John McCain's vote on healthcare

I previously wrote--and I will now reiterate--that I very much hope that Senator McCain recovers from his recently diagnosed brain cancer. (Although, realistically, there many not be a great deal of hope here.)

That said, I am rather disappointed that he cast the fifty-first vote against the so-called "skinny" repeal of ObamaCare.

It was surely preordained that Susan Collins and Lisa Murkowski--who are true RINOs--would vote against it; and especially the former, as the latter is attached to a quite red state.

The chief argument set forth by Sen. McCain--and apparently, at the very heart of the matter--is the fact that he wishes to see more bipartisanship: ObamaCare passed without a single Republican vote, and he did not want to see the obverse happen.

And that sounds like fairly sound reasoning--except:

The Democrats desire "bipartisanship" only if it is on the minority's terms. (For instance, Sen. Schumer said, just this week, that he believes in "working together to improve the healthcare system rather than sabotage it"; suggesting that ObamaCare is fundamentally a very good thing, merely in need of a few minor tweaks; and that any proposal to repeal and replace it would amount to "sabotage.")

Bipartisanship is a very good thing, I believe.

But if it means coming together somewhere on the center-left, then it is really a sham, in my opinion.

 

The skinny repeal is aweful. It tries to keep all the benefits of Obamacare like the Medicaid expansion, covering pre-existing conditions and a minimum coverage but removing the mandates that keep prices lower and pay for it and makes sure the system works. Republicans basically want a free lunch but this is going to destroy health insurance and increase our national debt. The CBO has correctly predicted this would raise premiums which was exactly the thing Republicans were complaining about.

 

In short, your response would seem to be something like this: You simply cannot have the cake without consuming the cod-liver oil first.

Anyway, I have a solution to this: Simply get the government out of the healthcare business. Altogether.

It worked from our very inception until 2010...

 

Obamacare ensures that you won't be turned down for health insurance and won't be charged crazy rates and that you can get your medical condition covered under a normal plan by requiring a minimum coverage. But to pay for these benefits for the sick we need healthy people paying in or insurance just doesn't work and a mandate is needed for this. This cod-liver oil is supplemented by helping people pay their premiums and in other countries they do a lot better job at doing this.

Our healthcare system is already privately run. I don't understand what your proposal is here.

It was actually worse before Obamacare. Those protections Obamacare has for the poor and sick didn't exist, costs were rising much more quickly than today, and the uninsured rate was rising sharply. Our system was on the brink of collapse.

 

In other words, we "need to" force "healthy people" to pay into a system that they will likely never use--even if they really do not wish to do so.

As for the assertion that "in other countries they do a lot better job" of "helping people pay their premiums," this sounds to me like a very thinly disguised plea for socialized medicine...

Funny.

You could have fooled me...

 

We need some way for them to pay in or healthcare doesn't work. If only sick people are paying in premiums are going to be sky high. The alternative is that if you have a pre-existing condition or a condition your insurance doesn't cover you can be denied access to health insurance, insurance for those conditions, or insane sky-high premiums. Also insurance companies negotiate much lower rates than inflated rates hospitals would have originally charged, and without insurance you get charged these inflated rates that have even less to do with the actual cost than what insurance pays. Near-universal insurance coverage is the only thing that works with our system or else it will mean even more unreasonable cost. This is why a mandate is so important. We make up for the mandate turd by helping people pay their premiums so that its not such a big deal for them. It works out in the end rather than the horrible system when million were losing insurance and 50 million were uninsured before Obamacare.

Universal healthcare doesn't mean socialized medicine. We see socialized medicine the UK and Scandinavia but in most other countries they have a private healthcare system where the government either pays for the premiums, or there is an individual mandate where the government has generous subsidies especially for the poor and sick. The government also regulates the cost of healthcare to keep it down which is why healthcare in other developed countries are 2 1/2 times lower yet US healthcare isn't 2 1/2 times better and they pay less for universal healthcare systems than we do for just Medicare and Medicaid.

 

In other words, you prefer pragmatism over principle. (The free market evidently does not mean a great deal to you.)

An addendum: If you are, say, just 16 years of age--and, to make things even worse, if you are male--then you pay higher automobile (liability) insurance rates than a middle-aged woman would pay, all other things being equal. And that, even though you are not to blame for either your age or your gender. But insurance rates are based upon actuarial tables--not upon something touchy-feely.

