Real Death Panels
Jonathan Cohn calls it a “squeeze play” but whatever you call it there’s something bizarre about watching an American conservative movement whose general goal is to have the public sector provide as little as possible to anyone, and whose specific goal is to prevent public policy from extending health insurance to the tens of millions of currently un- or under-insured Americans, posing as the defenders of the right to access to generous health care services.
And of course the right-wing does want “people” to have access to generous health care services—rich people. Others will just have to, you know, get sick and die for the sake of free market principles. As Joe Conason says these are the real death panels:
When Republican politicians and right-wing talking heads bemoan the fictitious “death panels” that they claim would arise from health care reform, they are concealing a sinister reality from their followers. The ugly fact is that every year we fail to reform the existing system, that failure condemns tens of thousands of people to die—either because they have no insurance or because their insurance companies deny coverage or benefits when they become ill.
The best estimate of the annual death toll among Americans of working age due to lack of insurance or under-insurance is at least 20,000, according to studies conducted over the past decade by medical researchers, and is almost certainly rising as more and more people lose their coverage as costs continue to go up.
They die primarily because they didn’t have the coverage or the money to pay doctors and thus delayed seeking treatment until it was too late. They don’t get checkups, screenings and other preventive care. That is why uninsured adults are far more likely to be diagnosed with a disease, such as cancer or heart disease, at an advanced stage, which severely reduces their chances of survival.
There’s pretty good evidence that consumer driven health plans can save money without producing worse health outcomes (see also this and this) but it doesn’t work at all if what “cost-consciousness” compels people to do is skip out on preventive care or basic health screening. That just leads to people dying. And that’s what lack of adequate health coverage does in today’s United States.
63 Responses to “Real Death Panels”
Register
RSSLogin
Topic Cloud
ArchivesBlog RollAbout Matt YglesiasContact Me
Donate
August 12th, 2009 at 10:27 am
Yes! This is why the current moment is an excellent chance to fracture the Republican coalition, at least ideologically. The contradiction between free-market totalitarianism and the “pro-life” crap is quite stark when you have the opposition to government healthcare hanging its hat on the threat of “death panels.”
Of course, Republicans don’t give a shit about ideas, but nonetheless, they do matter.
August 12th, 2009 at 10:32 am
So, the market fetishists DON’T want health care withheld on the basis of the patient’s productivity?
Ummmmm….?
August 12th, 2009 at 10:35 am
I would say that we need a socia-list President if the CAP’s imperialist word filter allowed me!
August 12th, 2009 at 10:36 am
Do you know why spam filters block the words “s-o-c-i-a-l-i-s-t” and “s-o-c-i-a-l-i-s-m?”
Because they contain the word “c-i-a-l-i-s.”
August 12th, 2009 at 10:38 am
Do you know why spam filters block the words “s-o-c-i-a-l-i-s-t” and “s-o-c-i-a-l-i-s-m?”
They do?
Socialist
August 12th, 2009 at 10:41 am
The Conservative Movement on government-paid health care:
The food is terrible–and such small portions!
August 12th, 2009 at 10:43 am
Marshall,
Some do. They have a problem with that Balloon Juice.
August 12th, 2009 at 11:10 am
I’m sick of seeing that people argue that 20,000 in the annual death toll of our for profit health care system. I sick of it because it is a gross underestimate. The 20,000 number comes from studies comparing mortality rates among the uninsured in America with mortality rate amongst the insured in America. But our for profit health care system is failing the insured as well.
A study published in 2007 by the London School of Hygiene and Tropical Medicine compared mortality rates for treatable diseases in America with other developed nations and found that if our for profit health care system provided care as good as the best government funded systems in the world (France’s, Japan’s and Australia’s) we would be saving an additional 101,000 lives every year.
101,000 is the annual death toll of our system, not a mere 20,000.
August 12th, 2009 at 11:21 am
@Theo
Not that I agree with you, but if there is a 20K disparity between those with and without insurance and a 101K between those with and what those with should be, then wouldn’t the real number have to be at least 121K (101K + 20K).
August 12th, 2009 at 11:29 am
20,000, 101,000, 121,000? Even so, still it must be said “the judgments of the Market are true and righteous altogether.”
August 12th, 2009 at 11:45 am
There’s a bit of a double-standard here. When bureaucrats driven by profit motives deny care it is okay to treat this as a “death panel”; but when bureaucrats driven by political and budgetary concerns deny care it is not.
