, that way nobody pays $8 for a band aid because it's being billed to insurance any way.
And of course the really, really big one. Those that pay, shouldn't have to pay the difference for those who can't pay. Quality of health care provided to paying customers shouldn't be based upon how many illegals got "freebies" in the ER that month.
I think if everyone was equal in terms of what they paid for the same service, and insurance companies were forced to compete in the free market that would solve most issues. This would of course only leave the ungodly liability insurance rates that most doctors are forced to contend with. I have actually seen people close their practice because their insurance requirements cancelled out their earning potential.
The_War_Wagon
09-24-14, 06:42
http://rlv.zcache.com/obamacare_because_grandma_is_shovel_ready_bumper_sticker-r19543aac91764c5fbf67791b84bdc74b_v9wht_8byvr_512.jpg?bg=0xffffff
You're required to provide your own shovel, though.
I think it is the implications of those statements and many of the logical conclusions that are arrived at that have so many people concerned.
My solution of course is a pure free market system where insurance companies are forced to compete for customers by offering them quality of service and price packages. Doctors and hospitals also need to establish a one price system for the insured and uninsured patients, that way nobody pays $8 for a band aid because it's being billed to insurance any way.
I'm not sure that what you describe is a free market system.
And of course the really, really big one. Those that pay, shouldn't have to pay the difference for those who can't pay. Quality of health care provided to paying customers shouldn't be based upon how many illegals got "freebies" in the ER that month.
What you are describing is cost sharing which is a direct result of price controls such as Medicare and especially Medicaid. Trying to regulate this with more price controls will only result in more market distortions and unintended consequences
I think if everyone was equal in terms of what they paid for the same service, and insurance companies were forced to compete in the free market that would solve most issues. This would of course only leave the ungodly liability insurance rates that most doctors are forced to contend with. I have actually seen people close their practice because their insurance requirements cancelled out their earning potential.
I'd be very careful putting the terms "equality" and "free market" in the same thought. A true free market system is one that removes price controls such as Medicare and Medicaid. Long-term health savings accounts are a good example of this, but equality of outcomes and cost is not the goal.
I wish the solution to the whole health care debacle would be as simple as price controls or more competition. The fact of the matter is that is not the case. The health care system, while possibly the best on the planet, is plagued with all sorts of issues. They all need to be addressed because onesie twosie solutions are tits on a boar effective. The biggest hurdle that has to be answered is a philosophical one: do you believe in the concept that medical care is a right or privilage? If you think it's a right how far do you take it? Unlimited access to anyone even if they can't pay aren't a citizen, dont pay taxes... If you think it's a privilage are you ok with letting those who can't pay die from the flu. Right now this country is of the belief that medical care is a right like free speech.
Once you wrap your head around that question and can come up with a concrete answer instead of some nebulous feel good crap answer then we can move on to address issues like litigation, insurance competition, price variations...
I've now watched the interview 3 times. So far, I'm not seeing where he is calling for people to die at a particular age or that the government should prohibit people from using their own financial resources to fund their healthcare beyond age 75.
I didn't hear him say either of those things either. While I think I was fairly clear, again my interpretation of his commentary, he being someone who is likely far more familiar with obamacare than most, is that medical treatments for people over 75 will eventually begin to become either harder to obtain or substantially more expensive under the ACA.
Do you believe there is any possible truth to that interpretation?
Personally, I think Zeke is pure evil.
His "The Complete Lives System" is very disturbing to me. As is much of his earlier "work".
In The Complete Lives System he writes,
"Consideration of the importance of complete lives also supports modifying the youngest-first principle by prioritizing adolescents and young adults infants. Adolescents have received substantial education and parental care, investments that will be wasted without a complete life. Infants, by contrast, have not yet received these investments. Similarly, adolescence brings with it a developed personality capable of forming and valuing long-term plans whose fulfillment requires a complete life.
When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated."
Attenuated. Wow.
Your baby is not worth the expense since "the collective" will get no guaranteed ROI.
For me, it's out of a horror movie.
But that's just me.
Harold
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TAZ, answering that important philosophical question will have much less practical impact than people think. Accepting healthcare as a privilege only will raise costs unless access to emergency services is curtailed, which is impossible logistically and from professional ethics standpoint.
Can you have a Right to something that must be provided by the labor of someone else?
