The American Interest
Analysis by Walter Russell Mead & Staff
Let's Do the Single Payer Pivot

obamacare

Even though it’s called the “Affordable Care Act,” Obamacare’s main goal is expanded access, not lowered costs. But a piece at Wonkblog notes that the law won’t even come close to achieving universal access to care:

The Affordable Care Act, the most sweeping health care program created in a half century, is expected to extend coverage to 25 million Americans over the next decade, according to the most recent government estimates. But that will still leave a projected 31 million people without insurance by 2023. Those left out include undocumented workers and poor people living in the 21 states, such as Virginia, that have so far declined to expand Medicaid under the statute, commonly called Obamacare.

“The law will cut the number of the uninsured in half,” said Matthew Buettgens of the Urban Institute. “This is an important development, but it certainly isn’t the definition of universal.”

This is not the first time Wonkblog has run a post on Obamacare’s lingering uninsured (see here, e.g.) Obamacare’s failure to cover everyone is seemingly the only ACA failure its supporters are comfortable talking about. We’ve noted before that for those who support a public option or a single payer system, some Obamacare’s flaws are actually features, not bugs. If the ACA both succeeds and fails in the right kinds of ways—if it lowers prices, but doesn’t fully expand access—these wonks believe they can make a case for supplementing Obamacare’s reform with even more government regulation and control. Obamacare worked and now we just need more of it.

Expect left-of-center health care writers to more and more ask “what’s next?” and execute the single-payer pivot as the answer.

Published on September 10, 2013 3:45 pm
  • lukelea

    “Expect left-of-center health care writers to more and more ask “what’s next?” and execute the single-payer pivot as the answer.”

    Let’s hope so, and hope they succeed.

    • Loader2000

      If it lowers costs. Since Obamacare does not address the fundamental reason health care costs have gone up so much (that reason being that the consumers who make the decisions are largely insulated from the costs) it is hard for me to believe that premiums will go down. Furthermore, in Europe, the government takes a more active role in limiting expenses in the sense that their regulatory agencies (FDA equivalents) actually take costs into consideration when approving new drugs and medical procedures. The FDA absolutely does NOT do this. In fact, they almost do the opposite. If two diagnostic tests come out and one costs $5000 dollars per test and has 5% accuracy, and the other costs $30 per test and has 7% accuracy, no consideration whatsoever is given to the lower cost of the slightly less accurate test. Furthermore, the %accuracy test limits the FDA comes out with are often arbitrary and go beyond what most doctors would consider safe and effective. I have seen this happen first hand working at a medical device company. Consequently, even the modest reductions in price that single payer systems in France exhibit, wouldn’t happen here unless the extreme pro-regulatory culture of the democratic party somehow reverses itself when it comes to FDA appointees. There is a whole lot more to this that cannot be discussed in a blog comment.

      • I_Go_Pogo

        OK, so when we let geniuses like obama and Pelosi totally take over, and it takes you 8 months to see a doctor, will the fact that it’s ‘free’ matter?

        • bpuharic

          And how long do you wait to see a Dr when you have no health insurance?

          …you wait for the rest of your life.

          • I_Go_Pogo

            Really? I pay cash for my health care- and my doctors are always happy to treat me.

          • bpuharic

            Must be nice to be a billionaire. Or you just haven’t had cancer or a heart attack

            yet.

            Liberals argue evidence. Right wingers argue anecdotes.

          • section9

            But you don’t argue cost. You never do. You’ll always lose that debate.

          • bpuharic

            Sure I argue cost

            Let’s start with

            “Which country has the most expensive healthcare in the world’?

            Care to tell us?

    • ouldbollix

      To libs cost is a non issue until its their money we are spending.
      Look at the so called war on poverty 16 trillion dollars and nothing to show for all the gubmint programs. More poverty now than in 40 years and you have dopey libs saying well tax the rich more and all will be well in libville.
      Well we libs mean well and conservatives don’t so we have to keep taking money from the winners in society to give to the losers and all will be well.

      God libs are the dumbest people on earth.

      • bpuharic

        To the right wing, Mitt Romney’s a winner. He’s rich, you see

        other than the fact he got a $10,000,000 FDIC bailout. But welfare for the rich isn’t welfare. It’s only welfare if it goes to the moochers…the middle class.

  • Fat_Man

    Responding to the failure of the biggest Federal program in history with an even bigger Federal program.

    Yeah, that’ll work.

    • bpuharic

      Funny every advanced nation on earth has some type of govt healthcare. They all work

      Except us. We’re a failure. And the right considers that a victory. After all, people get rich in our system. The poor die

      What better way to prove American exceptionalism?

      • I_Go_Pogo

        Your boy, obama, has already condemned ‘American exceptionalism’ as a blight on the planet.

        • bpuharic

          You by all means provide a reference

          other than Rush (PBUH), of course.

          • I_Go_Pogo

            I should take the time to marshal the volumes of evidence against imam obama that would never penetrate your wooden head? I don’t think so.

          • bpuharic

            Calling Obama a Muslim is primae facie evidence of racism since he’s not. The ONLY reason you’d call him a Muslim is because you hate the black president.

          • charlie_peligro

            he’s also gay and born in Kenya..a blacktard!

          • bpuharic

            You gonna lynch him or just burn a cross on the White House lawn?

          • Chillycat2

            Calling someone a Muslim is no more racist than calling someone a democrat or socialist or episcopalian or a Shriner… Its a group that holds certain beliefs that you decide to be or stay a part of …. Geesh… Frankly saying it is is rather racist of you towards Muslims….

          • bpuharic

            Calling a Christian, black, American president a ‘Muslim” is a code word for ‘foreign’…’alien’. And the most ‘alien’ thing about Obama vs his predecessors?

            He’s black.

            Frankly, you denying it is proof of your racism. It’s apophatic racism.

          • I_Go_Pogo

            You remind me of a phrase obama used last night – ‘pin-prick’

          • bpuharic

            And in YOUR case, you’re half right.

          • I_Go_Pogo

            You are assuming I am white. RAAACIST!

          • bpuharic

            Sorry, sport. 90% of Romney’s voters were white

            Good luck with that.

          • I_Go_Pogo

            And 100% of obama’s voters are brain-dead. Good luck with THAT. See you again,never.

      • ouldbollix

        The way you prove American exceptionalism is to get the government out of healthcare and have each INDIVIDUAL and family care for themselves.
        Touting other countries is a favorite of the libs, they have no idea what they are talking about.
        I lived the socialist healthcare and it isn’t even close to the US system at least until bamster got a hold of it.
        You obviously want others to pay for your free ride. You are also probably on food stamps and welfare. GET A JOB BUM

        • bpuharic

          Fine. Then I’m happy with America NOT being exceptional, and ensuring that every American gets healthcare.

          Liberals go with what WORKS. Conservatives love failure, as long as it’s an AMERICAN failure.

          You obviously feel your life, or those of your kids, is worth nothing. Great. that’s your choice. However, America is a rich country and it’s time we started treating the MIDDLE CLASS like we LIVE in a rich country instead of bailing out the rich everytime they screw up

          You’re a socialist…for the rich.

          • charlie_peligro

            you’re gov’t lacky..ready to look into anyones records, personal info, ready to implement the death panels..anyone who disagrees with you, or is not up to your standards will be gassed, politically outcast…IRS, NSA..mean anything to you?

          • bpuharic

            You’re corporate lacky. Companies sell your info to telemarketers, etc. And insurance companies have death panels that kill people today. It’s done today.

            As to your hysteria about people being gassed

            Look up Godwin’s law.

          • charlie_peligro

            look up IPAB!

          • bpuharic

            Uh…Charlie. You go first

            I was a hospice volunteer. I’m a volunteer EMT. I was a student nurse and I took economics.

            There never was a death panel, no matter what Sarah Palin, in her paranoia, screamed

            I care for the dying. I’ve done it for years.

            There never was a death panel.

          • VigilantNAZ

            Actually, there is in the ACA law, page 373: SEC. 3403. INDEPENDENT MEDICARE ADVISORY BOARD.
            Board members will be appointed by the President and will a mix of government and healthcare industry appointees.

          • bpuharic

            Hey Viggie…you go ahead

            prove that’s a death panel.

            We’ll wait.

          • VigilantNAZ

            You can take your chances, but I won’t! The government is not going to tell me that I or my loved one cannot have a procedure that might save my life because I’ve reached a certain age or because it would cost too much money. I feel sorry for you. You are an acerbic, bitter person who cannot have a civil, respectful conversation for the purpose of educating and persuasion of ideas. I would prefer to live in a country that didn’t think I was too stupid to make decisions about my healthcare, my finances, and my life in general. If I felt so intensely as you do, I would leave the US and live elsewhere. You won’t encounter us self-responsible types in Europe. The most conservative European would be considered quite to the left over here.

          • bpuharic

            And yet insurance companies do it

            every day. So you live in a world of leprechauns and fairy dust.

