January 20, 2014
— DrewM Avik Roy is considered one of the right's leading healthcare policy experts. Unfortunately, his current plan isn't exactly conservative.
His latest idea does away with Medicaid & Medicare as we know it. A laudable goal to be sure but there are a few catches.
To credibly advance this approach, conservatives must make one change to their stance: They have to agree that universal coverage is a morally worthy goal.
Color me cynical but if your "conservative" plan relies on first redefining conservative principles to make what you want to do fit the definition of conservative, it's not actually...conservative.
So what approach is Roy advancing?
First, weÂ’d deregulate the Obamacare exchanges and modify the lawÂ’s subsidies to broaden AmericansÂ’ coverage choices and encourage adoption of health savings accounts and catastrophic coverage.Second, weÂ’d raise MedicareÂ’s retirement age by three to four months per year forever. Since people below the Medicare retirement age would be in the means-tested exchanges, this would gradually replace the fully subsidized Medicare program. For example, over 15 years the retirement age would be roughly 70, meaning that individuals aged 65 to 69 would get their health insurance through the exchanges.
Third, weÂ’d transform the Medicaid program by folding its acute-care population into the deregulated exchanges, while returning its long-term care and disabled populations fully back to the states, free of federal interference.
Let's unpack that a bit.
First, we're keeping and reforming the ObamaCare exchanges, not doing away with them.
Given that conservatives have campaigned on repealing Obamacare for nearly four years, itÂ’s jarring to consider a reform plan that does not formally scrap the law. But such a plan has several advantages.
Say it with me...we all hate ObamaCare equally. Even those of us who want to keep parts of it or implement it at the state level.
Second, his plan basically requires the privatization of Medicare and Medicaid. Is there anyone who has half a clue about American politics who thinks that's anything but a fantasy?
What will happen is big government conservatives will have forced the right to concede the liberal goal of "universal coverage" as a worthy and legitimate government endeavor. They will then do what they always do...cobble together some gigantic program that keeps the worst elements of all the plans which then doesn't do exactly or even remotely do what it's most ardent supporters claimed it would. That will naturally lead to calls to “fix” the unforeseen problems with more government intervention in the market place.
What Roy suggests, catastrophic plans paired with Health Savings Accounts (HSAs), is a good plan. It was an option available before ObamaCare came along. But there's no reason to make it universal. Aside from the fact that some people may chose other options because it's simply their right to do so, you can have a system like this as an option by...simply repealing ObamaCare and returning to where we were in the dark days of 2009.
Would it be nice to turn Medicare and Medicaid into this type of program? Sure. But aside from it being a political fantasy that has some glaring holes (like how exactly are Medicaid patients going to fund their HSAs?), there's no reason to force the rest of the country into this model.
Roy will say including everyone in this type of system is the only way to control the overall cost of healthcare in this country. Again, this ignores some major historical realities. When the government tries to control the overall cost of a product/good while at the same time acting as the major provider of funding for that product/good, two things will happen.
1. If the government says "here's a pile of money" people will find ways to spend that money. Think of the college loan system and the higher education bubble. Once almost everyone could afford college thanks to government subsidies, grants and loans (whether they were suited to going or not), colleges found ways to spend all that "free" money.
The healthcare industry will do that too.
2. Once costs do start rising because of all this money flowing the only option (other than “spend even more!”) will be to directly control prices and/or limit access. This is just the fact of how government works when it interferes in the marketplace.
Yes, Roy points to similar plans in Switzerland and Singapore but those tiny, homogeneous countries have nothing in common with a diverse, continental nation like the United States.
Of course Roy is right that the big drivers of government healthcare spending are Medicaid and Medicare. But the way to control those costs is not adding another huge entitlement to coverage. Find ways to reform those programs and minimize the governmentÂ’s role in the private healthcare/insurance sector.
Big government conservatives like Roy are the flip side to die hard lefties...they ignore history and insist that their big government idea will work because none of the ones that came before were done the right way.
We've been trying big government ideas and promises like universal coverage for close to a century. How about we try something completely different for a while? Like letting people make and live with their own choices. It's so crazy it just might work.
Posted by: DrewM at
08:13 AM
| Comments (232)
Post contains 885 words, total size 6 kb.
Posted by: Niedermeyer's Dead Horse at January 20, 2014 08:16 AM (DmNpO)
Posted by: Dorcus Blimline at January 20, 2014 08:17 AM (iB0Q2)
Posted by: AllenG (DedicatedTenther) Ah, F It. at January 20, 2014 08:17 AM (PYAXX)
Posted by: NCKate at January 20, 2014 08:18 AM (x6fKj)
Posted by: President Kim Kardashian Yeezy typing through the Time Space Continuum at January 20, 2014 08:19 AM (RJMhd)
Posted by: akula51[/b][/i][/s] at January 20, 2014 08:19 AM (+fNrM)
Posted by: Burn the Witch at January 20, 2014 08:20 AM (hpVGZ)
Posted by: Jim Scrummy at January 20, 2014 08:21 AM (+BGwj)
Posted by: Burn the Witch at January 20, 2014 08:21 AM (hpVGZ)
The Republicans can't compete on the Left's playing field, and to pretend they can reform or tweak Obamacare just plays into the Left's premise that we *need* heavily government controlled healthcare.
Posted by: Lizzy at January 20, 2014 08:21 AM (POpqt)
Posted by: President Kim Kardashian Yeezy typing through the Time Space Continuum at January 20, 2014 08:22 AM (RJMhd)
Posted by: Niedermeyer's Dead Horse at January 20, 2014 08:22 AM (DmNpO)
Posted by: Purp[/i][/b][/s] at January 20, 2014 08:23 AM (zxsxA)
No thanks.
Posted by: BurtTC at January 20, 2014 08:23 AM (BeSEI)
Posted by: jwest at January 20, 2014 08:23 AM (u2a4R)
Posted by: Niedermeyer's Dead Horse at January 20, 2014 08:24 AM (DmNpO)
Personally, I am in favor of a national safety net that covers catastrophic expenses - funded by a tiny payroll tax.
