Well, Well, Well Look What We Have Here!
It appears a PRIVATE HEALTH INSURER also provides for end-of-life planning coverage that is similar to that being put forth by House Democrats.
Under the "Member Rights and Responsibilities" portion of United Healthcare's website there is an outline of "exactly what you can expect from your health care experience and how you can improve that experience, too." The list includes the following pledge:
Consumer will be allowed to "Choose an Advance Directive to designate the kind of care you wish to receive should you become unable to express your wishes."
The goal of the provision, it seems, is to offer consumers the type of medical consultation that is often needed (and frequently forgone) to make end-of-life procedures can be smoother and less painful. If it sounds similar, that's because the House provision that has been derided as creating government-administered.
Officials with United Healthcare did not immediately return request for comment.
but but but this is different. So says some loon.
August 27, 2009 3:56 PM | Reply | Permalink
Okay, I'm that loon.
It does make all the difference in the world if the patient pays for the service, or the government.
ex animo
davidfarrar
August 27, 2009 7:37 PM | Reply | Permalink
You said it so I don't have to.
August 27, 2009 9:22 PM | Reply | Permalink
Are you retarded?
Even if we get single-payer someday, we're going to be paying for health care. That's what "payer" implies. The only people who won't pay into the system are the ones who can't afford it. Kinda like today, only less people falling through the cracks because the money will go toward actual coverage instead of a house in the Hamptons for an insurance company CEO.
Patients pay under private insurance and patients will pay under government-administered insurance.
August 27, 2009 9:23 PM | Reply | Permalink
O, please do not insult retarded people by suggesting that our friend here is one of them...it's just not nice.
August 27, 2009 10:24 PM | Reply | Permalink
People aren't retarded, only minds are retarded.
August 28, 2009 8:34 AM | Reply | Permalink
Switching to a single-payer health care system will simply exchange a private monopoly or a public one. It will do what every monopoly does, increase prices while reducing services.
ex animo
davidfarrar
August 27, 2009 11:31 PM | Reply | Permalink
A simple question about public "monopoly" vs. private: You don't see a difference in a for-profit, patient(i.e. consumer)-be-damned monarchy that lacking checks and balances becomes corrupt, skimming, and bogged down in its self-sustaining bottom-line bureaucracy and living-large executives vs. a totally regulated, medicine-based, efficient, cost conscious and quality oriented public service, whose mandate is equal protection for all?
No discernible differences? Nothing?
PS It has been under Republicans, exclusively, that the Federal government has become inefficient and unrestrained through oversight. That folows their "ideology" after all.
August 28, 2009 12:36 AM | Reply | Permalink
Surely you jest?
Let me be brutally clear with you here: Even if every, single member of a single-payer public health care monopoly had the best of intentions and was dedicated to bringing about a totally regulated, medicine-based, efficient, cost conscious and quality oriented public service, mandated to bringing equal protection for the common good of all, it still would end up raising costs while diminishing service. It's just the structural nature of the beast. A monopoly is a monopoly, is a monopoly.
What we need is both private and public systems to comtete against each other for their clients.
ex animo
davidfarrar
to Of course everyone will have the
August 28, 2009 7:59 AM | Reply | Permalink
Is that why all of our public utilities cost so much?
August 28, 2009 8:37 AM | Reply | Permalink
Our public utilities cost so much because they are traded like commodities. Like comparing apples and orangutans.
Saying that a public-private hybrid will lead to the most efficiency and lowest costs is pretty much what is being delivered right now via the efforts of various committees. The evidence in from countries that have single payer versus private-public is still mixed, but countries like Germany, Switzerland and the Netherlands are all experiencing pretty good outcomes using various mixes of the two.
Nothing David is saying should get the kinds of responses he is seeing on this thread since I think the numbers are on his side with regards to what Americans in general prefer. There is very little traction for single payer among the silent majority, with most supporting the kind of hybrid system that is being considered.
This is why the democratic party lacks cohesion on this effort and the president isn't sitting at 70% or more on this issue. Check out Eric's post on the subject. Democrats need to quit belittling potential conservative opponents who approach the debate from slightly different framing but agree on the broad goals as outlined by the president.
The continued acrimony is making it impossible to get anything done. For every republican bashed on at TPM, ten more are lurking who have now had their worst prejudices about "liberals" confirmed.
