Or not. Do you have any idea how much it costs for a family of four to purchase insurance for a month - it's about 2500 month, and that's for a family that's w/out pre-existing conditions. Do the math - that's 30,000 a year minimum to self insure. These are the going rates in our area, YMMV.

It sucks. I know. But by opening up the market to more competition it should hopefully go down.

Personally I would rather do everything I can to keep myself healthy and work at a job where health insurance is covered in some way as part of a larger group plan. I'd rather my tax dollars not go to subsidize middle-class people with more children than they can afford (see port1080's post) or who have made completely unhealthy lifestyle choices.

Considering the fact that the gov't routinely gives out billions of taxpayer money in corporate welfare, I find it amusing that people are so up in arms over the possibility that a few people at the outer spectrum of the set income levels may get some gov't assistance. Big. Fucking. Deal.

Corporate welfare sucks, but just because this is on a much smaller scale does not automatically make it right, either. Both need to be seriously reconsidered.

It sucks. I know. But by opening up the market to more competition it should hopefully go down.

Perhaps, but I don't think that's the reality.  Competition definitely exists in this market, and prices are going through the roof.  In a way insurance is also the cause of this: we don't care if a doctor's office charges $2,000 for a simple blood test, 'cause our insurance company picks up the tab.  The problem is that the insurance companies then pass these costs on to us in terms of higher premiums, but it's rather a boiling frog thing; we expect premiums to go up.

This is one advantage, IMO, of socialized healthcare (which is not to say that'd be a panacea for this country's health care problems): with one insurance provider, that organization could dictate costs.  As long as the balance between profit for the medical sector and affordability is in the right place, I think this would help a lot.

Q: What do you think of western civilization? Gandhi: I think it would be a good idea.

This is one advantage, IMO, of socialized healthcare (which is not to say that'd be a panacea for this country's health care problems): with one insurance provider, that organization could dictate costs.  As long as the balance between profit for the medical sector and affordability is in the right place, I think this would help a lot.

Giving one person or party all the power tends to remove balance, not add it. One could (and I would) argue that the best balance is already in place, with plenty of competing interests trying to get the best deal.

For this balancing to work requires equal power on both sides, and that is not the case here.  If healthcare costs go up across the board, where is a sick person supposed to go?  It seems clear to me that health care providers aren't competing, so if you're sick you have to pay what they want you to pay.

Q: What do you think of western civilization? Gandhi: I think it would be a good idea.

It seems clear to me that health care providers aren't competing, so if you're sick you have to pay what they want you to pay.

That's a faulty premise. A sick person has a number of options, besides "pay what they want you to pay." Patients can refuse or delay tests or treatment, request older or generic drugs, use "alternative medicine," and so on. These are mostly bad options, but there is at least one which is worse for the healthcare providers: bankruptcy. If enough patients default on payments, a healthcare provider will fail.

I'll point out here that every country with universal healthcare coverage makes plenty of use of the bad options above. Patients are regularly placed into queues for expensive treatment (where they sometimes die), or receive older, less effective drugs; hospitals in areas without a sufficient population base close, requiring patients to travel long distances for treatment. In the US, we choose to get Rolls-Royce treatment as often as possible. This can appear to be a conspiracy to inflate healthcare costs, but it's actually just an outcome of market demand.

Perhaps, but I don't think that's the reality.  Competition definitely exists in this market, and prices are going through the roof.

-More healthcare providers = more competition for the same amount of business then the costs go down. Competition right now is pegged lower than it should be, and mostly between MDs.  The amount of providers right now is being kept artificially low. Look at those storefront/pharmacy based clinics and the controversy started by the AMA. These numbers are hypothetical but if you need a physical for work, immunizations for your kid, or antibiotics because of a sinus infection why pay $100 to see an MD when you can do it out of pocket for $40 (or perhaps insurance would pick that up) with a NP or PA-C who is just as competent to handle the minor problems? Of course the AMA has a problem with this because they advocate for their members and the best way to keep those MD salaries high is to limit the number of providers.

In a way insurance is also the cause of this: we don't care if a doctor's office charges $2,000 for a simple blood test, 'cause our insurance company picks up the tab.  The problem is that the insurance companies then pass these costs on to us in terms of higher premiums, but it's rather a boiling frog thing; we expect premiums to go up.

Then the insurance companies go out of business when subscribers or HR departments moan and groan about higher reimbursement rates and switch to another carrier.

