Thursday, September 10, 2009

Comments on Obama's Health Care Speech...

One of the really nice things about being in the radical middle is that I am allowed to try and embrace the best of ideas from both the left and the right.  My inclinations are somewhat to the conservative side of the fence, but frankly, the conservatives can be ass-stupid sometimes.  I just find that in a few more instances, the liberals can be ass-stupider. 

That sort of goes along with the territory, as the definition of conservatism generally means "conserving" an existing order and liberalism generally involves tinkering with the formula.  The liberals have the harder job:  trying to make improvements on systems that have been proven throughout the entire course of human history.

As some who know me already know, I support Obama's government health care reform.  In fact, I support some of the more radical options including a government-option.  My preferrence would be a Medicare for all provision that allowed every American the ability to enroll in the same health insurance program that our seniors do.

I have some personal perspective on this.  I didn't have health insurance for a few years during my 20s.  Fortunately, I was young and healthy, but I also had to pay for things like an ambulance ride to the ER when a little kid cut my wrist open with an ice-skate.  I also remember removing my stitches with a swiss army knife because I couldn't afford a doctor visit to have a physician do it.

Also, as a small business owner, I simply cannot afford to provide health-insurance to my employees the way we currently fund health care in this country.  I know that a government overhaul that included adding health benefits would be expensive to me.  However, my hope is that it would be possible, which it isn't right now.

We are paying 2 to 3 times more, per patient, on health care in this country than any other industrialized country.  I know that providing health insurance to every American will be expensive, but it makes sense that the following areas are areas for improvement:

1.  Trial lawyers are not improving the health of americans.  Threat of litigation drives insurers and physicians to perform unnecessary tests and procedures and adds to the cost of health care.  Trial lawyers would argue that without the ability to sue, doctors would not perform good medicine.  However, if this were true, we'd have the best medicine the world had to offer.  We don't.  In many cases, our health outcomes are actually WORSE than those of other industrialized nations.

2.  We pay 2 to 3 times more per patient on health care in the US than any other industrialized country.  The medical industry is remarkably non-standardized.  There are centers of excellence that produce superior health outcomes at lower costs.  The Mayo Clinic is one such center.  We need to do a better job of proliferating best-practices through the health care industry.

3.  The pharmaceutical companies are thieves and are stealing from you just because you're American.  They want to destroy the American economy and to prove it, they're charging you about twice what most other industrialized countries pay for pharmaceuticals.  They're charging you 20 or 30 or 40 times what they charge in the developing world?  Why?  Because we'll pay it. 

All we have to do is say we won't pay it, just like everybody else in the world has done, and they'll stop.  Trouble is, their lobbyists are constantly trying to protect their right to steal from Americans.  So far, they're doing a great job.  Any meaningful reform of American health care would include constraints on pharmaceutical costs.  I'm not advocating that we pay any less than any other industrialized country.  I just don't think that paying 50% or 100% or 150% more should be allowed. 

There are other ways we could control costs:  for instance, insisting that we can import pharmaceuticals from any other country in a fee-trade zone.  That way, we could import drugs from Mexico and save 80% or so.  They've already retaliated by threatening not to sell pharmaceuticals to any country that exports them to the United States.  We should counter-threaten to deny the US market, entirely, to any pharmaceutical company that violates free-trade agreements and takes punative action against free-trade partners.  Personally, I wish our legislators would use threats like this as a club to get big pharma to stop trying to destroy the United States.

If I had my way, I'd take every major executive from every major pharmaceutical company one-on-one into a locked room for 30 minutes and show them the error of their ways.  These are America-hating, profiteering organizations who are trying to bankrupt us.  Just us.  Not Canada.  Not Japan.  Not Great Brittain.  Not Germany or France.  Just the United States of America. 

4.  Although aggregate costs will rise moderately, individual health policy cost should, in theory, go down.  Why?  Because we've got a terrible free-rider problem in America.  Employers (like me) who don't offer health insurance benefit if spouses of our workers have health insurance.  ANOTHER COMPANY is subsidizing the health-care of some of my employees. 

Why, you might ask, don't I insure my employees and right this wrong?  One of the main reasons is that I can't afford to subsidize the health-care of SOME OTHER COMPANY'S employees. 

Also, as we all know, uninsured people will sometimes delay care until they have to be taken to a hospital where they receive the most expensive health-care we can offer:  the emergency room.  With regular access to a physician, we may be able to avoid some of these $1,000 ER visits by providing a few $80 periodic checkups.

