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A Very Loud Pause at 5:19 of the First Video



August 18, 2009 – Comments (8) | RELATED TICKERS: WLP , UNH , CI

But then Joe struggles to get it...

Medicare for all Americans!

After this many months, it is nice to be heard on television.

America needs HR676.

And Joe, I am more afraid of depending upon the finances of some private insurer than the success of Medicare. And it is not just me.


8 Comments – Post Your Own

#1) On August 19, 2009 at 1:14 AM, ajm101 (32.27) wrote:

I can't even put together a polite blog post on this subject, I'm glad you are posting these.

It literally astounds me that anyone supports this health insurance industry that has provider zero value-producing innovation.  What a broken system.  Even cash for service would be better.  And look at no-brain Joe Scarborough totally unable to understand the debate.  Too bad the congressman brought policy into the discussion, Joe is only comfortable discussing how the issue is being framed.

"You know what I hate about the 'Death Panel' discussion?  It reminds me of Mediscare in '96".  Why is this guy on TV?  Liberal media my rear.

I can't believe the debate on this issue is between actual data from real world experience in other countries versus the gut feel of a guy with an assault rifle that was part of the 90's militia movement outside a town hall.

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#2) On August 19, 2009 at 2:29 AM, QualityPicks (54.81) wrote:

I don't get it. I have to say I would have paused the same way. When I hear the question at 5:19, my jaw dropped and I asked to myself "Are you kidding me? He actually asked that? I think I would have stayed silent and kicked him out of my show, there is no need to answer such a stupid question". What value do insurance companies bring to the table? I guess he meant "What value do insurance companies add over a government run plan?".

First let me say we need to do something about healthcare. But a government takeover is just the wrong thing to do. 

Exactly what he saw as bad, is what is good about a private system. A private company needs to make a profit. The government doesn't. If you don't care if you are profitable or not, that means you will just pay whatever to whomever, making healthcare costs rise faster, exactly the opposite of what you want (unless you are a Doctor). Why is there no overhead in Medicare? because they don't check anything, they just pass the bill to the taxpayer. Why is the government on the way to bankruptcy? Because they don't care about profits.

Then, what about choice? Some people will pay more for a better plan than others. Other people would rather live a healthy life and pay less to insurance companies. With a government plan choices will be close to zero. You either take what the government says or you are royally screwed.

Last, the money is going to come from whom?

And sure, housing is also an essential thing. Nobody should be homeless and without a place to live. So, should the government give houses to everybody and take over the private industry? I bet you this guy would say "Yes!!! that way the government doesn't need to make a profit, and that would be cheaper for everybody". Are you kidding me? Sheesh. 

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#3) On August 19, 2009 at 3:43 AM, ajm101 (32.27) wrote:

Make no mistake.  You, as a taxpayer and healthcare customer, are paying through the nose for the uninsured already.  They have inefficient care that results in emergency room visits, which have to be written off by hospitals that pass those costs along to insured patients.   It's far more cost effective to have a basic plan for a middle aged person on diabetes and treat the disease, as opposed to having emergency room visits for gangrene, renal failure, insulin shock, glaucoma treatment...

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#4) On August 19, 2009 at 4:13 AM, FleaBagger (29.37) wrote:

First, Devoish, let me say that I hope you never get kicked off this site, or ever decide to leave it.

Second, let me say that that was painful. Joe is obviously intellectually unprepared to defend liberty in the face of a charismatic socialist onslaught. So allow me.

The reason insurance companies exist in a free market is to pool and mitigate risk, to wit, the financial risk that is immanent in the risk of other catastrophes, such as natural disasters, disabling accidental injury, death of a family's financial provider, etc. The way an insurance company profits in a free market (that is, a market where government has no power to regulate the transactions between the insurer and its customers) is to offer financial compensation in the event of catastrophe in exchange for premiums paid in the meantime. For example, as long as the Stevens family pays Aloe Fire Insurance (not a real company) a regular premium, AFI agrees to pay the Stevens family a much larger sum (typically much more than all the Stevens family's lifetime premiums combined) if their house burns to the ground. Of course, AFI has investigators who will find out if the Stevenses burnt their own house down to collect the insurance money. 

Also, AFI has a powerful incentive to make sure that the Stevenses have incentives to minimize the fire hazards in their house. Lower premiums for fire resistant material in the walls or some such (I'm not a carpenter, I have no clue about such things). Perhaps a clause exempting AFI from paying if the fire was caused by someone smoking in bed or some other reckless act. As you can see, AFI not only helps out the Stevens family in case of fire, but can (and will) provide expert help in fire prevention and fire safety. That's because it affects their bottom line.

