52 thoughts on “A Two-Tier Health System”

  1. Resolved: that all federal and state employees must enroll in ObamaCare, without exception. Except, there is no such plan!

    There is no single plan that “the common people” must use. They get a choice of plans, provided in an exchange. The fact that the Pajamas Media author is making that claim suggests he does not understand what has been proposed.

  2. There is no single plan that “the common people” must use. They get a choice of plans, provided in an exchange. The fact that the Pajamas Media author is making that claim suggests he does not understand what has been proposed.

    We keep forgetting that it’ll take some time for the other shoe to drop. How about just dumping government employees into Medicare? I think that would be a reasonable compromise given the uncertainty of the moment.

  3. Karl Hallowell – this is what I find so frustrating about this health care debate: I end up fighting ghosts. No matter what the facts are, what the bill says, or the intent of the authors, what matters is what, in your own mind, “will” happen at some to-be-determined date, despite that what “will” happen hasn’t happened anywhere else.

  4. Karl Hallowell – this is what I find so frustrating about this health care debate: I end up fighting ghosts. No matter what the facts are, what the bill says, or the intent of the authors, what matters is what, in your own mind, “will” happen at some to-be-determined date, despite that what “will” happen hasn’t happened anywhere else.

    There are several things to remember here:

    1) There is no single health care bill and the huge bills out there can never be fully characterized. There’s no “this is what the bill says”. It’s not my problem that the Democrats cannot stay on message.

    2) The intent of the authors (especially not the public claims of intent) doesn’t matter.

    3) What is known is that all the current plans force people to have health insurance in one form or another, and eliminate much of the insurance industries ability to reduce costs. A natural consequence is either a return to the status quo or moving on to public health coverage. Given that government already has its own generous health coverage, it’s likely that government care will be better than the public health care. Hence, a two tier system.

    4) No other health system in the world is trying this approach.

  5. Actually, there is a single plan – the plan passed by the senate will need to be passed by the house verbatim if they are going to proceed. What they do after that (reconciliation) is under debate.

  6. As for applying the plan (whatever that means) to all federal employees; I think would (and should) have a military exemption for any such amendment. It is likely that any such exemption would be cynically crafted in such a way that congress gets an exemption too, but for even better care.

  7. As little as Mr. Gerrib understands the way markets work, it’s little wonder he can’t grasp how predictable are the ways government intrusion distorts markets.

  8. There is no single plan that “the common people” must use. They get a choice of plans, provided in an exchange.

    Must be why it’s so popular. All Obama needs is more cowbell.

  9. Chris Gerrib wrote:
    There is no single plan that “the common people” must use. They get a choice of plans, provided in an exchange. The fact that the Pajamas Media author is making that claim suggests he does not understand what has been proposed.

    Mr. Gerrib gets the point exactly backward. It doesn’t matter whether hoi polloi have one plan or many, what matters is that the nomenklatura have a separate plan that isn’t available to commoners. And that is indeed the case with the Senate bill — Congresscritters, for example, are exempt from the bill’s provisions and have their own entirely separate provisions for heal th care. So Tier 1 is Them and Tier 2 is Us.

  10. Oh, Curt, that’s just false consciousness. The proles just don’t know what’s good for them, so their moral and intellectual betters must decide.

  11. One of the reasons the health care bill is unpopular is the incorrect facts being promulgated about it.

    “Funny how the people who run the most sophisticated communication operation in the history of the presidency keep concluding that their difficulties stem from their inability to get their message out and never from what their message actually is.” Like I said, More Cowbell.

  12. Chris Gerrib writes:

    “One of the reasons the health care bill is unpopular is the incorrect facts being promulgated about it.”

    Yes, indeedy. It’s a little known fact that it will be an entirely voluntary system, supported only by voluntary contributions, and involving not one jot or tittle of State coercion . . .

    . . . on Bizarro Planet. (Which is where Mr. Gerrib learned economics. by the way.)

  13. Curt and Bilwick1 – there are none so deaf as those that will not hear.

    Anybody who writes an article saying “make Congress sign up for Obamacare” will not hear.

    But for those that do hear, I will keep providing facts.

  14. What facts? That it’s whole purpose is to expans the power of the State, which is why State-fellators love it? There’s a fact worth mentioning.

  15. Speaking of Bizarro Planet, as I was, did it ever occur to anyone that on Bizarro Planet, most of us would be the State-fellators, and Chris Gerrib would be actually DEFENDING individual liberty?

    Mind-blowing, man.

  16. Bilwick1 – Mark Steyn, in his article, made fun of somebody who couldn’t afford their own set of dentures. In America. If you really want to be associated with such a heartless piece of shit, fine by me.