Overall, I'm not naive.  I know this will cost money.  However, we're already insuring our nation's most expensive patients:  the elderly and the poor. 

When my business was very new, I had a person who worked in my office who made $8 or $9 an hour.  She supported 2 kids and a worthless sperm-donor baby daddy.  They had better health-care at lower copays and deductibles, than my family did under the plan I was paying for, myself. 

So, the idea that "government health care" is worse than what we're getting through private insurance is laughable, in my opinion.

One problem occurred to me as Obama said these words about detractors of Ted Kennedy, a long-time supporter of a government health-care plan:  "In their mind, his passion for universal health care was nothing more than a passion for big government."

Trouble is, it isn't like that.  The problem with Kennedy is that people perceive that his passion for big government was simply manifesting itself at the moment in a passion for universal health care.

I believe health care is a necessary and important government service.  However, the left's willingness to tax everybody to death and try to provide a wasteful government solution to every problem has left people wary.

On this, I will only say:  let's not shoot the messenger in this case.  Not every government program is bad.  Yes, if the left weren't so willing to tax every possible penny away from us, and to waste our money on pointless, stupid and useless government programs, there wouldn't be such a "boy who cried wolf" aspect to this entire debate. 

Which leads me to the next resonant thing Obama said:

"the plan I'm proposing will cost around $900 billion over ten years - less than we have spent on the Iraq and Afghanistan wars, and less than the tax cuts for the wealthiest few Americans that Congress passed at the beginning of the previous administration".

At first, I cringed.  The fundamental need of Democrats to demonize and punish successful people is one of the more embarassing things about the Democratic party, in my opinion.  They may as well come out and say, "We're losers.  We'll always be losers.  We can't achieve anything.  But we can get together and drag down anybody who won't be a loser just like us."

Putting aside the class-warfare implications of his statement, though, there are things that are sometimes worth the cost.  Again, yes, if the Democrats didn't have such an extensive history of simply taxing for the sake of taxing, and spending for the sake of spending, they would be taken more seriously.  However, the Republicans, under George Bush, were guilty of the same thing, just to a much smaller extent. 

I can't help but believe that the one and only government initiative that I can see justifying a rollback of tax cuts, or even justifying an increase of taxes, is the ability to finally provide some health-care security to everybody, and to extend coverage to the 30 or 40 million Americans who currently lack it.

It was refreshing to see Obama finally take the lead on this issue.  He made a grave error by turning this thing over to congressional Democrats to sort out.  Granted, he was trying not to repeat the mistakes of the Clinton health initiative, but handing his program over to a bunch of special-interest whores was a bad idea from the start.  I'd be surprised if more than a dozen of them gave a damn about health care for anybody.  The few things they managed to produce were written entirely by lobbyists.  For example:  the number of proposals that preserved big pharma's ability to destroy America were astounding.  The provisions that made everybody sacrifice, except the labor unions, was impressive.  And not one single proposal to curtail the cost of litigation was brought forth.

I trust Obama.  I think he's an honest man and a brilliant man.  I don't agree with his politics a lot of the time, but I think he's smart enough to learn. 

Most of all, I trust him more than I trust the lobbyists who own Washington.  So, I'm glad he's taking charge of this debte.

9 comments:

John said...

Obama hates the United States and its founding principles, including capitalism and individual freedom. He is a communist and he will take us in that direction as fast as he can. He will compromise whenever he needs to as long as the result reduces individual freedom and gives the government more control over the economy. He loves this issue, because everyone knows that the current health care system is not a free market system and there are certainly plenty things that are wrong with it. Unfortunately, I don't think you will get lower cost or better care when you finally get the government take over of health care that you want.
This one issue won't destroy the nation, but it will be one big step in that direction. Congratulations Obama.

Banana Boy said...

It’s good to see that you’re open minded. I usually don’t jump into the fray when it comes to political debates because most of the time it ends up resorting to ad hominem attacks rather than debating the issue at hand.
I have no problem admitting that I consider myself Liberal and side more with the Dems. Frankly, it’s the lesser of two evils and I think I could present a good argument that if looked at side by side, Liberalism has benefited the country more than Conservatism. Conservatism always seems to be at the wrong end of the stick. I equate conservatism to traditionalism. It was the conservative ideology (I’m not talking about the Dem or Republican tag) who continually fought against civil rights, interracial marriage, woman’s suffrage to name a few. Granted this is a generalization, but traditionalists/conservatives seem to be more wrong than right.

