5-4 Insurance Mandate Upheld

[quote]DrSkeptix wrote:

[quote]kamui wrote:
Given the nature of its products, and current laws on intellectual property, the pharmacy business will always be oligopolistic at best, and monopolistic at worst.

One thing to consider :
During more than a century, from 1844 to 1959, drugs were not patentable in France.
One could still patent the industrial processes, but not the chemical formulas themselves.
Apparently, it didn’t killed the market.
[/quote]

Oh?

So, how many drugs were developed in France between 1909 to 1959 compared to 1959 to 2009?
Just askin’

(I can tell you how many French chemotherapy drugs were developed before 1959.)[/quote]

I don’t know the specifics of the debate you’re having, but I do know that’s not a fair argument. You’d have to control for technological advancement to get an accurate idea of chemotherapy drug development under the given situations.

[quote]Schlenkatank wrote:
I have to say to thunderbolt and the Dr. that I like some of your ideas. I can guarantee that some of the issues in affordability of care stem from the lack of competitive pressure from insurance companies and drug companies.

One problem I have with the idea that the issue is as simple as disentangling insurance from employment is that while I think it’s possible that this could reduce the cost of care, I don’t think it would be enough to make the remaining problem a cinch. Not that I’m opposed to the idea, I’m just not sure that the effect would be as grand as you suggest–obviously governemnt spending on healthcare is insane as i’m sure you know.

What do you think about the provision in the ACA that allows for more approval of generic drugs to increase competitive pressure with drug companies? Also, what about one of the provisions that states physicians will be paid based on the quality of their care effective 2016 (I think)? [/quote]

I have given the counter examples to the notion that generic drugs lower costs. I cannot prove it, but I observe it. The generic drug makers are few, and anti-competitive. They have manipulated shortages of critical drugs; i.e., with nominal price controls, they have created absolute scarcity. Big Pharma was an early supporter of ACA because it proscribed any attempt to curb drug prices. Contrary to Canada and Europe, the US is not allowed by current law to negotiate price and volume discounts for MediCare, and this will be preserved in the ACA. As a result, drug costs in the USA are 25% to 35% higher than in Canada and Europe; it is the American consumer which supports the profitability of domestic and foreign pharmaceutical companies.

I mean no disrespect, but you believe that physicians’ pay will in some way be tied to the quality of outcome. And I say that this is impossible.
First, I defy any committee to define quality in medical care–the outcomes for the acutely ill are not confined statistically in the same way as outcomes for the chronically ill or for health maintenance. I have yet to meet a lawyer or a layman who can recognize quality, let alone institutionalize it.

Instead of real quality, what is substituted is that which can be documented, however unrelated to real health outcomes: a check list of preventive measures which may include foot exams for diabetics, cholesterol measurements for hospitalized patients, pneumonia and flu vaccinations, etc. If it can’t be quantified it will not be counted as “quality.” So, we will have inane recording of such minutiae, and no credit will be given to the physician who cures Hodgkn’s disease and preserves a young man’s fertility.

Next, how does the ACA propose to pay for quality? Anyone’s guess, since the real villains have yet written the rules. But one proposal is the “medical home” whereby some central authority collects (MediCare) funds and then distributes it among various providers. (What MediCare does, other insurers shortly follow.) I will not be around to battle my colleagues for the scraps and leftovers after the hospitals have fed at the trough.


So despite your wishes to the contrary, the ACA provides for no cost containment and no price competition.
You and I may wish for pay commensurate to the quality of outcomes, but it is a radical concept which is impractical to execute, doomed to failure and confusion, and will serve only to limit services further.

The ACA is worse than unconstitutional; it is bad policy, and pointlessly destructive.
To those that point out its disconnected “good parts”–no preexisting conditions, coverage to age 25 etc.–I point out that all that and more could be achieved more cheaply by better policy.

And, put simply, you can put chocolate bonbons in a pile of stool, but it makes neither more palatable.

[quote]TigerTime wrote:

[quote]DrSkeptix wrote:

[quote]kamui wrote:
Given the nature of its products, and current laws on intellectual property, the pharmacy business will always be oligopolistic at best, and monopolistic at worst.

One thing to consider :
During more than a century, from 1844 to 1959, drugs were not patentable in France.
One could still patent the industrial processes, but not the chemical formulas themselves.
Apparently, it didn’t killed the market.
[/quote]

Oh?

