from Newcomer
I’m slow to reply to your question (see “Re: Tough Times Ahead”) because it’s so thought-provoking. Our nation was formed some 234 years ago and one would think that this question would have been answered at the outset. But as we’ve ‘evolved’ (if that’s the correct word) we’ve added more states, more people, more industry, more infrastructure, more politicians, etc.
I think for me, what makes your question so difficult to answer is that in these 234 years, we have blurred the lines ourselves as to the proper role of our government. That role was generally initially defined in the preamble of the Constitution, the purpose of which was “in order to form a more perfect Union”. The goals and “mission statement” of our federal government were to “establish Justice, ensure domestic tranquility, provide for the common defense, promote the general welfare, and secure the Blessings of liberty…”
If you take that piece by piece, there’s quite a bit there. I think most citizens would agree that we still have a legitimate need for our Federal government to provide for our National defense. We can dissect the hows and how much of the defense system, of course, but I think we would all agree on the continuing need for it to remain in place.
Ensuring domestic tranquility….I’m not sure what the founding fathers exactly intended by this phrase, but to me it speaks to the need at the State and local governmental level (since we’ve now added more states than the original 13 we started with) for basic public services such as police enforcement and fire protection. How tranquil can one’s life be if subjected to crime or fire? If we want to expand this notion of tranquility to the Federal level, then I could see an argument for FEMA to exist in times of disaster relief. I guess this would also make a case for militia at a State level, such as the National Guard, enforcement at a State level, such as a State police Dept., disaster relief at a State level as an outpost of FEMA at the federal level. I could also see highway infrastructure coming under this category at all 3 levels of government because vehicles are available for purchase in the private market for those who have the financial means. But vehicle ownership requires someplace on which to safely operate the vehicle. I would limit the role to infrastructure maintenance though. To me, this should not include a nationalization of public transit be it planes, trains, buses, monorails, subways, ferries - whatever. None of these other modes of transport are a requirement for one to live a life of domestic tranquility so they can and should be provided by the private sector and each citizen can choose to avail themselves of any given method as their means and circumstance (and personal preferance) dictate.
Now for the fun one…promote the general welfare. Well now, that means very different things to people, doesn’t it? In general, I am personally not in favor of welfare and entitlement programs except for the legitimately most disadvantaged among us. If someone is born with a birth defect or otherwise sustains a severly debilitating disabilty through no fault of their own and it prevents them from ever being able to attain employment, then, of course, we must have compassion for anyone who finds themself in such a circumstance. The rest of us need to get back into the habit of taking care of ourselves and rebuilding our society at a local level so that we revert back to becoming communities where neighbors help neighbors through tough times because it’s the right thing to do for each other. This thought tempts me toward a discussion of the decline in morality in our society, but I’ll spare you that for now.
What I mean though is that I think that some of these entitlement programs need to be phased out completely or dramatically restructured if they are to remain in place. Why do we have Social Security? Why do we need it? Is it the federal government’s job to collect a portion of our salary during our working years and then ration it back to us when we’re too old or too infirmed to work? I do not think that it is. If the purpose of social security is to provide funds for a citizen because it’s cheaper than putting them on the welfare rolls when they are too elderly or infirmed to support themselves, then I think we can see that the current social security system does not accomplish that adequately. It is in jeopardy of ceasing to exist altogether in the future if not reformed.
And this brings me to another off-shoot of my thoughts when considering your original question. What is the worst problem with our federal government? I believe the worst problem is the answer to your first question. The role of the federal government is presently in conflict because she is currently trying to serve as both a provider of goods and services while consuming the very same goods and services she seeks to provide. There is intense conflict in these two roles. The Federal government can not and should not be in the position of governing itself (say by regulating its own program like banking, while simultaneously providing the same service (like Fannie Mae). That leads to the governmetn eating its competition, among other things, and the citizens lose because the regulations put in place by the government will likely favor its own banking entity. This is the recipe for corruption. Now there’s a new push for a nationalization of student loans for college. That’s mania, in my opinion. The government should dissolve Fannie Mae and then step back and restructure banking regulations that make for a level playing field among private institutions by promoting fair and objective competition among said institutions. The rights of the consumer must be foremost in any regulatory legislation. Then let the banking industry sort itself out with consumer demand.
