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Posted at 2:57 PM ET, 02/ 3/2011

What would conservatives do for Hillary St. Pierre?

By Greg Sargent

Ezra Klein points us to the difficult dilemma of one Hillary St. Pierre, who has Hodgkin's lymphoma but says she might be forced to drop her treatment if the Affordable Care Act is repealed:

The legislation put an end to lifetime limits on coverage for the first time, erasing the financial burdens, including personal bankruptcy, that had affected many ailing Americans.

For example, Hillary St. Pierre, a 28-year-old former registered nurse who has Hodgkin's lymphoma, had expected to reach her insurance plan's $2 million limit this year. Under the new law, the cap was eliminated when the policy she gets through her husband's employer was renewed this year.

Ms. St. Pierre, who has already come close once before to losing her coverage because she had reached the plan's maximum, says she does not know what she will do if the cap is reinstated. "I will be forced to stop treatment or to alter my treatment," Ms. St. Pierre, who lives in Charlestown, N.H., with her husband and son, said in an e-mail. "I will find a way to continue and survive, but who is going to pay?"

Ezra charges that Republicans and conservatives are irresponsibly advocating for repeal without having their own idea in place to deal with the plight of those who are in Ms. St. Pierre's situation.

That's an awfully harsh verdict, so I'd like to give conservatives a chance to respond. So, a question for any Republican and conservative readers or bloggers who feel like answering: If the health law were repealed, what would you propose doing for Hillary St. Pierre instead?

By Greg Sargent  | February 3, 2011; 2:57 PM ET
Categories:  Health reform  
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Comments

I can answer for the Republicans and Conservatives. It's what Alan Grayson said they wanted. "Die, and die quickly!"

Posted by: PhilPerspective | February 3, 2011 3:03 PM | Report abuse

Conservatives would do just what Arizona Governor Jan Brewer has done. Drastically cut the budget and then watch the people in need die. Republicans already have their Death Panels you see. And they've already killed some of their citizens.

Be proud repubs. Only 160 million more of us and you will rule the place.

Posted by: kindness1 | February 3, 2011 3:20 PM | Report abuse

I guess teh internets are slow b/c its been almost 25 minutes since Greg posted this thread and I'm still waiting for an answer. They've had years to think about this and supposedly they have Bills in the works and *ready* in Congress, right?

Just like they do with unemployment...

Posted by: ChuckinDenton | February 3, 2011 3:21 PM | Report abuse

Do you really find this a serious question? The easiest way to demagogue this issue is to find one person in a sad state and say "Ooh, bad Republicans, are you really going to push this person's wheelchair into the snow?"

But there isn't one Hillary St. Pierre. There will be hundreds of thousands, if not millions. Is there a total budget for health care in the US? If so, will it contain limits, or will it run infinitely for every single patient? If it runs infinitely for every single patient, will you simply keep borrowing to fund it, or keep raising taxes? If the lenders stop lending, or the taxes kill economic growth, what will you do then?

Yes, they're uncomfortable questions. They're hard questions. And that's why no one wanted to deal with them, and when Sarah Palin raised them for you, you raced to call her an idiot. But the questions remain. Will you pay infinitely for an infinite number of people? And if so, what are you willing to sacrifice in return-- high speed rail? Education? Economic growth going into the 2012 election and beyond?

Or do you simply imagine that you will never have to make hard choices, only pose them to the other side and shout "Aha!"?

Posted by: mgmax | February 3, 2011 3:22 PM | Report abuse

@mgmax: Well, either repubs believe in health care rationing or they don't. If they don't then the eliminating of lifetime caps makes sense. If they do, then they should come out and say so.

As a progressive, I believe there should be illnesses that are covered in full and those that are not. I don't think medicare should be paying for Cheney's heart transplant at his age and with his resources, for example. So I believe in rationing based on medical efficacy. What is the relative improvement in the quality of life and life expectancy after this treatment vs the cost.

This is what Oregon tried to do and I thought is was a good effort.

Posted by: srw3 | February 3, 2011 3:29 PM | Report abuse

There's your answer Greg, let her die!

Posted by: Alex3 | February 3, 2011 3:31 PM | Report abuse

The GOP amendment in the nature of a substitute included the same prohibition.

SEC. 103. NO ANNUAL OR LIFETIME SPENDING CAPS.

http://docs.house.gov/rules/health/111_hr3962_boehner_sub.pdf

Posted by: NoVAHockey | February 3, 2011 3:33 PM | Report abuse

""and when Sarah Palin raised them for you""

You mean how she raised those questions for us by saying this:

"The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's ‘death panel' so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,' whether they are worthy of health care. Such a system is downright evil."

Democrats were dealing legitimately with end of life counseling issues until Miss Sarah came along and tried to scare everyone with the lie of the year. That was really helpful. Good for her for being such an honest broker for lowering health care costs.

And Greg, didn't you know people don't die because they lack health insurance, they die because they get sick. /s

Posted by: lmsinca | February 3, 2011 3:34 PM | Report abuse

"Well, either repubs believe in health care rationing or they don't."

Unfortunately, this has been the tactic all along in this debate:

DEM: Look at our bright shiny healthcare reform.

REPUB: Did you think about X?

DEM: You just want people to DIE, you heartless scum!

It's YOUR proposal for changing everything. You made it quite clear you didn't want anyone from the other side putting Republican cooties on it. So answer the questions yourself, first.

Posted by: mgmax | February 3, 2011 3:36 PM | Report abuse

mgmx - the answer to all that isn't as impossible to come up with as you suggest. We're talking about a 28-year-old woman with a treatable condition. Of course she should continue to get treatments. Obviously the situation would be different if we were talking about an 85-year-old with an aggressive brain cancer. The 28-year-old may have another 60 years of life after treatment; the 85-year-old probably wouldn't survive treatment.

This was why it was a good idea for Medicare to pay for end-of-life patient consultations with doctors. A lot of terminal patients would opt out of going to heroic lengths in treatment if they knew up front that they offered little or no hope for continued quality of life. I've never met anyone who's said "I want to be kept alive for weeks/months/years in a persistent vegetative state" or anyone who wants to live in extreme pain. But to talk about it = "death panels".

I mean, we could take the other extreme position and argue that since everyone dies eventually, what's the point in treating any illness? So yes, there are limits - but they shouldn't just be based on what it costs but on what the outcome is likely to be. And that's a fluid line that doctors and patients are best able to judge.

Posted by: JennOfArk | February 3, 2011 3:37 PM | Report abuse

Pelosi-Care death-panel matrix for Hodgkin's lymphoma prescribes:

"Eat patient's liver with some fava beans and a nice Chianti."
--Dr. H. Lecter--

The private sector solutions call for curing disease through R&D. Far more compassionate than innovation killing Pelosi-Care and guaranteed death panels.

*chew-swallow*

Posted by: KaddafiDelendaEst | February 3, 2011 3:38 PM | Report abuse

Greg:

""If the health law were repealed, what would you propose doing for Hillary St. Pierre instead?""

I propose that Obama use his not insignificant pull and connections to prevail upon a wealthy liberal (Soros? Gates? Buffet - who actually knows something about insurance?) to start up a new, non-profit insurance company. Premiums can be set at an "affordable" level regardless of the risks being covered, as per liberal economic desires. Then, using the DNC's mailing list as a starter, it can begin to solicit for customers to join its insurance pool. Naturally, it will not descriminate against anyone with a pre-existing condition, so Ms St. Pierre can be its first client. Indeed, it should use Ms St Pierre's story as a marketing tool to attract new clients. It should target those people who are disappointed with the repeal of Obamacare, and who think it is a moral duty (a private, personal moral duty, naturally) to help out people like Ms St. Pierre. I am sure you, Greg, along with many of the progressive commentors here, would be more than happy to switch your coverage over and even pay an increased premium so that you can all help Ms St Pierre cover the costs of her condition.

That is what I propose. Are you in, Greg?

Posted by: ScottC3 | February 3, 2011 3:39 PM | Report abuse

"Or do you simply imagine that you will never have to make hard choices, only pose them to the other side and shout "Aha!"? Posted by: mgmax "

Wewll, the Democrats answered that question with the affordable health care act. It actually costs less than any alternative the Republicans have offered, which currently consists of repeal and wait. So only the Republicans need to answer.

Paying for the AHCA isn't all that difficult either. We simply sacrifice tax cuts for the very rich. In fact we rewrite the tax code to declare that part of personal incomes that exceeds 100 times the full time minimum wage as excessive income and tax the daylights out of it. No exceptions, no deductions, no shelters.

Then we put a ten percent additional tariff on everything we import from everywhere but Canada. If those two taxes won't balance the budget and pay for affordable health care, bump the tariff by another ten percent.

So, you have a Democrat proposing a very concrete way to have affordable health care. easily enacted, easily administered, and historically proven to work.

