I was perhaps a little naive and it was ill-timed on my part to reopen this issue. There seems to be a lot of partisan emotion running and I certainly don't want to be the cause of turning forum members or anyone else against each other.
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History has an unpleasant tendency to repeat itself. If america goes that way we all lose - even here in Australia.
MM
Let me help you with my opinion. First, it is a spotlight fallacy to view your news and then assign an attribute to a group of people who oppose the legislation. That's a very common error.
Second, yes there is hate in some places, disgust in others, outrage in many, etc. However, it's not as if hundreds of Americans are killing hundreds of Americans over this. Our society is very forceful and direct, as just about any and all intercultural communications classes will discuss. Most view freedom of speech very highly. Those who are racist should be allowed to say all the hateful things they wish, as it clearly exposes them, and their arguments can then be summarily ignored. There's no sense making the wasp flying around invisible.
Regarding the issue of socialism, it doesn't help when key Democrats are quoted as saying, "When American voted for Obama, they voted for socialism." And yes, this healthcare legislation is designed to redistribute wealth, as Max Baucus said.
Healthcare is indeed in need of reform, but this "reform" does not accomplish what is needed. The problem with our healthcare is the cost of it, or, in a better description, the value of it.
The problem involves the fact that that there are so many different rates. Medical procedures don't have a foundational value. Call a provider and ask them what a procedure costs; they'll ask what insurance you carry. And if you don't have insurance? Not good for the providers if it's emergency care.
A massive part of the problem is that many Americans don't see medical care as having concrete value, and rightly so. It's either something they can pay for, or something they can't. No one gets competing offers or shops around; insurance companies "compete" in secrecy, which is to say, they don't really compete at all.
A huge problem involves the following: My patients with good insurance want every procedure they can get, because "it doesn't cost me anything; it's free." Without any copay, the care is further devalued. What is amazing is that the cost of our mostly insurance-covered, technology-based procedures have risen with age! Where else does that happen? It doesn't happen in any other sector, because the equipment needed becomes better, more efficient, and cheaper. When "someone else" is always paying, cost-conscious decisions go out the window. We need to reform the value, so that the cost of procedures goes down. Instead, we pathetically address a symptom, but leave the cancer to spread. It's tragic. It's also tragic that people, burdened by medical costs, have fallen for the legislation which proclaims to be scientific, when it is indeed based more upon rampant emotionalism and the woes of the masses.
We need reform, but we need an open, competitive system, not the futhering of this anguine beast, struggling to move in the end under the avoirdupois brought about by its voluminous, unhelpful rules.
I should also add that efficient systems reduce costs overall, while systems which have proclivities to expand also show a bent toward exceeding cost analyses. For this reason, we should be seeking a true reform of value, which this does not address, nor make any significant inroads toward doing so.
It is also worth noting that the CBO has consistently underestimated the costs of medicine, and by amounts which are large indeed. Let me present these small exhibits of their major healthcare-related estimates:
-Medicare (hospital insurance). Originally estimated to be $9 billion annually by 1990; actual cost was $67 billion.
- Medicare program. Originally estimated to be $12 billion/year by 1990; actual was $110 billion.... See more... See more
-Medicaid DSH. Originally estimated to be less than $1 billion/year; actual cost in excess of $17 billion/year.
-Medicare home benefit. $4 billion/year versus actual of $10 billion/year.
Now, I do take issue with using past estimate histories to accurately argue current facts, so consider those as more of a point of interest. What does remain true, however, is that we currently spend vastly more than other countries on healthcare, yet we achieve less with that money. We are hoping to correct this by spending more money, which we estimate will put us right around the breaking even point, at least according to the CBO.
So, unfortunately, we are not addressing the value of healthcare, and we are not making inroads toward becoming more efficient. Many people are advocating in the extreme on either side due to partisan interests, which are merely a result, I believe, of our need to psychologically ingroup with a particular unit. This can been seen when we cheer for one team over another, when the tangible connection in tenuous at best. Will we ever overcome this, or will politicians remain readily able to access our frail psyches, garnering votes even when they lie, cheat, and remain unethical in so many facets?
The legislation is really this mish-mash, pseudo-socialistic, pseudo-capitalistic quagmire of rules. It subtly purports its scientific roots while polarizing many peoples. In actuality, it burdens us more, and it is not at all what it claims to be.
I think that addressing the above is a long, hard process, just like many other things in life. However, it's also the most realistic way to achieve what you want, and it address the underlying causes of expensive medicine, not just the symptoms. As I've said, though, we spend a lot of money without seeing the appropriate returns, because our system of valuation is broken.
On a quick note, if the SCOTUS says that the legislation does not violate the 10th Amendment, I am willing to bet that the supporting argument is going to be the Interstate Commerce Clause. However, many Americans simply do not agree with the underlying concept that they can be forced to purchase health insurance. Some have argued, both on the Hill and in private, that it is akin to purchasing car insurance, which it is most certainly not. Our roads are financed by the people, and others travel on them. This means that not only is it a privilege, but some of the actions taken can impact other people, which is one reason for the insurance. Our lives, however, are our own, and are not paid for by the government, so the argument is very dissimilar.
Some other points of interest are present, as well. Firstly, this bill will not insure everyone, and will most likely not bring down premiums significantly. Also, as said, it does not address the cost of healthcare, but the cost of insurance, and that is barely theoretically tangible. Furthermore, the bill was loaded with unrelated pork. Americans don't like pork all that much.
Some more interesting notes:
-The bill doesn't have an enforcement mechanism to keep people from being dropped from coverage due to illness. I suppose that this part of the bill is being left to the states.
-Some smaller businesses will save money by taking a penalty for not providing insurance, rather than buying a reasonable package.
-The bill does not limit private insurers' rate increases.
-The bill requires funding immediately, but is not fully active for years; this has greatly skewed the CBO number, which also assumes that people will purchase select packages. As noted before, the CBO routinely botches estimates for healthcare; it is doubtful that the thousands of pages of legislation will work out as predicted.
-Having insurance DOES NOT prevent medical-related bankruptcy. In fact, the vast majority of the medically bankrupt have insurance-around 3/4, IIRC.
-Between 24 and 54 million will be left uninsured by 2019. This is a CBO figure, as well.
Is it any wonder, then, that some do not enjoy this huge amount of legislation? I daresay it is not.