Philosophically, no. Application of philosophic principles in real life is a whole different story.
Can you have a Right to something that must be provided by the labor of someone else?
You mean like a firearm? Or do you make your own?
A speedy trial is court generated. Or can you also be your own court?
Not at all trying to be a smart-butt, hopefully you get the idea.
That's where I get stuck.
Once we apply those principals, which I dont want to do an all honestly, how can the providers not make the arguement that they have the Right to control the behavior of those they are providing for?
If I have to pay for your (not you, sir) healthcare, why should I allow you smoke? Or eat fast food? Or partake in unprotected sex? Can I MANDATE exercise?
Do we not see the consequence-free result of welfare? Especially as it applies to having more children than someone can afford? We have to pay for others children but have no say when they want to have more. They do as they please knowing full well someone else gets the tab.
Your decisions have a consequence to ME financially 5het I have no say in those decisions.
I just cant accept that. It leads down a path I despise. The proverbial Slippery Slope.
You mean like a firearm? Or do you make your own?
A speedy trial is court generated. Or can you also be your own court?
Not at all trying to be a smart-butt, hopefully you get the idea.
Good discussion Sir. Thanks.
Resoectfully, I have a Right to buy (or make) a firearm.. I do not have the Right to have one provided to me. That is where I see the distinction. The Right gaurantees my freedom to bear arms if I choose. Not the the providing of arms at taxpayer expense.
I dont have the need for a trial until i have been accused of a crime. If someone chooses to indict me, they must provide the speedy trial. My Right to a speedy trial is the result of someone taking legal action against me.
And I should have worded my original question better.
For clarification. - Can you have a Right to something that must be provided, BY FORCE, by someone else?
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thopkins22
09-24-14, 14:40
And I should have worded my original question better.
For clarification. - Can you have a Right to something that must be provided, BY FORCE, by someone else?
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To me it depends on where you believe rights come from. The greatest thinkers(at least in my opinion) essentially made the argument that rights are what exist if you were in a vacuum. Life, property, and liberty. You have the right to not be killed, the right to own what you want, and the right to do what you want within your vacuum. As soon as you interact with another human, then their right to life, liberty, and property must be respected.
So no...unless you believe that rights come from government.
That is precisely how I feel. Excellent, thank you.
My Right to swing my fist ends at the tip of your nose.
That's why I do not believe healthcare, a job, food are Rights from a Government-provided stand point. I have the Right to buy any of those if I choose to, provided someone else willingly sells/gives them to me. I don't have a Right to have them provided to me by someone unwilling to do so at the point of the governments gun.
To me it depends on where you believe rights come from. The greatest thinkers(at least in my opinion) essentially made the argument that rights are what exist if you were in a vacuum. Life, property, and liberty. You have the right to not be killed, the right to own what you want, and the right to do what you want within your vacuum. As soon as you interact with another human, then their right to life, liberty, and property must be respected.
So no...unless you believe that rights come from government.
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That is precisely how I feel. Excellent, thank you.
My Right to swing my fist ends at the tip of your nose.
That's why I do not believe healthcare, a job, food are Rights from a Government-provided stand point. I have the Right to buy any of those if I choose to, provided someone else willingly sells/gives them to me. I don't have a Right to have them provided to me by someone unwilling to do so at the point of the governments gun.
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I don't disagree, but EVERYONE gets old unless you die early. Even people who "live right" and eat steamed broccoli and boiled chicken breast every day, don't drink, don't smoke, run 5 miles a day, etc. will still get old. Shit starts to break as you get old. Sure, your lifestyle has a huge impact on it, but so do genetics (in fact, one could reasonably argue that genetics play the larger of those roles). What then? I keep hearing the almighty dollar brought up, words like "unsustainable", pointing out that the non-contributors still reap the bennies. Unfortunately, that stuff is true. But since ALL of us get old isn't there some way we can work this out? I don't necessarily have an answer, but if you live to be a ripe old age and don't die peacefully in your sleep one night, then according to some you'd better be independently wealthy or your fooked when costly ailments arise (and they will).
Free market competition and Tort reform was all that was needed. Hell they could have wrote the ACA on a damn 3x5 card doing that and we'd all be better off.
I admit I dont have the answers either. Its a topic full of emotion and emotion doesnt always give us the correct answer. Think gun control activists, for example.