So, how many drugs were developed in France between 1909 to 1959 compared to 1959 to 2009?
Just askin’

(I can tell you how many French chemotherapy drugs were developed before 1959.)[/quote]

I don’t know the specifics of the debate you’re having, but I do know that’s not a fair argument. You’d have to control for technological advancement to get an accurate idea of chemotherapy drug development under the given situations. [/quote]

THe same logic applies to kamui’s assertion; technologic advancement is not confined to one country, but the application of technology does not progress without intellectual property protection. Patents promote development.

As it turns out, the French pharmaceutical industry produced no chemotherapy agents–none–until patent protection could be achieved. Why invest in any trials when one could establish a Swiss or English or American patent? French industry produced a few antibiotics, but the major advances in cardiac cardiology in the 1970s were in Switzerland and Germany, and cancer therapy was largely an American and British accomplishment.

Yes, I know that Jonas Salk–whom I knew, but briefly–chose not to patent the polio vaccine. But he also did not fund its testing and development personally, and his type is not likely to come this way again.

[quote]pushharder wrote:

[quote]Severiano wrote:

[quote]Aragorn wrote:

[quote]Severiano wrote:

It only seems humane that in the United States people can go to a hospital if they are injured and not have to worry about losing their home, or not being able to pay rent because of it.[/quote]

You and I probably don’t agree on much politically speaking, but it seems you are a pretty intelligent person who likes to think, and I like that. This statement is problematic for a couple reasons: First, it constitutes a marginal appeal to emotion in argumentation, which is obviously a logical fallacy. More importantly however–and what I believe you may have been intending to get at, is the cost issue of healtcare bankrupting people for operations. THIS is important because as Thunderbolt, Skeptix, Powerpuff’s relative (hospital admin), and myself have all already noted the ACA does NOTHING TO FIX. It doesn’t even address the foundational issue you speak of!! In fact, almost all the fundamental issues that are causing healthcare to skyrocket will be made WORSE by the bill over time. It was made on pure political ideology, to buy votes and push an agenda, not because it was the most reasonable way to approach the problem. Historical evidence from Mass and the UK indicate that costs will go up, not down (referencing UK, look at inflation adjusted figures for various costs from decades ago to today).

The further difference is that the tax and govt structures that exist in Europe which allow these national healthcare systems to avoid bankruptcy for so long do not exist in the US. Call it a difference of culture. So not only is it bad economic policy, the gov’t infrastructure that allows it to sort of function overseas is not present here. That makes the problem worse, not better. We just put a tiger in a room of bystanders without giving it anything to eat first.

[quote]If there is shady shit in the bill, which I’m sure there is I’d like to hear the specifics from both sides. Getting the truth about this sort of stuff is usually an independent venture that takes a bit of time (for me at least).

But, what I found here were people moaning and crying (like little girls, look at the first several pages) about how it’s a tax and wrong in all the exact same ways Romneycare was wrong. That is honestly what I read the first few pages before my initial post. [/quote]

Well, I disagree with you on several levels. First and foremost, this was not, is not, and never was, a “tax” no matter what Justice Roberts’ tortured logic dictates in his opinion paper. It is and has always been a penalty, and that is a HUGE issue for me.

A second and gigantic issue is the re-definition of “tax” according to the recent ruling which essentially endangers and destroys a large chunk, a huge piece, of the separation between freedom and Federal power. This is related to the Constitutional issues–and anybody choosing to conveniently ignore or dismiss (my eye here is on several noted left leaning posters) shows their ignorance of the monumental issues at hand, regardless of the visage which these issues took in the court (that appearance would be insurance and healthcare, as opposed to say, firearms or religious issues or whatever).

Thirdly, this is wrong economically in all the same ways Romneycare was wrong (and look at the increased costs there–that is the exact opposite of what needs to happen), however it is wrong in many more principled ways that Romneycare–howevermuch it was terrible policy and economically burdensome–is controversy free by virtue of there being a significant and often not understood difference between what a State may do legislatively and what the Federal legislature may do Constitutionally.

[quote]I’m certainly concerned with state vs. federal law and how that impacts our rights, and that is definitely a point that would change my position on this particular topic due to precedent, even if the end result is something I agree with, precedent trumps… After some of your posts (not you Zeb, wont give you the satisfaction :P) I realize there is a bit more to this than meets the eye, and if I try to intelligently defend the bill (which I probably wouldn’t), I need to get very familiar with it’s consequences. Hopefully that clears things up!

Cheers folks, great discussion.

[/quote]

If you haven’t read it already, I would start by reading the Judge Napolitano piece pushharder posted up a few pages back and then the dissenting opinions. They give a very clear reasoning to the difficulties at hand. If you are able to do it without resorting to partisan knee-jerk reaction–which I believe you are–you will likely come up with a very long list of issues that concern you, much as they do us who are opposed to the bill.