            You’re an ignorant, uneducated, ideologically bound right winger

            But I repeat myself.

            Unlike you, I’m a patriot. I believe in making this country better, not glorying in its failures, as the right wing does.

      • VigilantNAZ

        It doesn’t work in other countries. Italian socialized medicine, for example, failed my grandfather. They made a determination and sent him home to die. In Italy today, socialized medicine is still the law of the land, but the more wealthy Italians can purchase health insurance for themselves and their families. Whenever one of my relatives has a serious health issue, they come to the US and pay cash for care.
        Socialized medicine is a mine field politically. There always comes a point in time where premiums need to be raised or else coverage will be cut, but it’s political suicide for any politician who even suggests to raise premiums, so coverage gets cut.
        The real solution is expose the cost of care to people and give them the power to negotiate costs and have options other than insurance to pay for care. Allow people to divert pre-tax dollars into health savings accounts. Many doctor visits can be paid out of pocket at a reduced rate. Save the insurance for the big ticket items.

        • bpuharic

          Sure it works. Their mortality rates are similar to ours, except among the poor where they’re better. And in the US, insurance companies ROUTINELY deny coverage for medical procedures they don’t want to pay for.

          And if their medical care is so expensive…then why does the US have the most expensive on earth? Did you really not know that?

          • VigilantNAZ

            No they are not! In Italy, people are more resigned to the idea that no one lives forever and don’t require their doctors to pull out all the stops to save their lives, as they do in the US. Also, the level of care is not on par with the US. If an Italian doctor decides to migrate to the US to practice medicine, they need to go to medical school before they can practice in the US. The US is still the best place in the world for the latest advances in medicine.

          • bpuharic

            If what you say was true, it would show up in healthcare statistics.

            Let’s do what the right wing NEVER does: Look at evidence

            Italy life expectancy: 82

            US:79

            Golly. I guess according to right wing math, 79 is better than 82, huh?

          • VigilantNAZ

            You should be comparing the life expectancy for Americans of European ancestry to the European life expectancy statistics. Your statistics are flawed because the Italians are a homogenous population whereas the US population is very varied. Whereas the US caucasian population, for example, might approach 82%, other races might be much lower, thus bringing the total life expectancy in the US down.

          • bpuharic

            Here we go with the handwaving!

            The EU has

            Germans, Swedes, British, Italians, Swiss, French, etc etc

            More people than the US.

            And their life expectancy is either equal to, or better than ours.

            So you go ahead, keep begging.

          • VigilantNAZ

            The ACA is all about healthcare outcomes based on the input HHS will glean from encounter submission. HHS and IPAB will use this information to determine the appropriate method of care at the least cost. Providers will eventually have to participate in an ACO and give up individual practice, and there, they will be subject to incentives and penalties based on the adherence to these protocols. So, if a provider has one patient that responds well to the protocol but another of the same age, gender, racial background, and condition as the first but does not respond to the protocol, if the provider deviates from the protocol to find a different drug or procedure to help patient #2, the ACO will be on his back because he’s costing the ACO their incentive payment. The ACA describes in detail the back and forth of payments and refunds related to the incentive payment. (How is this an effective use of money and how will this keep a plan’s administrative costs down so that they meet their MLR?

          • bpuharic

            So it’s a method of establishing best practices?

            Yeah that happens in evidence based medicine. We EMT’s do it all the time

            I notice you failed to provide any evidence that anyone will be denied coverage

            HOWEVER, if you’d like, I can provide a list of cases of insurance companies being sued for having their own death panels.

            Unless you’d like to google that yourself.

          • VigilantNAZ

            If someone doesn’t like a health insurance company’s denial of coverage, they can always go to another insurer; where do you go when your government rejects your care? In Canada, if you are denied care, you can’t get it in Canada even if you plunk the dollars to pay for it! That’s not choice! It’s really scary how you think that the government is the answer to all of our problems, that somehow those in the government know better than we do!

          • bpuharic

            You go with what works

            If you lose your healthcare here, no insurance company will cover pre-existing conditions, so your comment is academic.

          • VigilantNAZ

            The problem is that if your way doesn’t work, we will be stuck. The government is not perfect and does not work in the interest of the little guy. You are naive if you believe otherwise.
            I agree that the system we have now is not great, but I am a firm believer that the government is not the solution but an obfuscation. Let the market decide. I would educate adults and even kids about how insurance works. How to determine your responsibility of payment after having calculated the plan’s responsibility. It’s interesting how plans coordinate benefits and how one plan will apply coinsurance before the deductible or count the deductible for one member as the family deductible.

            And I am not ignorant just because I disagree with your viewpoint. I wonder if you would have the guts to talk to me so abusively if we were face to face on this. I harbor no resentment against you. I realize that my viewpoint might not be in the majority but that doesn’t decrease its validity. A great American once said (and I paraphrase), I might not share in your belief, but I will defend you to the death to express it!

          • bpuharic

            Holy cow. I know the right views evidence like vampires view garlic, but this goes above and beyond

            Uh…’my way’ is evidence based

            AND IT’S IN USE IN VIRTUALLY EVERY ADVANCED COUNTRY

            Yep. The right insists we re-invent the wheel. Gotta go back to square one.

            Why? Well…just because.

            Corporations aren’t perfect either. Remember the 2007 recession? Wall STreet isn’t the govt and those folks cost us 8M jobs.

            Let the market decide?

            It did. It failed.

          • VigilantNAZ

            Yes, corporations aren’t perfect, but they can be prosecuted if they break the law. It’s much more difficult to bring an errant government to justice.
            You are always bashing the markets, but no one was complaining throughout the 90s when Wall Street’s activities were padding our 401k accounts. Markets fluctuate. Nothing is fair and even in nature, the lion kills its prey.

            A large part of the 2007 recession can also be placed at the foot of the federal government. Due to the foolish practice of giving out mortgages to people who couldn’t afford them and then pushing off the risk to other financial institutions, here and abroad, directly led to the recession. The fault lies with Fannie Mae, Freddie Mac, as well as most lenders.

            I live in AZ and saw this in my own neighborhood. Suddenly, a dozen houses on my block were empty with foreclosure notices. We left because we knew the values would never come back and we were the only homeowners on the block, the rest being occupied by rentals. The market has come back in Phoenix, and we are seeing the same crazy mortgage offerings again.
            You are not a patriot, sir. You are a blind statist who uses bullying tactics to shout down people who don’t believe with your world view.

          • bpuharic

            Corporations can’t be prosecuted under the law because they WRITE the laws in America. That’s why no one has gone to jail for the plunder of our economy in 2007.

            You’re always singing the praises of Wall Street but you have nothing to say about the socialist bailout of the rich by the middle class under TARP. While you scream about the middle getting healthcare as ‘socialist’, the fact the rich have direct access to our taxes is just ignored by the right.

            Markets don’t fluctuate if they don’t exist. The right sells the fabrication that we have a free market in the US. 5 banks control over 50% of all assets in the country, they’re TBTF

            but GOD FORBID the middle class gets healthcare! That’s socialism.

            You’re a blind corporatist who believes in myths and fables, which have cost the US the middle class on which it depends for survival.

          • VigilantNAZ

            There’s a lot of hyperbole in your statements! I am not “always” doing screaming or singing praises about anything (have you witnessed me doing this?)
            I am pro-business because I have been provided with opportunities to live independently without government assistance because of it. If I were to give up and take the government hand outs, my standard of living would be much lower. I am not blind to how corporations operate, however. I’ve worked for places in which upper management behaves very much like a government: not valuing their peons’ opinions about the business; not sharing more of the wealth that we peons have helped generate.

            But we are human beings, and there will always be those who believe that they are smarter than everyone else and that they deserve more of the lion’s share than anyone else. These people are drawn to positions of power anywhere they can get it (not just corporate, not just government).
            But in a society where the government is not in such control of the people, the effort that I put into my career has a positive effect. In a government run society, I will be impeded from being successful. This is the reason why my family came to the US in the mid 1950s from post-war Italy. Despite their efforts, they lived in poverty. I am proud that my father has been able to achieve the level of success that he has by living this country. All that he has is from his hard work and his intelligence. Back in Italy, it’s who you know, not your ability. And this is what you want this country to turn into. No thanks.

          • bpuharic

            First, giving mortgages to people who couldn’t afford them had zip to do with the financial collapse in 2007. If you’d like, I’ll run the numbers for you, but it’ll make your right wing head explode, so let me know if you have a helmet on. Neither, of course, did the GSE’s; those are more right wing talking points.

            YOU were the one who said I wasn’t a patriot. Since this is 9/11, let me tell you I was IN NYC after 9/11 with the United States Coast Guard. Guess that makes me a red, huh?

            You live without govt assistance?

            Except for govt financed hospitals, roads, schools, water treatment systems, air pollution laws, etc

            The right has such fables and myths as to make an adult blush. Our right wing is the most extreme it’s been in 60 years. You guys keep proving it again and again.