You see, when I read the Constitution and the Bill or Rights I see documents that grant more freedom and rights (sound familiar), not documents that seem to take them away.
As Americans, we tend to be spoiled and unrealistic. We want the government to do everything to protect us and we scream and yell at the Government when something bad happens – like the tainted crap we get from China – yet we continually refuse to pay taxes. Then we find another excuse and call the Government incompetent and argue for more private contracts, which obviously means it will cost money, and so on and so on..
I’m not an economist or mathematician but when someone says we are getting a tax cut, I tend to believe that means less revenue in the Treasury. I think we can all admit by now supply –side just doesn’t work – even the Laffer Curve has been disproved. And it doesn’t matter which party you belong to, no one has been able to really cut Government spending – the private sector relies too much on it. Conservatives love to brag about how they decrease Government spending and they make the Government smaller – unfortunately I don’t think history has shown that.
Anyone who even mentions a tax increase might as well kiss their political career goodbye.
Although I stand firm to my convictions I’ve also said if presented with some solid empirical evidence to disprove my position on any policy issue, I’ll change - seriously. I just wish people would look a little deeper when they consider how they feel about a political issue.
For example, when people talk about letting the invisible hand of the free market fix everything if an issue pops us and conversely start throwing out charges of Communism or Socialism (there is a difference, trust me) whenever someone recommends the Govt fix a problem, they seem to forget how much the Govt. funds the private sector (Pharma R&D, infrastructure, defense spending, security/safety, etc, etc.) A lot of people also don’t realize a large majority of Govt. agencies were created because of the egregious miscount of the private sector (USDA, FDA, EEOC, OSHA, EPA, FLRA, FDIC, etc. etc.) Of course, if you don’t think that the FAA is necessary and you trust the airlines to police themselves and adhere to rigid safety practices, more power to you.
I don’t have any problem with the private sector or the free market as long as they don’t pass their bad decisions off or risk on the backs of the American people – and unfortunately, history has shown that’s exactly was has happened and continues to happen.
Think seriously why are health care system is such a mess in the first place – a few folks thought that the free market was the answer and would fix the problem – but surprisingly the insurance companies care more about the bottom line that they do people. Don’t blame them, it is what it is - a business out to make money. That may work for the airlines, phone service or any other commodity, but when you deal with life or death, it just won’t work.

Regards Jimmy – love the blog.

ArmyNavyGame said...

Thank you so much for your thoughtful and well-constructed comment, Bookeel.

A few things I would point out:

1. When taxes go down, it does not necessarily mean that government's total tax revenues will decrease. Here's a great example: George W. Bush cut taxes for every American and even increased refundable tax credits for those Americans who didn't owe any taxes.

What happened after the Bush tax cuts? Government tax revenues from individual income taxes increased from 793,699 to 1,163,472. (Expressed in millions.)

http://www.taxpolicycenter.org/taxfacts/displayafact.cfm?Docid=203

I don't know about conservatives on the issue of civil rights. However, I do know that republicans supported the Civil Rights act of 1964 to a far greater degree than democrats did in congress.

420 members of congress voted. 290 supported and 160 opposed.

Republicans favored it by 138-34. Democrats 152-96.

I have heard some argue that the Democrats who opposed the act are Republicans now, but I hardly see how that could be the case. I'm not aware of any mass party-defections.

It's not that the congressmen, themselves, changed party. It's that their districts did.

Although that particular blog seems to be a bit hard on Democrats, you'll probably see ones in the future that are as hard or harder on Republicans.

For the time being, though, on this issue, the Republicans are being obstructionist. The Democrats have the ball and can run with it.

BTW: I totally agree with you that Republicans, especially recently, have completely lost the high ground on fiscal responsibility.

Seems that during my lifetime, things work best when the president and congress are of different parties. That way, one acts as a check and balance on the other.

Some of the worst presidencies of my lifetime have been when president and congress are of the same party.

Thank you so much for reading!

Banana Boy said...

You give a cogent, intelligent argument Jimmy. Sometimes when I read your posts, I’m tempted to become a Libertarian :)

Maybe I should have framed my point about the tax cut differently. I guess what I should have said is that revenues would have been higher if the cuts had not taken place thus the deficit and debt would have been lower.