Fundamentally, what has most of us so up in arms is the fact that this is not an Insurance issue, as countingbeans has so clearly hammered in his posts. Further, think of this: the door is open for this new “tax” paradigm to be pushed by the Right on things that the left-leaning people will find extremely dis-tasteful—but they won’t be able to cross it since this was their “baby”. This is a weapon NEITHER side should have access to.
[/quote]

I’ll be the first to admit that was an appeal to emotion, it was an outright Ad misericordiam fallacy. But what is wrong with that? I’m not trying to appeal to logic, I’m appealing to patriotism and Christian ethics, which are basically parallel to my own. There is this one saying that I find sort of haunting, and has always struck me from the days I used to be Catholic; “Whatsoever you do to the least of my brothers, that you do unto me.”

You are supposed to treat our impoverished with charity as Christians, for me it is about treating people as ends in themselves. I know people who work several jobs and barely make it, I know what I get paid for what I do, and I know I would struggle doing what they do period. Treating a person as an end in themselves would mean that business owners should have an endeavor to treat people as ends in themselves in the form of a living wage so long as they are willing to put in that sort of effort. If your boss doesn’t care about you having a living wage, and is more concerned about their extra home, or their extra fancy french horses who trot around all pretty, that bugs the shit out of me. I know if I were an employer and I had people doing good work for me, I’d want them to share in OUR success.

This gets into pay structure, and I’m not saying I have all the answers, but I think at some point we have to recognize greed for what it is, and put it in check. We need to check our own ethics and stick to them as a way of life, rather than voice them when it is convenient. [/quote]

All of this ^ is fine and good if done from and through the church and charity. It’s when it’s done from and through the edge of the sword that folks like me and many others tend to get a bit discombobulated. Ya know what I mean?

Distinctions are always essential.[/quote]

Distinctions are indeed always essential. There are a lot of conservative Christians here who proudly claim that title. I feel I wouldn’t be a good person, or doing what I feel is my sort of duty if I didn’t call some of you out.

I was a kid when George Bush Sr. talked about, “A thousand points of light.” I was in the Military when George Bush Jr. talked about compassionate conservatives. Lets just say I have zero faith in Christian Conservatives being compassionate or points of light who chip in and do their, “duty.”

I’ve come to understand what, “duty” actually is. I think it was defined best by Immanuel Kant.
He described one man who donates much of his money to charity because it brings him great joy and happiness. Another man donates money and experiences no joy or happiness, but he does it because it’s the right thing to do, out of a sense of duty to his fellow man (and God).

Guess who is doing the right thing, for the right reason? Ideally you can do the right thing for the right reason, and still get a warm fuzzy at the end, but the example is supposed to illustrate the fact that we don’t always feel great about the good things we do. But the good person is going to do the right thing regardless, if he is fortunate he will be able to do the right thing for the right reason and get a warm fuzzy on top.

I’ll tell you right now, I’m completely underwhelmed by the sort of Charity, compassion and, “points of light” output by everyone, but I’m especially disappointed in Christian Conservatives who tout these values, but I haven’t seen that many actually possess these values that I’m familiar with, because I grew up learning many of the same values. It’s like I said, tend to talk a good talk, but when it comes down to it, they don’t even do the right thing part, let alone doing the right thing for the right reason.

Just calling it like I see it.

I knew you weren’t “just askin’” :slight_smile:

For the record, i don’t think we should (or that we could) abolish patent laws. And i agree that they do promote innovation and development.
But in a quite oligopolisic market, less protected monopolies could contribute to lower the prices. So maybe we could shorten the length of some patents, or apply stricter condition before allowing patent term extensions, for example.
The “it will kill the industry !” argument sound a bit like “too big to fail” in my ears.

[quote]Schlenkatank wrote:

[quote]666Rich wrote:
Yes,

it is a stupid comparison. Take public transportation like millions of people in new york city. Walk. Ride a fucking bike. You wont have to purchase auto insurance.
[/quote]
I’m not ignoring the rest of your post, but I have to take issue with this here. The comparison to car insurance seems very similar to me; the argument that you and others make that you don’t have to own a car in one scenario is silly because you’re not thinking about this clearly. Let me see if I can help.

To clarify:

Everyone who owns a body and is uninsured is a liability to everyone else because everyone in their life will get sick. This is common sense.

Not everyone owns a car, but amoung those who do they are required by law to purchase car insurance to protect them from liability. As was diuscused, all 50 states require you to prove you can cover dammages to drivers and the state should a lawsuit result.

The difference between owning a car and owning a body? Everyone owns a body and the dammages to it can be considerably more expensive. Why should the rules be any different?[/quote]

You can’t refuse to be in an automotive accident when you are not the cause. You can, however, refuse medical treatment for what ails you.