            And another myth you believe…like a great fairy tale meant to frighten children…is that of US social mobility.

            The US and Italy have the lowest social mobility of any western countries:

            http://en.wikipedia.org/wiki/File:The_Great_Gatsby_Curve.png

            So far EVERYTHING you’ve said has either been a myth or a lie.

            Shall we continue?

          • VigilantNAZ

            Giving people who can’t afford to pay for a mortgage was definitely a contributory factor in the 2007 recession. I lived through it. I saw it first hand. My perceptions are not a lie. I am making the same salary as I had in 2007. Food and gas cost more than they did in 2007. I am my family’s sole wage earner. I know about every cent that goes in and out of my accounts. I cannot afford the things I used to in 2007. I am driving a car that’s almost 15 years old and I will drive it into the ground. I do not have new things, but I have two children who need clothes and things and I am struggling to give them as much as I can. I don’t take anything from the government; it takes from me, at the local, state, and federal level. If I go to the hospital, I get the bill.

            I wouldn’t take too much credence in Wikipedia, but it’s no surprise that the level of mobility in the US vs Italy is parallel, especially in the past 5 years. Obama is trying to bring the US down to the European standard. He’s doing an amazing job. We are no longer #1, he’s made that abundantly clear by his actions.

          • VigilantNAZ

            Let’s see what your perspective is 5 years into this healthcare quagmire. Let’s see how your financial situation is. Unless you join the government, I think you will be struggling more than you are now.

          • bpuharic

            More special pleading. Germany’s going fine. So is Canada. France. Sweden. Etc. etc.

            And their systems are older than 5. The evidence is in

            Your view is a failure.

          • VigilantNAZ

            So quick to dismiss and win this argument! However, I am not wrong. These countries aren’t going to collapse in an instant. Socialism is a failure that takes a long time to collapse. There are many death throes. Look at Greece. It’s in bad shape, but it’s not dead yet. It can take a long time for a government to collapse. But once it gets to a point that a government has reached critical mass, it will explode (or implode). But everyone will know that things aren’t as good as they used to be.
            Europe will have a problem if the US stops having its back militarily. These countries have been able to afford their socialist policies in part because they don’t have to spend the amount that we do for defense. The moment there is a military threat, Europe comes running to us. If Obama is right and is successful with his plans to make us Europe, we won’t be able to come to their rescue. This could speed the ruin of these nations along.

          • VigilantNAZ

            Can’t really see anything militarily happening though. Europe is proceeding with its islamification very nicely, so there’s no reason for an Iran or other militarized Islamic country at this point to decide to take over Europe. Maybe Putin or his successors might decide to take Europe for Russia. All big IFs, but my point is that as long as Europe does not have an existential threat from another country, they will plod on slowly to their own eventual demise when they finally run out of other people’s money.

          • bpuharic

            And what’s the right wing gonna do in the US when they run out of middle class money and can’t bankroll the rich via TARP programs

          • VigilantNAZ

            The Right Wing is totally out of power right now.The Republicans in DC are really distinguishable from Democrats. We have no representation at this point.If I had my way, senators and representatives would only be allowed to serve one term and the federal government would be limited to defense. Let social aspects go to the states. The primary responsibility of the federal government is to protect its people from invasion.

          • bpuharic

            Really? Ever hear of the House of Representatives? It’s the most right wing it’s been in 60 years. Google it.

            And who says the primary responsibiility of the feds is to protect us from invasion? Rush (PBUH) may believe that.

            I don’t. Nor does the constitution.

          • VigilantNAZ

            Congress is split between the parties. Nothing that one body passes will be passed by the other.

            I believe that the responsibility of the federal government is defense. I am my own mouthpiece. I do not regurgitate the ideas of others. You project alot. Is that what you are doing?
            The purpose of the US Constitution is to ensure that the federal government is limited. The power belongs to the people and it’s been steadily eroded since the end of the Civil War. Late nineteenth century Presidents expanded the federal government, Chester A. Arthur being one such example. Obama seems to be accelerating this process. If Obama does step down after this term and another like minded President wins election, the Europeanization of this country will be complete.

          • bpuharic

            God it’s a good thing I don’t have to sit in a room and listen to the right wing drone on and on about ‘limited govt’ except when you’re busting labor unions or passing laws on abortion, or homosexuality, or a thousand other laws that destroy the middle class while protecting the rich.

            End of the civil war? Yeah all those laws on civil rights were a real drag on state’s rights, weren’t they? Because we know how free blacks were under ‘states rights’

          • VigilantNAZ

            I agree that it is a fine line, but it should be up to the states to
            make these determinations, although I will make an exception for civil
            rights, which should be under the federal umbrella under the argument
            that the federal government should guarantee the freedoms and liberties
            of its people, regardless of race, creed, or color. The people of each
            state should decide if laws are required in regard to the other issues,
            regardless of person opinion.

          • bpuharic

            Liberals argue evidence. Conservatives argue anecdotes

            No one cares what your mechanic’s barber’s aunt saw. What counts is evidence

            For the last 30 years, home ownership in the US has ranged between 64-68% of all households. That marginal change is not enough to damage our economy

            BUT…between 1997 and 2007, credit default swaps increased from

            $320 BILLION in 1997

            to SIXTY TWO TRILLION DOLLARS in 2007 an increase of

            TWENTY THOUSAND PERCENT (and more than the GDP of the entire planet)

            So go ahead. Convince me that a MARGINAL change in home ownership was drowned out by a 20,000% casino game played by Wall Street.

            And this happened BEFORE Obama.

            You’re Italian? Why not blame Pompeii on him while you’re at it?

            Makes as much sense.

          • VigilantNAZ

            If liberals truly cared about evidence, they would be the first to point out the fact about their Emperor’s new clothes! Obama is a product of Affirmative Action, a man who has had everything handed to him on the basis of his color, regardless of his actual ability, which we are seeing every day, is limited.

            Your arguments are getting more and more incomprehensible and desperate. Why would I blame Pompeii?

            I do not blame Obama for creating the mortgage crisis, but I do blame him for doing things that extended it.

          • bpuharic

            Ah, let’s play the race card when we lose an argument…that’s the right wing’s favorite scam.

            You’d blame Obama for Pompeii because you’re blaming him for the recession which hit in Nov 2007, over a YEAR before he became president. Why be so selective? If you’re going to lie, go for the big one!

            And what did he do to extend it? He tried to get the banks reregulated, which the right wing has fought. TBTF has gotten worse, but the right wing, in love with moral hazard theory for the middle class, but ignoring it for the rich, just plows on defending the banks.

          • VigilantNAZ

            If the government really wanted to lower healthcare costs, they would look at all the disparate administration systems these plans have for claims processing, payment, eligibility, and provider management! It’s a nightmare. Sure, they implemented the HIPAA transactions, but plans don’t always use them the way they were intended and you still have to contend with data mapping. CMS doesn’t even use HIPAA for Medicare. It uses this antiquated data format from the 1970s (RAPS).

            Plans also need to make their rates transparent. Many balk, claiming that this is proprietary but that’s ridiculous! A doctor should be able to post their rates for the most common services. Americans also need to not accept the fee. Inpatient bills are filled with inflated prices that the hospital bills in the hopes that it can make up for the nonpayment of services from patients who could not pay. I can see a whole industry popping up to advocate for patients, regardless of coverage, to help them negotiate payment with providers and advise patients before and after a procedure about what charges are real and which are bloated.
            The ACA law is not going to address any of this.

      • rmkdbq

        By work, do you mean the NHS in Britain? The almost broke system where people have literally starved to death in nursing homes. The system that requires people to wait months for an appointment and then wait months more to see a Dr and then more months waiting for treatment. The more Gov gets involved in our system, the more broke it becomes. Oh by the way, we do have Gov healthcare it is called Medicare and Medicaid and they are teetering on the verge of collapse. At some point you should pull your head out of the sand and see what is really happening in the world.

        • bpuharic

          Guess you didn’t realize San Francisco is suing Nevada for patient dumping. In our free market system. Funny how you ignore our failures, isn’t it?

          And which country has the world’s most expensive healthcare?

          Guess Rush (PBUH) didn’t let you in on that little secret.

      • MTF2

        “They all work”

        That’s why Canadians visit the US for necessary care. That’s why a primary mission of the NHS is to kill citizens, via the Liverpool Pathway”. That’s why authoritarian governments transitioning to freer policies first allow private medical care, like in China and Russia.

        They “work” only for the deluded.

        • bpuharic

          You right wingers really don’t know much about the US do you, other than what Rush (PBUH) tells you

          Look up “Medical Tourism”

          500,000 Americans go abroad every year for medical care they can’t afford here.

          You were saying.

          • ptm

            WE CAPITALISTS, FREEDOM LOVING CITIZENS vs Socialists/Communists.

          • bpuharic

            There are no socialists left. So your tin foil paranoia, itself, is evidence you need treatment.

