1. Sam

   Very perceptive. It’s about time someone put it that way. Words, no matter how direct are ALWAYS twisted to serve the side a speaker wants. When people reference the constitution, You can automatically assume they are going to try and fit a square peg into a round hole with it. Most of the problem is that people think, and are raised to believe that they should have an opinion on everything, and no matter how little thought they have put into it they still take a side and fight to the death for it. And heaven forbid they change their damn mind and become a “flip-flopper”.

   Aug 19th, 2009

2. Dustin

   Of course the framers didn’t address Universal Healthcare (or Universal Anything). They wanted the smallest possible functioning federal government. For better or worse, they would have never gone for New Deal policies or a progressive income tax or socialized medicine. In addition, the insinuation of some that the Constitution was framed by racist old white men for racist old white men is asinine — there’s not one sentence in the entire thing that could be construed as racist by an objective reader with an understanding of history.

   I don’t believe that’s what you’re doing here, though. It looks like you’re simply saying that the Constitution is outdated and that it doesn’t deal with the political and economic realities of our time. That’s an understandable position, but one that I wholeheartedly disagree with. The reason that the Constitution doesn’t deal with social programs of any sort is that the framers believed they were a poison to freedom and free trade. There is simply no way to pay for them and maintain the freedoms intended by the founding fathers. They demand a progressive income tax and corporate taxes and payroll taxes and sales taxes (on the state level) and property taxes and estate taxes and luxury taxes. And these taxes, when they reach a certain point, begin to be insufficient meals for a monster that can no longer be fed. There’s a reason that social security, medicare, and medicaid are broke. The federal government is a child that has sucked the teat of the private sector dry — or at least as dry as the current tax code will allow.

   One glance at any socialized medicine program will back up what I’m saying — even those touted as successes (like the Netherlands and France) in the stead of what proponents of Obamacare call “red herrings” (UK/Canada). The fraud, tax rates, and economic realities connected to the Universal Healthcare of those countries make it very unpalatable for any person with an understanding of why the US economy, despite being in the dumps at the moment (due to lack of proper regulation and irresponsible legislation during the ’90’s and early ’00’s), is the driving force in the world economy. The Netherlands will be unable to pay for their shiny new healthcare system in a mere 7 years (10 if you believe the more optimistic estimates). France is already falling behind, and fraud rates are over 100 times what they are here in the US.

   The only way that universal healthcare can be afforded for a sustained period of time is to raise taxes even further, crippling the private sector even more and turning us into a GDP-bleeding zombie. That’s something we simply can’t afford to do.

   Healthcare *does* need to be fixed, but there’s not a current plan from either side that will do so in a way that doesn’t do greater harm than good. Reforming the insurance industry, you’ll be happy to hear me say, is the first step. But that reform can be attained without giving up our freedoms, without inventing another monster that can’t be fed, and without polarizing the American public. If it were regulated the same way as, say, the life insurance industry, healthcare would become more affordable and the conversation could move to “How do we get those who can afford healthcare to purchase it?”

   For those who can’t purchase healthcare, a renovation of Medicare/Medicaid would work wonders. And, lest we forget, they are a much smaller group than the current 40-million figure being thrown around that includes people who can afford it + illegal aliens (which, no matter how much one sympathizes with them, do not deserve the benefits of tax-payer dollars beyond simple emergency healthcare). There is no economic or legal justification whatsoever for socialized medicine. While pragmatism should never be the ruling mindset in ethical questions, it cannot be thrown out with the bathwater, either. And even the smallest injection of pragmatic thought into the discussion leaves the currently proposed plans from both sides of the aisle gasping for air.

   Aug 27th, 2009

3. nostraboris

   What really cripples the private sector, especially small businesses, is the burden of having to provide health care coverage. It is the exact opposite of progressive taxation: smaller payrolls carry more weight than large ones.

   For the self employed, and independent contractors it is practically impossible to get coverage. This stifles entrepeneurship and steers Americans away from starting their own business, into the hands of the corporate tyrant.