Then, replace all the exchanges with nationally approved private providers. I want to be able to buy health insurance from Flo or the Gecko guy and have it be portable no matter where I live.
You have to register with one of these companies to get the catastrophic coverage, but you don't have to purchase any insurance from them.
Otherwise there are no rules governing how these companies sell you gap insurance, except for a must-carry rule - which would be cheap as hell since there is no longer any high-end risk.
Posted by: Chi-Town Jerry at January 20, 2014 08:24 AM (f9c2L)
Posted by: Cicero (@cicero) at January 20, 2014 08:24 AM (8ZskC)
Posted by: akula51[/b][/i][/s] at January 20, 2014 08:24 AM (+fNrM)
Posted by: boulder toilet hobo at January 20, 2014 08:25 AM (vCyy6)
Incredible. This guy can have half a clue about reality (markets, human behavior, logic), and suggest almost any of this nonsense?
First, the idea that "universal coverage" is some sort of stand-alone idea in its own right, and makes any sense, and is not a ridiculous straw man from the outset. Hey Avik, here's a clue: almost everyone already was "covered".
The way that (alleged) "gaps" in morally desirable things (housing, nutrition, etc.) are taken care of by logical intelligent policies is to, uh, simply cover the gaps. Food stamps. Sec. 8 housing. In earlier times, tuition subsidies for college. NOT remake the entire universe, thus incinerating liberty and (unavoidably) producing vastly, vastly worse outcomes for everyone (as with O-care).
The guy simply cannot be taken seriously. The only serious analysis of the entire subject starts with reality - i.e., that medical service delivery is almost entirely like any other kind, and thus is best produced when competition and choice are maximized.
Both the services themselves (medical, pharma R&D) and the completely unrelated financial product associated with them (insurance, real insurance, not the frankenstein hybrid that displaced real insurance over the last 30 years) are vastly over- and mis-regulated, cartelized by state interference and distorted by federal tax code and involvement. This has led to vastly excessive inflation in the costs of these things.
Restore normal, competitive market conditions to the medical services, products and financial products associated with them and presto! You won't have much of a discussion because what will there be to discuss? Any gaps dues to the usual human vagaries that produce gaps in other areas (housing, food, employment, etc.) should be addressed directly, an entirely separate matter. And doing so will, naturally, be fairly easy, as the costs of everything will be much lower. In doing so, the usual principles apply: avoid the pernicious side-effecxts of intervention by being always minimal and short-term in your interventions, in most cases.
To see such a smart guy produce such frankly idiotic crap would be discouraging, if it were possible to be more discouraged than I've been for a very long time.
Posted by: non-purist at January 20, 2014 08:25 AM (afQnV)
Posted by: AllenG (DedicatedTenther) Ah, F It. at January 20, 2014 08:26 AM (PYAXX)
Posted by: boulder toilet hobo at January 20, 2014 08:26 AM (vCyy6)
And the GOP are just the guys to do it.
Posted by: Eric Stratton, Rush Chairman at January 20, 2014 08:26 AM (8ZskC)
Posted by: Prez'nit 404 at January 20, 2014 08:26 AM (Dwehj)
Posted by: Dang at January 20, 2014 08:27 AM (MNq6o)
Posted by: D-Lamp at January 20, 2014 08:27 AM (bb5+k)
Posted by: Count de Monet at January 20, 2014 08:27 AM (BAS5M)
Posted by: Avik Roy at January 20, 2014 08:28 AM (8ZskC)
If it can't be repealed (lacking 60 votes in the Senate and Presidential signature) is it really so wrong to have a Plan B?
Posted by: Hollowpoint at January 20, 2014 08:29 AM (SY2Kh)
Posted by: [/i]andycanuck[/b] at January 20, 2014 08:29 AM (vuh7l)
Step 1: ????
Step 2: ????
Step 3: ????
FTFY.
Has there ever been a Superbowl where both teams lost?
I thought I heard about that somewhere.
Posted by: eleven at January 20, 2014 08:29 AM (KXm42)
Posted by: Null at January 20, 2014 08:30 AM (xjpRj)
Posted by: Andy at January 20, 2014 08:31 AM (vGQV1)
Posted by: joncelli at January 20, 2014 08:31 AM (2hQvD)
Old and Busted:
Never interrupt your opponent when he is making a mistake. - Napolean
New Hotness
Hey.... I think if act just like you.... winning!!! - Squishes everywhere.
Posted by: fixerupper at January 20, 2014 08:31 AM (nELVU)
Posted by: President Kim Kardashian Yeezy typing through the Time Space Continuum at January 20, 2014 08:31 AM (RJMhd)
Posted by: D-Lamp at January 20, 2014 08:31 AM (bb5+k)
Posted by: MTF at January 20, 2014 08:32 AM (oKs5r)
Maybe Avik would understand if we made it simpler for him: hey, let's just keep the old "system", minus the federal tax subsidy for employer-provided insurance and the barriers to inter-state competition, and provide vouchers for those "not covered" to buy insurance.
My god, people, how can such idiotic ignorance of basic economic realities be exhibited by supposedly wonkish policy types?
And to to start his nonsense with the appeal to moral concern, entirely stipulating the nonsense about the involuntarily uninsured, really beclowns him. "Conservative", like all lazy short-cut and tribalist labels, is stupid and empty and a distraction. His analysis is absurd, and his "solutions" are ridiculous, and none of it takes into account economic reality or common sense.
A "safety net" that is really a safety net doesn't change and control and consume the rest of society. Pretty simple to understand, Avik.
Posted by: non-purist at January 20, 2014 08:32 AM (afQnV)
Yep, and back in the day those things the poor needed, like food, clothing, housing, medical care were provided by... wait for it... charities.
Not the government. Charities.
Which had the added benefit of allowing PEOPLE to decide how and when to help their fellow men, and allowed for a dignified exchange between the helped and the helpful.
But no, we have the inhumane provision of all these services done impersonally by government, which helps create the sense that the helped are entitled to it.
What a world.