          • ptm

            You’re PROOF positive they EXIST!

          • bpuharic

            The right uses ‘socialist’ like the left uses ‘nazi’.

            Both are evidence of brain death.

    • ouldbollix

      Govt is always their response, more and more and more gubmint and the bigger the failure of the first program the bigger the follow up program will be.

  • bpuharic

    So the deliberate decision of right wing states to deny healthcare to their poor citizens is a flaw of Obamacare?

    Folks…you can’t make this stuff up…

    • mariee

      Your B.S. propaganda isn’t working anymore. No one has ever been denied medical help because they are poor. You just try to scare people to get your way. In Arizona, I can’t tell you how many times illegals crossing Illegally! have had to be rescued because of a van accident etc. We have had vans with 20 people roll on our highways, everyone of those people received outstanding care!

      • mariee

        Oh, and if the government would just get out of the way, the private sector and charities would do a better job helping people that need a hand up, not a hand out!!!

        • DrDean

          Exactly. A nation of people who help themselves is always better than a nation that thinks the only way the poor can prosper is by continuously enlarging government and spending more.

          Moral hazard is killing this nation and most moral hazard today comes from government.

          • bpuharic

            Moral hazard? Funny how the right FIGHTS banking re regulation even though we had to bail out the rich

            Guess moral hazard only applies to the moochers…AKA the middle class.

          • VigilantNAZ

            You have no idea what you are talking about! How is the middle class the mooch class? I would not be able to be in the middle class if I did not work to support to myself and my family. We currently have people living off “funemployment” for 99 weeks!

            This law will impoverish hard working people like me, who have more pride than to live off government hand offs.

            If you make 400% of the federal poverty level, you will qualify for a federal subsidy of the premium for participation in a healthcare exchange. However, HHS says that my spouse is not considered a dependent, so my subsidy won’t cover him. And employers won’t be contributing the 70-80% of premium costs that they used to, so I will have to pay for a huge portion out of post-tax dollars. If I happen to get a raise or bonus that puts me over the 400% FPL, I will have to return some portion of the subsidy back to the IRS.
            If I lose my job, I MUST continue to pay my premiums! No more COBRA! How are people who lose their jobs in the future going to be able to pay their rent/mortgage, put food on the table, and pay their premiums? If they don’t, this money will be due come tax time. People who rely on tax refunds will be sorely disappointed.

          • bpuharic

            Don’t ask me, ask the last GOP presidential candidate who said the middle class was moochers, while he was getting welfare.

            COBRA? that’ll cost FAR more than Obamacare.

            And, again, which country has the MOST EXPENSIVE healthcare in the WORLD?

            I notice you refuse to answer.

          • VigilantNAZ

            I actually didn’t refuse to answer, I didn’t realize this response was here. Why are you so hostile? Is it only with people you don’t have face to face conversations with?
            Romney said that 47% of the US citizenry are dependent on government handouts. This figure does not constitute the middle class.

            Healthcare costs are expensive in this country but the quality of care is the highest in the world. As I have explained in previous posts, the ACA law does not address the way health insurance companies manage their processes. There are disparate data systems, antiquated processes, duplicative work, and people who are resistant to change. The ACA implements the Medical Loss Ratio but at the same time increases the amount and complexity of reporting that these plans have to do. In order to participate in an exchange in CA, a health plan has to purchase a specific computer system based on the number of lives so that HHS can access their encounter data for clinical analysis and premium rating. All the processes, as well as the expense to purchase and maintain these machines, adds to the overall administrative costs, which increases the likelihood of a plan not meeting its MLR for a given plan year.

          • bpuharic

            Who could guess that half the population excludes the middle class?

            If we had the ‘highest quality’ of care, it would show up in life expectancy stats

            It doesn’t. The US ranks something like 36th. It’s a typical right wing talking point.

            Why am I so hostile? Because, I’m middle class. I’m tired of right wing lies. I’m tired of justifications for an economic system that destroys the middle class while making the rich INCREDIBLY rich, and being told it’s god’s will because the US is exceptional and is a light on a hill or other somesuch Calvinist nonsense.

            Computer systems are a minor component of all costs. In fact, we know from private business that hte massive investment in IT has paid off in increased productivity.

          • VigilantNAZ

            And you trust the government to protect the middle class? Who’s being facile here?

          • bpuharic

            If the govt is of the people, certainly. The right has allowed our govt to be hijacked by their Wall Street masters which is why we keep having to bail out your rich friends under right wing socialism

            Bank robbers and rapists are also in favor of small govt. Drug dealers are too. That’s why drug dealers set up shop in small towns.

            Wonder why

          • VigilantNAZ

            Stop with the right! It’s the right and the left! NYC and the entire Eastern seaboard is filled with people on the Left! They ran the show back in the 90s when everyone was making money, unemployment was around 4%. They are running it still. It has nothing to do with left and right. It has to do with grabbing power and being greedy.

          • bpuharic

            I agree. But the right has constructed an elaborate mythology, based on Calvinistic fundamentalism, and supply side mythology, to justify the plundering of the middle class with this Horatio Alger nonsense. It’s all wrong. All a lie But it’s destroying the middle class.

          • VigilantNAZ

            Please explain. My understanding of Calvinism’s influence is that of hard working, self reliance. Sloth is a sin. I can see this being a “tool” of the right in that sense and I think it’s what has made America great. I see that it is eroding to some extent, with our young adults especially no longer buying into working hard producing results. But I don’t think it’s a bad ethic for people to have and I don’t agree that just sitting on your hands and letting some government entity hand everything over to you when you haven’t done anything to deserve it is good for anyone.

          • bpuharic

            Calvinism is a belief in predestination, with the idea that god will shower financial blessing on his favored. Thus, if you’re rich, it’s evidence that you’re saved.

            And the rich are the new welfare class. As Joseph Stiglitz has pointed out, we’ve privatized reward and socialized risk. The rich, as a study released YESTERDAY found, took the largest share of national income since 1927. But when they blow up the economy, they run to the middle class and get TARP bailouts.

          • VigilantNAZ

            OK, but I don’t agree that the government is the entity that protects the middle class from the upper classes. The government is like the king; no one can stop it from doing what it wants and it can turn on a dime. I do believe that a rising tide will lift all boats and I can attest to that. It was so easy to find a job, start up a business, make money back in the 90s. People expect the markets to go up forever, people expect their 401ks to increase forever. That’s not natural, not the way things work. Banks capitalized on greed; as with any other business, they need to exceed last year’s profits and need to find new ways of making more money. Thus, they came up with derivatives and other risky ventures, passing on mortgage debts to others. It was bound to happen.

            The middle class is a fairly new phenomenon, first arising during the Middle Ages in Europe when people started leaving the feudal lands and forming guilds in towns. The upper classes have always viewed the middle classes with contempt. Here in America, we don’t trap people in classes; there is social mobility. The fact that it has been lower these past few years is the affect of enduring unemployment and underemployment since 2007. The increased regulations on banking and on business has also had the negative impact on the development of new business, which originates by middle class people. We are seeing a shrinkage of the middle class. It is my fear that ACA will further shrink the middle class because it’s essentially setting a ceiling (the 400% FPL which is currently $85k for a family of 4) and lowering the overall incomes of middle class people who make 6 figures. The way to protect the middle class is to grow it. Government and the banking institution are in collusion. We need ultimately to shrink the federal goverment so that they cannot collude with upper class and their institutions.

          • bpuharic

            Sure the govt is what protects the middle class. That’s what laws DO. If they didn’t, we wouldn’t have prisons.

            A rising tide doesn’t life all boats, no matter what you believe. That’s provably false:

            http://dish.andrewsullivan.com/2013/09/11/americas-recovery-is-in-full-swing/

            And it’s funny that when Detroit fails, it’s the fault of the labor unions.

            When the rich trash our economy, that’s a ‘business cycle’.

            Social mobility? Look up “Gatsby Curve”. Look at which country is the worst for social mobility, other than Italy. I don’t want to spoil your rosy view…but if you have the courage, check the data.

            Elizabeth Warren pointed out we regulated banks after the 29 depresssion and we didn’t have another one until 2007, about 10 years after we REPEALED deregulation. Funny how that works.

            American businesses are sitting on 2 trillion in cash. How much money are we supposed to give them before they start creating jobs?

            And what makes you think that if you shrink govt business will be more generous than it is now?

            The right has always believed in 1 dollar, 1 vote. They said so in “Citizens United”. We now have the best govt money can buy

            0.01% of contributors gave 28% of all political contributions in the last election. Do you think that’s healthy ? Conservatives do. Justice John Robert, Scalia, etc. do.