Posted by: ceflynline | February 3, 2011 3:40 PM | Report abuse

There are plenty of conservatives who constantly and repeatedly post on these blogs, where are they on this question.

Skip? Khaddafi? RainForest? Quarterback? Scott? Where are you guys? What is the solution? Why so suddenly quiet?

Posted by: Amminadab | February 3, 2011 3:42 PM | Report abuse

[ScottC3 blasphemed: "I propose that Obama use his not insignificant pull and connections to prevail upon a wealthy liberal (Soros?"]

"There is no God but Soros, and Obama is his messenger."
http://www.bluecollarphilosophy.com/wp-content/uploads/2010/12/Obama-reuters-halo-197x197.jpg

Posted by: KaddafiDelendaEst | February 3, 2011 3:44 PM | Report abuse

ScottC3 - why should Greg, or I, or anyone else pay an increased premium for a young woman to get treatment when those costs can easily be covered by moving the uninsured and indigent from ERs to clinics, where they can get care much less expensively now rather than waiting for their illness to become critical? And why should Greg, or I, or anyone else pay an increased premium when the only reason Ms. St Pierre's insurer won't cover it is that it would cut into executive salaries and shareholder earnings?

Posted by: JennOfArk | February 3, 2011 3:46 PM | Report abuse

Amminadab:

""Scott? Where are you guys?""

Er, look up a couple of posts.

Posted by: ScottC3 | February 3, 2011 3:47 PM | Report abuse

[Amminadab whined: "Why so suddenly quiet?"]

Good grief. We can't leave for coffee without you baby's screaming for answers?

*grow up*

Posted by: KaddafiDelendaEst | February 3, 2011 3:47 PM | Report abuse

"Skip? Khaddafi? RainForest? Quarterback? Scott? Where are you guys? What is the solution? Why so suddenly quiet?"

Well, one of RFR's points was always have the Democrats pay for everything. It seems like The Smartest Conservative In The World Scott is proposing the same thing.

I don't think it's fair for Conservatives to come up with a solution that quickly. Glen Beck doesn't come on for another few hours to tell them the answer.

Posted by: DDAWD | February 3, 2011 3:50 PM | Report abuse

Of course, if all the Dems go and move over to Scott's idiotic plan, the private pools will be pretty much left with the pro-obesity crowd and the geriatrics. I wonder how that would affect their premiums.

Posted by: DDAWD | February 3, 2011 3:55 PM | Report abuse

Off-thread thought:

When the GOP held Congress and the Executive and didn't significantly alter SS and Medicare, does that make them Socialists? A sin of omission?

Maybe we should ask the Tea Party. They seem pretty hell-bent on purging the idealogically weak.

Posted by: ChuckinDenton | February 3, 2011 3:56 PM | Report abuse

Jenn:

""why should Greg, or I, or anyone else pay an increased premium for a young woman to get treatment...""

Because she needs it, of course. Isn't it your moral duty to provide for those in need?

""...when those costs can easily be covered by moving the uninsured and indigent from ERs to clinics, where they can get care much less expensively now rather than waiting for their illness to become critical?""

Perhaps you weren't paying attention, but the hypothetical assumed that Obamacare was repealed.

""And why should Greg, or I, or anyone else pay an increased premium when the only reason Ms. St Pierre's insurer won't cover it is that it would cut into executive salaries and shareholder earnings?""

That's the beauty of it. In my solution, Ms St. Pierre's insurer WILL cover it, because it is run by benevolent liberals who don't care about profits...remember, it is a non-profit. No big executive salaries, again because it is being run by benevolent liberals who don't care about their own compensation. Isn't this precisely the kind of compassionate insurance company you have been waiting for? Come on, Jenn...are you in?

Posted by: ScottC3 | February 3, 2011 3:56 PM | Report abuse

ScottC admits that he really does not give a rat's arse what would happen to the women in question.

That is the true profile of a "compassionate conservative"

Posted by: Liam-still | February 3, 2011 3:56 PM | Report abuse

Greg's question sets up a false dichotomy.

This silly gripe pretends that there were no solutions until granny Pelosi set up her death-panel scheme.

In fact, all of the major private Pharmaceutical Companies have Indigent Programs for these hard cases.
http://www.gistprobono.org/id98.html

Conversely, Pelosi-Care kills the geese that lay the golden eggs, then offers death panels for the consumers.

Rebuttal? ...anyone?

*crickets chirp*

Posted by: KaddafiDelendaEst | February 3, 2011 3:59 PM | Report abuse

Has Paul Ryan introduced his Health Care Reforms Bill yet?

He told us, before the Health Care Reform bill was passed, that he had the Republican reforms ready to be voted on.

Now that The House has voted to repeal the Democrats' version of Health Care Reform; where is your bill Paul Ryan?

You said you had it already prepared, so:
Where Is The Beef; Mr. Beefer?

Posted by: Liam-still | February 3, 2011 4:00 PM | Report abuse

DDAWD:

""Of course, if all the Dems go and move over to Scott's idiotic plan, the private pools will be pretty much left with the pro-obesity crowd and the geriatrics. I wonder how that would affect their premiums.""

What a win-win situation for you guys. Come on DDAWD...are you in?

Posted by: ScottC3 | February 3, 2011 4:01 PM | Report abuse

Liam drooled: "ScottC admits that he really does not give a rat's arse"]

Wrong. ScotC addresses some of the trade-off analysis that the crybaby Leftists (like Liam) refuse to acknowledge.

Don't be an apologist for Pelosi-Care death-panels your whole life, Liam.

Posted by: KaddafiDelendaEst | February 3, 2011 4:03 PM | Report abuse

Scott,

Do you have any REAL solutions?

Posted by: Amminadab | February 3, 2011 4:05 PM | Report abuse

So are we conceding that Scott's idea is the best Conservative alternative?

Posted by: DDAWD | February 3, 2011 4:05 PM | Report abuse

It's simple they are too busy trying to redefine rape then to be concerned about health insurance coverage. Love the fetus hate the person.

Posted by: MerrillFrank | February 3, 2011 4:06 PM | Report abuse

There is no reason for them to propose an alternative to the PPACA because all of their efforts to derail it have nothing to do with health care. They have everything to do with keeping up the attacks on Obama and his policies. If they lose the public relations battle over HCR before Anthony Kennedy decides if it's constitutional, they'll have precious little to run on. They sure as hell can't run on their record.

Posted by: fishellb | February 3, 2011 4:07 PM | Report abuse

just to be clear, lifetime limits are gone, but annual limits are still in place until 2014 (increasing year by year).

Posted by: tegrat | February 3, 2011 4:09 PM | Report abuse

The Republican House leaders say that they will also pass a bill that prevents the Insurance Companies from dropping people with pre-existing conditions.

So where is there bill, to do so, and how do they propose to pay for it, without requiring healthy people to also purchase insurance.

ScottC gave a flippant non answer, because he truly doesn't care about what happens to the women in question.

That is what being "a compassionate conservative" is all about.

Posted by: Liam-still | February 3, 2011 4:12 PM | Report abuse

Not sure if someone else has yet mentioned, but Boehner offered an amendment to Pelosi's act back in Nov 2009 that proposed no annual or lifetime caps.

http://docs.house.gov/rules/health/111_hr3962_boehner_sub.pdf

Posted by: sbj3 | February 3, 2011 4:14 PM | Report abuse

Did everyone just skip the link I posted. It's a BS question because the GOP alternative included the same prohibition.

if the question is how are the R's addressing Mrs. St. Pierre's problem ... the answer is exactly like current law.

Now whether it makes sense to have someone whose gone through $2 million in benefits to continue to be in an insurance system rather an an outlier pool or something along those lines is a different issue. there are a lot of options. reinsurance, charity, you could make the government an insurer of "last resort," kind of like the high risk pool. open Medicare those with X million in expenses.

there are plans out there that have lifetime limits well above $2 million. perhaps disclosure and consumer choice is a better method. if "unlimited" plans are so popular, I'm sure there would be a market for them.

Posted by: NoVAHockey | February 3, 2011 4:16 PM | Report abuse

Amminadab:

""Do you have any REAL solutions?""

Why is this not a real solution? Just because it doesn't use the government to force people to do something?

Think outside the government box a little bit. If libs are going to be stymied by Republicans (and a little thing called the Constitution) from enacting their grand plans, they are going to have to come up with some other way of achieving their ends. The Democratic Party could even make it a condition of party membership that one be insured by, oh let's call it, We Care Insurance. (If the Dems think it reasonable for the government to force every citizen in the nation to carry insurance, surely it is reasonable for the Dem Party alone to require its members to be covered by WCI.) This requirement will provide WCI with a solid foundation to start.

Come on, Amminadab...are you in?