    Me, I want my fellow citizens to be able to afford to get health care. It’s a simple desire, something that every industrialized country in the world manages to accomplish.

    The reason Canadian conservatives don’t abolish their health care system is because the majority of Canadians like it.. That’s how democracies and republics work – majority rule.

    Regarding the rest of Steyn’s lament – sometimes you just can’t go back. Very few people are willing to ditch their cars and get a horse and buggy. Similarly, the dreaded entitlements Steyn wants to role back are popular – nobody wants to go back to the good old days of working until you died or moving back in with your kids.

  17. the proposed system is very similar to the French system

    Total BS. Let’s look:

    the average American physician earns more than five times the average US wage while the average French physician makes only about two times the average earnings of his or her compatriots.

    Does the healthcare bill determine doctor’s pay?

    the lower income of French physicians is allayed by two factors. Practice liability is greatly diminished by a tort-averse legal system, and medical schools, although extremely competitive to enter, are tuition-free.

    Does the healthcare bill get rid of existing tort law and creates a board that determines an average cost for tort cases?

    Does the heathcare bill provide free tuition-free education for doctors to alleviate the risk of collecting a large debt and getting paid less, or losing ones source of income for a single mistake?

    It’s not uncommon to visit a French medical office and see no nonmedical personnel. What a concept. No back office army of billing specialists who do daily battle with insurers’ arcane and constantly changing rules of payment.It’s not uncommon to visit a French medical office and see no nonmedical personnel. What a concept. No back office army of billing specialists who do daily battle with insurers’ arcane and constantly changing rules of payment.

    Does… hahaha… I can’t even pose the question. Medicare reinbursements are notoriously small and painful to get for most new doctors. Gerrib will claim some friend or family member has no problems, but then Gerrib makes a lot of claims.

    Doctors only agreed to participate in compulsory health insurance if the law protected a patient’s choice of practitioner and guaranteed physicians’ control over medical decision-making.

    Will Doctor’s have control over medical decision-making or will we have standardized procedures for diagnoses?

    French legislators also overcame insurance industry resistance by permitting the nation’s already existing insurers to administer its new healthcare funds.

    Hey, a kernel of truth for Gerrib.

    Like all healthcare systems, the French confront ongoing problems. Today French reformers’ number one priority is to move health insurance financing away from payroll and wage levies because they hamper employers’ willingness to hire. Instead, France is turning toward broad taxes on earned and unearned income alike to pay for healthcare.

    Another kernel of truth, that also goes back to Obama’s statements in 2003. It’s all just a progressive step. Just like passage of the HMO act in 1973 that was going to solve all these problems. Just like the Social Security Act of 1965 that gave us Medicare. Just like the original Social Security Act in 1935.

  18. I want my fellow citizens to be able to afford to get health care. It’s a simple desire, something that every industrialized country in the world manages to accomplish.

    What you want is doctors to work for less despite the time it took for them to gain knowledge that is then put at risk in treating patients with nothing to lose and everything to gain by claiming malpractice. Then there is the maker of the dentures as well. But hey, the flipside of the argument isn’t of your concern. You only care about the guy who wants dentures. Screw the people who took the time to help the guy who needs dentures.

    The reason Canadian conservatives don’t abolish their health care system is because the majority of Canadians like it..

    And the majority of Americans don’t want Obamacare.

  19. The reason Canadian conservatives don’t abolish their health care system is because the majority of Canadians like it.

    Having American health care available right across the border might have something to do with that.

  20. Does the healthcare bill determine doctor’s pay? – No. If it did you’d be screaming “Communism” even louder.

    Does the healthcare bill get rid of existing tort law? It has tort reform provisions in it.

    Does the heathcare bill provide free tuition-free education? No. Maybe it should.

    Does… Medicare reimbursements are irrelevant. We’re not putting everybody on Medicare. (But yes, my parents and grandparents are on Medicare and they seem to have no issues getting to a doctor.)

    Will Doctor’s have control over medical decision-making? Yes.

    Few problems stay solved forever.

  21. Curt Thompson – ask one question – who is paying for those Canadians running over the border to the US? The answer is “Canadian Medicare.” It’s not like all those Canadians are paying for Canadian care and out-of-pocket in the US.

  22. Does the healthcare bill determine doctor’s pay? – No. If it did you’d be screaming “Communism” even louder.

    Then there is disparity between the French system and the US system. Seems like the US system will cost more, yet Obama claims he will save us money? How will he do that?

    Does the healthcare bill get rid of existing tort law? It has tort reform provisions in it.

