Sunday, June 21, 2009

Comment rescue--er, maybe comment kidnapping: Why not Single-payer

Again, cassandra has an interesting post up at Delawareliberal with a lot of interesting nuts and bolts links.

Cassandra herself has a very important point to make following a riff on single-payer as the secular equivalent of the rapture:

Comment @3 is a big example of what is wrong with the single payer arguments as made — lots and lots of claims made for how much better it is, but no discussion on how it would be implemented here. Implementation is the battle and there is a reason Dems took it off the table. The politics does matter.

This comment is spot on, because the politics and the motives do matter.

Here's the comment from that thread I wanted to rescue, or kidnap, from [unfortunately] an anonymous:

Single-payer is nice if you can get it.

Until then, ugly as it is, a public option is more progressive than what we have now, because the haves will be taxed to pay for coverage for the have-nots, who are currently not being covered at all.

Once the taxes get high enough, the haves will rebel and look for cost savings, which will be found by moving to single-payer.

(well, first they will try to cut service or kick the have-nots out to save money, but we won’t let ‘em).

Anonymous [not to be confused with Anonone, who at least has a distinctive persona] is a primary example of what many opponents or skeptics about health care reform fear: that the object of the process is as much to raise taxes on the haves as it is to extend health care to the have nots.

Within the health care debate, unlike the presidential campaign season wherein then-Senator Obama defined those who needed to pay more as families with incomes over $250K, the current plans on the table include taxes on workers with health insurance whose premium value exceeds $13K per year: which is, to cite but one example, any Delaware State employee with a Family Health Plan.

In other words: a school bus driver or cafeteria worker making $18-22K per years is suddenly a have for tax purposes in the progressive health care agenda.

We tend to forget that when we say 50 million Americans do not have health insurance we are also saying that over 250 million Americans do have such coverage, and that those 250 million folks cover an extremely broad range of incomes. It is even true that many who do have health insurance make less money than some who don't.

What I've noticed in the health care debate is what the military tends to call mission creep. First, we were talking about making sure that all Americans had access the health care, which generally meant making sure that the 50 million with no health insurance had at the very least basic access. Then we started expanding this to tinkering with the issue of under-insurance and regulating the profits of the insurance companies. Then we moved into discussing a public option that anyone would be able to take, paid for by the taxpayers but nonetheless somehow on a level playing field with private insurance. Then we had the people talking about the public option as only a stealth pre-cursor of single-payer.

Finally, full circle, we have those who think health care reform is the perfect excuse to ramp up government to address perceived wealth inequities in our country, and to redistribute resources between the have and have nots.

When you reach that point, you're no longer talking primarily about health care any more.

Which is why so many people don't trust so many of the so-called advocates for change.


jacksmith said...
This comment has been removed by a blog administrator.
Steven H. Newton said...

The previous comment was deleted as spam. Jacksmith has posted this comment verbatim at every blog that has discussed health care reform.

Nancy said...

An anony OUTING riff ~

Besides what a great post Cassandra wrote, one of the things that jumped out at me was that Cassandra went ahead and 'outed' Liz Allen on that comment...FWIW.

And now you have done the same, prof. Perhaps it is Liz wanting to be anonymous. What hypocrits some of you are --CASS--.

Liberal Geek did that to me once when I didn't attach my name to a comment --deliberately. LG decided to attach my name to the post 'for me'.

Liz may well have written that post on DL but she knows how to include her name should she choose to do so.

Steven H. Newton said...

Mea culpa, Nancy.

I was not reading carefully--saw Cass respond to the previous comment and did not note is was unsigned. Liz often posts under anonymous but then signs her name.

I have corrected the post, although you cannot unfire a weapon.

Bowly said...

It never ceases to amaze me how casually some people will justify tyranny.

Bowly said...

Further, I do not believe that admitted thieves (I have no other way to describe someone who wants to take things away from one person and give them to another) have a right to anonymity. If I rob a bank, the cops won't let me walk because I was wearing a mask and didn't leave fingerprints.

Further, there is no right to anonymity. If anything, it's the other way around--if someone discovers your identity, they have the right to publish it. If blogging had been around in 1974, do you think an enthusiastic blogger would have sat on the identity of Deep Throat?

If you want to remain anonymous, I suggest shutting up.

Anonymous said...

I guess that means you too, Bowly.

Isn't Bowly about as anonymous as anon?


Anonymous said...

Steve, not only do we have healthcare coverage shortfalls to deal with, we also have costs.

It seems to me that a public option, which covers only primary healthcare, would compete with the private sector to lower costs.

The private sector could then compete in the supplementary insurance arena, and could even bundle it in with primary coverage.

If the public option eventually leads to single payer, is that so undesirable? Following up from Cassandra's post on DL, there are a number of nations that run a single payer system quite effectively.

Anecdotally, I have travelled to several single payer countries like Finland, Norway, and Great Britain, and found people generally quite happy with their systems.

We can cherrypick from these systems to choose what is best for us within our budget constraints. To go on as is is unsustainable - everyone agrees on that it seems!