Posted by: ScottC3 | February 3, 2011 4:19 PM | Report abuse

Mrs. Palin already fisked Greg's refried Leftist smear;

"The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's "death panel" so his bureaucrats can decide, based on a subjective judgment of their "level of productivity in society," whether they are worthy of health care. Such a system is downright evil."

Posted by: KaddafiDelendaEst | February 3, 2011 4:20 PM | Report abuse

Not sure if anyone mentioned it yet, but Boehner just voted to repeal the entire health care reform bill, and since he is now in charge of The House there is nothing stopping him from passing the reforms that Paul Ryan claimed they had all ready put together.

Call Boehner and ask him; Where's The Beef?

Posted by: Liam-still | February 3, 2011 4:20 PM | Report abuse

Shorter Scott: "Why should I have to pitch in to help anyone get medical care when I don't care if they get it or not? You liberals should pay for it so I can get a free ride."

The thing about conservatives that never ceases to amaze me is how they all claim to be uber-patriots, while at the same time, giving not a whit about their fellow citizens. It's as if they believe a "nation" is made up of a chunk of land, a flag, and some documents elevated to mystical reverence, and not of a group of people.

You can't love your country if you don't care about the people in it. And conservatives for the most part don't.

Posted by: JennOfArk | February 3, 2011 4:21 PM | Report abuse

NoVA, I'll take a look at it, but can you tell me how premiums are kept in check without an individual mandate?

Ok, took a look. It's 220 pages. I certainly won't read it.

Posted by: DDAWD | February 3, 2011 4:23 PM | Report abuse

In a footnote, Judge Vinson quotes a critic of the individual mandate idea as observing, "If a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house."

Guess who?

*Barry Soetoro*

Posted by: KaddafiDelendaEst | February 3, 2011 4:24 PM | Report abuse

Where was the GOP from 2002 to 2006 regarding HCR? Why didn't they get Reform passed?

Posted by: ChuckinDenton | February 3, 2011 4:24 PM | Report abuse

All, American journalists threatened with beheading in Egypt:

http://voices.washingtonpost.com/plum-line/2011/02/gibbs_targeting_of_journalists.html

Posted by: Greg Sargent | February 3, 2011 4:25 PM | Report abuse

"But there isn't one Hillary St. Pierre. There will be hundreds of thousands, if not millions."

No, there won't. Most people in their twenties don't get cancer. Seriously, ask around. There are, in fact, very, VERY few Hillary St. Pierres in the US. Certainly not hundreds of thousands, and certainly not millions.

The elderly, who get cancer much more often, didn't need the ACA to get insurance with unlimited coverage. It's the young who didn't have it. And the reason why is before the ACA, the government guaranteed unlimited coverage for old people but not for young people. All the ACA did was extend the same benefit to young people that old people get when it comes to insurance limits.

Whether we repeal the ACA or not, we're still spending whatever it costs to treat old people's cancer. The question is, what happens to young people like Hillary St. Pierre?

I'm still not hearing any answers.

Posted by: theorajones1 | February 3, 2011 4:26 PM | Report abuse

@DDAWD -- I'm guessing from memory, but it's the GOP we're talking about, so i'd imagine it had something to do with tax cuts. they're an elixir.

As far as premiums costs, FWIW, CBO says they'd go down relative to current law at the time.

http://www.cbo.gov/ftpdocs/107xx/doc10705/hr3962amendmentBoehner.pdf

Posted by: NoVAHockey | February 3, 2011 4:33 PM | Report abuse

Scott,

Sorry, I thought you were a serious commentor, my mistake. If you don't see a problem, I shouldn't expect you to find a solution. Sorry to engage, I'll try not to make that mistake again.

Posted by: Amminadab | February 3, 2011 4:34 PM | Report abuse

mgmax @ February 3, 2011 3:22 PM: It IS a serious question, and goes to the essence of a society's responsibilities, and the challenge of governing.

So, what is the Republicans' answer?

From what I have seen, it is 'Die Quickly'.

I WANT to be proven wrong, so what is the Republicans' solution? (PS: that means don't give me a speech, but point me to a SPECIFIC Republican plan that they have committed to vote for). (PPS: There is none, which means that their plan is 'Die Quickly').

But, I really do want to be proven wrong!

Posted by: AMviennaVA | February 3, 2011 4:34 PM | Report abuse

"In my solution, Ms St. Pierre's insurer WILL cover it, because it is run by benevolent liberals who don't care about profits"

Um, but back in the real world, liberals care about SOLVENCY.

In the scenario you outline, St. Clair's insurer wouldn't cover her, because her insurer would be out of business.

Intentions are all very well and nice, but you clearly understand zero about how health markets actually work. What you're proposing isn't an insurance plan--it's an "adverse selection death spiral." (google it, we'll wait.)

Posted by: theorajones1 | February 3, 2011 4:36 PM | Report abuse

Jenn:

""Shorter Scott:""

Come on, Jenn. Be a doer, not a complainer.

Let's suppose, just for the sake of argument, that you are right about me and about conservatives in general. We don't care and will do just about anything to avoid our moral responsibility. (But how can it be our moral responsibility if our own "personal" morality tells us it isn't? Oh well, let's put that conundrum aside for the moment.) Are you more concerned with getting Ms St Pierre her treatment, or with getting me to help pay for it? Isn't it a better idea to simply let us evil republicans wallow in our hate for the country and the people in it while you come up with a solution that doesn't depend on us? And hel, you don't even have to come up with it, since I already have done it for you. You just have to implement it.

Come on Jenn. Are you going to help Ms St Pierre or just sit around and fret that evil Republicans won't do it for you?

Posted by: ScottC3 | February 3, 2011 4:36 PM | Report abuse

And of course, I should have added: Scott already pitches in to help others get medical care, if they are in his insurance pool. He could pay about the same thing and everyone could be insured under ACA, but that's objectionable because the free riders will be forced to pay for part or all of their insurance or be fined, instead of Scott and his fellow insured picking up all the ER costs via higher premiums.

So it really boils down to it not being so much about Scott worrying about what it's going to cost him, as opposed to Scott worrying that "those people" won't have to wait until they're REALLY sick to get care in an ER.

Pretty sick, if you ask me.

Posted by: JennOfArk | February 3, 2011 4:38 PM | Report abuse

I'm banging my head on my desk here. The GOP voted for a plan that includes the same prohibition on lifetime limits that is included in current law. Here's the roll call vote:

http://politics.nytimes.com/congress/votes/111/house/1/885

Posted by: NoVAHockey | February 3, 2011 4:40 PM | Report abuse

Peripherally related... yummies for us but screw the people category...

" every single Republican contacted by ThinkProgress has refused to deny government health benefits to their staff. Congressional staff members are granted the same taxpayer-subsidized, government-regulated health plans available to members. Unlike lawmakers, staff are often middle-class Americans who are not independently wealthy and need regular coverage in case they get sick. While lawmakers and their staff work ruthlessly to repeal health reform — thus denying coverage to over 30 million Americans and helping insurance companies continue outrageous, life-threatening abuses to their customers — pro-repeal members believe their staff should be “free to choose” quality government care"

http://thinkprogress.org/2011/02/03/repeal-staff-gop/

Posted by: bernielatham | February 3, 2011 4:40 PM | Report abuse

@kdaffy:
And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course.

Who suffers now from the price rationing that we have now? The sick, the elderly, the uninsured, and the disabled, of course.

And what have repubs proposed to make this not be the case? crickets or Ryan's vouchers to death plan...

Rationing by price is already here. Should we make the system more dependent on wealth as the arbiter or who gets health care or less dependent on this?

Posted by: srw3 | February 3, 2011 4:41 PM | Report abuse

"Are you going to help Ms St Pierre or just sit around and fret that evil Republicans won't do it for you?"

Liberals ALREADY helped Ms. St. Pierre. You're the one who wants to un-do what liberals did. The burden is now on you to tell us what you will do to help her.

Ideally, we were hoping for something slightly more realistic than fairy godmothers.

Posted by: theorajones1 | February 3, 2011 4:41 PM | Report abuse

ScottC.

Why don't you just go back to your flat tax heaven and haven of Hong Kong, that you were recently waxing all nostalgic about.

No one has put an American Anchor on your selfish Arse!

Posted by: Liam-still | February 3, 2011 4:43 PM | Report abuse

Amminadab:

""Sorry, I thought you were a serious commentor, my mistake.""

No, your mistake was to think that Greg's demagoguery deserves serious contemplation.

And I am not being entirely facetious. Liberals seem to always and automtically look for a government solution. There are other ways of going about helping Ms St Pierre.

Posted by: ScottC3 | February 3, 2011 4:45 PM | Report abuse

@NoVAHockey : The GOP voted for a plan that includes the same prohibition on lifetime limits that is included in current law. Here's the roll call vote:

Well then, why couldn't even 1 repub in the house support a bill that included a provision that they supported (among lots of other supported items like the insurance exchange, originally proposed by repubs, for example).