That much is certainly true. (The "Submitted Charges," according to my EOBs, could certainly be characterized as being "inflated." The "Plan Allowance"--i.e. the negotiated rate--is far less.)

Well, at least you are honest in admitting that you favor UHC (or "[n]ear" so, anyway.)

But that begs the question, viz.: Why don't you just advocate strongly for this, rather than doing so for ObamaCare--which is almost nobody's first choice? (And please do not give me that old saw about ObamaCare's being all that could be passed. It is actually the worst of both worlds. Given a choice between ObamaCare and UHC--and a binary choice between only those (i.e. a choice between only those two), I would choose the latter; and without a moment's hesitation.

And so, I would imagine, would most other conservatives.

That is just how much we despise ObamaCare.

I really cannot say whether healthcare in the US is "2 1/2 times better" than in other developed countries.

I can say, however, the US is the magnet for those seeking healthcare--not other countries.

Moreover, it is my understanding that if the statistics are "normalized" by excluding deaths by traffic accidents and handguns, the US is number one in the world in life expectancy. (I cannot prove that to be the case--I have just read it--but until it is explored further, it might be good for those on the other side of the debate to quit claiming, as many do, that Americans' life expectancy is lower than that of individuals in other countries. It seems like just a talking point.)

 

Perhaps that ****** will go on the exchange for his insurance

 

Nope, my principal is that healthcare should be affordable for ordinary Americans in general.

I believe in a regulated free market system where the government helps some people pay. We short of have that now but our version is a mess.

Currently under Obamacare the sick can be charged 3 times as much in premiums. The sick also usually max out those deductibles (like $5,000 or more) and have to pay the out of pocket part (about 25%). People with major health conditions often have to take time off work or are unable to work so as it is, it is hard enough for them. So I don't think we need to make life any more misearble for them by removing protections for them like the Republicans want.

Which is why universal coverage makes the most sense, because without it you are basically getting screwed, preventative care isn't being prioritized, the uninsured get ruined when they get sick, and we have to pay the tab.

Yup, every advanced nation has it and there are very good reasons why. Most of them have less government healthcare expenditures per capita than we do.

Obamacare was a partial implementation of the most free market type of universal healthcare system the Bismark Model which is seen in Japan, Switzerland, Australia, Netherlands, and Germany. It does need more improvements to really be as effective as these systems. Obamacare isn't all bad, it has insured 25 million people, healthcare costs as a percent of GDP hasn't risen since it was implemented, the uninsured, sick, and poor have more protections and can more easily get coverage, and it encourages preventative care. But it wasn't ever tweaked after putting it out and didn't help the healthy enough with those extra premiums from helping cover the sick more.

But all your improvements will either raise premiums, destabilize the insurance market, hurt with sick and poor, and leave tens of millions without insurance. This really shows that Obamacare has done a lot of good because of the harm reversing it will do.

America has better cancer and expensive advanced care and our quality is one of the best so maybe that gets some people here especially if there are long waits for an advanced expensive procedures in Europe but we see a lot of Americans getting care in Europe and Mexico because they are far more affordable. And if you come over here for custom care you are going to have to pay 100% of the cost without the discounts insurance can get instead of the free care that is in Europe.

It not, its not even close. Our healthcare system is rated below every other advanced country by multiple studies.

That doesn't make any sense because handguns and traffic kills a tiny number of people compared to other causes of death and American life expectancy is years behind other countries in life expectancy. We also have much higher infant morality.

 

Deleted

 

Interesting discussion.

What do you two think of a compromise that (1) brings almost everyone into the insurance pool through a mandate, while (2) using free market principles?

My idea does involve a government mandate, and it is that all employers provide medical insurance to its employees and their families. This would bring in young and old, male and female, healthy and sick. It is true that the more healthy people you have in the pool, the lower the cost of insurance. And under this plan, healthy people couldn't just opt out if they were employed. (The only way to opt out would be to be unemployed.)

Since all businesses would be under the same mandate, there would be little effect on their competitiveness with each other. All of them would have to carry out a business plan that resulted in a profit (as they do now), and this would be a cost of doing business that was fairly uniform. The employer would be responsible for directly paying the insurance company, but, in reality, we would all be paying the premiums through the cost of goods and services we pay for. There is a certain fairness about this because the more you make, the more you spend. The more you spend, the more you would be paying for the cost of insurance. The less you make, the less you spend. The less you spend, the less you would be paying for your insurance.

