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Warming Up To The Repeal Of The Health Bill?

By Big Tent Democrat, Section Other Politics
Posted on Mon Jan 31, 2011 at 06:36:11 PM EST
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I find the arguments from the decision striking down the individual mandate to be ludicrous, but this Ezra Klein post makes me think twice about my views of the GOP strategy to undermine the health bill:

The resulting policy [after a successful GOP obstruction} isn't too hard to imagine. Think something like opening Medicare to all Americans over age 45, raising Medicaid up to 300 percent of the poverty line, opening S-CHIP to all children, and paying for the necessary subsidies and spending with a surtax on the wealthy (which is how the House originally wanted to fund health-care reform). That won't get us quite to universal health care, but it'll get us pretty close. And it'll be a big step towards squeezing out private insurers, particularly if Medicaid and Medicare are given more power to control their costs.

Where do I sign up for this result?

Speaking for me only

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    Warming Up To The Repeal Of The Health Bill? | 61 comments (61 topical)

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    Sounds dreamy (5.00 / 1) (#20)
    by Militarytracy on Mon Jan 31, 2011 at 08:16:42 PM EST
    I did think if the current reform failed it would likely mean more government run coverage and programs.  Healthcare is a necessity for everyone, and when you have family members suffering you will put aside the rhetoric and do a very scary thing and vote accordingly....at least most of us will.

    If this happens though, it will be the 11th dimension that the Obama set us up for to attain :)  Wait a minute, will it be an 11th dimensional chess win or the winning end product of incrementalism?  I know, it will be a magic unicornucopia of both birthed in the mind of an unfathomable genius.

    If only I had been born an Obot instead of a leftwinger hoping to get old enough to be a curmudgeon, I too could know bliss :)

    I Want That And a Pony! (5.00 / 1) (#24)
    by msaroff on Mon Jan 31, 2011 at 09:59:48 PM EST
    Ezra is wishing for a pony here.

    Parent
    Ezra thought that the mandates (none / 0) (#37)
    by inclusiveheart on Tue Feb 01, 2011 at 10:07:28 AM EST
    would help to curtail the rise in the cost of premiums.

    Ezra thinks a lot of things, writes about them and even gets on TeeVee, but that doesn't necessarily mean that he's a great predictor of outcomes - or even political realities.

    I saw him last night saying basically the same thing and it was difficult not to be entranced by how completely fantastical his "logic" was.  Republican are going to open up Medicare when one of their party's objectives this term is to cut Medicare?  And where are the Democrats who are going to run with the idea of expanding Medicare after working so hard to AVOID expanding Medicare when the HCR bill was crafted?  It is all nonsense.  Probably a set of talking points from the extremely lame communications department over at the DNC.

    But, honestly, I don't care about this healthcare bill nearly as much as I care about Social Security and Medicare - I think that this whole attack on the HCR bill is a diversionary tactic to keep people from noticing what people on both sides of the aisle are considering doing to Social Security and Medicare.

    Parent

    How is all of this not more obvious (5.00 / 1) (#40)
    by Anne on Tue Feb 01, 2011 at 10:32:18 AM EST
    to people?  Is it that Ezra's Magical Thinking makes sense to people who haven't been following this as closely as we have?  Or is it just too painful for people to admit what is really going on, so Ezra's punditry helps them with their denial?

    I just think it's crazy for anyone to think that the people who want to effectively kill - or privatize - programs like Medicare and Medicaid are the least bit interested in expanding them to solve the health care problem.


    Parent

    It seems to me that a lot of (none / 0) (#46)
    by inclusiveheart on Tue Feb 01, 2011 at 11:41:12 AM EST
    debate these days would be great fodder for the likes of Lewis Carol's Alice in Wonderland.

    But my guess is that Ezra is working off of Democratic Party talking points.  And the reality is that political talking points are largely nonsensical - they serve only one purpose which is to win the day's news cycle - they aren't meant to have lasting value and whether or not they reflect reality is generally optional these days.

