The American Spectator : Is It a Right or Isn't It?

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Is It a Right or Isn’t It?

By Ross Kaminsky on 12.29.10 @ 6:08AM

We’re finding out that health care is an Obama-granted “right” until such time that his panels pull the plug on it.

In an October, 2008 debate against John McCain, Barack Obama said that health care “should be a right for every American.”

In rights parlance, his assertion is one of a “positive right” meaning that others may be compelled to provide a person’s health care. This is distinguished from essentially every right laid out for Americans in our Constitution: these are “negative rights,” meaning that they proscribe others from inhibiting you from exercising your right but do not otherwise require active cooperation of others. Your right to free speech does not require others to help you breathe; it simply requires them to leave you alone (except in a few very specific circumstances where your speech is likely to cause imminent harm to others, thus infringing on their negative right not to be killed, beaten, or robbed).

On the other hand, if health care is a right, that means that an American who for whatever reason does not have access to a doctor must be provided that access, whether that means redistributing taxpayer money to the would-be patient or even the potential of forcing a doctor to provide his services in an area “underserved” by health care professionals.

The problem with Obama’s positive right formulation — as with all positive rights — is that one never knows where such a right ends, if or when such a right might be curtailed when it conflicts with citizens’ other (usually negative) rights.

Those who argue that perhaps our foundational (and negative) American right to the pursuit of happiness is infringed upon by the government’s taking money earned presumably “according to our ability” and distributed presumably “according to our need” are called heartless and told that our policy suggestions will lead to children starving in the streets. Conservatives and libertarians have never figured out how to counter such heart-rending arguments — even if the arguments are utterly belied by real-world outcomes, such as the 1996 welfare reform bill signed by a reluctant Bill Clinton (who now proudly claims that legislation as one of his great achievements).

In the modern welfare state, the asserted positive right seems always to win; in particular, there seems to be no limit to the amount of a “rich” person’s money the left is willing to redistribute in order to fund America’s own socialism-lite, pleasantly rephrased “the safety net.”

Indeed, why should there be a limit if welfare or a retirement income or health care is a right?

But at some point, even the charitable and constitutionally illiterate American populace pushes back on the cost of these so-called rights. With trillion-plus-dollar budget deficits as far as the eye can see, we’ve reached that point in America and the government is now looking for ways to curtail the cost of the latest created right, the so-called right to health care. And when looking to contain costs, it only makes sense to look where government’s costs are highest: in the last year of a person’s life.

Studies have shown that the percentage of Medicare spending for people in the last year of their lives has been in a narrow range just under 30% for several decades, with about 5% of Medicare patients dying each year.

Chief of the Centers for Medicare and Medicaid Services, Dr. Donald Berwick, a health care socialist who idolizes the British National Health Service — that’s the group who will only treat macular degeneration in one eye because it’s better for a person to go blind in one eye than for the government to spend another £1,500 to save both eyes — is on record saying that health care must and will be rationed. In that vein, and despite a similar provision being removed from the Obamacare bill during debate in the Senate with cries of “death panels,” Berwick has issued a rule allowing reimbursement to doctors for end-of-life planning.

Of course, the only way such planning will save money is if the plan calls for grandma to die a little sooner. (Take that, former Congressman Alan Grayson.) And suddenly, liberals come face to face with the contradiction, or at least unsustainability, of their assertion of health care as a right.

After all, if it is a right, shouldn’t Grandma Smith be entitled to as much of the Jones’ and Jacksons’ money as necessary to keep her alive for as long as she wants to and can have a pulse in her heart, a breath in her lungs?

The big-picture problem for the left is that in the context of government-run health care Berwick’s rule is not only sensible, but it’s the only possible outcome. This leaves proponents of a “right” in the uncomfortable position of having to say that it’s only a right up to a certain age, a certain degree of sickness, or a certain cost.

Yet, if a “right” ends at an arbitrary point set by bureaucrats and legislators — a point not based on conflict with other rights but rather with changeable financial or political considerations — then it can’t be a right. Furthermore, if a positive right such as that claimed by supporters of Obamacare can be curtailed because of cost, then every government program that relies on the redistribution of wealth can be curtailed. Either they’re all “rights” or none of them is.

Of course, the idea that government, with an incentive to “control costs,” would be involved with end-of-life counseling is disturbing enough. But perhaps the biggest problem for Progressivism in the news of Berwick’s giant step toward health care rationing is that the country is learning in an unmistakable way that the emperor has no clothes. In our constitutional republic, positive rights are anathema to liberty and to life itself.

About the Author

Ross Kaminsky is a self-employed trader and investor and is a senior fellow of the Heartland Institute. He is the host of The Ross Kaminsky Show on Denver’s NewsRadio 850 KOA at 11 AM on most Sundays. You can reach Ross by e-mail at rossputin(at)rossputin(dot)com.

Letter to the Editor View all comments (269) | Leave a comment Leave a comment

Ken (Old Texican)| 12.29.10 @ 7:00AM

Ross,
(heh, I'm up really early today aren't I?)

You know, those "rights" things in our unique social contract as Americans are declared in no uncertain terms to being "endowed by our Creator".
Everything added is merely a government puppet-string.
The people spoke very loudly at the tea-parties, town-halls, and finally at the ballot box.

One of our brighter conversationlists here used a sentence that I shall not forget. It is absolutely elegant in its simplicty:
"We the people have only three boxes; the soap-box, the ballot box, and our bullet-box."

The next few months are going to demonstrate if the first two boxes are sufficient any longer.

I pray earnestly that they are.
Check out my new E-novel at www.texassaidno.com

Ken (Old Texican)| 12.29.10 @ 7:06AM

OOPS!
I forgot. We do have one other box to stand on; our money-box. A widespread sit-down strike thus deferring our income-(taxes), combined with our withdrawal of savings accounts and even excesses in our checking accounts, will put a severe crunch on the communists, (pardon the shorthand).

Franco| 12.29.10 @ 12:51PM

Bullets also come in jars.

I saw a youtube video clip of a guy demonstrating one of Browning's pump-action .22LR's. He had a huge jar filled to the brim with .22 LR cartridges.

Very impressive.

Freedom Lover| 12.29.10 @ 9:23PM

Texican, please define communist.

Ken (Old Texican)| 12.30.10 @ 9:58AM

Freedom Lover,
If you don't know all the words and all of the euphemisms by now, I can't help you.
Sorry.

Dave | 12.29.10 @ 4:02PM

Not sure which American history page many linkers reading this site have missed - but after the dung begins absorbing the federally mandated Obamacare mandates (like Social Security and the Federal Income Tax) all will be yet another of the mind-numbing, soon-to-be- social failing of the pro Nazi Socialist Government entitlement scams.

Not true. Trotsky? Well, the always unanswered question remains: "Where on this planet has it ever worked ... before?"

For the continuailly brain dead- numbs nutz attempting to analyze this post -- I won't hold my breath for an answer. In the end, the RINO keister supporters who'll cast yet another ballot in the Liberals' ballot box will show you (ultimatley) all you'll need to know regarding the term --- "SELF DESTRUCTION.

Or as that ol' '70s dectective to say - "'Dat's da' name 'o 'dat tune."

At the end of this rant (and next 24 months) -- there'll still be enough RINOS around to push and pulls the socialists toward the finish line. When the Leftist fruit begins to (prematurely) bloom -- the last American stink fan will have already .... jammed.

Not true? Well, when's the last time you read a history book and enlightened yourself with ... those initial government propositions called The Federal Income Tax, Social Security and ... the U.S Post Office? And I won't even mention the DMV.

Oh, yeah ... it's all gonna work out juuuust fine.

At Disney World.

Freedom Lover| 12.29.10 @ 9:10PM

Please think and stop praying.

Jack London| 12.29.10 @ 7:12AM

Yawn... another dishonest, fact free article. How many times can the far right spin the same lies?

Just take: 'Of course, the only way such planning will save money is if the plan calls for grandma to die a little sooner.'

Er no - there is growing evidence that less aggressive care can lead to longer life of higher quality. And of course to the whole premise of this stupid article is that more treatment is always better, when we know that huge amounts of completely wasteful 'care' is expended in the final weeks and months of life, while a huge amount of waste is also expended in unnecessary diagnostics and treatment in those not terminally ill.

The word 'rationing' is loaded but it shouldn't be - you can ration on the basis of cutting out waste.

In short, there is no conflict between a right to a higher standard of care and lower costs, given the billions we chuck away each year now on nothing except to fund doctors' club memberships.

Jack London| 12.29.10 @ 7:22AM

By the by I see that 'Ross Kaminsky is a professional derivatives trader' - clearly an expert on healthcare of course. A better title would be 'Ross Kaminsky is a professional drivel trader'.

Steve A| 12.29.10 @ 11:05AM

Hey Jack, Good thing we have uberexperts Obama & Pelosi with all of their vast health care industry experience to guide us.

Thekingprawn| 12.29.10 @ 1:13PM

Jack,
If you're gonna attempt to discredit what he says by attacking his profession then be prepared to credential up to support your core arguments against his statements lest we turn your own weapon against you. The other option is to step off and stop trolling.

Negro X| 12.29.10 @ 5:25PM

Jack, here is something to ponder.
" You can lead a liberal to logic but you can't make him think".

Ol' Will| 1.3.11 @ 4:36PM

Jack London was a pirate, wasn't he? Maybe that's why liberals love him so much.

Angry Infidel| 12.29.10 @ 7:45AM

Jack, great example of progressive non-critical-thinking ignorance. You belong on the site's left of us here.

Bladerunner1954| 12.29.10 @ 11:38AM

Soylent Green, anyone?

The Democrats can solve the health care crisis and food shortage crisis with a stroke of the pen . . . come on, Dr. Berwick, don't tell us you haven't already been thinking about this.

Have you considered| 12.29.10 @ 8:43AM

JL, you seem to ignore the point of this article. It is a discussion of positive vs. negative rights as embodied in the US Constitution, which ostensibly governs Every Act Of the Federal Government. This article is exactly correct in that regard.

Secondly, I see you post rhetoric regarding some " growing evidence that less aggressive care can lead to longer life of higher quality" yet I can't intuit to what you are referring, and you post no substantiation. Are you arguing Quality vs. Quantity? If you are, I personally might agree, but someone like Ron Santo who had both legs amputated in order to extend Quantity vs. our interpretation of Quality may not.

I also agree to some extent with your "waste" argument, but there is a conflict when a doctor can be sued by the patient or family for NOT testing. How would you manage this conflict? Should the doctor expose himself to legal action to save money in your world? Just curious.

INTJ| 12.29.10 @ 8:44AM

Typical. You cannot refute the premise, so you resort to sarcasm and name-calling. The simple fact is that no one can have a "right" to anything that forces by law another citizen to do something he or she does not want to. Call it what you want, but that is authoritarianism at its worst.

Dan Hirsch| 12.29.10 @ 5:55PM

Oh you betcha we've had "positive rights" in the US before - it was when slaveholders had a positive right to the efforts and production of their (sic) slaves!

Socialized medicine is nothing more than white collar slavery for health caregivers. You cannot practice medicine where you want, you cannot practice medicine how you want, on whom you want, or when you want! But you do have to provide to whomever you are told to and no others. Will US Federal employees be better masters than the ol' crackers from the Old South? Probably, yes, because they'll all be members of AFCSME...

One would think that the especially-sensitive President Obama would be careful about enslaving people....

We are SO screwed! And the Congressional RINO's re-surge and even FOX News misses the point about 90% of the time - they do all want to work at a "major." Take a good look at O'Reilly-case closed.

Sheesh!

Tom| 12.29.10 @ 8:56AM

BLAH BLAH BLAH Waste
BLAH BLAH BLAH Someone making too much money.

Mr. London,
Every thing is rationed. Every thing. In capitalistic countries the rationing is through cost; in socialistic nations it is through time and bureacratic rules. Even if your argument about waste is true, it is but that is beside the point, at some point rationing has to take effect. Otherwise, we have a situation where scarce resources are used in inefficient ways.

If you limit payments to doctors there will be opportunity costs incurred, most specifically time and quality of care. If you limit the types of treatments and the situations where treatments are allowed you end up with the social cost of Granny dying because she was refused her heart transplant. There is no way around rationing, it is an economic fact, the question is how it is addressed.

JimBeam| 12.29.10 @ 9:31AM

Conservatives want to ration by cost. (Let the child die on the hospital steps because his parents cannot afford care, while a wealthy granny gets her heart transplant.)

Liberals want to ration by bureaucratic decision. (Death Panel chooses to treat the poor kid and let granny die. Then they send granny's heirs a tax bill for the whole thing.)

Compromise is the government acting like Santa Claus and not telling anyone no. This is what we do now and will lead to insolvency.

The reality is that difficult and unpleasant things will have to happen no matter what. The real problem is not too much government intervention nor too little, but that private charity has failed to solve the problem. Christians (the largest religion in the US) are more interested in building "Family Life Centers" and state-of-the-art worship auditoriums than they are in taking care of their fellow man. Non-Christians are frequently even worse.

Government cannot make up for a lack of charity in the hearts of the population.

Danny| 12.29.10 @ 9:57AM

Two things about the conservative approach. a) If we let healthcare be driven by private enterprise and get the government out of the healthcare business, I suspect we'd have enough money left over so that no one's kid would die on the hospital steps. b) The conservative ethos, if practiced, would mean more people would work to take responsibility for themselves, so that there would be a lot fewer kids on the hospital steps to begin with.

Appleby| 12.29.10 @ 9:57AM

Christians should indeed do more, and we who DO more are always telling the rest the same thing. Ronald Reagan said once that if every church in America took responsibility for 10 people (or families) then there would be no poverty or want. The real advantage of this kind of adoption, which I will freely admit the Mormons do to perfection, is that those who are assisting these people in need can know them as persons, can ascertain exactly what their problems are and how to help get them out of the hole they are in, and can by doing that model the format so they can understand it. A person cannot understand the love of God if s/he has never experienced it translated through the love of a human being.

In the days when the government didn't jump in to save everybody from taking responsibility for himself and his family -- thus leading the liberals and scrooges to opine that they paid taxes to solve these problems so they'd spend their own money on an iPod for their newborn instead -- this used to be more usual.

Ross Kaminsky | 12.29.10 @ 9:58AM

Jim,

The idea that conservatives want people to die if they can't afford care is utter bunk.

Study after study after study shows conservatives to be more charitable than liberals.

Furthermore, it's not a fair test to question what charity will or won't do while we live in a situation where government takes a huge percentage of our income in order to fund what many of us would already consider "charity".

It's no wonder that charities don't do as much as you'd like since government squeezes charities out of business in many cases. Still, the amount that charities do do is remarkable.

Seems to me there are far more instances of people dying due to poor care or lack of care in England (at least as a % of the population) than in the US. And in England, health care is "free".

Steve A| 12.29.10 @ 11:07AM

JimBeam, Jim, please provide me with ONE SINGLE EXAMPLE in the USA where a child has "died on the hospital steps" for lack of insurance. I would greatly appreciate it.

Jack London| 12.29.10 @ 11:44AM

Maybe not on the steps, but in hospital:

'Lack of health insurance might have led or contributed to nearly 17,000 deaths among hospitalized children in the United States in the span of less than two decades, according to research led by the Johns Hopkins Children's Center.

"If you are a child without insurance, if you're seriously ill and end up in the hospital, you are 60 percent more likely to die than the sick child in the next room who has insurance," says lead investigator Fizan Abdullah, M.D., Ph.D., a pediatric surgeon at the Johns Hopkins Children's Center.

"From a scientific perspective, we are confident in our finding that thousands of children likely did die because they lacked insurance or because of factors directly related to lack of insurance," he adds.

http://www.hopkinschildrens.or.....eaths.aspx

Steve A| 12.29.10 @ 12:02PM

Jack, I am calling bu*****t on that report & I will give you a real life example why.

I have a friend who recently had a heart attack. No insurance. He went to the ER. They did bypass surgery & he was in ICU for 4 days. Guess what he paid. Go ahead & guess. Correct, ZERO. They told him to pay what he could whenever he could. He even got discounted prescrips.

The reality is that NOBODY, (kids, grandma, your sister, whoever) is simply not ENTITLED to insurance. Sorry pal. You will never convince me otherwise.

reasonable man| 12.29.10 @ 12:54PM

But you're example shows that we already have the right to health care. In an emergency, federal law already requires the provision of health care. Therefore, the question is only whether there is a corresponding duty to buy insurance to pay for it (assuming the financial ability to do so).

Jack London| 12.29.10 @ 1:02PM

Steve - 'Guess what he paid. Go ahead & guess. Correct, ZERO.'

Sorry but you're not comparing the same thing. The children's study shows what happens in outcomes to kids who've not been insured during their lives. For many, they arrive in hospital later and in worse condition.

And I still don't get it - with your friend you're happy to pick up his bill through higher premiums and taxes but not that he get himself insured under mandate?

Steve A| 12.29.10 @ 3:17PM

Jack & reasonable, You are both missing the point. The costs are already being absorbed & paid for when I (a responsible citizen) pay my Health Insurance Premium. You are correct. My pal is a deadbeat sucking up assetts with no outlay & he could frankly care less. In this regard, I kinda like the mandate.

However, my belief is that the Federal Govt. has no right to force my deadbeat pal to be socially, morally or ethically responsible in this regard. We, as a society, have already agreed to provide care for those like him & do so currently. It may not be 100% identical to what I would get because I pay through the teeth & play by the rules, but though s***t for him. Further, the law contains a provision to require insurers to issue coverage after the fact for pre-existing conditions when these conditions are already being paid for in the system (my pal had no coverage & got treated). This absolutely must & will definitely blow the insurers reserve pool to bits, result in an increase in premiums. The Govt. then rails against the carriers as gouging & takes over all of it. Then, they have total control over the ultimate decisions regarding treatment which now lie between you, your Dr. & the insurance carrier on what coverage will & will not be compensated for. It is a classic, transparent, Trojan Horse.

If I have a guy with 5 DUI's, 3 total losses & 4 tickets on his DMV, should ABC auto be forced to replace his car when he has no current coverage, tows it to their lot on a wrecker & then tells them to retro a policy to comp it?? Obviously not. Nor should this example pay the same insurance rate as a guy with no priors on his record. This is Insurance 101 for dummies. The same principle applies here. If you force ABC to cover & comp the guy with the total ALL OF OUR RATES NOW GO UP. Get it??

