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What do we want?

Justin Fox was annoyed to hear Sen. Tom Coburn claim that "We all want the same thing." In response, Fox lists 18 separate, and occasionally contradictory, things that various people want out of health-care reform, and comments:

If all you care about is reducing health care spending as a share of GDP, then the best solution might be complete privatization — no tax deductions for health care, no taxpayer-funded health programs, no nothin'. But that would of course leave lots of individuals — sick ones, especially — much, much worse off. If all you care about is making the populace healthier, you might want to focus on campaigning for a $3-a-gallon gas tax and a ban on the sale of high-fructose corn syrup. But that wouldn't help flax-eating triathletes who come down with cancer (or a lot of other people). And so on.

In fact, hardly anybody (apart perhaps from some Washington lobbyists) is really that single-minded. We understand that there have to be tradeoffs. Which is why making all our differing health care reform priorities explicit, and trying to put them in some kind of order, seems like it would be a better way to go than either approaching the health care debate as a Manichean struggle or pretending that our priorities are the same.

By Ezra Klein  |  February 26, 2010; 2:54 PM ET
 
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Comments

The "we" Coburn was talking about was Republicans. The thing "we" all want is for Obama to face his "waterloo" and "fail".

That 44,000 people die a year from lack of health insurance does not matter, Republicans winning the next election, that matters.

Republicans have shown time and again that they will do almost anything to win an election. Remember the rush to war in Iraq? I'll admit that the neo-cons lusted after an Iraq war for a long time, but the timing of it was all about reelection. If the GOP is willing to bomb another country into a parking lot to help insure a midterm election victory they sure as heck won't flinch at letting another measly 44,000 Americans die from lack of health care.

Posted by: nisleib | February 26, 2010 3:07 PM | Report abuse

I believe the two sides DO want different thing and the difference is THIS:

Democrats want to cease their moment of power and design a generous entitlement that provides affordable medical services to every American.

Republicans want to cease this moment of economic crisis and finally deal with our spiraling healthcare costs that are likely to lead to unmanageable structural deficits that will absolutely destroy everything that has made USA great in world history----specifically weaken our ability to deal with the emerging threat from the tyrannical trinity of Hugo-Chavez---Ayatollah Khameni---Vladamir Putin.


This is the WHOLE Difference.

I believe Democrats are short-sighted to believe that a generous entitlement will make any difference in 10-years from now when the USA won't be able to afford anyone's healthcare.


Structural Deficits are DIFFERENT than any deficit we've had before. We are poised to become a banana Republic, and the Chavez' hegemony in Latin America will eventually evolve into a vulture that eats North America too.

If Democrats SUCCEED at designing a new healthcare system that provides access for all BUT does not fix the spiraling healthcare costs, the USA is finished as we know it! Ultimately human freedom is finished as we know it.

Do any of you supporting this bill care that there is no longer the freedom to dissent in Chavez' Venezuela, Khameni's Iran, or Putin's Russia?

Posted by: FastEddieO007 | February 26, 2010 3:07 PM | Report abuse

To put the STRUCTURAL DEFICITS and their effect on National Security in perspective, listen to what THIS Democrat is saying (although she tries to blame Republicans of course---even ones married to liberal progressive reporters eager to get Obama's ambitious progressive agenda passed)

http://www.reuters.com/article/idUSN2511749320100225

Posted by: FastEddieO007 | February 26, 2010 3:09 PM | Report abuse

Shorter FastEddie: we have to whip up fear and enthusiasm for war among the populace to make sure they don't decide to improve the quality and accessibility of their health care system.

That and he seems pretty angry that there is talk of spending money on something other than open-ended occupations in the middle east.

Posted by: constans | February 26, 2010 3:11 PM | Report abuse

they should be taxing sodas and high fructose corn syrup. I was looking for an article on cbsnews.com that had stated that I read sometime back that stated that if the US reduced their obesity level to zero (obviously unattainable) then we'd add 4 years to the average life expectancy putting us at the top of the charts worldwide in life expectancy. Then if we got everyone covered (or as much as possible) then imagine how well we'd do.