    Most people don't follow any political issues particularly closely; and that is to the great benefit of the spinmeisters.

    I just think that it is ironic that Ezra was so committed to the notion that a public option was politically "impossible" during the heat of the debate over the deal in a Democratically controlled Congress; and now he's saying that if the bill is repealed then Medicare expansion is the next "logical" step at a time when the GOP controls the House.

    I seriously can't figure out why so many people feel the need to describe him as "smart".

    Parent

    The only way that (5.00 / 1) (#23)
    by NYShooter on Mon Jan 31, 2011 at 09:53:07 PM EST
    that healthcare bill could become law is if:

    1.We had a president committed to "changing the way Washington works"

    2.He had large Majorities in both houses of Congress,

    and

    3.He enjoyed a strong mandate from the voters

    What?

    never mind

    Under the circumstances, this is a (5.00 / 1) (#26)
    by oculus on Mon Jan 31, 2011 at 10:42:20 PM EST
    wonderful title.

    I'm not (5.00 / 1) (#28)
    by lentinel on Tue Feb 01, 2011 at 03:53:48 AM EST
    an attorney, but it seems to me that the government mandating that I purchase insurance from an out-of-control private profit-making insurance company should be unconstitutional if it isn't already.

    I forget who made the analogy, but one person posting compared this to a solution to homelessness: make everyone rent an apartment.

    I think it is unethical to force (5.00 / 1) (#33)
    by Militarytracy on Tue Feb 01, 2011 at 08:50:03 AM EST
    people to buy a product from an out of control industry.  I'm not sure it is Unconstitutional though, otherwise I would think that forcing me to buy auto insurance would also be.

    Because this healthcare reform and its cheerleaders never took into consideration how unethical it was to do this to people, and have now created large scale anger and fight from those already experiencing doubled insurance premiums now....who knows where we are at now in reaching any working solutions?

    Parent

    The bottom line is that it (5.00 / 1) (#39)
    by inclusiveheart on Tue Feb 01, 2011 at 10:14:11 AM EST
    isn't a sweet enough deal for people to want to follow the mandate.  But that's typical of Democrats these days.  Not great dealmakers.  Really not great at all.

    Parent
    Here's my question: (5.00 / 1) (#41)
    by republicratitarian on Tue Feb 01, 2011 at 10:35:25 AM EST
    There are some good things about this bill, but it is mostly a giant piece of crap. It seems most people hate it for one reason or another (didn't go far enough or it went too far). Everyone agrees that something needed (needs) to be done, but no one is happy with this bill.

    Would we be better off if this was struck down and something different were to come as a result? Both sides would still not get everything they want, but it would have to be better than what we got.

    Parent

    The problem is (none / 0) (#48)
    by jbindc on Tue Feb 01, 2011 at 12:16:51 PM EST
    The time has passed for us to get a "better bill."  Obama had huge majorities in both houses (and lots of goodwill from the American people when this all started back in 2009).  The process was unecessarily dragged out, and the bill became more cumbersome.  It helped spawn the Tea Party movement, and the conversation got away from "health care" to "the bill".  There's no way it's going to be fixed for a generation now - the Dems blew their one chance but good.

    Parent
    I don't think this effort was ever (5.00 / 0) (#57)
    by Anne on Tue Feb 01, 2011 at 02:39:27 PM EST
    about actual care; from Day One, it was about insurance.

    About maintaining a structure where insurance is less a bridge to care than it is a wall.

    If care had been the goal, single-payer would have been part of the conversation.  If care had been the goal, there would be cost controls to prevent people from being sucked dry by insurance companies and left unable to afford the care.  If care had been the goal, people would not be made to wait years for help.  

    Care was never the goal.

    Parent

    The goodwill didn't last long (none / 0) (#56)
    by republicratitarian on Tue Feb 01, 2011 at 02:24:56 PM EST
    I'm just curious if both parties realize how much is wrong with this bill and if they could actually come up with a (forgive me) bipartisan bill that corrects some of the shortcomings of the current bill.

