Patterico's Pontifications

5/8/2009

How will Democrats pay for their takeover of healthcare?

Filed under: General — Karl @ 9:11 am

[Posted by Karl]

Pres. Obama has staked quite a bit of his administration on making a “downpayment” on a government takeover of the healthcare system.  However, even laugh-inspiring amounts of creative accounting fail to pay for Obama’s health scheme.

Of course, the money would ultimately be extracted from the citizenry, but how?

Ian Murray makes a pretty good case that Obama intends to pay for healthcare reform with the money from his economy-crushing cap-and-trade scheme for greenhouse gases.  The supposed slowing of global warming that would occur under the Waxman-Markey bill in the House is insignificant, but the $600 billion a year the government would plan to raise — a cost of about $3,000 per American household — is not insignificant at all.

This theory would explain why Obama is pressing the House to tackle cap-and-trade before healthcare, despite significant opposition from the Blue Dogs there.  Indeed, while the Democrats’ budget resolution kept open the option of trying to railroad cap-and-trade through Congress in tthe budget reconciliation process, the Senate has shown no stomach for passing the cap-and-trade scheme — which would be another reason for Obama to lean on the House first.  It also explains why Obama has been so desperate to sell the idea that his “too much, too soon” agenda cannot be dealt with piecemeal.

This is a gamble with serious risks to the Obama and the Democrats.  The all-or-nothing approach could easily result in the failure of both cap-and-trade and healthcare.  Conversely, passing cap-and-trade could seriously damage not only Democrats facing reelection in 2010, but also Obama’s chances in 2012, when the bills come due with consumers.

–Karl

121 Responses to “How will Democrats pay for their takeover of healthcare?”

  1. It’s very simple. You have a government-run “free” HMO and a 100% tax on all private medical plans, for those who want to opt out.

    This also allows them to claim that the public plan costs far less per person than the private plans.

    Win-win.

    Kevin Murphy (0b2493)

  2. Rationing supply will also be used. Demand always outstrips supply in government universal health care programs. Expect months-long waiting lists of the kind familiar in Canada and the UK.

    Brother Bradley J. Fikes, C.O.R., (77f8db)

  3. I don’t think you get it.

    They may only have a year of genuine filibuster proof legislating. This only happens once a lifetime. And they still need to pass amnesty. They will do it all and more.

    They don’t care how it will be paid for. They really don’t. And neither does the majority of the American public. We are past the point where paying the bill is a serious issue.

    They look to Europe, not to the future.

    Amphipolis (fdbc48)

  4. “How will they pay?”

    Democrats never pay for anything – Republicans do…

    EricPWJohnson (4485ad)

  5. I always had the idea that fiscal legislation all had to begin in the House of Representatives. Silly me. All we need to do is re-define the words we use and we can make the rules say whatever we want.

    And it makes all the sense in the world to use the cap-and-trade money to pay for health care. After all, when people can’t afford to heat their homes a lot of them will probably get sick.

    Gesundheit (47b0b8)

  6. OK, but what happens when the glorious green revolution comes and carbon emissions are substantially cut down? How do we pay for all the goodies Dear Leader promises then?

    This is why I always vote against raising tobacco taxes to fund projects. I am not a tobacco user myself, but for the life of me I can’t understand why if something is so unhealthy that we are relying upon it to pay for all the goo-goo social programs that we supposedly want.

    If Obama has any pretensions of being honest with his subjects — er, I mean his constituents — he’ll admit that they only way we will pay for his health plans is rationing of services.

    JVW (eabe68)

  7. Karl, this is probably a rhetorical question, but do you really think Obama cares who pays the bills as long as the legislation he wants is passed so he can preen a little more?

    GM Roper (85dcd7)

  8. If Dems told the truth about what they wish to do, no one –
    other than those with the mentality of teen-age girls –
    would ever vote for them.

    AD - RtR/OS! (b70629)

  9. The arrogance of the Democrats to think that they have the mandate to destroy the American economy in this manner is truly astonishing.

    SPQR (72771e)

  10. We can’t even pay for existing entitlement programs! Why is no pol pointing that out?

    I guess it’s like Rush said a few days ago, gov’t health care a “belief” for some, and therefore anything fiscally relevant is not up for discussion. “Just make it happen…whatever the cost”.

    Cranbone (9a454f)

  11. “If you think health care is expensive now, wait until you see what it costs when it’s free.” –P.J. O’Rourke

    Horatio (55069c)

  12. GM Roper,

    I doubt Obama cares. However, the Blue Dogs do care — and it’s hard to cross them because (a) he needs the votes and (b) Obama is on-record supporting Pay-Go. Obvsly, (a) is the one that matters, but (b) makes it harder for Obama to use the stick on them.

    Amphipolis,

    I generally agree that Obama is trying to seize the moment (though he’s basically punting on immigration). The problem for Obama is that 60 Senate seats does not equal 60 Senate votes — or even a House majority. Cap-and-trade is anathema to Dems in the Rust Belt and coal states. It’s not a party issue; it’s a regional one.

    Karl (e59f40)

  13. How will Democrats pay for their takeover of healthcare?

    By sending us the bill.

    That, and lots of rationing.

    These sorts of systems do OK at preventative care and minor treatments, but they kill the proverbial golden goose for development of NEW, cutting edge (expensive) treatments. That’s why there is an 8-month wait in Utopia, I mean Canada, for a routine MRI, and a 2-year wait for the most unocmplicated of hip replacements.

    Mitch (890cbf)

  14. Karl -

    I hope you are right. I once thought that Senators voted based local and even individual interests too. I thought this would be a restraint. I think so no longer.

