Washington Post columnist Robert Samuelson isn’t impressed with the “public option.” Here’s a key paragraph:
The promise of the public plan is a mirage. Its political brilliance is to use free-market rhetoric (more “choice” and “competition”) to expand government power. But why would a plan tied to Medicare control health spending, when Medicare hasn’t? From 1970 to 2007, Medicare spending per beneficiary rose 9.2 percent annually compared to the 10.4 percent of private insurers — and the small difference partly reflects cost shifting. Congress periodically improves Medicare benefits, and there’s a limit to how much squeezing reimbursement rates can check costs. Doctors and hospitals already complain that low payments limit services or discourage physicians from taking Medicare patients.
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Counting on miracles — things that have never happened before despite many people’s efforts over time — is not a strategy.
It’s always good to approach these things with caution, but in a lot of ways that’s a false comparison. Medicare doesn’t really compete with anyone – it dominates the market for insurance for the elderly. There is some supplemental insurance, to be sure, but Medicare is essentially a monopoly.
Presumably the public option would be competing more literally with private insurance companies. However, I think the lesson still stands – a fee for service system where benefit levels are going to be a political football, costs are shifted to the private market, and no good cheap catastrophic coverage is offered on the menu of plans is not going to be a good public option.
Medicare doesn’t really compete with anyone…
Medicare was supposed to keep seniors from paying a lot of money in out of pocket expenses for their medical care; that hasn’t been the case. It has failed with regard to its primary mandated. Medicare does in fact compete … with the money that seniors pay out of pocket for services.
Anyway, since the public option really is just a stalking horse for single payer, the comparison is spot on.
“since the public option really is just a stalking horse for single payer, the comparison is spot on”
Why do you say that? I mean – I can see how it’s convenient for your argument but do you have any other reason? It seems to me you’ll have a hard time convincing anyone that doesn’t already agree with you unless you explain why it’s a stalking horse for single payer. After all, if we’re going to go back and dig up the mandate of Medicare, wasn’t the fear back then that that would lead to single payer? How did that work out? Most people that like the public option wouldn’t stand for single payer. Combine those people with the people that never liked the public option to begin with and you have an overwheliming majority that’s not going to let single payer happen.
But you’re right – roping them together a priori and imagining to yourself that everyone secretly wants single payer does help your case quite a bit.
Because advocates of the public option have stated that it is a way to get to single payer, that’s why.
I would note that the majority of nations with “socialized medicine” do not have public option components at all or or any significant size. So why the hard push for a public option exactly? I would argue that is largely because single payer is something that some believe in reflexively.
Well of course some advocates support that – but how many, mommsen1625? Some people that choose to label themselves conservatives advocate the violent overthrow of the U.S. government or white supremacy. That doesn’t taint all conservatives. It would be ridiculous and offensive to suggest that it does.
I personally am not “pushing hard” for it. It’s last on the list of things I advocate. And I’m even less enthused with the a public option now that it looks like we’re going to have this ridiculous mandate. Seems to me it’s a bad idea to create a new program at the same time that you dump tens of millions more people on the market.
Pre-match, much had been made of United fans’ mischievous plans to bring beach balls into the ground, and kick-off was slightly delayed as a host of inflatables rained down on one penalty area – although not, as expected, thrown by United fans but rather by home supporters on the Kop.
Heh, wtf – not just that this is clearly on the wrong blog (disqus bug?) but I actually completely comprehend your post as I watched that match.
The ironic part is that most of the beach balls thrown by United fans had Liverpool’s logo on it. So the Liverpool club actually benefitted financially from this “prank.”
“From 1970 to 2007, Medicare spending per beneficiary rose 9.2 percent annually compared to the 10.4 percent of private insurers — ”
Robert Samuleson
First of all Samuelson’s numbers are not supported by the data as collected by The Henry J. Kaiser Foundation. See their Medicare Primer below. Also note that private health insurance IS heavily government subsidized as well.
