I’m having an exchange with a left-wing opponent of the Health Care Reform bill (aka Obamacare) here on BlueOregon. But for some reason, BlueOregon won’t let me post. So I’m posting my response here instead.
Barry Deutsch apparently is another of those low-information supporters so common in the NW who repeat superficial talking points about the bill that depend on glossing over the facts.
I wish you wouldn’t get insulting; I don’t think it adds anything to the discussion. When your arguments are solid, there’s no need for personal attacks.
Obama today said this bill is not about health care reform, it’s about protecting the insurance companies from disruption.
I frankly doubt this is true. Do you have a link to Obama saying this?
And we know that’s true because the CBO said this bill will leave over 23 million non-elderly uninsured.
It’s true, this bill “only” insures 32 million. The remaining 23 million are people who will choose to pay the mandate penalty rather than buy insurance. But at least if these uninsured have a critical need for insurance, they’ll then be able to buy into the system — under the status quo, people who can be insured but choose not to, are turned down by the private insurance companies if they find themselves urgently needing medical care.
The only thing that would cover 100% of Americans is single-payer. But single-payer is not going to happen in the US in a single step, anytime in the next two or three decades, and maybe not ever.
If you’re saying that no health care reform that fails to cover 100% of the uninsured is ever acceptable, then you’re saying we can never have health care reform, ever. You’re saying that the 32 million this bill would cover should remain uncovered, forever.
Those who end up with private insurance — the specific benefits are not specified in the bill, by the way
“Specific” benefits? No. But the general scope of insurance under the health exchanges is defined in the bill; all such private insurance must include, at a minimum:
(A) Ambulatory patient services.
(B) Emergency services.
(C) Hospitalization.
(D) Maternity and newborn care.
(E) Mental health and substance use disorder services, including behavioral health treatment.
(F) Prescription drugs.
(G) Rehabilitative and habilitative services and devices.
(H) Laboratory services.
(I) Preventive and wellness services and chronic disease management.
(J) Pediatric services, including oral and vision care.
That’s a direct quote from the Senate bill; you can find it here (pdf file), on page 105.
Note that under the law, all members of Congress and their staffs would have to buy their insurance from the same health exchanges. Do you really think that Congress would pass a law requiring Congress and their staffs to buy lousy insurance?
Under this bill, 32 million currently uninsured people, would be able to buy insurance the same way Harry Reid does. That’s not a bad thing.
As many don’t accept Medicare and various private insurance plans right now.
The large majority of doctors do accept Medicare, actually. And HCR increases Medicaid reimbursement rates, so presumably that will increase the percentage of doctors who take new Medicaid patients.
That said, let’s say that only about 55% of doctors will take new Medicaid patients, and 75% new Medicare patients. If I’m someone who’s broke and can’t afford to see a doctor, I’m far better off if this bill passes and I can get on Medicaid — which means that about half of all doctors will see me — than I am if this bill fails, and I remain too broke to see a doctor at all.
Are you saying that the only acceptable law is one that will force doctors to accept all patients and all insurance plans, against their will? Do you have any realistic plan for passing such a law over the opposition of the AMA? (The AMA is a far more powerful lobby than the private insurance lobby).
Health Care Reform is a good bill, but it’s not a bill that solves every imaginable problem with the health care system under the sun. You can go on forever saying that this bill doesn’t make everything perfect. But we’re still better off passing this bill and then trying to get more in the future, than we are if this bill fails and we’re starting out again with nothing.
Medicare didn’t make everything perfect, either. But it was a vast improvement over the status quo before Medicare, and for that reason it’s good that Medicare passed. The same is true of Health Care Reform.
And for the next four years waiting is exactly what we will boing and people will continue to be die because they are uninsured. [….] We could instead be putting pressure on Congress….
Four years is better than 15 years, which is about how long it has taken, historically, for Congress to try again after each health care failure.
The Democrats have an unsustainable majority in Congress; it’s guaranteed that they will be losing seats this November. If this is the best health care reform the Democrats can do when they have large majorities, what makes you think they’ll be able to pass a much better, more comprehensive overhaul with a smaller majority?
Or do you think the Republicans are going to pass something better when they’re in the majority?
There will be no next chance anytime in the next four years. “Pure” lefties like you have been “pressuring congress” for my entire life; have you delivered universal care yet?
