Patterico's Pontifications

12/19/2009

The Perfect Health Care Storm

Filed under: Health Care,Politics — DRJ @ 10:47 pm



[Guest post by DRJ]

Why are Democrats jumping off the cliff for health care? Kimberly A. Strassel explained yesterday in the WSJ:

“So why the stubborn insistence on passing health reform? Think big. The liberal wing of the party—the Barney Franks, the David Obeys—are focused beyond November 2010, to the long-term political prize. They want a health-care program that inevitably leads to a value-added tax and a permanent welfare state. Big government then becomes fact, and another Ronald Reagan becomes impossible. See Continental Europe.

The entitlement crazes of the 1930s and 1960s also caused a backlash, but liberal Democrats know the programs of those periods survived. They are more than happy to sacrifice a few Blue Dogs, a Blanche Lincoln, a Michael Bennet, if they can expand government so that in the long run it benefits the party of government.”

Similarly, Prof. William Jacobson at Le-gal In-sur-rec-tion looks at what led to this Perfect Storm and at the rocky Road Ahead. I agree with Jacobson that it’s bad and also that we can’t give up. As Jacobson says, “this is the political fight of our lives for the future of the country.”

— DRJ

81 Responses to “The Perfect Health Care Storm”

  1. DRJ, I’m fairly certain that another reason the The Dems are also willing to jump off a cliff for this bill because it ensures taxpayer funds will go to pay for abortion for the first time. Sen. Nelson denies it, but the text of Reid’s “manager’s amendment” shows that Nelson is mistaken.

    http://www.redstate.com/andrewhyman/2009/12/19/the-sneaky-abortion-deception-in-senator-reids-managers-amendment-2/

    Andrew (59b742)

  2. That’s a good point, Andrew, but I’m not convinced that Sen. Nelson got snookered. I think he knew it was a sham, which is why he refused to let the Nebraska Right to Life folks read the abortion compromise language beforehand. All he wanted was a little plausible deniability plus some goodies to show the folks back home.

    DRJ (84a0c3)

  3. Well, if Senator Nelson wasn’t snookered, the American public is sure getting snookered.

    Patterico’s favorite rag says: “The breakthrough came after Senate Majority Leader Harry Reid (D-Nev.) and his lieutenants engineered a delicately crafted compromise to prevent federal funding of abortions….”

    It prevents no such thing.

    Andrew (59b742)

  4. The American public is getting the worst of this deal, that’s for sure.

    DRJ (84a0c3)

  5. It would be great if a lawyer like Patterico would expose this LA Times lie.

    Andrew (59b742)

  6. I’ve sent him the tip, Andrew, and we appreciate it.

    DRJ (84a0c3)

  7. at this rate, the Iranians won’t have to nuke DC: the scum there will have destroyed America for them.

    redc1c4 (fb8750)

  8. Great civilizations, throughout history, had imploded well before the barbarians stormed the walls.
    Why should this one be any different?

    AD - RtR/OS! (88245d)

  9. They’ve been obsessed with this goal for years and years now—I don’t remember just when it got started. I think it’s partly envy of the Brits for their “wonderful” NHS.

    Technomad (677f63)

  10. What has been passed can be repealed or watered down. Then, there’s always another Constitutional Convention of succession. Liberty will find a way.

    cedarhill (013a8c)

  11. Nelson just proved to be a more expensive hoo-er than Landrieau.

    JD (a5d4c8)

  12. Since Nelson is a man are we now allowed to call him a “whore” without being accused of misogyny?

    bill (0d4ddf)

  13. #9, said, “I don’t remember just when it got started.”

    First time I encountered it was back in 1974. A girl active in college level student politics, and daughter of activist Democrat parents, started talking up healthcare. She ran it up the flagpole, but had few takers, government healthcare sounded like something from the Soviet Union, and alien to American values. Still does if you ask me.

    ropelight (a6c477)

  14. Um, looking around, the phrase “American Values” unfortunately is sounding more and more alien to me these days.

    I don’t know that the phrase means anything anymore, aside from some sort of wry nostalgia for what once was. I keep telling myself this too shall pass, that the prior generation said the same thing about what mine was doing in our political youth (my own driven opinions in my 20s and early 30s). But somehow it sure doesn’t feel that way.

    When the WSJ is publishing stories about how widespread “strategic mortgage defaults” are becoming, the governmental example is to spend money it doesn’t have and just raise the debt ceiling ad infinitum, and ‘recovery’ is judged by jobs ‘created or saved’ counted by pairs of shoes…this doesn’t seem at all to be just a case of generational schadenfreude at all.

    I strongly suspect our country ended a long time ago and we were too stupid to notice. Glued as we were to our American Idol and gimme-mentality American Makeover feelgood shows….

    rtrski (47b90a)

  15. So here’s an interesting exercise (well, to me, anyway), maybe would make a good separate topic.

    Given that the US seems to be on the “precipice” (how adroit!) of becoming the next European socialist shrinking economy, IF you could pick up and move your job and family to anywhere else in the world….where is there to go?

    Did this a while back brainstorming with the wife. The best idea we had was New Zealand, but they’re not exactly hugely conservative, either. At least they welcome immigrants (have an active recruitment campaign even for certain specialties), but the taxes wouldn’t be any lower than what I think we’re facing within this administration’s term.

    rtrski (47b90a)

  16. “First time I encountered it was back in 1974.”