August 28, 2009 11:50 AM | Reply | Permalink
Jason, some where around here yesterday I read the suggestion that some polling be done to see what people would think about being able to buy into Medicare before age 65 to see if that changes the outlook for single pay. If it does, wouldn't we then know that it isn't government involvement that is the problem, but rather the scare tactics that opponents have been able to capitalize on?
I haven't heard anyone who is against the public option suggest that we dump Medicare, in fact I think you'd see blue hairs rioting in the streets on their hovercrafts if that happened!
August 28, 2009 6:01 PM | Reply | Permalink
Totally agree that an opportunity was missed to position the public option as long-overdue Medicare reform. Enter the debate with an overwhelming majority who support the concept and all sorts of things become possible.
August 28, 2009 6:33 PM | Reply | Permalink
Not in the mood Dipshit. check out these private monopolies who probably own your ass too:
http://www.washingtonpost.com/wp-dyn/content/article/2009/08/27/AR2009082704193.html
Go fuck yourself.
August 28, 2009 12:51 AM | Reply | Permalink
See my comment above to Jonnie.
I don't think this sort of thing is really all that useful to the ongoing reform effort. David is actually a conservative who believes that health care reform (particularly health insurance reform) is required. He seems to support perhaps 80% of what is on the table based on what I have read of the current legislation compared to his comments here.
Telling a potential ally to go fuck himself seems more than a little self-defeating.
If the end goal is creating a more just and equitable society, liberals must be able to define that goal independent of specific policies. The actual solutions are going to be conservative at times and liberal at times, but can be consistently progressive regardless if we can start to converse again at the grassroots.
August 28, 2009 11:56 AM | Reply | Permalink
Not in the mood today, Jason. He can go fuck himself.
Happy to play along another day.
August 28, 2009 12:15 PM | Reply | Permalink
Then you should probably refrain from commenting at all.
Nothing the man said deserves being told to go fuck himself. Would you say something like that in person? If so, I bet you have spent a significant amount of time with your jaw wired shut.
Using tactics you condemn in others is the height of hypocrisy.
August 28, 2009 12:20 PM | Reply | Permalink
ex aminmo is enough for me.
Thanks for being the resident hall monitor. ;)
August 28, 2009 12:39 PM | Reply | Permalink
And you don't know me. I work in blue collar trades. Yes if someone said sincerely to me in latin everytime they spoke I would tell them to their face to go fuck themselves.
If you want references I would be happy oblige,
Yours truely,
Saladin
August 28, 2009 12:45 PM | Reply | Permalink
I was in the blue collar construction trades as well for many years before joining the Navy, another blue collar profession. Both are well-populated by democrats and republicans alike. Telling someone to go fuck himself for disagreeing over a rather wonky point about a bill that isn't even final yet has nothing do with what type of work you do.
Again, but for a slightly different viewpoint on this one, David could be yet another advocate for massive regulation of the health insurance industry as a way to stabilize the system. Isn't that worth a half and ounce of patience in getting the point across or in finding enough consensus to move forward?
These sorts of tactics smack of biting off your nose to spite your face.
August 28, 2009 1:13 PM | Reply | Permalink
Jason.
I consider you a friend but I told you I wasn't in the mood, but you always ALWAYS have to have the last word on everything. Fine.
Did you even bother to read Roottie's post today before chiming in with your usual broder nonsense? Do you ever think about the big picture? The historical changes, the slow death by a thousand cuts as the richest bankroll fox and friends and watch us fight over bullshit philosophical ideals that are irrelevant? Public or Private, any large monopoly is suspect. No shit. I would prefer one that is legally responsible to me. I know it is know fail safe and can be inefficient, but private armies and banks that own everything scare the living shit out of me.
Did you follow the link I posted? Ever think about the consequences? Who is writing the laws. Did you read Rumpole's blog today re tarp? or how about Nathan's from two days ago. No. You just skim and then begin you quixotic quest to get us liberals to see the light of bipartisionship? What the fuck does that matter?
The only way you get change with a two party working together is if you have an outside existential threat that is larger then either(like war, or threat of nuclear annihilation). That will return again and then maybe your time will come, but today's GOP is ran by ignorant thugs who endorse blind wars and torture. To return then to power will continue the series of absolute disasters that W embraced and the raping of the middle class and working class that has continued unabated since Reagan. Great political changes in our history came from periods of absolute domination by one party.