    It’s about power and control. Those rust belt Senators will do what they are told. All local sensitivities they project are an illusion, like Obama’s opposition to gay marriage.

    Amphipolis (fdbc48)

  15. They didn’t call the pre-Reagan Republicans the “tax collector for the welfare state” for nothing. At one point the difference between Reps and Dems was that one party wanted “good government” and the other one wanted as much government as possible.

    Reagan argued that “good government” was an oxymoron and that the idea that government solved problems was a chimera.

    We forgot that recently. We need to get back there.

    Kevin Murphy (805c5b)

  16. I don’t think Obama pays attention to matters like paying for programs. When has he ever paid retail for anything ? Rezko got him his “dream house.” He bought his first condo with the advance for his first book and then didn’t write it for another year.

    Did Lenin ever have a job ?

    Mike K (2cf494)

  17. Did Lenin ever have a job ?
    Comment by Mike K — 5/8/2009 @ 11:22 am

    During the majority of his years in external exile, Lenin seems to have led a life in Academia; lecturing and writing, and living off of the contributions of various Socialist orginizations and patrons in Europe.
    Other than the manual labor he most likely was compelled to work at during his period of internal exile, it is highly doubtful that he ever really held a job – not too dissimilar from our own Exalted Leader.

    AD - RtR/OS! (b70629)

  18. #3- They look to Europe, not to the future. Funny, you don’t see European nations dumping their healthcare systems to embrace the American model, do you.

    DCSCA (9d1bb3)

  19. 18, no, but we see Europeans coming here for healthcare they can’t get at home.

    PCD (02f8c1)

  20. #2 – Rationing supply will also be used. Demand always outstrips supply in government universal health care programs. Expect months-long waiting lists of the kind familiar in Canada and the UK. =yawn= I lived in the UK for years and their healthcare system works fine. Economical, timely (and imperfect to be sure,) but much more affordable for its citizenry. Yes, if you’re 95 and want a heart transplant, a 40 year old who needs one gets it ahead of you. It’s a system that works for the benefit of its people. America’s doesn’t.

    DCSCA (9d1bb3)

  21. #19- A conservative myth, of course. Always the scare with you people.

    DCSCA (9d1bb3)

  22. #19- A conservative myth, of course. Always the scare with you people.

    DCSCA (9d1bb3)

  23. #19- A conservative myth, of course. Always the scare with you people.

    DCSCA (9d1bb3)

  24. If the Euro systems, not just limited to health-care, are so great, why are they “lining up” to emigrate to the United States, but we don’t find any lines at their embassies of Americans wanting to emigrate to Europe?

    AD - RtR/OS! (b70629)

  25. 22 & 23- Mega-apologies for the multiple postings! Internet glitch!!

    DCSCA (9d1bb3)

  26. If socialist health-care models are so great, why did Fidel have to import a doctor from Madrid?

    AD - RtR/OS! (b70629)

  27. #24- Again with the conservative myth. This generation of Americans isn’t buying it.

    DCSCA (9d1bb3)

  28. DCSCA, so now you are endorsing rationing. No surprise there.

    By the way, the British Medical Journal published a study a few years ago that compared the NHS to Kaiser Permanente. It concluded that Kaiser provided better care at approximately the same cost as NHS.

    So much for your little testimonial.

    SPQR (72771e)

  29. #26- Why did President Bush agree to buy French-built helicopters for the Presidential chopper fleet? Or why does Boss Limbaugh crave Cuban cigars? The fear card isnt going to work this time.

    DCSCA (9d1bb3)

  30. Meanwhile, what is the solution at NHS for their long waiting times? How about making patients pay out of pocket to get advanced.

    So much for DCSCA’s little testimonial.

    SPQR (72771e)

  31. “Distract! Distract! My little troll! Don’t get into substantive discussions; they’re beyond your pay grade as a bottom-level part of Team Obama. Stick to the bumper-sticker slogans I sent you. Leave the deep thinking to the professionals.”
    — Rahmbo.

    Brother Bradley J. Fikes, C.O.R., (77f8db)

  32. If Cuba, N. Korea, Iran and Fwance are so superb why the don’t the various feckwads posting here and the likes of Mikey Moore carry their obese, smelly propagandist asses there forthwith?

    I wonder how long I would last trying to post over in the fever swamps of DU, KOS and that sort of nattering nabobs of Babel?

    Why is it that vaunted Cuban health care doesn’t stop Cubanos from striving to reach Florida or Mexicans wanting to go to Cuba rather than USA? Why do Canadians come to US for health care? How come so many Europeans I know come to US for serious treatment options, such as oncology surgeries? And still the cretins bitch about how Ireland is so much better than the US, for example.

    aoibhneas (0c6cfc)

  33. It is also amusing Bradley, when DCSCA attempts to make factual assertions, they are inevitably completely false. “timely” … LOL. The long waiting times for NHS surgery is discussed monthly on the floor of the House of Commons … but DCSCA is ignorant of it.

    SPQR (72771e)

  34. Since I’m afraid of neither French Helos (the Coast Guard has been buying French helos for years – they use them to catch smugglers with Cuban smokes, among other things) or Cuban smokes, just WTF are you blathering-on about.

    What they love about Ireland is the low level of taxation, though we still haven’t heard from Chris Dodd just exactly why he bought that seaside “cottage”.

    AD - RtR/OS! (b70629)

  35. Did Lenin ever have a job ?

    No, and neither did Marx. Marx was perpetually on the dole of some sponsor or acquaintance, borrowed money and threw a fit when he was expected to pay it back, and was so lazy that it took him years to finish Capital. The man quite literally embodied all of the worst traits of the socialistic philosophy and none of its virtues.