Posted by: srw3 | February 3, 2011 4:46 PM | Report abuse

srw3-

one word- waterloo.

Posted by: ChuckinDenton | February 3, 2011 4:49 PM | Report abuse

@nova: Stop banging. Many folks here refuse to recognize that the GOP has offered alternatives that incorporate no annual or lifetime caps. You can link and link and link and it won't matter.

Greg and others here are gaming out a hypothetical and their only intention is to use it for political gain. There's no "there" there. The ACA hasn't been repealed. The GOP knew that it would not be repealed. If the GOP had been able to repeal the ACA then the liberals here would have some argument but as it is, they are arguing with their own imaginations.

Posted by: sbj3 | February 3, 2011 4:50 PM | Report abuse

I'll answer. And for the record, the removal of lifetime limits on insurance converts the product from insurance to wealth transfer. It’s important to call it what it is.

The question Ms. St.Pierre, and her family have to ask themselves is, how much is her life worth? The 10 year survival rate for Hodgkin’s lymphoma is at least ten years. Is her life’s worth everything to her, and those that love her? I can only assume that she and all who love her would agree. Therefore, she should enact the plan she intended to use prior to the passage of Obamacare, if the repeal of Obamacare is passed and signed, by Barry, into law (fingers crossed).

So, let’s assume that does in fact happen. Ms. St.Pierre needs to first go to her current care provider’s to let them know that she no longer has insurance and is paying out of pocket, in case they are willing to accept a lower fee, or perhaps more likely, waive their fee altogether. If they refuse, she needs to shop around for care providers who charge less or waive their fee. Miss also needs to contact the manufacturers of the chemotherapy products that she uses in her regimen so as to inquire about indigent programs. (Also, Miss St.Pierre needs to examine the sourcing and cost of every product she and her caregivers use in the treatment of her disease to insure she is utitlizing the most cost effective treatment and treatment products she can find.) Because we do not know her economic situation, she may not yet qualify for those programs, but it is important to know what those qualifications are, and how to access any of them (indigent programs offered by chemotherapy manufacturers) so that she can access them ASAP should she need to. My guess is at some point, all her and her immediate family’s assets are going to be exhausted, requiring bankruptcy most likely. It’s at that point she needs to exercise the part of her assumed existing plan to access New Hampshire’s indigent medical care system. This may require her to divorce, for example, and is another reason why she needs to spend the time she has now, while covered by insurance, too understand in every detail, the requirements these systems and plans have. What we are trying to avoid, and good planning can help achieve that, is disruption in her care. Once approved, she will need to follow the treatment regimen that the New Hampshire indigent plan offers, or, not go on it and rely on the indigent care programs her chemotherapeutic manufacturers offer, along with whatever arrangements she made with her caregivers. This option may prove more beneficial in that it may allow her to stay married and her husband to keep working at his job.

Finally, she should also inquire, through her church, her husband’s employer and any other civic or religious organization, what charity they might offer her to help her continue her care.

That’s what I would do.

Posted by: TrollMcWingnut | February 3, 2011 4:52 PM | Report abuse

How do the Republicans propose to pay for the coverage of people with preexisting conditions, without requiring healthy people to also purchase insurance?

Why isn't the "liberal media" demanding an answer from the Republicans.

Posted by: Liam-still | February 3, 2011 4:52 PM | Report abuse

Hey ScottC3, we are all ready for you to step up and pay her bill.

Posted by: srw3 | February 3, 2011 4:54 PM | Report abuse

"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness"

Of course in the fine print they added:

that Life bit, does not apply to poor sick people.

Posted by: Liam-still | February 3, 2011 4:57 PM | Report abuse

Whoops, the "ten year survival rate for Hodgkin's lymphoma is 90%."

Posted by: TrollMcWingnut | February 3, 2011 5:00 PM | Report abuse

@tmwn: If they refuse, she needs to shop around for care providers who charge less or waive their fee.

I am waiting to see you comparison shop when you are dying of a treatable disease, vomiting daily from chemo, weakened by radiation "therapy", etc.

I don't know where this person lives in Maine, but there are lots of rural (and urban) areas where the choice of doctors and hospitals is severely limited. Driving hours to another town (or taking public transit, more likely) is a huge burden to put on a seriously ill person.

Somehow relying on the kindness of strangers and promotional gimmicks from big pharma is the best that you and scottc3 can come up with, as far as I can tell.

Posted by: srw3 | February 3, 2011 5:02 PM | Report abuse

Thanks, NOVA. Reading the CBO link.

But right off the bat, repealing PPACA and replacing it with the Boehner plan increases the deficit by like $100 bil, I believe. At least for the first 10 years.

Still on page 2, though.

Posted by: DDAWD | February 3, 2011 5:06 PM | Report abuse

Well, reading the Boehner plan, given the objections raised by Republicans, it wouldn't ever pass a Republican controlled house much less pass filibuster in the Senate.

Posted by: DDAWD | February 3, 2011 5:09 PM | Report abuse

If you don't cover the healthy, how can you afford to cover the chronically sick. Without the healthy paying into the insurance pool, requiring coverage of people with pre-existing conditions will drive premium rates to a level, that people might just as well not have coverage.

Posted by: Liam-still | February 3, 2011 5:10 PM | Report abuse

Boy, everyone has such clever lines to sling at each other. But one-upping the guy with the other point of view doesn't really help Ms. St. Pierre much. Setting emotions aside, what are the options? I mean, really, what are they? The health care law IS unconstitutional. It contains some really great features but it still amounts to a the federal government exceeding its constitutionally-granted powers. But no one DESERVES to die when death can be avoided with modern science. All the snark in the world doesn't change the fact that this really is a terribly difficult problem. If Dems REALLY think the individual mandate is necessary -- and I think they're right -- why not implement it in a constitutionally valid way? The federal government had NO authority to mandate a national drinking age. Yet Reagan got one. How? He told every state -- and THAT'S where the authority really lies -- that if they failed to increase their drinking age, the federal government would withhold highway funds. Miraculously, every state raised the drinking age. Regarding ACA, if the states pass an individual mandate, its legal. But the federal government can't. So while we throw insults at each other, someone like Ms. St. Pierre becomes collateral damage. I can support a program that helps the likes of Ms. St. Pierre. But not at the cost of the Constitution. Too many others before Ms. St. Pierre died to protect it. There are a lot of ways to fix health care. NONE of them are easy. Single payer? Private but government-subsidized (McCain's plan)? This health insurance mess is a by-product of Depression-era deal-making. We've ignored it for years. Ms. St. Pierre's story is terrible and I hope she recovers and lives a long, happy life. But offering her and others a lifeline at the expense of the Constitution isn't the fix. Too many others died defending it and many more may die if the federal government is allowed to do whatever it likes. Take a look at Egypt. Tunisia. Yemen.

Posted by: outsider6 | February 3, 2011 5:11 PM | Report abuse

Scott,

If there are other solutions, please offer a viable one. You seem to advocate "charity", which is inefficient, and insufficient.

Posted by: Amminadab | February 3, 2011 5:15 PM | Report abuse

@tmwn:My guess is at some point, all her and her immediate family’s assets are going to be exhausted, requiring bankruptcy most likely. It’s at that point she needs to exercise the part of her assumed existing plan to access New Hampshire’s indigent medical care system. This may require her to divorce

Do you really think that bankrupting and breaking up her family is a prerequisite for her to get care is any kind of reasonable system?

Posted by: srw3 | February 3, 2011 5:16 PM | Report abuse

Let us try it the Republican way.

Every person who is healthy, cancel your health insurance. If enough people do so, they will destroy the Insurance Ponzi scheme, which requires healthy people to keep paying in, and those who might need medical care to get out.

Healthy people can bring about a single payer system, if they are willing to boycott the Insurance Companies for twelve months.

Posted by: Liam-still | February 3, 2011 5:16 PM | Report abuse

"I am waiting to see you comparison shop when you are dying of a treatable disease, vomiting daily from chemo, weakened by radiation "therapy", etc.". 

In the example given, she at least has a husband who she can legally authorize to negotiate on her behalf (always wondered why Barry allowed his dying mother to argue with her insurance company rather than he do it, interesting, no?) and it may in fact be advantageous to appear and sound seriously ill when negotiating. Again, how important is her life to her?  

"I don't know where this person lives in Maine, but there are lots of rural (and urban) areas where the choice of doctors and hospitals is severely limited. Driving hours to another town (or taking public transit, more likely) is a huge burden to put on a seriously ill person."

She chose to live there.  That aside, it may prove advantageous for her to move closer to her providers.  Again inconvenient for her, but it would increase the likelihood that she maintains care, which is the point.  Seems like a good idea even if insured, no?  Plus, from a charity standpoint it demonstrates commitment which would increase the likelihood of donations.

