Yessssssssss. We want the last dollar!
Paul Krugman writing in the New York Times has a great article about the supposed benefits of the private health insurance industry. Ostensibly as part of defense of the movie Sicko, it’s a very good read.
The persistence of that myth puzzles me. I can understand how people like Mr. Bush or Fred Thompson, who declared recently that “the poorest Americans are getting far better service” than Canadians or the British, can wave away the desperation of uninsured Americans, who are often poor and voiceless. But how can they get away with pretending that insured Americans always get prompt care, when most of us can testify otherwise?A recent article in Business Week put it bluntly: “In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems.”
A cross-national survey conducted by the Commonwealth Fund found that America ranks near the bottom among advanced countries in terms of how hard it is to get medical attention on short notice (although Canada was slightly worse), and that America is the worst place in the advanced world if you need care after hours or on a weekend.
Hip replacement surgery in the US is more available than in Canada. But, there’s a little catch you probably didn’t know.
On the other hand, it’s true that Americans get hip replacements faster than Canadians. But there’s a funny thing about that example, which is used constantly as an argument for the superiority of private health insurance over a government-run system: the large majority of hip replacements in the United States are paid for by, um, Medicare.
That’s right: the hip-replacement gap is actually a comparison of two government health insurance systems. American Medicare has shorter waits than Canadian Medicare (yes, that’s what they call their system) because it has more lavish funding – end of story. The alleged virtues of private insurance have nothing to do with it.
Here’s one of his examples of health-care treatment through an insurance company;
This can lead to ordeals like the one recently described by Mark Kleiman, a professor at U.C.L.A., who nearly died of cancer because his insurer kept delaying approval for a necessary biopsy. “It was only later,” writes Mr. Kleiman on his blog, “that I discovered why the insurance company was stalling; I had an option, which I didn’t know I had, to avoid all the approvals by going to ‘Tier II,’ which would have meant higher co-payments.”
He adds, “I don’t know how many people my insurance company waited to death that year, but I’m certain the number wasn’t zero.”
One of the little discussed issues with private health insurance discussed is the cost it adds to businesses in the US. Countries with state health care allow businesses to pocket that expense directly, or add a supplementary insurance option for things that are not covered via universal coverage. In Soviet Cannuckistan, my employer offers medical benefits of pharmaceuticals and dental care. All my other needs are met by the universal medical care. And those costs are a fraction of the cost of complete health care. How much does a business save when they don’t have to foot the bill the government could and probably should? You may not like this source, but the facts are strong.
In 1988, Chrysler’s CEO Lee Iacocca reported that each car his company produced in the U.S. cost $700 in health benefits alone, while the same car produced in Canada by Chrysler cost only $233 in health benefits.
The situation hasn’t changed much since then. In 2005, General Motors of Canada’s CEO Michael Grimaldi reported that each U.S.-produced car cost $1,500 in health benefits, compared to less than $500 in Canada. And in 2006, the Conference Board of Canada reported that in the U.S., health care and pensions add between $1,400 and $1,800 to the price of each vehicle – a major reason Toyota cited for building its newest plant in Ontario.
The carmakers aren’t the only ones bearing the burden. Wal-Mart’s annual bill for health benefits is $1.5 billion, even though fewer than half of the company’s 1.3 million U.S. employees are actually insured.
One of the top advocates for public health care in the U.S. is Howard Schultz, the chairman of Starbucks. He has been outspoken about the “moral responsibility” of businesses to provide health coverage. But he also knows that this is one of the best ways for companies like his to retain employees. Given that 45 million people in the U.S. have no health coverage whatsoever, even a low-paid job slinging coffee is desirable if it includes health benefits.
Several major weaknesses of the current setup –
-It is an unfunded mandate on employers.
-Health insurance is tied to employment – golden handcuffs for employees
-It gives large businesses an advantage in hiring over small businesses, and is a disincentive to self-employment.
-A true “actuarial” form of health insurance would work in a for-profit environment. However, no one wants that – and “social” insurance (where premiums are not a function of “risk”) and the need to earn a profit are a conflict of interest.
-Unlike auto repair or funeral services, you never know what you’re going to wind up paying until AFTER the service is rendered and the insurance company has denied your claim.
-Ditto from the perspective of the doctor.
-Premiums are tied to the size of the “group” – again giving a disadvantage to small businesses and the self-employed (or anyone else who needs to purchase an individual policy).
Scott, Thomas,
The issue shouldn’t be how to best run a universal health system. Nor should it be about some states might be worse off or some states can afford better care. The minutia of the details are something that may be worked out later. For now lets just try to get some form of health care that all Americans have access to. When we can get people on side and in agreement that we need it, then we can discuss “how”.