    What happens at the end of the ten years that this bill covers? Is it automatically renewed or does it have to be passed again?

    Parent

    Well many states demand (none / 0) (#32)
    by smott on Tue Feb 01, 2011 at 07:58:21 AM EST
    ....that you purchase for example auto-insurance. At least, liability coverage is mandatory.

    I suppose the distinction would be that you must purchase this product to protect someone else. Coverge to protect yourself (medical, collision) is not required.

    Still it is a mandate to purchase....

    Parent

    The (5.00 / 0) (#34)
    by lentinel on Tue Feb 01, 2011 at 09:16:07 AM EST
    difference is that you can choose whether or not to buy and drive a car. You accept the condition that liability insurance is part of the deal.

    In the case of medical insurance, you are mandated to buy it. Period.
    It is, in my view, the government absolving itself of its responsibility to provide healthcare as a basic right to its citizens.

    Cure for homelessness: Mandate that everyone rent an apartment.
    Cure for joblessness: Make it illegal for anyone not to have a job.

    Maybe those analogies are off the wall, but they resonate with me.

    Parent

    Not everyone is born with (5.00 / 0) (#38)
    by inclusiveheart on Tue Feb 01, 2011 at 10:11:56 AM EST
    the burden of owning and maintaining a car like we are born with our bodies.

    Personally, I am opposed to the mandate because it is not a government administered program and there's very little regulation of the private insurers to assure that the mandate be a rational and reasonable trade off.  It isn't a good deal for people.  It is a great deal for the private insurers though.

    Parent

    Agreed (none / 0) (#52)
    by smott on Tue Feb 01, 2011 at 12:55:48 PM EST
    Not everyone can simply choose not to drive...however you're spot-on that the crux of the matter is the GOvt's abdication of their duty to help preserve the common good/health/security/welfare and that IMHO extends to the notion that our society should offer everyone health care.  You can call it a right, or whatever, but to me it is simply a moral obligation that we all have as a whole society, to take care of those who are ill, or to keep those who aren't, healthy.

    Parent
    It should be that people (5.00 / 0) (#58)
    by inclusiveheart on Tue Feb 01, 2011 at 03:29:36 PM EST
    recognize the cognitive dissonance of our political leaders saying that the nation has a duty to provide healthcare in the interest of the common good; and then in the next breath insisting that the obligation be met by private enterprise.

    Common good is not rewarded on Wall Street.  Profits and shareholder value are.  The latter will win almost every time over the former.  Government, on the other hand, is responsible for the welfare of the citizenry and the nation - although since few hold them to that obligation these days, they are punting to private enterprise - and enriching them at the expense of the people.

    Parent

    Or (5.00 / 1) (#45)
    by lilburro on Tue Feb 01, 2011 at 11:41:05 AM EST
    they could vote to expand the public option in the bill so it's more effective.

    Oh, wait...there wasn't a public option in the bill?  That's too bad.  What a missed opportunity.

    Won't work (2.00 / 1) (#19)
    by jimakaPPJ on Mon Jan 31, 2011 at 08:16:30 PM EST
    The people with health insurance their employer is paying for will be afraid of loosing it and jealous of those who won't have to pay.

    They will see this as a huge tax increase to pay for someone else's insurance.

    The only way is to go 100% and pay for it through a national sales tax (POS no VAT). Some items could be excluded... i.e unprepared food, cars over 5 years old.. utility bills of under $300... come to mind.

    Everyone is covered. Everyone, to an extent, pays.

    Won't work (none / 0) (#22)
    by waldenpond on Mon Jan 31, 2011 at 09:48:34 PM EST
    Just noting that a tax does nothing about cost.  There are firm studies out... if you hit those at the margins, they start skimping on meds and appts and increase healthcare costs overall.

    You need a flexible system.... there are three critical areas: the poor, the elderly and the chronically ill that all require a different health care approach and then, I imagine, everyone can be dealt with in a comprehensive manner.