    Ronald Reagan cut a record against Medicare in 1961. Paid for by the AMA. He said it would lead to a socialist dictatorship. Now the GOP whines against medicare cuts. When not proposing their own.

    imdw (017d51)

  17. That was impressive array of canards, lies, and misrepresentations, iamadimwit.

    JD (a5d4c8)

  18. You can go listen to it on Youtube. If you’re bored with today and want to hear wingnut panic from 50 years ago. Let us know if it sounds like a broken record.

    imdw (6951c3)

  19. What has been passed can be repealed or watered down.

    cedarhill, can you think of a single big-government program that has been repealed, watered down, or even slightly reduced in the last 80 years?

    Some chump (7d157e)

  20. Reagan reformed the tax code in 1986? 😉

    nk (df76d4)

  21. […] bad laws are just as bad as big ones By datechguy A lot of the right (and some of the left) is outraged over the impending passage of the heath care bill it […]

    Small bad laws are just as bad as big ones « DaTechguy's Blog (e2a3c0)

  22. And then there is one too far …

    bill-tb (541ea9)

  23. The Obama administration and this Congress are demonstrating contempt for the US Constitution, rule of law, private property, due process, personal privacy, for the offices they hold and for the American People in general. Before we take up arms to oppose this tyranny, we should look at serious civil actions that will make their lives hell on earth.

    1. Reduce your federal income tax withholding to the legal minimum.

    2. Flood your Senators’ and representative’s offices with snail mail, email and telephone complaints. Each member of your household should register one every day.

    3. Write your doctor and tell him you will not approve releasing your health records to any government agency without your express written authority.

    4. If you own any T-bills, dump them immediately.

    5. Attend the next Tea Party in your area. Volunteer your time.

    6. Using cash, buy at one shotgun, one centerfire rifle and one centerfire pistol per person. Do not register for a warranty or use a credit of debit card the record of which could trace it back to you. Stockpile 500 rounds of rifle and shotgun and 1,000 rounds of pistol ammunition. When you shoot, always collect your brass and hulls. Set up to reload and buy up components, especially pistol primers. Practice shooting at human silhouette targets. Do not disclose the ownership of any firearm.

    7. Vote in every primary and every election until these criminals are out of office, in prison or dead.

    arch (24f4f2)

  24. Ronald Reagan cut a record against Medicare in 1961. Paid for by the AMA.

    I’m reluctant to reply to this twit but the propaganda of the left seems to have been successful in airbrushing the facts of the Medicare debate from history. The AMA supported a program called “Eldercare” which would have supplied basic healthcare to the poor but would not have been the financial disaster of Medicare. Medicare distorted all health insurance by creating an incentive for first dollar coverage. Before Medicare, insurance covered unexpected events, insurable events. Doctors drove Chevys. After Medicare, the cost curve became unsustainable and doctors drove Mercedes for a couple of decades. I watched this happen and debated the pediatricians who wanted well baby care covered by insurance. I lost those debates and we have now lost the war. Fortunately, I will be 72 soon and will not have to live with the results for long.

    Mike K (2cf494)

  25. I totally agree. People say Obama is nuts to gamble his second term on this monstrosity, but what does he care, the Dems will control most of the economy after it passes! The hundreds of boards and commissions will be stacked with his peeps, and their bureaucracy will live on, outliving and out maneuvering any mere president.

    Did Reagan disband the Department of Education or Energy? No. RINOS loved the power just as much as the Carter did.

    Van Jones will control more of your life than your local congressman.

    Patricia (b05e7f)

  26. I recall in one debate last year, Obama was trying to say what he like about American and his response was that what he liked was what it could be.

    Well, here we are American. We’re Europe!

    And let’s have a standing ovation for Hugo Chavez while we’re at it.

    You voted for change. Hey, that is a great idea for a bumper sticker: You voted for change.

    Alta Bob (e8af2b)

  27. See Continental Europe.

    An abundance of limousine liberalism seems to be encoded into the way a civilization — or certainly late-20th-century, early-21st-century Western civilization — changes through the years.

    It would be nice to think we in the US were exceptional, but I observe the way that large portions of “sophisticated” America are devolving, particularly areas like the Atlantic Seaboard and California, and there’s no reason the specter of “Continental Europe” isn’t in this nation’s future.

    One difference, however, is that the Europeans are being, and will be, impacted by the demographics of Islamic-ization, while the US is being, and will be, impacted by the demographics of Latino-ization.

    So we’ll end up with the worst of both worlds, both politically and culturally. And all the limousine liberals throughout modern society will be required to really ratchet up their phony compassion, their do-as-I-say-not-what-I-do doublespeak and ton of hypocrisy.

    Mark (411533)

  28. Doctors drove Chevys.

    That’s an interesting observation, because I know you’ve stated for quite awhile that this country should adopt a healthcare plan similar to the one used by France. And when reading up on the situation in that country, there was one statistic that surprised me: The average French doctor makes about $50,000 a year—of course, he or she also has had tuition for medical education picked up by the government, so the burden for doctors in that society is diminished from the outset.

    Mark (411533)

  29. Mark, a lot of French doctors live in villages where the cost of living is nothing like Paris or Cannes. A friend if mine, a chief of surgery at a local medical school, told me that he could get board certified, fellowship trained in a subspecialty surgeons for $60,000 per year.

    My niece, who has two degrees from major universities in Illinois, declined to apply for medical school because she didn’t want the debt. She became a nurse and makes about 75% of what she would make as an MD. She was going to become a nurse practitioner, in which case she would make about 90% of MDs in the same field. She liked the operating room so has stayed there plus her rock band which is doing well.