Nor can you bump into someone with your body and give them diabetes, heart disease, obesity, cancer, etc.

That is why the auto insurance analogy sucks. That is why the rules should be different.

[quote]SkyzykS wrote:

[quote]Schlenkatank wrote:

[quote]666Rich wrote:
Yes,

it is a stupid comparison. Take public transportation like millions of people in new york city. Walk. Ride a fucking bike. You wont have to purchase auto insurance.
[/quote]
I’m not ignoring the rest of your post, but I have to take issue with this here. The comparison to car insurance seems very similar to me; the argument that you and others make that you don’t have to own a car in one scenario is silly because you’re not thinking about this clearly. Let me see if I can help.

To clarify:

Everyone who owns a body and is uninsured is a liability to everyone else because everyone in their life will get sick. This is common sense.

Not everyone owns a car, but amoung those who do they are required by law to purchase car insurance to protect them from liability. As was diuscused, all 50 states require you to prove you can cover dammages to drivers and the state should a lawsuit result.

The difference between owning a car and owning a body? Everyone owns a body and the dammages to it can be considerably more expensive. Why should the rules be any different?[/quote]

You can’t refuse to be in an automotive accident when you are not the cause. You can, however, refuse medical treatment for what ails you.

Nor can you bump into someone with your body and give them diabetes, heart disease, obesity, cancer, etc.

That is why the auto insurance analogy sucks. That is why the rules should be different.
[/quote]
Most people without health insurance do refuse treatment actually. Right up to the point when they’re having a heart attack, a stroke, kidney failure, etc. Then the decision to intervene is made by someone else. Too bad they didn’t have the tools to prevent a $500,000 hospital bill.

Come on. In the end nobody can refuse treatment. It just doesn’t happen.

Also, there’s a body of evidence that goes to show that health is a broader issue than what you’re describing. Diabetes and obesity in reality are infectious diseases, it’s passed like wildfire from parents to kids, kids to all over school, and in work environments. Research shows that communities/families that are protected by strong ties to excercise and proper diet show resilience, whereas people without such ties are much more succeptable to ANY illness.

The lesson? Your decisions in health don’t just affect you, they affect everyone you’re close to.

Edit: The analogy doesn’t suck.

[quote]Schlenkatank wrote:

[quote]SkyzykS wrote:

[quote]Schlenkatank wrote:

[quote]666Rich wrote:
Yes,

it is a stupid comparison. Take public transportation like millions of people in new york city. Walk. Ride a fucking bike. You wont have to purchase auto insurance.
[/quote]
I’m not ignoring the rest of your post, but I have to take issue with this here. The comparison to car insurance seems very similar to me; the argument that you and others make that you don’t have to own a car in one scenario is silly because you’re not thinking about this clearly. Let me see if I can help.

To clarify:

Everyone who owns a body and is uninsured is a liability to everyone else because everyone in their life will get sick. This is common sense.

Not everyone owns a car, but amoung those who do they are required by law to purchase car insurance to protect them from liability. As was diuscused, all 50 states require you to prove you can cover dammages to drivers and the state should a lawsuit result.

The difference between owning a car and owning a body? Everyone owns a body and the dammages to it can be considerably more expensive. Why should the rules be any different?[/quote]

You can’t refuse to be in an automotive accident when you are not the cause. You can, however, refuse medical treatment for what ails you.

Nor can you bump into someone with your body and give them diabetes, heart disease, obesity, cancer, etc.

That is why the auto insurance analogy sucks. That is why the rules should be different.
[/quote]
Most people without health insurance do refuse treatment actually. Right up to the point when they’re having a heart attack, a stroke, kidney failure, etc. Then the decision to intervene is made by someone else. Too bad they didn’t have the tools to prevent a $500,000 hospital bill.

Come on. In the end nobody can refuse treatment. It just doesn’t happen.

Also, there’s a body of evidence that goes to show that health is a broader issue than what you’re describing. Diabetes and obesity in reality are infectious diseases, it’s passed like wildfire from parents to kids, kids to all over school, and in work environments. Research shows that communities/families that are protected by strong ties to excercise and proper diet show resilience, whereas people without such ties are much more succeptable to ANY illness.

The lesson? Your decisions in health don’t just affect you, they affect everyone you’re close to.

Edit: The analogy doesn’t suck.[/quote]

The analogy does suck. If why it sucks escapes you, then there is no reason to explain why it sucks, because you will not understand that either.