"
Somehow relying on the kindness of strangers and promotional gimmicks from big pharma is the best that you and scottc3 can come up with, as far as I can tell."

So?  I thought the point of Greg's bad faith question was so that you and those who. Agree with you could point to how heartless and evil we are.  Mission accomplished. Yet you complain. Strange.

Posted by: TrollMcWingnut | February 3, 2011 5:16 PM | Report abuse

"Do you really think that bankrupting and breaking up her family is a prerequisite for her to get care is any kind of reasonable system?"

That's not up to me, it's up to what her fellow New Hampshirians (?) decide, as it should be.

Posted by: TrollMcWingnut | February 3, 2011 5:20 PM | Report abuse

ScottC3, of course that's all a sensible plan, but if I were Mr. St. Pierre, I would also consider moving my wife 40 miles south (Massachusetts). Thank you, Gov. Romney!

Posted by: clawrence12 | February 3, 2011 5:26 PM | Report abuse

outsider6, would it be OK to have a refundable tax credit proportional to health insurance premiums? No insurance, no tax credit. Constitutional, yes? No penalty for not having insurance, just no tax credit, like the home mortgage deduction....or is that unconstitutional too?

Posted by: srw3 | February 3, 2011 5:29 PM | Report abuse

"If so, will it contain limits, or will it run infinitely for every single patient?"

Ohhh this is getting so tiresome. OK cretins see if you can comprehend.....
WE ALREADY HAVE RATIONING IN PLACE!!!

Does anybody really wish to debate that point. Rationing right now is based on a profit motive. Compassionate rationing would be a sane rationing based on what we can afford. We are one of the last nations on earth that does not BUDGET for health care...e.g. we can afford 15% of GDP for health care now what is the smartest way to spend it.

Do we wish to give a comatose 83 year old woman in ICU a pap smear...a colonoscopy...really? We'd rather spend money on an organ transplant for an 80 year old than provide basic care for a 30 year old? Just sayin' we need to confront this reality. Our health care $$$ are rationed absurdly right now with not much thought to the "tough" questions.

There is plenty of savings to be had in the system...Medicare fraud is outrageous..ask the Governor of Florida about that one..."procedure' driven medicine is totally out of hand and incredibly costly and inefficient.

At the end of the day what the righties simply fail to comprehend is that the "free market" does not work in health care.
Shop for a car and you have some decisions to make...can I afford it...do I wish to afford it...which car...plenty of relatively simple information to guide me in my selection...

Now medicine..your on vacation when one of the most painful yet easily treated illnesses hits...a simple kidney stone...ALL you care about is stopping the pain..and yet you're supposed to shop..really?...you're supposed to stop while in excruciating pain...start calling all the hospitals to find out the cost of the procedures..ohh wait you haven't been diagnosed yet you just know that you're on all fours puking your guts out because of the severity of the pain...but don't omit the details..how much for meds, durable medical supplies...disposable medical supplies...doctors fees..of course perhaps several to shop and compare...the Urologist..the Anesthesiologist...the OR folks...The fundamental problem as articulated by righties is there is a disconnect between provider, patient and who pays...since the patients who are insured supposedly don't feel the financial pain they make bad consumers...well that's true whether it's private insurance or public insurance that is covering the insured.

It is so self evident that free enterprise does not function with health care that only a real dim bulb fails to understand.

Posted by: rukidding7 | February 3, 2011 5:33 PM | Report abuse

TrollMcWingnut, don't worry about what they say. Leyden or Bernardston, MA are the closest areas for this family to move (or maybe they could only afford to move her). Of course, how far it is to drive from that point and what the quality is, to her treatment in that State need to be factored in as well.

Posted by: clawrence12 | February 3, 2011 5:34 PM | Report abuse

Kathleen Madigan recently returned from entertaining the Troops in Afghanistan.


She tells of having been briefed by a US Officer, on how many miles of new roads, and how many schools, the US military have provided to Afghanistan.

Kathleen said to him; That many, miles of new roads, and that many new schools. When you get back to the USA, could you please invade Detroit?

Posted by: Liam-still | February 3, 2011 5:34 PM | Report abuse

"So?  I thought the point of Greg's bad faith question was so that you and those who. Agree with you could point to how heartless and evil we are.  Mission accomplished. Yet you complain. Strange."

I didn't necessarily mean that you are asking questions in bad faith (unless you are), just that I think Greg asked the question in bad faith for the purpose of derision.

Sorry if I falsely accused you or anybody else. I want you to know I appreciate your question and have always appreciated your comments. :-)

Posted by: TrollMcWingnut | February 3, 2011 5:34 PM | Report abuse

A client of mine was successfully treated for cancer of the jaw in Mumbai for $11k. Cost would have been @ $400k in Houston.

We could boost medico-tourism, until catastrophic care costs come down in America.

I would prefer that the poor young woman did not have to travel for care, of course. I wish her well.

Posted by: mark_in_austin | February 3, 2011 5:37 PM | Report abuse

Greg didn't ask the question in bad faith. Not surprised, however, that you see it that way. The lack of an answer, or a poor one, has nothing to do with the asking...just sayin'.

Posted by: ChuckinDenton | February 3, 2011 5:40 PM | Report abuse

"So? I thought the point of Greg's bad faith question was so that you and those who. Agree with you could point to how heartless and evil we are. Mission accomplished. Yet you complain. Strange."

Man, you all are REALLY lucky for getting that Citizens United ruling.

Posted by: DDAWD | February 3, 2011 5:41 PM | Report abuse

@tmwn: I said "Somehow relying on the kindness of strangers and promotional gimmicks from big pharma is the best that you and scottc3 can come up with, as far as I can tell."

You replied:
So? I thought the point of Greg's bad faith question was so that you and those who. Agree with you could point to how heartless and evil we are. Mission accomplished. Yet you complain. Strange.
============
Just to be clear, you are agreeing that (mostly nonexistent or wildly overstretched) charity and pharma gimmicks are all you have, beyond fantasizing about a place where all your caregivers are close by in one spot and agree to become charitable organizations solely for her benefit, that affordable housing is available there, that her spouse could get a job there before they have to divorce, etc., or that so far unnamed (read nonexistent) charities will come to her rescue...

I am not saying you are heartless and evil, just clarifying what your position is. Others can judge for themselves if bankrupting a family, forcing a divorce, uprooting a family to move to a place that doesn't exist, begging health care providers to become charitable organizations, etc is a viable plan for this person or just the demented ravings of the farrightwingnutistan crowd.

I report, they decide...

Posted by: srw3 | February 3, 2011 5:44 PM | Report abuse

Mumbai eh!

So Republicans have been misleading us, about "America having the greatest health care system in the world"?

I am shocked, shocked I tell you!
Sounds like sick people should not be traveling to Mumbai, because it makes them traitors to "American Exceptionalism", and they should all be turned in to Kathleen Parker.

Posted by: Liam-still | February 3, 2011 5:46 PM | Report abuse

"Now medicine..your on vacation when one of the most painful yet easily treated illnesses hits...a simple kidney stone...ALL you care about is stopping the pain..and yet you're supposed to shop..really?...you're supposed to stop while in excruciating pain...start calling all the hospitals to find out the cost of the procedures..ohh wait you haven't been diagnosed yet you just know that you're on all fours puking your guts out because of the severity of the pain...but don't omit the details..how much for meds, durable medical supplies...disposable medical supplies...doctors fees..of course perhaps several to shop and compare...the Urologist..the Anesthesiologist...the OR folks...The fundamental problem as articulated by righties is there is a disconnect between provider, patient and who pays...since the patients who are insured supposedly don't feel the financial pain they make bad consumers...well that's true whether it's private insurance or public insurance that is covering the insured."

Hi ruk!  I'm assuming (perhaps wrongly) that this is directed at me.  However, that wasn't the bad faith question posed by Greg.  Greg's bad faith question was about a woman reaching the end of a lifetime limit on her insurance plan if Obamacare was repealed.  Your asking, I'm assuming in good faith, what one would do if in pain and in an emergency situation.  I'd mortgage and/or sell everything I had if it would make the pain stop.  What's wrong with that? Nothing is more valuable to me than my loved ones and myself.  Makes sense, no?

"It is so self evident that free enterprise does not function with health care that only a real dim bulb fails to understand.". 

Its not so self-evident to me, though I am a self-admitted below average intellect.  I readily admit to being a "dim-bulb."  i feel no shame for the limited gifts I do have.  I felt sorry for myself for my poor quality footwear until I met a man with no shoes...  if I thought healthcare was a Right, I'd agree with you.  However, I do not.  I believe healthcare is a service and/or commodity.

