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Public option argument over and government own

By | September 11, 2009, 11:18 AM PDT

The argument over whether people will use a public option is over.

Almost 30% of us do. And the number is rising.

The Wall Street Journal reports that over 87 people got their health care through the government in 2008, citing Census Bureau figures. Kaiser Health News expects the number to rise substantially when 2009 figures are released.

The growth is coming from Medicaid and State Childrens Health Insurance Programs (SCHIP), and is fueled by the faltering economy.

Despite this the number of uninsured also continues to grow, according to the report.  The Census figure was 46.7 million, although the President only claimed 30 million on Wednesday, removing all those who might be in the country illegally.

In terms of economics, private health insurance is rapidly pricing itself out of the market. While some analysts say the trends make it harder to strike a deal, given the increased government burdens, the numbers also move insurers toward the table, because a mandate would mean more customers and more revenue.

There is another hard fact. The government is now the largest buyer of health care services by far.

A failure or refusal to pass health reform won’t change any of this. Republicans refusing to vote for reform are betting taxpayers would rather kill Medicare and Medicaid under financial pressure, when it comes to that in a very few years

That’s a big bet on the 19th century. (Picture of 19th century Belgian poverty from Ancestry.com)

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Dana Blankenhorn

About Dana Blankenhorn

Dana Blankenhorn was a contributing editor for SmartPlanet from 2009 to 2010.

Dana Blankenhorn

Dana Blankenhorn

Contributing Editor

Dana Blankenhorn has written for the Chicago Tribune, Advertising Age's "NetMarketing" supplement and founded the Interactive Age Daily for CMP Media. He holds degrees from Rice and Northwestern universities. He is based in Atlanta.

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Dana Blankenhorn

Dana Blankenhorn

Dana Blankenhorn has been a technology reporter since 1982, a business reporter since 1978, and a writer for as long as he can remember. His Schwab IRA has a few tech stocks in it, most notably some Intel and Applied Materials bought over 10 years ago. But the vast majority of his tiny fortune (emphasis on the word tiny) is invested in mutual funds. He presently writes for no one else but ZDNet, SmartPlanet and himself. But if you've got an opportunity let him know. If he takes the gig he"ll first add it to this disclosure page.

He writes for SmartPlanet and is not an employee of CBS.

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0 Votes
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RE: Public option argument over and government own
I believe you are mistaken in your assertion that "Republicans refusing to vote for reform are betting taxpayers would rather kill Medicare and Medicaid under financial pressure..."
Republicans will vote for reform if it means reforming the current system to make it financially sustainable by introducing torte reform, allowing national competition (now restricted by the Federal Government), and waste and fraud reductions.
To say that because "the government is now the largest buyer of health care services" that we should make it bigger is a rediculous arguement. Everyone can agree that the current system of healthcare is unsustainable; making it more inclusive and bigger results in a bigger problem. Let's see government reduce waste and fraud FIRST, THEN use the savings to increase coverage.
Posted by awalker@...
14th Sep 2009
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I agree
I agree. To argue that we need to make a system even more dependent on the government is ludicrous. SS and M&M are already $50 trillion in the hole and unsustainable. Soon they will be bankrupt. Why can't we shop any of the 1300 private insurance companies ? Why can't businesses pool their employees together ? Why does a doctor have to pay six figures just to have mal-practice insurance ? Why do they have to order defensive tests ? Because of government regulations.

Now we are down to 30 million uninsured. Of that total there are quite a few people from Medicare and Medicaid that are double-counted into this total and many others simply do not want to pay for their coverage. This is yet another myth concocted by this administration.

Government ruins everything it touches and having a public option means an estimated 88 million people will lose what they have now. There is no way I will be forced to take the public option. Fine me all you want. I will go without insurance. They want to arrest me then I will become another unproductive member of society and take resources.

It is time to stop the lies and realistically improve the system. Although expensive it is one of the best. We need to improve the economices but a government-run system is not going to be cheaper, better, and will be another control mechanism for our government to lord over us. Read the story about the baby in England that was born at 22 weeks and their guidelines do not support pre-mature births at this age. They didn't even help the poor baby and it died 2 hours later. Long waiting lines, rationing, a centralized committee, and inefficiency await us if we allow this to happen.

This is about un-american as it gets.
Posted by pizzaman7
14th Sep 2009
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RE: Public option argument over and government own
Come on - government funded insurance?!! Who is the government? We the people! So who pays? You do and I do!!! There is no less cost for you and me, perhaps it could rise even higher than competitive insurance companies. Who will pay for R&D? Just more government control by a few politicians.
Posted by jander65@...
14th Sep 2009
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Good luck, Dana...
... you'll need it, and a lot of it, as long as you persist in presenting facts. However, some of us are with you, and willing to share the attack on the delusional. For instance, let's take on at least parts of the first three offerings for this post...