So, taking the example of my pal, under your system, he walks in to the ER (or is carried in), ABC Health Insurance has a freaking Kiosk at the ER door, they wirte a policy & the hospital ships them the bill & they jack everyones rates to cover it in the ABC pool of customers. Can I possibly make this any more clear. It is utter nonsense.

Jack London| 12.29.10 @ 5:34PM

Steve,

your pal would at least have been paying the fines for being uninsured. I think the pre-existing conditions part of Obamacare is designed to cover existing chronic conditions and not emergencies. Under EMTALA he would be treated anyway.

But why wasn't he billed for his treatment? Is he indigent? I thought you were sending your kids privately to get away from folk like him.

Only jokin'!

N Riano| 12.29.10 @ 3:24PM

Since EVERY state has an SCHIP program for those who cannot afford health insurance, why isn't it the parents responsibility to buy this subsidized insurance for their children?
If the child dies "because the parents chose not to get said insurance, it is totally the parents fault for being irresponsible.

LeftCoastRightBrain| 12.29.10 @ 12:21PM

And the major reason may not be financial or insurance based. It could very well be that the first entry point to the health care system for these patients is the ER and that their condition upon entry is significantly more critical that other patients who entered the healthcare system earlier through primary care or pediatric clinics.

This is a situation where the parents/guardians should act responsibly and seek medical care early. I've been in health care management for over 25 years and have NEVER had one of my docs turn away a sick patient because they lacked health insurance.

Laura| 1.3.11 @ 5:20AM

http://www.associatedcontent.c....._care.html
Seriously? This is a very gray area, not so B&W

Herbert Rubin, M.D. | 12.29.10 @ 2:46PM

Where can I find a "right of privacy, or a "right to health care" in the US Constitution? Doesn't exist. You get "Life, liberty, and the pursuit (not attainment) of happiness (property). Every other asserted right is negative on government specifying what it may NOT do to us.
As a doctor in the free market, I will let you die unless you pay me directly. Mr Lincoln ended slavery; it was in all the newspapers at the time.

Herb Tarlek MD| 12.29.10 @ 7:00PM

That's the first time I've ever heard a doctor talk like that. Letting someone die for lack of payment would definitely make the papers boss.

sly311| 12.30.10 @ 4:42PM

Hey JimBeam, lay off the Jim Beam. You're starting to slur your incoherent, ignorant and uninformed thoughts.

GeauxDoc| 12.29.10 @ 10:30AM

Wow, speaking of yawn...
Mr. Facts ends his message (and his credibility) with the "fact" that we are spending "billions" on club memberships for greedy doctors. Check your own sarcasm and hyperbole next time. BTW, I practice medicine in one of the poorest districts in the USA - I guess the club fund hasn't made it here yet.

Jack London| 12.29.10 @ 12:18PM

So it's your contention that docs are not like other people and not influenced by money? Eg see this where it seems a reform has saved many millions of dollars in unnecessary fees in early stage prostate cancer:

http://jnci.oxfordjournals.org/content/102/24/NP.2.full

Tom| 12.29.10 @ 10:23PM

Well, you really want to decrease over unnecessary treatment? Reform the medical malpractice system. An awful lot of treatment is driven by fear of lawsuits. Defensive medecine is costly as all hell.

Laura| 1.3.11 @ 5:38AM

Absolutely agree...I think private medical law suits should be illegal. The whole problem with the medical system are it's fees, and the narcissist greed that defends it.
The fed should fine the Dr, & keep half for proven malpractice, give the rest to the family. The fed should reward Drs monetarily for excellent care performed, as well.

Joe| 12.29.10 @ 11:21AM

You think that's a response? That old people are better off with less care? You're an idiot.

LeftCoastRightBrain| 12.29.10 @ 11:53AM

Yo, Jack you missed the majority of the points raised by "a professional derivatives trader." The major point is that government can not and should not attempt to create 'rights' (positive rights). Nor should government infringe on our basic rights (negative rights).

Additionally, how do you resolve in the inherent conflict of a government created right that has an expiration date?

Wayne | 12.29.10 @ 12:54PM

At what costs? Individual liberty and freedom. What we object to is the Government encroaching in our health decisions. What I find is that liberals ignore individual liberty. You ignore it in all debates. Tell me, why would I want a bureaucrat with a spreadsheet deciding what procedures I can have? I include limiting all options which includes alternative medicine.

Luap Leiht| 12.29.10 @ 3:08PM

I will take your comment as your wish not to be resuscitated.

JohnLeeHooker| 12.29.10 @ 3:59PM

Dr. Berwick, recess appointee to head CMMS: The question is not IF we will ration health care but whether we will do it with our eyes wide open.

Zeke Emanual, Odumbo's health "advisor": If you are not, or can not become, a productive citizen treatment should not be guaranteed.

We have some truly diabolical people imposing this orwellian named patient protection and affordable care act. We are on the road to perdition.

Orren M. Cross| 12.29.10 @ 6:57PM

Rationing occurs either by government edict or the
market place. If you do not drive a $250,000 Ferrari, why not?
Take your choice.

Al | 1.2.11 @ 5:24PM

Jack,

Well, maybe less intensive care is called for: but that is the decision of doctor and patient--not government bureaucrats.
Like most liberals, you don't refute the logic, just make gratuitous ad hominem attacks on the writer and close with class envy.

Ken (Old Texican)| 12.29.10 @ 7:21AM

Hi Jackwagon.
(Sorry, I couldn't resist it.)
You had better pick another flavor for your deadly koolaid.

Jack London| 12.29.10 @ 7:37AM

Hey Ken, I'm not the one wailing and throwing my toys out the stroller, and threatening deadly violence.

Hmmm Texas - 'ranks close to last in access to healthcare, quality of care, avoidable hospital spending, and equity among various groups.'

Way to go!

MikeD| 12.29.10 @ 8:41AM

Jack; Since you're so confidently spouting facts about healthcare access in Texas, please provide the sources for this set of facts. Even if you do provide the source, I'd like to see how valid the source is. You're the one who spouted off; now back up your mouth.

You libs love to spend other people's money; and scream and yell if you don't get your share. When George Bush tried to reform Social Security, the dems screamed about 'granny eating dogfood'. How are you gonna 'spin' it this time when you make conscious decisions that cause granny's death because the costs simply cannot be sustained by any economy, thus the deficits.

When your moronic policies have driven the Country bankrupt, and armed gangs are roving around stealing what is no longer available because you killed the free market system; you'll be the first to huddle under a rock and cry out for some big bad guy with a gun to protect you. You have got to be a student, a govt. employee, or a leach, as in welfare or trust funder.

HAHA| 12.29.10 @ 9:04AM

Yes, citations and proof of statements are good things. Glad to see you on board, Mike.

BTW, Texas does not do a bad job with healthcare. The census has all the numbers you can ask for. The statistical abstract is a wonderful tool for those who are more data driven. The one area Texas is somewhat lacking is the percentage of people below the poverty line, a number I'd guess was primarily due to the number of low skilled illegal aliens resident in the state.

http://www.census.gov/compendia/statab/rankings.html

MikeD| 12.29.10 @ 8:45AM

Jack; One more point: If this healthcare bill is such a great idea, why has obama and the congress, as well as federal employee unions; and state employee unions (ad nauseum) exempted themselves? Of course, they have also exempted themselves from Medicare. We already have a plan; just put EVERYBODY on Medicare. I really would like to see what you have to say about that...

Beefonrocks| 12.29.10 @ 10:14AM

Texas is solvent.

martin j smith| 12.29.10 @ 8:08AM

If "health Care " is a "right"of every citizen, the would it not follwo that "access to the actual care" is a logical consequence of such a " right" or are we just talking about having a "card" that shows you " have" healthcare," wether or not you actually get it.
And, let me add this in lign with current day events: How about our entitelment as a right to streets cleared of snow ? After all how can we access " health care" if we cannot get it ? And what about our "right" to the practitioner of our choice ? And, our right to go to court against mal practice ? And our right to change practitioners if we are not satisfied ? Exactly what does the right to "health care" actually mean ? I would bet must people have not the slightest idea--especially those who are in favor of Obamacare.

Laura| 1.3.11 @ 5:54AM

I think "the right to health care" means the "the right to health care that doesn't take an entire annual salary from an average citizen to pay for one heart attack" or "the right to health care that doesn't cost 4-5x more than it ethically should"

Calvin | 12.29.10 @ 8:15AM

Missing from all the arguments for and against rationing is that there is no disincentive for patients or their surrogates to decline heroic care. Patients' families almost all believe that our modern hospital cae will somehow bail an elderly patient out and send them home to a good quality of life. Neither the patient or the family have any financial risk in this game. When a critical care physician recommends that perhaps today would be a good time to take a step back and let the patient die in the natural course of his terminal illness, the family almost always chooses to hope against medical advice to continue. If Medicare asked each family to put at risk a few dollars a day to actually pay for this futile care, I believe a lot of this futile care/cost would go away. Please stop blaming the doctors. They are not at all happy seeing your dying aged family member on a ventilator in the ICU. Thanks you.

chuck| 12.29.10 @ 9:03AM

I don't think your right as to families almost always choosing to continue care. With the internet and Google, information about a loved-one's disease, treatment options, prognosis is readily available without having to pry it out of doctors. I just lost my father after a short illness. After learning of the diagnosis, and reading about the treatment they were going to try, it was apparent that his time was limited(3 weeks as it turned out). We he was moved into ICU, the decision to stop care, and allow him to pass in as much comfort, and as much dignity as possible was easy, and mutual, as we all knew the end was soon, my father was at peace, it is was what he would have wanted.
I believe this end of life planning is a deeply personal thing, and should be left to individuals and their families. Paying doctors to provide end of life conseling is absurd, a waste of resources,and a waste of time.

Appleby| 12.29.10 @ 10:03AM

I agree -- we placed our beloved Daddy in hospice care when the doctors said frankly that no more could be done for him, and so did my Auntie with her husband, my uncle who recently made the decision to discontinue dialysis and come home to die with dignity, and the hospice helped him to do that.

There are options other than heroic measures or death by neglect. We old folks are smart enough to know when one of them ought to be chosen -- and to make sure a family member who isn't itching to beat the death tax by pulling the plug is the one who carries out these wishes.

Have you considered| 12.29.10 @ 9:09AM

I agree with you Calvin. That is why I think the voucher proposal by Paul Ryan would be an interesting line of inquiry. When you have an HSA, the Patient has incentive to ask...Is this worth it?. And you are exactly correct that the family will almost always want a herculean effort to extend the quantity of life for a loved one, and the costs be damned.

da monk| 12.29.10 @ 9:20AM

Right on, Calvin

Jay Dee| 1.1.11 @ 7:53PM

Calvin obviously you haven't had to deal with aging parents and their decline. You will know when enough has been done and it is time to accept the decision for them to meet God.

No one is blaming doctors, they are being told to offer end of life counseling for a fee, annually. In the past, doctors offered this information as part of their regular care of elderly patients.

Since you are obviously young, I hope you have the proper legal papers in place in case you have a tragic accident. Asking a parent/wife/partner to pull the plug on you when you have no brain activity (since you are missing some brain waves now) will help them with the decision.

Curly Smith| 12.29.10 @ 8:36AM

"Conservatives and libertarians have never figured out how to counter such heart-rending arguments"

It's called "charity". It's a free people giving freely of themselves to others. But "charity" only works if it's community driven and administered by people who want the recipient off charity. It's an odd world where I'm responsible for you but I'm not responsible for me, where I'm responsible for your parents but not for my parents, or where I'm responsible for both your debts and my debts.

JimBeam| 12.29.10 @ 9:35AM

"Charity" has failed because the institutions that traditionally administer charity (churches, synagogues, private benevolent organizations, etc.) are in severe decline. People would rather spend the money on themselves. Even churches that have a large amount of giving from the congregation usually spend it on the congregation instead of on charity.

No government can solve this problem.

Danny| 12.29.10 @ 10:02AM

You know, I wonder if you are wrong, and that the institutions that used to provide charity do not now do so because the government has taken over their functions. If there were no government, there would be more charity. The issue of the decline of the institution is related, I imagine, but separate.

Brian Mc| 12.29.10 @ 10:25AM

Government compassion is for the god-less. Those whose lives are based in faith know this. Put your faith in man, no matter what form that 'man' might take and you end up with the monstrosity our Constitution never intended.

Laura| 1.3.11 @ 6:14AM

The definition of social judgment: to interpret and announce another's motives and other unprovable internal state.
Our Godly decree is to use discernment. The definition of discernment: to stick to the provable facts and give ethical opinions on them when using the legal def. of "judgment".
I think it's ludacrous to Speak of God when Speaking of the Government, as well. And yet, how can one rail on separation of Church and State from this position?
The laws our government put in place are compassionate in the first place, anyways.
Envoking God's name in defense of the ultra-conservative mentality always irks me. God is not ultra-conservative, nor is controlling.

Curly Smith| 12.29.10 @ 10:19AM

Think back to the charitable organizations of the 40's and 50's. The vast majority were community and church driven. They collected from the community and distributed to the community. They didn't subsidize irresponsible behavior, they forced people to find work, any work, and they helped the recipient become a productive member of society.

Now we have national charities whose sole purpose is to raise and distribute more money every year with the largest charity being the Federal Government. This new "charity" is aimed at keeping the recipient unproductive and irresponsible because it gives more power to the organization. There is never enough money, the need is never satisfied, there's always a call to give more but there's never any audit to determine if the money is being spent to positive effect.

I think Danny is right, the churches are floundering because their traditional role has been circumvented and they're struggling to find a niche. The congregations see their giving wasted on trivialities and they stop giving.

Luap Leiht| 12.29.10 @ 3:33PM

The problem with many (if not most) churches today is that they focus more on the temple they worship in than Christ's message of love and charity.

The gospel of wealth be damned. I'd like to see Christians begin behaving as Christ instructed.

doug| 12.29.10 @ 12:59PM

Perhaps if the government did confiscate 30-40% of our income, we would have more money for charity. Or maybe we wouldn't have to be 2 income households and parents could take better care of their own elders and kids.

Gregg| 12.29.10 @ 8:38AM

Jack London wrote:

"Er no - there is growing evidence that less aggressive care can lead to longer life of higher quality."

What "growing" evidence? Where is it? How fast is it Growing? The statement has to be tossed. It's unmeasurable.

But even more important, WHO gets to decide what constitutes higher quality of life? I do not want the government deciding that. No siree.

And then you spout:

"when we know that huge amounts of completely wasteful 'care' is expended in the final weeks and months of life,"

Wasteful? By whose measure? Who is to say what is wasteful for each individual. You? The government? By what right do you figure you can decide that? Why would you EVER want to give the government that ability?

"The word 'rationing' is loaded but it shouldn't be - you can ration on the basis of cutting out waste."

And who will decide that an expensive procedure to lengthen the life of a terminally ill elderly patient is "waste"?

You?

The Government?

No thanks.

MikeD| 12.29.10 @ 8:58AM

Jack; Me again. Please read the post just above. These are the very hard, specific questions that libs just don't want to get into. But, in the real world, the 'devil' is in the details; and one of these days YOU might be the one under discussion by obama's death panels.

There is not such thing as a free lunch, and we can't afford these liberal wet dreams. Besides, this is not a healthcare bill, it is just another way for obama, reid, pelosi, and the rest of you self proclaimed 'elites' to gain control over the rest of us.

I have an incurable disease that is going to kill me. I can also afford to pay for my own healthcare, but under obama's abomination I am not permitted to use my own money to take care of myself and my family. Have you read this 2,000 page abomination? It might change your mind. I've read it; cover to cover. Want to read it all? Send an e-mail address and I'll forward it to you.

Jack London| 12.29.10 @ 9:42AM

I don't get it - you say we can't 'afford these liberal wet dreams' but I take it you are against rationing unnecessary care if someone on Medicare wants it? Strikes me you're the one who's dreaming - I'm with those who want to get costs down.

Then you say you'll be stopped from paying for your own healthcare - who's going to stop this? Any time you can pay privately for anything in America for goodness sake.

As for the other points:

Here's a link about Texas:

http://www.insurancenewsnet.co.....p;id=80824

There are lots of studies about say the benefits of palliative and hospice care. When you have a serious/terminal illness quality of life is very important and is often ignored in the drive to over-treat.

The waste in say giving chemo in the final weeks of life is extensively documented, as is the waste in procedures such as stents, CT scans etc - there's no argument here. We do much more in the US on things like this for no better outcomes, and it's driven by money not patient care.

And for the record, I don't agree with mandating people to buy private insurance (it's a compromise), but I do agree with an affordable public option for all that is mandatory as a payroll tax.

HAHA| 12.29.10 @ 10:30AM

The study is meaningless. And this is why: It takes into account areas that are not outcome related. Health insurance does not equal health care. When one looks closer at the numbers Texas fares pretty well. Its overall score is hindered by its relatively low rates of people with health insurance.

However, when you click through to outcome based criteria Texas does much better. Look at infant mortality rates, death rates of breast and colorectal cancer, or percentage of non-elderly people limited in any activity because of physical, mental or emotional problems and you'll find that Texas fares pretty well, scoring above the national median.
Here is the link to the actual study, not a newspaper's take on it.

HAHA| 12.29.10 @ 10:32AM

Sorry, forget the link from above:
http://www.commonwealthfund.or.....card-2009/

Laura| 1.3.11 @ 6:36AM

Laughing? You're not serious, especially since you simply cited the resource to the study in Jack's link.

Steve A| 12.29.10 @ 11:12AM

Jack, Re: your last paragraph. What is the difference? Please explain. I am paying either way, against my will, correct ? So why would you be against the mandate? thx

Jack London| 12.29.10 @ 11:27AM

Steve,

it's just that we need to take more cost out of the system and having a complex network of private insurers just isn't going to work in the long-term. I don't particularly want to be forced to buy a for-profit product. But we are where we are and as you know it was because of a false outcry against a public option. As least the subsidies are going for Medicare Advantage.

SteveA| 12.29.10 @ 12:17PM

Jack, I respect your argument & I understand what you are saying. Where we part ways is in the belief that Government can run the "business of insurance & treatment decisions" more effectively than private industry. Give me an example where Government is more efficient at doing anything superior to private industry & I am willing to listen (besides killing terrorists & blowing up things).