Posted by: BurtTC at January 20, 2014 08:33 AM (BeSEI)
Posted by: tsrblke, PhD(c) No Really! at January 20, 2014 08:34 AM (GaqMa)
Clip, clip there
We give the Leftard laws
That certain air of savoir faire
In the merry old land of Oz
Posted by: Avik Roy at January 20, 2014 08:34 AM (8ZskC)
Posted by: backhoe at January 20, 2014 08:34 AM (ULH4o)
A camel shall pass through they eye of a needle, first.
Posted by: Prez'nit 404 at January 20, 2014 08:34 AM (Dwehj)
Posted by: D-Lamp at January 20, 2014 08:34 AM (bb5+k)
I worked for 45 years after I got out of the Army (Vietnam, class of '70) and have paid the full amounts due each year for Social Security and Medicare.
I'm now pushing 69 years old. Medicare SUCKS - right now you HAVE to purchase a Medicare Supplemental Plan to cover the costs that Medicare doesn't cover (that is, Medicare allows $x for something and the cost allowed by Medicare is $x+$y), unless, of course, you have A LOT OF MONEY in the bank. The Premiums for "y" are significantly higher than Medicare and going higher, with less coverage since Obama decided to take $75 BILLION a year for 10 years out of government supports to Medicare.
So the talk of doing away with Medicare is more than a little bit upsetting to me. Its at the point now where finding a doctor who will accept Medicare Patients (even with the supplemental "y" plan) is very difficult indeed.
Does this mean that younger folks are gonna be subsidizing MY Medicare? YES,it does. BUT if it wasn't for people like me, many of y'all would not have any kinds of opportunity at all. My generation (a year or so before the start of the "Baby Boomer" generation) worked our collective asses off, defended this nation and helped to make America the nation of Opportunity. So now the "Millennials" and Gen X are more than willing to accept what WE PROVIDED and then take away what we paid for.
Not from this ole boy.
NEVER.
Posted by: Realwest at January 20, 2014 08:35 AM (30LIS)
Posted by: Niedermeyer's Dead Horse at January 20, 2014 08:35 AM (DmNpO)
-----
Well... how else would the gubmint get to skim off the top???
Posted by: fixerupper at January 20, 2014 08:35 AM (nELVU)
Posted by: Ribald Conservative riding Orca at January 20, 2014 08:35 AM (RFeQD)
Posted by: Hurricane LaFawnduh at January 20, 2014 08:35 AM (pginn)
"Tomorrow, Americans across the country will celebrate the legacy of Dr. Martin Luther King, Jr.
His remarkable vision showed the entire world that by working together, we can all be empowered to make our communities better places. Recently though, a shameful nationwide pattern of attempts to dismantle voting rights in our country has emerged.
Hillary explained perfectly what's happening: "We've seen a sweeping effort across our country to construct new obstacles to voting, often undercover and addressing a phantom epidemic of election fraud." "
[usual crap]
end of the email:
Quentin James
Black Americans Director, Ready for Hillary
[still dividing people by race, are we, Democrats..?]
Posted by: Mallfly at January 20, 2014 08:35 AM (bJm7W)
I have been called a lot of names on this site and others for pointing that out.
I'm not sure how much more obvious the GOP can be that it will not repeal Obamacare before everyone on the various conservative blogs believe it.
Obviously, both Boehner and McConnell outright stating that their plan is to "fix" Obamacare rather than repeal it did not convince many of my fellow conservatives, so I'm guessing in 10 years, when the GOP is still sending out fund-raising letters telling us it will repeal Obamacare after the next election, many conservatives will still believe the GOP.
Posted by: I at January 20, 2014 08:35 AM (sOx93)
Posted by: Andy at January 20, 2014 08:36 AM (vGQV1)
Posted by: Anna Puma (+SmuD) at January 20, 2014 08:36 AM (LLNW+)
Posted by: Jay Fucking Cutler at January 20, 2014 08:37 AM (At8tV)
Posted by: tsrblke, PhD(c) No Really! at January 20, 2014 08:38 AM (GaqMa)
Posted by: AllenG (DedicatedTenther) Ah, F It. at January 20, 2014 08:39 AM (PYAXX)
Avik Roy.....
And you expected something other than minor tweaks to Obamacare to be the PLAN A for Mitt Romney's main heathcare advisor?
How charmingly innocent.
Posted by: Laurie David's Cervix at January 20, 2014 08:39 AM (kdS6q)
Posted by: --- at January 20, 2014 08:39 AM (MMC8r)
you know they are thinking it
Posted by: Jay Fucking Cutler at January 20, 2014 12:37 PM (At8tV)
-----
Oooooohhhh.... It would be so freaking COOL if we could get FREE oil changes and FREE wiper blades and FREE tires and FREE roadside service and FREE washer fluid and FREE rotations and FREE headlamps and FREE muffler belts.
**spit**
Posted by: fixerupper at January 20, 2014 08:40 AM (nELVU)
==========
No.
Forcing someone to do anything--no matter how "good" it is for them--is evil.
Always and forever.
It is multiplied evil when the good is for the good of society.
Posted by: RoyalOil at January 20, 2014 08:40 AM (VjL9S)
Posted by: tsrblke, PhD(c) No Really! at January 20, 2014 08:41 AM (GaqMa)
Posted by: joncelli at January 20, 2014 08:41 AM (2hQvD)
What will happen is big government conservatives
-------------------------------------------
That's quite an oxymoron, Drew.
Posted by: Soona at January 20, 2014 08:41 AM (ycijm)
Posted by: navycopjoe at January 20, 2014 08:41 AM (At8tV)
AllenG and Null, spot on. When does this nightmare sequence end? Supposedly "conservative" (again, stupid label) analysts who recognize much of the idiocy at the root of our problems then go on to propose almost equally disastrous and obviously stupid "solutions", while stipulating (implicitly/explicitly) both factual and moral myths of the those who created this mess.
And folks, WFT with the HSAs? ELIMINATE THE EASILY ELIMINATED OBVIOUS DRIVERS OF HYPER-INFLATION IN MEDICAL SERVICES and then leave things the f**k alone. Oh, and to address the delicate moral sensibilities of the apparently clueless Mr. Roy, provide vouchers to the very few (compared to what people seem to think) needing only some $$$ to participate in the (now vastly cheaper and simpler) system.