    Parent

    The (none / 0) (#31)
    by Ga6thDem on Tue Feb 01, 2011 at 07:41:06 AM EST
    number of people with insurance like you are saying are declining daily. These people are also getting care denied by their insurance companies. So don't bet on them being "jealous". I'm sure some will but frankly the people who do have insurance are having all the costs shifted onto them so they really should support something like single payer.

    A lot of people don't really understand the healthcare system or non-system as it is in this country and are susceptible to rhetoric.

    Parent

    Maybe you didn't notice (none / 0) (#42)
    by jimakaPPJ on Tue Feb 01, 2011 at 10:48:09 AM EST
    that AARP lost thousands and thousands of members because it supported Obamecare because of the $500 billion cut.

    And there aren't enough of the groups you show to make up for the opposition.

    Obamacare pits groups against groups. Rich vs poor. Young vs old.

    Time for us to unite and have a system for all.

    Parent

    AARP loses thousands of members (5.00 / 2) (#54)
    by Harry Saxon on Tue Feb 01, 2011 at 01:27:50 PM EST
    every year:

    There are two sides to every story, and in this case the other side provides the whole truth... Let's look at the figures, first, regarding membership numbers for AARP to see why Fox News' claims are misleading. AARP claims that they regularly lose 300,000 members per month due to reasons including death. AARP also gained 400,000 members and 1.5 million members have renewed since July 1. AARP has around 40 million members, making that 60,000 a fraction of a percent.

    Click or Foxnewsboycott Me

    0.15% of the membership dropped out because of Obamacare.

    Yep, that proves, what, exactly?

    This is your brain on Fox News.

    Any questions?

    Parent

    Oh really? (none / 0) (#55)
    by jimakaPPJ on Tue Feb 01, 2011 at 01:57:44 PM EST
    Then why have they been making all those efforts to get people back??

    AARP is worried. Obamacare is designed to drive new customers ... the individual mandate... into United Healthcare, their in-house company.

    Obamacare is, simply put, Government Capitalism at its worst.

    Parent

    Because they're ALWAYS trying ... (5.00 / 1) (#59)
    by Yman on Tue Feb 01, 2011 at 05:22:51 PM EST
    Then why have they been making all those efforts to get people back??

    ... to recruit more members, just like any organization.  Which is, of course, completely irrelevant to your claim that "the AARP lost thousands and thousands (is that supposed to sound better than just "thousands"?)of members because of Obamacare."

    Parent

    If you have a link to your assertion, (5.00 / 1) (#60)
    by Harry Saxon on Tue Feb 01, 2011 at 05:22:56 PM EST
    that would be interesting, but if it came from the same source that at 0.15% loss is a major leak, color me skeptical, Mr. Jim.

    AARP is worried. Obamacare is designed to drive new customers ... the individual mandate... into United Healthcare, their in-house company.

    Again, if you have a link to your claim, that would be interesting.

    Obamacare is, simply put, Government Capitalism at its worst.

    Yes, that's what happens when you let the originally Republican ideas become part of the final product.

    Parent

    The same place (none / 0) (#1)
    by andgarden on Mon Jan 31, 2011 at 06:40:34 PM EST
    you sign up for a Democratic House of Representatives. . .

    Plus (none / 0) (#3)
    by Big Tent Democrat on Mon Jan 31, 2011 at 06:45:38 PM EST
    something more, like repeal of the health bill?

    Parent
    Well, for what it's worth (none / 0) (#4)
    by andgarden on Mon Jan 31, 2011 at 06:54:18 PM EST
    I do not think there are the votes on the SC for invalidating the entire law. Skepticism for facial challenges runs high outside of First Amendment cases.

    Of course, the reality is that the Justices will turn on a dime when it suits them.

    Parent

    To expand on that point (none / 0) (#5)
    by andgarden on Mon Jan 31, 2011 at 06:57:09 PM EST
    If the mandate is essential to the legislation's operation, then it is protected by Gonzales v. Raich. If it isn't, it is severable.