Second, Medicare cost have increased in large part because of Medigap insurance provided by private insurers and because of the lobbyist written give away that is Medicare part D.
Third think of what private insurance does and what medicare does.
Medicare takes care of the sickest people in our population those over 65. It denies no one. Private insurance cherry picks the healthiest people all under 65 , denies coverage for pre-existing, sets yearly caps and rescinds policies regularly.
If you force a level playing field it won’t even be close.
I hate when people have to lie and distort to make a point and think they’ve served some purpose.
Again all we have to do is look at the 30+ other countries with public plans that run for as much as half of our costs.
http://kff.org/medicare/upload/7731-02.pdf
Over the long run, average
growth in Medicare spending
per beneficiary has been lower
than per capita growth in private
health spending for comparable
benefits, although over some
periods of time the opposite has been true (Exhibit 7).
Medicare (average annual growth = 8.5%)
PHI (average annual growth = 9.7%)
There is a fair amount of evidence that medicare part D has actually saved a lot of money. That shouldn’t be that surprising; on average treating something with drugs would seem to be just at face value cheaper than other types of treatments.Again all we have to do is look at the 30+ other countries with public plans that run for as much as half of our costs.They are cheaper in large part because they deny certain types of care that can be found in the U.S. Of course in those countries as they have become wealthier there has been a significant amount of pressure to increase what will be paid for, how quickly it is delivered, etc.
It is also the case that lots of medicare patients end up in ERs because they cannot find PCPs that will take them. Unless you make all doctors, etc, state employees or you ban private insurance or any sort of private payment I don’t see anyway around that except increasing what medicare pays for services.
“There is a fair amount of evidence that medicare part D has actually saved a lot of money.”
Really? It was unfunded. No tax increase to pay for it.. nothing. How did it save money.
Other countries do restrict care just as we do. Their outcomes are certainly no worse.
Medicare patients show up in ED’s because they are sick just like any other sick patient. They almost ALL have private doctors to care for them. Definatly there are reimbursment issues that distort payments to doctors that make no sense. The Republicans recently voted down a bill to fix this problem.
We don’t restrict care in the U.S.; you can get any kind of care you want to in the U.S., as long as you get the financing for it. In many other countries you can have all the money in the world and some procedures are still not allowed. That is really the difference between the state making these choices and the market; in the marketplace I can still seek charitable contributions to get over some financial hurdle, with the state, well, if some bureaucracy determines that the treatment doesn’t fit some CBO, well, I don’t get the treatment no matter what my resources are.No, they show up at ERs because doctors refuse to take them as regular patients.
idiot.
Engrossing contribution, matt
Please stop calling Muirgeo names. If you dislike or dispute what he writes, either address his points substantively or ignore him (as I do).
I agree wholeheartedly that his grasp of the (genuinely) liberal case for markets is weak and that he misses the substance of posts and others’ comments with remarkable regularity. But intellectual failings are not moral failings, and ought not elicit emotional responses.
I want to be clear WHY I ignore Muirgeo. I ignore him NOT because I disagree with him, but because he too seldom engages other persons’ arguments on their best terms.
Because he too-seldom knows what others are talking about, he too-seldom knows what he himself is talking about when he thinks that he’s responding to, or otherwise engaging, other persons’ arguments.
Fair enough. I only restarted calling him names when the format for commenting was changed.
But anyway, I have a question… Why is calling him an idiot worse than what he writes? At least “idiot” is short. You’d probably make just as much sense saying “Muirgeo, please stop writing things. If you dislike or dispute what I write, either address my points substantively or ignore me.”
Biscuit!!! Good Boy!!!
The numbers that Samuelson used are similar in nature to the one’s you site (though I wish he referenced his source): Medicare is the lower of the lower of the two that he cites (9.2 v 10.4), just like the one’s you cite. Thus Samuelson’s point still stands that the difference is from cost shifting from Medicare to PHI.