Now before you say, "That's just a round about way of paying for the insurance of the minimum wage-type worker", keep in mind that a great many low-wage people are young and healthy people, and they are exactly the type of people you want in your insurance pool because they keep the cost of insurance lower.

So where does the free market come in?

I would suggest that insurance should be made to cover most things, regardless of age or gender. But I would suggest that employers be allowed to select insurance that covers these things to degrees that they choose. For example ....

Your company provides insurance that covers everything, but at a 60% rate. You pay the 40% of your medical bills. But, for "x" percent of salary deducted from your pay, you can have the 70% plan. For "x plus x", you can have the 80% plan, and so forth.

And employers could compete with each other for employees. This would pretty much force employers to offer the better plans. "Come to work for me, and the you'll get "x" dollars per hour plus the 80% plan." But someone else is offering the same money, but the 85% plan. Who are you going to work for? If you're working for an employer who only offers the 60% plan, and you get the opportunity to go to work for someone offering the 80% plan, who are you going to work for?

So you see, this plan would entail a mandate to get virtually everyone into the pool. This is good for keeping the cost of insurance down. But it would also give you choices and force competition among employers. And it would be paid for by us - all of us - through our labor and our spending.

OK guys, there's my idea. Fire away

 

Are you prepared to have your income drastically cut to pay for it, as you would have the physicians'?

 

The crime! Cutting their pay to $200,000-250,000 per year! How can anyone live on that?

 

so you are volunteering to have yours cut to help pay ?

 

No it didn't. Go back and look at the rate total spending on healthcare was increasing. Or the fact that the US spent much more of it's GDP on healthcare than any developed country while getting inferior results. Both parties agreed at the time the system wasn't working it is just that the Drmocrats tried to do something about it. Obamacare did not work very well, the Republican proposals are as bad or even worse. Time to look at the solutions other countries have developed and that are working.

America cannot continue to afgord spending 17 plus percent of it's GDP on healthcare. And if nothing is done thst percentage will continue to increase.

 

What you are suggesting is really not a principle at all, but a desire. (By the way, it is "principle"--not "principal," which is a homophone.)

A "regulated free market" is an oxymoron--a bit like, say, a square circle.

The left (and even the center-left) has seldom seen a regulation that it does not like...

One person (on another political forum) said that he must pay $3,000 per month for ObamaCare--or $36,000 per year--which is more than some people make in a year. (And that is if it is only an exact $3,000--not, say, $3,250 or $3,330; he may have just been rounding it off.)

And some deductibles are $22,000--or even higher.

It seems all that the proponents of ObamaCare really want is to be able to tout the expanded number of people who are "covered" for healthcare--even if that "coverage" is virtually useless...

As I have said previously, I am not in favor of UHC; but I greatly prefer it to ObamaCare. Believe me, that is not even close.

And most of them have less in the way of innovation, what with the profit motive removed.

Or do you not think that makes any significant difference?

Many of whom would have chosen to go without healthcare insurance, absent the "mandate."

In other words, ObamaCare is all about government coercion...

And do you really think that this superior quality will continue--and that the waiting lists will not become longer--if we go to UHC?

Or is egalitarianism a more important value to you than superior quality is?

According to what metric, exactly?

By the way, please link to those "studies."

Both automobile fatalities and handgun accidents disproportionately affect younger Americans; so, once these are removed from the pool of those who may achieve longevity, the average life expectancy declines rather dramatically.

 

I am a bit hesitant to be a complete naysayer--it is always much easier to tear down than to offer a constructive alternative--but I feel compelled to say that I oppose anything that includes a government mandate (whatever the rationale).

You are certainly correct in noting that many people in the healthier group are young people--no surprise there--but I would not want to force them to purchase a product that they do not desire, even to help out the rest of us.

 

"Inferior results"?

Just what metric are you using, anyway?

And if other countries truly experience superior results, just why do you suppose that so many non-Americans come here to get their healthcare?

 

Life expectancy, infant mortality, and many more. You can look it up on the internet. Not that hard to find. . And the fact that the rich can come for the best care has absolutly nothing to do with the results of the system. The difference between the actual overall results of the system and the results for the few that have unlimited funds should not be that difficult to understand.

 

John McCain plays a conservative when he's campaigning and then enjoys being a maverick (two faced liar) when he's elected. I assume he is motivated by the fawning press he gets. He is the definition of "Establishment" and anyone knowing his history should have expected the vote he gave. The man is not a true republican and of course he wants that type of bi-partisonship that promotes the democrat agenda.

 

Hey there ... Thanks for answering back.