[quote]kamui wrote:
I knew you weren’t “just askin’” :slight_smile:

For the record, i don’t think we should (or that we could) abolish patent laws. And i agree that they do promote innovation and development.
But in a quite oligopolisic market, less protected monopolies could contribute to lower the prices. So maybe we could shorten the length of some patents, or apply stricter condition before allowing patent term extensions, for example.
The “it will kill the industry !” argument sound a bit like “too big to fail” in my ears. [/quote]

Understood. ANd not entirely correct. What follows is the contrarian’s argument.

If one wants cheaper drugs, lengthen the patent protection.

As it stands, a drug patent protects the company for 17 years from the date of “filing for purpose.” In those 17 years, the three phases of human trials may cost tens of millions of dollars and consume a dozen years. So, as an example, all the costs of development and marketing have to be recouped in 5 years.

If that length of time were extended, then the time to recoup expenses would be lengthened, and the unit cost of the drug could be lowered. What would motivate the company to lower drug pricing? The emergence of “me-too” drugs–similar but not the same–as competition. Identical generics are not necessarily competitive, at least as the generic drug mills would have it.

(For added pleasure, just follow the current patent debates on “bioidentical” agents, which heretofore cannot have “generic” equivalents.)

[quote]SkyzykS wrote:

[quote]Schlenkatank wrote:

[quote]SkyzykS wrote:

[quote]Schlenkatank wrote:

[quote]666Rich wrote:
Yes,

it is a stupid comparison. Take public transportation like millions of people in new york city. Walk. Ride a fucking bike. You wont have to purchase auto insurance.
[/quote]
I’m not ignoring the rest of your post, but I have to take issue with this here. The comparison to car insurance seems very similar to me; the argument that you and others make that you don’t have to own a car in one scenario is silly because you’re not thinking about this clearly. Let me see if I can help.

To clarify:

Everyone who owns a body and is uninsured is a liability to everyone else because everyone in their life will get sick. This is common sense.

Not everyone owns a car, but amoung those who do they are required by law to purchase car insurance to protect them from liability. As was diuscused, all 50 states require you to prove you can cover dammages to drivers and the state should a lawsuit result.

The difference between owning a car and owning a body? Everyone owns a body and the dammages to it can be considerably more expensive. Why should the rules be any different?[/quote]

You can’t refuse to be in an automotive accident when you are not the cause. You can, however, refuse medical treatment for what ails you.

Nor can you bump into someone with your body and give them diabetes, heart disease, obesity, cancer, etc.

That is why the auto insurance analogy sucks. That is why the rules should be different.
[/quote]
Most people without health insurance do refuse treatment actually. Right up to the point when they’re having a heart attack, a stroke, kidney failure, etc. Then the decision to intervene is made by someone else. Too bad they didn’t have the tools to prevent a $500,000 hospital bill.

Come on. In the end nobody can refuse treatment. It just doesn’t happen.

Also, there’s a body of evidence that goes to show that health is a broader issue than what you’re describing. Diabetes and obesity in reality are infectious diseases, it’s passed like wildfire from parents to kids, kids to all over school, and in work environments. Research shows that communities/families that are protected by strong ties to excercise and proper diet show resilience, whereas people without such ties are much more succeptable to ANY illness.

The lesson? Your decisions in health don’t just affect you, they affect everyone you’re close to.

Edit: The analogy doesn’t suck.[/quote]

The analogy does suck. If why it sucks escapes you, then there is no reason to explain why it sucks, because you will not understand that either.
[/quote]
hmm. indeed. Please explain why.

The last thing I didn’t understand when I gave up talking to you over a year ago was a quote you supplied reportedly by Nietzsche who you claimed said “televesion is the opiate of the masses”.

You of course were calling me an idiot, saying I was too young to understand shit. Again.

The Irony? Nietzche was dead 40 years before the invention of television and you were mistakenly quoting a Murrow quote that he stole from Karl Marx. Forgive me if I mistake your name calling as insecurity.

Let’s leave the name calling at home, shall we?

[quote]DrSkeptix wrote:

[quote]kamui wrote:
I knew you weren’t “just askin’” :slight_smile:

For the record, i don’t think we should (or that we could) abolish patent laws. And i agree that they do promote innovation and development.
But in a quite oligopolisic market, less protected monopolies could contribute to lower the prices. So maybe we could shorten the length of some patents, or apply stricter condition before allowing patent term extensions, for example.
The “it will kill the industry !” argument sound a bit like “too big to fail” in my ears. [/quote]

Understood. ANd not entirely correct. What follows is the contrarian’s argument.

If one wants cheaper drugs, lengthen the patent protection.