Is it your job to ensure you can support your needs until you die if you do live a long, healthy life? I would say yes if the alternative is having someone else support you. Dont they have the right to spend or save their money as they choose? Perhaps they are saving to care for themselves as they get older. Why should someone else get their money to spend?
Ideally we should all plan to care for ourselves and our familes, I would think. Could we need the assistance of others? Certainly. Who would be willing to help us? A charity perhaps? Maybe a group of folks WILLINGLY pooling their money to care for those that need it....
Again, I dont have an iron clad answer as to what will work for everyone. I know i have made decisions so that I will be able to provide for my family and not be burden when I get old.
I do know that healthcare for all, run by the government will not be the utopia some think.
Again, read Zekes Emmanuel's 'The Complete Life'.
Disturbing stuff.
I don't disagree, but EVERYONE gets old unless you die early. Even people who "live right" and eat steamed broccoli and boiled chicken breast every day, don't drink, don't smoke, run 5 miles a day, etc. will still get old. Shit starts to break as you get old. Sure, your lifestyle has a huge impact on it, but so do genetics (in fact, one could reasonably argue that genetics play the larger of those roles). What then? I keep hearing the almighty dollar brought up, words like "unsustainable", pointing out that the non-contributors still reap the bennies. Unfortunately, that stuff is true. But since ALL of us get old isn't there some way we can work this out? I don't necessarily have an answer, but if you live to be a ripe old age and don't die peacefully in your sleep one night, then according to some you'd better be independently wealthy or your fooked when costly ailments arise (and they will).
Free market competition and Tort reform was all that was needed. Hell they could have wrote the ACA on a damn 3x5 card doing that and we'd all be better off.
Totally agree. Our govt has created monopolies in the pharm/medical industry and protects them while they gouge consumers. What other industry gets away with doing things to you without full disclosure of costs then bulls you 40x the market rate and perhaps multiple times? Obamacare was written to maximize profits for insurance companies.
Get govt out of healthcare, prosecute medical providers by same laws as any other business, and disassemble state regulation of insurance companies. Karl Denniger on market-ticker.org posts extensively on the corruption in medical industry and how to fix it so competitive rates of 40x less result. Spot on!
montanadave
09-27-14, 16:11
Although I disagree with most of his positions on health policy, I didn't hear him say anything too inflammatory in the interview. He was not calling for people to die at age 75, only that he was going to stop going to the doctor at that time.
I say consume as much healthcare as you desire, just don't expect me (i.e. the government) to pay for it.
Spot on.
I'm not sure that what you describe is a free market system.
What you are describing is cost sharing which is a direct result of price controls such as Medicare and especially Medicaid. Trying to regulate this with more price controls will only result in more market distortions and unintended consequences
I'd be very careful putting the terms "equality" and "free market" in the same thought. A true free market system is one that removes price controls such as Medicare and Medicaid. Long-term health savings accounts are a good example of this, but equality of outcomes and cost is not the goal.
I believe Steyr meant is once you get rid of regulations prohibiting selling insurance across state lines, more insurance companies will have to compete with each other. Also when you show up at the ER without insurance, that person gets the bill instead the hospital billing EVERYBODY else for higher costs to make up for that loss.
Personally, I think Zeke is pure evil.
His "The Complete Lives System" is very disturbing to me. As is much of his earlier "work".
In The Complete Lives System he writes,
"Consideration of the importance of complete lives also supports modifying the youngest-first principle by prioritizing adolescents and young adults infants. Adolescents have received substantial education and parental care, investments that will be wasted without a complete life. Infants, by contrast, have not yet received these investments. Similarly, adolescence brings with it a developed personality capable of forming and valuing long-term plans whose fulfillment requires a complete life.
When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated."
Attenuated. Wow.
Your baby is not worth the expense since "the collective" will get no guaranteed ROI.
For me, it's out of a horror movie.
But that's just me.
Harold
Sent from my iPad using Tapatalk
The devil is in the details, Zeke's details and train of thought at least.
I believe Steyr meant is once you get rid of regulations prohibiting selling insurance across state lines, more insurance companies will have to compete with each other. Also when you show up at the ER without insurance, that person gets the bill instead the hospital billing EVERYBODY else for higher costs to make up for that loss.