    Another Chris (2d8013)

  36. I lived in the UK for years and their healthcare system works fine.

    More fantasy. A recent survey found that 56% of Britons say the NHS is so bad it should be scrapped and start over.

    The French system is excellent but it includes fee for service, the patient pays the doctor, then is reimbursed by the plan; the plans are funded by payroll deductions; and hospitals are private.

    I favor a national plan on the French model. We could do the transition over about five years and the McCain proposal during the campaign would be a good start.

    Mike K (2cf494)

  37. “…the McCain proposal during the campaign …”

    Which was attacked vociferously by the Obamabots, yet -just the previous year- had been advocated by Obama’s prime health-care advisor.

    AD - RtR/OS! (b70629)

  38. While living in the UK, the little troll drafted a complete health care plan. However the document mysteriously disappeared just before Ernie Bevin announced the NHS.

    Brother Bradley J. Fikes, C.O.R., (77f8db)

  39. Every time there is a comment war on some blog, you can bet your bottom dollar (unless Obama has already taken it) that some advocate of single-payer government-run health care will chime in with “I lived in Britain [Canada, France, Cuba, etc.] and the health care system there is GREAT!” It may be true that you like those systems, provided all you need from them is an annual checkup and an occasional cast for a broken arm. Stories abound, however, about long waits to see specialists such as cardiologists, neurologists, orthopedists, and even obstetricians in these countries.

    I don’t object to people arguing for socialized medicine, even though I disagree with them. What I object to is this notion that there is no cost to it or no potential pitfalls. If medicine in Britain is so damn great, how come Tony Blair spent most of his time as PM working to expand the Thatcher Government’s move towards more reliance on private health insurance plans?

    JVW (eabe68)

  40. Funny, you don’t see European nations dumping their healthcare systems to embrace the American model, do you.
    Comment by DCSCA — 5/8/2009 @ 12:51 pm

    A number of years ago, while working as a therapist at one of Texas’ State Hospitals, I sat with a number of co-workers including a veddy Brittish doctor. He was extolling the many superior attributes of the National Healthcare programs in the land of the Brits. After being “bowled over” (not!) by his bragging, one of our docs asked “If it was so great, how come you are practicing here in the US, in Texas no less?” Dead silence from our cousin from across the big water!

    GM Roper (85dcd7)

  41. (Left this out)(damn fumble fingers) So yes DCSCA, I do see them dumping their health care systems to come over here! Especially the ones in the trenches like docs, dentists, nurses!

    GM Roper (85dcd7)

  42. #40– You might find this amazing, but the prospect of practicing medicine in Texas in a different land might actually be more appealing- and exciting- then pushing pills in Tumbridge Wells.

    DCSCA (9d1bb3)

  43. #41- You see greed.

    DCSCA (9d1bb3)

  44. DCSCA, like the “greed” of hospitals in Great Britain accepting payments to advance people in line for surgery.

    How do you like wearing floppy shoes and big red nose?

    SPQR (72771e)

  45. Most of Canada’s skilled specialists left in the 80s. A lot of GPs left, too, including one who settled here in Mission Viejo. I used to attend a laparoscopy conference in Saskatoon but one year it was cancelled as all the speakers had emigrated. The worst mistake the Canadians did, and the French avoided, was the banning of any practice outside the government system. Had they left the private option, the Canadian system might well have done OK. They banned private practice and balance billing because of concerns about equality so what they got was well off Canadians coming to the US. For a while (I don’t know if it is still on) the Province of Ottawa was paying for CABG patients to have surgery in the US. They had driven out the heart surgeons and had nobody left to do the cases.

    The Canadians even stopped building hospitals, closed nursing schools and reduced the number of places in medical school. I was at a meeting two years ago where I met a Canadian architect who was designing the first new hospital in decades.

    In Britain, they didn’t ban private care at first but, in the 70s, the unions refused to care for private patients in NHS hospitals, even teaching hospitals. As a result, the Harley Street specialists all moved to Belgium. After a Labour woman health minister had a hysterectomy in Belgium there was a scandal. Thatcher restored private care by allowing private hospitals to be built. When I was there about 15 years ago, about 25% of the population of southeast England, Greater London, had private health insurance and went to private hospitals. I don’t know what has happened since in the NHS except that Blair kept many of Thatcher’s reforms, like fund-holding.

    Since the troll was there and is an expert, I won’t have to explain fund-holding.

    Mike K (2cf494)

  46. Mike K (2:22 pm), the other side of current doctors leaving the national system in Canada and Britain is that potential doctors end up deciding not to study medicine at all. I read a polemic against the Canadian system a few years back in which the author quoted statistics purporting to show that the best and brightest college students in Canada were now less likely to study biology and pre-med than previous generations. Instead, they go into business and engineering, fields with jobs primarily in the private sector.

    JVW (eabe68)

  47. Re: France

    Today French reformers’ number one priority is to move health insurance financing away from payroll and wage levies because they hamper employers’ willingness to hire. Instead, France is turning toward broad taxes on earned and unearned income alike to pay for healthcare.

    American advocates of mandates on employers to provide health insurance should take note. The link between employment and health security is a historical artifact whose disadvantages now far outweigh its advantages. Economists estimate that between 25 and 45 percent of the US labor force is now job-locked. That is, employees make career decisions based on their need to maintain affordable health coverage or avoid exclusion based on a preexisting condition.

    Let me know when the Dems start talking about doing away with employer-based coverage.

    Karl (e59f40)

  48. Again:

    France must make big changes to its health system in order to cut waste and increase efficiency, a government-commissioned report is warning.
    The report says citizens must pay more and doctors must alter their behaviour.

    Failure to do so could add 66 billion euros a year to France’s public budget deficit by 2020, it adds.