What to do about the portion of the uninsured who cannot afford necessary preventive care is, however, an interesting question, quite apart from the debate over comprehensive reform.
August 12th, 2009 at 11:45 am
[...] 12, 2009 · Leave a Comment yglesias cites the real death panels: When Republican politicians and right-wing talking heads bemoan the [...]
August 12th, 2009 at 11:54 am
I’m curious, Aaron: have you even been within 1000′ of a government office?
When did anti-government conservatives start believing that government bureaucrats strive to deny benefits to members of the public for political purposes?
When did anti-government conservatives start believing that government bureaucrats strive to avoid spending their budgets by the end of the quarter?
August 12th, 2009 at 11:56 am
Democrats have a majority in the House. Democrats have a filibuster-proof majority in the Senate. The only reason Democrats haven’t passed anything is because they can’t get Democrats to vote for it.
As far as controlling the message, Democrats have had control of the agenda and the message pretty much since Obama got elected last November. Like the lying leftists that support them, Democrats have proven utterly incompetent at governing and explaining their agenda to the American people.
So what do the lying Democrats and leftists do? Blame conservatives and Republicans, call them racists, etc. Because they don’t have a plan or a message, as with everything else. And what’s funnier, these idiots can’t even convince enough Democrats to vote for it.
August 12th, 2009 at 11:59 am
@JD
The 101,000 is the difference in survival rates for treatable diseases in America as a whole (insured and uninsured alike) and that of other nations. So no you don’t add the two numbers together.
My problem with the 20,000 number is that its based of comparing mortality amongst the uninsured here in the US with that of the insured, but many insured Americans are actually under insured and receive limited treatment as a result.
The issue of Health Care Reform is larger than simply getting some kind of insurance for the uninsured and closing that 20,000 annual death gap. Real reform must include better health care results for all Americans; uninsured, under insured and fully insured.
August 12th, 2009 at 12:01 pm
As a matter of fact, majority of both houses of Congress would pass the bill tomorrow, if Republicans weren’t abusing the system and demanding a supermajority vote.
Like Americans in general, a majority of Congress is already on board. The volume of the screamers doesn’t actually translate to real numbers.
August 12th, 2009 at 12:10 pm
Interesting how all the likely suspects got all hot and bothered and made us completely change around our laws regarding drinking and driving and forcing the states to bow to a federally mandated drinking age in a matter that is constitutionally specifically left to the states (way to go on the hypocrisy, Repubs!) – for way far fewer deaths.
August 12th, 2009 at 12:12 pm
Democrats have proven utterly incompetent at governing and explaining their agenda to the American people.
Yes, it is the Democrats’ fault that Conservative Movementarians simply make crap up and that the media nonetheless takes them seriously. Poor Sarah Palin–the Democrats used their mind-control satellites to put the phrase “death panel” in her brain. She should have worn her tin-foil hat.
Anyway, the House and Senate will both pass bills, and then a semi-decent bill will emerge from conference, pass both houses, and become law when Obama signs it. People will quickly realize that the bill helps most people, and that the fearmongering of the Conservative Movement was once again completely baseless. And the Conservative Movementarians will once again be reduced to lamenting to themselves, “What happened? I thought we were winning!”
August 12th, 2009 at 12:23 pm
Democrats have a filibuster-proof majority in the Senate. The only reason Democrats haven’t passed anything is because they can’t get Democrats to vote for it.
So true. And why did the Dems give Ted Kennedy brain cancer? And make Robert Byrd old and sick?
August 12th, 2009 at 12:31 pm
As an evil Republican bent on destroying the poor, I must say that it has been a joy sitting on the sidelines and watching the Democrats do what they do best – circle up and commence firing at each other. Complain all you want about the vile right wing in this country. The FACT is that the Democrats own Washington, DC and can pass any legislation that the Democrats – and Democrats alone – can agree upon. The reason that there was no health care “reform” bill passed by both houses of congress in July and signed by St. Barack is that the Democrats failed to cajole their own members to vote for any of the ludicrous plans then circulating on Capitol Hill. And the funniest part is, it only gets more difficult from here. “Speaker Boehner” has a lovely ring to it.