There seems to be some misunderstanding on what drives healthcare costs. To clear things up, let's start with the Emergency Department. Of the annual $2.4T spent on healthcare in the US, emergency care represents anywhere from 2-6% depending on whose data you believe. Even if you accept the 6% figure, we are not going to "fix" healthcare costs in America by keeping people out of the ED or making it more cost effective place to practice. That is to say, even if you kicked all of the uninsured and Medicaid patients out of the ED, you are only going to save about 0.5% on total healthcare expenditures because most dollars are not spent on the poor in our Emergency Departments.
Next, even people without insurance get a bill when they come to the ED. EMTALA requires a medical screening exam for emergency conditions on every patient coming to the hospital, and healthcare providers are allowed to bill for this service. Thus, many uninsured receive a bill a month after their care that they ignore because they live by cash and have no fear of collections reports. This unreimbursed care is added to the deficits from under-reimbursed Medicare/Medicaid care as part of a healthcare provider's operating expenses. The laws of economics state that it will get passed on to other paying customers barring some other form of market distortion. So, if you do not like paying extra healthcare costs because somebody else failed to pay their bill or has public insurance, then you have 3 options: 1) overturn EMTALA, Medicare, and Medicaid so that healthcare providers can deny care to these patients; 2) pay healthcare providers from the public fund (i.e. your taxes) to cover their losses; or 3) change the laws of economics.
The bottom line is that our healthcare system is so riddled with market distortion that trivial measures such as malpractice reform (look at TX's experience if you think it lowers costs), interstate insurance, and getting the poor out of the ED will have trivial effect on long term expenses. The only way to solve this riddle is to gradually institute a system of HSA's and phase government out of healthcare delivery except in the most extreme circumstances (military, prisons, mental institutions, etc.). In one respect, Emmanuel may be correct because the government does need to begin a process of re-evaluating the healthcare it provides otherwise we are headed for a collapse. We simply cannot afford to provide this level of service to this many elderly people from the public coffers. He and I differ in that I expect Americans to gradually take on more responsibility for their own fate while enjoying more opportunity (and risk). Guys like Emmanuel want the government to be the one who picks winners and losers. In my system, the vast majority win big and a few will suffer the consequences of their own choices. It is the difference between conservation (self imposed) and rationing (government imposed).
You guys all realize we pay for healthcare either way. Not providing healthcare doesn't mean it's magically free when Joe Billy Bob and his GF Candy go have a baby at the ER. News flash, your paying for it every time you see your doctor. It's disgusting that anyone in this wonderful country has to decide whether they need food or a doctor.
You can't blame this on illegals. The numbers don't add up. You want productive members of society? Help people focus on education rather than paying for medical conditions they didn't ask for.
Yes, OBAMA care sucks. It's not going to work. But there is no reason we can't get a true single payer system to work. Just about every other western country has a working one.
Yes, OBAMA care sucks. It's not going to work. But there is no reason we can't get a true single payer system to work. Just about every other western country has a working one.
Well, we are not every other Western county and I can give you several reasons why a SP will not work. Here are some that came to mind in less than 5 seconds of thinking about the issue:
1) The Constitution - A true SP would need an Amendment - good luck
2) Public support - There is none for SP; most awake Americans realize that the VA is a microcosm of SP and want nothing of it
3) Taxes - Let me guess, the rich are going to pay for it
4) Cost - Related to number 3 but we are already $18T in debt and growing. In addition, we have a combined $100T in SS and Medicare liabilities. I though the idea was to reduce our liabilities?
5) Labor supply - There are currently not enough doctors and nurses to keep pace with the current demand. Single payor would make this worse for everybody and the market distortion would make it a long term problem. This is currently happening in most systems that you refer to as SP.
Finally, keep in mind that most systems you call SP are not truly SP. They are 2-tier systems with the government paying the bill for those who cannot afford private insurance. So, tell me about a true SP system that you like.
How is that some folks think there is such a surplus of medicine and medical care that we can afford to pay for everyone to have great coverage under the current Congressional-Medical-Pharmaceutical complex?
Probably if we got rid of the corrupt cabal 90% of folks could easily afford their own coverage out of pocket. But as it is, there is no way enough money available through forced premiums or taxes to pay for everyone. Never will be possible.