So what does this have to do with health insurers? As we all know, they withhold payment from doctors for months, deny customers coverage for needed procedures, and increase the overall cost of health care - they are skimming profits off the top, and providing no useful service to society, right?

Sure. But why aren't enterprising greedy bastards stealing their customers away by providing better service, as happens in all unregulated sectors of the economy? Because government is already stifling competition with Medicare, Medicaid, tax break-subsidized health insurance for all, feel-good coverage mandates for smokers and the obese. Government prevents health insurance companies from allocating risk the way they do in the free market, but protects their profits in a bizarre "compromise" that resembles the socialism/profiteering hybrids that one might have observed in Italy in the 1930's.

As Rep. Weiner and our president have said, health care reform is about providing a public option to compete against health insurers. Someone well might point out that it isn't really competition if one side is funded by tax dollars (including some from its competitors!), protected by onerous regulations against its competitors, and free from any profit/loss judgement. It's more like the public schools "competing" against the private schools whose property taxes and whose customers' property taxes go towards funding them.

Or, as the Obama points out, like the USPS competing against FedEx and UPS (and staying afloat by receiving government-backed - that is, FedEx and UPS tax dollar-backed - loans). 

But Medicare must be working well, because it's so popular, right? That's a bit like saying the mortgage interest deduction must have done a great job of boosting the economy by helping make us an ownership society in the 2000's, because it was so popular. If you ask everybody who didn't get the credit if they liked paying an extra $100 or so in income taxes so that someone else could get the mortgage interest credit, they probably wouldn't have liked it as much. But they didn't start organizing to protest the credit until about 2006, because it was the people getting the money who were thinking about it.

Similarly, Medicare is popular because a large number of people are each paying a little money to a few in whose hands the benefits are very concentrated (and who are often related to those paying a relatively small figure). Do the ones paying have any large incentive to focus on this issue instead of on other tax issues or government programs that hand them money? Nope. And besides, if they do away with Medicare now, they lose everything they've already paid in - better to stick the next generation with the spiralling bill. Do Medicare recipients want to do away with their free money? Not a chance. Does that prove it's a wonderful, cost-effective system? Nope. The reason there's no political will to do away with it is like the reason there's no political will to do away with Social Security, even though it's a Ponzi scheme with returns that would be unimpressive even for a bond fund, let alone a small-time pyramid crook (who usually pays out 10%+ to his early clients). If people just kept their money in a savings account, they'd 1) be able to use in case of emergency, such as a medical emergency, 2) have about the same return on their money as with SS, and 3) not have to keep making adjustments to save SS every couple of generations, as it starts to go bankrupt again and again. But there's no political will to change it, because the benefits are concentrated in the hands of the politically active, the harm is spread and discreet, and those being harmed are promised benefits if they stick with it long enough.

I wonder how Weiner came up with the 4% figure?

Anyway, let's assume that's true. So what? Comparing Medicare's wastefulness and bureaucratic overhead to an insurer's margins is apples to oranges. In one case, a well-lobbied interest group is suckled at the public teat for the benefits that being a politically favored group can provide, and in the other, well... okay, I guess they are pretty comparable. But in the one case, you have the bargaining power that Weiner was talking about applied so clumsily that many doctors agonize over the decision of whether to accept Medicare patients, or take take only non-Medicare patients, limiting their pool of potential patients, but skipping a huge paperwork nightmare that could be expensive to outsource. Many doctors are opting for the latter. If Wal-Mart were administering Medicare, no doctors would opt out of it (unless they were already protesting Wal-Mart for some reason, but you get my point, I hope: Wal-Mart would pay them enough and find paperwork solutions for them so that everyone would be happy).

So, yes, health insurance company profits are obscene, health insurers are not working for America, and Medicare is politically popular. But Medicare for all Americans is going to be like the Post Office handling all of our health care, unless we pay good money to the alternative to a system that we were already forced to pay good money to support. The funding decisions will be slow, just like they are in Canada and the UK and Norway, and everywhere else that has a single-payer government health care system (and just like the USPS's package delivery versus UPS and FedEx). The costs will be hidden, and to the extent that a "private option" is allowed, lobbyists will make sure that it is obscenely profitable, and to the extent it is regulated and curtailed, government will be controlling our health care. And we may eventually get bureaucratic review boards deciding whether or not we get open heart surgery ("Sorry, Mr. Stevens, but since you were a smoker from 2003 to 2006, the Party has decided that you are not worthy of an expensive surgery to heal an organ your poor choices helped destroy.") - in other words, a death panel.

So maybe if you dig a little deeper instead of attributing every profit in the world to "free market greed," maybe you could get a more nuanced picture of what a free market really is, how it could improve our level of prosperity and even our health, and how it is the opposite of government invading our privacy and controlling our lives. And how the problems of today arose from the very solutions you are proposing when they were implemented in another form in days past.