          • VigilantNAZ

            Can you please read this article with an objective mind and share your thoughts? http://www.americanthinker.com/2013/09/why_millennials_wont_turn_conservative.html

          • VigilantNAZ

            The real problem with allowing a government to run your health care is that if there are mistakes, it takes an act of Congress to override them!
            I say we take the power away from both the government and the insurance companies. I know most people don’t want to deal with healthcare claims, but we must in order to wrest control from them. We have become docile sheep when it comes to this aspect of healthcare. People need to know the cost of care. They need to be able to save pre-tax dollars in a health saving account that they can spin off to an adult dependent to help them get started as well as leave it as an inheritance–without being subject to estate taxes.
            There was a recent study about how the average elderly couple needs about $300k to finance their healthcare costs. Imagine if people could save for healthcare as they can for retirement! That is power to the people!

        • bpuharic

          Proof? If that were the case we wouldn’t have had massive poverty in the late 50′s and early 60′s until the govt stepped in

          We DID have churches back then, you know.

        • VigilantNAZ

          The government can never help the people as much as the people can help themselves. I think you need to go live in a socialist country and see for yourself. Our ancestors left these countries because they wanted the fruits of their labor to result in a livable lifestyle. How sad they would be to find that the US is becoming just like the country that they left.

          • bpuharic

            The right wing uses ‘sociallist’ like the left uses ‘nazi’.

            Neither word means anything today except the user is brain dead.

          • ptm

            Because they’re interchangeable!

          • bpuharic

            Actually only the Rush (PBUH) right says that because they don’t know history

            Nazism was fascist. Fascism, as defined by Mussolini, was the fusion of state and corporate interests. I’m not saying this is the stance of the GOP…

          • ptm

            So KRUP Industries among thousands, didn’t exist in Germany? You’re a lying Alinsky devotee.

          • bpuharic

            Who bankrolled hilter? Oh…

            Krupp. Like I said..fusion of corporations and the state

            busting of labor unions

            you know…right to work laws..that kind of thing

          • ptm

            So in just one posting you got caught in a LIE, had to backtrack and ADMIT that PRIVATE ENTRPRISE funded Hitler!

          • bpuharic

            WTF? Gee. Of course private enterprise backed hitler

            I’ve never claimed otherwise.

            Don’t read much, do you?

      • bpuharic

        And your proof that no one’s been denied?

        Tell you what. You go to a dr. Tell him you have no health insurance and think you have lung cancer. See what happens.

        You’re too brain dead to realize that right wingers think ‘emergency care’ is ALL there is to health care

        I suggest that, if you don’t know what you’re talking about, stop, for god’s sake, listening to Rush (PBUH)

        • Chillycat2

          And just what evidence do YOU have that having insurance means you get any care… Ever lived in the UK or even Canada… Well I have and having insurance has about the sesame value as an Obama promise…isn’t worth the paper it’s printed on!

          • bpuharic

            I’ve been to Canada. And the UK. Don’t recall seeing that either was like Calcutta, with people dying on the streets. And their life expectancies are at least as good as ours while their medical care costs less

            But no one gets rich off medical care in those countries…which is what the right wing objects to.

          • Chillycat2

            Oh so you have been there… Oh well… I stand corrected.. I guess having lived there for years and having had to be subjected to their socialized medicine and long waits and denial for care notices…Well you having gone on vacation there and not seeing piles of body in the streets MUST mean the horrible second rate care I had didn’t really happen…good to know

          • bpuharic

            Liberals argue evidence. Conservatives argue anecdotes.

            Life expectancy differences?

            Europeans are generally higher.

            No one cares about your Reader’s Digest anecdotes. Evidence is what mattters.

            So let me know when you’re done standing in the checkout line of the grocery store, reading the Digest, OK?

          • ptm

            The GREAT BRITISH Health Care system:

            “In comments that appeared to prejudge an
            official inquiry into the LCP, the Health Secretary said ‘one or two’ mistakes
            should not be allowed to discredit the entire end-of-life system.

            But Elspeth Chowdharay-Best of Alert, an anti-euthanasia
            group, said: ‘The Pathway is designed to finish people off double quick. It is
            a lethal pathway.

            ‘Mr Hunt
            has made a nonsense of the claim of his ministers that there is going to be an
            independent inquiry.’

            The review follows a public outcry over a string
            of disturbing cases, highlighted by this paper, in which patients or their
            families were ignored.

            The pathway involves withdrawal of lifesaving
            treatment, with the sick sedated and usually denied nutrition and fluids. Death
            typically takes place within 29 hours.

            The 60,000 figure comes from a joint study by
            the Marie Curie Palliative Care Institute in Liverpool and the Royal College of
            Physicians.”

          • bpuharic

            I googled ‘health insurance company sued for denial of care’

            I got 4.2 million hits.

            You were saying

          • ptm

            You’re STILL an IDIOT, of course Insurance companies turn down people, just as MEDICARE does. In fact they turned you down for your mental condition, nothing can be done, it’s genetic. BUT they DON’T KILL 60,000 people!

          • bpuharic

            So insurance companies have death panels that kill people and that’s good

            Govt has death panels (which it does NOT and which you haven’t PROVEN) and that’s baaaaaddd!!!

            Money good! Govt bad!

            Death? irrelevant.

          • ptm

            Show us the DEATHS by Insurance companies. I’ve shown you the OFFICIAL Liverpool Protocol with it’s DOCUMENTED DEATHS. The IPAB is exactly the same thing, modeled after the British system, Emmannual ADMITTED to it.

          • bpuharic

            Uh the IPAB has NO statutory authority to determine healthcare. None. It’s an advisory body. Not a regulatory one.

            I realize that to the right wing, corporations are gods, but some of us actually prefer EVIDENCE.

            And too lazy to use google? Pehaps you can’t read…just listen to Rush (PBUH) all day?

            Here you go:

            http://www.nbcnews.com/id/22357873/ns/health-health_care/t/family-sues-insurer-who-denied-teen-transplant/#.UjDCH8bkt8E

        • VigilantNAZ

          I’ve been working in the healthcare industry for over 13 years with a focus on the ACA law. I review the federal register on a weekly basis and review the interim and final rules. This law is a threat to my individual rights and freedoms as an American citizen. I have first hand knowledge of so please don’t insult my intelligence.

          People need to get smarter about health care and payment! We overuse health care insurance. I don’t submit a claim to my auto insurance for an oil change, so why am I submitting a claim for routine, non-emergent care?

          Americans don’t like negotiating but a provider would much rather be paid today than have to wait for payment from the health plan or government.

          • bpuharic

            And with all that experience, you’re still wrong. Guess your right wing ideology corrupted your ability to think.

            If you HAD intelligence, I’d insult it, so you’re starting from a false premise.

            This law SUPPORTS my freedom by ensuring my family and I have access to quality healthcare. That’s American patriotism.

          • ptm

            FORCES your family – Totally UN-AMERICAN.

          • bpuharic

            Hmm…I guess you never went to school, huh? Totally unAmerican!

    • VigilantNAZ

      Go ahead and blame the right wing without presenting any facts! This is really a left wing conspiracy to control the people of this country.

      The government does not have any expertise in healthcare insurance administration. Just take a look at Medicare and Medicaid.

      And doesn’t it disturb you that the government will have so much information on you? Not only name, SSN,and DOB, but your health status, your marital status. Preceding this law is the federal requirement to update is diagnosis code set from ICD-9 to ICD-10. These codes are part of encounter submission data that CMS currently requires Medicare and Medicaid plans to furnish so that they can determine the premium rate for the following year. For Medicare, it’s quite subjective. Your premium will go up next year if you had high utilization this year and your diagnoses for utilization represented a high risk for the government. CMS is using the same model for healthcare exchanges. Imagine the bulk of the populace healthcare status data going to the government for bureaucrats to sift and make judgments upon! And this information is to be stored in a system that currently has not be completed yet and is vulnerable to illicit attack.I can see the number of identify theft increasing with the full implementation of this law. Another unintended consequence.

      • bpuharic

        Death is a pretty good method of control, and the right loves it.

        No expertise? Let’s see…we went from no expertise to putting a man on the moon in 10 years. Golly. What a failure! And EVERY advanced country does what the right wing says we can’t do. Apparently they love failure as long as it’s an AMERICAN failure.

        You’re paranoid. Doesn’t it bother you that you may DIE rather than get healthcare? That your kids may die?

        If it’s a choice between giving up my SSN, and getting rid of my tin foil hat, or DEATH, let me dump the hat.

  • Chillycat2

    Ok the 20 million illegal aliens….not our problem to provide healthcare… We didn’t ask them to come and don’t force them to stay so we owe them exactly ZERO. When and how did people people start thinking we owe them anything?!?! It defies all logic and good sense…

  • I_Go_Pogo

    Let’s NOT. Eff obama, and anyone who is still allied with that son of a Kenyan marxist.

  • SteveAR

    The state of Oregon recently put out a study over a 2-year period on the effects of poor people being on or not being covered by Medicaid (roughly 13,000 people, with about half on Medicaid and half that weren’t). The results showed virtually no difference in the health of the people in the two groups. Obamacare supporters, who are stuck in their narrative that health care coverage equals health care, have ignored the results of this study as it completely refutes their narrative.