Amtrak, Post Office, SS, Medicare, Public Education & on & on all bleed $$ endlessly & are grossly inefficient at best. Why would I possibly think that the Fed. Govt. is finally gonna figure it out & get this one right.

Further, the average profit margin for health insurance companies is roughly 2%. If you completely make them a non-profit, as they did in Mass. you are having next to zero impact. Then pile on mandatory coverage for pre-existing conditions & you blow the reserve pool of $$ to bits. Rates MUST go up or they are insolvent. This is the goal. Clear as day.

Jack London| 12.29.10 @ 12:55PM

Steve, I think there's a bigger picture to see here. As you know I think healthcare is too important and to leave to the market because it is a crucial part of our underpinning infrastructure. Without secure, affordable health and social care, we can't progress fully with the innovation and productivity American is famous for. Only the government can enable this - before Medicare for example half of older people had no cover. Now 99% do. The free market can never provide affordable policies for millions suffering from often multiple chronic conditions.

Is Medicare inefficient? Well, not as inefficient as private insurers in bang per buck. But obviously we have to drive down provider costs.

As for other systems - there's a good reason why they are provided by local/state/federal government - like Medicare there is no chance we could say have a properly functioning school system under private means alone.

Many of the supposed inefficiencies are because of gross underfunding or about the bigger picture - the awful inequality we have in the US that creates a lot of deprivation that is very difficult to serve.

Steve A| 12.29.10 @ 1:31PM

Jack, I suppose we shall just agree to disagree. I would buy your argument if you sincerely recognized (A) tort refor is critical to controlling costs (& then actually did it!). (B) School vouchers is a huge winner for ALL, particularly minority & or poverty heavy school systems. I pay a private school tuition to a private, Catholic school system that is a fraction of what the Fed. pays per pupil to subsidize a garbage program with a dropout rate over 40% within 3 miles of the location.

When you, & those on your side, finally man up & recognize these absolute no brainer facts, we can move forward. It is the failure to do so that splits us. Regards, Steve

Jack London| 12.29.10 @ 3:00PM

Steve,

Tort has been shown to be only small factor in healthcare costs - about 1% I think.

The problem with helping people to opt out of public schools is you just accelerate social divisions, which are awful anyway now. Again, this is part of a bigger picture of inequality.

I think the essential position is this: you either want to support policies that will make America a more equal and cohesive country, or you prefer to make divisions worse and watch more dysfunction grow year by year. The middle ground is we do a little bit to stop things getting worse, but no better.

Steve A| 12.29.10 @ 3:34PM

Jack, With all respect, you are wrong on this. As for vouchers. If the crew at the garbage public school, which gets subsidized at 40% higher than the rate at the private school, got a voucher & got to choose to attend the alternate (rich kid school which sends 95% to college), the line would be out the door & down the stret to sign up. I say great.

Society would be more integrated & these kids would now have a shot at a productive life. You seek to perpetuate a failed model. It flat out sucks & churns out dropout social liabilities with no future year after year & you & your pals throw them $$ & hope it goes away.

Jack London| 12.29.10 @ 3:50PM

Ok - I'm happy to go along with the school voucher opt out as long as every kid can attend the rich kid school.

MikeD| 12.29.10 @ 3:33PM

Jack; I so relieved that you know what's on my mind and are willing to do my thinking for me. Just two questions: Do you actually have a job? If you do; do you work for a government or non-profit? Because, if you answered yes, you have no vote here since any public employee is essentially living off the sweat and effort of the private sector; established by people who risked money to start, and build a business that became (GASP!) PROFITABLE in order to hire people who then pay the taxes that support every single thing that government, and government employees, do. No government in history has ever created anything except cost. Business is the only thing that generates wealth/resources. Because of obama and democrat actions, they are making it impossible for business to ever generate enough resources to get out of debt; much less provide health care to everybody. Thanks to barry the muslim and his thugs we simply cannot afford these wet dreams; he has placed so many restrictions on business that our economy will not be able to do these things you libs love. We cannot afford it period.

One last point: Every study any of us cite was done with a specific point to make and has to be considered biased. Look at the crap that passes for Climate Science that has been quoted by barry and algore. they are bogus and invalid; but, since they porve their points, they are held as gospel.

I have spent way too much time in hospitals; and I have NEVER seen one incidence where anybody was denied treatment because of lack of funds. Not one!

HAHA| 12.29.10 @ 10:43PM

" No government in history has ever created anything except cost." Never? Not once?

A good and efficient government is a pre-requisite for wealth. No matter how vibrant the private sector is a badly run public sector will destroy wealth.

Yeah, our government is too big. Yeah, it destroys wealth. It inhibits risk taking and innovation. But a government that is too small, that cannot deliver public goods also destroys wealth. Maybe government never creates wealth, I would dispute that, but without a real run government wealth creation is crushed.

Laura| 1.3.11 @ 7:09AM

Seriously? You say links are biased because you haven't placed any, and no - other links are other links.
http://www.nytimes.com/2010/11.....f=business
And I suppose we should have farms on the national forests and parks by now. Oh, and darn those federal highways. How dare we not privately own and maintain them.

James Baker| 12.29.10 @ 12:38PM

Even if he does not want to read it, I do. I would be quite obliged if you would send it to me.

MikeD| 12.29.10 @ 7:42PM

James Baker; The full text is easily found several places on the internet. Just go on your search engine, like Google; and enter "OBAMA HEALTHCARE BILL 2010" and it will come up in several forms, from the full text as unread by the House and the Senate, to excerpts from multiple groups putting their own spin on it.

If you have difficulty, I will send it to you, but I'm not sure how to do so. I am not comfortable with anybody publishing their own e-mail address, regardless of poilitical persuasion, on this forum. Just read about some of the freaks on the far left who have proven their ability to commit acts of violence against anybody who disagrees with them.

It's not a coincidence that it was democrats who get caught stealing votes, threatening voters, and slashing tires of Republican volunteers; just to name a few. These people are really nutcases, and capable of almost anything. Be careful what you divulge.

Laura| 1.3.11 @ 7:11AM

I'm sure all the British-Flag baring militia would be quick to agree with you.

JimBeam| 12.29.10 @ 9:42AM

"And who will decide that an expensive procedure to lengthen the life of a terminally ill elderly patient is "waste"?"

The person who should decide is the person who is paying for the procedure.

The problem is that many conservatives want the people to be able to determine "wasteful" while government still foots the bill.

They want to be able to determine not only whether granny gets the treatment, but whether Medicare pays for it. You can't have it both ways.

As long Government has every right to stop paying for decisions that it deems to be wasteful. If the government is writing the check, then they MUST have "Death Panels" to determine which checks they should write or the country will go broke.

Of course, you should have every right to be able to continue treatment on your own dime. But very few people are financially able to do this.

soggy | 12.29.10 @ 10:36AM

I agree...healthcare decisions should be based on whose paying the bill...in fact if you are under age 65 and can't pay the bill you should get no care...I believe in survival of the fittest...but you er when you suggest that medicare is government paying for old people to have free healthcare...for over fifty years those folks have been paying into what was sold as government health insurance...for the past 25 years I have paid an average of 200 a month to medicare payroll deduction...if I pay the same for the next 20 years...at 65 I will have pre-paid 108,000 dollars in premiums...not including interest I could of made on that money which would have tripled that total....so I paid the equivelent of 300k in premiums for this free government healthcare....then I still gotta buy a supplemental policy because medicare does not pay worth a rip and docs won't see patients without supplemental coverage....free coverage...lol

Curly Smith| 12.29.10 @ 10:08AM

We know that huge amounts of completely wasteful care is expended in the final weeks and months of life because huge amounts of completely wasteful care is expended in the final weeks and months of life. If you believe the comment at the bottom of this editorial (http://www.registerguard.com/csp/cms/sites/web/opinion/25536704-47/care-health-law-percent-cost.csp ), and I tend to as it fits the old 80/20 rule, then 25% of Medicare recipients account for 85% of the spending.

BUT we only know that the money was wasted after the fact. And, therein, lies the problem with trying to curtail end of life care. How do you know which patient with a 20% prognosis for recovery will actually recover? The answer... you don't know so either you treat none of them or you treat all of them and you accept that 80% of the spending will be "futile care".

However, if you're the Government running a Ponzi scheme with a dwindling pot of money then you have to make some decisions. Do you spend on newborns or on the elderly? Do you spend on schools or the elderly? One might give you a good return with years of productive tax paying, the other has already exhausted the majority of their productive years. Which gives you the "most bang for the buck"?

You're right to be scared. Government run health care is the ultimate terror weapon. The only answer is to get government out of health care.

rocknal| 12.29.10 @ 9:03AM

All "rights", whether negative or positive, are LIMITED: even the most absolute "rights" like "Free Speech" have limits (e.g., there is no "right" to shout "Fire" in a crowded theater). So the whole premise of the article is a wrong-headed one.
The issue is NOT whether there is (or should be) a Right to Healthcare (or health insurance, as the case may be), but whether the USA as a Society will provide access (for those unable to pay for it independently) to medical care. And whether this access will be extended to all citizens, or all residents, or all visitors, or any other group we choose to define. (The French, who the Right loves to hate, provides care to whoever needs it without any cost......at a much cheaper rate than we pay for far worse care for only those who can pay).
We ration care now.......we just do it based on money. Is that the best approach to rationing? Some on the Right believe it is......most people (if they thought about it at all) would probably conclude it is not the best way to ration care. If any of our so-called "Christians" applied the WWJD (what would Jesus do) standard, they would quickly conclude rationing by ability to pay is completely contrary to their religious beliefs.
We live in a complex, capitalistic system. But we do not let that drive access to police protection, fire department response (at least in most communities), military protection, etc. Capitalism works well for distribution of some goods and services (like televisions, autos, etc.), but far less well when it comes to safety, protection, health. When we can acknowledge THAT reality, we can really begin to solve "healthcare" in the only sensible way (and the way most civilized, modern countries do so): Single Payor.

Tom| 12.29.10 @ 9:14AM

Not a bad post. You admit that rationing is present in all systems. The question always is what mix of costs - both monetary and opportunity - we use to create that rationing.

I have a few areas I disagree with you about though. I doubt Jesus would have been for governmental charity. You are probably right he'd want to see more personal charity. But even if you are correct in your original assumption so what? I no more want to run a government on what Jesus would do than I would on what Buddha or Muhammad would do.

It is debatable whether France's health care system is superior to the United States. It is all dependent on how you look at the numbers. Most gross differences can be accounted for by lifestyle and violence. Depending on how you value certain variables the differences in outcome disappear, some even show an advantage to the American system. What the French system is is more egalitarian, it creates equality of treatment for the vast majority of patients.

rocknal| 12.29.10 @ 9:48AM

Tom, I agree that "WWJD" is irrelevant to how we should approach healthcare. I used that only as an example I thought would res0nate with the audience at this site.
As to the comparison of our healthcare system with the French, I agree that there are lots of compounding factors in any such comparison. I also agree that if you look at the data throught various different lenses you get different conclusions. So, for example, if you are in the top 20% (by income) of USA families, OUR infant mortality rate is among the best in the world. If you look at our average rate overall, we are 36th in the world. And if you look at the average for families in the lowest 20% of income, our infant mortality rate is an awful and embarrassing 104th in the world (lower than most 3rd world countries), according to the WHO (World Health Organization). SO our system IS the best in the world for the RICH, it is a little below average for most, and awful for the poor. (France's system is 1st in WHO rankings, and routinely in the top 5 of most rating organizations). And it delivers that care at about 8% of GDP, while we pay about 16% of GDP here.
I agree this is a very complicated subject, and will not be solved on a blog........it is the kind of complicated subject with TONS of externalities (e.g., I NEED to care whether you are sick or healthy, because it DOES impact my quality of life and health) that needs management by some central "authority". That should not be AHIP (American Health Insurance Plans), or big Pharma, or the AMA (which has opposed every health industry reform for the past 100 years). So while I am not wedded to it being the federal government, at least they are elected officials who have to face the public every 2-4-6 years.

ArmyGuy| 12.29.10 @ 12:14PM

The comparison of child mortality rates is a farce and has been proven as such in several articles posted on this magaizine. The criteria for what c0unts as a viable fetus is different in Europe (France is part of Europe for those of you in or near Rio Linda) than it is in the USA. Their infant mortality rate is much better because certain infants that are born alive do not count because they have not reached a sufficient age of gestation. Therefore if they live, well great, the numbers improve. But if they die, no harm done because they didn't count to begin with. The USA on the other hand considers every live birth viable even if the chances of that fetus surviving are less than 1 in a milion. If it breathes one breath of air it counts. So you can take your class warfare drivel, the holy grail of liberal propoganda, and stuff it. You think it's so great in France, then spend the money on a plane ticket and go have your baby over there. Feel free to stay there too. One less liberal equals on average 3 fewer votes for a liberal in the next election (10 if you're a liberal from Illinois).

EZ-livefreeordie...| 12.29.10 @ 1:27PM

ArmyGuy,

Love that sentiment (and slap) in your last few sentences. Seems the liberal disorder has floated across the Atlantic, and we need the tide to reverse...

Ross Kaminsky | 12.29.10 @ 9:40AM

Rocknal,

Interesting points. Allow me to respond:

Yes, money is the best approach to rationing as it is the only way we have to ensure that the proper signals regarding supply and demand are sent and received. Health care is, after all, essentially like any other service, or should be, in terms of economics. I realize that the operation of the health care "market" is wildly distorted by government but that doesn't mean there are any answers to be found by distorting it more.

As to why we do not ration police or military protection by money, it's because those are legitimate constitutional functions of government which are put in place to protect our negative rights.

In a sense, your question proves my point: If health care were really a "right" then it should not be rationed by money (or perhaps by anything else.) But since it's obvious that it must be rationed, then it's also obvious that it's not a right.

Finally, you talk about "solving" health care and suggest that other western countries are models for that. Yet many thousands of people (who can afford it) leave their "free" systems to come get care in the US because they care about quality over price when their lives are at stake.

Single payer is a recipe for disaster. Just ask people in England with wet age-related macular degeneration.

rocknal| 12.29.10 @ 10:05AM

Ross,

Your points are rational but wrong-headed.

The reality is that we DO ration police and fire protection by money in most communities......compare the response times for 911 calls by zip code and you will see a very disturbing relationship (at least is is disturbing if you believe we do not ration by money) between wealth and police and fire protection. I believe that correlation should be the source of national shame, as it should be for health care.

As to healthcare being like any other good or service, again I think you miss the reality. I may not care whether you own a good car, a lousy car, or no car at all, but I certainly SHOULD care whether you are sick or healthy: if you have a communicable disease, I may catch it. The "free market" (which no longer exists in our complex, media-drenched, over-populated society) does not allocate goods effectively when it comes to health care for MANY reasons, including:
1. Too many externalities (I am impacted by your health)
2. Too much inequality of information between suppliers and demanders: markets work when information is roughly equal between supply and demand, but in healthcare the balance is completely tilted in favor of suppliers: doctors tell us what we need, then they provide it.
3. There is no good evidence that real economic decision-making operates in healthcare: our system of insurance has been shifting more and more economic burden onto individuals for over 20 years in the form of higher copays and deductibles, to the extent we now have the highest individual "out of pocket" expenses of any country in the "industrial world". Yet we still have the highest consumption rates. Shifting economic responsibility to individuals has done nothing to bend the cost curve.

I could go on and on, but bottom line is that healthcare is NOT a "normal economic good" by any definition recognized by economists, so relying on the market to ration it is doomed to failure. And failure is what we have.........unless you are very rich. See my note to Tom.

As to your point that wealthy people from all over the world seek treatment for some conditions in the USA, I completely agree. We do have some of the absolute best care and resources in the world. The price we pay for that is below average care for the majority of people for the majority of conditions. You may think that is a good deal. I do not.

Ross Kaminsky | 12.29.10 @ 10:15AM

Rocknal,

Unequal provision of particular services is not the same as rationing by cost. Remember, Medicare is one central pot of money. Police are funded by local governments. The fact that they may be constrained by their local finances does not mean that someone made a decision to ration service based on income of service recipients.

You should care whether someone is sick or healthy, but that doesn't mean that health care is not an ordinary good. You should also care whether someone is driving a car with functional brakes.

Your argument that markets only work when information is symmetrical is absolutely wrong. When you are determining whether to buy a Windows-based computer or an Apple computer, do you know how to write an operating system? Does Microsoft or Apple know anything about you or your intended use for the computer?

No, information need not be symmetrical. All that's necessary is that both sides believe they're making a mutually beneficial transaction.

As for "overconsumption", the problem remains very low deductibles and co-pays even if they have been rising. When people feel like they're spending other people's money, there is no spending discipline.

Where is your evidence of below average care for a majority of the people? I would suggest that's a ridiculous proposition.

rocknal| 12.29.10 @ 11:30AM

Ross,

I guess you are one of those who are so caught up in their own political biases that reality is just another inconvenience.

From the bottom up:

The US healthcare system is one of the lowest rated in the industrialized world on most common measures, including overall efficacy, nosocomial infection rates, life expectactancy, infant mortality, etc., etc. See the WHO (World Health Organization).

Re. "overconsumption" and "other people's money": we have the HIGHEST out of pocket expenses (paid by the INDIVIDUAL, and along with Switzerland) of any industrialized country (See the OECD, 2009). We also have the highest consumption. So individual responsibility for expenses has no correlation with resource consumption. If it did, all those other countries where they really DO spend "other people's money" would consume more care. Your argument is just wrong.

As to symmetry of information, you are again missing the obvious. Of course information is never perfectly symmetrical. But the relative degree of imbalance in healthcare far outpaces the imbalance in things like technology. There are multiple competing vendors, ratings organizations, market intermediaries, etc., which help balance the scales in regard to consumer goods. This is just not (at least not yet) true in healthcare, where no one can even agree on what good quality is or is not, except in regard to systemwide performance issues (like infection and mortality rates). You know whether you want to buy a computer, but you have no idea whether you want (or "need) and MRI rather than a PET scan or a CT. You only have your doctor's word on it. And before you cite WebMD, that is just not a substitute for a professional opinion. At its best it prompts good questions, at its worst it makes people think they have enough information to formulate answers (while it does NOT).
As to ordinary goods, please see any economics textbook. Where there are major externalities (e.g., national defense), markets do not work to regulate industries. The externalities in healthcare are huge.
Finally, your "local market" distinction re. response times for services does not address the differential between, for example, Harlem and Sutton Place. Both are served from the same local fund of money. But ambulance response time in Harlem (22 minutes) is 3 times slower than Sutton Place (7 minutes) on the same island (NYC Health and Hospitals corporation, 2008). Same island, same fund, different per capita incomes, different response rates. THAT is rationing based on money. It is ugly, and it stinks.