Most countries don't have such a massive corrupt congressional-medicalcomplex to pay for. Canada gets the same drugs for 10-20% of what we pay.
We should be attacking the corrupt politicians and industries that inflate the prices of care, not bemoaning that citizens are unwilling to spend 30% of their paycheck to buy subpar coverage and socialist warehouse care.
Yes, OBAMA care sucks. It's not going to work. But there is no reason we can't get a true single payer system to work. Just about every other western country has a working one.There is a HUGE reason we shouldn't: liberty. Countries with government monopoly on health services have tax rates even higher than we do, almost no military (we're footing the bill for military coverage for basically every country that isn't England, Russia, or China) so they can be taken over by anyone at any time, and government can basically tell them to do anything they want at any time. If we get gov't only healthcare, if you do ANYTHING they don't want you to do then they can call it a health risk and drop your coverage. No way in hell will they not tell us gun owners give up your guns or you've got no health coverage. They very well could say if you support the other political party that's a mental health risk so no health coverage. Have you heard of Operation Chokepoint, closing gun stores' bank accounts? How about the IRS targeting of conservative 501c(4)'s? That's EXACTLY the kind of thing they're doing now as it is. If they can decide who they don't like and shut down their money, imagine what they'd do to you when they can withhold medical care as they wish. At that point, no amount of voting you will ever do will fix that, because guess what, they can levy consequences on you beyond your ability to bear.
Oh, and joy of joys, they already can monitor communications. But nobody is doing jack shit about fixing that problem. Yay, NO ONE can effectively organized political opposition now to any effect because the so called establishment can simply read everything and see it all coming.
Think about that really, really seriously.
Averageman
09-29-14, 15:29
Back when we built quality American made stuff in this country employers had to compete for labor. When employers compete for labor, especially skilled labor they provide incentives in salary and benefits to find and keep them. One of the benefits was healthcare.
Today we farm most of our labor out to third world countries. We are happy to do this because it keeps the prices of consumer goods lower. Slowly though, we have seen many of our jobs go overseas.
We are left with more people now in the job market looking for a good job with benefits. With fewer jobs available to a larger labor force this was eventually going to happen.
Surprised by this?
The answer isn't to demand Government healthcare, the answer is to provide incentives to bring those jobs back.
Overseas they're not stupid enough to tax, sue, and regulate businesses to the point of it being too expensive to operate there. Here businesses spend $35K per employee per year on average to stay in compliance with tax law, state, federal, and local regulations and licensing, avoid getting sued, appease the EPA, OSHA, and a dozen other alphabets instead of putting that money into making stuff and selling stuff. That's the main problem keeping jobs away.
Averageman
09-29-14, 15:55
Overseas they're not stupid enough to tax, sue, and regulate businesses to the point of it being too expensive to operate there. Here businesses spend $35K per employee per year on average to stay in compliance with tax law, state, federal, and local regulations and licensing, avoid getting sued, appease the EPA, OSHA, and a dozen other alphabets instead of putting that money into making stuff and selling stuff. That's the main problem keeping jobs away.
You mean like all that Big Government stuff put in to make this safe and your life so much better?
Look how well the VA is doing with healthcare, that's government provided healthcare in a nut shell. I'm pretty sure in my lifetime as long as the government has their hand in it, most healthcare in America will fall to that level. It almost can't help but do so.
thopkins22
09-29-14, 16:07
The jobs that are gone...by and large are gone. Not coming back regardless of tax policy and regulations. And that's not really a bad thing. In fact economic efficiency and globalism(in the sense of a much larger marketplace and a free market of labor,) is incredibly positive all the way around, even if it doesn't immediately feel like it in whatever dead industry we're feeling nostalgic about. The world is better with cheap consumer electronics being made in China, t-shirts and caps being made in Bangladesh, and so forth.
Certainly the rate at which this is happening is artificially boosted thanks to regulations and corporate taxes, but it would absolutely happen anyway.
Americans are capable of digging ditches too...this doesn't mean we should pine to get those jobs back from backhoes. Not very many t-shirts are made in America anymore, because those jobs are better filled by Bangladeshis. This is okay, and in fact healthy. Americans are now free to use their labor more efficiently, in new sectors or by growing others which grows the economy, grows their wealth, and leaves all of us better off. The same is true of jobs that were filled by Americans that are now filled by illegal immigrants.