You both earned points for well made arguments and no personal attacks.
#104
I’ll conceded that indirectly coverage does affect the quality of care yet the primary issue is still coverage not care per se. In addition, the assumption made by proponents of a universal health care system is that by providing said system, care will increase as a consequence. Thus, it is not relevant to talk about the quality of care when talking about “universal” health care coverage.
> We will have to agree to disagree on this point. I find
> that position morally unconscionable
That is a ridiculous standpoint. There are countries around the world that provide a continuum of coverage for health care. Are you saying that we should go into every one of those countries that provide no “universal” coverage and provide care for them as well? Just as other countries are responsible for the care of their citizens, so too are the people of each State responsible for the care of their constituents. How do you figure that is “morally unconscionable”? If a given State has a poor implementation of a coverage system then blame falls squarely on the voters in the State. The people responsible for said system are far more accountable if it is a State system then if it is a Federal one.
That same concept holds true for education. Should we go into every country in the world that implements poor education and cover their education costs too? Of course not, because the people in other countries are responsible for themselves, just like States are responsible for themselves.
> We can’t simply say that it is OK for a state where people
> are overly religious, for example, to deny a decent science
> education or to allow children to die because treatment is
> against the religion of their parents
Just as there are Federal standards of education there would need to be similar standards for coverage were we going to implement such a thing. If a given State did a poor job of implementing those standards then it is up to the voters of that State to fix it. You seem to not want the States to take responsibility for whatever solution they implement. When it comes to domestic affairs, the Federal government should *only* be making standards or playing referee. Everything else should be up to the States.
#107
If we decide that the State’s should provide it, then THAT change can happen now. If people in their State want universal health care, then elect local politicians that campaign on creating such a system. There is no reason to wait for the Federal government to implement such a thing and in fact we shouldn’t implement it at the Federal level. The solution is for people to get involved in their State’s politics to get such a thing implemented.
#105
RE: Moving
If a terrible system is implemented at the State level, then those that couldn’t move to another State would in fact be stuck. However, how do figure that is different if a terrible system is implemented at the Federal level? The situation is orders of magnitude worse if that happens as moving to another country is a far more difficult process. Thus, no matter how you slice a bad system is bad for the poor and everyone else. However, a bad State system is only bad for that State as opposed to the entire country.
RE: Enslavement
This entire analogy is completely empty and I fail to see how that is unfortunate. THAT something should be changed has never been the issue. WHAT we do to alleviate the problem is crux of the issue.
> It may have escaped your notice, Mr. Train, but
> we ALREADY HAVE a cluster fuck of a system.
EVERYONE agrees that the current system of health care has problems. That isn’t the issue. The issue is in the proposed solutions to that problem. Substituting one cluster!@$#$ system for another simply makes things worse.
> And requiring each state to work this critical issue out in
> isolation, 50 times over (or 51, or 54, or whatever) would
> guarantee a cluster fuck * 50.
Who said anything about doing it in isolation? Do you think it is a coincidence that most of the motor vehicle departments across the country operate the same way? It is likely that many of the solutions will be similar perhaps even identical to some European systems. However, by having independent systems, it makes them more answerable to their constituents AND it makes it possible to implement alternative solutions so that the other States can see how it goes.
> Kinda like having a well, vs. city water…
I don’t know where you live but in LA it is never the case that ALL the city water everywhere goes out simultaneously and if it did I sure as hell would want well water. Furthermore, you notice the key word “city” water as opposed to State or Federal water. Imagine how “efficient” your water system would be if you were simply one of 300 million customers.
Let me see…
I pay my Employer,
He pays another company,
That company Pays an HMO,
Which pays for my doctor, 6 months AFTER my appointment…
THEn I STALL have to pay 20%+ for my coverage..
And Im Still not Fully covered.
ANd if I dont call the coverage corp, and ask permission, they have the RIGHT to decline?
wouldnt it be easier to CALL up affiliated hospitals, and decide on HOW MUCH to pay. Didnt Kaiser do this already??
>>I sure as hell would want well water
I guess you’ve never had a well then. Very easy for them to become contaminated with deer shit, toxic chemicals, run dry, all kinds of things. Then, you’re fucked.
As for your whole state vs. federal knicker-twist, I guess we’re just going to have to agree to disagree. Probably won’t affect me anyway, as I live in an “enlightened” state, and I’m not to worried about the thing from a personal standpoint.