Posted by: TrollMcWingnut | February 3, 2011 5:47 PM | Report abuse

@tmwn:"Do you really think that bankrupting and breaking up her family is a prerequisite for her to get care is any kind of reasonable system?"

That's not up to me

Nice dodge, but I didn't ask what Mainers voted for, but whether you think that breaking up a marriage to qualify as indigent is good social policy...

Posted by: srw3 | February 3, 2011 5:48 PM | Report abuse

mark_in_Austin, of course I would prefer that the poor young woman could get doctors to make house calls, but you do what you have to do. I wish her well too.

kindness1, do you feel that the 13th Amendment should be optional?

Posted by: clawrence12 | February 3, 2011 5:50 PM | Report abuse

"Greg didn't ask the question in bad faith. Not surprised, however, that you see it that way. The lack of an answer, or a poor one, has nothing to do with the asking...just sayin'."

Hi Chuck! We're expecting snow in Houston, exciting?

We disagree on the "faith" good or bad, in Greg's interest in asking. ;-). I did however, answer, didn't I?

Always enjoy your comments, though don't always agree with them! Stay warm!

Posted by: TrollMcWingnut | February 3, 2011 5:51 PM | Report abuse

@tmwn: I believe healthcare is a service and/or commodity.

Are you really ready to take that statement to its logical conclusion and create a system even more focused on treating diseases of the rich, spending research money on drugs that cure baldness and not malaria, Denge fever, etc.?

People on the street dying of preventable diseases while within the fortified hospitals, millionaires get liposuction, hair transplants, and face lifts is your preferred visions of healthcare...

As a commodity, I guess you think it would be fine for a cartel (say Anthem) to corner the market for health providers or hospitals in a region, state, or nation and then charge whatever the market (or lack there or) will bear, right? I mean anti monopoly laws are an unconstitutional restraint of the free market aren't they?

Posted by: srw3 | February 3, 2011 5:58 PM | Report abuse

It's only a bad faith question if there is no answer.

Posted by: DDAWD | February 3, 2011 5:59 PM | Report abuse

"Just to be clear, you are agreeing that (mostly nonexistent or wildly overstretched) charity and pharma gimmicks are all you have, beyond fantasizing about a place where all your caregivers are close by in one spot and agree to become charitable organizations solely for her benefit, that affordable housing is available there, that her spouse could get a job there before they have to divorce, etc., or that so far unnamed (read nonexistent) charities will come to her rescue...

I am not saying you are heartless and evil, just clarifying what your position is. Others can judge for themselves if bankrupting a family, forcing a divorce, uprooting a family to move to a place that doesn't exist, begging health care providers to become charitable organizations, etc is a viable plan for this person or just the demented ravings of the farrightwingnutistan crowd.

I report, they decide..."

Thanks for the provocative follow-up.  I answered with what I'd do, if I was in that situation, which I stated in my original comment.  The question wasn't, as far as I could tell, not a request for an ultimate Federal solution to healthcare, it shuld be obvious that I do not think there should be one, but an answer to Ms. St.Pierre situation should Obamacare be repealed.  I think my answer is completely valid and used everyday. I also think that any larger, more organized answer to Ms. St.Pierre's situation, a question you seem to be asking (as opposed to Greg's more literal nd bad faith question) should Obamacare be repealed, should be centered on the state level.  Ergo, whatever she and her Fellow New Hampshirians decide is the best plan should she become indigent do to disease.

And again, I hope I have answered your question.  Please ask any follow-ups you have.  I'll do my best to answer in the course of the evening.

Posted by: TrollMcWingnut | February 3, 2011 6:00 PM | Report abuse

"Nice dodge, but I didn't ask what Mainers voted for, but whether you think that breaking up a marriage to qualify as indigent is good social policy..."

It wasn't a dodge, and I'm answering in good faith. I'd like to direct you to the Sunday Open Thread to what I think state taxpayer funded indigent healthcare should look like. Short answer, vouchers. But, in specific answer you your query, I would vote, or vote for state representatives who did not require the indigent to divorce (or be single parents, for example) before being eligible for the welfare care. I could, however, be outvoted.

Posted by: TrollMcWingnut | February 3, 2011 6:07 PM | Report abuse

Don't be squandering American money on sick people. Mubarak and Karsai need it more.

Posted by: Liam-still | February 3, 2011 6:09 PM | Report abuse

"@tmwn: I believe healthcare is a service and/or commodity.

Are you really ready to take that statement to its logical conclusion and create a system even more focused on treating diseases of the rich, spending research money on drugs that cure baldness and not malaria, Denge fever, etc.?"

Again, very provacative, thanks!  I do not see that as a logical conclusion.  Does the availability of, say, Wagu beef, result in American children starving?  I do not.

"People on the street dying of preventable diseases while within the fortified hospitals, millionaires get liposuction, hair transplants, and face lifts is your preferred visions of healthcare..."

See above.  Do five star restaurants cause famine?

"As a commodity, I guess you think it would be fine for a cartel (say Anthem) to corner the market for health providers or hospitals in a region, state, or nation and then charge whatever the market (or lack there or) will bear, right? I mean anti monopoly laws are an unconstitutional restraint of the free market aren't they?"

I'm not a beleivef in a monopoly or cartels and they are illegal in this country unless specifically authorized by the Federal government.  See various sports leagues.  And for the record, I Think anti-monopoly laws are crucial for a free economy?  I'd also bet the other conservative posters agree with me.

Posted by: TrollMcWingnut | February 3, 2011 6:14 PM | Report abuse

@tmwn: I think my answer is completely valid and used everyday.

Greg's question : If the health law were repealed, what would you propose doing for Hillary St. Pierre instead?

So, you would not do anything, (i.e. propose any additional government sponsored help,) for Ms St. Pierre, just leave her to what is currently available, i.e. nonexistent charity equal to her needs, begging health care practioners and institutions to become charities, bankrupting her family, divorcing her husband to qualify as indigent, etc.

I want to represent your position accurately...

And whether is is used everyday is not the question. Clearly this is impractical for lots of other people (rural, poor, uneducated, etc.) The question is should these be the only recourse. Your answer, if I understand it, is yes.

Posted by: srw3 | February 3, 2011 6:15 PM | Report abuse

For every ER visit of the non insured we pay $1000k. We didn't have a health care bill. Ike, Truman, Nixon, Clinton tried to get a health care bill. Lets call it Romney care lite.

In the dissenting opinion pieces I read its all about Obama care. No mention that the bill has plenty of Repub ideas. The mandate is one of them. Now all the Senators that spoke of it before are running from it now.

The simple fact is whatever this guy in office does, its a bad thing. It started 20 Jan 2009.

OT

Where was the tea party when GWB spent money like a drunken sailor or engage in two conflicts and a new medicare entitlement that wasn't paid for. We talk about the debt now, because all of this is on the books, not paid for through supplimentals.

Look it up.
BTW... Where are the jobs bills?

Posted by: ttanner509 | February 3, 2011 6:18 PM | Report abuse

For every ER visit of the non insured we pay $1000k. We didn't have a health care bill. Ike, Truman, Nixon, Clinton tried to get a health care bill. Lets call it Romney care lite.

In the dissenting opinion pieces I read its all about Obama care. No mention that the bill has plenty of Repub ideas. The mandate is one of them. Now all the Senators that spoke of it before are running from it now.

The simple fact is whatever this guy in office does, its a bad thing. It started 20 Jan 2009.

OT

Where was the tea party when GWB spent money like a drunken sailor or engage in two conflicts and a new medicare entitlement that wasn't paid for. We talk about the debt now, because all of this is on the books, not paid for through supplimentals.

Look it up.
BTW... Where are the jobs bills?

Posted by: ttanner509 | February 3, 2011 6:18 PM | Report abuse

Well

I would like to realistically assess this woman's situation - and review her alternatives for treatment

What did she do BEFORE Obama???


And Obama's plan isn't supposed to have kicked in yet - so technically she is STILL PRE-OBAMA, right?

Posted by: RainForestRising | February 3, 2011 6:21 PM | Report abuse

"@tmwn: I think my answer is completely valid and used everyday.

Greg's question : If the health law were repealed, what would you propose doing for Hillary St. Pierre instead?

So, you would not do anything, (i.e. propose any additional government sponsored help,) for Ms St. Pierre, just leave her to what is currently available, i.e. nonexistent charity equal to her needs, begging health care practioners and institutions to become charities, bankrupting her family, divorcing her husband to qualify as indigent, etc.

I want to represent your position accurately..."

You do not.  I answered Greg's question in terms of what I would do.  As I mentioned in the previous comment, I proposed, on the Sunday Open Thread, a state voucher system for indigent care.

"And whether is is used everyday is not the question. Clearly this is impractical for lots of other people (rural, poor, uneducated, etc.) The question is should these be the only recourse. Your answer, if I understand it, is yes."