    The warning comes after thousands of health workers protested on Thursday over staff shortages and the “creeping privatisation” of the health system.

    There’s that “creeping privatization” again! Why must it creep?

    Karl (e59f40)

  49. The little troll, who advised Von Braun on the space program, sniffed Rush Limbaugh’s armpits, fought terrorists as a SEAL and invented the UK’s National Health Service, will provide free medical care.

    Brother Bradley J. Fikes, C.O.R., (77f8db)

  50. Karl, have you ever read Eat the Rich by P.J. O’Rourke? He writes about Sweden as a country famous for its general social welfare benefits and how this system seemed to work pretty well in the 1950s and 60s, but suddenly started to go off the rails in the 70s and 80s when productivity declined and unemployment, out-of-wedlock births, divorce, etc. shot up. The big difference, he concludes, is that starting in the 1960s Sweden began to extend all their government-mandated goodies (health insurance, long vacations, subsidized living expenses, etc.) from people who held a job to the general population at large. Suddenly, you no longer had to be gainfully employed to enjoy all of the benefits so there was no real incentive for the layabout to find employment. It’s an interesting piece and ought to be considered before the Obama Administration takes us into a European-style social welfare state.

    JVW (eabe68)

  51. Ta-pocka, ta-pocka, ta-pocka, Bradley.

    Eric Blair (c8876d)

  52. #52- And here I thought you were in Casablanca for the waters as well, ‘Ugartti.’

    DCSCA (9d1bb3)

  53. Deficits only mattered when Democrats pretended to care about them under Bush. Now that Obama’s racking up deficits many multiples of Bush’s, the Democrats can’t pretend they care about them anymore, otherwise they would cut back on the insane spending.

    daleyrocks (5d22c0)

  54. Shoo, little troll. Your insulting of Scott Jacobs today of all days says it all.

    Low rent troll.

    You give Walter Mitty a bad name.

    Eric Blair (c8876d)

  55. #49- There’s that “creeping privatization” again! Why must it creep?

    Because they see the creepy American mess, that’s why.

    No system is static. To ignore reviewing or adapting alternative systems, or subsystems, of healthcare systems working in other countries is conservatism in a nutshell- resistance to change.

    Socialism – the ol’ fear tactic. Ban Medicare. Tell your folks to mail back their social security checks, too! Socialism! BOO! Americans aren’t buying conservative scare tactics this time.

    DCSCA (9d1bb3)

  56. I only lived in the UK for a couple of years, but Mrs. Carlito did fly home for one surgery because she could. As non-citizens, we had private insurance, but I can’t say that the system impressed me much. I had a Dr. take my blood while not wearing gloves, in a carpeted, not-really-sanitary office. My wife had to go to the emergency room once, and they kept trying to give her pain medication that she knows she can’t take. She actually had to physically give it back to the nurse about 3 times, telling her “NO IT”S NOT FINE – THIS STUFF MAKES ME SICK!” Ancient wheelchairs, nurses who give you about as much customer service as the local DMV, and a blasé local attitude that it’s “free” so why not take an ambulance instead of a taxi. Not impressed. I have been in charity hospitals in the US that are nice than the NHS ones in the UK.

    carlitos (027922)

  57. I strongly advise you all to ignore the poster who recently posted, without comment, a list that had Dominica and Morocco ahead of the US in terms of health care. You will not receive rational response.

    carlitos (027922)

  58. Actually, carlitos, I posted a thorough debunking of the WHO rankings that was utterly ignored by the Michael Moore groupie.

    SPQR (72771e)

  59. Tommorow’s talking point for the Right:

    Oppose the Metric System! Europe uses it so you can’t count on it!

    DCSCA (9d1bb3)

  60. Tommorow’s

    This was the loser flaming others’ spelling earlier, was it not?

    SPQR (72771e)

  61. “You” might not be able to count on it,
    but quite a few of us are very able to count with it.
    Oh, BTW, if it’s Mil-Spec, it’s Metric.
    The only measurement that I am aware of currently in use in the Military that isn’t Metric, is the Navy habit of rounding off nautical miles to 2000-yards.

    AD - RtR/OS! (b70629)

  62. The little troll beclowns itself once again!

    Brother Bradley J. Fikes, C.O.R., (77f8db)

  63. #39- Gee, that sounds good… for insurance companies not health care.

    DCSCA (9d1bb3)

  64. “The incoherent little troll beclowns itself once again!”

    Fixed that for ya, Bradley.

    SPQR (72771e)

  65. #45- Yeah. Americans do it better. Show’em Walter Reed.

    DCSCA (9d1bb3)

  66. “The incoherent, orthographically challenged, little troll beclowns itself once again!”

    Let’s see how many more appropriate descriptions we can add!

    Brother Bradley J. Fikes, C.O.R., (77f8db)

  67. Carlitos (3:32 pm), here is what happens when socialized medicine leads to filthy hospitals.

    JVW (eabe68)

  68. Bradley, I bow before your superior adjectives!

    SPQR (72771e)

  69. SPQR,
    Someone should write a program in BASIC to emulate the little troll. All you need are a stock supply of leftist slogans, a few gratuitous insults to Bush and Rush, some incoherent asides, along with randomly introduced spelling errors.

    The program would fare about as well as the little troll with the Turing Test.

    Brother Bradley J. Fikes, C.O.R., (77f8db)

  70. JVW,

    I have read Eat The Rich. I would add that Euro-nanny states also functioned more smoothly when their cultures were more homogeneous. When being unemployed makes you a social pariah, there’s an incentive to try to get off the dole faster. When that social pressure is gone, well…

    Karl (3bf5f8)

  71. DCSCA wrote:

    Show’em Walter Reed.