    The golden age for physician’s incomes ended about a decade ago. There are still plenty making good incomes but they are mostly older and already established. Shortages in some specialties are now developing and may affect incomes but they will all be on salary.

    Mike K (2cf494)

  30. Problem being the Republicans have become as much a party of government as the Dems. They proved that from 1998 to 2006.

    glenn (757adc)

  31. We have this state of affairs because many of us weren’t paying attention. Those of us who were have been dismissed as cranks, greedy and stupid.

    We MUST take back Congress first, then oust the Senate over the next 6 years. We must elect men and women who will commit to dismantling all of this loathesome bureaucracy.

    It’s that or rebellion later.

    Repeal, Rebellion, Revolution. I’m not kidding.

    Vivian Louise (643333)

  32. I don’t think that millions of other like – minded Americans are kidding either, Vivian. This monstrosity will be used as a cudgel against any politico that voted for it – you can count on that, no question. I think it’s indicative that almost as soon as the local congresscritter here (Kirk) voted for the Cap and Trade, he started immediately running away from it when he announced his candidacy for the Senate.

    Dmac (a964d5)

  33. Doctors drove Chevys.

    C’mon Dr.Mike, that might be true out in the sticks of the OC in the Fifties, but over here in the Dairy Center of LACo, Doctors in private practice drove Buicks (a proper Doctors car – they even had, at one time, a model they called a Dr’s Coupe).

    AD - RtR/OS! (1217bb)

  34. Comment by Vivian Louise — 12/20/2009 @ 10:04 am

    There’s the Three Box Theory of Politics:
    First, the Soap Box;
    Then, the Ballot Box;
    Finally, the Bullet Box!

    AD - RtR/OS! (1217bb)

  35. I wish I was optimistic about people rising up and throwing out the crooks and rent seekers. The truth is most people are pretty passive and the kids coming out of college have been given the left’s version of reality for four or more years. I think what we may see is the loss of the social contract that caused the vast majority of Americans to pay their taxes and obey the laws. I can vaguely remember the black market of World War II. There was a lot of evasion of rationing. I think we will see a rapid growth of the grey economy and the black market. Theodore Dalrymple wrote a good essay on this a decade ago.

    MIke K (2cf494)

  36. A Nebraska Tragedy: The Selling of Ben Nelson Soul

    We are a simple people in Nebraska but do not misinterpret the term “simple” to mean dumb. Far from it.

    In Nebraska, we take you at what you say. We are not a people who likes parsing of words. We are not a people who likes shades of meaning. You say what you mean and you mean what you say and then you follow through on your words:

    “My vote is not for sale. Period.”
    Ben Nelson quoted in Lincoln Journal Star December 16, 2009

    I believe that we will find that as the days go on and Nebraskans statewide come to realize how Senator Nelson sold his vote and his soul to Liberals in Washington, the anger will only increase. Be assured America, we will clean up our own house . . .

    NebraskaPatriot (221944)

  37. fantasies about getting vetoproof majorities or getting both chambers and the white house back and repealing are harmful. Obamacare has to die now. Its not going to be repealed if passed. Now whats funny is with the way things are going the battle in the senate is probably lost, but i think we have the votes to defeat the bill in the house when the two bills are reconciled. Of course i may be wrong and by next year the country may be demanding obama change or resign or we’ll make him change or resign but i doubt the country is going to really go even farther in disgust with the majority party than it did in 2006.

    Chaos (7c068a)

  38. Its not going to be repealed if passed.

    How was Hawaii’s universal child health care program repealed?

    Michael Ejercito (6a1582)

  39. Ronald Reagan cut a record against Medicare in 1961. Paid for by the AMA. He said it would lead to a socialist dictatorship. Now the GOP whines against medicare cuts. When not proposing their own.

    The problem is that Medicare is too popular.

    What if it could be phased out, for example, restricting eligibility to those over the age of 65 and born before January 1, 2011? Will people still oppose that on principle, or just not care if it is adopted since it does not affect them?

    Michael Ejercito (6a1582)

  40. Chaos:

    All we need is a net 41 seats in the house. In 1994, the country was in much better shape and Newt picked up 53 seats. The White House and the Senate are powerless without funding. The House must initiate all appropriations. If the House does not fund it, it doesn’t happen.

    With our current deficits, justifying defunding Energy, Labor, Education, Homeland Security, HHS, NEA and FEMA would be a snap.

    arch (24f4f2)

  41. With our current deficits, justifying defunding Energy, Labor, Education, Homeland Security, HHS, NEA and FEMA would be a snap.

    But Obama would veto it and we would be back to a 1995 sort of stalemate between Congress and the White House.

    As much as I fear what could happen over the next three years, I almost think the GOP is better off not winning either branch of Congress in the midterm elections. If they can pick up 30 seats in the House and six or seven in the Senate, they could hopefully put the brakes on the Obamization of America and still be able to run strongly against Dear Leader, Nancy Pelosi, and Harry Reid in 2012.

    JVW (0fe413)

  42. michael: if you want to fantasize and use a flimsy foundation for it like they repealed somethin in hawaii feel free to do so, but it aint a gonna happen in dc. Never has yet. Dont let your hopes blind you. Bill needs to die now.
    also 41 seats isnt going to get it repealed. Id rather see the gop get to 47 or 48 in the senate and around 215 in the house and then blow the dems outta the water in 2012. I dont want this conservative resurgence to peak at the wrong election lol.

