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The Competitive Disadvantage of GOP Healthcare Rhetoric
Despite the shock and awe of Democrats' melodramatic press releases, nobody was genuinely bewildered or surprised by the recent McClatchy newspaper headline screaming that "GOP lawmakers tout projects in the stimulus bill they opposed." We all know that politicians love to brag about bringing home the bacon - even the bacon they vote against.
Far more baffling are those same politicians contradicting their entire foundational philosophy. When that starts happening, as it is in the debate over health care, things can become authentically confusing.
Anyone who remembers the 1993-94 health care fights knows that Republicans have long asserted that private insurance is more efficacious and more adored by patients than government-run programs like Medicare. To solve the health care crisis, those on the right say we must foster more price-cutting, efficiency-producing competition. "The American people know that innovation, choice, and competition work," wrote Sen. Tom Coburn, R-Okla., in an archetypal opinion piece titled "Competition Solves Health Care."
Give conservatives credit here: At minimum, this argument had a logic to it, however flawed. Sure, it is belied by data - the Urban Institute reports that private insurers spend up to 30 percent of their revenue on administrative costs (read: salaries, paperwork, etc.) while government programs spend just 5 percent, and polls show Medicare recipients are far more satisfied with their health care than those in the private system. But, in nonetheless claiming that the private sector will always outperform the government, Republicans at least presented an ideologically coherent (if fantastically inaccurate) hypothesis.
That all changed, though, when Democrats this week began pushing to let citizens buy into a government-sponsored health plan similar to the one federal lawmakers enjoy.
The allegedly competition-loving GOP immediately stated its strong opposition on the grounds that the initiative would begin "forcing free market plans to compete with government-run programs," as congressional Republicans lamented. While Rep. Roy Blunt, R-Mo., insisted that the GOP remains "committed to common-sense solutions that promote competition," he said his party is "concerned that if the government" is permitted to compete, "it will eventually push out the private health care plans."
Hold on a second.
Don't Republicans insist that "competition solves health care?" Yes, ad nauseam.
Haven't they been telling us that government programs are obviously worse than private health insurance? Yes again.
Then, don't they welcome a private-versus-public competition, believing that the former will easily trump the latter? Well ... uh ... no.
As I said, this is truly perplexing.
In one breath, GOP Jekylls say government medical plans will be inefficient, inferior to private insurance and thus hated by Americans. In another breath, Republican Hydes effectively admit that government programs would be so efficient, superior to private insurance and loved by Americans that they will attract most consumers and dominate a health care competition.
Of the two assertions, of course, the latter is closer to the truth - and the GOP knows it.
Republican lawmakers received the new Commonwealth Fund report showing that a public system would save consumers $2 trillion through reduced premiums and lower administrative costs. They see surveys showing the country overwhelmingly wants the government to create a public health program - and they know that if given a choice, many Americans will opt into that program rather than swim with the private insurance sharks.
Republicans can't simply acknowledge these truisms, however, because doing so would undermine the insurance industry that's filling their campaign coffers. So instead, we get pro-competition, government-is-ineffective "conservatives" working to thwart competition and implicitly admitting they believe government will be too effective.
Yes, when it comes to competition, Republicans were for it before they were against it. And this time, that confounding flip-flop doesn't merely threaten a bumbling presidential candidate, it imperils a health care revolution.
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112 Comments so far
Show AllAmazing isn't it? Government is the problem until private industry has to compete against something technologically "simple" such as health care.
Does anyone know if there is a proposal to allow individuals to opt out of their employer-provided programs and demand the money that goes towards the health care premiums as compensation towards buying into the national health care plan?
What a great idea! We'd probably get enough extra money that that would make up for the raises we haven't been getting.
The government run healthcare the GOP has obviously doesn't include psychiatric treatment.
That's true the GOP worships profit-driven competition over cooperation for the common good. Given that much of their base is against the theory of evolution, they are nothing if not 'social Darwinists,' and worship profit through competition, which holds a certain irony. It's also no wonder that they are warmongers as well, paranoid that someone--some other country, ideology, or religion--will out compete them and knock them off their supposed perch.
They do not see that their approach is sadistic, punishing those for 'limitations' that they cannot help, either because of lack of opportunity or ability. They call themselves 'Christian,' and claim that their self-created sadist 'god' bestows benefits upon those whom 'he' favors, and punishes and deprives those whom he disfavors. And in their perverted 'righteous judgment' THEY decide which is which. Pure destructive and ugly nonsense. If nothing, the fruit of the past 8 years has proven this. That may be why many now are dis-identifying with their religion and leaving their churches, that and the fact that they feel embarrassed that they no longer have anything to contribute the basket.
Disillusionment, used correctly, provides a great opportunity for awakening.
The Grand Obstructionist Party will change their rhetoric every hour if they need to in order to drag down any progressive idea. They got so drunk with power during the eight years of dictatorship that they cannot even think of the common good, but only of themselves. They preach morality, freedom, fiscal conservativism, and opportunity for all while their actions show just the opposite. Republicans have turned into a cult, where they all shut their eyes and turn off their brains to become robotic morons, following their great leaders to destruction.