Ross Kaminsky | 12.29.10 @ 11:48AM

Rocknal,

We're going to have to agree to disagree on most of this.

One quick point I want to make is that much or most of the WHO's low rating for the US is based on the fact that we don't have socialized medicine. I'd also point out that the life expectancy and child mortality stats are wildly distorted by the differences in how we measure them versus how other countries measure them.

I'm leaving for the day and probably won't respond to comments on this article again, but thanks for reading and thanks for the conversation, including the polite disagreement.

Tom| 12.29.10 @ 12:38PM

Rocknal,
You make some good points. Some things to ponder:
A large chunk of the lowest income quintile already has access to government insurance and their infant mortality and life expectancies is not statistically significantly different than those in that quintile without access to insurance. There might be more going on here than simply insurance access.

Infant mortality numbers are notoriously tricky. Some nations encourage terminations for difficult pregnancies. Also, some countries do not count extremely premature babies as live births. See http://www.webmd.com/baby/news.....ality-rate

One interetsing statistic to look at is current life expectancy, the number of years an individual can expect to live. The UNited States does better on such a rubric. One of the leading reason behind our less than stellar life expectancies is the number of young men killed accidentally or by violence. This impacts the overall life expectancy statistic but really is not a measure of quality or access of care.

I agree with your point regarding response times. It is pretty easy to plot response times to particular zip codes. And most of the time response times will be faster the higher the income level is for that zip code. That of course is a failure of government. Why do you think it would be different with health care?

Laura| 1.3.11 @ 7:41AM

I guess you have never heard of Sicko? I don't know what single payor is, I have not read the bill because I'm sure I wouldn't agree with much of it. There is simply a great need for reduced health care PRICES, period, that is the problem.
What I do know, for sure, is that I am currently on State of WI Health Care. I had to have relatively major surgury about six months ago on a condition that I had 4 other prodecures done one in the previous six months. As usual, my Drs and Surgeons claim to know more about me than I do. I don't get the exact procedure I want. I am angry the Dr is getting money from the State each time he mandates a "follow-up" that lasts for 5 minutes. I've voraciously researched homeopathic medicines, and I think that I just squelched a flare-up with a $20 bottle or organic oregano oil. Not even close to the whole bottle. I resent the idea that if I go back to get "checked-up" this Dr will get paid, again. Paid to look and give opinion and advice. Whatever.

Jack London| 12.29.10 @ 10:23AM

Excellent post rocknal - I was too angry with the writer to remain as calm as you. To pretend that the health and wellbeing of people is not an underpinning asset to a nation is ridiculous, while of course the constitution speaks of 'promoting the general welfare'.

Your economic points are to the point. And what Kaminsky fails totally to realise is that the aim of healthcare reform is not to give people a free ride but to get them to contribute to something they can then see as a right.

He could also wonder why many thousands of Americans are driven abroad for care, and many millions live day by day with treatable conditions because they can't afford treatment/fill prescriptions.

Ross Kaminsky | 12.29.10 @ 10:54AM

"Jack",

Your argument could be used to support anything you think is a good idea. Replace "health and wellbeing" with "a good car" or "a big house" or anything else and your statement is still something some liberal would say.

That's because your intellectual approach puts no limits on government.

Furthermore, your understanding of the General Welfare clause is dangerously wrong. If the intent of the Constitution was to allow government to do anything that politicians thought would be good for the people, then what would have been the point of enumerating specific rights that the government has and saying explicitly that it has ONLY those rights?

Your statement that the aim of health care reform is to get people to contribute is laughable.

Please tell me how many "thousands of Americans are driven abroad for care" in comparison to how many foreigners come here for care.

I don't know where you get your information, but you strike me as someone whose only economic learning comes from the Daily Show and the DailyKos.

It's lucky for Obama that there are people like you out there because if more people understood economics and our constitution, he wouldn't have a chance to win reelection.

Jack London| 12.29.10 @ 11:16AM

I see your disguise is coming off Ross. This is fatuous by any standard.

To equate a 'good car' with say a safe delivery of a baby and all that means to our population is so far out of any useful comparison I hardly think it's worthy of further comment.

As for the reform, what is your understanding of the purpose of the insurance mandate if it isn't to get every American who is able to to contribute, as we do with Medicare?

You can do a bit of Googling yourself on medical tourism. What I can tell you is that many people also go to clinics in Switzerland, UK, France, Germany etc. But no one is disputing that the US doesn't have many great facilities, given the money. But they are not available routinely to many Americans.

Tom| 12.29.10 @ 12:44PM

No, promoting the general welfare does not do give carte blanche to gvernment to provide services. The pre-ample to the Constitution describes the purpose of the document it does not enumerate powers.

If the people of a state are clamoring for government sponsored health care let their states enact such care. That would Constitutional and proper.

Ken (Old Texican)| 12.29.10 @ 3:56PM

Hey Jackwagon.
Missy, you are dreadfully misinformed.

ALL of our facilities...except the hospital Michelle Obama sent people away from.....give the best they have for everyone.
They don't do breast enlargements, or facelifts and such, but other than that, God bless 'em they heal poor people every single day.

Uh, they do so with NO pay. They just add a couple of hours of desperately hard work per day to do so...
.....you scrawney communist, (pardon the shorthand), stupid.

Laura| 1.3.11 @ 8:01AM

Wow, which party does the one who spews the abuse adhere to then?
My Drs get paid bucho for looking and acting important for 5 minutes. That's the case for most that make the most.

Curtis Rasmussen| 12.29.10 @ 12:41PM

If I had to guess, Jackass London and Rocknal are one in the same. No other rational person would agree with the oppressively left, contradictory, and irrational arguments made by this individual and his supporting cast of sock puppets.

Ross' article makes perfect sense. Cost becomes the primary factor when government is involved. Watch expensive but effective treatments dissappear for the common bad and Medicare betray the elderly to early death to save a buck.

Obama holds these truths to be self-evident, that all men are created to serve the welfare state, that they are endowed by Obama with certain temporary positive Rights, that among these are Life, Liberty and the pursuit of Happiness

Laura| 1.3.11 @ 8:14AM

But, cost is the primary factor because government is not involved. The free-market has been skewed to artificially favor the already successful (with help from the gov), to the point that the richest no longer have regulations. De-regulation mandated by the WTO is what has caused rapid globalization. Allowing huge payouts to the failed corps by the gov is what continues to spur our elite-baised, un-free market. At this point I would simply pursue law-suit reform because they are what raise private insurance for the providers. I earnestly believe that the FDA is one of the most heinous organizations on the planet. Soon we will all be sick, tired pill poppers. Having the feds mandate more than they should is a bad idea. If it weren't for the FDA, ephedra for example, wouldn't be illegal. According to the FDA, "Only the FDA Can Cure, Treat or Prevent Disease." In reality, they say we can only have artifical chemicals and surgery.

George S| 12.29.10 @ 11:43AM

Your economics is way off. The reason the cost of medical care is rising has nothing to do with a defect of the free market. The reason is the same as the price of housing outpacing the rate of inflation by a factor of seven during the late '90's to the mid 2000's. When government mandates that mortgages be made available to those who would otherwise not qualify, it lets loose more buyers into the market, driving up demand of a scarcity (housing) which causes the prices to rise. This, in turn, encourages more buyers and then investors, all of which put upward pressure on prices. This encourages more money to be shifted toward the bubble as new financial instruments are created to meet the demand. The market reacted to external (government) influence. Reacted, not initiated.

Health care is the same. When employers were able to offer health insurance in lieu of wage increased during WWII, this increased the consumption of health care as employees did not incur the direct cost of the services they consumed. The medical providers saw insurance as a way of increasing their business so they lobbied government to mandate insurers cover their services. Government then mandated all sorts of medical services to be covered, prohibited insurers from tailoring custom policies at different price points and also prohibited sale across state lines. Coupled with tax breaks to employees, and insurers being able to tailor policies only to businesses, employee health benefits were the staple of most of the health care spending while those who paid for their own policies saw their premiums rising. More consumers, coupled with limited suppliers increase the costs as those who consume do not pay the value of what they receive. This only encourages those with excellent coverage to seek out the best medical care has to offer, thus driving up the price. Those who pay for their own policies with after tax dollars are left holding the bag.

But it doesn't end there. Medicare, which is supposed to reimburse providers simply is not efficient in paying, often making providers wait months and paying only 30 cents on the dollar. This shortfall is what causes providers to overcharge insurance companies in order to make up the difference and keep their doors open. Insurers then pass on this cost; employers absorb it easier than the private individual.

So it is not the free market failing, it is the free market reacting. It cannot ration on price because no one pays their fair share of consumption; it instead rations on those who have the better employer policy. Government has created the problem but is very adept in shifting the blame so people can believe that if only there was single payer, there would be no problem.

Remember, all of this started with the premise that there are 48 million uninsured (30 million citizens). How many of those uninsured were priced out of the market by all-or-nothing insurance premiums, which were no difference in price even among non-profits?

Making insurance cheaper is the only way of providing health care to all. The only way to do that is to let insurers offer what risk you are willing to buy. Then the only excuse for not having access to health care in a Medicaid and mandatory ER treatment world is that you choose not to buy it.

Jack London| 12.29.10 @ 12:09PM

Well, you've left out crucial facts such as the enormous increase in technology (machines, drugs) and its cost. But yes, making insurance cheaper is the answer and all you are saying from what I can see is that we should have a single payer system.

George S| 12.29.10 @ 3:50PM

Jack, correct me if I'm wrong... but wasn't the selling point of including single payer in the health care bill that it would provide competition and lower the price? That's was the talking point over and over at MSNBC. But leaving the government as the only payer is a monopoly and monopolies cause prices to rise, not fall. This is the justification the FCC is using in net neutrality.

Unfortunately, the only way to reduce the cost of insurance is to let the insurers compete by offering different coverages at different prices and -- the unfortunate part -- not to prohibit the insurers from choosing their customers. Would you invest in an insurance company that waited until people had a fire, an accident, or an illness to cover them? Where would the money come from?

About technology... that refutes single payer, it doesn't support it. Those advances were made because people took risks that those expensive medicines and machines would have a market. If government were the sole payer, what would entice me to take a risk with my time and money to develop a technology that the government may not buy because it deems the cost as wasteful? That is the problem with single payer -- capital is directed where it benefits government politically whereas the market directs capital where it provides a return. Since the latter causes one to lose money if they guess wrong, capital is more efficiently allocated and more people benefit. Government, on the other hand, need not worry about efficient use of capital as it can always compel a supply at threat of imprisonment.

Jack London| 12.29.10 @ 6:18PM

Well George, I appreciate your thoughtful response, at least you're trying to analyze the issues.

First, there's no way private insurance will be driven out of the US. I believe that even England has a thriving private market. There will always be several tiers of insurance but a national plan is in my view an essential lower tier. It will also help drive down provider costs, which have run away in recent years. Just Googling around on this I see that the UK health service has been instrumental in getting major drug discounts, which other European countries have also benefited from.

As for innovation, I appreciate that we are the engine room of medical progress. But I can't see that stopping either, as it is the providers who buy it and not the insurers. The American market is simply too large for innovators not to continue, and we mustn't forget that it is the government that funds much research, at say the National Cancer Institute. Who were the major funders of the Human Genome Project? We taxpayers were.

That said, it is clear that the market doesn't give us the best medical benefits. Many conditions go without any private investment while other 'blockbusters' are targeted by several companies, often for dubious medical returns but marketed with more money than the development costs. Just look at what's happened with cardiac stents and latest cancer drugs that give only a few weeks extra low quality life.

Laura| 1.3.11 @ 8:24AM

As far as housing inflation is concerned, I have never heard or read any media source citing building supply cost as a factor. I worked for a RE until fall '08, and am also a homeowner that has the entire exterior of my home redone. This was a major factor in housing cost inflation after Hurricane Katrina and exporting our materials to Iraq. The price of oil increase is also about the same as Asphalt Shingles, etc. I have been tempted to find blogs about this and start pointing to those blaming the consumers to start looking at other reasons. After all, everyone needs a home regardless. If they don't own, they rent what someone else therefore still owns.
I'm a lucky Gen X that has seen crazy inflation, not equaled throughout history, in my lifetime.

George True| 12.29.10 @ 2:13PM

"Capitalism works well for distribution of some goods and services.....but far less well when it comes to safety, protection, health."

In my humble experience, the about statement is absolutely without basis in fact or evidence. A truly free market will always deliver the goods at a lower cost and with greater efficiency than government ever can. And health care is no exception.

The ONLY way that costs will ever come down is for government to get out of the way completely and allow a consumer driven health delivery system to function properly. Single payer will fail even more miserably than the current system at controlling costs, simply because there will still be a third party payer involved. There is no incentive for providers to compete for the consumer's business.

Why is it that our parents' and grandparents' health plan worked so well for the last 60 years, but it's not working so well now? The answer is, back in those days the health plan paid the catastrophic stuff (hospital, major surgery, etc) but the small stuff (everything else) was paid out of pocket by the insured. Costs stayed affordable because people were paying their own money, there was no third party payer, except for hospital/surgical.

A cash customer needing a surgical procedure today can get it for 20-25% of what the third party payer (insurance company) is billed. This is a fact. I have researched it, and I also know from my own personal experience and that of a few friends.

Under single payer costs will only go higher, and at the same time quality and timeliness of treatment will suffer. And the government will have destroyed a system that is currently covering 90% of Americans under 65 (who are not on Medicaid) at no cost to the government.

rocknal| 12.29.10 @ 6:02PM

So much ignorance, so little time.....

I see I have wandered into Fox Noise territory....mostly well intentioned people who do not understand who their enemies are....

Government is far from perfect....no one I know ever claimed it was.....but I would prefer the government be in charge of the "commons" (i.e., basic infrastructure, safety and security, yes, the Post Office, air traffic control, and healthcare) than having them be run as "for profit" enterprises. I will not bother defending the Post office here, but I will challenge any of its detractors to find a private delivery service who can get a letter across the country (particularly to areas that are sparsely populated) for the subsidized rate of $1.25 (the average cost of subsidy plus first class postage). Last time I looked, you could not get Fed Ex to go to those places for any price......and if you could, they would likely charge more like $50 for 3rd day service.

Be that as it may.......

Obama is about as much of a socialist as Alan Greenspan. And almost as misguided. Anyone who believes otherwise is too dumb to even respond to.

The comments about healthcare as a normal economic good are pathetic in their ignorance. Go read a text, even a conservative one, on what makes a normal good. I will not waste my time on that level of ignorance either.

What is most frightening is how well the Right wind noise machine has done at persuading people to act against their own economic interests. If you are not earning over $250K annually (which I am, by the way), and you support the right wing agenda of endless tax cuts for the rich, you must either be living in some fantasy where you will become rich (increasingly unlikely in America, which has gone from the most socially mobile society 60 years ago to one of the least socially mobile societies in the industrialized world), or you must just like the idea of someone fiddling while Rome (the US of A) burns. And no, I am not moving to France. It is those of us who are Progressives who are the true Patriots: I am fighting against tax breaks for corporations shipping jobs overseas. It is the Conservatives in Congress who are fighting for them. I am opposed to the US being the international poster child for torture. It is Dick Cheney who supports that (while shipping not only jobs but corporate headquarters overseas to reduce the taxes paid to the USA). He is the War Criminal and traitor, not the Progressives.

It IS class warfare, and the superrich have been waging and winning that War for the past 30 years, with the help of Reagan, Bush, Clinton, Bush, and now Obama. The middle class is on life support at best, and running out of the money to keep paying for the machines.

Getting back to healthcare and class warfare, it is true that the poorest in this country are insured under government health programs, like Medicaid and CHIP. It is also true that these programs pay so poorly that most qualified providers either refuse to take them as a form of payment AND /OR cut every possible corner in delivering care for Medicaid recipients. There is nothing inconsistent about recognizing that these programs are grossly inadequate while wanting MUCH MORE government involvement in funding care. It needs to do so at more competitive levels. Like Medicare (which is also less than perfect, but far better than Medicaid).

As to the efficiency of the public vs. private health insurance programs, Medicare uses 96% of its funds to pay providers, and 4% to pay overhead. Commercial insurance uses about 80% of its funds to pay providers (which they call the "medical loss ratio"......which gives doctors fits) and about 20% to pay overhead, advertising, and PROFITS.

As to the 2% profit number, it needs to be looked at in context. You cannot compare insurance company profits to operating companies, which need operating margins in the 15-20% range to yield profits in the 8-12% range. Insurance companies, like banks, are in the business of handling money. They make most of their money off investments and the FLOAT of the money they handle, not from "operations". If you want a little history lesson, look up the rate of premium increases in malpractice insurance. They correlate very well with poor stock market performance, and correlate very poorly with increased malpractice suits or settlements. But the insurance companies blame the injured patients and their lawyers rather than their poor investment performance. And most of you buy into their drivel......

To quote an old time socialist: YOU DO NOT KNOW WHO YOUR OPPRESSORS ARE. You have been duped (unless you really are both filthy rich and socially indifferent).

Turn off Glenn Beck and Bill O'Reilly. Find better news sources. Read a book. You owe it to your children.

Jack London| 12.29.10 @ 6:33PM

Excellent again Rocknal. I'm saving this one for future reference.

LiveFreeOrDie| 12.30.10 @ 4:06PM

"Government is far from perfect....no one I know ever claimed it was.....but I would prefer the government be in charge of the "commons" (i.e., basic infrastructure, safety and security, yes, the Post Office, air traffic control, and healthcare) than having them be run as "for profit" enterprises. "

I got two words for you pinhead, SOLVENCY and SUSTAINABILITY.

Liberals being lead around by politicians who love ponzi schemes who will never be around to pay the piper. Turn off Chris Matthews, you owe it to yourself.