August 12th, 2009 at 12:33 pm
From a purely-partisan perspective, I’m hoping that this Congress will pass a compromise bill without a public option, so the Democrats can run explicitly on that in 2010, and the gains they make in Congress can serve as a clear mandate for more extensive health care reform.
That’s assuming, of course, that the backlash that’s growing against the Deathers doesn’t, like the backlash against the Sotomayor-bashers, result in the complete collapse and capitulation of the Republican position.
August 12th, 2009 at 12:38 pm
Yes, Elmer, you’ve got dat wascally wabbit this time.
Not like all of the other times, at all. You have your finger on the pulse of America! Again!
August 12th, 2009 at 12:43 pm
The statement that conservatives want health care for the “rich” is such CRAP! I’m not rich, but I have health care because I have a JOB. This isn’t about the rich versus the poor…this is about the fact that the gov’t will NOT be able to manage this program. Pure and simple. I understand the liberal view that we should all have health care in a perfect world. Well guess what, this ISN’T a perfect world. If universal health care were a viable system in the US, don’t you think it would have been done by now? Seriously…there’s a reason it hasn’t. It won’t work for us.
August 12th, 2009 at 12:48 pm
Theo is referring to a study summarized in a Health Affairs article from Jan/Feb 08. It is gated but here is a link to a summary by Kevin Drum:
http://www.washingtonmonthly.com/archives/individual/2008_01/012860.php
But he draws much too broad a conclusion from it. While he correctly identifies the US as the worst and the gap of 101,000 in amenable lives between the best and the worst, the problem with his conclusion that “our system” is responsible for all 101,000 deaths is that there are 14 other nations between the best and the US, and the gap between the US and say, Denmark, or England, both of which have dramatically different health care systems from the US, is only about 7,000 or 10,000. If all other systems were bunched closely to the top, his point would be valid, but the facts are otherwise.
August 12th, 2009 at 12:58 pm
Of course government can run a healthcare system. It could run the entire healthcare systme more efficiently than it is running now. That isn’t even what’s at issue here.
As for having a job, when your premiums double as a share of your pay, and they will very soon, will your company still pay for your insurance? How about when your company’s share of your insurance is equal to a quarter of your pay, do you think they’ll keep providing it?
August 12th, 2009 at 1:03 pm
Why does MY deem those studies ‘high quality’? Because the report says so? From what I read, the plans were employer based, so they may be OK for a population with a long term relationship with a single employer. These were observational trials. The discussion of the selection bias problem was not good. Any employed population has selection bias because they are healthy enough to work.
The highest quality study is usually considered a randomized controlled trial. The fact is that the only randomized controlled trial (The Rand Health Insurance Experiment) found that poorer individuals had higher death rates, even with special income related subsidies for their care. The leader of this investigation, Joseph Newhouse, himself has repeatedly pointed out this unfortunate finding.
August 12th, 2009 at 1:03 pm
I understand the liberal view that we should all have health care in a perfect world. Well guess what, this ISN’T a perfect world.
It’s quite amazing how every other modern country manages to accomplish this, but the “greatest country on earth” couldn’t possibly do it, because hey, this isn’t a perfect world!
Seriously…there’s a reason it hasn’t.
You’re absolutely right. That reason is because people like you, and the people you vote for, have furiously spent millions and millions of dollars trying to systematically dismantle every single reform effort that has been attempted, just like they’re trying to do with this one. Millions of dollars that have come from the coffers of the insurance companies whose pockets are lined by our failure to have a sensible health care system, and who are rewarded by failures to fix it.
August 12th, 2009 at 1:05 pm
this is about the fact that the gov’t will NOT be able to manage this program.
Of course, his reasoning as to why the government can’t manage this program is based on the complete disaster that is our government whenever the party he supports runs it. Every other modern government seems to run such programs just fine. It’s as though one party is completely incompetent and void of ideas, and runs on the explicit platform of accomplishing nothing, and then claims the government can never do anything once they get a chance to show they can’t.
August 12th, 2009 at 1:06 pm
sorry, typed my comment too quickly: I should have made it clear that poorer individuals enrolled in the high deductible plans in the Rand Health Insurance Experiment that had ‘consumer driven’ features had higher death rates than poorer individuals in other plans, even with special subsidies for preventive and chronic disease care in the high deductible arm.