What's with the combo of recognizing the essentially pernicious nature of guvamint intervention and this fanatical devotion to tax-code manipulation of the populace?
Posted by: non-purist at January 20, 2014 08:41 AM (afQnV)
Posted by: Hurricane LaFawnduh at January 20, 2014 08:41 AM (pginn)
Posted by: Ribald Conservative riding Orca at January 20, 2014 08:41 AM (RFeQD)
Posted by: navycopjoe at January 20, 2014 08:42 AM (At8tV)
Posted by: --- at January 20, 2014 08:43 AM (MMC8r)
I agree with you on the general issue Drew, but you shouldnt refer to Switzerland, a country that has a population made up of 4 nationalities with 4 different official languages, as "homogeneous".
Posted by: The Awkward-Turtle at January 20, 2014 08:43 AM (j5uh3)
Posted by: AllenG (DedicatedTenther) Ah, F It. at January 20, 2014 08:43 AM (PYAXX)
Posted by: --- at January 20, 2014 08:43 AM (MMC8r)
Posted by: The Awkward-Turtle at January 20, 2014 12:43 PM (j5uh3)
----
Still typical white folks.... homgeneous.
Posted by: Our President at January 20, 2014 08:44 AM (nELVU)
Posted by: President Kim Kardashian Yeezy typing through the Time Space Continuum at January 20, 2014 08:45 AM (RJMhd)
Posted by: Burn the Witch at January 20, 2014 08:45 AM (hpVGZ)
Posted by: Normal man, spitting on his hands at January 20, 2014 08:46 AM (agLwc)
Fix bayonets.
Thanks for the laugh. Ø-Merica really is screwed. Big time.
Posted by: backhoe at January 20, 2014 08:47 AM (ULH4o)
Posted by: t-bird at January 20, 2014 08:48 AM (FcR7P)
Posted by: Andy at January 20, 2014 08:48 AM (vGQV1)
ok, what does that mean?
Then transform medic[whichever] into the deregulated health insurance exchanges.
So, would that mean the medic[thingy] itself becomes 'deregulated'?
Language is so confusing. It would probably take 3-4 thousand pages of legislation and 10k pages of regulations to 'deregulate' these two programs. That would really 'simplify' things.
Posted by: Harold Quintenese at January 20, 2014 08:49 AM (VnBW7)
Posted by: Seamus Muldoon at January 20, 2014 08:49 AM (g4TxM)
‘Parallel universe’: Woman spends 6 weeks trying to disenroll from ObamaCare
Hill went on a blitz, breaking through to another layer at the
HealthCare.gov help line. But the answer she was given was that
cancellations are handled by a "special department," the number of which
could not be given out.
Posted by: LC LaWedgie at January 20, 2014 08:49 AM (0It32)
Posted by: tsrblke, PhD(c) No Really! at January 20, 2014 08:50 AM (GaqMa)
Posted by: President Kim Kardashian Yeezy typing through the Time Space Continuum at January 20, 2014 08:50 AM (RJMhd)
Posted by: Normal man, spitting on his hands at January 20, 2014 12:46 PM (agLwc)
-----------------------------------------------------
This is the point I made upthread. This is not a conservative person AND it is not a conservative plan. But it's Drew. He gets confused sometimes.
Posted by: Soona at January 20, 2014 08:51 AM (ycijm)
Posted by: GnuBreed at January 20, 2014 08:51 AM (wNF3N)
Posted by: akula51[/b][/i][/s] at January 20, 2014 08:52 AM (+fNrM)
Thanks for another laugh. I actually have a sawzall clone from Harbor Freight. Very handy tool.
Posted by: backhoe at January 20, 2014 08:53 AM (ULH4o)
Posted by: Captain Hate on an iPad at January 20, 2014 08:53 AM (qr6PR)
Posted by: Brother Cavil needs to sort his socks at January 20, 2014 08:53 AM (m9V0o)
Posted by: navycopjoe at January 20, 2014 08:53 AM (At8tV)
Posted by: Niedermeyer's Dead Horse at January 20, 2014 08:53 AM (DmNpO)
Anyone want to argue there is any hope? With "smart conservatives" such as Roy beclowning himself in such a lightweight manner on the most important - and most politically doable - policy issue before us?
Cannot get past just his first jaw-dropper: that "universal coverage" is some magical animal, and that certain people oppose it in principle. This is - minus the histrionic demagoguery - nothing more than the brain-dead moral narcissism of the "left" screaming "you don't care about people???!!!"
Listen up, Avik, you idiot: almost everyone IS covered already, everyone IS covered already for urgent care, the question is how to lower costs in the system and THEN, when the small cohort requiring subsidies is identified, to provide them a subsidy (as with every other safety net program).
The intellectual vapidity of America - especially its "elites" - really never ceases to astonish. And it is the death-knell of an America as the much better place it was and should be.
Posted by: non-purist at January 20, 2014 08:54 AM (afQnV)
You'll be happy to know, NCJ, the discussion around these parts is what to do with all the quality starting pitching the Cardinals have.
You have a rookie who won 15 games last year, and couldn't even make an appearance in the World Series. There was an article today about that, and I don't know what it said, but I just thought you might want to ruminate on that: The Cardinals are not sure what to do with Shelby Miller, because they have TOO MANY high quality starting pitchers.
Good luck, Cubbies.
Posted by: BurtTC at January 20, 2014 08:55 AM (BeSEI)
Posted by: President Kim Kardashian Yeezy typing through the Time Space Continuum at January 20, 2014 08:56 AM (RJMhd)
TO: Republicans
FROM: Me
SUBJECT: Government-Run Health Care
KILL IT WITH FUCKING FIRE, GODDAMMIT!!!!
Posted by: Vortex Lovera at January 20, 2014 08:57 AM (wtvvX)
==========
Exactly.
Insurance has nothing to do with health care.
Universal [insurance] coverage does nothing to make health care more affordable, more accessible or better.