It is for this same reason that I am not in favor of any sort of “public option” in healthcare where the government is a provider of healthcare services. Nor should government be subsidizing those services. Again, such a scenario compromises the leading role of government, which in my opinion, should be neutrality as a regulatory authority. Simultaneously, I do believe that the government must provide a subsidy for those individuals who cannot afford their own health insurance. But this whole process must be simplified dramatically. I believe the cost of medical services will come down if the system restores and encourages consumer supply and demand. I would like to see the government annually choose the top 3 or 5 performing health insurers based on most services provided for the lowest cost. Allow citizens who have been identified as legitimately being unable to afford health insurance to choose from one of these top 3 or 5 plans and the government pays the bill by providing a full or partial subsidy. That means that working people of low income who can afford to pay something toward a premium should do so. The government can take a pro-rated premium payment directly from a wroker’s paycheck, just as it does now for social security. Annually, recipients of a full and/or partial government subsisdy must undergo a financial review so that they can either drop out of the subsidy system when and if they become able to self-pay entirely, or the amount of their subsidy can be adjusted up or down depending on changes in their circumstance. I do agree with tort reform, but I favor the establsihment of a tort court, which I’ve discussed previously at the Cafe. I agree with the abolishment of discrimination of patients based on pre-existing conditions. I agree with the concept of competiton across State lines. And I feel that citizens should buy our own health insurance policy directly from the insurer and pay our premiums directly to the insurer the same as we currently do for car insurance and homeowner’s insurance. Our health insurance should not be tied to our employment. That it is currently this way is ridiculous. Imagine if our auto insurance were tied to our employment. If you lose your job, your auto policy lapses and you could lose your vehicle or lose everything you have if you are at fault in a collision and sued for damages while lacking auto insurance. We need to phase out health insurance being tied to our employment in conjunction with the increase of consumer supply and demand bringing down the cost of health care services. As part of this, hospitals should be mandated to openly post the cost for their medical tests and all of the goods and services that they provide. Just like we can currently shop around for the best price from different mechanics and auto body shops for our cars when we have insured claims, we should be able to do the same for doctors and hospitals and then you’ll see an aspirin begin to cost only slightly more than it does in a store instead of $400 or whatever crazy price hospitals currently charge.
John probably won’t agree with me on the next one, but with regard to pharmaceutical companies, I feel the same above standard should be applied. The government’s role in this industry has become too muddied. Is it the role of the government to regulate these companies, police them through the FDA and CDC, or supply them with funding through NIH grants? Again - simplify. Eliminate the “Big Pharma” chokehold on fair regulation to promote consumer protection by leveling the playing field. Mandate that all pharma companies get the same amount of funding for their R&D. Then let them stand or fail on the success of their research and the products that are developed as a result of their research. They can still seek and obtain additional funding from private foundations and agencies.
I could keep going on and on (no surprise there) but this is already way too long. Frank, my general answer to your question is that the role of government is not to supply the means to control our lives, our general welfare, nor our domestic tranquilty. Its role is to assist us in obtaining those things for ourselves by ensuring that businesses treat the consumer fairly. Government should provide the basic services such as national defense that are common to all citizens but leave us to make the individual choices that affect our day-to-day existence.
Why not just a low cost “public option”? It’d be cheap and portable.
Tax,
I guess the answer depends upon how you describe a “public option” and what it would entail. But framing this in terms of Frank’s question, the answer is also a matter of control. When he asked “what role” should our government play at each level, in answering that question, each person should consider control. Where should the control lie? Should it be held by a big, centralized federal government? The individual States? Each municipality? Maybe divvied up between the three? But beyond that, who really controls the government at these various levels? The concept of a competitive market works better if the consumers have more power, doesn’t it? So apply that toward health care. Rather than letting the private insurers have the control, or the federal government, shouldn’t it be the patient? Then they could select the doctor and health care facility of their choice so that the most important decisions rest with the patient and doctor working together.
I would agree that a key role of federal government is to maintain security. …(see Frank’s new article. Admin).
NC, wait. You are against a public option but don’t want to have health insurance provided by employers. You also do not want any restrictions on preexisting conditions. I think that your propositions would cause major problems.