    Chaos (7c068a)

  43. They want a health-care program that inevitably leads to a value-added tax and a permanent welfare state.

    They do, of course. But I don’t think that this bill is that health-care program. In fact it seems like it was custom designed by Karl Rove to discredit the whole idea of government run healthcare.

    Subotai (5ac85c)

  44. Why are Democrats jumping off the cliff for health care?

    Some people are attributing evil genius to the things they do. I prefer to go with the old adage about never attributing to malice what is more easily explained by stupidity. Perhaps they are jumping off a cliff because they’re not very bright.

    Subotai (5ac85c)

  45. There are two items that work against the current healthcare plan, even if it passes now.
    !) the benefits don’t start until 2014
    2) this is debt beyond belief and …

    The United States cannot force foreign governments to increase their holdings of Treasuries,” Zhu said, according to an audio recording of his remarks. “Double the holdings? It is definitely impossible.”

    Neo (7830e6)

  46. Before Medicare, insurance covered unexpected events, insurable events. Mike K

    And what we call “insurance” today is little more than pre-paid medical care, and even that is usually paid for by someone else than the recipient.

    This bill goes further — it OUTLAWS actual medical insurance AKA “catastrophic coverage.” Because true insurance does not pay for routine care, it does not count as “insurance.” People who wish only to have catastrophic coverage will be taxed and penalized in an effort to coerce them to get full pre-paid medical.

    Kevin Murphy (3c3db0)

  47. How was Hawaii’s universal child health care program repealed?

    If Hawaii had access to Washington DC’s Dept of the Treasury’s printing presses it likely wouldn’t have repealed its program.

    The 50th state — not to mention Massachussetts — probably is the US in microcosm in the way that the economics and social trends of socialized healthcare will start unfolding throughout America—and note how the budgetary problems affecting Hawaii and its childhood healthcare program somewhat predate the height of the current recession:

    HONOLULU (AP), Oct 17, 2008 – Hawaii is dropping the only state universal child health care program in the country just seven months after it launched.

    Gov. Linda Lingle’s administration cited budget shortfalls and other available health care options for eliminating funding for the program. A state official said families were dropping private coverage so their children would be eligible for the subsidized plan.

    “People who were already able to afford health care began to stop paying for it so they could get it for free,” said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. “I don’t believe that was the intent of the program.”

    State officials said Thursday they will stop giving health coverage to the 2,000 children enrolled by Nov. 1, but private partner Hawaii Medical Service Association will pay to extend their coverage through the end of the year without government support.

    Hawaii lawmakers approved the health plan in 2007 as a way to ensure every child can get basic medical help. The Keiki (child) Care program aimed to cover every child from birth to 18 years old who didn’t already have health insurance—mostly immigrants and members of lower-income families.

    It costs the state about $50,000 per month, or $25.50 per child — an amount that was more than matched by HMSA.

    The Republican governor signed Keiki Care into law in 2007, but it and many other government services are facing cuts as the state deals with a projected $900 million general fund shortfall by 2011.

    The universal health care system was free except for copays of $7 per office visit.

    ^ An annual cost of $600,000, although it sounds modest by the standards of the huge and bloated bureaucracies of Sacramento or Albany, nonetheless swamped Hawaii’s state government. Moreover, the childhood healthcare program was another new entitlement approved, no less, by a Republican governor—someone who I suspect is not much less ideologically squishy than Schwarzenneger of Sacramento.

    Here’s the kicker: Hawaii doesn’t even have the huge and growing underclass that areas like California or Michigan, etc, have. When a society becomes more and more socialized, the only way that socialization won’t soon cause the total socioeconomic straitjacketing (or meltdown) of a society is if its demographics are very stable, very functional, very reliable.

    IOW, is the US’s population like a bigger version of Norway or Denmark, a bigger version of the cozy confines of the SF Bay Area, the upper east side of Manhattan, the Westside of Los Angeles?

    Uh, oh-oh.

    Mark (411533)

  48. People who wish only to have catastrophic coverage will be taxed and penalized in an effort to coerce them to get full pre-paid medical.

    Comment by Kevin Murphy

    I have been trying to tell people this for a while. I think what will happen, if it is not repealed, is that those who can afford it will go to doctors in cash practices for routine care and will be obliged to pay the taxes for the government system which only the poor will use. That may actually help keep costs down. It will be expensive for those who have to pay twice but we see that in Canada now.

    In England, a survey (I have a copy) of NHS members has 56% of them saying that it is so bad it should be abolished and they should start over. We may be obliged to go through ten years or so of misery until our people arrive at the same conclusion.

    The other possibility is that the reckless spending of the progressives will kill the bond market for treasuries. Then, there will be hell to pay. With all the gun owners in this country, we could have a revolution. We are not the passive English who get falling down drunk every night in the high streets of the Midlands towns. They have been conditioned by 50 years of welfare state. This has happened too fast here. There is still an institutional memory of freedom.

    Mike K (2cf494)

  49. Put it another way:

    If we were talking about car insurance, the Obama plan would be:

    1. All people, whether they drive or not, must have transportation insurance, covering all events that might happen while traveling or commuting.

    2. Such policies must cover mechanical repairs, gas, oil, towing, rental cars, and all other routine maintenance in addition to the old-style “liability and collision” coverage.

    3. No one will be required to pay more than 10% of their income for transportation, and the poor will not have to pay more than 2%.

    4. People convicted of drunk driving, young drivers and people with lots of tickets cannot be asked to pay more than 2 or 3 times the premium paid by drivers with spotless records and 20 years of experience.