You are incorrect.  Allow me to point you to my answer to your (but not Greg's bad  faith) question.  The Sunday Open Thread.

Again, thank you for the dialogue.  I'll keep answering to the best of my ability.

Posted by: TrollMcWingnut | February 3, 2011 6:23 PM | Report abuse

What the hell. Let us cut to the chase. She should have her doctor declare that she is brain dead, and on life support systems. Then her Husband should seek court permission to pull the plug, and every Social Conservative in the country will anti up, to keep her plugged in for ever.

We can even have Bill Frist do remote diagnostic evaluations of her brain scans, for free.

Next case please.

Posted by: Liam-still | February 3, 2011 6:30 PM | Report abuse

@tmwn: Do five star restaurants cause famine?

This nonsense is below you and is an odious and false analogy.

Food is plentiful and cheap in the us, mostly because it is heavily subsidized by the govt. (something I assume you disapprove of). But in health care, where there are lots of people competing for a very limited resource (mostly limited because the govt allows the AMA to strictly limit the number of medical schools and students as well as lobbying to keep foreign doctors out of the US), allocating health care resources strictly on the basis of who can afford them will result in poor people going untreated while rich people get lots of nonessential care because that is where the money is for providers. In fact, that is how it is now, especially if you are not poor enough to qualify for medicaid, in case you haven't noticed. That is why there are too many dermatologists and cosmetic surgeons and not enough family care doctors: there is more money to be made treating diseases of the rich...If money is the only thing determining who gets what kind of care, this trend will lead to people, unable to compete financially with the wealthy, dying of treatable illnesses while the wealthy have their tummies tucked and crow's feet removed. Again, that is how it is now, and unfortunately, the half measures by Obama don't do enough to improve this deplorable situation.

As far as I can tell, you don't have any problem with bankrupting people and their families because they get a serious and expensive illness or injury.


Posted by: srw3 | February 3, 2011 6:45 PM | Report abuse

@tmwn: I think my answer is completely valid and used everyday.

Greg's question : If the health law were repealed, what would you propose doing for Hillary St. Pierre instead?

So, you would not do anything, (i.e. propose any additional government sponsored help,) for Ms St. Pierre, just leave her to what is currently available, i.e. nonexistent charity equal to her needs, begging health care practioners and institutions to become charities, bankrupting her family, divorcing her husband to qualify as indigent, etc.

I want to represent your position accurately...

And whether is is used everyday is not the question. Clearly this is impractical for lots of other people (rural, poor, uneducated, etc.) The question is should these be the only recourse. Your answer, if I understand it, is yes.

Posted by: srw3 | February 3, 2011 6:55 PM | Report abuse

@tmwn: apologies for the repeat post...

Posted by: srw3 | February 3, 2011 6:59 PM | Report abuse

"@tmwn: Do five star restaurants cause famine?

This nonsense is below you and is an odious and false analogy."

Thank you for sharing your opinion.  I disagree.

"Food is plentiful and cheap in the us, mostly because it is heavily subsidized by the govt. (something I assume you disapprove of). But in health care, where there are lots of people competing for a very limited resource (mostly limited because the govt allows the AMA to strictly limit the number of medical schools and students as well as lobbying to keep foreign doctors out of the US), allocating health care resources strictly on the basis of who can afford them will result in poor people going untreated while rich people get lots of nonessential care because that is where the money is for providers. In fact, that is how it is now, especially if you are not poor enough to qualify for medicaid, in case you haven't noticed. That is why there are too many dermatologists and cosmetic surgeons and not enough family care doctors: there is more money to be made treating diseases of the rich...If money is the only thing determining who gets what kind of care, this trend will lead to people, unable to compete financially with the wealthy, dying of treatable illnesses while the wealthy have their tummies tucked and crow's feet removed. Again, that is how it is now, and unfortunately, the half measures by Obama don't do enough to improve this deplorable situation."

Please see my State level solution.  And, no surprise (;-)) I disagree with your conclusions.  If you're interested in discussing it with me, let me know.

"As far as I can tell, you don't have any problem with bankrupting people and their families because they get a serious and expensive illness or injury."

I think that people can and should spend the amount of money they're willing and able to stay alive.  And further, if it were me, I would bankrupt myself and those that would lend me money if I thought my continued existence would be of value to my family, as everybody currently does.

Posted by: TrollMcWingnut | February 3, 2011 6:59 PM | Report abuse

@tmwn: I proposed, on the Sunday Open Thread, a state voucher system for indigent care.

sorry i missed that one...

That means the this woman would have to be indigent to qualify, i.e. she would either need to totally impoverish her family or divorce her husband to use the "indigent voucher" system, correct? If one member of a family has a costly illness, the entire family needs to be essentially penniless (and then eligible for programs that you would prefer not to exist; food stamps, housing assistance (such as it is), what is left of welfare, etc) before any intervention you would propose...

I thought you conservatives believed in the sanctity of marriage and hated the social safety net....

Posted by: srw3 | February 3, 2011 7:07 PM | Report abuse

Srw3,

I'll respond in a bit. A few chores first though. :-(

Posted by: TrollMcWingnut | February 3, 2011 7:15 PM | Report abuse

Troll - you make a good argument for EVERYONE to just opt out of insurance.

I mean, if the inevitable result of any major illness is that you're going to go bankrupt, why bother paying the $500 per month (or more)in premiums you have to pay to get any kind of coverage that will cover anything? I mean, what's the point, what are you "insuring" against if you're going to lose it all anyway?

Posted by: JennOfArk | February 3, 2011 7:19 PM | Report abuse

@tmwn: I don't know what your "state" solution is, but if its like most "state" solutions, it involves a race to the bottom, like the competition for factories using tax breaks as bribes (talk about mortgaging the future)...And since we don't live in a dream world where it is feasible (financially or socially) for people to move immediately to where health care is affordable, jobs are plentiful, etc., I don't see how a state based solution works...

I notice that you didn't address the fundamental differences between a commodity that is both (relatively) cheap and plentiful like food and one that is scarce and expensive like health care.

Isn't the end state of your commodity worldview, a world where something scarce like health care is only available to the privileged few, like other scarce commodities; gold bars, large diamonds, Bentleys, and private planes?

Isn't there a moral dimension to healing the sick, feeding the hungry, clothing the naked etc.? According to St Sarah and Mother Bachmann, this is a christian country and it should legislate what Jesus taught....

Posted by: srw3 | February 3, 2011 7:38 PM | Report abuse

So far, here are all of suggestions (in no particular order):

1) Use the plan she was going to use before ObamaCare was passed

2) Attempt to negotiate for lower "out of pocket" rates

3) Comparison shopping

4) Move closer to her providers or travel to other State(s) and/or countries for treatment

5) Church, husband's employer, and any other civic / religious institutions she can inquire as to efficient and sufficient charity to help her continue her care

6) Bankruptcy

7) Get the U.S. military to invade Charlestown, NH (or, was just limited to Detroit?)

8) Drug company indigent programs

9) State indigent programs (divorced or not) preferably vouchers

10) Medicaid

11) Get more States (in this case, New Hampshire) to "voluntarily" pass individual mandate

12) Prayer

13) Get doctors to make house calls for free

14) SEC. 103. NO ANNUAL OR LIFETIME SPENDING CAPS

15) Have Obama use his pull and connections to prevail on a wealthy liberal to start up a new, non-profit insurance company just for registered Democrats

16) Die, and die quickly

Posted by: clawrence12 | February 3, 2011 7:47 PM | Report abuse

srw3:

""Hey ScottC3, we are all ready for you to step up and pay her bill.""

Isn't that just like a liberal...wanting someone else to pay for what you want done.

Posted by: ScottC3 | February 3, 2011 8:09 PM | Report abuse

McWing said:

""@tmwn: I believe healthcare is a service and/or commodity.""

srw asked:

""Are you really ready to take that statement to its logical conclusion""

Like McWing, the logical conclusion you draw doesn't strike me as particularly logical. But regardless, a distaste for the logical implications of something does not justify pretending the thing is something other than what it is. You may not like the fact that health care is a commodity, but it is a fact.

Posted by: ScottC3 | February 3, 2011 8:22 PM | Report abuse

"Food is plentiful and cheap in the us, mostly because it is heavily subsidized by the govt. (something I assume you disapprove of). "

I think food is plentiful for a variety of reasons and would be cheaper without subsidies, so you are correct in this assumption.