Laura| 1.3.11 @ 8:39AM

Yep, malpractice....
How can you put a price on a human life? It just shouldn't be done in such a way.
They prices charged for lack of positive outcome should simply be refunded. And the government should get a fine payment, And every regular period pay Drs a bonus if they have excellent track records. I believe this should alleviate the pain of losing a loved one due to malpractice. If a humiliating punishment was given due to malpractice, it would be enough. After all, I believe each life is worth more than all the money in the world. For, we created money to serve us.
But really, the oppressors are republic/corp. And that does, actually, include certain health care mandates.

Banjolou| 12.29.10 @ 4:16PM

The problem, indeed is money. You seem to feel that it grows on trees. Would you be willing to see your fellow indigents housed in quanset huts and fed from a mess hall to pay for this? Probably not. Would you see all the unwilling or unable once again housed together in high rises that are falling apart? I think not. All of these things cost money, and every time somebody cries foul you want to throw somebody elses money at them. How many square feet of housing is fair for someone unable or unwilling to work for it? How big a T.V. What quality steak or price of tennis shoes?
Jesus would teach them how to fish, you just want to take everybody else's fish and give it to them.

Aidan| 12.29.10 @ 9:09AM

Good article.
Shame it ended with "Either they're all "rights" or none of them is."
Should be "....or none of them are" since the sentence uses a plural pronoun (they) + verb (are) so none references "they."

Ross Kaminsky | 12.29.10 @ 9:32AM

Aidan,

Interesting point. It's long been taught that "none" takes a singular verb since it's basically short for "no one".

And while I see where you're going and while a little research shows me that either of us could be correct, I like the emphasis on each "right", one at a time, that the singular verb implies.

But I do appreciate your noting that level of detail (seriously!)

PerryM| 12.29.10 @ 9:11AM

Health Care is NOT a "right" - it's a "left"!

A "right" is something that everyone has and it costs not one penny to anyone.

The "right" of free speech is an example. Of course that "right" cost money and lives to get - our War of Independence, all the World Wars and our Civil War are examples.

A "Left" is something Wacko Lefties want their voters to have, for free, and the "rich" pay for it - a vote buying scheme.

I thought everyone knew this stuff......

Gary| 12.29.10 @ 9:15AM

I like this article; to say that one person has a right to healthcare is to say that another person has the duty to provide it. I have the right to not get punched in the face by an angry lib; the angry lib has the duty to not punch me in the face.
The problem with this (obvious to the non-statist) is, what do we do when the doctors decline to take Medicare or other gov't sponsored insurance that reimburses at rates which cause them to lose money? Do we force them to take this insurance? Let's say that we do. When thousands of doctors decide to retire early rather than be forced to provide their services at a loss, what do we do? Do we tell them they can't retire? What do we do when not enough college kids choose medicine, because it is no longer lucrative enough to attract the best and brightest?

Here's a simple litmus test for the statist: if what you're positing as a "right" imposes a duty on others that is inconsistent with the basic tenet that "slavery is bad, mkay?" then it is NOT a right!

Laura| 1.3.11 @ 8:50AM

I firmly believe that healthcare shouldn't be a chosen field because it is lucrative. This is a field of service, and should be the most humbling and collaborative at that. Do nurses choose healthcare because it is lucrative for them?
I believe that we have right to access, although technically I do have a right to access if I simply sell my house and have major debt/bankruptsy to cure a disease. Many ancient practices are banned in this country, cause the FDA said they aren't a right. I believe they are.

jimP| 12.29.10 @ 9:17AM

It has always seemed to me that no person can have a right to a good or service that some other person has to provide. Mr Kaminsky makes this point eloquently.

NavyBrat | 12.29.10 @ 9:29AM

Can any of our supposedly "intelligent" trolls tell me WHERE in our Constitution it says that health care is a "right?" This is, after all, the crux of the issue. Jack London, anyone? Bueller? Bueller?

Oh, & I too want to see the studies that you eugenecists are droning on about that say that people with less treatment towards the end of their lives live longer or have a better quality of life.

Michael| 12.29.10 @ 9:32AM

"populace" is the noun Kaminsky wants (paragraph 8); "populous" is the adjective.

Ross Kaminsky | 12.29.10 @ 9:35AM

Good catch, Michael. Will fix it. Those are the sorts of brain cramps I have when writing far after my bed time!

Harry2248| 12.29.10 @ 9:34AM

Nothing that someone else has to pay for is a right.

Martin Rheaume| 12.29.10 @ 9:35AM

Now if only I can get everyone on the right to agree that I have an inalienable right to smoke marijuana...

LibertyHight| 12.29.10 @ 11:29AM

You have the right to do anything you want as long as it does not directly harm someone else. End the war on drugs now!

George S| 12.29.10 @ 9:37AM

Sometime in the future...

Since government now has the power to determine the value of life, the next logical extension of the state is to define how long life should be. The HHS has determined that each individual has the potential to live 120 years, based on current records. Those who die earlier leave a deficit, which the state has a claim in terms of duties of citizenship. One of those duties is voting. Leave aside taxation and asset accumulation for now. The Congress now proposes a bill that will allow citizens to vote by proxy; the only citizens eligible are Post Mortem Citizens, those who are deceased less than 120 years from birth. For now, those proxy votes can only be for President and Vice President, and the law delegates the proxy vote to the Electors of the Post Mortem Citizen's state (to comply with the Constitution).

As one lays dying, the state offers a proposition: we will aggressively -- and at all costs -- treat your disease in an effort to extend your life as long as medically possible. In exchange, you sign over your proxy votes to the Democrat National Committee. Thus your right to medical care is upheld, as is your right to vote -- only the state does it for you. Neat and simple.

Of course, now would be a great time to repeal the 17th Amendment, making it constitutionally possible to assign your vote to your state legislature for the choosing of Senator.

All sorts of possibilities exist when the government has you by your health.

pacraft35| 12.29.10 @ 9:55AM

Take the "health care is a right" argument a little further. On a Maslow style hierarchy of needs, that would mean that every need below health care is a positive right - food, shelter, clothing, transportation, employment, not predicated on any responsibility or action on the part of the recipient. In other words, every person would have the right to demand such things, at a level that gives them dignity, of course, from the rest of the community. Even if one refuses to work, abuses drugs, has multiple children out of wedlock, or kicks stray dogs, one's positive right to the fruit of someone else's labor would still exist.

Want to live in such a world? Indeed, we have pockets of such places in this country and I can honestly say that I felt safer on the streets of Kabul than I do when I have to venture into those places after dark.

Tim Cox| 12.29.10 @ 9:56AM

If health care can be considered a basic right, then why not something even more basic - like food, clothing, or shelter? Ask anyone if people have a "right" to food, and they would surely say "no". Then why is health care considered a right? Or education?

The answer is because our welfare state has been providing these benefits to those who do not pay for them for generations. So we are moving from entitlements to "rights".

We have lost our collective minds.

Dixie Pixie| 12.29.10 @ 9:58AM

Pardon me for combining a reply to two threads in one post
(aka...."Net Neutrality is Theft" and "Is It a Right or Isn't It"....)

Gentlemen I have an open question.
How long does the current Federal Government expect to last.

In the net neutrality article it is openly admitted the President and his minions are beyond the constraints of the Constitution and written Law.
In the ObamaCare article it is implied that the Federal Government is striving to resolve a budget problem by killing off its most expensive citizens.

How long can a government last when its members openly flaunt its disregard for Law and are an active danger to its citizens.
Add to that the Federal Government is ignoring the last election results.
It then becomes clear the government no longer consider "The Consent of the Governed" or " Rule by the People, For the People" to be in existence.
How long will the American People allow this condition to to last when they loudly yelled "Hell No" just 2 months ago.
Also consider that the recent start-up of propaganda efforts by the MSM to sell life termination by governmental neglect, indicates the situation is Ruling Class wide.

How long can the "1st American Republic" last.

Or even a better question is, when will somebody notice the government has been running on "Good Will" vapor for years.

Mimi| 12.29.10 @ 11:26AM

I'm with you DIXIE...The crew that came in Jan.2009 is way out of the "mainstream"....They were rejected 57 days ago and remain in DENIAL... Keeping -up with the same old commie tricks is going to get them behind bars or fined til their broke!!...There is a spirit a blowing, a passion and great love of our founding principles, thru-out this country and it is multiplying...and REAL. The county is blessed...we will survive this time....God BLESS AMERICA!!

Dixie Pixie| 12.29.10 @ 4:54PM

Greetings Mimi
It is good to hear from you again.

What prompted my post was a Katie Couric interview with the CBS in-house Doctor.
I was not surprised that CBS was in full propaganda mode in support of the Obama administration.
Nor was I surprised that the in-house doctor was a perfect Couric hand-puppet.
What did surprise me was what he said.
To summarize he said that "....as doctors, we must train ourselves not to gave a patient all available treatments....".

I was astounded that any doctor would insist that blatant violation of the Hippocratic Oath, common decency and mercy was a good idea.
To insist that it is better for a patient to die of governmental neglect in squalor was astounding.
It would take the guts of a New Yorker stepping over a dying homeless person to ignore the such a basic evil.
But to do so is to add a cash motive to malice.

The Boomer demographic bulge is hitting retirement age.
As a result, the needs of the Boomers are impacting the Social Security money extracted by the Federal Government.
With the Governmental takeover of the healthcare industry, the Boomer demographic bulge will impact the amount of money the Federal Government can extract from the healthcare industry.
The preferred solution for the Federal Government is for the Boomers to kill themselves off before they are too expensive to keep alive.
If they don't then the next step is to "help" them make the "right" decision.

When a government tries to kill of a portion of its population then that population is highly motivated to eliminate the government first.
Thus my question, how long can the 1st American Republic last.

rocknal| 12.29.10 @ 6:14PM

the only death panels in action are the ones currently being run by the Republican Conservative governor of Arizona, who is denying life saving treatment to people who are in need of transplant services due to shortage of funds.

There is not now, nor ever was, provisions to deny treatment to people who want it as part of what you call "Obamacare", which never did go far enough. There is now (and was) only provisions to pay doctors to counsel patients on end of life OPTIONS. As a good capitalist you must realize that if you do not pay doctors to discuss options with patients, the doctors will not do it: they will (mostly) do exactly what they are paid to do, and nothing else. So people will not understand their legitimate choices regarding the length, intensity, and intrusiveness of care options. They will just get what their doctor recommends at the moment the decision is needed: which will usually be the highest cost, most intrusive care (because we pay the doctors the most for that, and they too are good capitalists). Denying people the opportunity to discuss options when they may have the time and perspective to consider what they really want, the trade offs between length of life and quality of life, the time to process with loved ones: IS THAT WHAT YOU REALLY FAVOR? LACK OF INFORMATION? If it is, then there really is nothing more to say to you.....

Dixie Pixie| 12.29.10 @ 11:06PM

Greetings Rocknal
You must have misunderstood the thrust of my argument.

Two months ago I had the nightmare experience of a family member who suffered successive organ failures. Over a period of a month the doctors did everything to keep a beloved uncle alive. They failed.

I was in the family-doctors conferences in which every treatment option was discussed. The problem is not a lack of information. The problem is under ObamaCare my uncle would not be given the options he was given under the current medical system.

Under ObamaCare, cost / benefit considerations would be paramount. He would have been sent home to die of deliberate governmental neglect. The family would been left with the question of what could have been. Under the current system all the family members were satisfied that all that could be medically done was done. Under ObamaCare he would have been tossed out of the medical system to die alone. Rage at the governmental system of ObamaCare would be the logical response.

So my question still stands.
How long does the current government expect to last when it openly kills its most vulnerable members due to cost considerations.

No government has ever survived the loss of the consent of the governed.
Are Obama, Pelosi and Reid so calloused and witless that they think they can last under those conditions.
How long does the "1st American Republic" expect to last under ObamaCare.

rocknal| 12.30.10 @ 6:57AM

Dixie Pixie, first, my condolences on your loss.

I am not sure where you get your misinformation about what you call "Obamacare", but as a professional healthcare consultant and attorney I have actually read the entire 2000 page legislation, and there is NOTHING in it that would restrict the access to care any more (or for that matter, any less) than the current system does (other than providing insurance to about 65% of the currently uninsured). If you can point me to that provision, please do. If you cannot, I suggest you stop listening to Fox Noise spin, and find a better news source. The ones you are listening to are lying to you.

Dixie Pixie| 12.31.10 @ 5:16PM

Greeting Rocknal
I assume you are an attorney of eloquence and elegance.
Although I do wonder why you hate the table as to pound it so much.

I did notice you failed to answer my question and did your best to ignore the facts presented.
The bottom line is Obama stood before the Congress , USA, World and GOD to dramatically deny the existence of "Death Panels". Now the "Death Panels" are back by Executive Edict.

My question addressees the political implications of Obama and the Liberals policies.
Strange isn't that Leftists will not face the results of their policies and do their best to obscure the obvious.

The Ottoman Empire took centuries to die, yet the Soviet Empire imploded in less than a year.
Does the Left truly believe the USA and its people can take an infinite amount of governmental abuse.
Rocknal, My question still stands, How long can the 1st American Republic last?

PS....I got my information from CBS not Fox News.
Does CBS lie?
That is another great moment of "DUH".

PS2....Just for the record I used logical analysis guided by historical and personal experience.

Crusader| 12.31.10 @ 6:25PM

The fact that it's 2000 pages is a travesty. Give me a 10 page bill and we'll talk.

Calvin | 12.29.10 @ 10:01AM

Chuck;
Blessings of liberty on you and your rational family. I have been a crtical care doctor in a small city for 3 decades. Over the yeass there has been a slow decline in patients' willingness to trust doctors or to believe the medical facts when they are presented. My experience is that the majority of families reject the rational process you and yours used to choose the path you wanted for your loved one. I think that the lack of economic incentive to choose the better path (as I see it) and to forego the cost, discomfort, and emotional pain is a big part of the problem. I sympathize with people who have a real hard time saying that it is time for their beloved aged family member to shuffle off these mortal coils today, as opposed to waiting to see what might happen; they are spending someone else's money while they wait, and it is emotionally a lot easier to defer that big decision.
I am sorry for your loss.

Gregg| 12.29.10 @ 10:20AM

Curly Smith wrote:

"We know that huge amounts of completely wasteful care is expended in the final weeks and months of life because huge amounts of completely wasteful care is expended in the final weeks and months of life."

Curly, who decides it's wasteful?

You?

Some bureaucrat in DC who knows nothing about you and couldn't care less?

How do you conclude that huge amounts of money spend in the last weeks/months of life is wasted money? By what measure?

Curly Smith| 12.29.10 @ 12:25PM

Try reading the entire post.

A. C. Santore| 12.29.10 @ 10:21AM

Two points:

1. Has anyone calculated the cost of providing this "Death Option Counseling" [call it by its right name] every year for every Medicare patient?

That money could probably pay for unlimited care for those who need it. We'll never know because the all-holy/unholy terrorists in Washington don't know or care to find out.

2. Perhaps I'm the lucky exception, but my primary care and specialist physicians discuss treatment options with me every time it's needed. Why does the government need to legislate this? [Oops! "Unconstitutionally mandate" it. Call it by its right name.]

GCTIII| 12.29.10 @ 10:25AM

These arguments do get old. I have never posted but had to chime in on this one. A terminally ill person no matter the age needs to have family or friends, their insurance, foot the bill.

We always talk about the cost of the elderly and never discuss people having children to get benefits from taxpayers. Maybe it is time to have these discussions about hte young lady who has had multiple children and does not work, nor intends to work and we continue to provide her with healthcare as well. There comes a point in time when enough is enough, no matter the age.

Yet most articles are about elderly and most people do not want to discuss people in the society that have never contributed a thing to it and continue to take from it. Maybe they need to be cut off as well. We cannot continue to promote bad behavior at both ends of the spectrum.

Laura| 1.3.11 @ 9:05AM

Here you would need to socially judge each individual person.
I'm sorry, but each and every system, and not just welfare, has those that take advantage of loopholes and get away with it.
It seems a remedy is to tighten up the benefits, and create a disincentive and apply it evenly across the board - no exceptions.
There would still be those that benefit unfairly.

PattyMor| 12.29.10 @ 10:31AM

The granting of rights to one group at the expense of another group, is simply slavery with a nicer gloss than the old plantation days.

Remember the words of Miss Nancy: she said everyone should be "covered" ie. insured. She didn't say everyone had a universal right to treatment. It may be the one time she said something that was actually truthful.

Lady Bountiful| 12.29.10 @ 10:45AM

I know a little about charity as I've been a volunteer for United Way and other charities. We were not permitted to ask for money until we'd made our pledges. I invariably found that while I could usually cajole at least a minimum pledge, the left wingers stood on Principle,"I think the Government should do that." Except for left wing causes e.g. save the children hurt by sanctions against, Sadam Hussein, they were the tightest SOB's I ever dealt with. They wouldn't kick in for coffee either!

Wayne | 12.29.10 @ 12:49PM

LOL. I found that the obnoxious guys in my softball league were all Obama donators. Their is a pattern.

martin j smith| 12.29.10 @ 10:57AM

My bottom line: If I do not like an individual practitioner or a Companies Health Policies, I can go to someone else or some other company. If it totally controlled by the government, I guess I could go to another country for health care Tourism --Is that about it ?

Gregg| 12.29.10 @ 11:09AM

A. C. Santore| 12.29.10 @ 10:21AM

1. Has anyone calculated the cost of providing this "Death Option Counseling" [call it by its right name] every year for every Medicare patient?

Even worse:

The doctor is to be paid for every consultation of that sort he/she gives. How will the government know how much of Jack London's money to give the doc?

I imagine it will come from filling out a form.

More paperwork. Making the cost of health care go up and use up something far more precious: time (in filling out the paperwork).

And since this is the President who claimed that doctors yank out tonsils and hack off limbs only because the Ferrari car payment is due, what's to stop the increase in fraud?

Why the government will hire Fraud Police of course! Who must check and cross check and visit and accuse....
all costing yet even more money.