    Parent
    It is protected by history (none / 0) (#21)
    by NMvoiceofreason on Mon Jan 31, 2011 at 09:47:35 PM EST
    http://blogs.forbes.com/rickungar/2011/01/17/congress-passes-socialized-medicine-and-mandates-health -insurance-in-1798/

    It turns out, the Founding Fathers would beg to disagree.

    In July of 1798, Congress passed - and President John Adams signed - "An Act for the Relief of Sick and Disabled Seamen." The law authorized the creation of a government operated marine hospital service and mandated that privately employed sailors be required to purchase health care insurance.



    Parent
    Kennedy will be a hard vote to get (none / 0) (#8)
    by MKS on Mon Jan 31, 2011 at 07:03:43 PM EST
    for holding the statute unconstitutional....

    Parent
    If they can get him, (none / 0) (#10)
    by andgarden on Mon Jan 31, 2011 at 07:05:50 PM EST
    it will only be because he thinks that the mandate is an affront to individual liberty. WIth that in mind, I think the briefing will have to focus on how ineffectual the mandate actually is.

    Parent
    It is like a tax (none / 0) (#11)
    by MKS on Mon Jan 31, 2011 at 07:11:46 PM EST
    Who cares what labels politicians used....How is it actually implemented?  Answer: like a tax.....

    Kennedy would have to a do a full Lochner and find a fundamental freedom...like a freedom to contract....

    Will we have a freedom to not be taxed?

    This ruling could help Romney--he will say it is okay at the state level because, as the ruling says, states have express police power, unlike the Feds....Or, is that too nuanced?....Yep, too nuanced.....Romney was for making people buy insurance....

    Parent

    If Kennedy doesn't like (none / 0) (#12)
    by andgarden on Mon Jan 31, 2011 at 07:13:36 PM EST
    the smell of a law, he will find a way to axe it. As a doctrinal matter, I agree with you that the taxation basis is independently more than sufficient. But then, so is the Commerce Clause.

    Parent
    Maybe Roberts will find some integrity on this one (none / 0) (#13)
    by MKS on Mon Jan 31, 2011 at 07:17:51 PM EST
    One can hope....

    Worst case:  Kennedy axes the mandate and leaves the rest....

    I could actually live with that.....Enforce the 85% rule.....Is there a private right of action to enforce that rule as a class action?  If so, no need to rely on AGs, who could well be Republicans...

    Getting rid of the mandate only--could it mean no more insurance industry?  Great Balls of Fire!

    Parent

    I think Roberts dissented (none / 0) (#15)
    by andgarden on Mon Jan 31, 2011 at 07:24:41 PM EST
    on some environmental regulation commerce clause cases when he was on the D.C. Circuit. He is probably clearly in the right wing camp when it comes to the Commerce clause. Though so were Rhenquist and O'Connor.

    Kennedy joined the majority opinion in Gonzales v. Raich without comment (thus giving it 5 votes), and Scalia concurred. Even Scalia's concurrence there ought to be enough to sustain the ACA in full, but I doubt he would agree.

    Parent

    Looking at some of Scalia's (none / 0) (#16)
    by MKS on Mon Jan 31, 2011 at 07:33:04 PM EST
    language in Gonzales v. Raich, I agree with you Scalia will be hard pressed to find the health care law unconstitutional.....His writing in Gonzales seems pretty unequivocal....

    But, I remember, "Get over it" with respect to his vote in Bush v. Gore, where he abandoned all principles of Federalism...

    Parent

    Commerce clause--one would think so (none / 0) (#14)
    by MKS on Mon Jan 31, 2011 at 07:21:08 PM EST
    But ever since (who was it?  Rehnquist?) held that banning guns in schools was outside the Commerce Clause, a little more support is a good thing....

    Parent
    Well (none / 0) (#2)
    by Ga6thDem on Mon Jan 31, 2011 at 06:40:56 PM EST
    for the last five years or so I've been a believer that we are eventually going to end up with single payer either as a national plan like Medicare or done state by state because we cannot sustain the current health care model. This might be one time I do agree with Ezra. If the ACA is overturned, the only option is single payer.