    Thanks for reminding us of the federal gov’t involvement in healthcare.

    Karl (3bf5f8)

  72. The cap and trade government windfall has already been spent! Remember, he was going to use that money to pay for his “tax cut for 95% of working Americans.” Never mind that most of those “cuts” are actually welfare payments to people who have no tax liability, that was what he said he would spend it on.

    Only, Markey-Waxman is sinking like a lead zeppelin with opposition from Dems in energy states (coal miner unions and all that). If it were just a matter of soaking productive people of petro dollars it would be no problem, but he’s got those unions against him. I saw that one coming last year when he first started passing natural gas about bankrupting the coal industry.

    MJBrutus (dc3d12)

  73. Americans aren’t buying conservative scare tactics this time.

    You, like many of our countrymen can ignore reality, but you can’t ignore the consequences of reality. Life’s a bitch that way. Medicare is broke. SS is the greatest Ponzi scheme ever devised and makes Bernie Madoff look like a piker. Don’t like that reality? Fine. Can you avoid it? No way in hell. Enjoy your fantasy.

    Horatio (e2e328)

  74. How will they pay? They won’t have to. Just pass it forward to the next generation. Paying sucks.

    The Emperor7 (0c8c2c)

  75. JVW – Thanks for that article. I was aware of brits traveling to India for plastic surgery and stuff, but didn’t realize that doctors were leaving, too.

    When I was there, there was at least one infectious outbreak that was attributed to the NHS hospital’s “open wards” vs. private rooms. And a lack of hand-washing, believe it or not.

    carlitos (027922)

  76. There’s that “creeping privatization” again!

    Karl, let’s not take object lessons – much less undertake decisions – from a 2003 study in France. Reforms in the intervening years may have annulled the linked analysis. More recent reports show 92% of the French have private health insurance – usually through their employer – to keep the single-payer scheme solvent.

    To champion a patchwork is not to admit failure. Going to the hospital should not mean going broke. Controlling costs should be the goal.

    The Dutch apparently offer universal coverage delivered entirely through private insurers. There is price competition for a standardized basic benefits package, community rating, sliding-scale income-based subsidies for patients, and risk equalization for insurers. In short, institutionalized comparison shopping.

    steve (b4bafc)

  77. i live in the uk now. the health care system is not so good. unqualified doctors are practicing medicine – last year i had a locum (temporary dr) who could barely speak english. those docs on the front line are lousy.

    it has taken me 4 months to get referred to an ent from my local doctor – 4 months! if i were still in my healthcare plan back in the states, it would have taken me less than a month. one knock

    yes you can jump ahead if you have private insurance, but is that fair? the nhs is struggling with the huge number of eastern europeans coming over here for treatment. so much that hospitals have signs up their waiting rooms saying, ‘do you know you might have to pay for your treatment today.’

    and justrecently, there have been discussions regarding kaiser-like facilities being set up over here. now how bad can that be.

    ktr (9277d5)

  78. They won’t. Having destroyed the economy, they’ll flee to … someplace that will have them.

    htom (412a17)

  79. Can you say VAT Value Added Tax?

    DayTrader (ea6549)

  80. Bradley, actually the problem with creating a simulacrum of the troll is that existing artificial intelligence programs like Eliza are more convincing that the troll is.

    SPQR (26be8b)

  81. steve,

    You do realize that pointing out that “More recent reports show 92% of the French have private health insurance – usually through their employer – to keep the single-payer scheme solvent” really makes my point, yes?

    Comparison shopping would be another market-based reform I would entertain.

    Too bad the Dems have no intention of doing any of these things.

    Also, I am sorta amused about you cost-control goal. Economics is invariably about scarcity. Medical care is inevitably rationed. The only question is whether that rationing is done primarily by market forces and their bureaucracies or primarily by politicians and their bureaucracies.

    Q: Why is there not a big push on for gov’t to control the cost of food?

    Karl (3bf5f8)

  82. As for funding, obviously here in the Banana States of America, it does not matter. The money will be printed or confiscated by the Obama thugs.

    SPQR (26be8b)

  83. #72- You mean a Republican oversight, of course– or conservative neglect, as the military is conservative by nature. Of course here’s a better reminder- Former First Lady Barbara Bush had heart surgery on a government health plan and is still alive! Perplexing to conservatives.

    DCSCA (9d1bb3)

  84. What’s more, the little troll performed the heart surgery!

    Brother Bradley J. Fikes, C.O.R. (0ea407)

  85. With its’ head up its’ ass.

    AD - RtR/OS! (b70629)

  86. I’m looking forward to DCSCA’s next attempt at a factual statement … probably something like socialized medicine has fewer calories and less cholesterol than US healthcare.

    SPQR (26be8b)

  87. #88- But it does, spork! Try carrot juice and aspirin for six months and get back to us.

    DCSCA (9d1bb3)

  88. Economics is invariably about scarcity.

    And so, there are far fewer doctors per population in France than the U.S.?

    Germany and France boast about 3.4 doctors per 1,000. The U.S. has 2.3/1000, ranking 52nd.

    You’re cherry-picking. Horror stories abound, as do worse-case scenarios. There is no viable, all-or-nothing approach in play. Any successful reform package will be an awkward fusion of private and public methodologies. Launching cannonades opposing an un-articulated plan – a shadow – is tilting at windmills.

    You don’t think the cost of food is controlled?

    steve (b4bafc)

  89. But steve, it is not fair that people with more money can buy more expensive gourmet food. Food is a right. There should be a single authority for the supply of food, everyone would have identical menus and no one could have more food or tastier food than someone else.