August 12th, 2009 at 1:07 pm
Another curiosity: a mere three posts down we learned that “health care is not an especially important determinate of health outcomes,” yet in this post Matt passes along with approval a criticism of our insurance companies for not providing enough health care to the insured, and our system for not providing enough care to the uninsured. Perhaps preventive care is an exception to the health care as unimportant idea?
Joe of Lowell: The government has a limited budget, just like an insurance company. An insurance company’s pursuit of revenues encourages it to provide generous care so that people will want to purchase coverage; its desire to limit costs discourages it from providing generous care.
Desire for political gain encourages government to provide care. Competition with other government priorities, fear of insolvency, and fear of Perotism (public concern about insolvency) discourage it from providing care. A government’s pursuit of political goals determines the bureaucrats it appoints and the rules it sets for these bureaucrats.
This does not by itself answer the question of which set of incentives produces superior outcomes; but it is poor analysis to treat deaths resulting from one system differently from deaths resulting from the other.
It may also be that Peter Orszag and Barack Obama are wrong about the government’s ability to control costs, and that political incentives will leave spending unconstrained, making the system more unsustainable than it is currently alleged to be.
August 12th, 2009 at 1:14 pm
Mark T:
Mark’s argument, that the difference in mortality isn’t due to systemic flaws, would only makes sense if all the other nations in the study had the same system; differing only from the US. That Denmark and The UK get results that are only marginally better than ours when compared to the best nations is can be attributed to the fact that they have different systems than the best nations, just like we do.
Mark is being extremely disingenuous here, and invoking a common right-wing deception, i.e. any government subsidized or administered system is effectively the same as any other such system. His argument is a rehash of the old “It would be just the Canada’s system which sucks” straw-man argument.
No one in favor of reform is arguing that we should emulate the mistakes or inadequacies of other systems, rather we should seek to emulate their successes. This is why it is valid, and indeed vital, to compare the US system to those systems which get the best results; so that we might try to replicate their achievements.
August 12th, 2009 at 1:15 pm
An insurance company’s pursuit of revenues encourages it to provide generous care so that people will want to purchase coverage; its desire to limit costs discourages it from providing generous care.
Or, it can promise to deliver generous care and then find bullshit reasons why it doesn’t have to pay. That provides them with suckers to pay upfront and cuts their costs on the back end.
Hey, you know, that’s kind of like what happens in the real world.
August 12th, 2009 at 1:19 pm
Conservatives spit on your so-called “real world”. We’re an empire now- we make our own reality.
August 12th, 2009 at 1:23 pm
Chuck – “If universal health care were a viable system in the US, don’t you think it would have been done by now? Seriously…there’s a reason it hasn’t. It won’t work for us.”
Why do you hate America? Are you saying we are too stupid to figure out a way to cover all citizens with universal and affordable health coverage? You think we are incompetent and deserve to be left to die when insurance companies decide it’s too costly to pay for treatment? Why is it that those moronic Europeans can somehow have governments that run really effective cheap health care systems, but Americans can’t? Are we too stupid? Serious question.
August 12th, 2009 at 1:37 pm
Jeff S:
Always an excuse. Why don’t the Dems put people up for office who aren’t old and infirmed instead of throwing the same fossils into Congress?
August 12th, 2009 at 1:58 pm
Aaron,
Which brings us to the problem of recission. “Generous care” that attracts customers – say, low co-pays, low deductibles, high limits – are all well and good, until the insurance company has to pay. The generosity of the plan’s benefits – that is, the generosity that matters in the attraction of customers – isn’t really relevant to your point about bureaucrats denying care.
No, it certainly does not. It doesn’t get at the fact that individual employees and offices working for private insurance companies have a direct financial interest in denying care, in a way that individual employees in government offices do not. It does not get at the point that people in a corporate environment have a personal, economic interest in minimizing the amount they spend, while people in a government environment have a personal, economic interest in maximizing the provision for services rendered for a set budget.
That would be poor analysis indeed, and if you catch anybody doing that, tell them that joe from Lowell does not appreciate it. At all.
August 12th, 2009 at 2:04 pm
@35: Kennedy was last reelected in 2006, and diagnosed with cancer in May 2008.
More generally, the answer is “because the Senate has a seniority system, incumbents have huge advantages in elections, and the party can’t stop an incumbent from running again unless that incumbent agrees to retire”.