Phillip T.| 12.29.10 @ 11:14AM

Take me, for instance; I am a 30 yr. old adjunct teacher at a local community college. I am waiting to be full-time, which will come with benefits. However due to deregulation and the financial crisis, my state is strapped for cash. This means I shouldn't hold my breath for the health benefits. What am I supposed to do? I'm a broken arm away from going broke. I'm a slip-and-fall away from being broke and out of a job. I don't completely agree with the healthcare mandate, but suggest something better. We make people have car insurance. We make people go to school till they are 16 when they could be working. This can be spun any way you like. But I would ask you to look at the personal aspect. Look at my case. What am I to do? I appreciate Obama if for nothing else that he has gone to bat for me.

LeftCoastRightBrain| 12.29.10 @ 12:15PM

Phillip-
You ought to know that the auto insurance comparison to the individual mandate is not a valid comparison. You are only required to have auto insurance if you choose to own a car and choose to drive it on public roads. If you don't buy auto insurance because you don't own a car you aren't subject to fines, taxes or penalties.

Tom| 12.29.10 @ 2:02PM

Philip,
Get a full time job while you wait for your teaching gig. Buy yourself some catastrophic health insurance, if Obamacare does not run them all out of business. Save some money. Ditch the cell phone. Buy used furniture.

Auto insurance is a silly analogy to use. Auto insurance rules are set by the state and no one is mandated to have it. It is solely a requirement to own a vehicle.

George True| 12.29.10 @ 2:29PM

Phil: You could buy some health insurance. At your age, it would be waay affordable. Probably $100/month or less if you are a smart shopper. This would include a plan deductible of $3500 for a hospital stay, no deductible for accidents, welllness benefits, and doctor visits for a co-pay of $35 per visit.

If all you want is accident coverage, it is very cheap - $15 to $30 per month for $10-20 thousand in coverage, no deductible.

Phillip T| 12.30.10 @ 10:35AM

You're a moron. You don't get a full-time job, while I'm teaching a fulltime load. I teach four classes a day. I'm just not paid for it. I'm also not allowed to have a fulltime job. I do have another part-time job though. I drive 30 miles three times a week to make a little extra.
And about catastrophic insurance: I've looked that up. Thanks! The deductible is outrageous, plus I don't trust the insurance companies to come through if I were to have a catastrophe. Let me guess: you have a job that has insurance and could care less about changing the system for your fellow man.
My parents pay my cell phone, thank god. I don't have any furniture. Sounds like you should go into poverty consulting. You don't have a clue. You think you can extrapolate the path of your life into everyone else's. That ain't how it works.
And people are mandated to have liability insurance. And that's a pretty convenient mandate when the government doesn't want to invest in public transportation. I'd be happy to give up my shitty car for a safe bus/train system.

Gregg| 12.29.10 @ 11:21AM

"This means I shouldn't hold my breath for the health benefits. What am I supposed to do?"

1) Buy your own health insurance if it's that much of a worry for you. Forego something else. Look into catastrophic health insurance.

2) When looking into your own health insurance figure out what the deductible is vs the yearly premium and see if it's not better to put that $$ away in an account.

3) So because of your life choices, I should be made to pay for your health insurance?

Jack London| 12.29.10 @ 11:54AM

Gregg:

'3) So because of your life choices, I should be made to pay for your health insurance?'

But you won't - from 2014 the mandate kicks in (hopefully) and we'll all have a portable standards-based insurance (or be fined).

Remember too who was first pushing for this - the GOP.

NavyBrat | 12.29.10 @ 12:12PM

Hey Jack, guess what? You ALREADY pay for people without insurance! The STATE eats the costs of the un-insured when they go to the ER. Tell me where the gov't. can mandate that you buy ANYTHING. Explain the convoluted logic that your ilk follows that says that NOT buying something affects interstate commerce.

Only someone on a permanent acid trip would believe that crap, let alone, expect anyone ELSE to buy it.

Jack London| 12.29.10 @ 12:23PM

'The STATE eats the costs of the un-insured when they go to the ER.'

Yes, I don't want this to go on. That's why I want people to hold insurance. Don't you?

NavyBrat | 12.29.10 @ 12:42PM

Not under penalty of tax code. Not at the direction of the gov't. Period. The end. Its NOT CONSTITUTIONAL. End of discussion.

Jack London| 12.29.10 @ 1:06PM

So you'll be happy, NavyBrat, to keep on picking up the bill for uncompensated care through your premiums and taxes. I guess you like freeloaders more than I do.

Curtis Rasmussen| 12.29.10 @ 2:31PM

Irrational. Contradictory. Whether the government forces me to pay into a pool or I have to foot the bill for the uninsured thru my current plan, the end result is the same. I'd rather choose for myself than have a faceless bureaucrat unconstitutionally decide for me under penalty of the tax code.

Look at Jackass London's prior posts. Arguing with this irresponsible apparatchik is pointless.

Laura| 1.3.11 @ 9:20AM

I'm just going to point out again that those that spew the abuse all adhere to one party.
Jack is not duped. The conservatives are not looking to cooperate. They want to compete. We live in the eat-you-all competitive, capitalistic society for God's sake.
And Yes, The Gov does demand, NavyBrat, that you pay for it. You have to pay for the Gov. I know, maybe we should all fire the Gov and be anarchists. It's so horrible. But, that's not irrational because the logic follows from your way of thinking.
Frankly, I think both the Libs and the Tight-Butts are right! We all need access to AFFORDABLE health care, health care that doesn't eat us alive in costs. I think we should have the option to pay for it ourselves. I mean seriously, we are all already slaves because we can't earn an hourly wage and still survive on the corporate-canned crap that is what we can afford. Damn all of the Retail Workers of the US. We don't need service or stores, certainly not healthy service at those stores.

Wayne | 12.29.10 @ 12:46PM

The state does not Eat the Cost as you say. The un-insured gets the bill, and an amazingly hefty one to boot. It also happens if the cost exceeds the max allowed by the insurance company.

One can not even get an estimate of what the costs are. That is because the AMA owns the Copywrite to the Fees. Yet none of this was addressed by ObamaCare.

Sonof Liberty| 12.29.10 @ 1:26PM

Actually you can get an estimate of what a procedure or visit will cost. But it is only an estimate. The actual final charges won't be known in some instances until you have a surgery or a procedure that is time and supply sensitive based on the individual patient. A simple X-Ray or Lab Test has a known charge that you can get.

Second, the AMA develops the ICD-9 and CPT codes. They have nothing to do with the fees that are charged by a physician, clinic or hospital. They are classifications for procedures that are used by the insurance companies, Medicare and Medicaid to develop their payment schedules to those clinics, physicians and hospitals.

Please get your facts right.

Also, the uninsured would get a much smaller bill if the federal and state governments would pay even remotely close to what it cost to treat their "beneficiaries". The uninsured are, in some respects, picking up the tab for healthcare commitments made by the governments that those same governments refuse to pay for.

Tom| 12.29.10 @ 2:05PM

The amount of money spent on care for the un-insured unable to pay is miniscule when compared to the overall cost of healthcare. Beyond that, many people will not be paying for their health insurance because they do not make enough money. So we end up in a situation where we are still paying for their health care but they are likely to use it more often.

Laura| 1.3.11 @ 9:26AM

Tom, I fully believe what you say.
Is it possible that when a system is in place the providers will suddenly mandate additional, unnecessary visits to boost their bills?

Sonof Liberty| 12.29.10 @ 1:10PM

Actually the State does not eat the cost. The hospital and physicians eat the cost. The states, other than Massachussetts I believe, only provide Medicaid. They pay far less than the cost of treartment. In the instance of the hospital where I work the state pays about 25% of what it cost us to treat a Medicaid patient.

What should happen is that people should be allowed to make choices and live by them. So should hospitals and physicians. People could choose to buy insurance or have money to pay for their treatment. Or they could choose not to. Hospitals and physicians could choose to treat or not treat a person if they couldn't provide payment.

So ,in Jack's case, if he has made the choice not to buy insurance or have any money set aside to pay for his treatment, and he comes to a hospital having a heart attack, the hospital and physicians would keep him alive long enough to determine what choise Jack had made with respect to his life. In this instance, Jack would have made the choice to take his chances. At that point we would stop treatment and let Jack take his chances. If he survived we would ship him home from the ER and he would take his chances at home on surviving any longer. If he died, we would send his body to the funeral home of his family's of significant other's choice.

It's all about personal responsibility and choices.

Gregg| 12.29.10 @ 1:09PM

1) I don't care who pushed it first...a bad idea is a bad idea

2) The 2014 mandate is a terrible dangerous idea, for all the reasons I've listed plus many more. Also, it could quite possibly be unconstitutional.

Jack London| 12.29.10 @ 1:24PM

Then if you get it all repealed we'll just go on paying the full cost of uncompensated care. If you're happy with that then so be it. Unless you want to further and stop any uninsured people from receiving any public care.

Tom| 12.29.10 @ 2:10PM

In 2004 uncompensated care accounted for 2.7% of total healthcare. Not even 3 pennies per dollar. Yes, I'd rather pay that than allow the federal government intrude into an area they A) lack a Constitutional mandate and B) have demonostrated an inability to perform in.

Jack London| 12.29.10 @ 3:46PM

Latest figures I see are that uncompensated care and bad debt together are running at 6%. I disagree that Medicare is not a success (just try and take it away from a Tea Partier). But there are other things going on:

- There are many millions of underinsured people, many of whom can and are bankrupted by medical care
- Many millions of Americans suffer worse health and wellbeing because they can't afford care and drugs
- The cost to the country of high chronic illness, health insecurity and mental illness is I would guess massive.

I just can't see why we're stalling on this. Is the prospect of a nation of decently insured people so frightening?

Tom| 12.29.10 @ 11:20PM

Oh please. Medicare is functionally broke. It is able to function because providers can overbill for insurance companies to make up for the lack of profits in treating Medicare patients.

Whether a program is popular with the people it serves or not is not the sole measure of its success. When wealth is flowing TO a group, such as the case in Medicare, it is likely that they will be in favor of that program. It would be shocking if it was not so. I am not a Tea Partier but I would not mind seeing Medicare phased out.

If single payer or health insurance mandates are a good idea they should be handled on the state level. It is where the issue belongs Constitutionally. There are limits of Federal powers for a reason.

P.S. - I am not afraid of a nation of decently insured people. I am afraid of a nation that promises more than it delivers. We are a nation of families 2 paychecks from bankruptcy because we spend as if nothing will happen that might cause economic hardship. Likewise, we are a nation whose Federal government borrows money year after year after year in ever increasing sums as if that will not cause economic hardship.

banjolou| 12.29.10 @ 4:38PM

Yeah, the last part, maybe that's a good idea. RESET

George True| 12.29.10 @ 2:34PM

Hopefully, Jack, the Health Deform bill will be repealed in its entirety. (Because the bill solved NONE of the problems that it was allegedly supposed to address.) Then and only then can we address the problems the right way, and without the government having to take over anything.

Phillip | 12.30.10 @ 10:38AM

You're also a moron. See about explanation. You have no stake in the weak advice you are giving, other than you are worried about someone taking more of your check. Just because you follow the rules, doesn't mean the rules aren't flawed.

martin j smith| 12.29.10 @ 11:43AM

Phillip T: I am retired. But when I was working for more than 40 years--When I worked I accepted jobs that had health care benefits as part of the package. . I had responsibility not only to myself but to my family. This is what I regard as responsibility as an adult. What you are asking for is for me to support the lifestyle that you prefer. No thanks. And by the way, your believe in Obama is an illusion because are Health care system we have now will collapse because the costs are unsustainable. Or, do you think Doctors should not get paid. ? And by the way, motivation for going into the medical profession will go way down. Then you will have a card but doctor. No thanks again. You get what you pay for and if something looks too good to be true, it is.

Phillip T.| 12.29.10 @ 5:32PM

I'm assuming you draw social security or will do so soon. I would love to trade you the wages I pay in FICA for some medical benefits. But somehow seniors think they are entitled to these benefits.
You make this sound like I should have had a plan in college, that I should have planned on a career that offered benefits. I got news for you--I did! I have a college degree and have taught English full-time. I live in Louisiana, and since the oil spill (something not in my control) the state is going bankrupt, so they are cutting back on staff. Since I'm young, I am the first to get cut. Don't pull a Glenn Beck on me and say if I don't like something then I should pull myself up off the mat and move to a place that has a teaching job. Relocating costs money that I don't have. That's why poor people don't just leave when a hurricane hits. It's not that they are inherently stupid. The risks don't outweigh the reward. I don't expect someone to pay for my health insurance. I expect to pay for mine. But with that comes my unwillingness to pay for other people's benefits, e.g., Medicare, Medicaid, Social Security, etc.

Laura| 1.3.11 @ 9:35AM

So are you for the Oil Industry Staying as it is, or apposed? I don't believe for a minute that everyone in Louisiana is apposed to it's absence, that what another media lie.

SonofLiberty| 12.29.10 @ 12:21PM

I have worked in health care for over 30 years. Some of what I am about to say is a broad generalization, which I know is dangerous but here it goes.

Health care is a privilege and a commodity similar to buying a car. It is not a right. You just can't make it work as a right. Many of those reasons were noted by the author.

In my 30 years plus of working in healthcare I have been able to observe the differences between those who think they are entitled to health care and those who view it as a privilege and a purchase.

Those who view it as a privilege are generally polite, compliant with their treatment plan, concerned with getting well and staying well and willing to pay their bills.

Those who view healthcare as a right and entitlement are rude, angry, non-compliant with treatment plans, gross over-utilizers of services and outrageously demanding. They are less interested in their long term health and what it takes to achieve it than they are of being entitled to call for an appointment and get in for treatment in an hour. They are the ones who have conditions that do not require emergency care but who sit in the Emergency Room and watch the clock and then complain about how long they had to wait. And they yell at you when you ask them to pay a $2 copay because they don't think have should have to contribute even that much to their care and treatment.

They are similar to a young lady one of my organizations treated during her pregnancy. She was uninsured. She was a drug addict. She was an alcoholic. She was a prostitute. She got pregnant. She never saw a physician during her pregnancy. She showed up at the emergency room as the baby was being delivered. The obtsetrician on-call deviverd the baby which, as you might imagine, was in severe distress and had multiple complications. The baby was in an intensive care unit for several months and then died. The mother sued the physician and hospital for malpractice and negligence. And she had an attorney who believed she had a case.

This was not a failure of the healthcare system, it was a failure of personal choices.

If we treated health care as a commodity, society and people would adjust. And babies would not be left in the street to die. We would take care of them. As it is now, the governments, federal and starte, pay such low rates, well below the cost of treatment, that there is very little money left over for many physicians and hospitals to take care of the poor.

In a commodity based system that would not be the case because the providers would not have a direct relationship with the government or the insurance company. That relationship would be with the patient.

As for rationing, that would be the choice of the patient. As consumers, we already ration in our daily decisions. I might like to have a Mercedes. I might even be able to afford it if I made the choice to have a smaller house or apartment, eat cheaper food, have less channels on my cable, forego a second car, go out less, and skip vacations. Since I don't want to do that, I decide to by a Ford or Chevy.

The same would apply to healthcare. If I didn't want to pay for the extra cost of one treatment for a condition that went beyond what my insurance would cover or what I chose to afford, then I would choose a different treatment (of which there are usually multiple options). If I wanted to be able to afford the more expensive path, then I would adjust my lifestyle and have either a better insurance plan or a significant stash of money set aside to pay for what I wanted.

As for babies dying in the street because the parent could not afford the cost of treatment, providers would likely provide the care for free. Society would respond locally, regionally and nationally to set up organization to help provide funds to those patients and families,

Or, even better, maybe some the the big time rich libs like Gates, Buffet, Paulson and his Wall Street investment bank buddies could establish foundations with their billions that would fund healthcare for those who truly could not afford it.

Government is not the answer to this issue, it is the problem. Government will not "fix" this "problem". It has created it.

George True| 12.29.10 @ 2:42PM

SonofLiberty: Thank you for stating the reality of things far more eloquently than I could have.

Phillip| 12.30.10 @ 10:43AM

Yes, this is a generalization, and yes it is dangerous. As rich a country as ours is, reasonable healthcare is a right. And if we stay with the car analogy, then let's segue into public transportation. The government has decided that it's better for all of us if everyone who can't afford a car can still travel to work. Same with Obamacare. If you can't afford it, then the government has a cheap bus/train for you to ride. You still pay, and so does the guy who has a nice car, but it helps the flow of commerce.

Rod Hug| 12.29.10 @ 12:25PM

It seems to me that the right to be free, that is not to be forced into servitude, is a natural right. Since America was founded we have applauded our fighting men who defended our right to be free. But we have never thought it necessary to go to war to defend anyone’s right to health care, right to food, or right to a home. These so called positive rights that FDR tried to put in a new bill of rights we try to achieve, but not at the expense of destroying natural rights.

The natural rights are right to speech, right to life, and right to freedom. The trouble with so called positive rights is that they require that money be spent, and that money must come from the earnings of people who work. Hence positive rights must put somebody into servitude to the recipient of the positive right. In other words, someone's natural right must be cancelled in order to dispense a positive right to another.

Then there is the problem of prioritizing positive rights. Right to food and to a home probably takes priority over right to health care. But we have not seen fit to have government feed and house the entire population, at least not so far. Natural rights need no prioritizing; they are facets of one trinity of rights.

John Samford| 12.29.10 @ 12:32PM

Once all the yapping is done, the fact is that the Constitution has no 'right to health care' listed.
That means health care isn't a right but a desire.
Obamacare is a boon for Insurance companies. Nothing more, nothing less.
As far as economics deciding health care, that is a much better system then bureaucrats deciding health care. Any American can better their economic situation. Can't do anything about bureaucrats.
Did you know that unemployment among those with a Masters or better is under 5% where it has been for the last several decades? The great majority of the unemployed are unskilled or semi-skilled labor. Those with advanced degrees are out of work by choice. They feel they can get a better job then the last one offered them.

George Trueusiness| 12.29.10 @ 2:46PM

John, agree totally except for one thing. Obamacare was designed to put the health insurance companies out of business.

Phillip| 12.30.10 @ 10:45AM

As it should. This is a disgusting conflict of interest: our health intersects at the profits of companies. That's a disaster waiting to happen. This is why basic education has public options.