    Um, not tort reform provisions. You need to understand the French system better than that. The French system creates a mediation board that determines what Doctors pay to injured patients. That’s a massive change is US law, and that’s not in the healthcare bill. So your claim that the system is like the French system shows your lack of knowledge of both proposed healthcare bills and the French healthcare system.

    Does the heathcare bill provide free tuition-free education? No. Maybe it should.

    It certainly solves the risk problem to the individual wanting a doctor’s degree. What other education can we make free to eliminate risk? We already have 12 years of free education, why not another 12?

    Medicare reimbursements are irrelevant. We’re not putting everybody on Medicare.

    Medicare reimbursements are relevant, because the system of paying doctors will be similar.

    Will Doctor’s have control over medical decision-making?

    They don’t in most countries with government healthcare. They don’t have full control with medicare.

  23. Chris Gerrib, I’d appreciate it if you don’t presume to speak for Canadians. You better believe people here pay twice when going to the US for medical services, our health system is funded by our income taxes, no choice in the matter. Sometimes we can get some of it back. We got sold a bill of goods, and just like you are now being warned about, we can’t undo the damage.

    Steyn commented on how stupid Rep. Slaughter is to base her support on an irrelevant sob story, he did not “make fun” of the toothless woman. You did realize that dental isn’t covered by Canadian (nor I suspect, your proposed) government health care plans?

    Like every liberal in history, you only want to make things better. These people don’t want to make it better, they only want your life in their hands. Given your time in the service, you had an opportunity to learn that there are bad people in the world – well guess what? There are bad people in the USA too. I don’t want to be insulting, but the phrase “useful idiot” comes to mind.

    Maybe you need to get out more.

    Sorry.

  24. Karl Hallowell – actually, the proposed system is very similar to the French system – go compare systems here.

    Ok, here’s what I see.

    1) The US system is a lot more expensive than the French system.

    2) Also, most of the expenses in the French system are from government. Private French insurance pays only $448 per capita while French government pays $2,693 per capita. In comparison, both US government and private insurance pay similar amounts per capita to French government.

    3) There is a universal coverage system in place in France. No requirement that everyone have a private health insurance plan. Private insurance is typically used to supplement government health care.

    4) The French national system pays full amount of health care costs for certain long term health problems like diabetes.

    5) French government sets prices for hospitals.

    As Karl Armstrong indicated, if there is going to be a huge health care plan passed, it is likely to be the Senate plan. Points 1), 2), and 3) indicate a profound difference between the Senate plan and the French system. Private insurance will have a huge role in the US system and a profoundly different role than insurance plays in the French system. It’s also worth noting that the US system already apparently pays a little more per capita in government funds than the French system does.

    In other words, the US system isn’t now nor will be “very similar” to the French system.

    One of the reasons the health care bill is unpopular is the incorrect facts being promulgated about it.

    For me, it is the consequences that I find unappealing. We have an increase in health care costs (simply because there’s a lot of policies for increasing costs combined with no serious attempt to reduce health care costs in these bills), no improvement in health care innovation, and a huge inroad for government interference in the lives of people which will result in a great decline in the freedom of the US citizen.

  25. One other thing. We’ll see how well Chris’ parents and grandparents fair AFTER the 500 BILLION in medicare CUTS to help pay for Obamacare which will cost twice as much as he says, at least. Why don’t you mention how underfunded Meicare and SS are? You tout them but ignore the gaping hole in their funding and Obama is about to make Medicare worse. Maybe he can pull a unicorn out of his butt and save us all.

    “Will Doctor’s have control over medical decision-making? Yes.”

    I’d type more but I’m laughing too hard.

  26. “who is paying for those Canadians running over the border to the US? The answer is “Canadian Medicare.” It’s not like all those Canadians are paying for Canadian care and out-of-pocket in the US.”

    Yes, we are. We have a two-tier health care system in Canada – the the government run system for the proles, and for those who can afford it the United States is next door.

    BTW dental care and optometry are not covered under the Canadian health care system, yet we somehow somehow manage to get wisdom teeth pulled and dentures and laser eye surgery. Abortions, however, are covered, and all Canadians pay for that through their taxes, no matter their opinions.

  27. So let’s get this straight. American doctors charge more than healthcare costs in other developed nations for several reasons. One is “defensive care” necessitated by the legal system in the USA making it absolutely necessary for a doctor to order all manner of tests that are almost certainly unnecessary. Another is the desire to get the kickbacks paid to the doctor for extremely expensive diagnostic procedures such as MRI, by the organisations providing them. Another reason for high healthcare costs is legal protection for the pharmaceutical companies’ protected markets in the USA – and along with that, kickbacks and freebies for doctors from said companies, for prescribing (often unnecessary and sometimes toxic) drugs from said companies.