@30,32: Insurance companies don’t have to attract customers. They only have to attract employers. The actual customers are a captive market. That changes the incentives considerably. (But, of course, the possibility of hiding non-coverage in the fine print is *also* something that insurance companies take full advantage of.)
August 12th, 2009 at 2:16 pm
I’m sorry, as a progressive I’m sick of these excuses by Obama, the Dems, Congress, and the Obama lackeys.
Math is not sexy thing, but it is irrefutable. The Dems have the votes. The GOP doesn’t. Therefore, the onus, the responsibility, and the blame is on the Dems.
Bush pushed through whatever he wanted with 50 + 1 in the Senate. I don’t want to hear right wing this, and right wing that when the Democrats have 100 more votes than the GOP in Congress.
Obama, Pelosi, Reid: stop the blame game, stop the excuses and pass a real reform bill or pay the price. Period.
August 12th, 2009 at 2:21 pm
- there is a reason AARP is right now shrieking that it has NOT endorsed ObamaCare – at the moment they are running scared of their members who loath it
- they loath it, because 1. yes the proposal does offer a mechanism for creation of death panels, deciding at what point care should be stopped for “unproductive” (old, disabled) members of society; 2. the proposal cuts millions of $ out of Medicare; 3. the proposal will in many instances remove family doctor from contact with a patient
August 12th, 2009 at 2:26 pm
chris:
What’s to stop him from resigning? Oh yeah…he never did an honest day’s work in his life, unlike his two brothers.
Excuse me, but employers are customers too. They have to buy things to sell, and they have to purchase health benefits if they want to provide that as a benefit to employees.
August 12th, 2009 at 2:26 pm
LOL….you people are funny. Keep tearing each other up…..love it. Down with the “Democrat / Republican Party”!!! They have been in charge of all politcal decisions since the begining, why do you keep turning to them? No more Donkephants!!! We keep voting in the same parties and lo and behold we get the same result…..simply amazing. I do believe that this is the definition of insanity!
August 12th, 2009 at 2:32 pm
You’re getting there. Keep thinking about it for a while and it may start to dawn on you that as the actual customers, they have incentives very different from those facing people buying insurance for themselves. Especially when employees have a “choice” of what the employer offers, or nothing.
August 12th, 2009 at 2:41 pm
That Denmark and The UK get results that are only marginally better than ours when compared to the best nations is can be attributed to the fact that they have different systems than the best nations, just like we do.
Its not really a system question all he time. The Brits are really cheap, their problem appears to be outright underfunding of an in general good system. The same with school education when i remember the numbers correct
. They have a habit to underfund every public infrastructure since Thatcher.
August 12th, 2009 at 2:46 pm
Bush pushed through whatever he wanted with 50 + 1 in the Senate.
Right on! Remember when he privatized Social Security? Pushed through immigration reform? Made his tax cuts permanent? He just did whatever he wanted!
Anyway, it is true that the constraints right now are largely internal to the Democratic Party (mostly the Blue Dogs in the House and a handful of red-state Democratic Senators). But that makes them no less real.
August 12th, 2009 at 2:53 pm
Chuck believes that if you have any job, you automatically have health insurance, and even better, have coverage that will be there when you get sick, no matter what the sickness or pre-existing conditions.
Interesting.
August 12th, 2009 at 3:09 pm
@45: Not only that, but he apparently believes that anyone who doesn’t have a job in the middle of the worst depression in 80 years, or who loses their job in the same circumstances, is completely to blame for their own joblessness.
Either that, or he combines a touchingly naive faith in his current insurer and employer with “I got mine, screw you”. I know which way I’d bet.
August 12th, 2009 at 3:09 pm
There is something about the Jason Furman plan that sounds vaguely French to me. Who is this Furman character? Do his taste buds tingle thinking about the next seasonal offering of beaujolais nouveau?
I have a sneaking suspicion that the United States will copy France, without acknowledgment, and begin building manly, US-style battleship gray roundabouts at rapid rate -ours devoid of effete flourish, of course, and definitely no flowers allowed.
For all we know, roundabouts might have been invented here. That makes the roundabout as American as apple pie. It might has well be written in the stars, our quick paced culture is destined to embrace the modern roundabout. Once Americans see them and get a feel for them, there will be a hue and cry such has never been heard for a roundabout for EVERY situation, including, no doubt, for a roundabout, to replace each and every 4-way found -in any Wal-Mart parking lot- throughout our glorious land.
