2 problems that have to be addressed before one can realistically expect massive health care reform to originate at the state level:

(1) State politics. Term limits in a lot of states present a challenge, insofar as healthcare is a gigantic topic and individual reps might not get enough time on the job to actually implement the details of a workable plan. Also, I think the idea that state legislatures are some sort of pure democracy doing the will of the people is, at best, a conjecture.

(2) ERISA, a Federal law that exempts self-insuring employers from a ton of health-plan regulations. In other words, states with lots of large employers might find it impossible to "crowd out" private insurance.

Posted at July 12, 2007 4:51 PM in response to Federal Delusion: DC Won't Deliver Health Care for All

Interesting. One of the major obstacles to large-scale policy reforms at the state level in the U.S. involves term limits. Are the provincial politicians termed out quickly in Canada or not?

Posted at July 12, 2007 4:23 PM in response to Federal Delusion: DC Won't Deliver Health Care for All

Not true. It depends on the system. In the UK the NHS is very involved in provision - it runs the hospitals and salaries the doctors.

Posted at July 10, 2007 9:15 AM in response to Fixing Health Care: Keep the Debate in the Gutter

But:
(1) can you necessarily count on competent, non-corrupt administrations always being in place?
(2) can you count on Congress's ability to allocate a massive amount of money wisely and fairly?

Posted at July 10, 2007 9:12 AM in response to Fixing Health Care: Keep the Debate in the Gutter

"Health and politics should never be mixed in any proportions."

So, you want a fully privatized system, then? :)

Posted at July 9, 2007 4:39 PM in response to Fixing Health Care: Keep the Debate in the Gutter

One word to all of you clamoring for the government to take over our health care system, please remember that this is the U.S. government we're talking about. Given the staggering incompetence I've witnessed over the past 6.5 years and what I know about the corruption in our budgeting process, I wouldn't trust this government to change the oil in my car, let alone take over health care. I'm just saying . . .

Posted at July 9, 2007 4:33 PM in response to Fixing Health Care: Keep the Debate in the Gutter

You're missing several important facts here. Privatization in Medicare was NOT the work of Republicans, and you're discussing this as though the government is just randomly subsidizing private insurers. HMO-style Medicare plans are known as Medicare Plus Choice; this is a part of Medicare (Part C), and it came to us in the Clinton era. Also, you're confusing the costs of Part C plans to Medicare with their costs to members. While these plans are quite costly because of risk-pooling problems, the members aren't necessarily "voting with their feet", because the out-of-pocket costs are often lower in Part C than in traditional Medicare (which can be staggeringly expensive to those on fixed incomes).

In short, I appreciate your enthusiasm for the subject, but understanding health politics requires a lot more homework than you seem to have done here.

Posted at July 9, 2007 12:24 PM in response to Fixing Health Care: Keep the Debate in the Gutter

Regarding Greg Oden: whine, whine, whine, whine, whine, whine, whine . . . And Go Blazers.

One other factor could cause the Patriots to not win the Super Bowl this year: complete lack of chemistry. This is the year of the prima donna wideout in New England. For recent data on the effects of a bad locker room on a talented team, see Bengals, Cincinnati.

And one team is more than capable of outpitching the Red Sox this year. I know you don't like acknowledging the existence of the West Coast, but the Angels have a far better rotation AND bullpen.

Posted at June 25, 2007 10:35 AM in response to Miscellaneous

I'm not sure that this is an example of the free market not working well. It's an example of a really terrible situation where a family needs an enormous amount of money to pay for something they need, and they might not be able to come up with the enormous amount of money.

I think many of the above comments are missing the distinction between uninsurance and underinsurance. My favorite example of this involves picturing a homeless man in the street: is he going to be helped more by a super-deluxe PPO plan that covers everything with no deductibles or copays, or by a roof over his head, a hot meal, and limited basic coverage? To read the health-policy discussions on this site, you would assume that his lack of a PPO is a far greater affront to humanity than the fact that he sleeps in a park. This is an area where I think the undiscriminating, reactionary hatred that many on this site have for private enterprise becomes a real problem. I don't know about you, but the Part D doughnut hole and means-testing in Medicaid bother me a lot more than the thought that my health plan might not cover some experimental scanning procedure for me someday. But ideas like that detract from the "evil insurance company" meme that folks here are so fond of. (On a related note, anyone who thinks that inefficiency will magically disappear from the U.S. system once we're in a single-public-payer environment needs to take a moment to contemplate Part D. I would think that TPM readers would have an idea of how amoral and spectacularly wasteful the Federal budgeting process is.)

Posted at June 22, 2007 2:54 PM in response to Matthew's Mom Responds

Where's the ignorance here? Empirical research has shown that cognitive-behavioral therapy, as well as any number of generically-available antidepressants, are effective in treating depression.

Posted at June 22, 2007 2:27 PM in response to No Help for Matthew