You’re shooting yourself in the foot with your DVM analogy. I have lived in probably 15 states, and know people who live in all 50. I have NEVER met anybody who thought the DMV did a good job. Nobody really cares about that though; having to stand in line for 4 hours to get your license renewed, then come back another time to complete the process, is a long way from having basic health care benefits denied by some $100,000,000.00 beaurocrat, and then you die.
It all comes back to the slavery analogy. See what a great job the states did with that? And you think if Alberto Gonzalez was the AG of Mississippi that anyone would give a flying fuck what kind of mischief he was up to and whom he fired? It’s only because it’s a FEDERAL CASE, so to speak, and it gets the attention of EVERYBODY, that so much attention is being paid to it.
Your “if you don’t like it here, get the fuck out” approach to shitty health care coverage afforded on a by-state basis brings to mind “compassionate conservatism”. And we all know how well THAT worked out. About the same as the slavery thing.
A big reason so many people get coverage through their employers is because of government rules. They provide all sorts of tax breaks which can make it a good deal for businesses to provide health care, but then they make it as cheap as possible on the coverage side. Yes, allowing people to pick their own coverages and buy their own insurance would help. But for the most part, government rules either outright ban such things, or push things in that direction.
#112
For every bad State solution you provide, I can easily extrapolate that example and ask what would happen were that the Federal version. If no State can implement a decent solution then what makes you think that politicians who are elected from those States (and usually worked for those State governments) will do any better?
The DMV example enforces my point that any government solution is going to have problems. Far better that problems are isolated at the State level than magnified at the Federal level.
> It all comes back to the slavery analogy.
This example is completely irrelvant. We are not taking about fundamental human freedoms and we are not talking about compromises in order to get a Constitution passed. We are talking about giving a tremendous amount of power to a single organization and the risk associated with that change.
Let me put it this way. Take the worst politician you can imagine and now imagine they were in charge of the entire country’s health care. Hate Bush? Imagine he was in charge of your health care. That reason alone should be sufficient to want to implement it at the State level.
RE: Attorney general
Again, you are off in la-la land. The State and Federal court system has nothing to do with this. If the Federal government sets down standards then failure to meet those standards can be handled in the Courts. However, that does not change how the solution is implemented.
> Your “if you don’t like it here,
> get the fuck out” approach to shitty
> health care coverage afforded on a by-state basis
You conveniently ignored the part about getting involved in your local politics. Health care coverage change does not require waiting around so that the Big Brother Federal government can “make it all better.” Even cities could implement solutions for collective drugs purchases for people that live in their city. There are alternatives to a one-size-fits-all solution. Furthermore, that “get out” solution applies ***no matter which level the solution is created***. If a crappy Federal solution is created you have the same choices: A: leave, B: get the politicians to make a change or get elected and make a change or C: do nothing. It MAKES NO DIFFERENCE where the solution is made. However, it is far easier for people to choose one of those choices if the solution is isolated to a State.
>>This example is completely irrelvant. We are not taking
>>about fundamental human freedoms
Yes we are, train man. What part of “LIFE, liberty, and the pursuit of happiness” do you not understand?
When $100,000,000/yr paper shufflers consign people to death because it’s going to cut into the profit picture and his $1.6 billion dollar golden parachute. THEN, we are talking about fundamental human freedoms.
And since you at least seem to think liberty is a “fundamental human freedom” and the states fucked THAT up so badly, why on earth would any thinking person leave another fundamental human freedom to individual states???
> Yes we are, train man. What part of “LIFE, liberty, and the
> pursuit of happiness” do you not understand?
Strangely, I find that people are living even with the current system. Even more shocking is that people have lived for thousands of years without universal health care coverage. In fact, people lived for thousands of years without health insurance much less the idea of someone else paying for it. In addition, you will also find it shocking that the Founding Fathers in no way, shape or form had universal health care on their mind when they crafted the Declaration of Independence. Furthermore, as I read the Constitution over carefully, I fail to find anything about the State’s obligation to pay for health care costs.
It appears you really do not understand the documents you are quoting. The Founding Fathers wanted to provide the *opportunity* of life, liberty and the pursuit of happiness and that they have. Opportunity does not in any way imply quality.
> And since you at least seem to think liberty is a
> “fundamental human freedom” and the states fucked THAT up
> so badly, why on earth would any thinking person leave
> another fundamental human freedom to individual states???
Where did I ever say that the States screwed up fundamental human freedom? If you are still harping on your idiotic slavery example, the obvious counter is abolitionist States and “imagine if slavery were instituted (as opposed to tolerated) at the Federal level.” For every bad example of State implementation you give me, I can easily counter with “Exactly. Now suppose that were the Federal version.”
Read carefully: concentration of power = bad. Distribution of power = good. Does that spell it out for you?
