Tonight's Debate
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Tonight's Debate
| Tue, 10-07-2008 - 10:21pm |
is anyone watching the debate? What do you think so far? Who is 'winning'? They don't seem to be answering many audience questions.
| Tue, 10-07-2008 - 10:21pm |
is anyone watching the debate? What do you think so far? Who is 'winning'? They don't seem to be answering many audience questions.
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The way I see it (feel free to correct me if I am wrong) is that we went into Iraq under false pretenses. By that I mean, the reasons WE were given were not the reasons Bush & Co. went into Iraq. Truth is, the vote that everyone refers to as a vote to "go to war" wasn't that at all. Congress voted on "authorizing the use of force" but it was to be used as a last resort rather than a first option. Funny thing is, at the same time Congress was voting Bush had half the Navy (give or take a ship or two) already stationed within striking distance of Iraq and troops were on their way... Congress did not declare war on Iraq.
After all of this time, however, the vote to "authorize force" has become a vote to "go to war" They are not, and never will be, the same thing.
As for the briefings that Congress recieved in order to facilitate their vote... well... that was slanted and skewed to bring about the desired result.
After all, Iraq did not create 9/11... those were Saudi's... but Bush & Co. (and family)certainly couldn't alienate the Saudi's, now could they> That might take that oil money out of their pockets...
Oh, I don't mean "skimming" in the illegal sense of the word, as in "taking funds they aren't entitled to."
What I mean is that they add a layer of for-profit bureaucracy - a HUGE one - to the existing system of delivery (and financing) of healthcare. Consider this question: how many entities are involved in the delivery of health care (in general, not every single last small one)? I would put it at two, like most business transactions. One the one hand, you have sick people or people in some need of care ("customers"), and on the other side, you've got doctors, hospitals, etc - the health care providers ("business"). Of course - just as in every other business transaction, it's more complicated than that (there are the people who supply the business with the raw materials or manufactured goods, distribution chains, etc)...but I'm simply talking in the most basic of terms, since most of the rest of that other stuff is handled behind the scenes by the provider or business, and factored into the cost of whatever the product is.
In every other first-world industrialized nation in the world (and many non-first world nations, LOL), that's almost where it ends, too. The only other entity involved, in the case of a system such as Canada's, is the government system of financing which allows money to flow from the customers to the providers. A true libertarian would probably argue that there should be no such entity, whether governmental body OR private insurance company, and that people should contract these things privately, with their own funds, and make their own deals for care directly with the care providers. But everyone who has to deal with the healthcare system pretty much understands the need for insurance, just as you do on your car and home. So - in places like Canada - there is this non-profit, governmental agency in place to administer the financial and record-keeping end of things, to pass money from the treated patients to the care providers. Three entities total.
But in America, instead of a non-profit governmental agency which administers this function, we have scores of FOR-profit, private health insurance companies, which the doctors and hospitals and care providers must sign up with if they wish to have access to the patients who have insurance - which is most of them. The ones who DON'T have insurance are either ridiculously wealthy, or completely indigent (or working in jobs that don't offer it, and can't afford it on their own). But the indigent and "can't afford it" far, FAR outnumber the ridiculously wealthy who can cover any medical cost out-of-pocket. So most health care providers, whether they work for a larger group or hospital or hang out their own shingle, have to do business with these for-profit insurance companies. And not just one of them, or even two. Often, doctors' offices have to sign up with at least a dozen or two dozen different insurance companies, in order to ensure that they've got a decent chance of attracting the widest number of potential customers. Because, from the customers' side, they're typically not going to visit an off-plan doctor, since that would mean they have to pay out-of-pocket. Even in the case of PPOs, where you can go to most any doctor you wish, that still means the care providers have to sign up with whatever for-profit insurer provides THAT plan, as well.
The result of having to sign up with all these various different companies - all of them for-profit - is quite obvious: each of these insurers has a different set of payment schedules, a different set of paperwork which must be filled out, a different telephone number (or numbers) which must be called in order to get authorization for various procedures (if the providers want to get reimbursed, that is), and a different set of rules regarding what things require pre-approval, how far in advance, and a whole galaxy of other intricate rules and regulations. Most care providers have nearly as many professional clerical people on staff to deal with the mountains and mountains of paperwork required to ensure that the actual medical staff - the ones who generate the business - will be able to get paid for the work they do, instead of having claims denied.
Medicare is not without its problems, for sure....but one problem it DOESN'T have - which the Canadian system of single-payer ALSO does not have - is high costs for administration. Why? Two reasons: one, it's non-profit. The difference there is that the entity in question is not attempting to accumulate as much money as possible to pass on to the executives and shareholders who expect a profit for their investment. It simply collects enough to pay the staff and the bills, and that's it. The second reason is that having to pay a large clerical/accounting staff to deal with twenty or thirty different for-profit companies, each with their own rules and schedules, is orders of magnitude more difficult - and costly - than having to deal with ONE entity which has consistent rules and schedules. Both American medicare and the Canadian system administer their entire programs for about 3.5¢ on the dollar - in other words, out of every $1 spent on healthcare, about three and a half cents goes to administration of the whole thing: billing, etc. And the figure for the American for-profit system, as a whole? TWENTY-SEVEN CENTS ON THE DOLLAR.
That's a difference of nearly a quarter of every single dollar spent on healthcare in the United States, going to literally nothing except duplicative effort and insurance company profits. You and I get nothing - NOTHING - for that money. And it's enough - were we to eliminate it - to be able to raise the basic standard of care for everyone and STILL cover all 47 million uninsured.
You want to talk wasteful bureaucracy and inefficiency? The waste of government hasn't got ANYTHING on the waste incurred by twenty or thirty different companies, all "skimming" off as much money (or jacking up the cost in order to take their profits), and all adding their own competing, conflicting rules and regulations into the mix.
Edited 10/9/2008 12:05 am ET by impalin_mccain
Sopal
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Supreme Court Justice Potter Stewart, in 1974, said essentially the same thing (as he did at many times throughout his tenure on the high court):
He's not saying every citizen has the right to access the means of PRODUCING such free media, but he IS saying that EVERY citizen has the right to have such a thing available to them for reading.
I happen to get pretty good care for my money, thank you. It is superior to any government care my state currently provides (ie Medicaid, VA). If I choose to spend my money to purchase a product (ie health insurance) from what you have determined is an inefficient company that's between me and the company. It's none of your business.
You have also conveniently left out an aspect of Medicare and Medicaid that you ought to look into. Namely a preposterously high rate of fraud. My guess is when you cheap out on all those "administrative costs" it is easier to perpetrate fraud.
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