The current GOP leadership is undefendable, but the other major corporate party is hardly run by saints.
Absolutely true! Otherwise, Single-Payer Health Care would not be shunted off to the sidelines.
I want single-payer, universal government provided healthcare but I gotta say, this argument is horrible. The Republicans are not contradicting themselves. Look, their argument is sound because the fear is that private companies will have to compete against a government that can go into the red and not have to worry about profit. Get it? That is not fair competition. Of course we know their real fear is that the government will be more efficient and will do a better job but they have a valid point. The problem is that the government will take on all those patients rejected by private insurance and will go into the red but only because the healthy people won't be in the pool to subsidize the sick. So in essence supporters of government healthcare should be worried. That being said, we need to make sure the public is ready to evaluate this "competition" in light of these possible differing pools because the Republicans may possibly leverage the debate in the future if the message is not adequately expressed. So let's not make straw man characterizations of Republican arguments now because it may get turned against us in the future. Let's be straight forward, we don't want competition because we want healthy people to subsidize sick people. If we make it a competition the government will lose because the private companies will cherry pick pools or inflate their numbers or whatever.
Please be clear though that you want to force all people to participate in this single payer system, with no option to opt-out. And that the penalty for not paying your taxes to support this system would be prison.
That's the same penalty to opt out from depositing depleted uranium on innocent people in Iraq that I'm forced to support with my taxes.
Which justifies neither forced support for welfare or warfare.
it's difficult to make people understand that the State is a criminal gang writ large, running the greatest protection racket in the history of mankind. All government edicts are backed by coercion and politically motivated violence.
Unless we hope to revert to a hunter-gatherer society, we must accept the presence of some kind of government. What kind of government is the only real question: how transparent and responsive is it, and how can it be made more transparent and responsive.
Thomas Jefferson in the Kentucky Resolutions of 1798: "...in questions of power then, let no more be heard of confidence in man, but bind him down from mischief by the chains of the constitution..."
The state has held the legal and moral monopoly on violence virtually forever. That's why murder has always not only been a crime, but a sin. People are not permitted to do it...but governments are, with limits.
freedomcorpse
I find your statement to be quite specious. Severely cutting the military budget would then mean that more money could be directed to a public good which would be the care and health of its citizens. No majority of citizens whose countries have a single-payer health care system have ever expressed their discontentment with their system by stating that they wished to emulate America's current inefficient way of providing health care for its citizens. The USA is currently ranked 38th in quality health care by the WHO with Cuba just recently moving ahead of the U.S. It should be obvious that something radical needs to be done. Obama's plan of keeping the insurance companies in the equation is not exactly the change that one expects from the [alleged] agent of change.
Why don't you get this?
The government does not produce anything. All its resources were taken from its citizens at gunpoint.
Would you be happy if a mugger stuck you up for $50 but promised to spend $50 in your store or restaurant? Hell no.
The government does not produce anything. All its resources were taken from its citizens at gunpoint.
Hey, that is a misleading statement.
1. The government does create/spur innovations through organizations like NASA.
2. In the current climate, we *do not want* the government to compete against its own citizens. That leads to too much concentration of power and resources.
So, lets all get off the specious "government does not produce anything" claim shall we.
I also disagree with the claim that the government doesn't produce anything. I think that it would be more appropriate to say that government produces things that the free market won't produce because these things are not amenable to collecting payment from beneficiaries of the "product"--like parks, scientific advancements and whatever else.
Yeah! we have NASA that is R&D for this great military industrial complex!
We export all kinds of kool death rocket/pills! That we share with our poor jewish friends across the sea, as a Gift!
We produce murder and carcinogenic armor piercing ordinance to hungry nations across this green&blue planet!
We produce rad prisons! and exellent crowd control devices!
So lets indeed get off this SPECIOUS "United States Government does not produce anything" claim!
Lol! NASA focuses on space exploration and related technologies, not military equipment. While there are areas of crossover, the Military-Industrial-Complex is irrelevant to NASA's existence.
So, lets *really* get off the specious argument that the government produces nothing, and that anything worthwhile produced by the the government is necessarily something that kills or destroys its or the world's populace.
Most of the medicines our pharmaceutical industry over-charges us for were developed by NIH (a part of our government).
Just as NASA isn't allowed to make money off of its discoveries, so to is it illegal for the NIH. Wonder who made those laws? Those "non-compete" laws...
Through my tax dollars, I already subsidize health care for military members and--correct me if I'm wrong-- government employees. (And who pays the health insurance costs for Congresspeople?)
I have no health insurance, but my tax dollars support other people who have access to much better health care than I'm able to receive. I guess when I was younger I could have joined the military, but why should one be forced to serve in the military (and possibly have to fight in an unjust war and risk being disabled or killed) in order to receive access to health care?