That's the lesson we should be taking from our 60+ year experiment of using insurance to pay for health care.
Instead, we are to look to "conservative" experts like this caliber who see the result of ever and ever more insurance to pay for health care and say "moar insurance!"
Posted by: RoyalOil at January 20, 2014 08:57 AM (VjL9S)
Judith [on Stan's desire to be a mother] Here! I've got an idea: Suppose you agree that he can't actually have babies, not having a womb - which is nobody's fault, not even the Romans' - but that he can have the *right* to have babies.
Francis: Good idea, Judith. We shall fight the oppressors for your right to have babies, brother... sister, sorry.
Avik Roy: To credibly advance this approach, the oppressors conservatives must make one change to their stance: They have to agree that universal coverage men having the right to have babies is a morally worthy goal.
Posted by: Count de Monet at January 20, 2014 08:57 AM (BAS5M)
Posted by: Vashta Nerada at January 20, 2014 08:57 AM (ZkzmI)
Posted by: Niedermeyer's Dead Horse at January 20, 2014 08:58 AM (DmNpO)
One family, convinced that Hospice would "accidentally" give too much Morphine in an effort to end life prematurely, withheld all pain meds until their family member was in writhing in pain. I listened to them crying and begging for pain meds at that point.
-------------------------------------------------------------
As long as the government has control over everyone's healthcare (Ocare), there will come a time where all of us "old useless people" will be getting a little too much morephine one day.
I don't blame that family at all.
Posted by: Soona at January 20, 2014 08:59 AM (ycijm)
Posted by: Insomniac at January 20, 2014 09:00 AM (UAMVq)
"Let's conservatively assume that your Social Security Income will be $30,000 per year."
He could not for the life of him figure out why I was laughing so hysterically....
Posted by: Vortex Lovera at January 20, 2014 09:00 AM (wtvvX)
This is not a conservative person AND it is not a conservative plan. But it's Drew. He gets confused sometimes.
Posted by: Soona
Avik Roy* writes for the totes conservative Nation Review, chills at the supposedly conservative Manhattan Institute, and advised the most conservative candidate that can win -- Mitt Romney.
That he can [x] all the conservative check boxes and still declare that a government monstrosity like Ocare will work with just a few nudges and is a noble effort as well, isn't Drew's fault -- it's the fault of the big tent idiocy of the Institutional Right.
*that stockcar boy, he too much to believe.....
Posted by: Laurie David's Cervix at January 20, 2014 09:01 AM (kdS6q)
Posted by: tsrblke, PhD(c) No Really! at January 20, 2014 09:01 AM (GaqMa)
Posted by: Brother Cavil needs to sort his socks at January 20, 2014 09:01 AM (m9V0o)
Unfunded is kind of a 'term de idiots' in that the liabilities aren't really unfunded. The money was collected through taxes, but it was spent on other things.
That level of spending and payola can't just stop. It would be like trains colliding in the old westerns.
The pyramid scheme that is our system now needs one sixth of the economy so they can add several more rows to the bottom of the pyramid.
Plus, when was the last time a law just imploded under its own weight. That whole idea is so idiotic as to be laughable.
Obamacare is not going away. Republican pols need it as badly as dems do. They will throw as much money at it as necessary in order to give the appearance that it is working. Just like Social Security and just like Medicare.
Posted by: LoneStarHeeb at January 20, 2014 09:02 AM (BZAd3)
Posted by: Niedermeyer's Dead Horse at January 20, 2014 09:02 AM (DmNpO)
Posted by: Brother Cavil needs to sort his socks at January 20, 2014 09:03 AM (m9V0o)
Posted by: President Kim Kardashian Yeezy typing through the Time Space Continuum at January 20, 2014 09:03 AM (RJMhd)
I read an article in the NY Times yesterday bemoaning how much more specialists make than general practitioners. One part that stuck out to me in particular, was when the writer complained about doctors in the same specialty not having the same treatment plan for the same patient. I can't wait for the government issued treatment checklist for all patients. It will be great. http://tinyurl.com/ltgzba3
Posted by: no good deed at January 20, 2014 09:03 AM (vBhbc)
I guess in a way that's true: we may have SS in 15-20 years, but the value of the dollars we get from them will asymptotically approach nil....
Posted by: Vortex Lovera at January 20, 2014 09:04 AM (wtvvX)
Posted by: Insomniac at January 20, 2014 09:04 AM (UAMVq)
Posted by: Brother Cavil needs to sort his socks at January 20, 2014 09:04 AM (m9V0o)
Not from this ole boy.
NEVER.
Know what else you "paid for"? Food stamps, welfare, ag subsidies, Alaskan bridges, etc, etc, etc. Do you feel entitled to a piece of all those too?
Fact is, you paid for your parents SS and Medicare. Not your own. Now we're going broke and money spent on the wealthiest segment of the population (seniors) is the primary reason.
The sense of entitlement from seniors is no less troublesome than that of the 20-something Millenials.
Posted by: Hollowpoint at January 20, 2014 09:05 AM (SY2Kh)
Posted by: D-Lamp at January 20, 2014 09:05 AM (bb5+k)
Posted by: MlR at January 20, 2014 09:06 AM (BYsxT)
Posted by: President Kim Kardashian Yeezy typing through the Time Space Continuum at January 20, 2014 09:07 AM (RJMhd)
It's just another form of pay-as-you-go welfare, folks.
Or more accurately, borrow-as-you-go....
Posted by: Vortex Lovera at January 20, 2014 09:07 AM (wtvvX)
Not from this ole boy.
NEVER.
=========
I mean this in the nicest way possible but: You also--as a group--voted overwhelmingly over and over for the politicians to spend that money you paid in on other stuff you liked.
That's a hard truth that I don't know how we're going to get around it. Yes, you paid in. But, the money you paid in--instead of being segregated and kept for your benefit--was spent. Roads, schools, welfare and farm bills, and on and on.
So, in that you did get back what you "paid." (It was stolen from you via taxes.)
And then, there is the fact that every single person who is on SS and Medicare for more than 8 years gets 100% of what the "paid" plus modest interest back.