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#5) On August 19, 2009 at 4:27 AM, FleaBagger (29.37) wrote:

I almost forgot to mention:

Make no mistake.  You, as a taxpayer and healthcare customer, are paying through the nose for the uninsured already.  They have inefficient care that results in emergency room visits, which have to be written off by hospitals that pass those costs along to insured patients.   It's far more cost effective to have a basic plan for a middle aged person on diabetes and treat the disease, as opposed to having emergency room visits for gangrene, renal failure, insulin shock, glaucoma treatment...

(Thanks, ajm101!) This is a big reason why costs are spiralling out of control. We have everyone else paying for emergency room visits of the poor (who can't get a job because of the minimum wage) and of illegal immigrants. If the government weren't bidding up the costs of preventive medicine, these things could be bought with cash for a tiny fraction of what they cost now. Wal-Mart is an excellent example of how costs are relentlessly pushed downward in a free market. The government, through Medicare, Medicaid, and tax breaks for employer-sponsored health insurance, has prevented this from happening in medicine (and higher education, affecting medical schools, and ultimately health care costs - but for the most part that's a different story).

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#6) On August 19, 2009 at 5:27 AM, AbstractMotion (54.15) wrote:

I'll give an answer to what private insurance brings, freedom of choice.  Is it worth the overhead they currently take?  No not really, but that doesn't mean there's not place for regulated private industry in all this.


I'm kind of shocked that this guy is surprised people don't want Medicare changed, why do you think that is?  Because seniors have become so hopelessly dependent on SS and Medicare as a retirement savings plan.  There is no choice about these plans as their costs are taken from people's paychecks, you can't just invest that money elsewhere and get a tax refund.  So of course people don't want to see such a system change, it's forcibly made a part of the average american's retirement plan.  Not that these systems are in some way superior or even have the actual ability to retain and accumulate money when surpluses do exist.  We know they're going to be functionally insolvent in a few years, which will either result in higher realized public debt or higher taxes.  This is fundamentally why I'm against a single payer or government run system, because once it's there choice is gone.  And if someone with nefarious intentions comes into power it gives them a very large chip to play against the people should the desire arise.  I don't understand how a lot of people who believe we were just so close to having Bush establish himself as a dictator can turn around and say: "You know what we need? An expansion of government in our day to day lives. "


That said, as much as I tend to disagree with devoish solutions, the fact of the matter is that current proposal lacks any sort of cost control mechanism.  Where a single payer system is essentially granted a consumer monoply and an ability to set prices with that mechanism.  What we have on the table is just going to increase costs and coverage rates.  The money hasn't really been allocated to pay for it, and I really doubt congress is going to cut Medicare cost increases when the seniors start protesting that.


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#7) On August 19, 2009 at 10:31 AM, 4everlost (29.50) wrote:


Thank you for some cogent thought that is very well written.

In an earlier post here:

"Uniquely American" healthcare.

devoish wrote:

Visit for information about Single Payer.

Visit Canada for a real world example without the lines we have in the USA.

Visit Sweden, Norway, Germany, or France for more.

All of these Countries are getting better results than the USA for half the cost.

As far as is concerned why don't you visit

AMA Opposes Public Insurance Plan

And "Visit Sweden, Norway, Germany, or France for more"as proof that we need the American governement to build a single payer system?  Are you kidding me?  Each one of those systems involves heavy taxation, rationing, long wait times and are close to insolvent.  In addition, in many countries with socialized medicine there are priviate insurance industries that cover the procedures that the government doesn't.  In fact, the Canadian gov't is trying to figure out how to make their broken system look more like America's.  

Finally, why not consider some "less government" approaches such as:

Alternatives to ObamaCare


• Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs). The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems.

Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair.

• Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable.

• Repeal government mandates regarding what insurance companies must cover. These mandates have increased the cost of health insurance by billions of dollars.

• Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. These costs are passed back to us through much higher prices for health care.

• Make costs transparent so that consumers understand what health-care treatments cost. How many people know the total cost of their last doctor's visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost us?

• Enact Medicare reform. We need to face up to the actuarial fact that Medicare is heading towards bankruptcy and enact reforms that create greater patient empowerment, choice and responsibility.

• Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren't covered by Medicare, Medicaid or the State Children's Health Insurance Program.

I agree that we need to improve our health care system and there are parts of the single payer system that work.  However, IMO, we ought to look at both socialized options and free market options closely and put a plan in place that combines the best of both and solves the problems for the long term.



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#8) On August 19, 2009 at 10:47 AM, outoffocus (23.59) wrote:

Wow...I wish I could rec Fleabagger's comment.
As a matter of fact, that comment is worthy of a separate blog post, if you dont mind...

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