As it stands, a drug patent protects the company for 17 years from the date of “filing for purpose.” In those 17 years, the three phases of human trials may cost tens of millions of dollars and consume a dozen years. So, as an example, all the costs of development and marketing have to be recouped in 5 years.

If that length of time were extended, then the time to recoup expenses would be lengthened, and the unit cost of the drug could be lowered. What would motivate the company to lower drug pricing? The emergence of “me-too” drugs–similar but not the same–as competition. Identical generics are not necessarily competitive, at least as the generic drug mills would have it.

(For added pleasure, just follow the current patent debates on “bioidentical” agents, which heretofore cannot have “generic” equivalents.)[/quote]

I actually agree.
But not every newly patented drug (and not every patent term extension) is the result a dozen years of development.
So maybe the length of a patent could vary with development time, development cost, novelty and importance of scientific discoveries and/or public health needs.
My initial point is that globally, the current system favor older and bigger players, and put newer and smaller players at a disavantage, making it more difficult for them to conquer a market simply by producing an already known drugs more efficiently. In other words, it may favor scientific innovation at the expense of industrial innovation.

[quote]Severiano wrote:
I’ll be the first to admit that was an appeal to emotion, it was an outright Ad misericordiam fallacy. But what is wrong with that? I’m not trying to appeal to logic, I’m appealing to patriotism and Christian ethics, which are basically parallel to my own. There is this one saying that I find sort of haunting, and has always struck me from the days I used to be Catholic; “Whatsoever you do to the least of my brothers, that you do unto me.”

You are supposed to treat our impoverished with charity as Christians, for me it is about treating people as ends in themselves. I know people who work several jobs and barely make it, I know what I get paid for what I do, and I know I would struggle doing what they do period. Treating a person as an end in themselves would mean that business owners should have an endeavor to treat people as ends in themselves in the form of a living wage so long as they are willing to put in that sort of effort. If your boss doesn’t care about you having a living wage, and is more concerned about their extra home, or their extra fancy french horses who trot around all pretty, that bugs the shit out of me. I know if I were an employer and I had people doing good work for me, I’d want them to share in OUR success.

This gets into pay structure, and I’m not saying I have all the answers, but I think at some point we have to recognize greed for what it is, and put it in check. We need to check our own ethics and stick to them as a way of life, rather than voice them when it is convenient. [/quote]

That’s what happens when labor and ownership to the means of production are separated.

[quote]Schlenkatank wrote:
SkyzykS wrote:
Schlenkatank wrote:
SkyzykS wrote:
Schlenkatank wrote:
666Rich wrote:

You of course were calling me an idiot, saying I was too young to understand shit.
[/quote]

Gee…I wonder why he would say such a thing?

[quote]Schlenkatank wrote:

Also, there’s a body of evidence that goes to show that health is a broader issue than what you’re describing. Diabetes and obesity in reality are infectious diseases, it’s passed like wildfire from parents to kids, kids to all over school, and in work environments. Research shows that communities/families that are protected by strong ties to excercise and proper diet show resilience, whereas people without such ties are much more succeptable to ANY illness.[/quote]

No, obesity isn’t an “infectious disease”. And you are undercutting your argument for universal coverage/universal shared health risk by noting that a number of these health care issues aren’t really driven by “health” at all - they are driven by lifestyle choices.

And this is why universal coverage in the US (and frankly, anywhere) is unsustainable - far too many people become “free” riders on the system. Witness Americans right now - overweight, poor eating habits, little exercise, obesity on the rise…and they are this way despite the fact that they have to pay for insurance to cover the effects of their bad choices. What happens if you exempt them from having any skin in the game and their health insurance is paid for by “rich corporations”, i.e., someone else? What then? Why is there any reason to think they’d modify their unhealthy behavior now that someone is pickig up the tab?

To the contrary - they will demand more health care services - why? They don’t have to pay for them. Basic economics - the price of a good goes down, demand goes up, and the “price” of health care goes down for a great many health care consumers because they won’t have to pay the “price” - so they demand more of it. In the aggregate, that means health care gets more expensive and people take even less better care of themselves than they do now.

No thanks.

One point you make, I think, is right - health care begins long before a consumer steps into a clinic and asks for treatment or medicine. The only way to salvage health care in the US is to reduce costs, and the primary way to do that is to simply reduce demand. Innovation of services, etc. will help, but not nearly to degree reducing demand will, and reduction of demand begins at the dinner table and in the home.

I read somewhere that obesity accounts for hundreds of billions of dollars in health care costs each year - and it is a health crisis that doesn’t need a doctor, a nurse, a surgical procedure or a medicine to fix. Yet we see people crowd into doctor’s offices seeking “care” for obesity - pills, surgeries, help with other health care problems caused by poor healthy habits.