The “public option” is really a monopoly option.
When a foreign government subsidizes a car company, so that it could better compete with American car companies, we call that unfair competition, aimed not at enhancing but eliminating competition.
Why is the “public option” in health care any different, any less unfair to private companies, and any less destructive of competition?
Because government bureaucrats are perfect in their decisions and they have hearts of gold.
Why does it seem like a government takeover of the health insurance industry and ultimately health care, in some manner, is inevitable? I’m left wondering what an average guy like me can do to help make this less inevitable.
Well, one thing we can be assured of is when the politicians totally screw this up they will blame it not on themselves and their “perfect system” but on the unwillingness of the market to fit into their “perfect system.”
Of course. Don’t you realize that the only reason we need health care reform is because the free market failed?
So what do we do Mommsen1625? I don’t like giving up my freedom and I don’t like seeing the public in general get lead into this con-job.
The best we can hope for is an individual opt out.
Lots, as best as I can tell, particularly in the political class.
In response to “Why shouldn’t we start with single payer new?” Barny Frank replied “Because we don’t have the votes for it. I wish we did. I think that if we get a good public option it could lead to single payer and that is the best way to reach single payer. Saying you’ll do nothing till you get single payer is a sure way never to get it. … I think the best way we’re going to get single payer, the only way, is to have a public option and demonstrate the strength of its power.”
There’s no stalking horse, it’s out in the open.
PARTICULARLY in the “political class”, huh? I can only think of couple in the “political class” – and I’d agree with you, the sentiment is probably even smaller outside the “political class”.
But you know, I am only a moderate Democrat. I’ve even voted for several Republicans. Maybe they don’t trust me enough to teach me the secret handshake yet, at which point I will get insight into the massive groundswell of support for single payer.
Yes – Barney Frank. You want me to give you another one? Bernie Sanders. Obama even did at one point – he suggests he’s changed his mind and I think that’s pretty credible. There are others too.
I don’t recall ever suggesting that no one residing between the Atlantic, the Pacific, Canada, and Mexico supports single payer.
I’m neither a Democrat nor a Republican, so I really don’t care whether you are a moderate Democrat or a moderate Republican. I stand with the long tradition in liberal thought that political parties are vile.
I can only think of couple in the “political class”…
I have no doubt that the vast majority of Democrats in Congress would vote for a single payer if they thought that was politically feasible.
What exactly is a “moderate Democrat” anyway? Sounds like a fairly meaningless phrase.
If the current President of the United States isn’t one of the couple you can think of, then push your list to three. Obama has stated emphatically that he wants single-payer.
The US National Health Care Act, by John Conyers is a bill calling for universal, single-payer health care. It has 88 co-sponsors. That’s about 1/3 of the Dimocrats in Congress as co-sponsors. Quite a few more than a couple.
Obama’s not the king that Yasafi makes presidents out to be, but he has plenty of support from the socialist wing of the Dimocrat party. The Swimmer championed single-payer ever since he climbed out of Chappaquiddick. Chuckie-doll Schumer wants single-payer, and has openly discussed ways to force it past a filibuster and past public opposition. Steven Gobi’s ex-boyfriend is in favor of single-payer. That’s some pretty heavy hitters at the top of the Dimocrat Party weighing in for totalitarian medicine.
You don’t need a secret handshake. They’ve never been shy about this particular piece of socialism.
Why do you think Obama’s change is credible?