David doesn't care (and his avatar is disgusting). Most of em don't. He is a foot soldier spreading confusion, maybe he knows this maybe not. He probably feverently believes that he is protecting individual rights- while defending companies rights to control them. Today, I don't really care. I am pissed.
Frankly, I don't know why you hang out here if you are looking to convince people. Most of us liberals have been so heart broken for so damn long that we will settle for whatever dog scraps we get.
Why don't you take your own advice and go to some of their websites and try and convince them.
Engage them in a conversation, see what happens. Maybe you can get your beloved GOP to redeem itself I wish you the best. More likely you will be labeled a nazi-commie (the only history they know) and they will run you out. I expect you will keep hanging out with us instead.
And to answer your question I guess I have something in common with Dick Cheney. David can go fuck himself.
August 28, 2009 1:49 PM | Reply | Permalink
I don't put words in my friend's mouths nor ascribe to them goals they have never once espoused. No one is talking about returning republicans to power, least of all me.
This post, as well as your insistence on black-and-white definitions, seems to miss the actual context of American history. This country wasn't born eight years ago or even 40. This cultural warfare you seem intent on waging is a failed political strategy supported by extremely damaging tactics.
I am simply advocating a more measured response to perceived insults.
August 28, 2009 2:10 PM | Reply | Permalink
Always have to get the last word, no matter how inane. Please reread my comment- it is clear from your response that you did not read it at all.
I have no idea where you get my culture war i an engaging in or black and white But hey you get bonus points for Rush Talking points. I would think that you would understand more about my intentions and historical understandings from the numereous back and forth that we have had. But perhaps you never read them either.
AS I said I simply don't like David and I don't have the patience to suffer fools today. Sometimes we blog to vent. There are no rules.
On that note, have a good day and good luck with them partisan windmills.
>>>>>last word coming in 3,2,....
August 28, 2009 2:32 PM | Reply | Permalink
Word.
August 28, 2009 4:21 PM | Reply | Permalink
Jason, i sincerely don't intend this as snark, but do you spend as much time on right-wing blogs - the corner, Malkin, etc - trying to get people to engage constructively with liberals?
Is there no opportunity cost to your mission here? Or do you regard the likes of OGD as 'radical' and 'ideological' as right-wing birthers peddling the foreign-nazi-commie conspiracy?
August 28, 2009 12:38 PM | Reply | Permalink
Apparently the idea that I should speak with people who might actually be reached never occurred to you? Republicans who can be reached are already here, both the ones that post here and those that lurk including many who actually voted for Obama.
The fringes found at those sites you mention won't be the ones that derail the very progressive changes we must make in the years ahead. That ironic monkey wrench will be provided by "liberals" who are unable to bring the silent majority over to their way of thinking because they lecture instead of persuade.
OGD and others are just as rabidly ideological as those right wing groups in the tactics they employ against political rivals. Obfuscation and belittlement of those opinions they doesn't agree with. It has never been about specific policy ideas or over-arching goals for the country. It is the irrational inability to have a reasonable conversation with someone who disagrees with you.
It is the reason Obama was elected since the majority of the country is tired of it, as much pleasure as some liberals appear to be having now that the show is on the other foot.
August 28, 2009 1:07 PM | Reply | Permalink
The difference between 'lecturing and persuading' would seem to be in the eye of the beholder. This little screed of yours about TPM's supposedly irrational leftist ideologues being the main impediment to national progress, for instance, looks to me like a lecture. (At least I don't see the persuasive force.)
August 28, 2009 3:21 PM | Reply | Permalink
You chime in to prove my point at every turn. The only time I say anything is when it appears that the baby and the bathwater is being tossed into the bonfire.
August 28, 2009 3:58 PM | Reply | Permalink
Don't know what that point might be, but you have a good evening anyway, Jason.
August 28, 2009 4:37 PM | Reply | Permalink
I didn't think it was that mysterious. Objection doesn't equal obstruction and treating every interaction with republicans as if did is self-defeating.
August 28, 2009 5:28 PM | Reply | Permalink
PS: You have a good evening, too.