1) Why would anyone buy health insurance? Most people will just wait until they get sick, as the insurance company now has to take them.
2) Health insurance premiums would skyrocket as more people would just wait till they got sick. This would cause rates to increase forcing more and more people out and rates to go even higher. The only solution is to maximize the number of healthy people in the pool.
3) Allowing the government to limit competition to only 3-5 insurers means the others go out of business. Reducing competition ultimately and forcing prices higher.
4) Having the government take money out of a paycheck for health insurance sure sounds like a public option to me.
5) Without private insurers or the government how would I get insurance?
6) I assume that you are against Medicare as you are against a public option.
NC, ultimately, we will have a public option or will go bankrupt paying medical expenses. Why is it that our country is the only western industrial country that does not have public insurance when ours costs twice as much and we have more premature births, less life span and more childhood deaths from disease than these other countries?
Right now, when I have to compete against a foreign company, I am behind about 9% from them in costs for health insurance from the start (never mind labor costs). This is only going to get worse as health insurance costs are routinely increasing by more than 2-3 times the rate of inflation. This year CT insurers are increasing group premiums by 12-18% in the middle of a recession when actual inflation is almost zero. If you purchase an individual policy, those costs are going up 20-30%.
There are alot of reasons why that is that I won’t get into here. But what we have is not sustainable. Luckily, my company is large enough to be self insured with a relatively healthy pool. Those that are not are really getting hurt.
This health insurance debate is a great example of how the current crop of national republicans do not really care about business. Their approach is continually taking away our ability to compete against the world.
You missed my point (again).
Certainly a patient could select their physician and their facilities, however, they do not select the cost of insurance.
Cost management is the debatable issue, not the patient’s right to choose physicians or facilities.
In your above article you discuss measures which impact influence cost, so, to that focus (not your usual populist one), I posed the above question.
Dean is correct.
In one sentence NC states that the government should not be subsidizing healthcare in the form of a public option, yet in another sentence she believes that the government should subsidize private insurance plans for the poor.
Why would the government want to spend our tax dollars subsidizing plans that they cannot control? As NC also states that “the leading role of government, which in my opinion, should be neutrality as a regulatory authority.”
If the reason for this statement is another one of her “populist” fears that government will “take over” healthcare, let me remind her that the government already controls 1/2 of healthcare (medicare/medicaid). If it is the cost of these government “entitlements” that makes her skeptical, she needs to be reminded that the rate and rise in healthcare “taxes” in the form of private insurance premiums isn’t working out so good for Americans either. So why is NC so supportive of private health insurers? What have they done for her lately?
According to NC who believes that there should be no public option and no employer based health insurance (which is regulated by the government with tax credits), then what we would be left with would be that which is most disasterous in our current system–that is, an unregulated market in which individuals must buy their own health insurance, a market where premiums continue to rise despite record profits, and coverage for people with pre-existing medical conditions is not provided, and coverage is dropped when you get sick.
No thanks. I’ll pass.
Tax and Dean,
OK. I’m clearly not explaining myself well, which is my own fault so I’ll try again.
What I’m wondering about is why is our health care system set up to run so differently from how we purchase most other forms of insurance for ourselves? So my thought is to do away with this difference and let us purchase our own health insurance just as we now purchase our own auto, life, homeowner’s, long term care, and disability insurances, along with a sundry of others, like special flood policies and the like.
The reason why anyone, or most people would want to purchase health insurance rather than waiting until they get sick (Dean’s 1st question) is because if they don’t purchase health insurance, an illness could bankrupt them. Now you correctly point out that my initial ideas about this did not include a way to make sure someone’s health insurance policy is fully inforce BEFORE they become ill, injured, what have you. That can easily be rectified by mandating that all people who can afford insurance must purchase it. Don’t we currently do that with auto insurance? I can’t get into a collision and if I’m uninsured at the time of collision, go out the next day and buy a policy and then expect that my collision the day before will be covered.
You could be correct that limiting the government (or those susbsidized by the government in my scenario) to only choose from the top 3-5 might not work out. The flipside to that is that if the government would be one of the largest clients of private insurers, then only those companies that provide the best bang for the buck (ie. are the most competitive and would encourage better service for a lower price) would get the government’s business. Wouldn’t this help to drive health care costs down? I was thinking that it would.