There is currently no price sensitivity in the market. That is to say that insurance as it exists today does not incentivize frugality nor finding the best deal for the money. More to the point, it isn't actually insurance...we all have pre-paid healthcare. We need MORE price sensitivity in regards to the customer and the healthcare provider, we need MORE price sensitivity between the customer and the insurance provider. HSA's help, but disconnecting taxes and employer-provided healthcare would be a huge step.
In regards to single-payer, I find it morally superior to the current system of corporatism. The problem is in the description of other systems being "working." First of all, as has been pointed out, there aren't really any functioning single payer systems. Also, you wind up with situations like was suffered by my Canadian neighbor. He was visiting family, went to the Dr. because something was off, and was diagnosed with colon cancer. Apparently he looked aghast at being told that he would be scheduled to begin treatment in six weeks...so they asked if he was insured in the US. He was, so he flew back to Houston and began treatment at MD Anderson(about the best place for cancer in the world,) and began treatment the next day. Single payer acts to artificially lower prices, which leads to shortages.
It does not matter if it is healthcare or chewing gum, if the market isn't allowed to set the price and it is held artificially low, there will be a shortage. Metered parking is exactly the same way. A market price would mean that the price was high enough that you could ALWAYS find a spot, but low enough that most of the spots would be filled.
Averageman
09-29-14, 18:43
The jobs that are gone...by and large are gone. Not coming back regardless of tax policy and regulations. And that's not really a bad thing. In fact economic efficiency and globalism(in the sense of a much larger marketplace and a free market of labor,) is incredibly positive all the way around, even if it doesn't immediately feel like it in whatever dead industry we're feeling nostalgic about. The world is better with cheap consumer electronics being made in China, t-shirts and caps being made in Bangladesh, and so forth.
Certainly the rate at which this is happening is artificially boosted thanks to regulations and corporate taxes, but it would absolutely happen anyway.
Americans are capable of digging ditches too...this doesn't mean we should pine to get those jobs back from backhoes. Not very many t-shirts are made in America anymore, because those jobs are better filled by Bangladeshis. This is okay, and in fact healthy. Americans are now free to use their labor more efficiently, in new sectors or by growing others which grows the economy, grows their wealth, and leaves all of us better off. The same is true of jobs that were filled by Americans that are now filled by illegal immigrants.
There is currently no price sensitivity in the market. That is to say that insurance as it exists today does not incentivize frugality nor finding the best deal for the money. More to the point, it isn't actually insurance...we all have pre-paid healthcare. We need MORE price sensitivity in regards to the customer and the healthcare provider, we need MORE price sensitivity between the customer and the insurance provider. HSA's help, but disconnecting taxes and employer-provided healthcare would be a huge step.
In regards to single-payer, I find it morally superior to the current system of corporatism. The problem is in the description of other systems being "working." First of all, as has been pointed out, there aren't really any functioning single payer systems. Also, you wind up with situations like was suffered by my Canadian neighbor. He was visiting family, went to the Dr. because something was off, and was diagnosed with colon cancer. Apparently he looked aghast at being told that he would be scheduled to begin treatment in six weeks...so they asked if he was insured in the US. He was, so he flew back to Houston and began treatment at MD Anderson(about the best place for cancer in the world,) and began treatment the next day. Single payer acts to artificially lower prices, which leads to shortages.
It does not matter if it is healthcare or chewing gum, if the market isn't allowed to set the price and it is held artificially low, there will be a shortage. Metered parking is exactly the same way. A market price would mean that the price was high enough that you could ALWAYS find a spot, but low enough that most of the spots would be filled.
Okay, but lets not talk about ditch digging or T-Shirt making, how about we talk about the auto industry, computer parts, machinists or engineers?
Seriously, when were ditch diggers or T-Shirt makers so in demand that they could negotiate a contract?
We're not making many of the things we used to and not only are they key to turning out a safe product (just ask GM about Chinese ignition switches) some industry is important to our safety and National Defense. We just aren't doing those things anymore not because we don't want to, we aren't doing them because we can't.
It doesn't matter how fast we can turn out an innovative design if we no longer have the work force capable to sustain its continued production.