    SPQR (26be8b)

  90. When Americans figure out a way to steal the best ideas behind the effective segments of the European health systems, slap the Stars & Stripes on it and sell it as Made In USA, America will buy into national healthcare. So it was with TV shows and rocket science, so it will be with health services.

    DCSCA (9d1bb3)

  91. “The Dutch apparently offer universal coverage delivered entirely through private insurers.”

    steve – “Offer” is the wrong choice of words. The Dutch govermnet mandates universal coverage, but they allow people to purchase it through private insurers and offer subsidies to both the purchasers for the plans and the insurance companies for forcing them to accept high risk applicants at the same rates as better risks.

    How big is the is the Netherlands and do you think this disguised government takeover can be applied here?

    daleyrocks (5d22c0)

  92. Democrats won’t pay zip. They don’t pay taxes, remember?

    Larry Sheldon (86b2e1)

  93. I find it amazing that anyone (including myself!!) responds to DCSCA. He wins everytime someone responds. You use reason. He uses ambiguity, and deflection. Time to stop humoring the troll. Let him rant away and for the rest of us to ignore him.

    Horatio (e2e328)

  94. #84, DCSCA wrote: “Former First Lady Barbara Bush had heart surgery on a government health plan and is still alive! Perplexing to conservatives.”

    Not perplexing at all. I’m sure Fidel Castro receives the best his country has to offer as well, as did Lenin, Stalin, and the rest of your heroes. Juan Sixpack on the other hand…

    Btw, Forrest, when did you live in the UK? Hopefully it wasn’t at the same time you were conducting safaris in the Congo or wrestling Yetis in Mongolia…

    danebramage (700c93)

  95. Let him rant away and for the rest of us to ignore him. <– Precisely how Americans are managing Boss Limbaugh and the Dittoheads, dittohead.

    DCSCA (9d1bb3)

  96. #78- i live in the uk now. the health care system is not so good. unqualified doctors are practicing medicine – last year i had a locum (temporary dr) who could barely speak english. those docs on the front line are lousy. Apparently you havent been taken ill in Los Angeles lately.

    DCSCA (9d1bb3)

  97. How is it a gamble when we’ll never be told neither are working, and in fact the opposite will be reported

    Hawkins (75e3c5)

  98. I would add that Euro-nanny states also functioned more smoothly when their cultures were more homogeneous. Comment by Karl — 5/8/2009

    That calls to mind my belief that the government (or the prevailing politicians and ideology thereof) of a society is a lot like the parents of a household. If the kids living in that household — ie, large percentages of people within a city, state or nation — tend to be innately disciplined, talented, resourceful, and reliable, then the negative impact of their parents being flakes and fools (ie, of liberal persuasion) is not as great.

    But if the kids of a household tend to be extremely irresponsible, mediocre, non-talented, undisciplined and bratty (or worse), then the combination of that with their parents being of equally screwed-up nature (“we think Fidel Castro is humane and generous, Hugo Chavez is heroic, and Michael Moore and Al Sharpton are wonderful and wise!!”) is a double whammy, a so-called recipe for disaster.

    If America is going to survive, much less thrive, under a peculiar mix of Euro-socialism and Third-World leftism, it will help if a high percentage of its people are in the category of college valedictorian, rocket scientist and Rhodes Scholar, or certainly better than what this portrays:

    New York Times, April 18, 2009

    For a demographic overview, The New York Times asked the Migration Policy Institute, a Washington research group, to analyze 2008 census data on immigrants and their children.

    “The good news here is that second generation adults are making significant progress — both compared to their parents and compared to their peers,” said Jeanne Batalova, the institute scholar who did the analysis. “The not-so-good news is that the progress is not uniform.”

    Ms. Batalova…examined Mexicans — the largest immigrant group and one with especially low levels of education. About 56 percent of adult immigrants from Mexico lack high school degrees, and Mexicans account for about a third of all immigrant families. (Salvadorans, who are demographically similar, add an additional 3 percent.)

    On average, Mexican-American children have higher incomes and more education than their parents. But a significant minority seem at risk. About 17 percent fail to finish high school (compared with 11 percent of native-born blacks). Their rate of nonmarital births is twice that of their parents. And other studies show them with high incarceration rates.

    Tracking children of Mexican immigrants in Southern California, Mr. Rumbaut [who teaches at the University of California, Irvine] found that 15 percent dropped out of school, 20 percent of the males were imprisoned, and 30 percent of the females became teenage mothers. The statistical profile resembled that of African-Americans, whom the professors warned the immigrants might join in “a rainbow underclass.”

    About 18 million youths are immigrants or children of immigrants. If only the bottom fifth is at risk — and three-quarters of them succeed — that could still swell a “rainbow underclass” by nearly a million people.

    Mark (411533)

  99. Your math is off a bit.

    $600 billion a year will cost the average household about $5,000 per year which is way more than your estimate of $3,000.

    I think there are about 120 million households in the USA.

    AJ Lynch (e54992)

  100. Let’s not forget that last summer, candidate Obama proposed paying for high energy prices with windfall profit taxes on the oil companies.

    So a tax on whatever company he deems too successful could always be employed to raise a little revenue, no?

    MayBee (61bfd7)

  101. “President Obama’s assertion to homeowners that refinancing their mortgage loans now with interest rates at a near-record low equates to a tax cut isn’t that cut and dried, according to tax analysts.”…h/t foxnews

    How will they do it?
    The old-fashioned, tried-and-true way:
    They’ll Lie!

    AD - RtR/OS! (3487f1)

  102. Today French reformers’ number one priority is to move health insurance financing away from payroll and wage levies because they hamper employers’ willingness to hire. Instead, France is turning toward broad taxes on earned and unearned income alike to pay for healthcare.