August 28, 2009 5:29 PM | Reply | Permalink
I wasn’t jesting, really. In the first place, the idea here is to cover those who don’t have health care. Why do they not have coverage? In most cases it is because they can’t afford the outlandish extortion the private insurers demand or because those private insurers deny them; they’re simply not profitable. Think about the idea of that: your well-being is a commodity that if it is too poor and cannot bring a profit to some guy in a suit, is worthless.
The big insurance cos., AMA, Big Pharma, etc. act like monopolies as it is. Medicare, while there is a supplemental that’s part of the program, is pretty much a monopoly for the elderly, isn’t it? I don’t see seniors flailing canes at the idea that government runs it or social security or even our security (how’s that Blackwater thing working out?) or, locally, the fire department and a myriad of other services.
I realize that, to some, capitalism is an ideology, a religion almost. It is seen as their path to riches and, therefore, sacrosanct. But the free market here isn’t working, is it? 50 million aren’t covered and “costs,” that thing no one seems to have any responsibilty for, have been escalating so long the system is threatening the whole economy.
Since the market will not, the government is going to pay to provide access to these millions who don’t have it. As taxpayers, should we really pay $billions to some Enron-type middlemen just to put their names on all of the paperwork they’ll generate, or should the government just expand the program they have in place- you know, the one that has worked for over forty years?
August 28, 2009 1:01 PM | Reply | Permalink
It actually makes no difference whatsoever. It is two insurance systems paying for a service that most experts in the field believe is necessary, which is why they pay for it. Nothing in the current legislation would change the current paradigm a bit in this regard.
What is unconscionable is that moderate conservatives allowed this meme to take hold and actually encouraged either through direct participation or by not saying anything counter to the claims. Using that same old tactic of playing on fear to reach political gains does nothing but hurt the country as whole.
No matter what single payer advocates say, the legislation emerging from various committees is a sane and sober attempt at fixing the existing system. It should be supported by any conservative who reflects the progressive roots the republican party was founded on.
Continued partisan warfare simply ensures we all fail together.
August 28, 2009 12:01 PM | Reply | Permalink
Whew, glad I no longer have United Healthcare. They might have tried to force me to commit suicide.
Rather than merely driving me to it.
August 27, 2009 3:56 PM | Reply | Permalink
good for you, koonsey. When you have the facts, pound the facts. And all others can do is pound their fists.
But maybe we should pound both are fists and the facts, just for good measure:)
August 27, 2009 4:08 PM | Reply | Permalink
No, we should pound the teabaggers.
A 2" x 4" should do nicely.
August 27, 2009 4:30 PM | Reply | Permalink
It's possible they're pounding themselves with a 2 x 4 with all their crazy talk, OG.
In other words, they may be doing more damage to themselves-- and the Republican party that uses them-- than we could ever do to them.
Right?
August 27, 2009 4:37 PM | Reply | Permalink
I'm inclined to make some kind of off color comment here about pounding teabaggers but I'll refrain for the sake of our friends' delicate sensibilities...
August 27, 2009 5:54 PM | Reply | Permalink
I admire your restraint:)
August 27, 2009 9:14 PM | Reply | Permalink
Restraint? Are we getting into sado-masochism too?
August 27, 2009 9:24 PM | Reply | Permalink
You only pound fists when things happen to support your ideas. Like Fran Townsend.
August 27, 2009 8:57 PM | Reply | Permalink
Really, could you post this to Think Progress and Salon and send it to Josh and Crooks and Liars and Americablog Truthdig and more? This needs to get out there in a big way. Nice sleuthing!
August 27, 2009 4:59 PM | Reply | Permalink
Let us all get together, buy a couple bucks of lipton and throw them at...
Insurance companies.
Mortgage companies
Ogres
August 27, 2009 5:01 PM | Reply | Permalink
...hooligans, scofflaws, and louts.
August 27, 2009 10:36 PM | Reply | Permalink
hahahahaha
August 27, 2009 11:37 PM | Reply | Permalink
Well I, for one, don't want government bureaucrats stepping between me and my Death Panel!
August 28, 2009 12:41 AM | Reply | Permalink
Exactly! The free market and private enterprise can administer the death panels far more efficiently than government bureaucrats. Put the government in charge of the death panels and there's no telling how long you'll have to wait for your pills or injection. Can you imagine getting all your affairs in order and then calling the 800 Death Line and getting put on hold?