    I am quite sure there are more. One way to get the cost of healthcare down might be to restore the Hippocratic Oath, and make failure to keep it a criminal offense.

  28. One is “defensive care” necessitated by the legal system in the USA making it absolutely necessary for a doctor to order all manner of tests that are almost certainly unnecessary.

    Caused by the out of control plaintiff bar, a problem that the Senate bill does nothing whatsoever to address.

    One way to get the cost of healthcare down might be to restore the Hippocratic Oath, and make failure to keep it a criminal offense.

    So, you’re proposing to ban abortions?

  29. Chris (“What’ so bad about serfdom?” Gerrib writes about the Mark Steyn article I linked to:

    ” Mark Steyn, in his article, made fun of somebody who couldn’t afford their own set of dentures. In America. If you really want to be associated with such a heartless piece of shit, fine by me.” In Bizarro Planet of the mind that Chris inhabits, no doubt he sees this as a cogent rebuttal to Steyn’s article.

    One wonders woth these State-fellators who show up on pro-freedom blogs whether (a) they actually miss the point, or (b)whether they’re pretending to miss the point to avoid addressing it. I’suspect in many cases it’s (b); in any event, I’ll give Chris the benefit of the adoubt and assume it’s (b), because he’d be a complete idiot if it’s (a). Fortunately Eric Weider does get Steyn’s point about the toothless woman, which was “how stupid Rep. Slaughter is to base her support on an irrelevant sob story. . . ” In formal logic it’s called the argument from pity;” a fallacious argument, but without it, modern statist “liberalism,” as a movement, would pretty much cease to exist.

  30. Hey Chris, read it & weep:

    Chuck Heath, Mrs Palin’s father, said they had had little choice but use the Canadian facilities given Skagway’s location.

    “There was no road out of there at that time. The ferry schedule was very erratic. We had no doctor in Skagway,” he said.
    “The plane schedule was very erratic. The winds dictated whether the planes could come in or not.”

    He said his family probably took the train to the Whitehorse hospital only twice – once when his son burned his leg and again when a daughter had rheumatic fever.

    Mr Heath also stressed that they had “much preferred” to use US medical facilities as his insurance did not cover any treatment in Whitehorse.

    I guess you’ve never lived on the frontier … but you could read a little history …

    In addition, that quite possibly was before there was “universal health care” in Canada. The wikipedia article on the Canada Health Act is quite interesting, have you heard of monopsony before? Rather enlightening. We already have an unacknowledged two-tier system in Canada, look at Danny Williams and Belinda Stronach in recent events. There is pressure to formalize this – lots of Canadians want more control over their own health care, and better control of the costs – the current system is heading towards bankrupting the country.

    Sound familiar?

  31. xj – The Oath applies to a doctor’s patients. And only to his patients.

    In any case, I agree that there are some abortions (specifically late-term abortions of healthy foetuses) that ought to be banned except when the health of the mother is at risk. A lot more people agree with that proposition than agree with the proposition that abortion of any foetus at any stage, regardless of the consequences to the mother’s health of bearing it full-term, should be banned.

    Some examples? Well, IMHO an abortion of a foetus early enough to have no nervous system ought to be legal. So should the abortion of one that is threatening the mother’s health. And so should be aborting a completely non-viable, or in other words lethally defective, foetus – anencephaly being one extreme example.

    The violations of the Oath that I specifically had in mind are such things as prescribing drugs with a black-border warning and no demonstrated utility, by doctors who are getting thousands of dollars’ worth of freebies for prescribing them. Which happens all the time. If I lived in the USA, I would use someone with the letters N.D. after his name in preference to M.D. – every time.

  32. Eric Weder – the point is simple – the “disfunctional” Canadian health care system functioned perfectly well for Palin. BTW, she was born in 1964 – universal health care came to Canada in 1996, so if she remembers it, it was after universal care.

  33. Wow–when she was a kid, Sarah Palin’s dad used to take her to Canada to see a doctor! Well, that clinches it, as far as I’m concerned! Socialism now! Viva Il Dufe!

  34. I never understood why morons act like they bolster their arguments for Obamacare by attacking Sarah Palin. I don’t give a flip if Sarah gave birth to Bristol over in the USSR because of their socialized medicine. Sarah Palin has never been a reason to oppose socialized healthcare.

    But I guess sometimes, you have to cling to the best argument you got. So keep hammering away at Sarah, Gerrib. We will keep laughing at your lack of intellectual depth.

  35. Eric Weder – the point is simple – the “disfunctional” Canadian health care system functioned perfectly well for Palin. BTW, she was born in 1964 – universal health care came to Canada in 1996, so if she remembers it, it was after universal care.