Wayne | 12.29.10 @ 12:40PM

Republicans have a hard time defending the "heartless" assertions because of their own inconsistencies. The go along with the Democrats, until they finally realize that it has a huge costs, then they rebel. So the same arguments that worked before are once again plied by the Democrats. The craziest one I heard, was the one about a woman who used her dead sisters dentures (as though dentures are now covered by ObamaCare).

So the legacy of the GOP is full of Nanny State laws and programs. The GOP has supported the Federal Reserve, Income Taxes, Department of Education, The War on Drugs, The Great Society, Medicare, Social Security, The FDA, Amtrak, the EPA, and on and on and on.

So it can not counter the Left when it itself is so deeply committed.

This is the for us conservative independents. We remember how close we were to a school voucher and a balanced budget amendment, only to see the GOP abandon them.

I know I still don't trust them. When given the choice between reducing the size of government or taking over an even larger government, the GOP will choose the latter EVERY time.

The only candidate I could trust since Reagan has been Perot.

Laura| 1.3.11 @ 9:44AM

Even when I was a child, I didn't believe that Reagan made sense asserting his trickle-down-economics. I didn't trust him them. He was out of office when I was 8 years old.

RIck| 12.29.10 @ 12:40PM

The Founding Fathers got it right. Rights are not given by man. Rights are innate to being human. Life, liberty, and the pursuit of happiness. Government cannot bestow rights, because what the government gives, the government can take away. Nothing that the government grants can be considered a "right". Health care is not something innate to being human, obviously, humans existed for millions of years without any sort of organized health care. Nor is employment, nor food, clothing, or shelter. The purpose of government is to protect our freedom, not to bestow rights. Rights exist independently from government.

Phillip| 12.30.10 @ 10:49AM

This is vague sophomoric logic. What happens when my freedom conflicts with your freedom? What is government's role then? For instance, my right to smoke, to tote a gun, to take a shit. Isn't shitting an innate right to man? Therefore, can I not shit in public? You're an ignorant anarchist, and you don't have the wherewithal to know it.

Soggy| 12.29.10 @ 12:42PM

You have a right to take care of yourself. That right extends to paying a company to assume your financial obligations, or a portion thereof, if you get sick. That is what health insurance is after all. You have a right to get the goods and services you pay for. The government should help to enforce those rights. The idea of "positive rights", wherein the government must take an affirmative action to ensure that you may exercise that right, is dangerous. Is the right to get married I hear about in the news all the time one of those positive rights? Will the government be forced to find spouses for ugly or mean people because there is created a new "right" to marriage? I cant help but wonder when people will stop expecting the government to give them their daily affirmation and their daily hand out.

Wayne | 12.29.10 @ 12:58PM

And I have a right to not have a yearly health exam.

Rod Hug| 12.29.10 @ 12:55PM

John Samford| 12.29.10 @ 12:32PM
Once all the yapping is done, the fact is that the Constitution has no 'right to health care' listed.
That means health care isn't a right but a desire.
________________________________

In fact the Constitution specifies to what purposes revenues can be spent, and redistribution of wealth is not one of those purposes.

Article 1, Section 8, Clause 1 of the Constitution states:
“The Congress shall have power to lay and collect taxes, duties, imposts, and excises, to pay the debts and provide for the common defense and general welfare of the United States….”

Article 1, Section 8, Clause 1 does not say that revenues are to provide for the general welfare of every citizen, or of any of the citizens of the United States. Article 1, Section 8, Clause 1 says that revenues are to provide for the general welfare of the country as a whole. The “United States” is not a person. This interpretation is clear and is consistent with how the early US Government spent revenues. There is nothing in the Constitution that suggests the Founders thought the new government must pay for individual welfare. No Constitutional authority exists for redistribution of wealth.

A clue to how Article 1, Section 8, Clause 1 should be interpreted is that the wording “provide for the common defense and general welfare” suggests that pay for the common defense and pay for the general welfare are linked. Pay for the common defense can only mean pay for defense of the nation as a whole. Linkage suggests, then, Article 1, Section 8, Clause 1 intends that pay for the general welfare means pay for the general welfare of the nation as a whole in the same sense that the common nation, not the individual, may need military defense.

Oldefarte| 12.29.10 @ 12:57PM

Let me attempt to add to Ross' excellent editorial by saying that healthcare [or any governmental welfare based upon income redistribution through taxiation] is NOT A RIGHT. For every RIGHT, there is and equal and corresponding RESPONSIBILITY, ie the right to own a gun has a equal and corresponding responsibility to use said gun in such a manner so as not to injure another/innocent person. Concerning healthcare/welfare, the issue is each person's responsibility to work and earn the sufficient income that would allow that person to pay for his/her own healthcare insurance. Responsibility is and exclusively individual matter, and no one is responsible for another's ultimate salvation [parents are responsible for caring and raising their children, but that responsibility ends with the child's adulthood, whereupon that child/adult them becomes responsible for their own life]. The indigent/impoverished are strictly responsible for their own well being, and cannot transfer that responsibility to others. If they lack income needed to cover their own needs, then it is their fault only, not society's at large [they should have taken advantage of the free public educational system to prepare themselves for income production, instead of having children that they couldn't afford, becoming hooked on drugs, etc]. As to governmental programs such as Medicare and SS, the recipients of same EARNED those benefits by their lifelong payments through payroll deductions. Medicaid recipients however have not PAID FOR their benefits and receive same through the income production of others which is then taxed by government. These Medicaid or Obamacare indigents cannot claim that they have RIGHTS to same, at the expense of others/taxpayers. They had a RESPONSIBILITY to provide for their own expenses/needs and ignored through selfishness their responsibility to provide same!!!!!!!!!!!!

Phillip| 12.30.10 @ 11:02AM

Is it comfortable for you to assume you understand the plight of the impoverished? You believe that will and determination can overcome all. It does--sometimes. You can change your own mind about your position if you were to work with the poor. What moronic conservatives fail to consider is the psychological upbringing of the poor. They don't necessarily have as strong a willpower as perhaps you, and sometimes they don't see that hard work will pay off. It's called misfortune for a reason. That said, your way of thinking about this isn't changing anything for the better. It only lets you off the hook.

Oldefarte| 12.31.10 @ 4:12PM

Wow, shazam, usens illerates don't beez understandings of yous intellectuals with Harvard Law Degrees, Ises guesses! [What moronic conservatives fail to consider is the psychological upbringing of the poor]. Does your 'upbringing of the poor' include their not giving a damn about obtaining [free or with food stamps] birth control methods that would contribute to their becoming UNPOOR from not bringing children into the world whom they do not have the financial means to care for? Does your bleeding heart consider the free [taxpayer funded] public school system that these poor don't encourage their CHILLUNS to take full advantage of in order to make them educationally able to earn an income that enables their financial independence? Does your liberal bleeding heart further the insane argument that poverty leads to criminal activity? Do you know the meaning of PERSONAL RESPONSIBILITY, moron? Do you recognize that all generations have included 'the poor' [immigrants, agricultural populations, etc], and that these POOR people have risen up to become community leaders, professionals, industry leading businessmen, etc? Take your bleeding heart and go tell your sob stories to El Chosen One, and maybe you two can go COMMUNITY ORGANIZING together, okay?????

Laura| 1.3.11 @ 9:51AM

If you look at the average annual wage of a US citizen and then look at the average cost of treating cancer, you will realize that the sick person cannot afford to both pay for their healthcare, and also keep up with their living expenses because they can't work.
It is not the average person's responsibility/fault that health care is INCREDIBLY EXPENSIVE. Which is the problem. Hello.

justasimplepatriot| 12.29.10 @ 1:08PM

You can have
1. High Quality health care,
2. Abundant health care,
3. Inexpensive health care.

Pick any TWO of the above. This is a principle that is as inviolable as the law of gravity.

James| 12.29.10 @ 1:43PM

I think Berwick would be correct if he contends we should not pay for care that is not effective. If you cannot establish the effectiveness of a certain intervention, it should not be paid for by taxpayers. Chiropractors and alternative med people would be paid out of pocket.

Laura| 1.3.11 @ 9:56AM

The reason the alternative med folks can't say they are affective, is that they have been banned from claiming and proving so. For "Only the FDA can Cure, Treat or Prevent Disease." Anything else that hasn't paid the fda for their stamp of approval is banned. Period Period Period. Some natural, homeopathic, anti Western have been approved along the line. Chiropractors have been. I go to a Chiropractor that refuses to accept insurance, and instead charges sliding-scale because he know he would have to bend the truth - which is what all Chiropractors are taught to do.

I would much rather pay for health care, than a war that the US started any day of my life.

Chromehawk| 12.29.10 @ 2:30PM

Mr. Kaminsky,

I do not think it IS a right.

But I think it may be a utility.
someone does NOT have the right to water or electricity.
But they do have the right to access them at a reasonable price.
And we give some support to those who cannot afford it.

Not right.
Utility.

Libertyguy| 12.29.10 @ 3:34PM

I disagree. You do not have a right to access water and electricity. You have demand for utilities. Others have a supply. The buyers and sellers come together and determine a price. You might say you have a right to participate in our economic system.

Chromehawk, | 12.29.10 @ 5:41PM

Chromehawk,

I disagree. The only reason we think of utilities as we do is because they are either natural or man-made monopolies in many or most cases.

It is only the fact of the lack of competition which gives government any justifiable involvement in those markets.

In most places, at least in places where there are a lot of people, there tend to be a lot of choices of places to go for health care.

Best,
Ross

Laura| 1.3.11 @ 9:58AM

UTILITY!!! Thank you for your actual education, all of the big talkers are actually referring to this economic term. UTILITY!!! I believe we have the right to access this at a price that doesn't cost an annual salary at a crack.

Scott| 12.29.10 @ 2:34PM

Rights come with responsibilities...My right to not have my speech infringed upon comes with the responsibility to not deny that right to someone else...My right to own my gun comes with the responsibility to not infringe upon someone else's life by killing them...If health care is a right, where is the responsibility of the recipient of it? I see none therefore it fails the "rights" test in my book...

MikeD| 12.29.10 @ 7:59PM

Actually, all this discussion of rights and responsibilities and monopolies vs utilities is very mentally stimulating, but it continues to beg the question of what's at the core of it all.

First, this is not a health care bill or debate. It is really the single most intrusive action by the federal government to gain life and death power us all; which is the ultimate goal of ALL liberals/democrats. (AS LONG AS THEY ARE IN THE "ELITE" THAT IS IN CONTROL.)

Second, it's a moot point. WE CAN'T AFFORD IT! We are functionally bankrupt; and the liberals conveniently ignore the fact that we can't afford to do what our government is screwing up now, much less adding any new, and very extensive, costs to the budget. WE ARE OUT OF MONEY! If any publicly owned company operated like our federal government, the officers would be in jail and the company would be dissolved under Chapter 13 of the Bankruptcy Code. Don't you get it? We're broke!

Laura| 1.3.11 @ 10:00AM

Yes, I believe every thinking American understands we are broke. We also know that just because you incur more debts that you can pay in a lifetime, doesn't stop you from needing to eat - for example. Should we all just keel over and die, like in a video game?

Sid Smith| 12.29.10 @ 2:45PM

I, who know everything about nothing, marvel at this argument since it is about nothing. The Bill has passed and it has some very good parts and some horrid ones. What must be done now is to mold it into an acceptable form for the citizens.

The article spawning this discussion is rhetorical and lacks merit in the real world.

We must deal with what is.

Where's my laudanum?

Laura| 1.3.11 @ 10:01AM

Rhetorical! An exercise...but a very good one.

George True| 12.29.10 @ 3:03PM

"I, who know everything about nothing..." Now that is clever and funny, Sid. Truly.

I would take issue about the bill having some good parts. I am not aware of so much as one good part. The bill solved not even one of the myriad problems it was allegedly created to address. At the same time, real solutions that were highly practical and workable, and a fraction of the cost, and without needing a government takeover of anything, were ignored. Worse than ignored, actually, as the Dems just pretended they didn't exist because it didn't fit their fraudulent narrative.

Even worse than passing "solutions" that didn't fix the problems, and worse than the fact that it was unconstitutional, was the tragic fact that it was really not even necessary.

Sid| 12.29.10 @ 5:04PM

George, the removal of lifetime maximums, the guaranteed issue for children, and the ability to keep children on until age 26 are great improvements.

I agree with the unconstitutionality of the mandate and don't see how premiums can go anywhere but up if we have new benefits.

30 Million uninsured will not be insured, it just isn't reasonable to expect it when the demographics of the uninsured include so many who could afford it now, but choose not to.

I am not a defender of the bill, I think that many changes are in the future if the mandate can be severed from the bill.

Medicare providers will not accept payment cuts without withdrawing from the market, and Congress will never cut out the Advantage Plans, so those savings are in Never, Never Land.

Other than that, and a few hundred other onerous points, what's not to like?

MikeD| 12.29.10 @ 8:03PM

I disagree. Keeping an adult offspring on your health insurance will create it's own market; sort of like extending unemployment compensation to 65 weeks builds in its own increase in the base unemployment rate. Bad idea. Plus, we can't afford THAT either. Giving people something for nothing is never a good idea because there is no such thing as a free lunch, and the unemployeed tend to wait until they're almost out of benefits before they start getting serious about finding a job. I know. I ran a union factory, and the union reps told his own workers NOT to wait. He knew it too. It's called human nature.

Mike| 12.29.10 @ 3:22PM

According to Obama and the left, rights are not bestowed by the Creator, but by government. Which makes him the arbiter of what our rights are, and gives him the power to take them away.

Ken (Old Texican)| 12.29.10 @ 4:10PM

Ross,
as sort of a coda to this conversation, I want to thank you personally for getting down in the trenches with us to clarify our thinking.

Nevermind the communist "true believers" here.
They just don't understand the TRUE cost of selling their birthright..............yet.

Ross Kaminsky | 12.29.10 @ 5:42PM

Ken,

You're welcome.

And more importantly, thanks to you and all those who make this one of the best comments pages on the web.

These discussions are one reason I enjoy writing for AmSpec so much.

Best,
Ross

Gregg| 12.29.10 @ 6:27PM

Ross,

This is a very good article by the way. And one of the reasons it's so good is that it begins to touch on the concept of rights.

"Rights" is a word thrown around so cavalierly these days and I bet many of the tossers haven't given 5 seconds thought to what a right really is.

It would save a lot of back and forth if there was a little more definition to the concept. That way, when someone says "People have a right to thus and such" one could measure that up against the definitions and see if that's really true.

Simply too easy to demagogue the concept.

thanks again

virginia| 12.29.10 @ 4:32PM

"Of course, the only way such planning will save money is if the plan calls for grandma to die a little sooner."

What obama knows and doesn't want to tell you is that in order to pay for obama care a fairly large number of sick people are going to have to "go early". That's the way they intend to pay for this "sucka" of a health bill. Volunteers? OK, then the government will decide.

Redstateboy| 12.29.10 @ 4:53PM

Ya know..? I'm sorry but I say F! the Left!! The 3 main Entitlements in this Country -

T. Dagger| 12.29.10 @ 5:26PM

This is such intellectual drivel. It is the kind of apologetics I am disgusted and annoyed to see. Kaminsky is making excuses because he feels Republicans have to justify their position, which they do not. The fact is, the poor haven't earned a "right" to health care. If you can't afford it you don't deserve it; that's how capitalism works. And neither I nor my company should be required to pay more taxes to give it to you. If you want the privileges, earn them. Start a business or get another job. You're not my problem.

My God we need to find more ways to stop these socialists from voting.

Ross Kaminsky | 12.29.10 @ 5:44PM

T.,

I find it strange for this article to be called "apologetics".

Just how am I making excuses for anything?

I don't think anything I said contradicts anything you seem to believe, as I believe those same things.

Freedom Lover| 12.29.10 @ 9:22PM

Ross, you frame your argument in conservative absolutes. The fact is there are plenty of ways to pay for health care. How about ending American Miletary occupations abroad for starters. Your ideology renders you blind to any positive, real solutions.

T. Dagger| 12.30.10 @ 12:55PM

I agree the military budget should be chopped in half (at least). We spend far more than we ought to on the military. I pay taxes for the government to protect our borders, not for them to parade around the planet.

Having said that, the best way to make health care affordable is to do two things:
1) Cut regulation on medical care providers. Get the government out of it. Then more people (like physicians' assistants and nurses) will be able to open health clinics, thereby increasing supply. Increased supply = lower prices.
2) This is where the government ought to be doing one of the things I pay them to do: Destroy cartels. The health insurance industry acts very much like a cartel with the hospital systems. The government ought to be using its police power to parade these executives off to prison and destroy the cartel. They are no better than Bernie Madoff, in my opinion.

Phillip T| 12.29.10 @ 5:34PM

@ martin j smith, et al
I'm assuming you draw social security or will do so soon. I would love to trade you the wages I pay in FICA for some medical benefits. But somehow seniors think they are entitled to these benefits.
You make this sound like I should have had a plan in college, that I should have planned on a career that offered benefits. I got news for you--I did! I have a college degree and have taught English full-time. I live in Louisiana, and since the oil spill (something not in my control) the state is going bankrupt, so they are cutting back on staff. Since I'm young, I am the first to get cut. Don't pull a Glenn Beck on me and say if I don't like something then I should pull myself up off the mat and move to a place that has a teaching job. Relocating costs money that I don't have. That's why poor people don't just leave when a hurricane hits. It's not that they are inherently stupid. The risks don't outweigh the reward. I don't expect someone to pay for my health insurance. I expect to pay for mine. But with that comes my unwillingness to pay for other people's benefits, e.g., Medicare, Medicaid, Social Security, etc.

Bill Hussein O'Stalin| 12.29.10 @ 5:43PM

The main thing wrong with this plan is that the government is final arbiter of services, not doctors.

Health insurance companies will soon be out of business which is the exact intent of this law and that will also be another disaster as uneducated morons make decisions about your health care.

One of the funniest comments above is that Ross Kaminsky is a derivatives trader, therefore he should not opine about government dictatorships.
That same reader endorses a system where bureaucrats, not doctors will be making decisions about your health care, including end of life counseling which means just that, i.e., you old hags and old men better die quick so we bureaucrats can provide better health care for the young who are more productive.

Many of the arguments for government run health care are simply ridiculous. Couple that with the fact that the government has never done anything in a cost effective matter and health care in the USA which is currently loved by 80% of the population will soon have the aura of a state run DMV who has a reputation right up there with the postal service for efficacy.