August 28, 2009 1:46 PM | Reply | Permalink
But the private death panels offer more opiates!
Think about it.
August 28, 2009 1:08 AM | Reply | Permalink
Hmmm.
It seems we are in a place where we can change the gov't. [There are so many people insisting we cannot do this.] Something is amiss and we, the people, are going to change it. Let's hope for the better, but we know, something will change.
These private companies. We cannot change them. Something is amiss, everyone knows it, but no one can change it, or, them, those people, are not going to change it. It will never get better, and we know, if it changes of its own volition, it will only get worse for we, the people.
It's kind of late, but that's what I got right now.
@Farrar: Private companies have a profit motive to encourage death panels. Anything that saves money puts more money in their pockets. None of that money ever goes to the one who pays premiums. Or, I should say, I have never heard of the policyholders getting money back, only shareholders.
Public entities have no profit motive. No one is rewarded financially for sabving money, although careers advance when changes are advantageous. Money saved goes elsewhere, but remains in the sphere of public service. Just think! If we save millions of dollars on helathcare because we are not paying for marketing and outrageous executive salaries, we will have more money for contractors in Iraq. Now doesn't that just make your heart all warm and fuzzy?
August 28, 2009 2:15 AM | Reply | Permalink
Which is precisely why public entities waste billions of dollars in ways private companies don't.
There is no silver bullet for this debate. It will be a private profit motive guided and curtailed by draconian federal regulations and enforcement that get us out of this health care mess we have created. If the government can't regulate health care insurance, I suspect they will never do better than Medicare/Medicaid which is proving insolvent in its current form with the current trends.
We need to make what we have work better, because replacing it with a purely government-run option would be putting all of our eggs into a single basket that has proved to have gaping holes in it.
August 28, 2009 12:07 PM | Reply | Permalink
JEM, you are the eternal apologist for the GOP. It seems that every time the GOP has power, they get about the work of ensuring public works are disabled and private enterprise can take more from the trough. That is their stated intention, but we are hear it as some kind of prophecy. "Gov't will be too costly and inefficient. Put it in private hands." Then, what we are not told is, "I have some friends who would do a really great job with this stuff!"
It would be better to have financial best practices exercised in the government then taking things away from public control, IMHO. In the private sector we learn how to be more efficient, it is true, but i do not believe we should take the gov't to the private sector. We need only take the private sector practices. Otherwise, we are throwing out the baby with the bathwater.
August 28, 2009 12:33 PM | Reply | Permalink
Where in anything I wrote am I apologizing for the GOP? Why is it that every call for a more holistic view of the debate is caricatured as being an apologist for anyone?
If anything, I see an illogical need to pin every American evil on the chests of "conservatives" while painting the "liberal" side of the house as the long-suffering victim. This continued need to paint everything in such stark, black-and-white partisan terms is what I am arguing against. That is not an opinion that has anything to do with either of the two modern parties.
I don't identify with either side, which is why I reached further back in American history for my political identity.
August 28, 2009 1:24 PM | Reply | Permalink
This:
is a particularly clueless remark (much more clueless than I have ever seen from you before). I'm not sure where you got this idea. If you have ever worked for a large private company, you should have observed all the empire-building that goes on in them.Dilbert is a comic strip, and yet much of it is solidly grounded in reality. (In fact, Adams gets suggestions from people who observe the insanity in their own companies, and transforms it into strips.)
There is only one fundamental difference between a government and a private corporation, when it comes to internal matters (note that funding is not "internal" here), and that is: government is automatically a monopoly. Where there is competition in private companies, fraud and waste and such will generally (but not always and/or not necessarily with any speed) cause the company to collapse and the competition to pick up the useful pieces. Where there is insufficient competition, whether due to monopoly or oligopoly or whatever, some other external force—such as voters booting out the corrupt, or some other government coming in and taking over (AKA "war" :-) )—must take the place of the forces provided by competition.
(This implies something important: When a corporation becomes "too big/important to fail", the line between government and corporation has thinned to the point of uselessness. Something should be done, whether that is "break up the corporation" or "regulate it to the point where it's effectively just more government" or whatnot.)
August 28, 2009 3:57 PM | Reply | Permalink
Absent proper regulations private industry is extremely wasteful. My point was they waste money in different ways, not that they aren't wasteful. The federal government is not a replacement for private industry if the goal is to stop fraud, waste and abuse in a given system.