You really need to read more about history and the concept of “compromise.” The United States WOULD NOT EXIST had the signers of the Constitution not accepted slavery. We would not be here chatting. You would likely be British or German at this point.
For every example of “the States screwing things up” I could give you ten examples of screw ups by governments with concentrated power. It is clear that you fundamentally do not understand the idea of a Federalist Republic where the States have power. The best (albeit still imperfect) example of how the country was envisioned is how the EU is shaping itself now. Individual countries with their own systems but an overriding set of human rights and economic principles. Just as the EU cannot tell Britain how to implement its health care system, so too should the Federal government not be able to dictate the implementation of a health care system to the States.
>>In addition, you will also find it shocking that the Founding
>>Fathers in no way, shape or form had universal health care
>>on their mind when they crafted the Declaration of
>>Independence.
That’s because in the days of the Founding Fathers, a visit to the doctor’s didn’t run you the risk of incurring a $400,000.00 bill and a lifetime of destitution. The founding fathers certainly didn’t rule it out when the crafted the DoI. As society “evolves” [koff, koff], so must the ways in which we interpret the literal words of the Constitution.
And I truly fail to understand your fixation on States’ rights. If “distribution of power” is the holy grail, why waste time an energy on a bloated, unresponsive beaurocracy like the state government? Why should people in San Francisco be deciding what’s best of people in Palm Springs (or vice versa)? Why should people in Boston or Cambridge be deciding what’s best for people in some tiny farming village in the Berkshires? What do people in Chicago know about what the folks in E. St. Louis need? Screw this state crap, let’s let every hamlet and unincorporated township across this great land make up their own rules about everything! And for cities like New York, LA, or Chicago, let’s do it on a neighborhood-by-neighborhood basis. Much more likely that a Chicagoan will be able to “vote with his feet” by moving from Rogers Park to Jackowo than by moving from Rogers Park to Minneapolis.
Not too enthused about your analogies, either. States may have their own retirement plans (for state employees, but not civilians), but these do not REPLACE Social Security. States may have their own National Guard brigades, but utimately they all report to Lieutenant General H Steven Blum, Chief of the National Guard Bureau. As a component of the Armed Forces of the United States, the National Guard is the responsibility of the FEDERAL GOVERNMENT.
Get over it, TrainMaster. Some things can be handled at the state, local, neighborhood, or individual homeowner level. Assuring adequate health care to the US citizenry is not one of those things. I don’t see poeple running for governor of states promising to make universal health care a top priority (although Ahnold and Catcher’s Mitt Romney have made some progress on that, it was not a campaign issue, and what do you expect…it’s CA and MA; unlikely that we’ll see that in Mississippi or West Virginia for a looooooong time to come).
#95, Mister Mustard —
I didn’t have a lapse in coverage, because I had began working for the worlds largest and most hated corporation, and they offered exactly what my mother had via the federal government. My rates are reasonable, they hadn’t gone up when I was insured under my mothers policy, and they won’t under my current one either because of my condition. It’s treatable, and will be curable if it worsens.
BTW, I’m in Ohio, not California. Kaiser is in more than one state, y’know 🙂
118 – Well, Miss Lavey, you’re one of the lucky ones. God bless you and Kaiser Permanente (you’re up quite late, for being in Ohio, btw).
Most people do not have the option you have. They take what their employer offers (which is some cases is crap), they take out an individual policy (and wait to have their policy cancelled once they get sick, and the bills they’ve incurred to date rejected), or they go uninsured.
Just because YOU are one of the lucky ones doesn’t mean that for every Miss Lavey there aren’t 1,000 unlucky ones. And those are the ones that a universal health care policy should seek to protect.
btw, nobody said universal health care was going to be “free”. It will just be cheaper (overall costs considered) and provide better health care to all citizens than the current shitty system we have now. You may “just want to look out for [your]self”, but I have a grander vision than that. We’re all God’s children. And if we can provide decent health care for everybody for a LOWER COST than we can provide crap, where’s the downside?
Thomas (all posts),
I don’t understand your assertion about states versus federal at all. At least we agree that everyone needs health coverage and it should be provided by a government.
I think where we differ is that I believe it’s time we became one nation, indivisible, with (something) and (something) for (somebody). Dang. I almost managed to get that out with a straight face.
Also though, you said:
If a given State has a poor implementation of a coverage system then blame falls squarely on the voters in the State. The people responsible for said system are far more accountable if it is a State system then if it is a Federal one.
So, you really believe our current state governments are representative of their constituencies? What state are you living in NeverLand?