The list of co-sponsors of The US National Health Care Act mentioned in my post, above:
Rep Abercrombie, Neil [HI-1] – 2/11/2009
Rep Baca, Joe [CA-43] – 10/7/2009
Rep Baldwin, Tammy [WI-2] – 1/26/2009
Rep Becerra, Xavier [CA-31] – 3/17/2009
Rep Berman, Howard L. [CA-28] – 1/26/2009
Rep Bishop, Sanford D., Jr. [GA-2] – 2/23/2009
Rep Brady, Robert A. [PA-1] – 2/11/2009
Rep Brown, Corrine [FL-3] – 3/3/2009
Rep Capuano, Michael E. [MA-8] – 2/23/2009
Rep Christensen, Donna M. [VI] – 4/21/2009
Rep Chu, Judy [CA-32] – 7/31/2009
Rep Clarke, Yvette D. [NY-11] – 1/26/2009
Rep Clay, Wm. Lacy [MO-1] – 1/26/2009
Rep Cleaver, Emanuel [MO-5] – 2/23/2009
Rep Cohen, Steve [TN-9] – 1/26/2009
Rep Costello, Jerry F. [IL-12] – 2/3/2009
Rep Cummings, Elijah E. [MD-7] – 2/23/2009
Rep Davis, Danny K. [IL-7] – 1/26/2009
Rep Delahunt, William D. [MA-10] – 1/26/2009
Rep Dicks, Norman D. [WA-6] – 6/15/2009
Rep Doyle, Michael F. [PA-14] – 1/26/2009
Rep Edwards, Donna F. [MD-4] – 1/26/2009
Rep Ellison, Keith [MN-5] – 1/26/2009
Rep Engel, Eliot L. [NY-17] – 1/26/2009
Rep Farr, Sam [CA-17] – 1/26/2009
Rep Fattah, Chaka [PA-2] – 2/11/2009
Rep Filner, Bob [CA-51] – 2/11/2009
Rep Frank, Barney [MA-4] – 1/28/2009
Rep Fudge, Marcia L. [OH-11] – 6/2/2009
Rep Green, Al [TX-9] – 2/23/2009
Rep Grijalva, Raul M. [AZ-7] – 1/26/2009
Rep Gutierrez, Luis V. [IL-4] – 1/26/2009
Rep Hare, Phil [IL-17] – 6/11/2009
Rep Hastings, Alcee L. [FL-23] – 2/23/2009
Rep Hinchey, Maurice D. [NY-22] – 1/26/2009
Rep Hirono, Mazie K. [HI-2] – 2/23/2009
Rep Holt, Rush D. [NJ-12] – 6/12/2009
Rep Honda, Michael M. [CA-15] – 2/11/2009
Rep Jackson, Jesse L., Jr. [IL-2] – 3/5/2009
Rep Jackson-Lee, Sheila [TX-18] – 1/26/2009
Rep Johnson, Henry C. “Hank,” Jr. [GA-4] – 2/3/2009
Rep Kaptur, Marcy [OH-9] – 1/26/2009
Rep Kennedy, Patrick J. [RI-1] – 2/23/2009
Rep Kildee, Dale E. [MI-5] – 2/23/2009
Rep Kilpatrick, Carolyn C. [MI-13] – 1/26/2009
Rep Kucinich, Dennis J. [OH-10] – 1/26/2009
Rep Lee, Barbara [CA-9] – 1/26/2009
Rep Lewis, John [GA-5] – 3/17/2009
Rep Loebsack, David [IA-2] – 3/24/2009
Rep Lofgren, Zoe [CA-16] – 5/20/2009
Rep Lujan, Ben Ray [NM-3] – 3/24/2009
Rep Maloney, Carolyn B. [NY-14] – 2/23/2009
Rep Markey, Edward J. [MA-7] – 6/12/2009
Rep Massa, Eric J. J. [NY-29] – 1/26/2009
Rep McDermott, Jim [WA-7] – 1/26/2009
Rep McGovern, James P. [MA-3] – 3/3/2009
Rep Meeks, Gregory W. [NY-6] – 1/26/2009
Rep Miller, George [CA-7] – 3/19/2009
Rep Moore, Gwen [WI-4] – 2/11/2009
Rep Murtha, John P. [PA-12] – 7/9/2009
Rep Nadler, Jerrold [NY-8] – 1/26/2009
Rep Napolitano, Grace F. [CA-38] – 1/26/2009
Rep Norton, Eleanor Holmes [DC] – 5/20/2009
Rep Olver, John W. [MA-1] – 1/26/2009
Rep Pastor, Ed [AZ-4] – 3/19/2009
Rep Payne, Donald M. [NJ-10] – 3/3/2009
Rep Pingree, Chellie [ME-1] – 1/26/2009
Rep Polis, Jared [CO-2] – 1/28/2009
Rep Rahall, Nick J., II [WV-3] – 9/29/2009
Rep Roybal-Allard, Lucille [CA-34] – 3/30/2009
Rep Rush, Bobby L. [IL-1] – 2/23/2009
Rep Ryan, Tim [OH-17] – 3/5/2009
Rep Schakowsky, Janice D. [IL-9] – 2/23/2009