August 28, 2009 4:01 PM | Reply | Permalink
At the very center of this controversy we have the fact that we don't accommodate our mortality very well. The uncertainty of death and what may or may not come after is extremely problematic. Our ability to cope with this is a variable unique to each of us. We deal with it in a variety of ways.
It should be apparent that this is a big piece of the argument and we need to recognize the role what we don't and can't know plays in this. The trauma of facing our mortality is more than some can deal with. We might do well to have a different, more enlightened interpretation of the seeming craziness of what is happening.
August 28, 2009 4:43 AM | Reply | Permalink
End of life counseling was never what anyone (until it was picked up by the media dolts - Beck, Hannity, Stewart et al.) meant by "Death Panels". Palin originally meant the IMAC panel which, if it were to be effective at all, probably would end up effectively ordering people to die earlier than they otherwise would, if only indirectly.
Seriously, read up on what the IMAC panel is supposed to do.
August 28, 2009 12:01 PM | Reply | Permalink
It's a medical best practices board that determines the efficacy of treatments versus outcomes versus drain on the system.
It is made up of doctors and educators and regulators all trying to come up with a sensible set of defined services that must be payed for no matter what, be the plan be public or private. It is sort of like the Federal Reserve in that it has a public mandate with private execution.
There is no grand conspiracy to create a government panel that decided what treatments are covered and what aren't. It was a mirage. A misunderstanding of what the best practices panels are for and how they would be run.
August 28, 2009 12:11 PM | Reply | Permalink
The panel is designed to save money. Of course, the legislation talks about efficiency, but the panel's intent is to tell doctors what not to do.
Maybe that's okay; after all, maybe there is a lot of waste and overtreatment that needs to be wrung out of the system.
But here's what the OMB (Orszag) says it's for:"This Independent Medicare Advisory Council (IMAC) would make recommendations on Medicare reimbursement policy and other reforms – playing a critical role in allowing health care policy to adjust flexibly to a dynamic health care market, thereby helping contain costs and improve quality over time."
Further:
"that moving toward a health system emphasizing quality rather than quantity will require continual effort, and that a key objective of legislation should be to put in place structures (like the IMAC) that facilitate such change over time. And ultimately, without a structure in place to help contain health care costs over the long term as the health market evolves, nothing else we do in fiscal policy will matter much, because eventually rising health care costs will overwhelm the federal budget."
And yet the debate still never centers on an entity which has the authority to set not only reimbursement policy in the new system, but to scale back Medicare reimbursement (which some physicians already refuse because it doesn't cover their costs).
It's designed to do rationing, plain and simple. I don't think there's an alternative to rationing, although my libertarian bent suggests that we let people do it themselves rather than investing in technocrats to do it on a one size fits all basis.
August 28, 2009 1:07 PM | Reply | Permalink
Like I told Gregor above, I don't think the debate is as simple as Private Good, Public Bad. I think a case can be made that each in the right doses can make the country much more sustainable as a whole.
Medicare is a whole other debate that has yet to take place and will likely change the nature of the discussion completely. Very few medical providers are happy to be paid 80% of rock-bottom rates, hoping that private insurance is there to pick up the delta.
By establishing a playing field and rules where none now exist, the entire game will be changed for public and private insurers alike.
August 28, 2009 1:28 PM | Reply | Permalink
That's part of my concern!
By establishing one size fits all "rules" for reimbursement, the government prevents experimentation, prevents individual providers or payors from negotiating price or service, etc.
The game would be changed! But that's the problem. If "Very few medical providers are happy to be paid 80% of rock-bottom rates, hoping that private insurance is there to pick up the delta." They'll be even less happy to accept that when the government is supporting private insurance NOT picking up the delta.
And yet the House plan proposes an IMAC boad to reduce reimbursements -in Medicare- where they are already arguably too low.
August 28, 2009 2:57 PM | Reply | Permalink
That seems an overly-simplistic view of what we are talking about. I don't think it will lead to anything but codification of what most doctors already agree on. Without some sort of industry agreed upon best practices, it will be impossible to contain costs.
I have not read all the particulars with regards to how it affects Medicare, but I suspect that any proposal that further lowers their already under-market rates with be a non starter in the final package.
August 28, 2009 9:03 PM | Reply | Permalink