The real world legislative process is messy and full of compromise. A compromised health care bill isn’t perfect; it doesn’t deliver all its benefits until 2014 (although some benefits would happen right away), it doesn’t cover 100% the way single payer would, it doesn’t force doctors to accept patients they don’t want to accept, and it doesn’t eliminate big corporations that make profits from health care.
But the perfect, pure health care plan — achieved in a single step, rather than through gradual improvements and compromised — is much worse than that, because it will never exist outside of your imagination. I’d rather have health care — even if imperfect — than have what you’d offer me, which is a chance to remain pure and die prematurely for lack of health care.
Boy, I sure wish you would post the names of the doctors that will accept Medicare.
I couldn’t find one real doctor in Phoenix in 2002 who would accept any Medicare patients. I could go to doc in a box and get script, but a real doctor, none. I wound up going to Nogales, Sonora, Mexico for health care. No they didn’t accept Medicare but because prescription drugs were so much cheaper, going to Nogales was cheaper than going to doc in a box.
Anyone who thinks that the Veterans Administration has good health care, please, contact me. They tried to kill me three times by trying to give me penicillin that would have killed me cold turkey. Yeah, those guys back from the wars get great service. LIE.
Nicely done, Mr. Deutsch. Passionate, well argued, even if I feel this could have been better handled, and the public option better advocated a year ago. Nonetheless, I reserve the right to get insulting the next we two meet again. That’s what friends are for.
I think the dispiriting thing is that as much of an improvement the health care reform proposal is over the current system, the reformed system will remain flawed and problematic and frustrating. Of course, single payer and other universal health care systems have flaws, too; but they are still vastly better than what the reformed system will be. And for advocates of universal health care it is mind-boggling that we seem systemically, culturally and politically incapable of meeting basic social needs of all our citizens.
When I searched here, I got:
When I narrowed it down to just general practitioners, I got 70, all in Phoenix.
Now maybe a lot of them are unqualified, “docs in boxes,” or whatever … but still … 70.
Next time you’re looking you might want to use that tool.
—Myca
Solved problem by moving to a third world portion of a second world country.
I have 6 excellent specialists. All but one speak excellent English. All of them listen to what I say. They all do house calls. None costs me more than $35 per hour. When they prescribe something new, they usually go and get it for me and make sure that I don’t have an allergic reaction.
When I was in Phoenix, I was asking for referrals to good GPs and psychiatrists and not one doctor was accepting new patients.
I didn’t know of the referral service. Thank you for bringing it to my attention.
I thought this was a pretty good rebuttal. Health care reform is clearly an improvement over what now exists. Many of its weaknesses can be improved on later, though the fact that this doesn’t kick in for four years is pretty crappy.
I would say to progressives that single payer shouldn’t be seen as the holy grail and I also strongly doubt that it will ever happen in the US. France doesn’t have single payer but is rated as the top health care system in the world. Many countries have a mix of private and public systems that would are just as good as single payer. IMHO progressives should generally just drop the idea of single payer though perhaps a few states might want to experiment with it.
I pledge to try to keep the tone of my posts with in the commenting guidelines.
Out of curiosity, which country did you move to?
I’ve thought of doing this, but I worry that I won’t be able to find the comic books I want if I move out of country.
Also, I guess I’d miss my friends and family. So that’s something, too.
Extreme southern Peru. The excellent doctors here cater to the Chileans and the rich Bolivians, this being a tax free zone, the cost is lowered.
I live in the heart of what was the driest desert in the world outside of Antartica, the Atacama desert. The humidity has gone through the ceiling in the last 5 years. Fog from the ocean. No rain, just fog. When I moved her the annual fluctuations in temperature were between 45 and 85 degrees Fahrenheit, Now 37 to 92.
Unfortunately, the weather has changed radically since I moved here. If the normal rain and snow doesn’t come in the next three years, this city will be a dust bowl in 5 years.
If that happens, I will probably move to Namibia or to Morocco.
Comic books and live music do not exist here.
However my excellent internet connections costs me 14 dollars per month (at that price, I can afford two.)
evil is evil: Can a working-class person in your part of Peru get (both in terms of “access” and “afford”) the same kind of health care you describe having?
The excellent doctors here cater to the Chileans and the rich Bolivians, this being a tax free zone, the cost is lowered.