    Or everyone for himself (none / 0) (#7)
    by MKS on Mon Jan 31, 2011 at 07:02:31 PM EST
    The conservatives will simply cap Medicaid, and cap Medicare for lower income folks...Just like Jan Brewer refusing to put $1 million into the transplant fund in Arizona...and people on the transplant list dying...

    Rationing for poor people....

    Parent

    Wondering what the health (none / 0) (#6)
    by oculus on Mon Jan 31, 2011 at 06:59:30 PM EST
    insurance lobby is urging Congress to do re messing with the current law.

    Court friendships? (none / 0) (#18)
    by waldenpond on Mon Jan 31, 2011 at 07:53:07 PM EST
    I wonder if a couple of the corporate masters in the insurance industry hang out with any of the Supremes..... if people think the SC is going to take away the insurance lobby and the pharma welfare, they are delusional.

    Parent
    agreed (none / 0) (#9)
    by jharp on Mon Jan 31, 2011 at 07:05:15 PM EST
    I've long thought that would be an excellent solution. All of the infrastructure is already in place.

    To quote Alan Grayson, "it's like allowing only 65 and older on the interstate highways," the structure is there, let's use it.

    I also must mention. I am in agreement with the Singapore model of forced health savings accounts. It's a great way for everyone to have a little skin in the game. If you don't use it, you get to keep it.

    Gotta give the GOP credit (none / 0) (#17)
    by BDB on Mon Jan 31, 2011 at 07:52:13 PM EST
    they just might save universal healthcare yet.

    The same people who want to (none / 0) (#25)
    by Anne on Mon Jan 31, 2011 at 10:39:16 PM EST
    shrink government are not going to expand Medicare and Medicaid, for heaven's sake; Ezra must be high on manure fumes, or something...

    If you can't pay, you can't play: it's just tht simple for these people.  They will happily stand around all day taking whatever bail-outs the government wants to reward their savviness with, but recoil in horror at using government - and their tax dollars - to come to the assistance of people who weren't smart enough, or hard-working enough to be able to pay their own way.

    The idea that people would consider expanding government programs they would just as soon see taken from government and placed in the private sector is just laughable - or enough to make one weep.

    Or is that the set-up: first welcome in all the poor saps who don't have health insurance and can't afford health care, and then - WHAM! - hand 'em all vouchers that wouldn't be enough to buy used Kleenex, and tell 'em to give WellPoint a jingle?  Toodle-oo, suckers...

    Now, there's some 11-dimensional moves, eh?

    I don't think (none / 0) (#30)
    by Ga6thDem on Tue Feb 01, 2011 at 07:38:14 AM EST
    that anyone thinks that the GOP is going to expand anything. I think the failure of the ACA will lead to single payer simply because there is going to be so many people without health insurance and like MT says above, people like this will be willing to ignore the anti-government screeching from the right.

    Parent
    There are already some 50 million (none / 0) (#36)
    by Anne on Tue Feb 01, 2011 at 10:02:54 AM EST
    people without insurance; that's a number that's continued - and is continuing - to grow, so what's the point at which there are enough people without coverage that, suddenly, single-payer makes sense?  With a shrinking Democratic majority that I believe will disappear altogether by 2012, there's just no way that legislators who have been consistently opposed to more government even in the form of expansion of existing programs are going to slap themselves on the forehead and say, "D'oh!  Of course single-payer is the answer!  Why didn't we think about that to begin with?"

    Most people just plain don't give a crap if millions of people don't have affordable coverage or access to affordable care - as far as they are concerned, that someone does without is just the default position and it isn't up to them to contribute in any way to the greater good.  You can make all the arguments about how single-payer would help the economy, but all they see is another government program for deadbeats - because in their world, people who don't have these kinds of basic things are just lazy parasites who want others to pay for them so they don't have to get a job - so whether it's 50 million people with no coverage or 100 million people without, it doesn't matter to them.

    These are the same people who think the foreclosure fraud mess is all about deadbeats who just want a free house.  And who can't stand the idea that any effort to do principal modifications might benefit someone who doesn't "deserve" help.