As an extreme example:
If suddenly we were on a war time mission to create 5000 heavy transmissions for M1A2 MBT's could we do that without China providing the computer boards and key parts to keep them operating? Could we do it without "Heco in Mexico" be imprinted on every gear?
I don't think so.
Your argument in regards to certain less essential production items being made here, only serves to insure that future essential items wont be made here in the U.S. ever again.
Remember "Shovel ready jobs" to improve our infrastructure promised by our POTUS? What do you want to bet much of that failure was due to a lack of skilled labor and machines available to pull that off?
The only way to keep the balance is to keep the middle class. The only way to keep the Middle Class is to have term limits and have Statesmen rather than Politicians.
The Canary in the Coal Mine moment happened when "None of this applies to us" was voted in with Obama-Care. We should have stormed the Bastille.
There seems to be some misunderstanding on what drives healthcare costs. To clear things up, let's start with the Emergency Department. Of the annual $2.4T spent on healthcare in the US, emergency care represents anywhere from 2-6% depending on whose data you believe. Even if you accept the 6% figure, we are not going to "fix" healthcare costs in America by keeping people out of the ED or making it more cost effective place to practice. That is to say, even if you kicked all of the uninsured and Medicaid patients out of the ED, you are only going to save about 0.5% on total healthcare expenditures because most dollars are not spent on the poor in our Emergency Departments.
This amount doesn't include those uninsured who you admit through EDs. All trauma, all strokes, most of heart from inconsequential troponins to STEMIs to CHF to VTs, all acute abdomens, all bleeders, all threatening OB and deliveries, ODs, sepsis, bad pneumonia, etc, you know better than I do who you admit. If EMTALA went away AND society decided it was OK not to provide to uninsured, cost cuts would be a lot more substantial than 0.5%. Rescue care is the most expensive part.
Current 75 year olds have paid into the insurance system what they were told to, and have no capacity to change their contributions now. I personally would first cut the access to those who are able bodied and don't bother even to buy a catastrophic coverage than to elders who are helpless.
This amount doesn't include those uninsured who you admit through EDs. All trauma, all strokes, most of heart from inconsequential troponins to STEMIs to CHF to VTs, all acute abdomens, all bleeders, all threatening OB and deliveries, ODs, sepsis, bad pneumonia, etc, you know better than I do who you admit. If EMTALA went away AND society decided it was OK not to provide to uninsured, cost cuts would be a lot more substantial than 0.5%. Rescue care is the most expensive part.
Current 75 year olds have paid into the insurance system what they were told to, and have no capacity to change their contributions now. I personally would first cut the access to those who are able bodied and don't bother even to buy a catastrophic coverage than to elders who are helpless.
All of the EMTALA-based care of the indigent, from medical screening through stabilization, represents only 15% of the $880B spent on in-patient care (hospital care). That is only about 8% of the $2.8T total healthcare dollars that were spent in FY2012 according to CMS. These numbers are so small because the disproportionate dollars are being spent on Medicare for the elderly. To put it in perspective, persons over age 65 represent only 13% of the population, but consume 20% of healthcare dollars through Medicare. This is going to grow to 25-30% over the next decade due to the baby boomers.
While it is true that the elderly have paid into Medicare, most will extract far more in benefits. Thus, rationing is unavoidable unless you are will to tolerate a mass tax hike or elect politicians who will make cuts elsewhere.
Again, the crisis in American healthcare is one of rising costs due to market distortion and the future insolvency of Medicare. The issue of indigent care is really an afterthought in the big picture.
montanadave
09-30-14, 09:08
While we might differ on some aspects of how healthcare should be delivered in this country, Sensei, I appreciate your measured, factual, dispassionate contributions to this thread.
I am going to have to review all of stuff from a couple of seminars I took from Brent James. There is more to expenses than indigent, there are also able freeloaders etc.
Regardless of insurance and age status, the highest expense is the rescue care, and we lead the world in it, for better or worse. Why not to start rationing there? 'Cause society won't accept it?
Medicare insolvency being a point nobody could argue with, the reason elderly consume that much care is because they need it. I doubt people of this society will come to rationing care for elderly by means of attitude change because it would mean eventually rationing care for themselves.
Which means either bankruptcy and rationing that way, or massively increased taxation. Or perhaps we can pull our cumulative heads out and enact a multiprong reform that will actually do something meaningful.
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