Rep Scott, Robert C. “Bobby” [VA-3] – 2/23/2009
Rep Serrano, Jose E. [NY-16] – 6/9/2009
Rep Thompson, Bennie G. [MS-2] – 2/23/2009
Rep Tierney, John F. [MA-6] – 1/28/2009
Rep Tonko, Paul D. [NY-21] – 1/26/2009
Rep Towns, Edolphus [NY-10] – 3/31/2009
Rep Velazquez, Nydia M. [NY-12] – 2/23/2009
Rep Waters, Maxine [CA-35] – 3/19/2009
Rep Watson, Diane E. [CA-33] – 1/26/2009
Rep Weiner, Anthony D. [NY-9] – 7/9/2009
Rep Welch, Peter [VT] – 2/23/2009
Rep Wexler, Robert [FL-19] – 2/11/2009
Rep Woolsey, Lynn C. [CA-6] – 1/26/2009
Rep Yarmuth, John A. [KY-3] – 2/23/2009
Obama lost all credibility with the auto bailouts.
Because he hasn’t even mentioned it for six years now, and he’s deliberately shut out Congressional single-payer advocates from White House talks on health reform. We’ve seen this in a lot of areas where Clinton-era economic advisors repeatedly come out on top in disputes in the administration. He shows a strong preference for that wing of the party, rather than for the liberal wing. Maybe he’s not virulently opposed. Maybe he holds out with a “well in a perfect world maybe this would be a good idea” sentiment. But I see no reason to believe he wants single payer as a practical matter. Do you have any reason to believe it, besides a 2003 speech that he gave to a union?
It doesn’t matter so much what Obama says or doesn’t say as much as what congress does.
The public option is a stalking horse for single payer; there is really no other way of looking at it.This is why “create or save” Obama uses weasel language like a public option not “requiring” one to change their current system of health care finance.
I’m not as trusting as you. He’s a politician. I don’t think he would view it his support for a public option as an effective means to the end.
But, that’s really beside the point. As usual with politics, we’re judging something based on someone’s intentions. Does he intend to get it or not? Who cares?
The real question is whether the changes that are being proposed would actually lead to it or not?
Well we’re just playing a who’s who of single payer supporters. That’s why we’re talking about what Obama says and believes.
Hey man. stop playing who’s who.
It’s not like single payer advocates are scary. In most instances I think they just have different priorities – equality in care, as opposed to innovation and quality of care, for example. But the fact is, single payer is a minority position. It’s a red herring. And it’s not the public option.
Not to mention the fact that I’m not even sure Medicare for all (that’s what the Act is billed as) is even really single payer. There will still be private insurance, after all. Still not something I’d want to see, but my point is even this minority of Democrats still isn’t the actual population that would support single payer.
You offensive piece of stinking garbage! I wouldn’t have an argument with you if your entire family’s staving off bankruptcy because of a catastrophic illness depended on it.
LMAO!!!!!!!!!!!!!!