Instead I found this link and liked it more. It shows the interactive graph showing BMI levels from 1986 to 2008. Scary stuff. We're being told its leveling off but at some point it'd have to as people would be dying from it or rather diabetes, heart disease etc.

So ya i'd think we should put a tax on things that cause this no?


So yes it wouldn't help the triathelete who developed cancer but then again that's not who its meant to help is it? Its meant to help the teenager who's 15 years old, 5'10 and 225 pounds who may already be diabetic and drinks soda in the morning because Mom and Dad can't either be bothered to make them breakfast or are both already at work. They need to find a better alternative and I congratulate the FLOTUS for tackling such a challenging and important problem.

Posted by: visionbrkr | February 26, 2010 3:13 PM | Report abuse

oops. forgot my link.

http://www.cbsnews.com/stories/2010/01/07/eveningnews/main6069163.shtml?tag=mncol;lst;7

Posted by: visionbrkr | February 26, 2010 3:15 PM | Report abuse

My ideology is simple. I try as hard as I can to imagine myself in the transporters dropping men off to the beaches of Normandy to face almost certain death.

They fought for a cause to save human freedom. The "lesson learned" is quite clear: never take human freedom so lightly that we let it get to the point where evil man as powerful as Hitler was such that it requires sending so many young men to die in the prime of their life.

I believe that should always be the number one priority of the federal government of the United States of America. Somehow, that a poor woman had to use her dead sister's dentures seem like such small potatoes in terms of the scope of what our federal government should be concerned about.

Posted by: FastEddieO007 | February 26, 2010 3:17 PM | Report abuse

Eddie - Take your medication, your paranoia is a tad out of hand.

We currently pay two times more (more by some estimates) for health care than any other industrialized country in the world. Does this bill do everything needed to fix that? No, but it is a good start.

Doing nothing is not an option. We can expect a 20% increase in health care insurance costs, on average, this year alone. Health insurance is twice as expensive as it was a decade ago and most estimates show that it will double again in the next decade. You say that if Democrats succeed the USA is finished as we know it. Well, if the Democrats DON'T succeed we will be in much worse shape than if they do.

By the way, most of the rhetoric we are hearing from right wing pundits today is almost exactly the same bogus junk we heard from right wingers about social security and Medicare back when they were passed into law. It wasn't true then and it isn't true now.

Posted by: nisleib | February 26, 2010 3:18 PM | Report abuse

We currently pay two times more (more by some estimates) for health care than any other industrialized country in the world. Does this bill do everything needed to fix that? No

Posted by: FastEddieO007 | February 26, 2010 3:21 PM | Report abuse

visionbrkr - Hear hear, I say put a tax on high fructose corn syrup and sodas.

I used to smoke two packs of smokes a day, I quit when they upped the tax to where it cost $4 a pack.

Posted by: nisleib | February 26, 2010 3:23 PM | Report abuse

In the case, I think it's helpful just to let FastEddie's ravings stand on their own to show everyone how crazed the opponents to HCR really are.

Posted by: constans | February 26, 2010 3:25 PM | Report abuse

Doing nothing is not an option---I AGREE!!!

But doing this is WORSE than doing nothing----it'll increase cost dramatically, as everyone is suddenly paying much more, there are now tax-payer funds going to pay for private insurance subsidies and since everyone has committed themselves to comprehensive coverage there is no protection to overuse of resources other than federal officials simply telling doctors they are not going to make more money no matter how much harder they work.

This is a disaster---and we will all go down together as their is no modularity. We crash and burn in the fire on unintended (though predictable) consequences!

Posted by: FastEddieO007 | February 26, 2010 3:27 PM | Report abuse

Does the estimation that we pay 2 times or more include the amount paid by fat cats like the President of Canada who come here for our premier service, apparently unavailable in Canada?

If so, then its deceiving. If a restaurant serves some expensive dishes on the menu, but other low cost dishes, is it fair to compare the average price of all the options to a restaurant like McDonald's $1 Menu.