I still maintain that if we can ever get passed the amazingly wealthy lobbyists that thwart universal health care every time it comes up, we would be far better off with a national plan. A national plan would have a single point of administration instead of exactly the same bureaucracy multiplied 54 times. I’m not personally a libertarian. But, I do believe government should not grow needlessly.
Corporations have gotten huge boosts in productivity by merging and laying off huge numbers of employees, even though I don’t have to like it, and I often don’t. Why should we start out right off the bat by replicating the same infrastructure 54 times? How can that possibly be more efficient at providing care?
As for your statement about other countries, no the U.S. should not provide for all countries and indeed cannot, as proven by our inability to provide for ourselves.
Perhaps if we form a planetary government, something that just may be both required for our survival as a species and completely impossible given our xenophobic nature, then we could begin a debate about such things at the planetary level.
For now though, I really would like to know why you think state governments represent people better than the federal government.
I would also still really like to know why you think the health care requirements of individuals in different states is really different. I do not believe you have really made that point. You have merely stated that poorer states should have the right to give poorer care.
You also fail to make any headway in convincing me with your analogy about the standards of schools. This is something that, in my admittedly child-free opinion, makes my point better than yours. Some states really do have much worse education than others. Why do you believe this to be a good thing? I believe children have the right to the same standards of education in all states. You claim the fed sets a standard. Perhaps. But, it does not appear to be enforced in any meaningful way.
Why would the fed be able to do better with health care? Or, conversely, why is it OK to do just as badly with health care as we do with education?
All the arguments for a Federally run system are pretty weak.
“just look at the DMV”. So would it be better if the DMV was run by the Feds? Actually, I have no problem with the DMV. One time, ONE time I had to come back because the computer network was down and I couldn’t write the test for my CDL. I’ve never waited more then five minutes for service.
“Well, look at property taxes”. Again, would you prefer the Feds run the property taxes and outline the rules in a one size fits all?
Phuk it. The individual States are not all phuk ups while the Federal government consists of saints. Suggesting such is NOT rational.
“well, there would be a lot of duplication”. Ya, so what? There is already more then enough duplication at the Federal level. You don’t think so? Well, lets see, there is the FBI, ATF, Border Patrol, Secret Service, TSA, Federal Marshals,and whatever else, all with police powers ready to investigate and arrest you. Even militarily we have the Army and Marines doing the same job. Then there are the Reserves and the National Guard (yes, state, but, …) doing the same thing.
Is the Federal Park’s Service doing a better job then the State Park services?
The Federal Highway system is all run by the individual States. If the States are so inept then why doesn’t the Federal Government run it themselves?
The Federal Government should set the ground rules and pay half the costs. That will ensure better equality and higher standards than if the States were to institute a system entirely on their own.
*
… it’s time we became one nation, indivisible, with (something) and (something) for (somebody).
Then why bother having city governments. Or counties. Or even States. Because, at least in my opinion, some things are just better when handled locally. Can you imagine what a Federal Police force would look like? Can you picture Star Wars’ Storm Troopers?
How about this.
Sence the US Gov no long TEACHES our soldiers, in the Basics of SUPPORT, we NOW pay another corp to do the job… These are NOT free services, as when They were done IN HOUSE….You are now paying GOOD wages to Other folks that dont Work for the Gov…
Wages IN the military dont even match Min wage, NOW we are paying 4-10 times, for something that WAS almost free.
How about the idea that Bush wanted to Privatize Social Security.. Insted of it, NOT being a HIGH paying job, and NOT designed to Make money OFF of the incomes being placed there, they wanted it to be in a MONEY making effort with a Very HIGH pay’d job at the top.
How about the Idea that the FREEWAY department, USED to be state/federally run… And was a great place to get a decent job for those getting out of School..
NOW we have to pay Corporations, for this service, and for the CEO, board of directors, and so forth, that get ALOT of money, for doing VERY little.
I (IMHO) would LOVe to see the fed, start its OWN business in competition with the Corps. NON-profit, or even LOW profit.
It could fund ALL our taxes, and force competition BACK into the market.
#120
> So, you really believe our current state governments are
> representative of their constituencies? What state are you
> living in NeverLand?
Do you think the Federal government is representative of their constituents? What country are you living in Neverland?
I am amazed you do not understand this fundamental point. If the States do it wrong what makes you think the Federal government will do it right?
In every point you make, where you chide the State governments, substitute “Federal” for “State” and you have the same situation if not worse.