I see it as more of a missed opportunity. While the rich paid a bigger share of the taxes, that’s because their incomes skyrocketed when compared to the middle class whose wages remained stagnant. The tax cuts really don’t benefit the middle class (estate and capital gains – from what I have read hasn’t really to increased investment) To me that’s regressive not progressive.

I’m not playing class warfare, I just think it’s right. To use a Navy example, its only fair that the Officers and Chiefs pay more than the E1’s and E5’s for a party, service fee, whatever – we have to look out for them and when they go up in rank, they’ll have their opportunity to help out too.

Americans really need to be honest with themselves. The Government – which supports the private sector significantly – is incapable of decreasing spending and Americans are unrealistic with their demands of government vis-à-vis their aversion to taxes. I even think Obama is doing the wrong thing by not raising taxes on the middle class by some percent. Something is gotta give…

Regarding my point about civil rights, Dixiecrat, Republican or Democrat – to me the party label shouldn’t be the focus, it’s the conservative/traditionalist ideology that I take issue with. Seems like they are always against change and to support their position, they often resort to scare tactics (the sky is falling, etc.) When people do that, it tells me that they are afraid of actually dealing with the issues.

Look at the conservative/traditionalist ideology across the world. We balk when we hear about another country that is stuck in their old world ways or cry foul when they don’t allow more freedom and rights. We use the term “hardliners” and see it as a pejorative. Which ideology are they more in tune with? Now I’m not saying that conservatives and traditionalists are terrorists or that they’re bad people – my point is that the ideology always seems to oppose progress.

I’ll fully admit I’m a bureaucrat and I love the civil service. It irks me when people continue to attack the Government without realizing how much it benefits the private sector. A perfect example would be the Small Business Administration. Lots of loans and help are doled out by the SBA – hell they even give loans out to folks to want to open a Burger King or Mc D’s. It’s a helping hand, not a hand out.

I just don’t have enough faith in the private sector when it comes to looking out for our best interest. If I have to choose who would better protect me from tainted beef, the food manufacturer or the Govt., hands down I’ll side with the Government.

Later Pork Chop,
Q

Tom M. said...

Lots to comment on here, but for the moment, I'll stick to they "Republicans passed the Civil Rights Act of 1964" canard:
420 members of congress voted. 290 supported and 160 opposed.

Republicans favored it by 138-34. Democrats 152-96.


True. And let's just be clear that NORTHERN Republicans favored it by 138-24, and SOUTHERN Republicans favored it by 0-10. That's right, ZERO Southern Republicans voted for it. Not one. And NORTHERN Democrats supported it 145-9 (stronger than Northern Republicans, you see) and SOUTHERN Democrats supported it 7-87, which is not much, but more than zero. I don't know about a mass defection, but certainly two young Democrats named Jesse Helms and Strom Thurmond defected, along with a young Trent Lott. Hardly unheard-of.

So what you see here is that the lines were not partisan at all, but geographic. And that Democrats in the North supported in greater ration than Republicans from the North, and that Southern D's supported it not very much at all, but greater than zero.

This was spearheaded by another D president, Lyndon Johnson, who named Thurgood Marshall the first black Solicitor General, and who later named him the first black Supreme Court justice.

After the fallout from the Civil Rights Act, the South was ripe for the picking by Republicans playing the race card. And play it they did. Goldwater vocally opposed the CRA in '64 and took five deep south states. This was unheard of, but that's how immediately the Dixiecrats jumped. Look at Wikipedia's articles on presidential elections of '56, 60, '64, and see the sea of blue that appeared everywhere after '64 except for Georgia, Mississippi, Alabama, Louisiana, and South Carolina, which switched from blue to red immediately. THey'd been blue since before 1900. What changed? The Civil Rights Act and the '65 voting rights act that the Democratic administration was pushing hard.

And two years later, the California Republican gubernatorial candidate, a professional actor, stated during his campaign that if an individual wanted to discriminate in hiring or housing against Negroes, it was his right to do so.

ArmyNavyGame said...

Trouble with the Bush tax cuts is that the more you pay in taxes, the more they'll benefit you. They actually did cut rates for the middle class and for the lower classes, they increased the size of the check you got. (Again, though refundable tax credits.)

The real problem is that if you give a guy with a $1,000,000 a year income a 3% tax cut, he saves $30,000.

If you give a guy with a $20,000 a year income a 5% tax cut, he saves $1,000.

So, did it disproportionately benefit the wealthy? Well... yeah, but also no.