This is one advantage, IMO, of socialized healthcare (which is not to say that'd be a panacea for this country's health care problems): with one insurance provider, that organization could dictate costs.  As long as the balance between profit for the medical sector and affordability is in the right place, I think this would help a lot.

And if said organization pays artificially high prices like you mentioned above? In that case the problem is not confined just to the subscribers of that insurance company (or the employer if they pay) but rather to everybody and their annual tax bill. Seeing as how wonderful the government is in keeping costs down I think I'd rather stick with a private system.

The amount of providers isn't kept artificially low, it's low because of what it takes to be a (good) provider.  Med school is hard, and it should be hard.  Medical equipment is specialized and complex enough it's going to be expensive.  So the number of providers can only get but so high before we start seriously sacrificing effectiveness.

Then the insurance companies go out of business when subscribers or HR departments moan and groan about higher reimbursement rates and switch to another carrier.

If this were the way it worked, why are health insurance costs still so out of control?  If switiching were the way to fix things, don't you think people would've figured this out and costs would've gone down in the ensuing competition you speak of?

The problem is, like some other industries, health providers have figured out that if they raise their prices less than some others, they're probably not going to loose too much business.  When everybody starts doing that, you get the situation we have now.  And again, people don't care about the costs of a doctor's visit, they care about what the insurance company charges them.  But since an increase in premiums feels a lot less severe than a sudden spike in the cost of a check-up, people are less likely to actually do something about it.  Plus, if the increases are as widespread as they appear to be, where are you going to go?  If insurance increases are influenced by healthcare costs and healthcare costs are going up everywhere, where can consumers go?  If they can't afford one, they're not going to be able to afford any.  Combine this with demand being relatively inelastic, and you get a mess.

Q: What do you think of western civilization? Gandhi: I think it would be a good idea.

Yeah, but then your co-workers are taking money out of your paycheck to subsidize the medical costs of their unhealthy lifestyle choices. Medical costs have *got* to come off the shoulders of corporate America. It's perverting the medical system and weighing down our ability to compete internationally.

Until the system is offering to cover my medical choices, I should be able to opt out entirely.

It is easy to buy small plaster models of what you think life is like.

...the gov't routinely gives out billions of taxpayer money in corporate welfare...

I presume you've never had children, and never worked with people who did?  Because let me tell you, my productivity plummets when my kid is sick.  And I don't mean it drops by 10%, like when I have a cold.  I mean it drops by 50% plus, as I drag my kid to the doctor, take care of him, and try to get him well.  If you're worried about productivity, provide good healthcare & childcare.  It'll increase my ability to work, and the ability of every parent to work by a lot.

Thalia

I presume you've never had children, and never worked with people who did?  Because let me tell you, my productivity plummets when my kid is sick.  And I don't mean it drops by 10%, like when I have a cold.  I mean it drops by 50% plus, as I drag my kid to the doctor, take care of him, and try to get him well.

Are you saying you currently don't provide healthcare to your kids? I am trying to understand your argument here but honestly I'm failing. You say your productivity drops 50% when your kid gets sick as you have to take care of the kid. Fair enough - but this happens by your own admission with your kid already having access to healthcare.

In the average work environment who picks up the slack for your productivity decline? The other workers of course. Therefore from an economic standpoint its best to ensure that those workers are covered preventive health-wise since not every worker will have kids but all kids will get various sniffles/minor illnesses in childhood which parents (rightly) tend to over-react to.

Given a CHIP like program, how does that assist with your productivity or someone in your situation?

Memory is a strange bell, jubilee and knell.

The fact of the matter is, it's not a work place productivity issue. It's a the government takes care of those who can't take care of themselves issue. The government should ensure children have proper health care just like it ensures old people have proper health care. Let the free market balance the rest out.

It is easy to buy small plaster models of what you think life is like.

The fact of the matter is, it's not a work place productivity issue. It's a the government takes care of those who can't take care of themselves issue. The government should ensure children have proper health care just like it ensures old people have proper health care. Let the free market balance the rest out.

If you are going to couch the argument that way, then you need to define the terms a bit more clearly. What counts as unable to take care of themselves? More importantly, why should my (hypothetical) daughter forgo ballet lessons so that someone else's latchkey kid gets free treatment?

Keep in mind here that these are NOT poor starving kids (thats Medicaid).

Memory is a strange bell, jubilee and knell.

What counts as unable to take care of themselves?

In the current health insurance market, lower middle class does as outlined in this law.