> As for your statement about other countries
> , no the U.S. should not provide for all countries
Then why should States provide for other States? We are a country of United *States*. Each State has its own autonomy. I guess people cannot grasp this concept because no other country in the world has had our form of government except as I mentioned the emerging EU. We are a federation of States. How do you think a central universal health care coverage system would go over in the EU? It wouldn’t stand a chance of passing because each country wants authority over the form of that coverage if they decide to provide it. That is exactly why it should not be at the Federal level in the US.
> For now though, I really would like to
> know why you think state governments represent
> people better than the federal government.
Firstly, a much better question is why you think that the Federal government represents the people better than the State level. Was it not just in 2004 that a President was elected that lost the popular vote?
Secondly, it comes down to the ratio of governing to govered. The smaller that ratio, the more responsive the politicians are to their constituents. If there are ten people in a district, every one of them knows their elected politician. If there are ten million, almost no one does and it makes it much harder to influence your politician. Thus, breaking up this solution at the State level forces the States to be more responsive to their constitutents. Granted this breaks down in very highly populated States like California which frankly should be split into multiple States but that is another topic.
> I would also still really like to know why
> you think the health care requirements of individuals
> in different states is really different.
Should accidents due to sky diving be completely covered by universal health care? Should melanoma extraction be covered by health care? Should tax breaks be given for people that take physicals every year? There is no clear answer to all of these. In one State they might cover all or part of these things but require the person to pay out of pocket or have additional coverage for the rest..
RE: Schools
It really is not difficult to understand:
1. Take the worst State’s school system you can imagine
2. Imagine that was how a Federal version was managed.
> I believe children have the
> right to the same standards of education in all states.
As do I. We are not talking about standards which *should* be set at the Federal level. We are talking about implementation of those standards.
> You claim the fed sets a standard.
> Perhaps. But, it does not appear to
> be enforced in any meaningful way.
Again, completely different topic. How those standards are enforced is an entirely separate topic.
#117
Attempting to use the Founding Fathers or the Constitution to imply any sort of health care coverage is completely ridiculous. It is not in there no matter how you try to twist it. The very concept of a certified doctor did not exist at the time. At the very least, you must agree that MANY disagree whether anything anywhere in the Constitution implies anything about covering health care costs.
> why waste time an energy on a bloated,
> unresponsive beaurocracy like the state government?
The Federal government is not bloated and unresponsive? It is the poster child for bloated and unresponsive.
> Why should people in San Francisco be deciding
> what’s best of people in Palm Springs (or vice versa)?…
That is upto each individual States to decide. They may very well decide to further break up their solution by county or city whereas others many not. That’s up to them.
> And I truly fail to understand your fixation on States’ rights
This is clear evidence that civics is no longer taught in school. Go read Locke. It is clear you fundamentally do not understand *why* the Founding Fathers designed the country the way they did. As I have said, a modern example that is closer to how the country was envisioned is the EU. Why are countries in the EU adamant about individual country’s rights as well as adhering to the general economic and human rights standards?
> Screw this state crap, let’s let
> every hamlet and unincorporated township across
> this great land make up their own rules about everything!
Again, it is already possible for cities and counties to decide to implement some semblance of coverage for their citizens. However, whether a given State decides to implement a solution that covers the entire State or not is upto the States.
RE: Social security
Frankly, if the States had implemented SS instead of the Federal government some of them might actually not be bankrupt instead of all them being bankrupt.
RE: National Guard
The National Guard is only under the authority of a Federal official when they are working in conjunction with other troops (either US Military or other National Guard troops). Other than that, they are under the authority of the governor of the State.
It is clear that you are simply ignorant about country’s founding principles. The country was not founded as a homogenous nation but as a federation of States. The best way to get change affected is to get involved in your local politics. Cities and obviously States have a tremendous amount of power to affect change for their people. Stop looking for someone else to solve your problems and look to your local communities to find ways of making change.
>>This is clear evidence that civics is no longer taught in school.
I went to school a long time ago, TrainMan. They DID teach civics in those days, so I’m not as ignorant of the topic as you may have deluded yourself into imagining.
As to what the founding fathers included in the Constitution, you may have noticed there’s nothing in there about stem cell research, cloning, the Internet, assault rifles, civil rights, or a million other things that Constitutional lawyers get rich debating. Just because something didn’t exist in 1776 doesn’t mean that the Constitution doesn’t apply.
>>look to your local communities to find ways of making change.
Oh, I do. I’m quite active in my local community. Not sure this town is ready to take on the challenges of conscripting an army, OR insuring adequate health care for all of its citizens.
>>Why are countries in the EU adamant about individual country’s
>>rights as well as adhering to the general economic and human
>>rights standards?