A tax cut (or increase) cannot cure (or solve) all of society's ills. So, if you weren't paying much in taxes before, a tax cut just can't do that much for you. (Which is why Bush expandes refundable tax credits so much. Even people who had a $0 tax liability benefitted.)

I agree with you that government gets a bad rap sometimes. I have seen them beat up the post office, for instance, in this health care debate. (As in, "do you want your health care run by the same people who run the post office?") Personally, I think the post office is a great example of a quasi-government service (though it is supposed to be financially self-supporting) that works great. AND it allows for competition from private industry companies like Fedex and UPS. But it will also deliver in places that Fedex and UPS won't.

I was commenting to somebody else the other day that if Obama were to institute a pay-as-you-go funding principle for health care reform, he'd cut the legs right out from under half the opposition. And as examples of government programs that I think are, at the least, less beneficial than universal health care, I mentioned programs like the NEA, funding for ACORN, the Americorps program, etc.

It's hard to cut anything, though. Those programs? Hey, nice to have, but a perfect example of the government not knowing the difference between "want" and "need", in my opinion. If you ask me, we WANT federal funding for the Arts, but we NEED comprehensive health-care reform.

ArmyNavyGame said...

BTW: Thanks to both John and Verbivore for reading and commenting!

ArmyNavyGame said...

BTW: this is an interesting take on the tax-cut issue. It is also predicts some of the issues that we're facing, now. (Tax increases on the wealthy and the need to raise taxes.)

http://www.slate.com/id/2108201

ArmyNavyGame said...

""... "Republicans passed the Civil Rights Act of 1964" canard"

I don't know of anybody who says the Republicans passed the civil rights act of 1964.

"...NORTHERN Republicans favored it by 138-24, and SOUTHERN Republicans favored it by 0-10. That's right, ZERO Southern Republicans voted for it. Not one. And NORTHERN Democrats supported it 145-9 (stronger than Northern Republicans, you see) and SOUTHERN Democrats supported it 7-87..."

I would merely offer that 10 republicans and 87 democrats should have been embarassed by their votes.

According to your logic, the Democrats were more virtuous in the North, because more of them voted for the act. And they were more virtuous in the south, because more than zero voted for the act.

The difficulty is that ultimately, although you make an argument that northern and southern democrats were more virtuous, the Republicans still supported the bill by a greater margin.

At some point, the math ceases to support any claim of moral superiority for the democrats.

Also, as you pointed out, Democratic support was due in no small part to political arm-twisting, threatening, cajoling, backroom-dealmaking, calling in of favors, promising future favors, etc., by LBJ who campaigned tirelessly for the passage of the bill.

No such efforts were made or needed on the Republican side of the fence.

"I don't know about a mass defection, but certainly two young Democrats named Jesse Helms and Strom Thurmond defected, along with a young Trent Lott..."

Trent Lott wasn't even in congress in 1964. He ran for the first time in 1972, as a Republican. Prior to that, I believe he was a Democrat (and was an aid to a Democratic congressman.) But to claim that he changed party because of the civil rights act of 1964 is a bit of a stretch. In fact, he continued to work for a Democratic congressman for 8 years after that vote.

He probably had many reasons for switching parties and maybe the ugly motivations you suggest were part of the mix. But it's pretty hard to connect the dots between the civil rights act of 1964 and him changing parties almost a decade later.

I'd say, again, it probably had more to do with the fact that his district had changed parties, and like any realistic and ambitious young politician, he did what he felt he had to do.

Jesse Helms? Probably a bit closer to what I would describe as being regressive on civil rights matters. Again, he didn't run for senate until 1972. So, to imply that he was part of some defection (large or small) of congressmen due to the civil rights act of 1964 is inaccurate to say the least.

Strom Thurmond? Yep, you're right about that one. He's not a legislator, nor a person for whom I have much use.

But unless there are more that I'm not aware of, we're literally talking about ONE democrat who switched parties. Otherwise, it's as I described: the districts changed, but the politicians didn't. New politicians came along and ran as Republicans and won. The Democrats who used to hold the seats lost or retired.

"This was spearheaded by another D president, Lyndon Johnson, who named Thurgood Marshall the first black Solicitor General, and who later named him the first black Supreme Court justice."

And he deserves a lot of credit for advancing civil rights in my opinion and probably yours, too.

"THey'd been blue since before 1900."

Which, if you ask me, is nothing for democrats to be proud of, either. Why were they solid blue prior to 1964? Because Republicans freed the slaves and Democrats pandered to racists, anti-abolitionists and segregationists.