It's a tough world and the Democrats wanted it this way--where even self-identified, true-blue conservative get angry about "their" money.
Posted by: RoyalOil at January 20, 2014 09:07 AM (VjL9S)
*that stockcar boy, he too much to believe.....
Posted by: Laurie David's Cervix at January 20, 2014 01:01 PM (kdS6q)
-------------------------------------------------
Oh, really? He starts a paragraph with, "What will happen is big government conservatives.....". That's a big oxymoron if there ever was one. That's where I stopped reading.
Posted by: Soona at January 20, 2014 09:09 AM (ycijm)
Posted by: Vortex Lovera at January 20, 2014 09:09 AM (wtvvX)
Posted by: Brother Cavil needs to sort his socks at January 20, 2014 01:03 PM (m9V0o)
It will eventually end, but the result and the consequences will be much, much worse. And the catalyst that will bring about the end will probably not be very pleasant. But for right now, the pols and their pals will continue to get well and their nest eggs will probably keep them afloat for quite a while after the crash.
Posted by: LoneStarHeeb at January 20, 2014 09:09 AM (BZAd3)
Posted by: D-Lamp at January 20, 2014 09:09 AM (bb5+k)
Remember when everyone here was screaming mad about the Dread Justice Roberts calling Stalincare a tax? Guess which other federal program got past the supreme court by being called nothing but a tax?
Social Security.
Posted by: Vashta Nerada at January 20, 2014 09:09 AM (ZkzmI)
Posted by: Hurricane LaFawnduh at January 20, 2014 09:09 AM (pginn)
Posted by: Niedermeyer's Dead Horse at January 20, 2014 09:10 AM (DmNpO)
Big GubMent Leftists are totes wrong. Vote for us !!! We'll do it so much better ... without cutting a single benefit for any special snowflake !!!
// The Establishment GOP
Posted by: ScoggDog at January 20, 2014 09:11 AM (zLR/k)
Posted by: tsrblke, PhD(c) No Really! at January 20, 2014 09:12 AM (GaqMa)
Posted by: Death Panel End-of-Life specialist fondling a ball-peen hammer at January 20, 2014 09:12 AM (8GKDa)
Posted by: AmishDude at January 20, 2014 09:13 AM (xSegX)
I have been called a lot of names on this site and others for pointing that out.
And rightly so, because it's a stupid opinion without basis in reality.
There's a big difference between a lack of will and lack of ability; a difference people like you seem incapable of comprehending. If a full repeal continues to remain impossible (and it is), a "fix" might end up being the best we can hope for.
Posted by: Hollowpoint at January 20, 2014 09:13 AM (SY2Kh)
If you are criticizing Drew for not continuing to put quotation marks around the word "conservative," you would have a point. But if you read it, in the context in which he was providing it, I think it was quite clear that Drew does not think of these people as conservative.
They call themselves "conservative, as this french-Canadian sounding surrender monkey, Avec Roi, does. But that's not Drew calling him or them conservatives.
Posted by: BurtTC at January 20, 2014 09:13 AM (BeSEI)
Posted by: Meremortal at January 20, 2014 09:13 AM (1Y+hH)
Social Security.
Posted by: Vashta Nerada at January 20, 2014 01:09 PM (ZkzmI)
I believe that Roberts wanted an issue that would ensure that he would be a 'notable' chief justice. This was laid at his feet like manna from heaven and he did not hesitate. He just needed that one ruling.
Posted by: LoneStarHeeb at January 20, 2014 09:14 AM (BZAd3)
====
55mph speed limits.
But, they made damned sure that stick was still in the government arsenal should they ever want to beat the states back into line.
Posted by: RoyalOil at January 20, 2014 09:15 AM (VjL9S)
Posted by: Dorcus Blimline at January 20, 2014 09:15 AM (iB0Q2)
Posted by: jwest at January 20, 2014 09:15 AM (u2a4R)
Posted by: Meremortal at January 20, 2014 09:15 AM (1Y+hH)
Posted by: Belgium at January 20, 2014 09:16 AM (aDwsi)
Posted by: brak at January 20, 2014 09:16 AM (iEoiA)
Posted by: AmishDude at January 20, 2014 09:16 AM (xSegX)
Posted by: Nevergiveup at January 20, 2014 09:16 AM (nzKvP)
Didn't help Spain, did it?
Posted by: Waterhouse at January 20, 2014 09:17 AM (RUvjp)
Posted by: Hurricane LaFawnduh at January 20, 2014 09:17 AM (pginn)
Posted by: Meremortal at January 20, 2014 09:17 AM (1Y+hH)
Posted by: Teleprompter Feed Crew at January 20, 2014 09:17 AM (RJMhd)
Posted by: Nevergiveup at January 20, 2014 09:17 AM (nzKvP)
Posted by: Mike Hammer at January 20, 2014 09:18 AM (aDwsi)
Posted by: LoneStarHeeb at January 20, 2014 01:14 PM (BZAd3)
---------------------------------------------
Well. He got his wish. He'll be notable for a long long time. Notable like Stalin.
Posted by: Soona at January 20, 2014 09:18 AM (ycijm)
Posted by: Teleprompter Feed Crew at January 20, 2014 09:19 AM (RJMhd)
Don't ask for or expect much other than Dem-lite. It's just too hard.
It's not a question of being "too hard".
As it stands today with Obama in office, repealing Obamacare is simply not possible. I don't like it either, but that's reality.
Posted by: Hollowpoint at January 20, 2014 09:19 AM (SY2Kh)
Posted by: Mike Hammer at January 20, 2014 09:19 AM (aDwsi)
Posted by: tsrblke, PhD(c) No Really! at January 20, 2014 09:20 AM (GaqMa)
Posted by: Normal man, spitting on his hands at January 20, 2014 09:21 AM (agLwc)
Posted by: D-Lamp at January 20, 2014 09:21 AM (bb5+k)
If you start from the premise that government will have a substantial role in health care, what should government's role be?
And I think that if you start from this premise, Roy's plan looks pretty good.