    5. People who run their cars without water, oil or ignore other normal maintenance are still completely covered when it comes to repairs.

    6. In order to get the vote of several Senators, Hummers are not covered beginning next September 31st in Nebraska, full-serve gasoline is covered in Oregon, and people in Louisiana get free semi-annual car washes. Oh, and Chicago gets a new airport.

    6. People who don’t have approved coverage (e.g. only have liability and collision coverage), will be taxed/penalized for several thousand dollars.

    7. Taxes for this start immediately — but only on other people — and payouts start in 4 years. The 10 year cost for this is only $1 trazillion, but for some reason we are unable to calculate what the cost will be in year 11.

    And just try to get “free gasoline” repealed after gas goes to $15/gallon.

    Kevin Murphy (3c3db0)

  50. “for example, restricting eligibility to those over the age of 65 and born before January 1, 2011? Will people still oppose that on principle, or just not care if it is adopted since it does not affect them?”

    Not care
    that they must support a system they will never benefit from? It could never fly without tax money from all of us. And I assume you mean to terminate Medicare for everyone on Social Security Disability as well? OK with me but that’s become a safety net for the drug-addled & morbidly obese, among others.

    cassandra in MT (570a42)

  51. a lot of French doctors live in villages where the cost of living is nothing like Paris or Cannes. A friend if mine, a chief of surgery at a local medical school, told me that he could get board certified, fellowship trained in a subspecialty surgeons for $60,000 per year. Comment by Mike K — 12/20/2009 @ 9:44 am

    Since you’ve been in the medical field, and since I trust your political instincts in general — and since I don’t want to be guilty of putting dogma before reality — when I see things you’ve been saying about the French medical system and, even more so, read things like the following, I do admit to becoming ideologically, well, squishy.

    Then again, I’m very aware of the long history of the King-Drew Medical Center in South-Central LA, the mess of socialized healthcare in Britain, the fact that the French healthcare system now is reported as running a large deficit. So the big question is where is the heart of the matter, the core of the ultimate truth?

    USA Today, 9/1/2009

    MEXICO CITY — It sounds almost too good to be true: a health care plan with no limits, no deductibles, free medicines, tests, X-rays, eyeglasses, even dental work — all for a flat fee of $250 or less a year. To get it, you just have to move to Mexico.

    As the United States debates an overhaul of its health care system, thousands of American retirees in Mexico have quietly found a solution of their own, signing up for the health care plan run by the Mexican Social Security Institute.

    The system has flaws, the facilities aren’t cutting-edge, and the deal may not last long because the Mexican government said in a recent report that it is “notorious” for losing money. But for now, retirees say they’re getting a bargain.

    “It was one of the primary reasons I moved here,” said Judy Harvey of Prescott Valley, who now lives in Alamos, Sonora. “I couldn’t afford health care in the United States. …To me, this is the best system that there is.”

    It’s unclear how many Americans use IMSS, but with between 40,000 and 80,000 U.S. retirees living in Mexico, the number probably runs “well into the thousands,” said David Warner, a public policy professor at the University of Texas.

    “They take very good care of us,” said Jessica Moyal, 59, of Hollywood, Fla., who now lives in San Miguel de Allende, Mexico, a popular retirement enclave for Americans.

    The IMSS plan is primarily designed to support Mexican taxpayers who have been paying into the system for decades, and officials say they don’t want to be overrun by bargain-hunting foreigners.

    “If they started flooding down here for this, it wouldn’t be sustainable,” said Javier Lopez Ortiz, IMSS director in San Miguel de Allende.

    Pre-existing conditions aren’t covered for the first two years, and some newer medicines and implants are not free. IMSS hospitals don’t have frills such as televisions or in-room phones, and they often require patients to bring family members to help with bathing and other non-medical tasks. Most doctors and nurses speak only Spanish, and Mexico’s overloaded court system doesn’t provide much recourse if something goes wrong.

    But the medical care doesn’t cost a dime after paying the annual fee, and it is usually good, retirees and health experts say. Warner said most American retirees enroll in IMSS as a form of cheap insurance against medical emergencies, while using private doctors or traveling back to the USA for less urgent care. Medicare, the U.S. insurance plan for retirees, cannot be used outside the United States.

    The IMSS system is similar to an HMO in the United States, Jemmy Miller said. Patients are assigned a primary care physician and given a passport-size ID booklet that includes records of appointments. The doctor can refer patients to specialists, a bigger hospital or one of the IMSS specialty hospitals in cities such as Guadalajara or Mexico City.

    In 2007, Ron Miller got appendicitis and had emergency surgery at the local IMSS hospital. He was in the hospital for about a week and had a double room to himself. The food was good, the nurses were attentive, and doctors stopped by three or four times a day to check on him, he said. At the end of it all, there was no bill, just an entry in the ID booklet.

    The Millers may soon move back to the United States, but Jemmy Miller said they want to try to maintain the IMSS coverage. “If something big really comes up, we’d probably come back to Mexico,” she said.

    IMSS is one of several public health systems in Mexico, each with its own network of hospitals and clinics. The program, which was founded in 1943, is funded by a combination of payroll deductions, employer contributions and government funds. It covers 50.8 million workers.

    IMSS facilities are a step up from the state hospitals, but not as advanced as Mexico’s private hospitals, which are often world-class, said Curtis Page, a Tempe, Ariz., doctor and co-author of a book about health care in Mexico.

    Most patients seem grateful nonetheless. When Michael Kirkpatrick, 63, of Austin, fell off his motorcycle near his home in San Miguel de Allende, IMSS surgeons gave him a stainless-steel artificial hip.