   The Netherlands and France use a hybrid system, part privatized, and part public. The only places that are truly “socialized”, and don’t offer a choice are Canada and the UK.

   If the insurance industry, the real hungry monster, needs to be regulated, who is going to do that? The industry itself? Like traffic lights, it will need to be done by a government of and for the people.

   Having to wait for a red light does not equate loss of freedom, and neither is sitting in the waiting room.

   Nobody is actually suggesting free care for undocumented workers, but maybe they should. They work for a living, employed by Americans.

   My point was not that the constitution is outdated, but that quoting it for partisan reasons doesn’t get us anywhere. Let’s debate the issue here and now, which is what we are doing right now.

   The statue of liberty holds up a torch, not a clip board:

   “”Give me your tired, your poor,
   Your huddled masses yearning to breathe free,
   The wretched refuse of your teeming shore.
   Send these, the homeless, tempest-tossed to me,
   I lift my lamp beside the golden door!”

   Aug 27th, 2009

4. Dustin

   What I would suggest is government regulation that causes health care providers to offer more than a 1-year contract and opens the industry up so that a person in Michigan can get coverage from a provider in North Carolina or Wisconsin. Long-term (25-year and greater) insurance contracts would drive costs down, nearly eliminate the “pre-existing condition” issues, and still allow for the necessary profits that providers need in order to exist. Insurance is an aleatory contract that allows its holder to transfer risk at a certain cost. The point is not to eliminate healthcare provider’s profits — it is to make the transfer of risk more affordable. Costs would be driven down by increased private competition in a way that could not be duplicated by a public option. The entire point of the public option is to lower costs for everyone to a level unsustainable by private insurers, so people would have to be crazy *not* to use the public option if it were offered.

   This would lead to the eventual demise of the private industry — and that may sound like a good thing until one takes into account the necessary rationing that would then occur (like what happens with our veterans now — our veteran healthcare suffers from the same rationing issues other socialized plans do).

   In fact, my grandfather, a WWII vet, nearly lost his life because of the long wait period he had to suffer through and the ineptitude of the doctors employed by the VA. He had two severely blocked carotid arteries, two blocked arteries in his heart, and a 99% blocked artery behind his abdominal wall that had cut off circulation to his foot. Thankfully, we got him to a private practice that my stereotypical rich uncle could afford. Four major surgeries and two weeks later, he was in a lot of pain but recovering well. Not only did two doctors working for the VA hospital miss his circulatory issues (one labeled it “gout”), the wait to see the specialist that the other doctor had suggested was 4 weeks.

   The only way that government-provided healthcare will succeed is if we manage to keep the number of people on it as small as possible (ie: limit the number to those who absolutely need coverage and cannot afford it — estimates are currently between 10 and 15 million) and keep the remainder in a more affordable private sector plan.

   You’re absolutely right about the burden that healthcare places on small businesses. This burden can best be alleviated by the course I outlined above. The harsh reality, however, is that the best course is not politically savvy. Unions will object (not that I wish to demonize them…they simply are opposed to that particular idea) because workers will be ostensibly losing “benefits”. Of course, if the plans were also drawn into a co-op, this would solve the employer problem — but only that. Many small-industry Americans would still need to purchase a plan of their own, and *that* is why what I proposed above is so crucial.

   It is better economically than Euro-style public/private hybrids, it lowers costs, and it is actually a plan that will work in the long-term while limiting fraud to negligible levels (fraud in privatized healthcare is over 100 times lower than that of public healthcare in the US, and fraud in the Netherlands and France has been gauged as anwhere from 13-18%). The trade-off is personal responsibility and a strongly-executed regulation committee that would oversee healthcare insurers.

   Aug 27th, 2009

5. nostraboris

   “fraud in privatized healthcare is over 100 times lower than that of public health care in the US”.

   What that really means is that insurance companies over bill government programs. In fact, the charge against public HC is lead by Rick Scott, who was involved in the largest insurance fraud scandal ever.