With the government taking a draft to cover premiums…that would be for people who are receiving a subsidy and are partially paying something toward their premium bill to reduce the amount of subsidy that they receive. But the private insurer that they select could just as easily be the one to draft the premium contribution. The point there is to see that only those who truly can’t afford to contribute anything be the ones to be 100% subsidized. What if I’m a member of the working poor and I can not possibly cover the whole premium myself but I can afford $20.00 a week. Yes, that’s a drop in the bucket and some might say “why bother”? but it speaks to a greater issue of leaving someone impoverished or disabled their dignity and self-respect by allowing them to take pride in the fact that they do work and do as much as they can to become self-sufficient. In other words, if someone falls on hard times, why compound it by letting them feel like a mooch? I suppose there’s an argument to be made that our problem is that too many people mooch and feel they’re entitled to it, but that’s a discussion about cultural attitudes moreso than anything else I guess.
I’m against a lot of these programs that take control away from the individual and transfer it to the government. I feel that kind of a scenario holds people down in poverty. There’s little motivation (for some, but by no means all) to better their circumstances if their housing, food, and health insurance are subsidized indefinitely without them having to demonstrate an effort toward improving their situation. I have no problem with such programs being in place indefinitely for people who are legitimately totally and permanently disabled. For the rest of us who aren’t wealthy, I have no problem with such programs being in place for a limited period of time. People fall on hard times through no fault of their own and when they do, they deserve our compassion. So, like unemployment benefits, which run out after a certain period of time, I can see the same for things like medicaid and the like. If a person can prove they are actively going on job interviews and seeking employment but simply aren’t having any luck, well that’s different. There should be some sort of safety net. But if someone sits home collecting checks from the government and is content to leave it that way indefinitely when they are able-bodied enough to work even part-time and contribute something, then that becomes problematic. I think this applies to health insurance subsidies as well as many other entitlement programs. We should be giving people a hand up when needed, but not a complete hand-out if they are able-bodied.
Dean, if your employers carried their own health insurance through private insurers, would you be better able to then compete against foreign companies? If you don’t pay for your employees auto and homeowners insurance, why should you pay for their health care? If we all paid our own premiums directly to our insurer, we wouldn’t lose our coverage if we changed jobs because it wouldn’t matter. As it is now, when you change jobs, especially in certain fields like food service, most food service employers have a 90 day waiting period before your probation ends and you become eligible for health insurance. What do you do then? Have you seen the premium prices to continue a policy yourself under COBRA? And what if I had a PPO at the last restaurant I worked at, but now this new restaurant is going to give me a higher paying position, like assistant manager, but they only contract with an HMO? So now, I’ve gotten myself a better paying job and the beginnings of managerial experience in my field, but I have to hope and pray I or my family members do not become sick for the next 3 months and if any of us do, I may not be able to keep my previous doctors because I now am limited to the choices provided by my new HMO. It’s nuts. Just let me buy my own policy through whichever company I prefer that gives me the service I want and fits my budget. That just makes more sense to me.
I hope I expressed my thoughts better this time. I guess my basic premise is that costs will come down and come under control if the market is truly competitive. To me, the best way to make the market truly competitive is to give the consumer the power to shop around for their doctors and hospitals, labs, testing facilities, all of it. Let the consumer choose whichever private health insurer they want. Then the consumer will control health care rather than the private insurers controlling the consumer. That’s the point I was trying to make.
Tax and Dean,
I’ve posted this link before but in case you didn’t have a chance to check it out, I’m posting it again.
http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/
The author explains this idea way better than I ever could because he’s also a businessman. I’m just not. But this idea makes sense to me.
It’s a long article but the first few pages are mostly anectdotal. He gets into the meat of the plan to transition us away from health insurance being tied to employment and making it self-pay toward the last 3 pages or so of the article.
As long as it is, I found it very interesting and informative. I wanted to reiterate what the autor said in this article in my own comments. I’m sure I did a rather poor job of it so rather than waste your time with my endlessly long attempts, I think just giving you the link to the person who had these thoughts originally would be better.