Um, because they’re different countries, they (for the most part) speak different languages, they have different cultures, until the 1993 Maastricht Treaty there WAS NO European, and their allegiance to one another pretty much stops with them all using the Euro. Ireland is much more different from Estonia or Sweden than New Hampshire is from Vermont.
And you may (or maybe not) have noted that within the European Union, health care provision is on a COUNTRY-BY-COUNTRY basis. Not by canton, arrondissment, province, region, municpality, OR STATE.
You should give it up, ZugMeister. You’re turning into a one-trick pony wth this unhealthy fixation on states’ rights. The Health Care Denial industry has made the whole provision of medical care FUBAR, and things need to be fixed. Maybe you’re wiling to wait another 200 years while ALL the states work out their problems (or even get started addressing them), but most people are not. They want change, and they don’t want it in the year 2525. If man is still alive. If woman can survive. And that’s what it may take, if you’re going to sit around waiting for universal health care to come to A State Near You.
> As to what the founding fathers included in the Constitution,
> you may have noticed there’s nothing in there about stem cell research,
Thus the reason those are not considered fundamental human rights unlike health care coverage according to you.
> health care provision is on a COUNTRY-BY-COUNTRY basis.
Exactly. Which is why it should be State by State. You simply do not seem to understand. The States are have their own governments *and* believe it or not, their own cultures which although similar across the country do in fact vary. We are united but not homogeneous. You should take the time to travel to some of the other States. While there is great commonality, there is also great diversity.
As Mr. Fusion asked, why have any other government than the Federal government if this is your attitude? If the Feds can do everything better than everyone else, then they should manage DMV, schools, water, fire, police, (all) roads, finance etc. We should simply dismantle the City, County, and State governments. Most people understand that this is a ridiculous stance. Another suggestion would be that you should either personally work at the State *and* Federal level or spend more time talking to people that have worked at both levels. You would be shocked how poorly run many Federal agencies really are.
It is sad, almost scary, really that you simply are incapable of understanding why one solution to rule them all is a bad idea. I’m beginning to get a small glimpse into problems that Jefferson dealt with when he proposed a republic.
Obviously, it has been longer than you think since your civics training. Instead of continuing to stick your foot in your mouth with regards to a Federal solution you should sit down and read a bit more history. Claiming that arguing for State’s rights is a one-trick pony is like the creationist that argues that the scientist is a one-trick pony. You appear to be suffering from the delusion that whatever national solution might be offered will work out of the gate for everyone everywhere and history has proven that is simply not the case.
Lastly, let me offer you a word of advice. I would recommend refraining from silly name calling. It tends to cement a low opinion of your intellect in everyone that reads your comments. It might sound cute at the time your write it but it reads like a fourth grader.
Thomas, the EU doesn’t operate the way you envision. So many things are decided across all states. For example, they mandate selling everything in metric, with some Brits being arrested. The states may get some vetoes, but not much.
Take a look at immigration. Here the Feds are doing one thing, somewhat open borders that lets in hundreds of thousands a year, with little interior enforcement, while different states and localities are doing their own thing. arizona is now requiring businesses to use the (federal) basic pilot enforcement for verification, some number of cities and counties are ticketing landlords who rent to illegals, etc.
>>> health care provision is on a COUNTRY-BY-COUNTRY basis.
>>Exactly. Which is why it should be State by State.
That pretty much sums up how much sense your entire argument has made, Train Man. None. Except for agreeing with the self-evident fact that our ability to provide medical care is a shambles because of the Health Care Denial industry, just about nothing else you have said makes any sense.
btw, I have been to every single state in this great nation of ours (except for Oregon, for some reason) and one thing that has impressed me with the diversity is that, for the most part, the concept of a “state” is virtually meaningless. Geographic regions, towns, villiages, sure. But YOU should take some time out to travel to some of the other states, Zuggie. If you think that California, Washington, New York, Massachusetts, Florida, or just about any other state is a homogeneous societal entity, it’s obvious you haven’t been anywhere.
As to shocking me, very little shocks me any longer, Train. I have seen town councils in East Bumfuck that are run so poorly they should be indicted. Small is not always good. And it has been my experience that the less oversight something gets (e.g., the smaller the unit of government), the more opportunity for mischief, abuse, and incompetence. Not every small-town police department is run by Andy Griffith, you know.
That’s why United States universal health care must be UNIVERSAL (within the universe of the United States, that is). Single-payer, sponsored by the federal government. Your state by state notion might be a nice pipe dream, but that’s all it is. A pipe dream. If it ever DID happen, we would be guaranteed to get a few good systems, and a bunch of shit.
Oh, but then we can pack up our families and move to another state, right? Once you get out and see some states, maybe it will dawn on you that it’s a long way from Abilene TX of Albuquerque NM to another state.