Is this particular crisis in need of more “insurance”? Of course not. Insurance is designed to assist with unforeseen calamity. But here we have hundreds of billions every year to “cover” the problems associated with obesity, which isn’t an unforeseen calamity - it is the end product of a slow-motion process and personal choices.

So, imagine how much your insurance premiums would be if we subtracted out the health care payments by insurance companies for obesity-related problems. Literally hundreds of billions of dollars would be saved and diverted to other health care problems, and countless hours of doctors and nurses could be used for something else.

I don’t write this to suggest that we throw obese people off of insurance coverage - I write it to demonstrate the folly of “universal coverage” in the real world. Obese Americans - most of whom can do something about their problems, but don’t - are precisely the kinds of free riders on the system that will destroy such a system, and the proponents of “universal coverage” have never provided an answer for these problems - they just insist the we have unlimited resources from “corporate wealth” that will always be able to pay for the spiraling bill.

Again, not true, and no thanks. I choose sustainability.

That doesn’t mean that we turn over health care to an amoral market that only distributes resources with cold efficiency - our health care market should be humane and realistic about its market failures. But there is nothing “progressive” - or sane - about building a system that is doomed to fail.

[quote]thunderbolt23 wrote:

[quote]Schlenkatank wrote:

Also, there’s a body of evidence that goes to show that health is a broader issue than what you’re describing. Diabetes and obesity in reality are infectious diseases, it’s passed like wildfire from parents to kids, kids to all over school, and in work environments. Research shows that communities/families that are protected by strong ties to excercise and proper diet show resilience, whereas people without such ties are much more succeptable to ANY illness.[/quote]

No, obesity isn’t an “infectious disease”. And you are undercutting your argument for universal coverage/universal shared health risk by noting that a number of these health care issues aren’t really driven by “health” at all - they are driven by lifestyle choices.

And this is why universal coverage in the US (and frankly, anywhere) is unsustainable - far too many people become “free” riders on the system. Witness Americans right now - overweight, poor eating habits, little exercise, obesity on the rise…and they are this way despite the fact that they have to pay for insurance to cover the effects of their bad choices. What happens if you exempt them from having any skin in the game and their health insurance is paid for by “rich corporations”, i.e., someone else? What then? Why is there any reason to think they’d modify their unhealthy behavior now that someone is pickig up the tab?

To the contrary - they will demand more health care services - why? They don’t have to pay for them. Basic economics - the price of a good goes down, demand goes up, and the “price” of health care goes down for a great many health care consumers because they won’t have to pay the “price” - so they demand more of it. In the aggregate, that means health care gets more expensive and people take even less better care of themselves than they do now.

No thanks.

One point you make, I think, is right - health care begins long before a consumer steps into a clinic and asks for treatment or medicine. The only way to salvage health care in the US is to reduce costs, and the primary way to do that is to simply reduce demand. Innovation of services, etc. will help, but not nearly to degree reducing demand will, and reduction of demand begins at the dinner table and in the home.

I read somewhere that obesity accounts for hundreds of billions of dollars in health care costs each year - and it is a health crisis that doesn’t need a doctor, a nurse, a surgical procedure or a medicine to fix. Yet we see people crowd into doctor’s offices seeking “care” for obesity - pills, surgeries, help with other health care problems caused by poor healthy habits.

Is this particular crisis in need of more “insurance”? Of course not. Insurance is designed to assist with unforeseen calamity. But here we have hundreds of billions every year to “cover” the problems associated with obesity, which isn’t an unforeseen calamity - it is the end product of a slow-motion process and personal choices.

So, imagine how much your insurance premiums would be if we subtracted out the health care payments by insurance companies for obesity-related problems. Literally hundreds of billions of dollars would be saved and diverted to other health care problems, and countless hours of doctors and nurses could be used for something else.

I don’t write this to suggest that we throw obese people off of insurance coverage - I write it to demonstrate the folly of “universal coverage” in the real world. Obese Americans - most of whom can do something about their problems, but don’t - are precisely the kinds of free riders on the system that will destroy such a system, and the proponents of “universal coverage” have never provided an answer for these problems - they just insist the we have unlimited resources from “corporate wealth” that will always be able to pay for the spiraling bill.

Again, not true, and no thanks. I choose sustainability.

That doesn’t mean that we turn over health care to an amoral market that only distributes resources with cold efficiency - our health care market should be humane and realistic about its market failures. But there is nothing “progressive” - or sane - about building a system that is doomed to fail.[/quote]
You seem like a sensible enough person–I appreciate thoughtful responses without attacks or accusations. It’s the 4th, but I’d love to address this later. The basic premise of the argument I’d make though is that obese people are already payed for in your insurance premiums; I would say healthcare is unavoidably a communal issue so why not go universal?