    There was no physical rehabilitation after the surgery, just a checkup a few weeks later.

    “There was not the kind of follow-through and therapy that you would expect if you were doing this in the first world,” Kirkpatrick said. “But it was satisfactory. The hip feels good.”

    Bob Story, 75, of St. Louis, had prostate-reduction surgery at an IMSS hospital in Mazatlán and discovered that patients were expected to bring their own pillows. It was a small price to pay, he said, for a surgery that would have cost thousands of dollars back home.

    “I would say it’s better than any health plan I’ve had in the States,” he said.

    Mark (411533)

  52. I talked to a doctor who just finished medical school in Germany and she said that she had opted not to join a practice that was paid for by the German government.

    She said that if she worked for the German equivalent of the UK’s NHS, then they only had time to spend a couple minutes with each patient if they wanted to make a decent salary.

    Instead, she opted to join a fee-for-service practice more along the lines of US medical practices. She said that since most Germans don’t have private insurance, it would be rough going, but she would be able to spend more time with each patient and get compensated appropriately.

    Also, people I know in the UK will only work for companies that offer private insurance, so that they can go to doctors and hospitals that are NOT part of the NHS system.

    The Dems are trying to sell us on systems that are not better than what we currently have.

    JHTRazor (a1f2bc)

  53. rtrski wrote: , IF you could pick up and move your job and family to anywhere else in the world….where is there to go?

    I’ve thought of the same interesting exercise, from the perspective of “Where can we send thoroughly disgusted conservatives who think a tentative step toward providing universal coverage through the same private insurers we have now represents the end of America?”

    Well, Canada is obviously out, since their system is straight-up government-run. As Sarah Palin found out recently, your right-wing views on their health care system are not necessarily welcome there:

    http://www.theglobeandmail.com/news/national/toronto/hospitals-no-longer-want-palin-on-their-ticket/article1406355/

    In fact, all western nations and just about every other developed nation is out, since they all have versions of universal care, most of them heavily funded by the government.

    You mentioned New Zealand, but why, rtr? I don’t think you’ll feel too at home there, either. Check this out, from Wikipedia. I’ve helpfully put in bold some parts I’m sure you’ll find terrifying:

    In New Zealand hospitals are public and treat citizens or permanent residents free of charge and are managed by District Health Boards*. Under the Labour coalition governments (1999 – 2008), there were plans to make primary health care available free of charge. At present government subsidies exist in health care. This system is funded by taxes. The New Zealand government agency PHARMAC subsidizes certain pharmaceuticals depending upon their category. Co-payments exist, however these are ignored if the user has a community health services card or high user health card. In 2005, New Zealand spent 8.9% of GDP on health care, or US$2,403 per capita. Of that, approximately 77% was government expenditure.[18]

    (*District Health Boards = Death Panels in right-wing vernacular)

    On the issue of health care, conservative Americans are to the right of conservatives everywhere else in the west. To find a non-universal and/or non-public system, you may have to start looking for comfortable environs in the Third World, and even some of those, such as Cuba, have universal plans.

    In other words, good luck in your quest and Godspeed. 🙂

    Myron (998393)

  54. It will be hilarious to see Democrats celebrate the passage of whatever frankenstein bill finally gets past the Senate and the House … assuming one does.

    This is because all of the reasons that Democrats have claimed we need this bill are not in fact accomplished. The recent versions do not cover all Americans, and not only do not reduce costs but will drive costs higher.

    All at the cost of destroying our nation’s finances.

    Yep, pretty hilarious work Democrats.

    SPQR (26be8b)

  55. what’s most shameful about what the dems are doing is they know theyre trying to spend trillions and at the end of the day it will still leave up to 25 million americans uninsured. They say this must be passed because so many people are uninsured or cant afford to keep their insurance much longer and their “solution” will still leave millions uninsured. Its ridiculous.

    Chaos (7c068a)

  56. JVW:

    The House can zero out the budget. The President can veto it, but they still have the authority to fund or not to fund. The President cannot force the House to appropriate anything. A Veto would still leave him without funding.

    arch (24f4f2)

  57. but at least barry o will have his place in history! A shame harry reid wont be around to enjoy it as long as “i couldnt lose reelection if they had me on tape eating babies” pelosi and “i won” barry o will.

    Chaos (7c068a)

  58. arch that is the theory but ever since lincoln presidents in practice can and have appropriated funds without congressional oversight or approval. Thankfully theyve recognized the implications of abusing that abuse of power too much but theyve still done it far too often.

    Chaos (7c068a)

  59. Chaos: Of the remaining uninsured, one-third are illegal immigrants. I’m sure if the GOP wanted to reach across the aisle to push for insuring these folks, the Dems would take them up on it. What do you think?

    On major pieces of legislation like this, you have to take what you can get initially, then work to improve them. The uninsured rises from 83 to 94 percent under this bill. That’s significant.

    Coverage will be universal one day, despite GOP opposition. Just sit tight.

    Myron (998393)

  60. Chaos:

    Funny you should mention “eating babies.” The reason Obama hates the British is that his grandfather was an elder in the Luo tribe in Kenya in the 1950. The Luo and one other began an anti-white insurrection called Mau-Mau. To drive out the whites bands of 40 or so tribesmen would surround an isolated white owned farm, attack with machetes, killing everyone there before burning the compound. Everyone, that is except the babies and toddlers, who were taken back to the Mau-Mau villages, cooked and eaten.