“I can only think of couple in the “political class” is what you wrote.I pointed out that one third of the House Dimocrats were willing to co-sponsor single-payer legislation. Not an insignificant number.
danielkuehn: “I can only think of couple in the “political class”So brotio tries to help daniel by providing a list of 87 members of Congress who voted for the single payer option. Daniel’s response? Redefining the word “couple” rather than admit he didn’t have all the facts when he first commented:danielkuehn: “But this list is STILL a minority of the House Democrats”daniel, learn to admit when you are wrong. When you persist in the face of contrary facts and better arguments, you just hurt your own credibility. Your contributions here would be much better received if you were a little more realistic about not being right all the time.I don’t expect you to publicly accept advice, but I still have hope you will consider it.
Learn to provide comments on here other than figuring out how to tell me I’m wrong. I could only think of a couple. Brotio provided a much longer list. I’m glad he did, but I could only think of a couple. Was I wrong to say I could only think of a couple when I could actually only think of a couple? And the underlying point remains – single payer isn’t particularly popular. Besides, I admit I’m wrong when I’m wrong – I admited I was wrong on the small business/minimum wage thing and you still hounded me. I’m fine admitting when I’m wrong – but those aren’t words I’ve ever heard you utter.
It’s not really a matter of trusting him – it’s a matter of thinking I have no reason to believe he still does – the evidence just doesn’t seem to be there, regardless of his trustworthiness. But I agree – it’s what they do that matters. And I’m very concerned that it looks like a public option will get passed on top of a mandate. We know from Massachusetts that that’s not a fiscally sustainable combination. Whether it will morph into single-payer, I don’t know. But I don’t think it will be good.
Not an insignificant number at all – and I’m glad you posted it. It still doesn’t alter the fact that I couldn’t think of 87 people before you posted it – I could only think of a couple!!! A third of the House Democrats, but only a fifth of the total House. This is not a popular policy, which is the whole point – we need to stop wetting our pants over some mythical single payer system on the horizon.
That’s a much better response, Daniel. Except for the insulting part about wetting our pants.
Single payer system is hardly mythical. For about 40 million senior citizens it is very real.
That’s a much better response, Daniel. Except for the insulting part about wetting our pants.
Single payer system is hardly mythical. For about 40 million senior citizens it is very real.
I’ve been providing insights and asking questions at Cafe Hayek for over three years, Daniel. I much prefer adding arguments and data for posts I agree with. But I have no intention of letting blatant errors by arrogant closet socialists and other self-proclaimed “moderates” go unchallenged. So either get used to it or start checking facts before you comment.
I’ve been providing insights and asking questions at Cafe Hayek for over three years, Daniel. I much prefer adding arguments and data for posts I agree with. But I have no intention of letting blatant errors by arrogant closet socialists and other self-proclaimed “moderates” go unchallenged. So either get used to it or start checking facts before you comment.
Not insulting, just driving the point home. I don’t literally think you have a problem with bladder control. I guess it’s good if you think it’s a better response. I’m not really sure what’s different about it.
Not insulting, just driving the point home. I don’t literally think you have a problem with bladder control. I guess it’s good if you think it’s a better response. I’m not really sure what’s different about it.
I don’t have a problem with you responding in a thoughtful way. It gets old when you go on withchunts because you see socialists lurking in every corner.
I don’t have a problem with you responding in a thoughtful way. It gets old when you go on withchunts because you see socialists lurking in every corner.
Not sure if you’ve picked up on this yet, daniel, but I really don’t care what “gets old” to you. I’m going to continue to correct bothersome mistatements by you and by anyone else.
Witchunts? That’s funny!
Not sure if you’ve picked up on this yet, daniel, but I really don’t care what “gets old” to you. I’m going to continue to correct bothersome mistatements by you and by anyone else.
Witchunts? That’s funny!
Makes no difference to me if you care or not – I never really expected you did. If you did I wouldn’t imagine you would always drone on the way you do.
Makes no difference to me if you care or not – I never really expected you did. If you did I wouldn’t imagine you would always drone on the way you do.