Sabastian Curry| 12.29.10 @ 5:59PM

The only right is the right to compete.

People are animals. Do not make all of this that complicated. Nobody owes you anything, nor does anyone care for anyone else, even friends and family are borderline when humans are starving. Do not kid yourself.

The best you can and should hope for is value for value. Anything else is theft. A situation, a transaction is either even or it is not. Either it is fair or it is not.

When humans compete but with liability, with a justice system that is impartial and ensures value for value, this is called being civil, and civil people make up a civilization.

Ken (Old Texican)| 12.29.10 @ 6:30PM

Sabastion,
You cannot even spell your own screenname..dolt!
Yours was one of the dumbest posts I have ever read here!
Go somewhere else, thank you.

HAHA| 12.29.10 @ 11:29PM

Clever, except Sabastian is an accepted variant of Sebastian.

Who Knows?| 12.29.10 @ 6:00PM

“Right” ON!

Or, “On Rights”.

I had a “write” on October 8th, 2008----

“Here’s a truly radical thought---with such a complete take “over” by the left, want to bet that if/when they begin to go hog wild implementing their one-man-one-vote-one-time agenda, such as the Fairness Doctrine, soon enough there will be an irresistible backlash?

So, true people power will have no recourse but to---TAKE IT TO THE STREETS!

If/when BO et al do gain control, a lot of the drive by their street protestors will be slaked, but those on the right will have no choice but to---REBEL!”

Here’s the whole blast from the past---

"Over "Over"

As it seems more and more obvious that the smelly fish, rotting from the head down---that’s our masters, the MSM---B.O., is going to manage to steal the election, the thought occurred to me that there’s going to be a whole lot of “over” clichés flying around in the noosphere.

First, it looks like the race is NOW “over”. It’s all “over” but the shouting, for BO, et al--- and crying for freedom lovers. However, remember Truman and Bradley, so it’s not “over” until the fat lady sings.

If Obama does win, does anyone think that investigating his nefarious past will be “over”?

Look, there’s no way the socialists will be able to consolidate their takeover fast enough to stifle free speech.

Indeed, if BO wins, I’d say that the existential fight for free speech will be the FIRST vital battle, and that you can bet that some of those who chose to support the Chicago-land emanation will soon enough be wailing their mea culpas---so, such leading leftists like Hitchens and many other less idealistic members of the MSM are very likely to go on the offensive, and we’ll see a great “over-wrought” public awakening about Obama's past.

Talk about buyer’s remorse! As Biden let slip in Seattle, he fully expects the spit to REALLY hit the fan when he and BO are not just speechifying, but wielding the ultimate power for the USA. Actually, from the endless-seeming stream of sub-consciousness words out of Biden’s mouth, I think he really doesn’t want to win. That is, in his heart of hearts, he is still the opponent of Obama, and thus he knows what a disaster it would be for this “transformative” shell of a man to win.

Well, say they win---as all hell breaks loose, expect to hear derision from the ones who enabled them to win, in the form of---“Get OVER it!”

What initially sparked today’s rant DOES stem from “over”, but it’s like this---

By dint of the very fact that such a tainted, inexperienced and socialistic showman like Obama could manage to con so many people to even become the Dems nominee for president, shows why America is “over”. This is just the latest manifestation of the fact that the baton has passed from the greatest generation to the smallest one---logic prevails.

Then, if/when BO takes “over” as the leader of the free world, the whole free world will be on it’s way to being “over”. With a veto-proof congress, with trial lawyers ascending in power, with the courts going “over” to the side of the leftists, who’s going to be able to stop the roll “over” machine?

It’s simply going to be the equivalent of what Putin pulled “over” on his slaves, ‘er’, fellow citizens, only this time, we’ll get the latest top dog from the Mayor Dailey machine---yes!

Taken “over” by the Chicago gangsters!

Bill Ayers WINS!

Quell your “over” and under-standing about your own personal situation. That is, as somebody noted, with the axis of evil triad criminal gang lead by Obama-Pelosi-Reid, they’ll have all the hands on the wheel of state, but there’ll be no BRAKES.

If people are hurting NOW, due to massive “haircuts” to their net worth because of the market’s adjustment, just you wait, Henry Higgins, when reality is “over” taken by the ugly truth behind all the con job words from such as Obama!

Here’s a truly radical thought---with such a complete take “over” by the left, want to bet that if/when they begin to go hog wild implementing their one-man-one-vote-one-time agenda, such as the Fairness Doctrine, soon enough there will be an irresistible backlash?

So, true people power will have no recourse but to---TAKE IT TO THE STREETS!

If/when BO et al do gain control, a lot of the drive by their street protestors will be slaked, but those on the right will have no choice but to---REBEL!

Won’t that be something? Take the angry people at McCain rallies, and expand and extrapolate the right-to-assemble crowds into the near future. Won’t it be a righteous turn about is fair play---TRUE “fair” play---to experience this gathering of “eagles”?

Let’s flip “over” the whole left-right game plan!

Yes, the simplest way to envision the future is with the permeating dimension described by---"over" whelming! Take a lesson from the ongoing meltdown of understanding and wisdom by the putative smart guys wrt the markets, and apply it to everyone.

Nobody, EVER, knows, truly, what a single thing IS!

And, NOW, at last, this is going to be the real test of our time.

We wanted some excitement, and the confusion has just begun!"

ken (Old Texican)| 12.29.10 @ 6:18PM

Philip,
well God bless your little heart.............heh!

Have you ever seen the world's smallest violin playing "my heart bleeds for you" ?

Hey, butt violin! We old farts have fought wars , bled honest blood, and contributed a significant percentage of our income for a LIFETIME to get a little payback when we are old.
We sorta gave you a free country to grow up in...

QUIT BITCHING.;

Ken (Old Texican)| 12.29.10 @ 6:38PM

Who Knows,
You are very wordy. Chop it, friend.

Keith| 12.29.10 @ 7:01PM

Kenny,
well god bless your old heart. I'm sorry you fought so hard and gave a significant percentage of your income in order to get "a little payback." Guess you could have kept a significant percentage of that income and paid your own damn retirement. And there you old farts talking about freedom again. Did you protect us from Vietnam or Korea? The Russians did the lion's share of the damage against the Nazis. No, I'm guessing you killed some Iraqis. They were almost to America before you stopped them. Thanks for my freedom! Simpleton military boy thinks he's right b/c he took some orders. I can tell, your not a complex person. And I'm also guessing that any politician that says America and freedom has your vote. What a sheep!

Bob Grant| 12.29.10 @ 8:31PM

Well, whaddya know:
You DO bring up cogent points on occasion!

Freedom Lover| 12.29.10 @ 9:16PM

Texican, what is your level of education. I have heard more influencing conservative arguments from high school students?

Bob Grant| 12.29.10 @ 9:25PM

Hold on there, you're talking about an accomplished novelist.

Freedom Lover| 12.29.10 @ 9:18PM

Fought in the "War on Terra" myself. You wanna talk about a waste of billions.

HAHA| 12.29.10 @ 11:57PM

I do not know why but I figured you for a mandolin player.

Roy Nichols| 12.29.10 @ 7:16PM

The real question is: If healthcare is a "right," why not other necessities, like food, clothing, shelter, transportation and utilities? Where does it stop?What about life insurance, and all other insurance, for that matter?

Bob Grant| 12.29.10 @ 8:58PM

What we need is an expert on article 1, section 8 of the U.S. Constitution, better known as the General Welfare Clause...

...it seems to me moving forward, they (the socialists) will use this clause to push all landmark legislation yet to become law, and also justify what they have already imposed...

...any experts out there who could provide detailed information?

cziggyfly| 12.29.10 @ 7:59PM

I know we call it healthcare but it is really medical care, Healthcare is free except for the money I pay for my running shoes and my strength training devices, etc... Medical care is what actually costs money.

Rod Hug| 12.29.10 @ 8:52PM

By choosing to label natural rights negative rights, and to label rights requiring the tyranny of earning seizure positive rights, the left once again co-opts the conversation. It is an attempt to delegitimize the Constitution and all natural rights which are in utter conflict with socialist order and the rule of law. It is a skirmish for the higher ground in the battle between the rule of law and the rule of leveler egalitarianism, between creative excellence and covetous “fairness,” between admiration of achievement versus envy and resentment of it.

The battle is between those who see capitalism as a zero-sum game in which success comes at the expense of the poor and the environment: every gain for one party comes at the cost of another. On the one side are those who fear freedom in the market place; on the other side are those who see the genius and the good fortune of some as a source of wealth and opportunity for all.

The test of which side a person is on is simple: What is his attitude toward people who excel him in the creation of wealth or in other accomplishments – these might be the “rich”? Does he aspire to their excellence, or does he seethe at it? Does he admire and celebrate exceptional achievement, or does he impugn it and seek to tear it down?

The envier’s mortal enemy is the set of natural rights that come from God, the same rights that when given expression produced the most productive and example society that all peoples on earth wish to emulate.

Nite| 12.29.10 @ 8:57PM

Previous posters who are concerned that Seniors get too many services through Medicare, should not worry. Dr. Berwick is taking steps right now to ensure that as many of us as possible die quickly. Obama and the Democrats are speeding things up as well by destablizing Medicare by removing 500 billion dollars. I am a medical professional and approve of hospice care and advance directives. However, it makes me furious that an unconfirmed Czar is making life and death regulations over patients on Medicare and Medicaid. It will not just be seniors who will be denied care, but handicapped children and adults, those with chronic diseases and anyone who the government feels is not beneficial to society. I hope the Republican controlled House can put some curbs on Obama and his Czars and quickly.

Righty-Tighty| 12.29.10 @ 9:08PM

Thank goodness. I never voted that seniors should get a handout. That's what Hitler was wanting. They should have taken better care of themselves and eaten better throughout their lives so that they can work longer and contribute to America. I mean, why shouldn't we give free healthcare to the young so they at least have a chance to work and pay some taxes, rather than help some old person out who has probably wasted more tax dollars on everything from the GI bill to Medicare.

Rod Hug| 12.29.10 @ 9:33PM

Medicare was never meant to be a freebie. Seniors paid into it for decades. Medicare is a medical savings plan administered by the government. When Obama cut Medicare by $500 billion he essentially stole from seniors who had for much of their lives paid into it. That makes Obama a thief. But, he also stole the GM bondholder’s money.
And or course, he made theft of wage earners pay checks (redistribution of wealth), a campaign promise.

Medicare is now denying payment for standard blood panels, after adopting a rule that it would pay for one blood test each year. Meanwhile the HHS secretary announced plans for Medicare to pay doctors for death panelism counseling. Obama can pay doctors for advice and perhaps encouragement to die, but cannot pay for treatments (blood tests) that prolong life. Speaking of negative rights, it seems to me this is a quintessential study in negativism.

I wonder what the good Lord in Heaven thinks when he sees the president of the United States asking doctors to countermand the Hippocratic Oath by coaching how to die?

Negro X| 12.29.10 @ 11:53PM

Someone please explain to me why the taxpayer needs to pay for healthcare for the Zeituni leach?

mulp| 12.30.10 @ 2:23AM

Can someone explain why the taxpayer needs to pay for investigating crimes against you?

Do you have a positive right to justice, or merely the negative right of government not treating you unjustly?

If you are murdered, then if some family member cares, they can investigate and bring a case in civil court - the Bill of Rights will protect the accused, but nothing says you have the right to government delivering justice for crimes in which you are the victim.

Yet Republicans and conservatives are the ones who find a requirement for government to impose their right of "justice" on people who they never knew based on their sense of personal harm from gays in the military, smoking pot behind closed doors, engaging in free trade to satisfy the desire to smoke pot, and much more.

By what right does anyone get to dictate what consenting adults do that affect no one else? But conservatives and Republicans are the most enthusiastic dictators of life behind closed doors based on their view they have the right to tell others how to live.

Compression Tube Fitting | 12.30.10 @ 12:23AM

Fangdun Instrument Valve Co. Ltd is a professional manufacturer of Needle Valve, Instrument Ball Valve, Compression Tube Fitting, Valve Manifolds, Compression Tube Fittings and other related products manufacturers.

Bill Hussein O'Stalin| 12.30.10 @ 5:52AM

Over the past several years the public has been introduced to a litany of excuses of why certain federal agencies failed. In many cases thousands of citizens either lost their wealth because the S.E.C. was asleep at the wheel, or the government looked like a clown fest with the after effects of Katrina, or the Minerals Management Services (Now known as the BOEMRE) screwed up with BP and the oil rig explosion. In each event the screw ups by government were massive but the White House under Obama would have us believe the government can now take on additional responsibilities impacting 1/6 of the economy.

It's not only not believable it's just another disaster waiting to happen.

Righty-Tighty| 12.30.10 @ 10:22AM

Go read a book. The financial crisis was caused by government deregulation of the markets; which means, since the dawn of Reaganites and his plutocracy, little government oversight has led to disaster. I know government isn't the answer, but the private sector is greedy and we have little leverage over them. At least we can vote someone out if they turn out to not be worth a damn. Try voting out AIG or Walmart.

Bill Hussein O'Stalin| 1.1.11 @ 7:40AM

You're a fool and you prove it when you write something like that.

First, nothing is ever deregulated only further regulated in a different manner.

Secondly, almost everyone agrees that the financial meltdown occurred because the government forced banks to lend money to people who had no money or jobs.

You sound uneducated, steeped in the phone values of liberalism. Perhaps you should read a book.

Bob Grant| 1.1.11 @ 7:13PM

Perhaps if the government didn't create the environment for companies such as AIG to behave recklessly, there wouldn't have been a need for a bailout. Had AIG been fully exposed to their reckless activities (credit default swaps), said activities wouldn't have occurred to such a degree.

The moral hazard was a creation of the Fed.

Dale Cord| 12.30.10 @ 9:56AM

2011 a year that will live in Infamy. Future school history books will read: The year the Muslims conquered the United States of America. With not so much as a whimper from its cowardly military leaders, and name calling armchair patriots. Disgraceful,Shameful there are no words to adequately describe her defeat. As the 300 Spartans strength and ingenuity conquered all of those who challenged them, so a small band of renegades conquered the greatest country the world has known. When Davids rock slued Goliath. It also foretold a warning. "The bigger they are,the harder they Fall." Our country lost its battle of survival when it became intoxicated with its deceptive mentality, that it did not need its Creator anymore, and wisdom no longer was apart of its citizens physiology to survive.

Righty-Tighty| 12.30.10 @ 10:26AM

When you spout cliches like this, it tells me something about how you think. It tells me that you don't process and question what you've "read," if you can even do that critically. To think and speak in cliches is for your mind to be on autopilot. What makes conservatives such an appealing voter base is how easily manipulated they are: god and country is the dinner bell, and you all come running, foaming at the mouth.

Bob Grant| 1.1.11 @ 7:17PM

I'm a proud backer of God and country. What's your specific beef with our God and country?

Let's see who's the real automaton.

Polaris| 12.30.10 @ 2:24PM

Wow. Directly targetted at the low-information goobers who will actually believe this nonsense. Responsible journalism anyone ? Anyone ?

Osamas Pajamas| 12.30.10 @ 4:38PM

If government-funded [taxpayer-funded] healthcare is a "right," then the government has a right to arrest any taxpayer who does not pay taxes for his neighbor's healthcare --- and the right to murder any taxpayer who puts up a fight. President OhBummer's view is that it is OK for him to commit murder to enforce "the right to healthcare." Arrest that man -- and all of the OhBummer Wrecking Crew.

Wendy| 12.30.10 @ 5:20PM

A brilliant column, and I would add one thing. If conservatives are to be consistent, we must reject the notion that the taxpayers HAAAAVE to cover people with pre-existing conditions because such conditions are SOOOO expensive and these people can't afford insurance and they NEEEED it.

No, we do not have to cover them, and we should not. If we start providing people with "coverage" for pre-existing conditions, we are no better than the left whom we denounce, and we will run into the very same contradictions and problems discussed in this column.

Conservatives must learn to tear up the left's victim list without giving it a glance and yell like a drill sergeant, "Stop your whining, you crybabies, and man up!"

Marie| 12.30.10 @ 11:43PM

Remember, in a government run healthcare system everyone has coverage, but not everyone will get care. While not perfect, in our present almost "free market system" not everyone is covered, but by law, everyone must get care. Which system actually takes care of the most people? I vote for the current imperfect nonObamaCare system!

FBanta| 12.30.10 @ 11:57PM

If healthcare is specifically delineated in the COTUS, it is a right that the federal government should provide.

Look as I may, I cannot find anything in the COTUS that lists healthcare as an inalienable right.

Therefore, hell no: healthcare is NOT a right!

Boy, that was easy!

Bruce | 1.5.11 @ 8:16PM

Who said the Constitution is the only document from which rights can derive. Certainly not me. And neither does the constitution ever say that the only rights that will ever be enjoyed by Americans must be contained within it. If it did, I'd be for changing it or else scrapping it completely and starting over.

FBanta| 12.31.10 @ 12:01AM

Rights don't come from government, they come from our Creator.

Bruce | 1.5.11 @ 8:13PM

Okay, now here's the alternative-- the quality of life, and sometimes the lives themselves, of those unable to afford decent health insurance or any insurance at all, are curtailed. The writer seems to unwittingly fail to perceive that the right's inability to come up with an answer to these heart rending stories is that the stories are, in fact, heart rending. I don't know any liberal who enjoys paying taxes, but most of us are willing to pay something extra to try to improve such people's lives, because NOT doing so is so obviously in conflict with any acceptable human understanding.

I know there are many on the right who don't consider themselves in any way obligated to their fellow human beings and are content to label the poor or indeed, anyone unable to pay for every aspect of their own lives as "parasites" or their insult de jure. And surely there are some among the entire cohort of America's and the world's poor for whom such a characterization holds-- but in most cases, this is a characterization which says a great deal more about the character of those making it than it does about those on whom such people cast these aspersions. And then, too, there's also the fact that for most people, even those whose choices have brought difficulties on themselves are still not people most Americans are content to simply see die.

Then, finally, throw in the right's myopia with regard to how much IT also depends on others in manifold ways, and throw in the discoverable hypocrisies of its membership, and in the end, Americans will generally agree that health care is not just a right, but it's one worth passing the hat for and insisting that all Americans capable of putting in for it do so.

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