Ah, yes, the Bill Gates approach to health care reform: just move someplace where you are wealthy enough that by underpaying your health care personnel you can afford to pay cash for health care.
In another thread, evil mentions hir generosity in paying for hir cleaning lady’s cervical cancer treatment. Apparently ze has either never considered the question of why she couldn’t pay for it herself. Or ze just doesn’t care.
#8 no, the common worker makes less than $3 per day for a 12 hour day 6 days a week. My employees are paid $5 per day for a 5 day week of 4 hour days. They have health insurance and I pay for dentists and eyes. I am paying for my former interpreter to go to university for her masters degree. No obligations, she is a nice person with a son and needs to have skills when I die.
#9 her previous employer of 35 years fired her when she found out that she had cancer. I really didn’t feel that I had a choice in the matter.
#9 I probably didn’t mention that I had 9 or 10 modern up to date computers installed at the local orphanage. I probably didn’t mention that all of the children in the burn unit at the local welfare hospital get Xmas and Easter presents from me. When the burn unit was running out of morphine last Xmas, the doctor called me and told me that he was running out and that he had a child burned over 90 percent of the body. I bought all of the morphine in town and paid for a doctor to courier a 3 month supply of morphine for the whole town from the capital. The kid died on Xmas day, but not in pain.
I probably didn’t mention (list of charitable contributions)
That’s very nice of you but it doesn’t really solve the problem. If a person in the US who was just as relatively You helped that kid and that orphanage. But what about the ones who don’t have rich American patrons? Wouldn’t it be better for the country to ensure that all the children had health care and that none died in pain, whether they had attracted the attention of a hyper-wealthy foreigner or not?
And what about the Americans in America who die from lack of medical care because they don’t have a patron willing to pay for it?
If a person in the US who was just as relatively
The internet gnomes seem to have eaten the rest of this sentence. It should end “…as relatively rich as you are in Peru helped you with your health care problems would you then say that health care in the US was all perfectly fine?” My apologies for my lack of proofreading.
Jane Hamsher 18 point critique of HCR from the left is here:
http://fdlaction.firedoglake.com/2010/03/19/fact-sheet-the-truth-about-the-health-care-bill/
Anybody got time to do a rebuttal particularly of the cost of insurance to individuals and families?
I am really failing to understand why people are piling on evil–who has probably done a lot more to directly help a lot of people than have many “let’s have health care!” people in the U.S., though I don’t apply that generality to people in this thread.
I mean, really:
Or, perhaps, ze doesn’t believe that ze is personally responsible for the health care system of an entire country, but nonetheless wants to help someone to whom ze has no particular obligation?
Or, perhaps, ze doesn’t believe that ze is personally responsible for the health care system of an entire country, but nonetheless wants to help someone to whom ze has no particular obligation?
Assuming ze maintained hir US citizenship then I suppose ze has no particular obligation to help people in Peru get health care. However, ze is holding up Peru and the inexpensive medical care there as an example of how it should be done without seeming to consider the consequences. I’m sure Evil is evil is a good person and is genuinely interested in releaving the suffering of those around hir. But ze is missing the bigger picture, including the potential problems of being the wealthiest person around by several orders of magnitude.
I’m reminded of a Garcia Marquez story (sorry, don’t remember the title) in which a wealthy US-American goes to Columbia to solve everyone’s problems there. Depending on how you read the story, he may or may not have had good intentions, but if one takes the interpretation that he did, he still somehow ended up owning the whole town.
Sometimes good intentions-or even helping some random people- are not enough. Isn’t that the (if you’ll excuse the phrase) sane conservative argument against the health care bill? That it is so messed up that it will make things worse despite intentions to the contrary?
Consider this however: The bad news though is there won’t be any improvement in the future- afl cio says their members should vote “no” on any future proposal of the public option:
http://workinprogress.firedoglake.com/2010/03/24/afl-cio-to-urge-no-votes-on-all-senate-amendments-including-public-option-if-introduced/
Thus we should focus on campaigns independent of mainstream labor unions because they aren’t delievering:
http://amleft.blogspot.com/2010_03_01_amleft_archive.html#7054449310110997434
The AFL-CIO isn’t telling Senators to vote no on “any future proposal of the public option.” They’re telling them to vote no on *any* amendment to the current reconciliation bill, including one adding a public option, because doing so would cause major complications in everything being passed and implemented.