Posted by: FastEddieO007 | February 26, 2010 3:31 PM | Report abuse

eddie,


relax. Its not worse. Should there be more cost-containment, YES. But they're all right. The status quo is not something anyone can live with. Just as insurers. They all agree to that fact and its the reason CA rates went up so high.

Posted by: visionbrkr | February 26, 2010 3:32 PM | Report abuse

I agree something should be done---but it should be either

A.)More modular, with more control at the state level, such that state officials can work out details of how medical care and insurance get regulated....

B.) Limited in scope, such as Marty Feldstein's plan which DOES provide affordable access to all, but maintain real world market mechanisms to control prices instead of federal decrees.

C.) A series of small fixes to known problems, such as eliminating tax exclusions

Posted by: FastEddieO007 | February 26, 2010 3:36 PM | Report abuse

I'm sure we can all agree, we want a majority vote in the House. Despite any differences, the House has passed a bill, it has been debated and accepted by a supermajority in the Senate, and now waits before the House, where it is now held, by the Democratic Party Speaker of the House, for an up-or-down vote.

We all want health care reform, in varying degrees. If the Speaker of the House would simply bring the matter for an up-or-down vote -- she isn't hamstrung by the 60-vote rules of the Senate -- we could end the matter TODAY. Amendments are always possible... in this Congress and even in the one that emerges after the November elections.

Is there not a quorum in the House to take a simple vote? Does Speaker Pelosi really want to put lives at risk by continuing to hold the health care reform bill?

Posted by: rmgregory | February 26, 2010 3:38 PM | Report abuse

constans is right!----you shouldn't try to talk with someone you disagree with....clearly if the disagree with you, there is no point in talk, they are obviously dumb/crazy/lying.....etc...etc...post partisanship era coming to a town near you.....

Posted by: FastEddieO007 | February 26, 2010 3:38 PM | Report abuse

Eddie - I don't know where you get your facts but you really should do some double checking.

"...it'll increase cost dramatically, as everyone is suddenly paying much more."

Not according to the CBO.

"...there are now tax-payer funds going to pay for private insurance subsidies."

So? Good. To fix the problem we need to get everyone access to health care. I'd rather go with a single payer system, but that won't get through Congress. Neither will a public option. That leaves subsidies.

"...since everyone has committed themselves to comprehensive coverage there is no protection to overuse of resources other than federal officials simply telling doctors they are not going to make more money no matter how much harder they work."

You do realize that makes no sense, don't you? How does one flow from the other?

I do think we need to radically change the way our health care professionals are compensated from fee for service to outcome based, but that is such a huge undertaking I am fine with it being its own piece of legislation.

Posted by: nisleib | February 26, 2010 3:40 PM | Report abuse

to fasteddie's defense (not that he needs it or wants it), IMO there should be more cost containment and CMS said that while public costs would go down private would not (i think i'm correct in that). Some private would go down but some would not with the net result not very changed. That's a whole lot of spending for not much change. We should hold all parties (insurers, pharma, docs) more to task than we are because this is probably one of the last times we can dangle something this good (30 million consumers on the government dime). Negotiation isn't a strong suit for government.

Posted by: visionbrkr | February 26, 2010 3:46 PM | Report abuse

Good lord Eddie, sigh.

A)More modular, with more control at the state level, such that state officials can work out details of how medical care and insurance get regulated....

That is called the status quo

B.) Limited in scope, such as Marty Feldstein's plan which DOES provide affordable access to all, but maintain real world market mechanisms to control prices instead of federal decrees.

These mythical market forces Republicans love so much do NOT self correct. They tend to not correct and lead to global econcomic meltdowns, for an example see 2008.

C.) A series of small fixes to known problems.

That is Republicanees for do nothing and hope for the best.

Posted by: nisleib | February 26, 2010 3:51 PM | Report abuse

visionbrker wrote:

"they should be taxing sodas and high fructose corn syrup. I was looking for an article on cbsnews.com that had stated that I read sometime back that stated that if the US reduced their obesity level to zero (obviously unattainable) then we'd add 4 years to the average life expectancy putting us at the top of the charts worldwide in life expectancy"

And then Social Security would really be in trouble. If we can up those 44 thousand deaths, then we can save social security.