For the record, I will admit that health insurance and car insurance are not 100% analogous. As SKYZYKS mentioned you don’t have to get health care, it’s just that almost everyone does.

They are however so analagous that a good point has been made I think. The reasons for enforcing car insurance are the same for enforcing health insurance.

[quote]ZEB wrote:

[quote]Schlenkatank wrote:
SkyzykS wrote:
Schlenkatank wrote:
SkyzykS wrote:
Schlenkatank wrote:
666Rich wrote:

You of course were calling me an idiot, saying I was too young to understand shit.
[/quote]

Gee…I wonder why he would say such a thing? [/quote]

He said such a thing because he honestly thought that Freidrich Nietsche said that television was the opiate of the masses. Weren’t you listening?

Silly goose. hee hee

[quote]Schlenkatank wrote:

[quote]ZEB wrote:

[quote]Schlenkatank wrote:
SkyzykS wrote:
Schlenkatank wrote:
SkyzykS wrote:
Schlenkatank wrote:
666Rich wrote:

You of course were calling me an idiot, saying I was too young to understand shit.
[/quote]

Gee…I wonder why he would say such a thing? [/quote]

He said such a thing because he honestly thought that Freidrich Nietsche said that television was the opiate of the masses. Weren’t you listening?

Silly goose. hee hee[/quote]

Thanks for the explanation It always bothers me when someone uses such strong language against children.

[quote]Schlenkatank wrote:

[quote]SkyzykS wrote:

[quote]Schlenkatank wrote:

[quote]SkyzykS wrote:

[quote]Schlenkatank wrote:

[quote]666Rich wrote:
Yes,

it is a stupid comparison. Take public transportation like millions of people in new york city. Walk. Ride a fucking bike. You wont have to purchase auto insurance.
[/quote]
I’m not ignoring the rest of your post, but I have to take issue with this here. The comparison to car insurance seems very similar to me; the argument that you and others make that you don’t have to own a car in one scenario is silly because you’re not thinking about this clearly. Let me see if I can help.

To clarify:

Everyone who owns a body and is uninsured is a liability to everyone else because everyone in their life will get sick. This is common sense.

Not everyone owns a car, but amoung those who do they are required by law to purchase car insurance to protect them from liability. As was diuscused, all 50 states require you to prove you can cover dammages to drivers and the state should a lawsuit result.

The difference between owning a car and owning a body? Everyone owns a body and the dammages to it can be considerably more expensive. Why should the rules be any different?[/quote]

You can’t refuse to be in an automotive accident when you are not the cause. You can, however, refuse medical treatment for what ails you.

Nor can you bump into someone with your body and give them diabetes, heart disease, obesity, cancer, etc.

That is why the auto insurance analogy sucks. That is why the rules should be different.
[/quote]
Most people without health insurance do refuse treatment actually. Right up to the point when they’re having a heart attack, a stroke, kidney failure, etc. Then the decision to intervene is made by someone else. Too bad they didn’t have the tools to prevent a $500,000 hospital bill.

Come on. In the end nobody can refuse treatment. It just doesn’t happen.

Also, there’s a body of evidence that goes to show that health is a broader issue than what you’re describing. Diabetes and obesity in reality are infectious diseases, it’s passed like wildfire from parents to kids, kids to all over school, and in work environments. Research shows that communities/families that are protected by strong ties to excercise and proper diet show resilience, whereas people without such ties are much more succeptable to ANY illness.

The lesson? Your decisions in health don’t just affect you, they affect everyone you’re close to.

Edit: The analogy doesn’t suck.[/quote]

The analogy does suck. If why it sucks escapes you, then there is no reason to explain why it sucks, because you will not understand that either.
[/quote]
hmm. indeed. Please explain why.

The last thing I didn’t understand when I gave up talking to you over a year ago was a quote you supplied reportedly by Nietzsche who you claimed said “televesion is the opiate of the masses”.

You of course were calling me an idiot, saying I was too young to understand shit. Again.

The Irony? Nietzche was dead 40 years before the invention of television and you were mistakenly quoting a Murrow quote that he stole from Karl Marx. Forgive me if I mistake your name calling as insecurity.

Let’s leave the name calling at home, shall we?[/quote]

Ohh! I misquoted someone in an off the cuff response over the internet a year ago! Damn me for the rest of my life! I’m wrong about everything!

Nice assumption, but I wasn’t referring to your ability to understand. I was referring to the willingness.