    Also ignored by Obamacare supporters, especially those who want single payer, are all the negatives, especially the greatly lengthening wait times for health care.

    And one other thing. All of those supposedly civilized nations that have universal health care aren’t the United States in either population, area, or the nature of our system. Unlike say England or France or Germany, countries with primarily homogenous populations and limited in area, the U.S. is made up of wholly diverse people spread out over an area larger than those three combined. Our culture isn’t just one culture, but many, whereas that cultural diversity doesn’t exist in those countries. So the idea that the federal government can direct a single plan like this is folly; this is shown by how each state can decide on how Medicaid works for that state. I’m sure some will say that the federal government Soc. Security and Medicare programs are successful without being beholden to the states; that’s only true if one ignores the fact that those programs are going bust.

    I have no doubt Democrats passed Obamacare so that it would fail in order to promote the disastrous single payer. And if single payer fails, which it will, the results will be ignored by its advocates since all that matters is the narrative and government control, not health.

    • VigilantNAZ

      Exactly right on the homogeneous population and impact on healthcare. Countries like Sweden and Japan, whose populations are ethnically homogeneous and small, can better predict healthcare outcomes because there is not the divergence of reaction to care as in the US. And the small population of these countries makes it easier to control both from a process and financial prospect.

      • bpuharic

        The EU is bigger and more ethnically diverse than the US.

        They have universal healthcare

        Oh well…facts have a liberal bias,it seems.

        • ptm

          You’re an IDIOT – ” more ethnically diverse than the US”, close to 50% minorities in US.

          • bpuharic

            Only an ignorant, provincial American would say there’s no difference between a Swede and an Italian.

          • ptm

            You’re a VERY stupid person, an Alinsky wannabe, EACH European country has it’s OWN Health plans – IDIOT.

          • bpuharic

            Hey genius. Which one of them costs more than the US does?

            None. And go ahead convince me how ethnically homogeneous Sweden is compared to Italy.

          • ptm

            QUIT trying to be a baby Alinsky, Apples and Oranges!
            What part of “WITHIN” individual countries are you missing – ON PURPOSE.

          • bpuharic

            And what part of ‘Less expensive than our system” don’t you understand?

            But go ahead. Keep telling us how Swedes are identical to Italians.

          • ptm

            Back to Alinsky – change subject.
            Keep repeating your idiotic mantra – it STILL REMAINS – WITHIN COUTRIES.

          • bpuharic

            Which, of course, is irrelevant.

          • ptm

            And of course you asked the Swedes, Italians and the OTHERS if it’s RELEVANT to them whether they’re called Italian or Swede or from Timbaktu.
            You need a good Mental heath expert, maybe your Health Insurance can help with that – forgot – it’s GENETIC, not covered.

    • bpuharic

      Oh look, 26,000 Americans died last year due to lack of access to healthcare:

      http://www.healthcarefinancenews.com/news/study-26000-premature-deaths-2010-tied-lack-health-insurance

      Wait times? Uh..how long do you wait if you have no health insurance? Answer: the rest of your life.

      By the way…the EU is larger than the US and they have universal healthcare. They’re more diverse than we are as well.

      So other than the fact you’re wrong about EVERYTHING…do you have anything to say?

      • VigilantNAZ

        First of all, it is not the government’s place to require or force people to have healthcare. My mother in law was an alcoholic and heavy smoker for most of her adult life. Her health started failing and she refused to go to the doctor. In the end, we aren’t sure what took her life. Maybe it wasn’t even the alcohol or cigarettes but something else. Should the government have forced her to get care? How would the government even know that she was sick? She wasn’t going to the doctor.

        And how is the government going to make sure that every single American has access? There are still many people out there who work off the books and don’t pay income taxes. Healthcare access is contingent on the IRS verifying your salary.

        In response to your assertion that the EU is larger than the US: Once the monetary and financial issues come to a head, the EU will fall apart. The EU is a loose confederation of states with distinct nationalities, and after providing cradle to grave care for decades, there will come a point where these governments run out of money, as it is with Greece.

        • bpuharic

          No one cares about your Reader’s Digest anecdotes. We’re talking national policy here. And everyone has a right to healthcare.

          I agree lots of folks are off the books, etc. Yet you right wingers insist we reinvent the wheel. Every advanced country manages to do what we fail to do.

          You guys keep engaging in special pleading about the EU

          You be sure and let me know when a meteor hits the earth as well, OK?

          Greece isn’t Germany or Canada. You know zip about Europe.

          • ptm

            A “RIGHT” – where is that in the Constitution or the Bill of RIGHTS.

          • bpuharic

            Alexander Hamilton pointed out in the “Federalist Papers” that the Bill of Rights does NOT contain ALL the rights of citizens. In fact he was opposed to the Bill of Rights for exactly the reason you just demonstrated.

      • SteveAR

        26,000 people, eh? Hundreds of thousands of more people die every year from the following: car accidents, smoking-related illnesses, cardio-vascular illnesses.

        That report on those supposed uninsured deaths came from the Obamacare-supporting Families USA. Based on the fact that this group is spreading the lie that Obamacare makes health care affordable, I doubt the truthfulness from those in this group.

        There is no EU universal health care system. Each country in the EU has it’s own system. To say the EU health system covers a more diverse population is a lie since the EU health system doesn’t exist.

        It doesn’t help your argument when you introduce untruths as facts.

        And as expected, you ignored the Oregon study because it doesn’t fit your narrative.

        • bpuharic

          Gee. Europeans die from being fat, too. And smoking. Yet our life expectancy is less

          And there’s good evidence that Obamacare DOES m ake healthcare affordable.

          Moreover, where’s YOUR study showing that NO ONE dies from lack of access? Because if that’s TRUE then we should shut down the healthcare industry since it has no effect at all. Which is what the right wing is claiming.

          Good luck with that.

          And I didn’t ignore the Oregon study since I gave a COUNTER study showing exactly the opposite

          Not used to reading much, are you?

          • water28

            It does make health care affordable? Thanks to it, most people who have insurance have seen cost go nothing but up…up a lot in fact. I pay 4x more for less coverage thanks to people like you. But hey… for the children right?

          • bpuharic

            Which nation has the world’s most expensive healthcare?

            BEFORE Obamacare?

            Oh. We do. But let’s just pretend we dont

            After all, pretending is what makes the right wing right wing.

          • SteveAR

            “Europeans die from being fat, too. And smoking. Yet our life expectancy is less”

            You said the EU had universal health care. That is patently false. Besides, with all that universal health care those EU countries have, people shouldn’t be dying of being too fat or smoking, should they? You’ve made it into an extremely expensive utopia.

            “And there’s good evidence that Obamacare DOES m ake healthcare affordable.”

            I’ve heard that, too. For about 17,000 people in NYC whose premiums are already through the roof thanks to state AND federal overregulation of health care there. For the rest of us 300,000,000, it’s gone up, around 20% in my case. Thanks to Obamacare.

            “Moreover, where’s YOUR study showing that NO ONE dies from lack of access?”

            Who said I needed one? I said that the Oregon study showed that poor people who had no health insurance weren’t any less healthy than those that were. It means that health insurance is overrated. Besides, what you all call “insurance” is in reality subsidies paid to health care providers from a 3rd party. Real insurance would be for chronic conditions and catastrophic care, not every little thing. If anything, government adding required coverage is why health care costs have gone up. Period.

            One other thing. The Oregon study was an actual study using science. The “study” you cited was from an organization beholden to the Democrats and charged to regurgitate Democrat propaganda. That makes them liars. Again, apples and oranges.

          • bpuharic

            I guess being right wing means never having to think

            I have healthcare. And I’m fat. My chances of dying from that are pretty good.

            Try thinking for a change instead of listening to Rush (PBUH)

            By the way, I notice you STILL haven’t told us which country has the world’s MOST EXPENSIVE HEALTHCARE

            Remember? BEFORE OBamacare, when our system was PERFECT because it punished the poor for BEING poor by allowing them to die?

            Which country has the MOST expensive healthcare?

            Oh. We do.

            If healthcare is overrated, then cut costs. GIve it up for you and your children.

            Betcha you don’t.

          • SteveAR

            I guess being a Democrat means saying a lie repeatedly means it’s the truth.

            I can believe the U.S. as a whole has the most expensive health care. Thanks to government, which I’ve explained.

            Here’s another thing I never said. I never said our health care system was perfect BEFORE Obamacare. The U.S. health care system does need to be reformed. Obamacare isn’t reform; it subsidizes the largest health insurers and adds on even more items that are required to be covered. Obamacare puts the pre-Obamacare health care system on steroids without actually reforming anything.

            We right wingers know a helluva lot more than you would dare to admit. We know a scam when we see it, like Obamacare. And we know how far Democrats will lie about it, just as Democrats lie about everything. And I am serious.