"Torte reform"... does that mean new recipes? The FACT is, lawsuits in the medical arena in general resolve to far less than 2% of the net dollars on the table. If you want to 'fix' this problem, get the AMA (and the other medical associations) to actively assist in identifying their own failures. How about a public list of quality factors in health care, including the identities of those who generate the problems? Let's find out who does the bad things, whether doctors, hospitals, clinics, or bureaucrats. Along those lines, why can't we know which claims insurance companies deny, and why, and how many of those denials are overturned? Better yet, how many die from the delays of care that IS provided? If there IS a problem, isn't sunlight still the best disinfectant? And by the way, if malpractice premiums are such a terror, why don't we get some truth about how much they generate for the insurors, and how much those same insurors really profit from them? Not so incidentally, all the 'losses' from malpractice suits reduce the insurors' bottom lines... think that might be interesting information? After all, in the end is IS your money... Waste and fraud ARE important, and we SHOULD be concerned.

Government is the problem? Yeah like that's serious. Reagan is gone, get over it. FACT here is that government does the best job, by FAR, in delivering services for the least cost. You don't like it, stop driving on my roads, or agree to pay by the mile to some benevolent banker for being able to go anywhere anytime. If you're upset that services are not as efficient at you think they should be, let's get together and make them BETTER. If your complaint is that government doesn't charge enough for what it does, that's one thing, but why are you whining that you're getting a good deal? The health industry, including insurance as a business, starts by adding 30% (OK, pick your number, it might be more) to EVERYTHING they do -- remember, they're vertically integrated and take that slice at every ledger line -- and you pay that FIRST. You're welcome to your distortions of the Adam Smith mythology, but you should at least understand the price delusions carry.

And the constant carping about 'government funded insurance'? Nobody -- NOBODY -- with a working understanding of the situation misunderstands who pays, no matter how the game is structured. Nobody with a rational view of the need argues that anything is 'free'. That's not the question, and no matter how loud the screams are it won't be.

What we're seeing is a misleading dislocation of the whole argument from what it SHOULD be -- health care -- to the protection of business interests -- insurance care. It's fine that we do that, as long as it's clear what's at stake.

I admit it... I'm tired of the bitching and the selfishness and the insane rhetoric of the current discussion. It's fine to not agree with the current administration, or insist on pursuing the inevitable outcome of measuring everything in dollars, but the argument doesn't work with private -- not to mention irrational -- 'facts'. If it's all imagined cost, or the bullet points of profiteers, or 75 years of political 'spin', those are problems in themselves and NONE contributes to anything useful.

Here are some better questions to kick around... how many children should die next year to save $20? How many years too soon should grandmothers die for the lack of flu vaccine or simple and cheap cardiac medications? And one more, just to be sure I cover all the options (with apologies to Strunk and White)... who's brother AREN'T we the keeper of?
Posted by semi-adult
14th Sep 2009
0 Votes
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Keep Up The Good Fight, Dana
semi-adult sure hits the nail on the head too.

Re: "Why can't we shop any of the 1300 private insurance companies?

Because private insurers cherry-pick their risks. Just try being a leukemia survivor and get health, disability, and life insurance without qualifying through employment. Even then, your benefits will be capped for life insurance, benefits exclusions will not insure your income for disability, and health insurers are actively trying to exclude all pre-existing conditions from coverage.

"Why can't businesses pool their employees together?

I'm not sure what you mean by this. Employers now are pushing for "wellness" - a complicated means for shoving more costs on some of their emplyees by trying to assign "fault" for their medical conditions. Unimplementable and unmanageable.

"Why does a doctor have to pay six figures just to have malpractice insurance?

Because malpractice insurers keep jacking up their premiums.

"Why do they have to order defensive tests? Because of government regulations."

Was fur quatsch! Doctors order defensive testing to reduce their liability against malpractice claims. That is a market issue, not a government one. Just look at TV and see the ambulance chasing lawyer ads: "You may be entitled to benefits!"

That is not the government in action.
Posted by cardhun@...
14th Sep 2009
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No Way!
Sure, insurance costs may be going up, but until those running (or is that ruining?) the government are willing to put aside their loyalties to trial lawyers and put torte reform in place, that will continue to be the story. States that have enacted torte reform have seen medical and insurance costs go down and the number of providers go up.

Also, instead of making another new government agency that won't work, let's fix what is in place, expand eligibility to medicare and state run children's health plans, and fix social security. We all see how well cash for clunkers was run. If the government runs our healthcare, is that facet going to have to close down in less than a year because it ran out of money?

If everyone does have coverage and unlimited access to medical care, but nothing is done to get more doctors trained and on the job, people won't have the opportunity to see if a doctor even if it is free, as the waiting period for an appointment will be at least 6 months. Better not have anything fatal! In Australia, doctors were recently told they need to keep 400 mg of caffiene in their systems, because the 80 hour shifts they have been working under their national healthcare system has been resulting in unnecessary deaths to sleep deprived doctors being mentally unable to make correct decisions about patient care.

Sorry, it's just not viable.

Posted by snow lover
15th Sep 2009
0 Votes
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"It's Just Not Viable"
Of course "it" isn't viable when people like you deliberately mischaractize the only option as a strictly contrived strawman of assuming a government-run disaster.