>>For example, they mandate selling everything in metric,
>>with some Brits being arrested.
That’s pretty zealous on the part of the EU, since the ban on anything other than SI units of measure doesn’t go into effect until 31 December 2009!
>>Feds are doing one thing, ……, while different states and
>>localities are doing their own thing.
Sounds like a great argument for FIXING THE FEDERAL SYSTEM. So what if Texas puts up an absolutely impenetrable border, if California, Arizona, or New Mexico decide to sink all their money into health care (e.g.), and just let people waltz over from Mexico? Then we can put up fences between states too?
Anything that is important enough to be a matter of life and death for ALL AMERICANS (e.g., health care) should be administered at the federal level. And what better time than now, before we get some 100-year-old beaurocracy entrenched, and while candidates are falling all over themselves (at least the ones who have any chance of being elected) to some up with a workable concensus system?
#123 – Thomas,
In every point you make, where you chide the State governments, substitute “Federal” for “State” and you have the same situation if not worse.
The same, probably. I agree. However, if you agree that federal and state can be substituted in this manner, why is all the duplication a good thing? You say we already have much duplication, also agreed. But, again, do you think that’s good?
…How those standards are enforced is an entirely separate topic.
Not in my mind. In my mind, the practicality of this is exactly the issue. What good are federal standards that remain unenforced?
#124 – Thomas again,
Frankly, if the States had implemented SS instead of the Federal government some of them might actually not be bankrupt instead of all them being bankrupt.
Actually, Social Security remains the most well-funded and least bankrupt portion of the federal budget. It will be fine for at least another 40 years with minor tweaking if no one allows people to invest their own money, though less than 10 if people are given control of their funds. This is why the federal government always includes it as a line-item in the rest of the federal budget even though they are not allowed to do so. It makes the rest of the accounting look far better than it is.
#126 – Thomas again and again,
> health care provision is on a COUNTRY-BY-COUNTRY basis.
Exactly. Which is why it should be State by State.
Huh??!!? Are you saying our states are really countries? Do we have different passports? Can our states go against the Supreme Court? Can our states implement laws in contradiction to federal laws? Do our states each have their own currencies? Border patrols?
>>Huh??!!? Are you saying our states are really countries?
I think that just as he has deluded himself into believing that states are homogeneous entities, Thomas believes that countries in the EU are also homogeneous. Therefore, if you know one Irishman, Belgian, or Italian, you pretty much know them all.
Don’t mind him. He doesn’t get out much.
1. The US is first and foremost a federation of States. We have lost our way in the past fifty years in some respect but fundamentally it is still true. If you think the Federal government is the end-all-be-all then why don’t we get rid of all governments from city up through State? Only a fool would think that is a good idea.
2. You are still seemingly incapable of understanding that for the very reason that poorly run government exist is why we should not implement health care coverage at the Federal level. Spend some time understanding system design and single points of failure. Perhaps you might eventually understand….Perhaps.
3. “Fixing the Federal system.” This is yet another example of your complete lack of understanding of how governments operate. The Federal government is too big and has too much power to “fix”. You have 536 people governing 300 million. The ratio is simply too large for them to be responsive. The best way to “fix” the Federal government is to take power and responsibility away from it and/or not give it any more.
4. Duplication. First, while many of the State organizations are *similar* they are not exactly the same. Second, by having multiple systems you enable the ability to determine what works and more importantly, what does not with less impact from problems than if those occur at the Federal level. Third, systems that efficiently work for a State like Vermont may not make sense for a State like California. This is true in business as well. Processes that work for smaller businesses do work in larger corporations and visa versa.
5. Social security. If you think that Social Security is not bankrupt then you are truly out to lunch.
6. States vs EU. Specifically, why should we treat the situation differently? Hell, there are differences in culture even in different parts of California much less the rest of the country. With respect to health care, just as the EU cannot and does not desire to implement one solution imposed on everyone so too should we not do that with the States. Every State has bright people that might think of solutions that the other States did not. The EU comparison is to illustrate that the US was also founded on the principle of independent States working together. That does not mean one bully government to push the others around like you want.
Frankly, if you cannot grasp that centralized power is bad then you are clearly lost. The fact that you don’t understand is yet another reason we should have separate solutions in each State. Those that live in States other than yours definitely do not want to have to deal with a Big Brother solution run by someone with the same concepts of centralized power such as yourself.
> Processes that work for smaller
> businesses do work in larger corporations and visa versa.
That should be:
Processes that work for smaller businesses do NOT work in larger corporations and visa versa.