But what I see are a lot of people here arguing against this premise. My cold libertarian heart agrees that the best situation is to have a de minimis role for government in health care. But, quite frankly, I don't think anyone will get elected on a platform of "privatize it all!", not in my lifetime anyway.
So I think we should borrow a page from the left when it comes to their tactics. They play the incrementalist game very well. Starting from the today's conditions, where it is assumed that government ought to play a large role in health care, how can we move the ball to the right incrementally so that we can finally get to the spot where government's role is reduced to the place where we want it to be?
Posted by: chemjeff at January 20, 2014 09:21 AM (9GG/0)
Posted by: AmishDude at January 20, 2014 09:21 AM (xSegX)
I've seen them in action in my family. They work.
Posted by: Meremortal at January 20, 2014 01:17 PM (1Y+hH)
-----------------------------------------------
Yes they do. And, yes, they alleviate a lot of un-needed emotional pain. Just losing a mom or dad, brother or sister is bad enough.
Posted by: Soona at January 20, 2014 09:21 AM (ycijm)
Posted by: tsrblke, PhD(c) No Really! at January 20, 2014 09:21 AM (GaqMa)
Posted by: akula51[/b][/i][/s] at January 20, 2014 09:22 AM (+fNrM)
I'm still looking for any law or regulation that the GOP has repealed
since 1986. The death tax doesn't count, since it was for one year only.
======
Oh, and the Mexican-American War telephone tax.
Only took them 100+ years but they did get around to repealing.
But, they'd already added another tax to pay for Obaaamaphones.
Posted by: RoyalOil at January 20, 2014 09:22 AM (VjL9S)
Posted by: tsrblke, PhD(c) No Really! at January 20, 2014 09:23 AM (GaqMa)
Posted by: Inspector Cussword at January 20, 2014 09:24 AM (UfYXk)
Posted by: georgeofthedesert at January 20, 2014 09:24 AM (Eq2MX)
Posted by: Normal man, spitting on his hands at January 20, 2014 09:25 AM (agLwc)
I just start with the assumption that when I see the name 'jwest' he's trolling the blog, and then don't bother reading it.
Saves time.
Posted by: BurtTC at January 20, 2014 09:26 AM (BeSEI)
Posted by: Mike Hammer at January 20, 2014 09:26 AM (aDwsi)
Posted by: akula51[/b][/i][/s] at January 20, 2014 09:26 AM (+fNrM)
Posted by: D-Lamp at January 20, 2014 09:27 AM (bb5+k)
Posted by: AmishDude at January 20, 2014 01:13 PM (xSegX)
They will want a "new and improved" model with shiny baubles.
Posted by: Bertram Cabot Jr. at January 20, 2014 09:27 AM (m2Izr)
They just don't want it to happen because they'd lose their precious.
Posted by: tsrblke, PhD(c) No Really! at January 20, 2014 01:23 PM (GaqMa)
------------------------------------------------
Rush calls abortion, "the left's blood-sacrement to the marxist cause". I agree. Blood sacrements have caused a lot of wars.
Posted by: Soona at January 20, 2014 09:28 AM (ycijm)
Posted by: Normal man, spitting on his hands at January 20, 2014 09:28 AM (agLwc)
Posted by: Ribald Conservative riding Orca at January 20, 2014 09:28 AM (RFeQD)
Posted by: jwest at January 20, 2014 09:29 AM (u2a4R)
Just think of jwest as kind of a "living will". He'll cease Grannie's living, against her will.
Gentlemen ... continue beating (or pounding, no real distinction intended).
Posted by: ScoggDog at January 20, 2014 09:29 AM (JbNtM)
Oh, and the Mexican-American War telephone tax.
Posted by: RoyalOil
Spanish-American War -- if you think about it. But your heart was in the right place.
And I'm not sure the Republicans repealed the tax. Looking at wiki, it apears like a partial overturn in court, followed by an IRS adjustment. Heller put up a bill in 2011 but it doesn't look like it got voted on.
Posted by: Laurie David's Cervix at January 20, 2014 09:30 AM (kdS6q)
Posted by: chemjeff at January 20, 2014 01:21 PM (9GG/0)
Since the money collected in taxes, fees and penalties will be spent multiple times on other things in addition to healthcare, I suppose never would be my guess.
Posted by: LoneStarHeeb at January 20, 2014 09:30 AM (BZAd3)
1) people are living longer
2) fewer people entering the work force
3) the workforce is getting smaller the last few years because our Genius ! president's policies.
-----
4.) (and the biggest) Baby Boomer Bubble hitting retirement age.
Posted by: fixerupper at January 20, 2014 09:30 AM (nELVU)
Posted by: jwest at January 20, 2014 09:31 AM (u2a4R)
Posted by: Mike Hammer at January 20, 2014 09:31 AM (aDwsi)
Posted by: Mike Hammer at January 20, 2014 01:26 PM (aDwsi)
----------------------------------------------------
They'll get old sooner or later, and then we'll see the morphine put to good use.
Posted by: Soona at January 20, 2014 09:32 AM (ycijm)
Posted by: NRO Policy Wonks at January 20, 2014 09:32 AM (BYsxT)
Posted by: chemjeff at January 20, 2014 01:21 PM (9GG/0)
Built into your argument is the assumption that the GOP also desires the same goal(s) we do. The past decade has disabused me of that notion.
Posted by: [/i]KG at January 20, 2014 09:32 AM (p7BzH)
Posted by: Niedermeyer's Dead Horse at January 20, 2014 09:33 AM (DmNpO)
Posted by: Fox2! at January 20, 2014 09:33 AM (cHwSy)
Posted by: irright at January 20, 2014 09:33 AM (8GKDa)
Posted by: AmishDude at January 20, 2014 09:33 AM (xSegX)
Burt, since technically you are not the first person to completely ignore jwest ... on this issue and this issue alone he may actually have a point.
Gentlemen ... Continue to Beat or Pound at your option. The fate of Grannie hangs in the balance.
Posted by: ScoggDog at January 20, 2014 09:34 AM (JbNtM)
People have the pesky habit of continuing to behave in their own self-interest, in spite of government's best efforts otherwise.