I am a fairly conservative person, although I admit that I hold my own views on what "conservative" means, and my definition often doesn't agree with what I'll call "establishment conservatism" or "Republicanism". Without digressing into a long dissertation about that, let me just say that I believe that what now passes as "conservatism" has lost its own way in many respects.

That said, I, too, do not want the government intruding into our lives more than necessary. But by the same token, I do believe that we don't necessarily contravene that desire to "be left alone" when we agree to enact laws and/or pay for things for the collective good. As examples, it doesn't bother me that we collectively pay for defense of the country. We collectively pay for local things likes schools, roads, law enforcement, fire protection, courts, and jails. It doesn't bother me that car owners are forced to carry auto insurance, as another example. I understand the need for these things, and I agree to the government's role in collecting the money for these things, or, in the case of auto insurance, forcing car owners to buy it. I see these things as rational choices that we, the people, are empowered to make through our democratic system. And so it doesn't bother me if we make rational choices about health care either.

One of my conservative values is being just plain patriotic. I love the sight of Old Glory, and I am proud to be an American. I served in the Army years ago, and if our Country was under attack, Uncle Sam would say I was way too old to rejoin the Army and fight for her now. So I'd just pick up a rifle and fight for her myself if it came down to that. I'd rather die fighting for her than to live to see the day when she was conquered by some foreign power. I digressed a bit, but all that to say that one of my patriotic values is the belief that we are all in this together. Together, we sink or swim. To my way of thinking, what's good for one of us is good for all of us in the big picture. In a general way, this is true of health care. You see, if every citizen has some mechanism for health care coverage, that is good for all of us. Yes, it costs money, but it saves us money as well.

And think about this ... The proposal I made said nothing about taxes. It says nothing about government spending. It says nothing about the government looking at your income and deciding how much of a subsidy you deserve. Instead, it encourages work. It encourages going out and getting a job and working for it. It leaves health care coverage within the realm of the free market, and it gives consumers choices. And, it encourages competition among employers.

Aren't these conservative values in play? Work, less taxation, less government involvement in health care economics, choices, competition ...

 

The real problem is the cost of health care, not the cost of health insurance.

Health insurance has been morphed into the health care payment system, and been put in the role of the middleman between the patient and the health care industry. Add in the govt, and the system has no actual free market cost control or responsibility to the patient.

Everything in your post is based upon the fact that health care costs are incredibly high - much higher today than before obamacare. Why does it cost $200 just to walk into a doctors office? Why does an aspirin in the hospital cost $20? Thats the real problem, obamacare did zippo reducing those costs.

 

McCain has always been a RINO. He voted against the Bush tax cuts, he supported the Democrats Dodd-Frank scam, he supported illegal alien amnesty going back to 2005.

Don't forget the S&L scandal in the 1980's, the corrupt "Keating 5" were McCain and 4 Democrats.

McCain has always been a typical corrupt pol, and a RINO.

 

I recently read that the US is number one in the world for life expectancy, if only we "normalize" the statistics by disallowing deaths by automobile accidents and handgun usage--which are particularly hard on younger people. This leads to a distorted "average."

Moreover, there can be a huge difference between the average and the median. (For instance, the average of 1, 2, 4, and 97 is 26; yet the median is only 4.)

 

Until about the early 1970s--about two-thirds of a lifetime ago--I was a true-blue liberal. Then I discovered William F. Buckley Jr. It seemed to me that he held the intellectual high ground--not liberals, as I had previously supposed.

It seems reasonable for the state (or local) government to require liability insurance.

But I would indeed chafe if the federal government were to require it.

And I would further chafe it either were to require comprehensive or collision insurance. (Both of these may be very good, in my opinion--I have both on my vehicle--but I would not wish to see either made requisite.)

And just how do you believe that conservatism has (supposedly) "lost its way"?

Do you believe that Ronald Reagan (who was president for most of the 1980s) would have endorsed something similar to ObamaCare?

Or that Barry Goldwater (who headed up the GOP ticket in 1964) would have done so?

Anyway, I do want to thank you for your measured tone. I firmly believe that it is possible to disagree without being disagreeable. And you appear to be evidence of that.

How is that possible?

Note: I have heard of $22,000 deductibles, and premiums of $3,000 per month, under ObamaCare. Whereas this may well vary considerably with the individual, it seems to me that the Democrats are much more interested in getting the greatest number of Americans "covered"--whether or not they can actually use the insurance; and whatever the cost of it.