Fiscal Responsibility

Sara - posted on 08/13/2009 ( 12 moms have responded )

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So, I'm curious what some of our Conservative cohorts think of this. This is from a blog by Andrew Sullivan in the Atlantic...he's a conservative blogger who has been, up until recently, against health care reform. Thoughts?



Conservatism And Healthcare

I find myself again in agreement with David Frum. It was one thing to oppose greater government involvement in healthcare in 1993. It is another to do so in 2009. There are several reasons for this and it is hard to improve on David's summary of them. The status quo means:



(1) flat-lining wages, (2) exploding Medicaid and Medicare costs and thus immense pressure for future tax increases, (3) small businesses and self-employed individuals priced out of the insurance market, and (4) a lot of uninsured or underinsured people imposing costs on hospitals and local governments. We’ll have entrenched and perpetuated some of the most irrational features of a hugely costly and under-performing system, at the expense of entrepreneurs and risk-takers, exactly the people the Republican party exists to champion.



I'd add the crippling health costs for the private sector - costs that are slowly killing their global competitiveness. But the deepest reason for reform is fiscal. No serious plan to reduce deficits without hugely increasing taxes excludes healthcare savings. There's no way to get from spiraling debt to stable public finances without tackling the exponentially rising costs of healthcare. So this is a fiscally conservative issue.



Instead of pulling a Palin, conservatives should propose real reforms: ending the tax exemption for businesses; medical malpractice reform; an independent body to provide some kind of data on the relative effectiveness of treatments; incentives to reward doctors less for any and all services provided than for health outcomes within clear budgets. This, actually, is not far from the Romney model, as the NYT notes today. Real conservatives should point out that the current proposals are not tough enough on costs - and criticize Obama for that, not for fantasies like a communist takeover or euthanasia program for special needs kids.



The Romney-Obama model will require fiscal boundaries to healthcare provision and this will mean a trade-off that will be hard to postpone much longer. We'll get less innovation, and probably some rationing at some point. But that is already happening - the rationing is done by insurance companies.



One final thing: most Americans do not want people dying in the streets.







If you have guaranteed emergency room care for the uninsured at public expense, you have already effectively socialized medicine. It makes no sense not to bring these people into the insurance system, and to offer less expensive, long-term preventive healthcare. To insist that ideology stand in the way of this piece of compassionate common sense is irresponsible.



I've come to accept that the fiscal and economic costs of the current system, however wonderful it has been for a few decades, simply cannot be sustained much longer. I say that not because I have become a socialist, but because the US is on the brink of the kind of bankruptcy it will be very hard to recover from if we do not tackle its source now. Taking measures to avoid fiscal collapse even greater than today's is a conservative impulse. Letting one sector of the economy destroy the rest of it - and public finances too - is sheer recklessness.



What do you want, GOP? A permanent populist culture-war? Or actual solutions to pressing problems? Let us know when you've matured enough to answer that question.

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Laura - posted on 08/16/2009

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Go Christa! I too agree that you explained it, that being the conservative objection, very well. It is alot to do with trust. Pelosi is a snake and no one wants anything to do with anything she's involved with for one. But it is also all the quick work that's been done and all the money that has been spent that I think this is the one thing that we've finally be able to say "Hey, let's slow down and take a look at what we are doing here for once.". Conservatives like a plan. They like to know where we are going, how much it's going to cost and what it's going to look like and they like to talk about it. We've pretty much been slapped around since Obama has taken office and have been made to feel like non citizens. It has now gotten old. It is also about trust. The last three Presidents have gotten in front of the American people and lied to us. Clinton about his relations with that girl, Bush about WMD's and now Obama about passing a budget with no earmarks when there were 9k. The first two weren't looking for such incredible changes. Obama is working with a snake, tax cheats, and he's already lied to us. What gets passed will not be able to be undone, this is what concerns us. Health care needs to be worked on, but let's work on it not just take the first liberal plan that comes along that the President himself didn't get to completely read at first.

Traci - posted on 08/14/2009

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I agree with Christa, the gov't should set the rules. But if they're setting the rules, they can't play the game, which is why a public option is ridiculous. Would it be fair for the referee to be playing for the home team? No way! The gov't doesn't have to compete, they can tax and print in order to make up for losses, insurance companies cannot do that. Look at everything the gov't runs losses in- the post office, Amtrak, just to name a few. Medicare has an unfunded liability at over 30 TRILLION dollars (go ahead and tax all the rich at 100% if you want, you still can't pay that), SS is broke, and they're both full of fraud. The gov't is inept...doesn't matter which administration it is, they are inept. It makes absolutely no sense whatsoever to give them one more thing to be involved in, they simply cannot handle the responsibility of it.



I don't understand the blind trust in that man. What is so wonderful about him? What is different than any other politician? How has he proven himself? He and his people are no different than any other administration that has ever served. It's still the same old political games, same old faces (with a few creepy czars added to the mix).