    It seems that the British Army thought this behavior was unacceptable and rounded up the Luo perps. The treatment was somewhat harsher than water boarding.

    Even today in BP Britain, eating English babies is frowned upon.

    Perhaps in their future vetting process, the DNC should ask if anyone in the candidate’s family had practiced cannibalism. Just a thought.

    arch (24f4f2)

  61. Yo Myro baby, which part of “on the precipice of becoming the next European socialist shrinking economy” did you take to be SOLEY about health-care? Sure, that’s a major part of it. But not even nearly the scope of the source of my recent ‘disgust’, as the preceding post of mine clearly showed.

    From the viewpoint of a ‘disgusted conserative’ I see your reading comprehension is up there with all the other prematurely jubilant liberals. You’ve used as much comprehension understanding my post(s) as you have this bill which just “takes a tentative step toward providing universal coverage”. Sounds like apropos yield for the costs we’ll all be seeing…and long before any of the plan actually phases ‘in’ on the output side.

    Anyway, it’s just an exercise, not any sort of ‘threat’ like the typical Baldwinite/Streisandish “I’ll move if ____ gets elected!” stridency. And there were ulterior motives in maybe looking @ NZ…another criterion of our discussion was close to good scuba diving. Yes, NZ has health care, and their taxes are higher because of it. Of course, from other research I’ve done they also get what they pay for…this plan isn’t even likely to come CLOSE to compensating me in additional/better care for the proposed additional costs I’ll be seeing.

    Feel free to tell me once again how benighted my opinion is. That ALWAYS makes people more interested in hearing yours. And if you want to pull a Maureen Dowd on me and hear a subtext, you’re perfectly right, the last word of the preceding sentence in my head was “…, prick.”

    rtrski (47b90a)

  62. Chaos:

    “[E]ver since lincoln presidents in practice can and have appropriated funds without congressional oversight or approval.”

    I don’t know of a single instance. Presidents have reprogrammed funds appropriated for another purpose, but even that required some congressional approval.

    I had a DoD range program with a $24M authorization and a $36M cost. We identified a source of USAF funding but could not proceed. The 4-stars were kicked out of Barry Goldwater’s office and we had to report.

    Senator Goldwater asked the program manager, “How did you wind up with a $36M program and a $24M budget?”

    “We screwed up, sir,” he answered. Goldwater smiled, signed off on the request and laughed.

    “That’s the right answer, son. We screw up up here too.”

    We thanked him, took the money and left.

    Approved budgets give the authority to plan and program, but nothing is spent without an appropriation.

    arch (24f4f2)

  63. “…The uninsured rises from 83 to 94 percent under this bill…”

    Well, that doesn’t seem to be so Progressive?

    AD - RtR/OS! (1217bb)

  64. “Funny you should mention “eating babies.” The reason Obama hates the British is that his grandfather was an elder in the Luo tribe in Kenya in the 1950”

    You know it’s going to get good and wingnut when it starts like this.

    imdw (c660ef)

  65. imdw is projecting again. Do some research for once.

    arch (24f4f2)

  66. Mark, I used to know a lot about the Mexican healthcare system but I’m out of date. At one time, a group of us wanted to build a new city hospital for Ensenada as the old one did not even have a defibrillator. We got one from the dog lab at Children’s Hospital and donated it. The hospital pharmacy did not have drugs. The doctor wrote a prescription and the family took it to a pharmacy where it was filled, then they brought to drugs back to the hospital where they were doled out.

    At that time, Social Security covered about 25% of the population, a small share used the private hospitals and the rest were out of luck or used the city hospitals.

    It looks like Social Security covers a larger share now than it did when I was dealing with it.

    A story about the private hospitals;

    A friend injured his neck body surfing in Mazatlan. He had a brief period of paralysis from the neck down and almost drowned. Two friends (they were all three physicians) dragged him out and they went back to their hotel room at the beach club. Pretty soon he felt better and a couple of codeines, plus a couple of margaritas convinced him that he could go to a party that night at the yacht club.

    At the party, he fell down and couldn’t move. A group of us put him on a board and took him to a private hospital in a station wagon. Two of us and our wives followed the station wagon and arrived a few minutes later.

    He was alone in the hospital room. Still drunk, I might add. Anyway, there was no doctor and the next morning when the doctor showed up and ordered an x-ray, he and a friend had to go to a radiology office in a taxi to get it taken. Fortunately, except for some cervical arthritis, he was OK.

    That was Mexican private care 30 years ago. I don’t know how it is now.

    Moron has uninformed opinions, as usual, about New Zealand health care. I do know about Australian. In 1987, the Labour Party convinced the public that they would provide free health care. They won the election and proceeded to dismantle one of the best health care systems in the world. Before that election, hospitals were owned by the state and the public paid into a system called Medicare to pay for doctors. It was quite modest in cost and everyone liked it, including the doctors.

    After the election, people just stopped paying their Medicare. The result was a crisis as there was no way to pay doctors. The Labour government had made no provision. They eventually worked it out but the system is much worse except in Queensland.

    Queensland is the most conservative state. There the doctors had built private hospitals so they were not dependent on the state hospitals to care for patients. They told their patients that they had better keep up Medicare payments or they would have to go to the public hospitals. That mean that private care continued there and it has the best quality in Australia. Two friends of mine were running a private day surgery (what we would call a surgery center) and doing quite well. The public hospital opened one across the street from theirs and made such a hash of running it that, about the time I was there last, they asked my friends to take it over and run it for them.