          • bpuharic

            “thanks to the govt”

            You know, you can’t make up stupidity like this. It HAS to be right wing

            Other countries have GOVERNMENT HEALTHCARE. We don’t. But ours is the most expensive, you see

            because of the govt.!!

            See how that works! It’s done with mirrors.

            Obamacare subsidizes insurance companies? Gee. So does every other country in the WORLD and their systems are LESS expensive than ours.

            You keep shooting yourself in the foot. Good thing that’s covered under Obamacare.

          • SteveAR

            What do you think Medicare and Medicaid are, carnival rides? Add in all the regulation that the state and federal governments have added over the decades and as it turns out, we have so much government intrusion into health care that to say it’s a free market system is another Democrat lie.

            No, every other country doesn’t subsidize health insurance providers. Single payer systems pay health care providers directly; Britain’s NHS is a government-run health care system. If anyone wants to pay for better care, they have to pay for it out of pocket, on top of what the taxes they pay into to support their systems.

            This is why I like arguing with Democrats about things like health care. They try to make it seem like they know what they are talking about when they regurgitate Democrat talking points. The fun part for me is bursting their bubble with the truth.

          • bpuharic

            `A perfect example of the “No True Scotsman” fallacy in action

            Our system is perfect and better than Obamacare the right says.

            BUT it’s far more expensive than ANY govt healthcare program in the world. And that proves it’s a govt healthcare program. Except it’s not because Obamacare js govt healthcare and it’s expensive.

            Got it?

          • SteveAR

            “Our system is perfect and better than Obamacare the right says.”

            Remember when I said “I guess being a Democrat means saying a lie repeatedly means it’s the truth.”? Well, you just did it with that statement. I had said previously our health care system needed reform and that Obamacare wasn’t reform. Then you come back with the same charge before, falsely making it seem like I said that America’s pre-Obamacare health system was perfect when you perfectly well I didn’t.

            You know that Democrat idea that telling a lie often enough will make it true? That’s a lie.

            Come back when you want to act like an adult.

          • bpuharic

            I guess being a right winger means lying about history

            Revisions to healthcare to cover everyone proposed by conservatives?

            None. Nothing. In fact, Obamacare IS A CONSERVATIVE programs, largely first proposed by Richard Nixon. But the right lies about history.

            Individual mandate? Heritage foundation…right wing think tank.

            So the right lies about their own history. Lies about the effects of Obamacare. then tells us how right they were all along

          • SteveAR

            Talk about revisionist history.

            Being a Republican doesn’t make one a conservative. Nixon was no conservative.

            I’ve read the bill that was dreamed up by Heritage. Do you know what they called the mandate? A tax. Not a penalty, a tax. Straight up. But when Democrats decided to incorporate the mandate, they called it a penalty in the law so that they could say the mandate wasn’t a tax increase. In other words, Democrats lied, especially since Democrats called the mandate a tax in the courts (and led to Roberts’ activist and unconstitutional ruling). No conservative, not even Heritage, lied about the mandate. That is something Democrats do.

            And take a look at this: http://www.telegraph.co.uk/health/nhs/10303403/NHS-patients-45-more-likely-to-die-than-in-US.html

            While Britain’s public health system isn’t single payer (the public health care industry is owned by the national government), this is what we can expect with a further government takeover of the U.S. health care system.

            By the way, this statement from the piece is a laugher:

            “‘Professor Don Berwick, a renowned international expert in patient safety and
            adviser to President Obama, published an independent report last month which
            said clearly that the NHS has the potential to be one of the safest healthcare
            systems in the world. Transparency is key to making this a reality.’”

            Oh sure, the government actually wants transparency. He’s a delusional statist. It’s no wonder Obama likes him.

          • bpuharic

            Nowhere…not once…have I said Republicans were always conservative. Certainly today the GOP is an extremist right wing party (google “GOP most right wing in 60 years” for evidence.)

            But in the south, racist conservatives were DEMOCRATS until Nixon’s “Southern Strategy” won them to the GOP.

            And it doesn’t matter what the mandate was CALLED. The fact is it was a CONSERVATIVE free market idea. The US right is SO extreme that previously conservative ideas are now seen as socialist.

            And there are MANY national healthcare plans.

            But America’s right wing is SO EXTREME that it thinks our system, which is the most expensive in the world, and doesn’t cover everyone, is a success

            Why? Because it’s an example of social darwinism in the extreme. The poor die. What’s better than that?

          • SteveAR

            You implied that being a Republican was the same as being a conservative. Yes, the GOP is more conservative now than it was. But that is because we want the Constitution followed. If following the Constitution is extremist, I don’t have a problem with that.

            Those racist “conservative” Democrats from the South? Another Democrat lie. They were all New Deal progressives (regressives).

            Yes, it matters what the mandate is called. Heritage didn’t lie about it. The Democrats who passed and signed Obamacare did. Which is their nature, isn’t it?

            What Democrats are now are the extremists. The Constitution? Immaterial to them. Following the law? Irrelevant to them. Violating basic civil rights, as they do regularly with the rights protected in the First, Second, Fourth, Fifth, Ninth, and Tenth Amendments? Those rights don’t matter to Democrats if those protected rights go against the Democrat narrative.

            And if you think the supposedly “free market” pre-Obamacare health care system (which was in no way a free market system) was a way to get poor people to die, think again. Who do you think will have their health care rationed by the government if they run or are the payer into the health system? The poor who can’t afford their health care. Any mention by Democrats of how free market health care will harm the poor is pure projection since government health care will make harming the poor legal. You can bank on it.

            We’re done.

          • bpuharic

            Not all conservatives are Republicans, but all Republicans are conservatives. Draw yourself a Venn diagram to see the difference.

            And you’re just pushing self serving crap about the constitution. Conservatism’s first loyalty is not to country or constitution, but to capital and private property, no matter what the social cost.

            And you’re saying southerners were LIBERAL?? Good luck with THAT lie! No doubt Rush (PBUH) has told you some version of that, but no one in his right mind thinks the south was anything but rock ribbed conservative. Except someone as delusional as you, of course.

            The mandate was a conservative idea. As I said, the US right wing is SO EXTREME that its own historical ideas are now called ‘socialist’. That should tell you how radical you are.

            And I appreciate your efforts to channel Rush (PBUH) and his vague statements that liberals violate the constitution. No proof of course.

            And we ALREADY RATION HEALTHCARE in this country. Yep.

            Only someone as truly ignorant as you would think that denying someone healthcare because they can’t pay for it is NOT rationing.

            You don’t have much to say

            And you say your nothing like a true, radical, extremist right winger.

          • SteveAR

            You are making this too easy.

            “And you’re just pushing self serving crap about the constitution. Conservatism’s first loyalty is not to country or constitution, but to capital and private property, no matter what the social cost.”

            Duh. What do you think the Due Process and Takings Clauses do? Have you ever even heard of them? Private property is sacrosanct to freedom. The social cost of violating those freedoms is tyranny. But I wouldn’t expect a Democrat to know that.

            Like I said, we’re done. You obviously cannot present legitimate arguments, preferring to use the old Democrat standby of lying to make your points.

          • bpuharic

            And the right wants to do away with freedom of religion and thinks the ONLY provision in the bill of rights worth saving is the 2nd amendment

            See how easy that is? You make vague, paranoid claims. I can do so as well

            Good for whipping up hysteria and writing fund raising letters.

            Bad for social policy

            Which is pretty much what the right wing is about.

            And the right wing took plenty from the middle class under TARP to bail out their rich buddies. But you’re a lying right winger, so want to hide the facts

  • MTF2

    Obviously, the next thing to do is to require the uninsured to become insured. When the cops stop a young driver it won’t be for texting, running a red light or speeding, it’ll be to check for proof of health insurance. You wait.

  • Michael Peter

    So if, as you say, the Affordable Care Act was never designed to make healthcare affordable, then it begs the question: Why go down this road when anyone, right now, can walk into a hospital and receive high quality healthcare? It’s not that it isn’t available now, it’s that people don’t want to incur the costs of it. Anyone can walk into a hospital right now and receive treatment.

    But instead of focusing on the costs and why they’re so high, your solution is to have the same people who created this “affordable” iteration on government healthcare (which wasn’t designed to lower costs) go many steps further.

    The government is not competent. It’s corrupt. It’s not accountable and, ultimately, cares more about the talking points of healthcare than actual healthcare.

    It’s stupid. If people were smart they would run from a government healthcare system as fast as they possibly could.

    • charlie_peligro

      it is designed to control the people. to hold the threat of cutting of your health care if you disagree with the regime.

      • bpuharic

        Gee. Nothing like not having health insurance today controls you, right?

        More tin foil hat right wing paranoia.

    • bpuharic

      You KNOW people have been listening to Rush (PBUH) too long when they spout the same lies

      Prove that you can walk into a hospital and get treated for cancer, or liver disease, or any other chronic condition, without insurance

      Go ahead. Otherwise you’re lying.