The US is a democratic republic. You are the government, along with everyone else who looks in a mirror in the morning. If you're criticizing the government for incompetence, you're criticizing yourself and everyone else for failing to be involved citizens.

If you aren't part of the solution, then you're part of the problem.

And problems abound with avoidable medical mistakes killing people every year:

http://www.medicalnewstoday.com/articles/11856.php

Wasting tons of money:

http://www.ahrq.gov/qual/errback.htm

The doctor shortage - especially in primary care - is a direct result of poor working conditions and inadequate pay:

http://www.nytimes.com/2008/06/17/health/views/17essa.html?_r=2&ref=health&oref=slogin

http://www.kevinmd.com/blog/2009/07/primary-care-doctors-face-burnout-and-how-that-affects-health-reform.html

Pharmaceutical companies push unsafe drugs with inadequate clinical trials in the name of profits:

http://www.smartplanet.com/technology/blog/rethinking-healthcare/will-even-a-23-billion-fine-change-drug-marketing-practices/364/

http://www.pharmalot.com/2008/03/glaxo-escapes-prosecution-over-paxil-in-uk/

http://www.injuryboard.com/national-news/merck-pays-for-favorable-gardasil-opinion.aspx?googleid=269292

http://www.cbsnews.com/htdocs/NVICGardasilvsMenactraVAERSReportFeb2009.pdf

(scroll to page 3, Conclusion.)

The insurance industry fleeces the public while anti-reformers fight vital regulation:

http://talkback.zdnet.com/5208-13593-0.html?forumID=1&threadID=68262&messageID=1314973

And there are bountiful options besides just declaring "'it' won't work" (whatever "it" is assumed to be):

http://talkback.zdnet.com/5208-13593-0.html?forumID=1&threadID=68316&messageID=1303755

Provide reputable sources for your claim about Australiab doctors. Your characterization is not what my Australian friends say about their medical care by any stretch of the imagination.
Posted by cardhun@...
15th Sep 2009
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Some Truth On Australian Doctors
Snowman's representation of Australian medical care is very misleading.

Australian doctors have not been told to maintain doses of 400 mg of caffeine in their bodies. Rather, Queensland Health ( astate-level agency) produced a 102-page document for Fatigue Risk Management that included using stiumlants as an option to increase alertness and fend off fatigue. Queensland hospitals are supposed to use the document to produce a site-specific plan.

The Australian Medical Association, The Salaried Doctors Queensland union, Australian physicians, and the press strongly oppose the idea as dangerous, short-sighted, and irresponsible.

http://www.news.com.au/couriermail/story/0,23739,26040339-952,00.html

One comment from Sam of Brisbane is especially relevant when he says: "The bigger issue is with the specialist colleges that train junior doctors to be consultants. It serves their interests and private incomes to limit numbers on training programmes."

Also see:

http://www.abc.net.au/news/stories/2009/09/08/2679456.htm
Posted by cardhun@...
16th Sep 2009
0 Votes
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Government run healthcare is severely rationed
in canada and england. You get less and pay more through taxes. You pay at least $5,000 per year in taxes, or more just to support and inferior government run system, whether you use the system or not. Governments have always had the 'lead' touch, everything they touch turns to lead. Government is so corrupt and inept that it could "bankrupt a whorehouse that sells alcohol".
Posted by katrillionaire@...
19th Sep 2009
0 Votes
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Do You Have Any Points With References?
Or are you just a fount of contra hominem attacks and anti-government slander?
Posted by cardhun@...
20th Sep 2009
0 Votes
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How to control health care costs and save america
costs are out of control because there is no sense of personal
responsibility. it is far too easy to let the "other guy" pick up
the tab - whether the other guy is a taxpayer or another ticket
holder in the lottery pool known as insurance.

what we really need to get costs under control is a pay as you go
plan. when you receive a service, you agree to pay for it and
negotiate the cost of the service with the provider.

if you can't afford it you decide if you can live without it or not
and if you cant live without it you ask your friends and family to
help you out or say your goodbyes.

somehow the human race has survived for hundreds of thousands of
years with very little in the way of healthcare. none of our bodies
are designed to last forever and our current healthcare expectations
are out of step with reality.

health care is not a right, it is a choice and it is a personal
responsibility not a government responsibility.
Posted by jeyost@...
2nd Oct 2009
0 Votes
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RE: Public option argument over and government own
Since when does a 30% minority constitute a "majority"? Obama's negatives are now well over 30% and growing, does that mean Obama is now always wrong?

As for why private health care costs are growing, much of that is because doctors and hospitals shift the cost of underpaying public systems such as Medicare onto private insurers. Another factor in private health care costs growing is because much of it is shielded from individuals by their employers. Making employees pay a small straight percentage of their health care costs instead of a fixed copay would go a long way in forcing people to make rational trade-offs about their medical care (e.g., no more trips to the doctor demanding antibiotics for a cold or flu).
Posted by zackers
16th Oct 2009
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