David:
I have no idea what public employees you have had the most  dealings with
in your life but most ( not all, but most ) of the ones I have had  
dealings with
have been conscientious and have sought to do good work.
 
You have a point, entirely valid, about the BHO admin, but I'm thinking  
about
the people, professionals, who will actually carry out the work of the  
plan.
 
To REPEAT, this particular plan SUX.   I  do  not like  it. My argument is
essentially hypothetical since it is about public option.
 
But , while you make some points, at no place do you address the  problems
which public option is most designed to remedy.  Should an exec at  Aetna, 
or 
any other company , be paid $ 15,000,000 when their actions or inaction  
means that 
an average stiff must pay $ 500 per day for a hospital room, $ 5000 for a  
medial procedure
that costs a doctor and his assistants $ 1000 to perform, or $ 50,000 over  
the
course of a decade for prescription drugs ?
 
Sure, aspire to wealth, it is legal and is useful in a hundred ways. But  
NOT when
that kind of reward level means that I get shafted when I need  surgery, or 
my mother
gets robbed at surgical knifepoint, or Uncle Harry needs to shell out 25%  
of his
income on drugs that a pharmaceutical company sells at a 250% mark  up.
 
Sometimes capitalism is legal robbery. 
 
Mostly I like the capitalist system. But in all cases ?  Not a  chance.
 
Billy
 
================================================
 
 
 
In a message dated 3/23/2010 9:53:37 P.M. Pacific Daylight Time,  
[email protected] writes:

Billy, 

With the way this administration is  working, I'm reminded of the Gang That 
Couldn't Shoot Straight. I don't trust  any administration with this. See 
how wonderfully solvent Medicare and Social  Security are. OOPS!!! Heck, just 
look at the new deficit figures. And by the  way, Government pay now leads 
private sector pay in applications programming.  So I could go get a 
government job and make more money (couldn't look myself  in the mirror any 
more, 
but hey). 

The Toll Road argument is specious,  the state owns both. Some highways are 
toll until they are paid for: The  Dallas-Fort Worth Turnpike, which is now 
the Tom Landry Highway (I-30) and  free. Under the control of the state of 
Texas for the whole time. It wasn't  ever private and then went public. It 
was public from the beginning.  

Citing the Huffington Post and a web site run by a pro-Obamacare group  is 
not persuasive to me. Not without hearing the old class warfare "evil  
Capitalist Oppressors" memes in my head while doing so. 

Frankly,  executive pay like that is something to shoot for. I don't really 
understand  why it is wrong for the head of Aetna to make big bucks, but OK 
for the head  of GE to make big bucks. Oh, that's right, the head of GE 
donated to Obama. I  forgot. 

I guess that all medical care should be charity driven.  

But government will soon set pay guidelines and everything will be  "fair." 
Just like the old Soviet Union. 

David 

 
"A  pleasant natural environment is a good - a luxury good, philosophical 
good, a  moral goody-good, a good time for all. Whatever, we want it. If we 
want  something, we should pay for it, with our labor or our cash. We 
shouldn't beg  it, steal it, sit around wishing for it, or euchre the 
government 
into taking  it by force."--P. J.  O’Rourke  


On  3/23/2010 10:33 PM, [email protected]_ (mailto:[email protected])   wrote:  
David :
Seems to me that criticism of private insurance companies in  the medical 
sector
--this has nothing to do with homeowner insurance, or automobiles, or  
anything else--
is entirely justifiable. Generally I favor market solutions to  just about 
anything, but
here is a case , financial institutions is another, where the market  
clearly has broken 
down and the best available solution is the public sector.
 
The argument that a public option would destroy private insurance  
companies is
false as I see it, for much the same reason that toll roads  and toll 
bridges 
continue to exist despite the existence of the Interstate or , for that  
matter, other
public  highways or bridges.
 
Consider these remarks from : Donald  Cohen, Executive Director, Center on 
Policy  Initiatives
in the Huffington Post for March 23, 2010, originally from last  year.
 
" Since health insurance costs are rising at nearly twice the inflation  
rate, there couldn't be a more important time to eliminate non-essential  
overhead through healthy competition. Families and employers are being  crushed 
under the burden of increased health care costs. Since the year  2000, 
employer-sponsored health coverage premiums have increased by 87  percent. 
 