      Corrupt? Yeah. Insurance companies are impeccable examples of honesty

      Which is why the US has the most expense healthcare in the world.

      Govt healthcare WORKS. Notice he doesn’t mention that?

      • water28

        Yea you must not have to live with gov insurance for any amount of time.
        I know a few people that are on it and its no treat. Need to see a doctor? Good luck finding on unless you want to commute to a big city . Then if you find one, good luck getting an appointment… there can be a few months wait for you to get in, even then your talking to the doctor only for a few minutes before you are on your way.
        Your not gonna like it take my word on it…When it screws you or your family from getting care because there is not as much “value” left in you or a family member… be happy and take a pill.

        • bpuharic

          And how long do you wait if you have no health insurance?

          For the rest of your life.

        • Michael Peter

          Agreed water28. I worked in Canada for a few years and had to deal with their healthcare system and it’s precisely as you describe it. Even worse, there aren’t enough doctors. And the doctors that do open shop have limits to how many patients they’re allowed to have. So you don’t get to see the best doctors, their patient allowance is full. You get stuck with the doctors that still have room for more patients, either because they just got out of school, or they suck, or they’re just awful people.

          • bpuharic

            And yet here in America, insurance companies have to be sued to pay for treatment, assuming you HAVE health insurance

            If you don’t. Well, coffins can be cheap.

      • Michael Peter

        bpuharic, Usually the impetus of proof is a burden placed on the party that is requiring action. The fact that you’re attempting to dismiss my reasoning through the shameless tactics of association, rather than supplying any sort of reasoning or evidence to contradict my point, is evidence enough that you are a hyper-partisan Little Eichmann crying for policies that you don’t understand to fix problems that you don’t understand in an industry that you don’t understand.

        However, for the interests of whoever else may read these comments, in 1986 Congress passed The Emergency Medical Treatment and Active Labor Act (EMTALA), which requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay.

        This isn’t to say that our healthcare is acceptable. It is to say that government doesn’t have quality healthcare for all as a leading objective. Politics, money/power and special interests will ensure that people profit from sickness regardless. Our government are the last people on earth you want managing your healthcare.

        • bpuharic

          I agree

          So prove your contention that you get healthcare for chronic conditions. Go ahead

          Cite the law.

          Eichman? Funny you right wingers can’t resist calling others what you yourself admire. Eichman, of course, denied healthcare to those he thought unworthy, just like the right does today.

          And the right wing pretends that the EMTALA, which I AM SUBJECT TO AS AN EMT

          covers CHRONIC conditions

          IT DOES NOT. It covers ONLY EMERGENCY CONDITIONS.

          So you’re ignorant. And a liar.

          But you’re right wing, so that’s a redundancy.

          • Michael Peter

            I never contended that. I said you can walk into any hospital and receive treatment, which prompted your vapid, anti-intellectual emotional hyperventilating about me being a liar. I supported THAT contention by providing the actual law that was passed by congress, illuminating your deception.

            Americans can receive all sorts of treatments for chronic illness. They just have to pay out of pocket for them. I do not know of any law that REQUIRES them to but there are also no laws about requiring McDonald’s to sell me a Big Mac, yet McDonald’s is more than happy to do that and it’s the same thing.

            You seem to be under the false impression that the only truth in life is if a law exists about it. There’s no law requiring you to breath air, to drink water or eat food but you do those things anyway.

            Socialism is an awful idea, as the Nazis so thoroughly exemplified. If you feel like you’re not a Nazi maybe you should consider why you’re espousing their values. The progressive movement, which is a national socialist movement (just like the Nazis), have adopted all of their apparatus as their platform, only with Jews being replaced by Christians, Capitalists and “Deniers”.

          • bpuharic

            Sure you’re a liar

            You said anyone can get treatment for any conditionin a hospital

            That’s a lie. A bald faced lie

            ANd I noticed your “Other than that, Mrs Lincoln, how did you like the play” qualification

            Yes, you can get treatment if you pay for it. That’s called a ‘tautology’. Typical right wing distortion, but a tautology.

            Need a stent for $150,000? No big deal! Just pay for it out of the change you find in your sofa! Right wing economics!

            Nazism was right wing fascism, supported by industrialists like Farben and Krupp. In fact, Mussolini defined fascism as a fusion of corporate and state objectives. Nazism was a right wing idea.

            And you Christians have murdered Jews for 2000 years. No wonder you’re such experts. The right replaces Jews with the middle class…thinking the middle class is expendable

            Good luck with that, my national socialist friend who thinks socialiism is great for the rich.

          • Michael Peter

            I’m not a Christian

            You can call a socialist right-wing all you want but those on the right, here in America, believe in free markets and individual liberty, which is the antithesis of the Nazi movement. Progressives, however, share many many similarities.

            I’m not going to convince you that free market healthcare is a superior choice and you’re certainly not going to convince me that socialism benefits mankind.

            I wish you good fortune despite your intentions of destroying it :)

          • bpuharic

            The right gives alot of mouth candy to ‘free enterprise’ but they’ve done everything they can to bankrupt the middle class while destroying markets. TBTF? A right wing idea authored by Phil Gramm and supported by Alan Greenspan, libertarian.

            And even as the economy collapsed the right STILL believed in the myth of the free market

            As Nobel Prize winner Robert Solow pointed out recently, “Free markets’ are IMPOSSIBLE. They do not and CAN NOT EXIST. Such markets are unstable and subject, as Adam Smith knew, to manipulation by businessmen.

            THAT is why we need laws to regulate the free market.

            But just as the right is fundamentalist in religion, so you’re fundamentalist in economics.

            And the nazi movement has always attracted support from right wing capitalists.

          • Michael Peter

            We haven’t had free markets since 1913, so don’t pass off every government policy supported by Republicans as free market ideas.

            Too big to fail is not a free market idea. It’s the opposite of a free market.

            And, similarly, industrialists using government to protect their own wealth is not a free market idea. You can say that that’s unrealistic because bribery is built-in to human behavior but then you have to admit that socialists are just as susceptible to bribery as capitalists are.

            Giving vast amounts of power to the government does not change anything. It never has. The rich industrialists somehow are still rich industrialists.

            When Republicans were in power it was “Too Big to Fail”. If a Democrat were in power it would have been “Save the Jobs of Working People”.

            I believe that the Democrat party, assuming it holds super majorities for the next 200 years, will not improve the quality of life for the poor, it will not clean up the planet, it will not accomplish any of its aims other than making ignorant politicians rich, creating further incestuousness between business and government, and obliterating the middle-class as taxes become heavier to pay for bloated bureaucracies that don’t actually produce anything.

            Leftists tend to like government regulation and control as a means of protecting the little guy. But, in reality, it ends up that politicians who “play ball” end up winning elections and, by doing so, further protect the same wealthy interests they vilify in their speeches.

            Essentially, there is no difference between a Wall St fat cat and a DC politician. They’re the same breed. Voting for bigger, more powerful government forces is really just asking the rich and powerful to protect you from the rich and powerful.

          • bpuharic

            So the 19th century, with its monopolies and oligopolies, was a free market?

            IOW you don’t know what a ‘free market’ is.

            I agree TBTF is not free market. Why, then,are conservatives fighting AGAINST breaking up large banks? Why are CONSERVATIVES fighting against regulations to protect us from another bailout?

            We have had meaningful reform for the middle class. That’s way labor related deaths dropped, things like black lung disease became and issue for regulation, etc.

            The right has always believed in 1 dollar 1 vote. Certainly moderate populists who gave voice to common concerns like those I just elaborated were subject to being demagogues. But the right has eliminated ALL checks on corporate power and eviscerated the middle class.

            It’s time to restore balance. Elizabeth Warren pointed out the other day that a study showed the current Supreme Court is the most pro corporate in 70 years, with Justice Roberts being the most pro corporate in history.

            Who’s protecting the middle class as the right goes on a rampage to enshrine the ‘free market’?

          • bpuharic

            There is no such thing, as Robert Solow has pointed out, as a ‘free market’. It’s a theoretical construct which exists only in economic texbooks and CAN NOT exist in the real world.

            But the right wing economic fundamentalists INSIST it does. The fact they preach this delusion is evidence they haven’t a clue about the way economics really works.

            And I’m as much a socialist as you are a nazi. The use of ‘socialist’ by the right is evidence of brain death.

            And the right SAYS it believes in free markets until it’s time to account for worker safety…then they’re against it. Or environmental damage…then they’re against it. Or decent wages for working people. Then they’re against it…etc etc.

            No one needs to ‘convince’ me of the value of the ‘free market’. The right believes in this as a matter of faith. We moderates see the EVIDENCE that a REGULATED free market works. And that’s all we need

            Evidence.

            The right is against evidence since they have faith in right wing ideology.

            Moderates think, as did Adam Smith, that a REGULATED free market is the best way to protect society while enabling it to grow