Posted by: hackett1 | February 26, 2010 3:53 PM | Report abuse

This bill steals money from a goverment-run Medicare program that is already in debt....robbing the loans given to keep Peter solvent in order to make Paul seem like an almost-affordable program.

And when you factor in the reconcilliation that finally gives doctors the money owed to them by Medicare---which Pelosi has duplictously put in a separate bill, this thing is a recipe for USA's chapter 11. I am siging up for my Venezuelan-Marxist lessons right now.

Posted by: FastEddieO007 | February 26, 2010 3:53 PM | Report abuse

And he's not the "President of Canada" He was the Premier of Newfoundland and Labrador.

Canada has a Prime Minister (and a Governor General.) But no President.

Posted by: hackett1 | February 26, 2010 3:55 PM | Report abuse

visionbrkr, I really don't take FastEddie's supposed interest in cost containment seriously. Rather, he has 101st Fighting Keyboarder fantasies and doesn't believe that health care reform is a sufficiently glorious use of America's resources while he harbors paranoia that Hugo Chavez is going to corrupt the purity of essence of his precious bodily fluids.

Posted by: constans | February 26, 2010 4:31 PM | Report abuse

constans,

sigh. I concede that point.

Posted by: visionbrkr | February 26, 2010 4:55 PM | Report abuse

I mean, visionbrkr, I do think that cost containment is important, even though I don't really have a lot of faith that HSAs are the way to go about it.

Posted by: constans | February 26, 2010 4:59 PM | Report abuse

I'm not sure how the Marines landing on D-day got into this discussion, but I'll throw in the fact that all of the western allies in World War II made the decision in the years after the war to adopt some form of universal health care. The U.S. was the only exception.

Are Britain, France, Australia and Canada now unfree countries who fought that war in vain? If the U.K is an unfree country, I'd like to know why they continue to be our ally.

Posted by: Virginia7 | February 26, 2010 5:10 PM | Report abuse

I read Fox's list. As far as I can tell, Democrats want all those things because that's a reasonable list of the elements of a difficult problem.

Republicans don't seem to want any of those things -- at least not if it would cost any rich person a penny or having to comply with a regulation.

Posted by: janinsanfran | February 26, 2010 5:15 PM | Report abuse

constans,

I know it works. I've seen it firsthand. HSA rates go up substantially (10% or so) less than non-HSA plans. I've told this story before but I have a 6 year old son who had a nice little gash in his head from messing around that was bleeding. I have an HSA now, I treated it myself and he was fine. in years past i've gone to the ER waited and paid a $50 copay and my insurer paid $500-$1000. Since i was cognizant that I was paying the cost i adjusted my behavior. The fear is that people will factor cost in too much and i get that part of the argument too.

Posted by: visionbrkr | February 26, 2010 5:29 PM | Report abuse

Actually, I think we make a more effective message by framing this a Manichean struggle. Most Americans may not know what that term means, but people love being able to figure out the world easily. Call GMOs evil incarnate and people will get right behind it, maybe even the tea partiers.

Posted by: StonedandHappy | February 26, 2010 5:39 PM | Report abuse

Virginia7 - UK is free, and they have a despicable healthcare system run by a bloated government bureacracy that terrorizes the middle class and poor:


Three thousand needless deaths every year in hospital as watchdog fails to spot poor standards
http://www.dailymail.co.uk/news/article-1231559/Figures-reveal-3-000-needless-deaths-year-hospital-scandal-deepens.html

Eleven more NHS hospitals at centre of safety scandal
http://www.guardian.co.uk/society/2009/nov/29/nhs-hospitals-safety-report

Hundreds of patients died needlessly at NHS hospital due to appalling care
http://www.telegraph.co.uk/health/healthnews/6661925/Hundreds-of-patients-died-needlessly-at-NHS-hospital-due-to-appalling-care.html

Posted by: FastEddieO007 | February 26, 2010 5:39 PM | Report abuse

"Do any of you supporting this bill care that there is no longer the freedom to dissent in Chavez' Venezuela, Khameni's Iran, or Putin's Russia?"