   Try comparing fraud numbers in Europe to America.

   I understand that insurance in general means transferring risk. But when you apply that to health care, you are speculating on human tragedy. It’s only natural that to make a profit, you have to reduce cost by excluding people (rationing).

   I love the free market, and capitalism, but health care, public safety, fire dept, and armed forces should remain non-profit.

   Sucks about your grandfather, I do believe that his case is anecdotal.

   Aug 27th, 2009

6. Dustin

   France’s fraud rate is through the roof — 18% of medical costs are attributed to fraud. I didn’t find any Netherlands numbers because I’m a bit rushed at the moment. Only 3-4% of Medicaid and Medicare expenses are attributed to fraud. In the private US system, less than a third of one percent is attributed to fraud. The disparity is astonishing, but it likely has to do with France’s inability to vet their patients properly. Hospitals in France treat people ineligible for French treatment (non-citizens, etc), driving the national costs of their healthcare to astronomical heights.

   All forms of insurance speculate on tragedy or, at least, really really bad things happening. That’s why insurance exists. Where healthcare providers are currently messing up is in not pursuing long-term contracts. These avoid most rationing issues since there aren’t going to be pre-existing conditions in most 25 year olds. Those who do have pre-existing conditions would get the Government plan (Medicare/Medicaid), and all issues would be, if not solved, severely mitigated.

   Fire/Police/Military are non-profit, but it isn’t strictly analogous. They are reactive and preventative forces with no risk transference and they do not exist as a corporation. That’s why homeowner’s insurance exists. Healthcare needs to be meted out via insurers simply because there’s no way anyone else can pay for it. Risk transference is a necessary component of health-care unless we find a way to pay doctors and nurses and drug companies a pittance for their services. If we could lower the average hospital stay from around $1,300 to $50, there’d be no issue. But we can’t. It’s impossible. We can’t even get the costs below $1,000. Some form of insurance is a necessary evil, and the lesser of all evils is highly regulated, purely private insurance.

   As for the military… the reason they’re superior to any other force in the world at the moment is due to the fact that all research and development is contracted to the private sector. The financial costs of the military are a major portion of our federal spending — and they should be. But as funny as I find Jon Stewart, there is absolutely no analogous relationship between healthcare and the post office or the military. The sweeping change we need is in lowering insurance costs and covering those very few who are still left out. It is not to be found in creating another massive federal program that can’t be paid for or eliminating or even competing with the private sector.

   And as for the story of my grandfather being anecdotal…you’re absolutely right. I normally shy away from anecdotal evidence, but the fact that veteran care is not something our entire healthcare system should aspire to is inescapable. His particular case was bad, but there are a plethora of cases to choose from — veterans being denied medication for PTSD, long waits for specialists, and various other rationing complaints have been issues for years.

   I’ve enjoyed our exchange. I’d never run across your blog until today. Oh, and I’m also enjoying the Noise Within material. OOC, and without sidetracking the discussion too much, what mic or mics are you using for the vocal recordings? They’ve got some great upper-mid response without being too harsh.

   Aug 27th, 2009

7. nostraboris

   We fundamentally disagree. Imo Health Care is EXACTLY like the post office. Fed Ex, and UPS can still compete. If there was no post office, some wouldn’t be able to send a postcard.

   The “pittance” for health professionals would be a capped, yet relatively high based on experience wage like any other government gig. The private sector would be able to set it’s own salaries.

   I think the military is what it is because of the trillions poured into it. If we’d spend a fraction of that on health care everyone would have a personal physician on stand by living in his basement.

   I use a cheap ass condenser mic (Rode NT1-A) run through a DBX tube pre-amp, the processing ace is the bombfactory compressor.

   Aug 27th, 2009

8. Dustin

   Nice. I’d used the NT3 but was unimpressed (my favorite vocal mic at the time as the MD-421) by the size of the proximity effect area. Gonna have to check out that preamp.

   Aug 27th, 2009

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