Just ask the Soviets.
Posted by: BurtTC at January 20, 2014 09:34 AM (BeSEI)
I have an anecdote about the cash discount rate.
My 16 yo son needed eye surgery last week to repair a hole in his retina from an accident.
Hosp A wanted $19,000 (insurance rate) discounted to $9,000 cash rate. Hosp B charged $2,028 cash rate (we did not get the insurance rate quote from the eye surgeon's office). Eye surgeon cash rate was $2,750 and while I saw the paperwork titles for Cash Rate and Insurance Rate (upsidedown) on the clipboards, I could not read the prices for the insurance rate for the surgeon.
The $4800 cash paid was less than the insurance deductible and co-pays I would have paid for Hosp A to do the job.
We had time to ask and shop. Had the injury been any more severe we would not.
He is recovering nicely, vision is fine thanks to top notch docs and surgical nursing staff even at the "discount" hospital.
Posted by: Count de Monet at January 20, 2014 09:34 AM (BAS5M)
Posted by: Teleprompter Feed Crew at January 20, 2014 09:34 AM (RJMhd)
Posted by: Niedermeyer's Dead Horse at January 20, 2014 09:34 AM (DmNpO)
http://tinyurl.com/4bn26o6
Posted by: LoneStarHeeb at January 20, 2014 09:36 AM (BZAd3)
Well of course they will. But that is where the incrementalist strategy works to our benefit because it blunts these types of charges.
Posted by: chemjeff at January 20, 2014 09:36 AM (9GG/0)
Posted by: AllenG (DedicatedTenther) Ah, F It. at January 20, 2014 09:36 AM (PYAXX)
Posted by: jwest at January 20, 2014 09:36 AM (u2a4R)
If you will take nothing less than 100% agreement on what is good then you will never get reform. What I think we all can agree on is:
1. Healthcare in the United States is the best in the world and that unfortunately all that is available is not available to everyone because of the costs.
2. The costs are artificially inflated because of the lack of free market practices at the same time higher because of free market consequences( cutting edge healthcare technology , R&D) .
3. Any safety net healthcare system , should not force those into that system that is outside of that safety net designation.
I think Roy is right except that any participation in a universal healthcare system should not be mandatory in anyway. We must get insurance and how medical payments are made and prices established through the free market system. The government can set up a safety net system to cover those that are involuntarily uninsured. This could be with the partnership with insurance carriers to participate in a risk pool. I would also bring back the subsidized Charity hospital system.
Posted by: polynikes at January 20, 2014 09:37 AM (m2CN7)
I have no idea what he actually said, so if you say he has a point, I can't argue. Somehow I doubt it, but I would have to read what he said to find out, and I'm just not into that sort of self-punishment.
Posted by: BurtTC at January 20, 2014 09:38 AM (BeSEI)
Well, maybe they don't. But once the idea is out there, it doesn't matter which spineless Republican is in charge.
Posted by: chemjeff at January 20, 2014 09:39 AM (9GG/0)
If one agrees with and accepts the central assumptions and underlying premises of an opponent's argument, then there is, technically speaking, no opponent. You're in agreement. All that's left is haggling over details.
We've seen it happen with the GOP Establishment and its ready acquiescence to amnesty and open borders disguised as immigration reform. We've seen it with entitlements of all stripes. We're seeing it now with Avik Roy and the Obamacare debate.
1. Come up with a high-sounding, idealistic goal, one set so high that anyone who opposes it can be portrayed as a mean-spirited, blackhearted, granny-killing, racist asshole.
2. Pass initial, somewhat modest legislation in order to establish the necessary bureaucratic infrastructure and expand from there.
3. Repeat.
Here's a clue: All of the assumptions of the Left are wrong. Here's another: these people could give a damn about the poor or the elderly or the sick. All they care about is power, period. For the political class, ideology is a gaudy parade float. Principles are for fools. Right and wrong are archaic cultural constructs devised by the patriarchy.
As a people, we really need to wake the hell up.
Posted by: troyriser at January 20, 2014 09:41 AM (O66NZ)
Posted by: navycopjoe at January 20, 2014 09:42 AM (At8tV)
Posted by: [/i]KG at January 20, 2014 09:43 AM (p7BzH)
Much of what was wrong with healthcare and virtually all other industries in which government intervened in the past was because of the unintended consequences of government intervention.
Posted by: LoneStarHeeb at January 20, 2014 09:44 AM (BZAd3)
But we *don't* accept the premise that government ought to be deeply involved in health care. I don't accept that premise either. But in today's world, we have to pretend to accept it so that we can gradually move the ball to the right in order to undermine the premise.
Posted by: chemjeff at January 20, 2014 09:47 AM (9GG/0)
Posted by: Mary Cloggenstein from Brattleboro, Vermont at January 20, 2014 11:00 AM (BttwM)
I agree. May I suggest one small suggestion that might help. First, release all Medicare repayment amounts for each treatment code in a searchable database. Do the same with Medicaid and Tricare payment schedules.
Right now, one cannot easily compare prices and at least this would give some sense of what costs should be at a minimum.
Next, end cafeteria flex plans use it or lose it. Instead, fold them into HSAs but do not require the catastrophic care insurance. Instead, allow people to build up savings for needed events.
Posted by: wg at January 20, 2014 11:41 AM (RRwZL)
Posted by: Abbie Normal at January 20, 2014 07:58 PM (PXnNl)
Posted by: sexypig at January 20, 2014 09:15 PM (dZQh7)
Posted by: sexypig at January 20, 2014 09:32 PM (dZQh7)
Posted by: sexypig at January 20, 2014 09:36 PM (dZQh7)
If Roy were a conservative, the Republican Party would be at war with him, and no one in the media would run his opinion!
Posted by: burt at January 21, 2014 04:32 AM (1+kJ5)
Posted by: Alborn at January 21, 2014 05:57 AM (z0B+b)
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Posted by: AllenG (DedicatedTenther) Ah, F It. at January 20, 2014 08:15 AM (PYAXX)