But a Froggy-style health care system? Never. Even the hint that we might add a touch of French elegance and efficiency to our current brutish system is.. well .. it’s goddamn un-American is what it is.
August 12th, 2009 at 3:10 pm
Seriously…there’s a reason it hasn’t. It won’t work for the rich bastards who control politics in the US.
Fixed your typo, there.
August 12th, 2009 at 3:21 pm
Steve LaBonne:
For the record, I didn’t say it was right or wrong for employers to be customers, just that they were.
August 12th, 2009 at 3:27 pm
I understand the liberal view that we should all have health care in a perfect world. Well guess what, this ISN’T a perfect world.
But Canada and Western Europe are? Why do you hate America?
August 12th, 2009 at 3:29 pm
No, I don’t agree. Most Reps understand coverage has to be provided. However, we want the coverage for the bottom 10% (welfare lifers) to be basic…not cadillac. And they’re already getting it:
-ALL children are covered under SCHIP
-All elderly are covered under medicare
-This leaves able bodied adults who ought to be working. Even if they’re not working they get full free emergency care…just not the preventive stuff.
And we’re not buying Obama’s kumbaya BS. Obamacare is a massive entitlement program for the bottom 20% that WILL jack taxes, hurt GDP growth, and eventually lower quality/quantity of health care for the top 80%.
August 12th, 2009 at 3:31 pm
If only the neocons would let Obama take over health care, then it would be absolutely free, with no waiting lines or rationing, med students would jump at the chance to be paid less for providing care, and the deficit would be cut to the bone!
Anyone who does not believe in Obama and his health care fairy certainly IS “bizarre”.
August 12th, 2009 at 3:35 pm
Spare me. Strom Thurmond’s staffers were propping him up like “Weekend at Bernie’s” for years before he died.
August 12th, 2009 at 3:39 pm
Actually, for the record, this is what you said:
And the response is, “No, they don’t, because the generosity of the coverage to members is NOT what makes purchasers – that is, employers – want to purchase it.”
August 12th, 2009 at 3:43 pm
All this whining from Leftists on this thread. Here’s the bottom line: Obamacare is dead because too many Democrats won’t vote for it. And they won’t vote for it because the voters have turned against it. Not because of the “eeevil” Republicans, but because:
-CBO confirmed Obamacare not only fails to bend the cost curve down…it add trillions (!!!) to Obama’s irresponsible plan to triple the national debt in 10 yrs.
-Voters started hearing the contradictions: you can keep your doctor; uh no you can’t: you can keep your insurance policy; uh no you can’t: it will save money; uh no it won’t.
-polls clearly show that 85% of americans are relatively satisfied with their current coverage. What they’re worried about is escalating costs, dropped coverage, and catastrophic illness. Obamacare either fails to address these things, or the Dems are to incompetent to explain it.
Voters simply aren’t ready to risk a huge roll of the dice and just “hope” that this administration is different from every other administration in US history…and can actually run a program efficiently and at lower costs. Just ain’t buying it!!
August 12th, 2009 at 3:46 pm
Once again, it’s fascinating that conservatives believe Americans are uniquely stupid and incapable of running things that work well in dozens of other countries. Isn’t that, I don’t know, sort of unpatriotic?
August 12th, 2009 at 4:06 pm
polls clearly show that 85% of americans are relatively satisfied with their current coverage.
As noted elsewhere, that’s pretty much meaningless, given that the real measure of health insurance is how well you’re treated when you get sick enough to test its limits.
You’re free to put your own insurance to the test: just step out in front of a bus.
This leaves able bodied adults who ought to be working.
Oh, how fucking facile is that? Notably absent from that classification are those who are self-employed or run small businesses and have to deal with the fraudulent shit-pit that is the individual insurance market, in which you pay for the privilege of thinking that you’re covered right up until something serious wipes out your savings, lands you with a pile of debt, and renders you uninsurable for life. Clearly, those people should get with the program and get “proper jobs” with big corporations.
Ah, Republicans. The party of free-enterprise and wage slavery. Whadda maroon.
(And I see that Freedom Fry, the platitudinous idiot last seen farting out Limbaughisms at Ezra’s joint, has joined him. Carnival of morons today.)
August 12th, 2009 at 4:24 pm
Right on! Remember when he privatized Social Security? Pushed through immigration reform? Made his tax cuts permanent? He just did whatever he wanted!