    FAIL!
    Michael Libin today in the National Post – I’d encourage everyone to read his piece, it’s very enlightening.

    “In any case, as there’s certainly no evidence the Heaths didn’t pay for the care they received in Canada. In fact, visiting Americans typically did (and still do). Actually, in the ‘60s, Canadians often did. U.S. journalists seem happy to take it for granted that health care up here has always looked exactly like it does today, but it hasn’t. As blogger Matthew Campbell rightly points out “if Palin’s family did travel in the mid-1960s, they would not have used the same state-run system that Canada uses today.” Rather, they would have used a system that looked and operated much like the American system at the time.”

  36. Speaking of morons and their devotion to ObamaCare, have you heard the latest Pelosianism? She’s quoted as saying we have to pass the health care bill to see what’s in it.

    As Instapundit often remarks: Yes, this country is in the best of hands.

  37. Speaking of the denture lady, I wonder if she had cable tv.

    Oh, I am such a heartless shit! How dare I criticize any comfort a woman takes as she watches the Lifetime channel with the rain pouring down her neck through the roof of her hovel while she gums her macaroni and cheese?

    Seriously, I can’t believe that people still fall for sob stories like “I have to wear my dead relatives dentures ‘cos I can’t afford my own!” For one thing, how could they possibly fit her mouth when they weren’t made for her? One reason dentures are expensive is they have to be custom made for each individual person. Not to mention the “ew” factor of wearing someone else’s dentures — I don’t care if you boil them for three days, I wouldn’t do it if I had no teeth. I can’t possibly say that this lady is a liar, but I am really suspicious of the truth of this story. But it sure works on people who base their decisions on their emotions instead of their reason.

  38. “…she was born in 1964 – universal health care came to Canada in 1996, so if she remembers it, it was after universal care.”

    So she had to be at least 22 to remember universal care? She had no ability to remember before that?

  39. I never understood why morons act like they bolster their arguments for Obamacare by attacking Sarah Palin.

    Any port in a storm. Remember back in the day when the Left believed that anything remotely near Palin was toxic? My, how times have changed….that was way back, like, before iPads…

  40. Bill, I think that was a typo – there was health care stuff starting to happen in the sixties, he probably meant 1966.

  41. The latest silly obsession by Enemies of Sarah Palin is a story she let slip during a speech in Calgary that, in the late sixties, her family used to slip across the border
    to get health care in the town of Whitehorse in Canada.

    Aha! goes the reaction. We’ve caught Sarah Palin in another act of hypocrisy. She’s preaching against the ills of socialized medicine and here she was making use of it. Indeed Whitehorse is a 15-hour drive from Wassila. There are a number of problems with this.

    First, Sarah Palin’s family lived in Skagway at the time, not Wassila, which was just across the border from Whitehorse.

    Second, these trips across the border took place when Sarah Palin was about three years old, hardly in any position to determine where and when she was going to go to the doctor.

    Third, as journalist Luke Dittrich points out, these trips are dictated by geography, not politics.

    “And that was it: a simple admission that I didn’t think much of then, and still don’t think much of now. Whitehorse General Hospital, where my own daughter was born three years ago, remains, to this day, the closest major hospital to Skagway. When Chuck and Sally chose to take their kids there, it would have been a choice dictated strictly by geography, not politics. There are many things one could criticize about Sarah Palin’s views of health care in the United States. That she once participated in cross-border medical tourism to Canada is not one of them.”

    Fourth, Conservatives For Palin point to a summary in Health Canada that reveals that even though the legislation that created Canada’s socialistic health care system was passed in 1966, it was not fully implemented in the Yukon, where the town of Whitehorse resides, until 1972. That means that Sarah Palin’s family paid fee for service.

    Of course all of this jumping up and down about three-year-old Sarah Palin getting health care in Canada before the system went socialist is as silly as the hysteria over Rush Limbaugh vowing to go to Costa Rica for his health care should Obamacare pass. Does not Rush know that Costa Rica has socialized medicine?

  42. Oh, sorry, I forgot another medical system abuse of patients. CRT scans as part of the “defensive medicine” system and also as part of the kickback system. The difference here is that, unlike blood tests and MRIs, the test procedure itself has associated risks; in CRT scans the patient is subjected to 20 times the ionising radiation dose from a standard chest X-ray. Extra exposure to ionising radiation is never a good idea, unless of course you think the backstory of the Incredible Hulk is realistic.

    The CRT operators and the doctor make more money; the patient gets an increased risk of cancer and a huge bill. Doesn’t seem very equitable to me.

Comments are closed.