    One of those friends is the guy whose girlfriend, a wealthy cattle station owner in the Outback, was detained by US customs for giving her occupation as “retired.” She owned about 100 square miles of land at the time.

    Mike K (2cf494)

  67. Mike K:

    Why wouldn’t highly skilled, expensive doctors in the US simply move offshore and practice on a cash basis? Obama can nationalize hospitals and insurance companies, but doctors can vote with their feet.

    The Left’s assault on America could do great harm even if ultimately it is unsuccessful.

    arch (24f4f2)

  68. “Why wouldn’t highly skilled, expensive doctors in the US simply move offshore and practice on a cash basis? ”

    Why not just work on a cash basis here?

    imdw (e66d8d)

  69. imdw:

    Government regulation, price controls, paperwork, junk lawsuits.

    Still having trouble with your research on the Mau-Mau?

    The British media had much more graphic accounts, but read what Time had to say 13 June 1960:

    http://www.time.com/time/magazine/article/0,9171,940578,00.html

    arch (24f4f2)

  70. “Government regulation, price controls, paperwork, junk lawsuits.”

    What price controls or paperwork are there on docs that work on a cash basis?

    “Still having trouble with your research on the Mau-Mau?”

    Oh it’s the obama connection that was lovely. Mau mau away!

    imdw (6eb217)

  71. arch, the point I’ve been making is that they are doing this now. I have some more detail in a post from last summer. This is going on now. It’s possible that, when the system collapses in a year or two, Obama might try to make private practice illegal. They did that in Canada but clinics are opening all over Canada now in defiance of the law.

    Mike K (2cf494)

  72. Mark,
    The trouble with Mexico’s system is that it goes bankrupt when too many people use it–as it appears is happening with the new patients from the U.S.

    In response to arch, I think that doctors will go offshore or to Mexico to practice medicine for things like elective surgery, etc., to avoid government interference.

    Patricia (b05e7f)

  73. Actually, Mike K., I think that there was a recent court decision from the highest court in Canada that ruled that prohibiting private practice was not consistent with Canada’s Charter.

    SPQR (26be8b)

  74. This petition has been floating around my extended family for a couple of days on this healthcare bill. Thought it interesting a concept. Goose and gander angle and all. Despite my agnostic ways, I decided without hesitation to put my name on the thing.

    HR 615

    On Tuesday, the Senate health committee voted 12-11 in favor of a two-page amendment, courtesy of Republican Tom Coburn which would require all Members of Congress and their staff members to enroll in any new government-run health plan.

    Congressman John Fleming has proposed an amendment that would require Congressmen and Senators to take the same health care plan that
    they would force on us. (Under proposed legislation they are exempt.)

    Congressman Fleming is encouraging people to go to his Website and sign his petition. The process is very simple. I have done just that
    at: http://fleming.house.gov/index.html

    Fleming’s site the quicker way

    political agnostic (62a956)

  75. “Congressman John Fleming has proposed an amendment that would require Congressmen and Senators to take the same health care plan that
    they would force on us.”

    Congressmen choose their plans from ones in an exchange subsidized by the government. This is different than the health care bill because….

    imdw (e6c812)

  76. The entitlement crazes of the 1930s and 1960s also caused a backlash

    I’m not a student of history, but my impression is that the biggest new programs, i.e. Social Security and Medicare, were popular when they were passed. So the parallel is not clear.

    What is likely is when/if the Repubs regain control of the White House and Congress, they will fail to repeal it. They may not even try, especially if it happens will into the future. There’s also a question of when they’ll regain control. From that point people who wanted it repealed and voted Repub for that reason may go away.

    Gerald A (a66d02)

  77. Well, under Shariah all of this will be meaningless.

    AD - RtR/OS! (ade0a9)

  78. Actually, Mike K., I think that there was a recent court decision from the highest court in Canada that ruled that prohibiting private practice was not consistent with Canada’s Charter.

    Comment by SPQR

    What she did was to rule that a “health care program” was not the same as health care. The clinics are using that as justification but they could be challenged. So far not.

    Doctors who do private practice are banned from the government plan, which in the past was enough to keep them south of the border. I know a bunch of Canadian docs who left in the 80s.

    Canada also cut medical and nursing school enrollment and stopped building hospitals. I was at a meeting two years ago with an architect who was designing the first new hospital to be built in Canada since the 80s.

    Mike K (2cf494)

  79. Now would be the time to find some remote acreage and start planning for a cemetary…
    A lot of people will be dying a lot earlier than usual…it’s a growth field.

    AD - RtR/OS! (ade0a9)

  80. Misinformation has spread rampantly about Hawai‘i’s Keiki Care program. Rollover from the HMSA Children’s Plan was a ONE TIME event when Keiki Care started. After that most kids were required to be uninsured at least six consecutive months. The plan had limited benefits and out-of-pocket expenses which also discouraged parents from dropping private health insurance. Outreach was for the small targeted “gap group” kids and approximately 40 were enrolling per month.

    For those who don’t philosophically believe we should cover all kids with health insurance the same as we cover all seniors through Medicare, think about where your tax dollars should be wisely spent: inexpensive children’s health insurance programs or bailing out hospitals for uncompensated health care. In 2008 there were 3,302 total number of visits to hospital rooms by uninsured kids in Hawai‘i. The average hospital bill was $1,346 for a total of $4.4 million.

    Go 4 Health (fffbdd)

  81. The Art Of War…

    …A post I read a while ago over at…

    The Art Of War (e57ed5)


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