It's no wonder, though, that the Health Insurers are frantically trying  to 
head off competing with a public plan. Private insurance overhead and  
profits eat up 20% and more of health care premiums while Medicare overhead  
(and no profit) is closer to 3%. There is big money to be made in health  
insurance. The top 7 "for profit" health insurers made a combined $12.6  
billion 
in 2007-- an increase of 170.2% from 2003. The same year, the _average CEO 
compensation package  _ 
(http://www.insurancecompanyrules.org/pages/insurance_company_ceo_compensation_2006_2007)
 for these health insurance companies 
was $14.3 million. Pay  packages ranged from $3.7 million to $25.8 million. " 
I simply cannot work up much or any sympathy for any business which  is 
usurious in essence 
Moreover from what I have read elsewhere, insurance company profits grew  
even more than usual in 2009 despite the recession for the simple reason  
that several million people dropped their private plans because they could  no 
longer afford them, and many of this pool of people were those with  higher 
costs due to health issues. In such a case inflation of profits is  immoral. 
There was also a Sanjay Gupta piece on CNN which showed the obscene  prices 
for medical equipment  that are commonplace in the "industry."  And you 
thought that military toilet seats at $ 1000 were bad, that kind of  pricing 
occurs up and down the line for everything from catheters to  bedpans, Clearly 
hospitals, if not also doctors, don't give a damn about  such pricing ( 
even if some do ) and are more than willing to require people  to pay through 
the nose. Even if families are bankrupted in the process. In  what way is 
that good ? 
The article below explains "public option" for anyone unclear on the  
concept. 
I am anything but anti-capitalist, but I am very much anti-gouging  and do 
not regard the government as evil by design. So, when a government  option 
can do a better job, OK with me. 
Today about 17% of GDP goes to health care,  twice the rate in 90% of 
modern nations  This trend has  gotten worse with, ironically, more 
competition, 
or presumably more  competition, from the time about 20 years ago when it 
stood at about 10 %.  The nation cannot afford more of this nonsense and 
anything that will stop  this is long overdue. 
Billy 
--------------------------------------------------------------------- 






OpenCongress blog
 
What is the Public Option? 
August 20, 2009 - by Donny  Shaw 
 
The public option as proposed in the _House health care bill_ 
(http://www.opencongress.org/bill/111-h3200/show) , is a government-run  health 
insurance 
plan, like Medicare, that would compete along side private  insurers in a 
new Health Insurance Exchange that the bill would set up. The  exchange is 
basically a place where people who aren’t on Medicare or  Medicaid and donâ
€™t have insurance through their employers would go to  comparison shop for 
a health plan. One of the plans available on the  exchange would be the 
public option. Like all plans on the exchange, the  public plan would have to 
meet certain minimum standards for care –  minimum services that must be 
covered, mental health benefits parity, a fair  grievance and appeals 
mechanism, etc. 
The public option and the private insurers on the exchange could still  
offer different levels of care – from catastrophic-only to comprehensive  –
 but plans would be relatively standardized by type so that comparison  
shopping is easier for consumers. The exchange would be available to the  
public as a website and a toll-free hotline, and would be focused on making  
information about the plans more transparent. 
Conservatives argue that the government-run public option plan would  drive 
private insurers out of business because, not being burdened by the  need 
to generate profit, they could offer the same level of care at a lower  
price. They fear that this would happen to such an extent that eventually  
there 
would not be any private insurers left. Liberals on the other hand see  the 
competitive advantage of a public plan as a way to bring costs down  
throughout the industry, thereby increasing the number of affordable health  
insurance choices for consumers. Without the public option there will be no  
real 
change to the current system that has kept health insurance out of  reach 
for millions of Americans, they argue. 
Who’s right? The Congressional Budget Office (CBO), a politically 
independent, non-partisan government  agency whose job is to provide economic 
data 
to Congress on the bills they  propose, has done some _analysis_ 
(http://www.cbo.gov/ftpdocs/104xx/doc10430/House_Tri-Committee-Rangel.pdf)  
(.pdf) of 
the public option’s likely  effects. This is as close as we can get to an 
unbiased, scientific take.  Based on how the CBO sees the public option 
working,  it’s safe to say that even if the conservatives are right and the 
goal is  to crowd out the private insurers, as written into the bill, it’
s not  going to have that effect: 
Another significant feature of the insurance exchanges is that they  would 
include a public plan that largely pays Medicare-based rates for  medical 
goods and services. CBO estimates that the  premiums for that plan would 
generally be lower than the premiums of the  private plans against which it 
would 
be competing. Because all plans  offered in the exchanges would vary their 
premiums to reflect the costs  incurred in each area, the difference in 
premiums between private plans  and the public plan would vary geographically—
but on average the public  plan would be about 10 percent cheaper than a 
typical private plan offered  in the exchanges. That difference in premiums is 
itself the net effect of  differences in the major factors that affect all 
insurance plans’  premiums, including their payment rates to providers, 
their administrative  costs, the degree of benefit management they apply to 
control spending,  and the pool of enrollees they attract (the effects of 
which would be  partly offset by the risk-adjustment provisions described 
above).
 
 
 
 
 
 




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