More importantly, why should my (hypothetical) daughter forgo ballet lessons so that someone else's latchkey kid gets free treatment?

The same answer as why your (hypothetical) daughter has to forgo ballet lessons and my (hypothetical) latchkey kid has to forgo free treatment so billions of unaudited dollars can go "missing" in Iraq.

It is easy to buy small plaster models of what you think life is like.

In the current health insurance market, lower middle class does as outlined in this law.

Ah but the law didn't pass..or rather it was not extended. Therefore your standard is not shared by the majority and obligates you to defend it more strongly than saying 'well thats the law'. On what policy basis do we want to provide free/subsidized health care to people in this lower middle class bracket?
Where does the funding coming from? What are the incentives to business to avoid striking children coverage from their own benefits plans? What are the incentives to encourage people not to have more kids than they can financially afford? If you are going to make an argument based on "this is the way it should work", then I think questions like these ought to be answered..in detail.

Given the past history of other aid programs spiralling costs, I'm skeptical of your current response which seems to be that the democrats thought it was a good idea to propose.

The same answer as why your (hypothetical) daughter has to forgo ballet lessons and my (hypothetical) latchkey kid has to forgo free treatment so billions of unaudited dollars can go "missing" in Iraq.

This is only true in the sense that the government considered the bill in the same fashion that it considered going to war. However where your example breaks apart is that the government in this case has chosen NOT to spend the money deeming it a bad idea. However if we truly analyzed your example, it seems an implicit admission that the money for free treatment is wasted just as much as the money gone missing in Iraq.

Memory is a strange bell, jubilee and knell.

This is only true in the sense that the government considered the bill in the same fashion that it considered going to war. However where your example breaks apart is that the government in this case has chosen NOT to spend the money deeming it a bad idea. However if we truly analyzed your example, it seems an implicit admission that the money for free treatment is wasted just as much as the money gone missing in Iraq.

Well, I'd certainly second that. You have to keep in mind that I'm not actually in favor of this thing, I'm just opposed to your patently offensive initial characterization that our nation's health care should be judged on a work place productivity basis. Aside from that, if you can't agree that a family of four bringing in under $50k a year is lower middle class, you're either being disingenuous or out of touch with how money works.

It is easy to buy small plaster models of what you think life is like.

The fact of the matter is, it's not a work place productivity issue. It's a the government takes care of those who can't take care of themselves issue.

I'm sorry. Somebody makes $45-60k a year (or $80k+ a year in some jurisdictions) and can't "take care of themselves?"

What child earns $45k per year?

It is easy to buy small plaster models of what you think life is like.

OK, let me make it clearer. Why does the government need to help out an average family with their children's health care if the household income is 45-60 or 80k/yr?

Do you know what the poverty line is where I live for a family of four? Last time I checked, for the purposes of federal assistance on a housing loan it was over $47k. $80k sounds like a lot in some places but you're not supporting a family of four on it very well in San Francisco or Manhattan. That's why the scale is sliding.

It is easy to buy small plaster models of what you think life is like.

From up thread the poverty level is ~$20.7k/yr for a family of four, although some adjustments seem to be made for higher cost areas such as AK or HI.

I hate to sound heartless, but $47k is above the median household income in ~28 states. Many people would be glad to be pulling in that $80k. And if a location's cost of living is the sole consideration for why families cannot make it work on $80k then there is always moving to another area, or commuting.

Many people would be glad to be pulling in that $80k. And if a location's cost of living is the sole consideration for why families cannot make it work on $80k then there is always moving to another area, or commuting.

For fuck's sake, man, nobody earning 80k is eligible for coverage.

Bush's spurious $83,000 figure comes from a request by New York state to use the program for some families earning four times the poverty limit. That request was denied by the Bush administration last month -- and that upper limit is not in the bill Bush vetoed. End of story. If New York or any other state were to ask again to be able to raise the income limits, the administration could simply say no

I hate to sound heartless, but $47k is above the median household income in ~28 states.

And what, you're saying that's too much money to be considered for help?  As I noted up thread, the cost of self-bought insurance in many places for a family of four can easily eat up half of that income (or more). That's a whole bunch of money that's now unavailable for everything else. The low end of the rent/mortage scale where I live is about 1000 a month - that's another 12k off the top of your income.
Let's see 47k - take 18k away for insurance at the conservative rate of 1500 a month and you're left with 29k - take away rent/mortage at 12k and you're left with 17k to make car payments, pay taxes, buy groceries, pay bills, save for college, etc. etc. fucking etc...
The point here being that 47k a year is in no way some massive windfall of fundage that should automatically disqualify some families from needing assistance. I'm not saying that everyone who makes that amount needs (or even wants) help from the gov't, but it's certainly not the ginormous pot -o- gold that you apparently think it is.