FastEddie,

I see you have now learned how to spell K-H-A-M-E-N-I after I corrected you when you ran this same paranoid rant on another thread.

Don't I get a thank you for the assist?

Posted by: Patrick_M | February 26, 2010 5:39 PM | Report abuse

Patrick_M---yes, thanks for the assist : )

...and by the way heres more on how UK's NHS Terrorizes the middle class who is literally trapped by them:


Question a doctor and lose your child
http://www.timesonline.co.uk/tol/life_and_style/health/article6823345.ece


'Doctors told me it was against the rules to save my premature baby'
http://www.dailymail.co.uk/news/article-1211950/Premature-baby-left-die-doctors-mother-gives-birth-just-days-22-week-care-limit.html


Daughter claims father wrongly placed on controversial NHS end of life scheme
http://www.telegraph.co.uk/health/healthnews/6156076/Daughter-claims-father-wrongly-placed-on-controversial-NHS-end-of-life-scheme.html

Posted by: FastEddieO007 | February 26, 2010 5:41 PM | Report abuse


NHS is paying millions to gag whistleblowers
http://www.independent.co.uk/life-style/health-and-families/health-news/nhs-is-paying-millions-to-gag-whistleblowers-1812914.html


Father of Baby RB fights hospital’s decision to turn off life support
http://www.timesonline.co.uk/tol/life_and_style/health/article6898708.ece


How junior doctors are signing 'do not resuscitate' forms for dying patients
http://www.dailymail.co.uk/health/article-1225323/How-junior-doctors-signing-resuscitate-forms-dying-patients.html

...very interesting what is happening in UK...the middle class suffers horrors that we'd never accept here....worse than anything that happens here with our inusrance companies!!!

Posted by: FastEddieO007 | February 26, 2010 5:43 PM | Report abuse

FastEddie,

You're welcome.

Now please go attend your "Venezuelan-Marxist lessons" or else work on your wingnut URL collection. The rest of us are trying have a polite conversation.

Posted by: Patrick_M | February 26, 2010 5:47 PM | Report abuse

I thin I've had an epiphany here....many of you liberals think "controlling the spiraling cost of healthcare" means controlling the cost that consumers pay.....

THAT IS NOT THE PROBLEM!

The problem is the amount we pay as a nation! Or more specifically how much tax-payers pay for healthcare. WE cannot afford to allow it to keep spiraling because it leads to unemployment and structural deficits.....its like committing to a mortage that cannot be supported by your monthly income, even if you give up food.....

That is the path we are on and we DO NEED TO FIX THAT!

You liberals really don't seem to get that....all you care about is desiging a generous charity service out of the federal treasury....I'm all for that, if it were really possible. It isn't Trying to do that will have the same consequences that reckless home loan giveawys did...IT WILL PERMANENTLY BANKRUPT THE USA..perhaps to the point of no return!!!

You don't realize it...but we're in a plane and our wing is on fire, and your fighting on why First Class passengers are getting glasses of champaign....who cares...we're all going down!!!

Posted by: FastEddieO007 | February 26, 2010 5:50 PM | Report abuse

Eddie, my friend, you do realize you just made a liberal argument? Admittedly, liberals are a bit more lackluster when it comes to emotions and urgency. Is that your quarrel?

Posted by: StonedandHappy | February 26, 2010 6:02 PM | Report abuse

FastEddie,

C-H-A-M-P-A-G-N-E

Now P-L-E-A-S-E go attend your "Venezuelan-Marxist lessons."

Posted by: Patrick_M | February 26, 2010 6:21 PM | Report abuse

"I thin I've had an epiphany here....many of you liberals think "controlling the spiraling cost of healthcare" means controlling the cost that consumers pay....."

Yep, that's what think. And they're not really even talking about controlling the cost that consumers pay, they are talking about subsidizing what consumers pay, no matter how much it costs.

Posted by: bgmma50 | February 27, 2010 7:23 PM | Report abuse

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