    Karl, I left for Tucson shortly after my post and did not see yours until now. The Caisse Nationale d’Assurance Maladie deTravailleurs Salariés (CNAMTS) is a fund for all salaried workers, regardless of employer. The job-lock problem does not apply because, if they change jobs, they stay in the same plan as long as they remain a salaried worker. They have had funding shortage requiring tax money to be added in recent years but remember the fund is not just health care. It includes workers comp and pensions.

    Having health care funded by the worker and not the government seems healthier to me. Second, the system has the patient pay the doctor’s fee at the time of the visit and the patient is then reimbursed by the fund later. This has the same effect as a co-pay. In fact, the French system includes a co-pay of 20% or more but that can be covered by co-insurance that is private.

    My point in suggesting the model is that it retains a number of features that we used to have (in California) and are losing. Fee-for-service has gotten a bad name here because of abuses with inflating fees and excessive treatment. The French deal with that by a national fee schedule, negotiated with medical associations that function like unions and the funds. The fee schedule determines what the fund pays but the doctor can charge more. He just has to convince the patient to pay it. Here you have some remnant of the market system.

    There are a lot of reasons for fee inflation in the US and I could explain them but it would be a very long post. I have a chapter in my book on it. One basic cause was that Medicare established a fee “profile” for each doctor and would not allow it to be changed even as you became more experienced and therefore worth more. That caused young surgeons (smarter than me, I might add) to start with high fees. I was astonished one time to learn that a new surgeon who required an observer, had a surgical fee about twice mine after I had been in practice 15 years. I learned about it because the assistant fee is 20% of the surgeon’s fee.

    Mike K (90939b)

  103. I would add that Euro-nanny states also functioned more smoothly when their cultures were more homogeneous. Comment by Karl — 5/8/2009

    Mister, we could use a man like Erich Honecker again.

    steve (8e2333)

  104. I should add that the biggest reason why employers are so slow to hire has nothing to do with healthcare costs. David Frum did a piece a year or so ago about a trip to France and how short staffed the restaurants were. I saw the same thing. Once they hire someone, it’s impossible to fire them. The 35 hour work week is also a big piece of it. And retirement at 50.

    Mike K (90939b)

  105. Mike K, that is true all over Europe. When you fire someone in Germany, IF you can do it at all, they still have the right to come into the office and use the company resources to look for a job for a period of months. We had one guy that was fired for performance issues, and he was around on full pay for a year using his company laptop and cell phone. We had to find another office and PC for the replacement.

    carlitos (aa025a)

  106. Temp agencies would seem a natural solution, if the Euro-nanny states allow them.

    Brother Bradley J. Fikes, C.O.R. (0ea407)

  107. Jeffrey – Which bible do you read?

    daleyrocks (5d22c0)

  108. Comment by Brother Bradley J. Fikes, C.O.R. — 5/9/2009 @ 4:45 pm

    They are definitely going to be coming for you over that.

    AD - RtR/OS! (b651c9)

  109. When you fire someone in Germany, IF you can do it at all, they still have the right to come into the office and use the company resources to look for a job for a period of months. Comment by carlitos

    It’s actually astounding that the foolishness or flat-out idiocy of public policy and legislation in that part of the world hasn’t undermined societies like the following to an even greater degree:

    By George F. Will
    May 2007

    Arson is a form of commentary favored by the French left, so at least 1,000 vehicles were torched by disappointed supporters of the Socialist presidential candidate Ségolène Royal after she was defeated 53 percent to 47 percent by Nicolas Sarkozy. Last spring, rioting was the left’s economic argument when the government proposed, then retreated from, legislation that would have made it somewhat easier for businesses to fire younger workers in the first two years of employment. The idea behind the legislation was that employers would be more likely to hire workers if it were not a legal ordeal to fire them. The rioters were, of course, mostly young.

    France’s unemployment rate is 8.7 percent, nearly double the U.S. rate of 4.5 percent. Among persons under age 25, a cohort that supported Royal, the rate is 21.2 percent, and it is apt to stay there unless Sarkozy can implement reforms that irritate rioters.

    Twenty-five years ago, President François Mitterrand, a socialist who had won election by promising to “break with the logic of profitability,” was keeping that promise and, in the process, killing socialism. He promised stimulative spending through expanded entitlements, a short workweek with no reduced compensation, job creation through public spending and higher taxes on the investing classes. So productivity fell and unemployment — it has not been below 8 percent since 1981 — rose.

    Statism, the inevitable concomitant of government attempts to administer France’s three ideological incompatibles (“liberty, equality, fraternity”), continued. And 47 percent of the French electorate just voted for Royal’s promise of much more of it, even though France’s 2006 growth rate was lower than that of 21 of the then-25 members of the European Union.

    During the 25 years that the French left and some right-wing nationalists have spent reviling “cold, heartless impoverishing Anglo-American capitalism,” France’s per capita gross domestic product has slumped from seventh in the world to 17th.

    Mark (411533)

  110. Mark – They’re obviously not doing it right. Obama will do it smarter. Heh!

    daleyrocks (5d22c0)

  111. [...] How will Democrats pay for their takeover of healthcare? [...]

    How will Democrats pay for their takeover of healthcare? | Money and Politics (318f0a)

  112. So, on Saturday the OMB blogged .. yes blogged .. that they would increase estate taxes to play in part for the healthcare.

    Frankly, the best propaganda for an increase in estate taxes is watching MTV. The spoiled little bastards with the 6 figure birthday parties and dreams of a lifetime with a “boat in the Caribbean and endless partying” makes the case.

    Neo (46a1a2)

  113. Neo, those kids are the subject of the Narcissism Epidemic and are disproportionately Obama voters. They are the “self esteem” generation.