Christa - posted on 08/14/2009

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I guess it all comes down to trust. I don't trust him and I don't trust what he says. If you look at things he has said years before, before the campaign started, they don't match up with what he's saying now. So either, he's changed his mind or he has another agenda, but he has to hide it for now and get there through small steps. I truly believe that his ultimate goal is UHC, and that is what I and many others do not want. I've said it since the election, I hope I'm wrong about him, I hope he really means what he says, but so far I still don't trust him. AND I think Pelosi is pure evil so as long as she's behind things I really won't trust them.

Sara - posted on 08/14/2009

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But I don't think the stuff that is happening now is from left field. Obama talked about it pretty explicitly throughout the campaign...and a majority of Americans voted for him...



I can understand what your're saying Christa and thanks for taking the time to expain it! But, I guess I just don't understand why people think he's out to destroy America...that seems really out of line to me. You may not agree with the changes that are proposed, but they are only being made out of concern for our fractured system. I personally think that it's been so long since we truly had a President that wanted to employ such sweeping reforms that it scares people, and that's understandable, but this is why I voted for Obama, and I'm assuming why so many other Americans did too...change.



But thanks again for your answer, Christa...you just explained it better to me from your perspective than I've been able to get from anyone else so far. :)

Christa - posted on 08/14/2009

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Your not hearing the other side because no one will listen to them. I obviously don't have all the answers, but I know keeping the government out of it, is ALWAYS the best solution. They can't run anything more efficient. (Medicare, Medicaid, SS) No I don't think the government should talk to doctors about treatments. How is that any different from the insurance companies telling doctors what is and is not needed? I think the governments place is to step in a set some ground rules so that the insurance companies have to cover people in a way that is fair. I think they come in and regulate the industry and regulate costs. When I gave birth the hospital billed my insurance 10K, but the insurance company came back and said no it's only worth 4500 so that's what we will pay. The hospital took that and that was the end. Now if I have been a non-insured I would have owed the whole 10K, things like that need to be stopped. Obviously the actual cost was the 4500, so that's what should be charged. The insurance companies should not be allowed to deny a premium paying customer what is owed to them. I also believe that ALL preventative care should be covered 100%, I would be ok with the govt subsidizing that, if everyone gets the preventative care they need then that lowers costs and disease for everyone. Also I think people who have "Dangerous" habits should be charged a higher premium because they are more likely to use coverage. These would include obesity, smoking, drinking etc. Behaviors that can be changed, not something that genetically pre-disposes you. They do it for auto and home insurance why not health?



To answer your question about the anger, I think much of this comes from frustration over how the stimulus bill was handled. Shoved through practically in the middle of the night and most admittedly didn't read the bill. Now we have wasted billions of dollars unnecessarily and many of the conservatives don't want this to happen again with this bill. So they are standing up now to make sure they can't be ignored this time. There is also a fear that we don't have a voice and therefore no say in what goes on and let's face it we have a pretty liberal president and a VERY liberal congress that has no checks and balances. How would you have felt if Bush had had a very conservative filibuster proof majority while he was in office? I think you can imagine the kinds of things he would have tried to push through. Stem cell, abortion, gay marriage, etc. You would have been screaming just as loud in fear that he would get something through that you are fundamentally against and would be very hard to un-do once he was gone. That is where the anger and fear is coming from. We don't want to see Obama/Pelosi push their liberal agenda through, unchecked, and mess up the country we love for our children. Many people voted democrat in this election because they were mad/unhappy with the republicans, NOT because they wanted this super liberal agenda pushed through. Why do you think Obama's rating has plummeted in the last several weeks? He has had the biggest drop in the shortest amount of time of any other president. There is a solution out there for our healthcare problem and if we ALL could sit down and talk reasonably we may find the answer. However I don't know if the Dems can get over themselves long enough for that to happen, so I don't know how this will end.

Sara - posted on 08/14/2009

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But really, what I can't wrap my mind around is what exactly people are so angry about? The vicious anger from the far right seems totally out of proportion to these proposed reforms. Believing that we have a fascist/communist dictatorship, that there was some fraud allowing a non-citizen to become president, that the government is about to "take over" all healthcare provision all seems so incredibly absurd to me, and yet this is what I hear again and again as the basis for arguments against reform...and all of those things are blatant misinformation...they have no factual basis.



Here is what we are debating: should we demand that insurance companies provide policies to anyone regardless of pre-existing conditions? Should we help the working poor buy that insurance with subsidies? Are competitive exchanges for health insurance a good or bad thing? Would a public option or a co-op help bring down healthcare costs? Does it make sense for the government to study the effectiveness of various treatments as a guide for doctors? Those are the real issues...so why aren't we trying to solve these things instead of getting mired down in misconceptions and obstinance? I'd be happy to listen to suggestions on how we can fix the very serious problem with our system, because it needs to be addressed sooner rather than later, but that's not what I'm hearing...all I'm hearing are the LIES.