"But in health care, where there are lots of people competing for a very limited resource (mostly limited because the govt allows the AMA to strictly limit the number of medical schools and students as well as lobbying to keep foreign doctors out of the US),"

I also agree with this.  Guilds tend to have the effect of keeping wages for guild members high.  I'm not a fan of the AMA, for a variety of reasons, not the least of which is the reason you presented.  I have no problem with their lobbying as we all have a Constitutional right to petition our government.  However, I'd like to insert a quote from Milton Freidman that, I think, addresses peoples concern over the seeming undue influence of longboard: ""Food is plentiful and cheap in the us, mostly because it is heavily subsidized by the govt. (something I assume you disapprove of). But in health care, where there are lots of people competing for a very limited resource (mostly limited because the govt allows the AMA to strictly limit the number of medical schools and students as well as lobbying to keep foreign doctors out of the US), allocating health care resources strictly on the basis of who can afford them will result in poor people going untreated while rich people get lots of nonessential care because that is where the money is for providers. In fact, that is how it is now, especially if you are not poor enough to qualify for medicaid, in case you haven't noticed. That is why there are too many dermatologists and cosmetic surgeons and not enough family care doctors: there is more money to be made treating diseases of the rich...If money is the only thing determining who gets what kind of care, this trend will lead to people, unable to compete financially with the wealthy, dying of treatable illnesses while the wealthy have their tummies tucked and crow's feet removed. Again, that is how it is now, and unfortunately, the half measures by Obama don't do enough to improve this deplorable situation

Cont next comment

Posted by: TrollMcWingnut | February 3, 2011 8:54 PM | Report abuse

"... allocating health care resources strictly on the basis of who can afford them will result in poor people going untreated while rich people get lots of nonessential care because that is where the money is for providers.  In fact, that is how it is now, especially if you are not poor enough to qualify for medicaid, in case you haven't noticed. That is why there are too many dermatologists and cosmetic surgeons and not enough family care doctors,"

One reason for the relative abundance of Plastic Surgeons and Cosmetic Dermatologists is that there revenue is almost entirely outside of either Medicare, Medicaid or Insurance.  It is completely cash paid.  This is where both of our abhorrence of guilds come in.  Imagine if training of Plastic Surgery and y were outside the purview of the AMA?  See how the guild (and the government) is skewing the allocation of resources?  But don't forget, the great skill that is required to help those afflicted by trauma or birth defect, is gained by the "bad" cash paying patients.  There's a trade off with central planning, among the many, many problems would be the relative low resources to repair disfigurement.

"... there is more money to be made treating diseases of the rich...If money is the only thing determining who gets what kind of care, this trend will lead to people, unable to compete financially with the wealthy, dying of treatable illnesses while the wealthy have their tummies tucked and crow's feet removed."

I disagree with your assumption, that it is a "zero sum game.". And my understanding from many commenter's here at PL, is that this is already the case. That is why,nwhen I was asked "what is your solution" on Sunday, I proposed a voucher type system.  And for the record, there will still be people dying of treatable illnesses under Obamacare.  My understanding is that, at vest, it will cover no more that 95% of the population.  Also, there will be people who will winllingly die of treatable illnesses, for any number of reasons.

"... Again, that is how it is now, and unfortunately, the half measures by Obama don't do enough to improve this deplorable situation."". 

As you've probably guessed, I don't think it's within Barry's purview to address this situation in the first place. So, I guess I agree if you also think Obamacare is deplorable.

Posted by: TrollMcWingnut | February 3, 2011 8:56 PM | Report abuse

"@tmwn: I proposed, on the Sunday Open Thread, a state voucher system for indigent care.

sorry i missed that one..."

No need to apologize. ;-)

"That means the this woman would have to be indigent to qualify, i.e. she would either need to totally impoverish her family or divorce her husband to use the "indigent voucher" system, correct?"

Not necessarily, it would depend on what the voters of the state decided,through their elected representatives, what the eligibility requirements should be.

"If one member of a family has a costly illness, the entire family needs to be essentially penniless (and then eligible for programs that you would prefer not to exist; food stamps, housing assistance (such as it is), what is left of welfare, etc) before any intervention you would propose..."

Well, again, it would depend on the voters of the state.  And yes, in partial answer to your assertion, I don't believe there should be a Federal welfare state.

Posted by: TrollMcWingnut | February 3, 2011 9:03 PM | Report abuse

"Troll - you make a good argument for EVERYONE to just opt out of insurance.

I mean, if the inevitable result of any major illness is that you're going to go bankrupt, why bother paying the $500 per month (or more)in premiums you have to pay to get any kind of coverage that will cover anything? I mean, what's the point, what are you "insuring" against if you're going to lose it all anyway?"

Hi Jenn!  Hope all is well with you, and thanks for posing such a thought provoking question. :-)

I don't think I've made an argument for opting out of insurance.  I think I addressed Greg's (bad faith) question about what Ms. St.Pierre should do if Obamacare is repealed and she reaches her, now renenacted, lifetime cap.

In terms of having medical insurance, I think it's a good idea to have. What I was addressing is if you get unlucky and become afflicted with a serious, costly illness.  It will preserve, for a while, your financial resources.  If you have a policy with a lifetime cap however, and reach it, then what I suggested is an option, in a scenario where Obamacare is repealed (says silent prayer to himself).

Posted by: TrollMcWingnut | February 3, 2011 9:15 PM | Report abuse

"@tmwn: I don't know what your "state" solution is, but if its like most "state" solutions, it involves a race to the bottom, like the competition for factories using tax breaks as bribes (talk about mortgaging the future)...And since we don't live in a dream world where it is feasible (financially or socially) for people to move immediately to where health care is affordable, jobs are plentiful, etc., I don't see how a state based solution works..."

Well, I suggest you read the thread.  It might not change our mind, but at least you would know the rough outline of my proposition.  And know, in case you were curious, I don't believe we live in a dream world either.  However, I do not think my proposals are of "dreamworld" material.  I think it allows citizens of the several States and Commonwealths to decide for themselves what they think they should do to help their fellow State/Commonwealth citizens.

"I notice that you didn't address the fundamental differences between a commodity that is both (relatively) cheap and plentiful like food and one that is scarce and expensive like health care."

I wonder what you would like me to "address?" for example, cars are commodities, and there are very cheap cars (used cars) and very expensive ones (Rolls Royce).  They both perform the same function.  Those that cannot afford, or do not need a car often walk, ride a bike, bum a ride, take the bus, etc.  Someone's need does not put a claim on my resources.  I may agree to help, but they have no right to my resources.  Now, my fellow state citizens (or city or county) may collectively decide to tax ouselves to help the indigent ge transportation.  I think Federal involvement in providing transportation is not only wrong but Unconstitutional.

"Isn't the end state of your commodity worldview, a world where something scarce like health care is only available to the privileged few, like other scarce commodities; gold bars, large diamonds, Bentleys, and private planes?"

No, I don't think thats the end state.  I don't know why you do.

"Isn't there a moral dimension to healing the sick, feeding the hungry, clothing the naked etc.? According to St Sarah and Mother Bachmann, this is a christian country and it should legislate what Jesus taught...."

Well, they may believe that the United States is a Christian nation (and since imt's citizens are overwhelmingly Christian, it's hard to argue against that) but I don't know that they've ever advocated legislating the teachings of Jesus. It's my understanding, and maybe I've misunderstood my history, but we are a secular government.  And in answer to your question, I think there is a moral obligation on my part to help the sick, the hungy and the naked.  I just don't think that it's a Federal obligation.  If any communal obligation exists, it should exist at most on a State/Commonwealth level.

Posted by: TrollMcWingnut | February 3, 2011 9:32 PM | Report abuse

Let me apologize for my appaling typing. I was in a hurry and didn't do any (as opposed to my usual poor) proofreading. I understand if, early on, you simply stopped reading it in exasperation!

And for the record, here is the Milton Freidman quote I somehow managed to not insert:

"I do not believe that the solution to our problem is simply to elect the right people. The important thing is to establish a political climate of opinion which will make it politically profitable for the wrong people to do the right thing. Unless it is politically profitable for the wrong people to do the right thing, the right people will not do the right thing either, or if they try, they will shortly be out of office."

Posted by: TrollMcWingnut | February 4, 2011 12:25 AM | Report abuse

There can be a difference between what you and a health insurance company consider healthy. Some insurers will say that you have a health condition if you smoke, are overweight, are taking prescriptions, or had a medical condition in the past. If this describes you, you may want to search and read “Wise Health Insurance” on the web.

Posted by: dichack | February 4, 2011 5:11 AM | Report abuse

The Republican slogan might be: "Ask not what you can do for your country, but what others must do without."

The current Republican Party has shown no interest in fixing the health insurance crisis.

The five largest U.S. health insurance companies set new industry profit records in 2009, “a feat accomplished by leaving behind 2.7 million Americans who had been in private health plans." This is based on U.S. Securities and Exchange Commission filings.

In short, the health insurance industry has flourished by a policy that excludes the sick. The Republican party endorses that policy.

Posted by: karlsPA | February 4, 2011 5:52 PM | Report abuse

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