Somewhere in my soul, there's always Rock -n- Roll... Joe Strummer

Yes, the national poverty level. The poverty level in Los Angeles County is twice that. Of course the median national household income couldn't handle life in a major metropolitan area. Topeka just doesn't have the cost of living that Manhattan has.

You have it ass backwards. A wage-earner doesn't take their $80k/year job from San Francisco with them to Tulsa. They're paid $80k to do their job in that area because that's what the area demands. That's why places like San Jose and Santa Monica have seriously considered adopting minimum wages of $10-$11/hour--numbers that, if you'll notice are both nearly twice the national minimum wage and come out above the national poverty level when taken over a 40 hour work week even at their minimum level.

I will agree with you to the extent that it is silly to have any of these laws at the federal level--they should all be at the state level for this very reason.

It is easy to buy small plaster models of what you think life is like.

Everybody who works at a $9 hour job in Manhattan lives in an apartment there? No, they likely commute thereby getting the most out of the higher wages and saving housing costs. If things get rough, they move. Eventually labor gets tight and the price of said unskilled labor rises to compensate.

I still do not understand why we should subsidize health care for a family who chooses voluntarily to live in high cost areas.

I still do not understand why we should subsidize health care for a family who chooses voluntarily to live in high cost areas.

I'm with ya, bro.  And while I'm thinking about it...what's up with these frigging Darfurians?  Why should we support peace for people who voluntarily choose to live in a high violence area?

I'd like to point out that while moving to greener pastures is a common thing to do, it is a simple solution that may not be so simple in its execution.  Moving isn't cheap...leaving family members behind is hard (especially if grandma/grandpa are providing daycare)...and finally, doesn't moving from a high wage/high rent area to a low wage/low rent area pretty much leave you at the same point in terms of health care?

It's the end of the world as we know it, and I feel fine

doesn't moving from a high wage/high rent area to a low wage/low rent area pretty much leave you at the same point in terms of health care?

One doesn't need to move cross-country to find lower rents in the highest cost-of-living areas. If a family is choosing to live in, e.g., Manhattan, the question becomes, "should a national tax be imposed to protect that lifestyle choice, or should they suck it up, move to New Jersey and commute?"

the question becomes, "should a national tax be imposed to protect that lifestyle choice,

No, the question is should a children's health care program be expanded to include somewhat higher income families taking into account the cost of living where they live.

But hey, as long as we're playing silly questions how about this one:

Should there be a national tax to protect families with children from becoming health care refugees?

It's the end of the world as we know it, and I feel fine

Not after this gets passed. I laughed when one of the articles noted something along the lines of opponents are afraid upper middle class families will dump their kids on the dole once this gets approved.

Are you kidding me? It's not going to be parents canceling their children off private plans. HR departments are going to start canceling coverage and benefits packages for underage dependents faster than you can say "TPS Report" if this goes through. I bet foundering companies with massive benefit costs (through their own fault! read: GM, automakers, etc) are salivating over this.

HR departments are going to start canceling coverage and benefits packages for underage dependents faster than you can say "TPS Report" if this goes through.

Yep. Might as well have titled it the "Slouching Toward Hillarycare Act of 2007."

Didn't GM just successful off their health care into a union-run trust?

It is easy to buy small plaster models of what you think life is like.

Good point. Bad example.

Unless... the union takes the cash and spends it on whatever unions spend money on and transfers all their members retirees children to SCHIP. Hmmm....

I just don't see employers wholesale downgrading their coverage...yet, although I could see them requiring using SCHIP first. Corporate jobs that have coverage as part of their compensation package where people are supporting a family of four -- hell, probably most auto workers, too, have got to be pulling down, $60K+, $80K+ anyway, right? Those numbers just aren't that high these days for a family of four.

It is easy to buy small plaster models of what you think life is like.

Reality check:  for GM and most of those companies, they're not offering healthcare out of the goodness of their hearts.  They're offering it because it is essential to retaining good employees.  For GM, it's part of a negotiated package for the employees.  This isn't going to change that one whit.

Thalia