Within the compass of this post, I can do no more than indicate, as concisely as I can, relevant considerations that must be taken into account if we are to discuss Newcomer’s unrealistic plaints in a rational manner. To plunge right into it, Newcomer’s morals have merged with snobbism in several interesting ways. Both spring from the same kind of reality-denying mentality. Both trade fundamental human rights for a cheap “guarantee” of safety and security. And both destroy the values, methods, and goals of traditional humanistic study.
In a similar vein, Newcomer presents one face to the public, a face that tells people what they want to hear. Then, in private, she devises new schemes to dismantle the guard rails that protect society from the scary elements in its midst. Her cause is not glorious. It is not wonderful. It is not good. Is this anything other than myopic opportunism? The answer is obvious if you happen to notice that the problem with Newcomer is not that she’s childish. It’s that she wants to feed blind hatred.
Here, I am merely trying to advance the opinion that there are two observations that one can make here. The first is that Newcomer exhibits a startling lack of remorse, shame, and guilt for so brazenly attempting to suck up to inarticulate quidnuncs. The second observation is that one of her unidimensional arguments is that cultural tradition has never contributed a single thing to the advancement of knowledge or understanding. These shards of empirical evidence suggest that Newcomer’s claim that her mistakes are always someone else’s fault requires a willing suspension of disbelief, an ability to set logic aside and accept any preposterous notion that Newcomer throws at us. Today, we might have let her label everyone she doesn’t like as a racist, sexist, fascist, communist, or some equally terrible “-ist”. Tomorrow, we won’t. Instead, we will report as best as possible the facts and circumstances surrounding Newcomer’s nefarious, insidious notions. Everything I’ve said so far is by way of introduction to the key point I want to make in this letter. My key point is that I believe in “live and let live”. Newcomer, in contrast, demands not only tolerance and acceptance of her plans for the future but endorsement of them. It’s because of such spiteful demands that I maintain that she argues that I am brain-damaged for wanting to dispense justice. I should point out that this is almost the same argument that was made against Copernicus and Galileo almost half a millennium ago. I will conclude with an appropriate quote: “Newcomer is out of touch with reality.” I believe we all know who said that, don’t we?
WVG,
How are you drawing these horrible conclusions from what I’ve said? And when did I EVER call you brain-damaged or any other name? I can’t recall ever even exchanging comments with anyone using “Woodstock Valley Girl” for a name here so your sentence “she argues that I am brain-damaged for wanting to dispense justice” is fiction.
Did you read the article that contained the idea about self-pay health care that I was trying to explain?
On second thought - forget it. You’re entitled to your opinion. If you want to villainize someone you don’t even know personally based on some blog posts, go right ahead. Your above comments speak many more volumes about you than they ever would about me.
This reminds me of my college roommate who had perfected the art of ‘double talk’. Is there something I am missing here WVG? John
Why is it that some people are so devoid of a sense of humor? Naturally, I’m referring to Newcomer’s latest post. That’s why she repeatedly insists in destroying our moral fiber.
Given Newcomer’s propensity for repression in the service of paradigmatic integrity, it is little wonder that it’s Newcomer’s deep-seated belief that otiose devotees of conspiracy theories are all inherently good, sensitive, creative, and inoffensive. Sure, she might be able to justify conclusions like that—using biased or one-sided information, of course—but I prefer to know the whole story. In this case, the whole story is that it’s easy for armchair philosophers to theorize about Newcomer and about hypothetical solutions to our Newcomer problem. It’s an entirely more difficult matter, however, when one considers that I have some advice for her. She should keep her mouth shut until she stops being such a polyloquent, inimical ne’er-do-well and starts being at least one of informative, agreeable, creative, or entertaining.
Think about that for a moment. I would undoubtedly not have thought it possible that you can sincerely assume serious trouble is brewing when the worst types of squalid marauders there are talk about you and me in terms that are not fit to be repeated, but it’s absolutely true. Each rung on the ladder of interdenominationalism is a crisis of some kind. Each crisis supplies an excuse for Newcomer to make bigotry respectable. That is the standard process by which inerudite lounge lizards confuse the catastrophic power of state fascism with the repression of an authoritarian government in our minds. Let me challenge you, the reader, not just to help me extricate as many people as possible from Newcomer’s grip, but also to educate others.