Christa - posted on 08/14/2009

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Oh yeah that's great. Just roll over and take it. I'll keep that in mind once we gain control back and are working on abortion legislation or something else you would fight kicking and screaming. Maybe the dems need to get over themselves and work on a compromise. Their current strong arm method is starting to fail them. There are a lot of people out there who have different opinions, they need to start listening to them.

ME - posted on 08/14/2009

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"If you have guaranteed emergency room care for the uninsured at public expense, you have already effectively socialized medicine"...



This is the part that gets me...WE ARE ALREADY PAYING FOR THEM!!!!!!!!!!!! Why not address it and regulate it, and make their care more cost effective. Don't conservatives like spending less money, and knowing what they are getting for it...?



And talk about lies..."death panals"...for real? Nice fear mongering SP...she got the (Liar, liar) "Pants on Fire" award from an idependent fact checking agency the other day...lmao! She may not be holding any offices any more...but she sure keeps sticking her nose into the mix every chance she gets...and there are a lot of deluded people out there who think her opinion is worth something...so she continues to be dangerous.



Lets just accept that this needs to get done, and do it...fighting, screaming, threatening, etc...not getting you anywhere!

Traci - posted on 08/13/2009

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So, he said we should end the tax exemption for businesses? Um...how about instead ALSO giving individuals a tax ememption on buying their own health coverage? That sounded very backwards to me...and-HELLO! Conservatives ARE begging for malpractice reform, but HE said no. Tort reform is off the table, the DNC gets waaaay too much money from the ambulance chasers-oops! I mean trial lawyers- to tick them off.



What's with this railing on Palin again? Can't they finally let her go? She's not holding any kind of office anymore...so get over it already! Real conservatives ARE pointing out that the bill does not do enough for costs. What planet is AS currently living on? I mean, I know he's salty about conservatives not being on board with the whole gay marriage thing, but that's no reason to lie and misrepresent what the GOP is offering on the healthcare reform debate....



This guy sounds as crazy as Bush "sometimes you have to abandon the free market principles to save the free market." That is NOT conservative! And it blows my mind how it's okay in his mind that we get less innovation...WTH??? And that's okay? That is madness. Yeah, forget about that pesky cure for cancer-Hell! we've got too many people on this Earth to begin with! Alzheimer's? Nah! They've lived their life, served their purpose...it may be better to just give them their pain medication and call it a day!



Sure insurance companies can be sneaky sometimes, but at least with our current system there are always other avenues to pursue-people hold fundraisers for medical bill help, etc. Obviously, things need to change, (the GOP does have good ideas, but their ammendments keep getting written out of the bill-amazing! Of course, the media is instead talking about a man who just happened to have a gun on him at an Obama town hall-that is SO much more important, after all!) but I'm not going to knock down a whole building to fix a doorknob, right? Why not try things that do not interfere with people so much first, and then see what happens? Why does it have to be all or nothing with them? Why is Obama demonizing doctors? Why is he lying? If this bill is the glory they all claim it to be, why don't we have a hard copy in plain English to peruse for our reading pleasure? Lots of questions....



Excuse all the sarcasm...I'm frustrated ;)

Christa - posted on 08/13/2009

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Sara, the GOP is not against reform. We are just against the government taking over. However I'm all for some more regulation. Obama keeps mentioning eliminating the pre-existing condition clause and preventing them from cutting coverage or denying coverage when you become seriously ill. I'm all for that, but I think those can be accomplished without his public option part. That's what I've been saying this whole time, there are things we all can agree on, why not focus our efforts there and forget this public option business. That's what's causing all the anger. There is a way to regulate the companies and lower costs without the government trying to come in and take over the whole system. Once you make it more affordable then most of these uninsured people will be able to pay for their own health care like the rest of us.

Dawn - posted on 08/13/2009

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oh and I'm not a dem or rep

i vote for who I think can do the job, too bad there is no one that can do it any more in the gov. Maybe there should be a limit on who can run. Like if you make over $500,000 a year you can't run cause you are into the money that you get for kick backs instead of whats right for the country.

Dawn - posted on 08/13/2009

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I'm not a fan of the UHC but I do believe that something needs to be done. I've seen the greed of the insurance companies. I started working as a claims examiner in 1988 and have seen the greed and destruction of the health care cause of them. When HMO's came into play that was the big start and they found out how much money they could make. I think pre-x should be not allowed. It use to be if you had a pre-x condition you had to wait a year then you could get coverage for that diag. But now they just deny to even cover you. (healthy people they can make more money on cause you aren't already sick) Then there is the pharm. it use to be that you never saw drugs commercials and now you can't miss them. Ever notice that almost every commercial break there is some ad for a drug or a lawyer saying that if you took this drug you might be able to get money. If the gov wants to do anything they need to crack down on these compaies and fix what they already have for the poor and STOP giving free benefits to illegals.

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