    Sarkozy has great ideas but no one to implement them. His appointees to his administration are all Socialists because there is no one else in French government. Bush had similar problems.

    Mitterand was such a disaster that he had to reverse many of his policies after two years. There was an amazing period in France when property, nice homes away from Paris, were selling for 1/3 or less of the value before his election. Paris, of course, is like the Greater DC Area, the home of government and never has a recession. I had friends who bought chateaus near Lyon for $250,000. They were amazing buys if you wanted a second home in France. The rich all left France.

    The French “Silicone Valley” is often said to reside in the Thames Estuary; they all moved to England.

    Mike K (90939b)

  114. Twenty-five years ago, President François Mitterrand, a socialist who had won election by promising to “break with the logic of profitability,” was keeping that promise and, in the process, killing socialism.

    It’s rather telling that even Mitterrand admitted that socialism was by nature illogical.

    Another Chris (a3bb8f)

  115. Sarkozy has his own silicone valley, to be sure.

    carlitos (aa025a)

  116. Thank you, carlitos. Thank you.

    JD (d71a7a)

  117. Actually, as bad as France is, a country several hundred miles east of there — Spain — apparently is even worse.

    Oh, well, as the saying goes: you reap what you sow. Or, sadly, c’est la vie, baby.

    Meanwhile, are France and Spain a window into the future of America, certainly of portions of it similar to Democrat-Party-lovin’ California?

    BBC, 27 April 2009

    French unemployment ‘rises again’

    French unemployment rose between 60,000 and 70,000 last month, Economy Minister Christine Lagarde has warned. Speaking before the release of the official data for March, she said the figure was still an improvement on the 79,900 who lost their jobs in February.

    She said that while “not good news”, the latest data was “not catastrophic”.

    France’s unemployment rate is currently running at 8.2%, one of the highest in Western Europe. It is expected to go above 10% by the end of this year.

    Despite passing a 26bn euro ($34bn; £23bn) economic stimulus package in February, France remains mired in recession.

    Young people have been hit particularly hard by the downturn, with unemployment among the under-25s reaching 21.2% at the end of last year.


    _____________________________


    Washington Post, March 10, 2008

    The Socialist party of Spanish Prime Minister José Luis Rodríguez Zapatero won a reelection battle Sunday, turning back a tough challenge by the more conservative Popular Party, which accused the Socialists of mismanaging the economy, opening Spain to a flood of illegal immigrants and capitulating to terrorists.

    But voters turned out in force to endorse the progressive social agenda that Zapatero championed in his first term — including new laws on women’s rights, divorce and gay marriage — and returned him to office for another four years. The Socialists increased their seats in the Congress of Deputies, falling about seven short of an absolute majority; they may now rely less on coalitions and compromises with smaller parties, strengthening Zapatero’s position.
    _____________________________

    New York Times, April 24, 2009:

    MADRID — The number of unemployed people in Spain rose to a record four million in the first quarter as the economy continued to shed jobs created over the last decade by inexpensive credit and a real estate bubble.

    The Spanish unemployment rate climbed to 17.4 percent, from 13.9 percent in the final quarter of 2008, or more than twice the European Union average, the National Statistics Institute said Friday. The 802,800 increase in the ranks of the jobless was the largest quarterly increase in more than 30 years.
    _____________________________

    brusselsjournal.com, Soeren Kern, 2008-09-08

    According to the OECD [Organization for Economic Cooperation and Development], Spain has one of the lowest levels of labor productivity in Europe. An average Spanish worker generated US $39.4 in GDP per hour worked, compared with US $49.9 per French worker; US $47 per German worker; and US $50.4 per American worker.

    In other words, of all those hours Spaniards are physically present at their work stations, how many of those hours are actually spent working? And how many of those hours are spent on siestas, coffee breaks, two-hour lunches, surfing the Internet, and other social activities?

    Then consider public holidays. Spain celebrates 14 public holidays (nine of which are declared by the national government and the rest at the provincial level). If one of the nine national holidays falls on a Sunday, no need to worry; regional governments get to choose a replacement holiday. And if a national holiday falls on a Thursday or on a Tuesday, businesses usually close on Fridays and Mondays in order to make a “bridge” for an extra-long weekend. Add to these public holidays the 30 days of vacation that are mandated by law and Spaniards get roughly 45 days off per year.

    Compare this with the United States, which observes ten federal holidays, and where, according to the Expedia 2008 International Vacation Deprivation Survey, Americans receive on average 14 days of vacation. (In Europe, French workers got an average of 37 days of vacation in 2008; Italians 33; Germans 27; British 26.)

    But that’s not all. Spaniards have found another way of getting extra time off from work: labor strikes, which have become a national sport in Spain. According to the Spanish Confederation of Employers’ Organizations (CEOE), Spanish workers held 541 strikes during the first half of 2008, which resulted in the loss of 23.4 million man-hours of labor. Compared to the same period in 2007, the number of striking workers skyrocketed by 90.3 percent in 2008 and the number of hours lost jumped by 69.9 percent in 2008.

    Does Socialism Breed Laziness?

    According to Adecco, the human resources management company, workplace absenteeism in Spain has doubled over the last four years, from three percent to six percent. This compares with a European average of 4.6 percent.

    …Still others maintain that Post-Vacation Syndrome is nothing other than classic laziness. And some go so far as to draw a clear connection between laziness and European socialism. Whereas capitalism rewards hard work and personal initiative, socialism inherently rewards laziness. Indeed, European socialist societies are teaching their citizens to expect everything, even if they contribute nothing. So why work if you can get it for free?

    Mark (411533)


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