    And some of the people with that mindset are members of Congress, members of state legislatures, governors - people with the power to make the kinds of decisions that mean the difference between life and death, poverty and prosperity.

    No, I don't see single-payer happening by default, at least not in my lifetime; when I think about how it could have been part of the conversation from Day One, but for Obama taking it off the table, that this was maybe a once-in-a-generation opportunity that greed and self-interest killed, I could just scream.


    Parent

    Oh, (5.00 / 1) (#47)
    by Ga6thDem on Tue Feb 01, 2011 at 12:09:40 PM EST
    I think there will come a day when enough people won't be able to afford health care that single payer will happen. I just don't see us continuing the same model we have been and being able to compete with business.

    You have to realize that the whole healthcare industry in this country is on the verge of collapse due to the set up we have. The people who do have insurance and don't care about the "others" will soon become the "others" themselves because they can no longer afford insurance. Insurance is pricing itself right out of viability and so is medical care. Everyone in the healthcare industry has been in an upward price spiral for quite a while making it un-affordable for more and more people every day. The thing that holds back any real reform right now is that the people who do have health insurance don't realize that they are paying for the uninsured already with rising premiums.

    Parent

    I think that as long as the insurance (none / 0) (#49)
    by Anne on Tue Feb 01, 2011 at 12:32:25 PM EST
    industry can keep squeezing money out of people, its grip on the system will continue - even though, as is painfully obvious, more and more people are going to have to walk away from it and hope their health holds up.

    The sad truth is that this just isn't affecting the people who make the decisions; not only do they get a choice of a wide variety of plans, but the premiums are highly subsidized, which is ironic given that most members of Congress have incomes and assets that are significantly higher than average.

    And while I think that "eventually" we may see the collapse of the current system, I don't think that collapse is at all imminent; I live in an area where you can't swing a dead cat without hitting someone in the medical profession, and every major hospital in the area - and there are a lot of them - is in the process of or in the final stages of completing major additions - new patient towers with concierge amenities, flat-screen TVs, catered meals, private rooms, new specialty centers for women's health, cancer, children, orthopaedics - and on and on.

    Competition for patients is stiff - they are all essentially competing for the same pool of patients, and the question is, how can this possibly be sustainable?

    So, when they stop building hospitals, and outpatient centers and surgicenters, that's when I will believe the end is near - but as long as a system exists which will accommodate the kind of multi-million (billion?) dollar building and expansion that we're seeing, I don't believe the impetus for single-payer will be able to trump that existing system.

    Parent

    It's (none / 0) (#53)
    by Ga6thDem on Tue Feb 01, 2011 at 01:14:48 PM EST
    not sustainable. I have a family member in the medical field and in small hospitals around the country they are completely dependent on Medicaid and Medicare as most small town businesses don't offer insurance to their employees. We have a number of hospitals here in GA that are going under. As the pool that they compete for gets smaller and smaller, they will be forced to make choices but as of yet it hasn't gotten to that stage.

    Parent
    you don't, (none / 0) (#27)
    by cpinva on Mon Jan 31, 2011 at 11:09:57 PM EST
    Where do I sign up for this result?

    because it only happens in your drug fueled dreams.

    You mean Ezra's (none / 0) (#29)
    by Big Tent Democrat on Tue Feb 01, 2011 at 07:25:26 AM EST


    Parent
    Wow, why didn't anyone come up with this (none / 0) (#35)
    by ruffian on Tue Feb 01, 2011 at 09:55:42 AM EST
    solution before? It is so simple! And of course it is the obvious result of the repeal or strike down of HCR.

    That was a nice stroll through Ezra's world for a few seconds. Back on planet earth, not gonna happen.

    Something happened (none / 0) (#43)
    by NYShooter on Tue Feb 01, 2011 at 11:04:50 AM EST
    To our country several decades ago; most knowledgeable observers point to the election of Ronald Reagan,1980.