Point taken, I should have said “Bush did whatever the Republicans allowed him to do.” Bush failed where the GOP blocked him.
If health care reform fails, it will be the fault of Obama and the Democrats. All this talk about the right-wing blocking this and that is thus moot. They don’t have the votes. The Democrats do.
My larger point stands. Right on!
August 12th, 2009 at 4:48 pm
Theo unfortunately misunderstands my point. I do not argue,as he thinks, that systemic flaws do not cause the differences in mortality. I simply point out that his cited study does not prove that they cause it. I have no idea whether they do or don’t. It seems fairly obvious that there are numerous factors that could be at work, such as population composition, immigration and so on that have not been accounted for in this study. If the UK with its NHS and the US with its “system” if one can call it that, have a .0001 difference in amenable mortality between their populations (i.e. 10 deaths per 100,000), and there are differences in population composition and immigration between their populations that exceed .0001, then the amendable mortality rates of the subgroups would need to be analyzed to determine whether those factors underlie the populationwide difference, in which case there could be explanations unrelated to healthcare systems (genetics, healthcare weaknesses inprior countries, etc). It also seems fairly obvious that the healthcare systems of the countries nearest the US in the study all share the universal coverage and state-driven attributes that distinguish the countries at the top of the rankings from the US. So I don’t think the study supports the argument that “if we had a universal coverage and state-driven healthcare like the ones at the top, we would have amenable mortality rates like them” given that other nations’ healthcare systems have similar attributes and don’t get the same results.
August 12th, 2009 at 5:38 pm
Re: Mark @ 59
Try explaining 5 percent of that (or of anything else, like risk pools) to the guy yelling at Arlen Specter yesterday (or anyone like him). Or even trying to make him understand that stuff like that even exists in trying to design ANY health care system.
August 12th, 2009 at 5:44 pm
Obama claims that he would not be helping illegal aliens and he says the 47 million can’t afford health insurance. Yet 10 million of that 47 million are illegal aliens and 17 million more live in households making $50,000 or more (aka the top 25%).
Obama and the Democrats say they are saving money by wanting to spend $1 trillion over the next 10 years. That’s just poor math. After 10 years, it’s going to greatly increase. It’s already expected that in 2082, Medicare and Medicaid will have a combined cost of the combined cost of Social Security and the rest of the U.S. federal expenses. Meanwhile U.S. income hasn’t beat inflation since the late 1980s and will probably not again.
Obama also touts that universal health care in Europe is cheaper. What he doesn’t say is medical tourism is a big deal in those countries. If you live in Germany and need a hip transplant, you would most likely be sent to Eastern Europe or even India to have it done. It’s not universal health care that’s cutting cost, it’s outsourcing the expensive stuff that’s cutting the cost. If a doctor in Romania botches the operation, you are out of luck.
Also, except for Germany, Europian countries import more medical supplies than they export. Canada also has a medical supplies deficit. According to an article by Jim Gilbert and Paul Rosenberg, the U.S. drug companies would be outspending all of Europe in pharmaceuticals by a margin of 2 to 1 starting in 2012. In the same article, between 1993 to 1997, Europe launched 81 new drugs compared to 48 for the U.S. But between 1998 to 2003, the U.S. has launched 2 new drugs for every 1 drug launched in Europe. Europe has more people than the U.S. and pay more taxes, but have managed to stymie innovation.
From the same article, Germany doesn’t give 74% of statins, a key preventive treatment for coronary artery disease while it’s 44% in the U.S. Cardiac mortality declined 8% from 1990 to 2000, while in the U.S. it dropped by 13%. Germany is also far less likely than the U.S. to give out medication to treat breast cancer.
Obama and the Democrats have greatly misled the American people on what the U.S. is getting. It’s no where near the rosy picture that they are presenting. In fact it’s really a nightmare and the American people shouldn’t go along with it.
August 12th, 2009 at 7:28 pm
This is ridiculous. The Republicans were in uniform lockstep for the Social Security plan, until the Democrats routed them in the court of public opinion and killed the plan.
August 18th, 2009 at 7:12 pm
[...] but does this make the Right Wingers the Death Panels that they lied would be set up by the Bill? Matthew Yglesias Real Death Panels Real Death Panels Jonathan Cohn calls it a