    Prior to that time common sense was generally accepted: We understood that there were smart people, and that there were not-so-smart people. The not-so-smarts accepted reality and deferred to the smarts on issues that required education and accomplishment. Teachers were respected, as were scientists, doctors, engineers, philosophers, and all sorts of analysts.

    The election of R. Reagan changed all that; a not-so-smart became President. This trained actor had developed a charisma which gave the not-so's a hero and suddenly challenging smart people became acceptable.  A cult was born, and, being not-so-smart, they were easily led to behave in ways that guaranteed their own degradation, as well as the degradation of our country.

    Until the majority of our citizens accept the fact that debating serious issues with intellectual illiterates is impossible the decline of America will continue.

    And that decline will be aided by (none / 0) (#44)
    by Anne on Tue Feb 01, 2011 at 11:30:30 AM EST
    the lesser-of-two-evils metric by which candidates for elective office are measured, guaranteeing the declining quality of the people we elect, and the governance that results.

    It's a downward spiral that shows no signs of changing direction.

    You can see this a little bit in the rhetoric that's a part of the coverage of the crisis in Egypt: I've heard more than a few US officials speak about the need for the Egyptian people to have free and fair elections, but what good is a free and fair election if the only choices are candidates who aren't going to advance a free and fair society?

    I think that unless and until we have major campaign finance reform - which would have to be 100% government-financed elections - we are never going to get high-quality candidates into the mix.  Money has so corrupted the system that it's no longer enough that we are "free" to vote, or that the votes are "fairly" counted; as long as the candidates are bought and paid for by private, corporate interests, the people's interests will continue to go unrepresented - which, it seems to me, is the antithesis of what it means to live in a democratic society.

    I think much of the electoral process in this country has become a charade, and that is reflected in the quality of governance.


    Parent

    I should add that I don't want anyone (none / 0) (#50)
    by Anne on Tue Feb 01, 2011 at 12:37:01 PM EST
    to think that I don't understand that the people of Egypt ought to have the right to vote in an election for whomever they want to lead their country - but if their choices would end up being Strong Man #1, Fascist-Lover-of-Torture #2 and Authoritarian #3 - what choice is that really?  

    Parent
    Yes, of course you're right (none / 0) (#51)
    by NYShooter on Tue Feb 01, 2011 at 12:50:31 PM EST
    But simply pointing out the obvious makes my point. Smart people know that the current way we elect representatives is the root of our problems. Not-so-smart people can't do the cognitive analysis to figure that out so they're easy prey for the charlatans of Fox and talk radio who speak to them in a language they understand....one liners and catchy slogans. Ask any "not-so" about the Citizens United issue and what do you get? You get a blank look, and then a face-saving comment like, "well, everyone should have a right to vote." They don't know what they just said, but it sounds pretty good, right?

    We know what the problems are: Oligarchs buying influence, representatives whoring themselves out to anyone with a buck, corrupt judges, cowardly7 entertainers masquerading as "reporters," etc, etc.

    And we know what we should do. Every pundit and commenter repeats and repeats these obvious facts ad-nauseum.

    Short of armed revolution, working within the current framework is the only realistic option. And, although the odds are stacked against us, every once in a while the stars align just right and an opportunity for real change becomes possible. 2008 was just such an opportunity.

    I don't know when they'll be another such opportunity but I do know that The Masters had their pants scared off at those prospects and they'll make sure it doesn't happen again any time soon. That's what makes the Obama treachery so tragic.

    Feeling dread for our future is not being a "gloom & doom pessimist;" its being a realist.


    Parent

    Ezra is out of his mind (none / 0) (#61)
    by Slado on Tue Feb 01, 2011 at 07:33:39 PM EST
    We don't have the money for universal healthcare.  We don't have the money for the services we currently have.

    That is why this dream of Obama's will ultimately fail.  It's too expensive unless you blow up the whole system and no one is man enough to do that.

    Even if this thing isn't neutered by politics or the judiciary the eventual reality of our fiscal situation will bring it down.

    Warming Up To The Repeal Of The Health Bill? | 61 comments (61 topical)

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