Although I hardly consider VA hospitals examples of "much better health care", I agree with you NML, you should not be forced into that position of killing other human beings for the state in order that you may live your own life peacefully afterwards.
Yes, but members of the military and any other employees of the government are paid by the citizens for jobs that we contract out on the free market. If part of that compensation includes health benefits (possibly at the expense of lower pay), then health benefits should be viewed as part of the wage. This is different than paying for someones health care simply because they are a fellow citizen. In one case, the person works for you, a generic citizen of the city/state/country as a contracted employee and in the other case, they do not.
"why should one be forced to serve in the military (and possibly have to fight in an unjust war and risk being disabled or killed) in order to receive access to health care?"
Because there is no such thing as a free lunch. My answer to this question is basically the same as above.
Single-payer isn't offering a free lunch. It will be paid for by our tax dollars, and we will be able to take part in a program similar to the one we are paying for to insure our elected officials.
Instead of having the premiums paid by our employers with our contributions the money will be collected, as is SDI, FICA, etc., and distributed by the government to the health care providers rather than to clerks whose job it is to deny claims. There is no profit motive in a government administered program.
We are not forced into military service, but we are unable to leave our jobs because we can't afford private medical insurance premiums without the subsidies paid by our employers which adds to the cost of the product/service and thus prices us out of the global economy.
How many of us over 60 would quit work if we could afford medical care? How many current college graduates could be hired to fill those positions?
The arguments against "Medicare For All" are all bogus.
"Democrats this week began pushing to let citizens buy into a government-sponsored health plan similar to the one federal lawmakers enjoy." - WTF is this? Federal lawmakers "enjoy" insurance, like everybody else. (Well, not everybody.) It is government-sponsored to the same extent as other employer-sponsored insurance plans are sponsored by the employer.
Does anybody know what's going on?
The difference is that members of congress get a really good plan which is better (supposedly) than a typical employer-sponsored plan.
In the 1970s Nixon instituted HMOs to help control the cost of health care – for insurance companies. It was an instance of creating a new separate layer of (private) bureaucracy with the claim that it would increase efficiency of the system! It did this, of course, by limiting claims on health care that eventually resulted in a lower state of health for the public.
The GOP and the media refuse to see that public bureaucracies are far more efficient than private bureaucracies, and that private interests are far more prone to price-gouging and stifling innovation. Efficiencies are considered only as cost savings to providers, not as the health of the public, each member of which faces a short time-constraint in the maintenance of health. In other words, foot dragging on providing treatment is perceived as efficiency by providers, but not by customers who ultimately pass beyond the complaint window.
Being pro-life, apparently, does not extend to being pro-health.
You're right, public bureaucracies are much better than private bureaucracies at blowing up people in never-ending foreign wars for empire.
You're mixing up healthcare with warfare.
Same state, different faces.
I'm rubber, you're glue.
Whatever you say bounces off me
and sticks on you.
…And by the way, I was being sarcastic.
Lest any one question your loyalty and service to the state, of course, that is very understandable.
Joy! The same great service we get at the DMV, only at the doctor's office!
If you people are sick of being bilked and robbed, ditch your health insurance and go to the local clinic instead. Pay out of pocket and be seen within an hour, not in two weeks. More government regulation is only going to make it harder to see this independent practice doctors who don't buy into the insurance-casino system.
And the government database scares me. How long before the cops have access to your full medical records during a traffic stop? How long before the government demands we all have yearly physicals and mental health evaluations?
Medicare has been simply outstanding for both my mom and dad.
Through ten years of illness including tests, hosptial stays, surgeries etc. I can't remember one problem or dispute with Medicare.
Every citizen should have the right to join Medicare.
Medicare is a symptom of the disease, not the cure.
I see two major reasons for why health care in this country is so messed up.
1) The majority of doctors should be little more than body plumbers. It doesn't take 8 years of medical school to sew up a wound, set and cast a broken bone, or send a small child with a fever home with a bottle of laudnum and a dose every six hours: 1 teaspoon for the child and 3 teaspoons for the mother. The overwhelming majority of what doctors should be doing is basic maintanence and treating essentially simple illness and injury.
By forcing them to go hundreds of kilos in debt with unnecessary school and training, we are forcing the prices into the stratosphere for simple basic care that a plumber could learn. Most people don't have lupus. Most people have diabetes and sprained ankles.
2) Health insurance is like any other casino: THE HOUSE ALWAYS WINS.
Many offices use nurse practicioners to see patients with minor issues freeing up time for doctors to treat complex cases. Heck, even the local drugstore has a nurse practicioner for walk-in appointments for common complaints.
"The majority of doctors should be little more than body plumbers. It doesn't take 8 years of medical school to sew up a wound, set and cast a broken bone, or send a small child with a fever home with a bottle of laudnum and a dose every six hours: 1 teaspoon for the child and 3 teaspoons for the mother. The overwhelming majority of what doctors should be doing is basic maintanence and treating essentially simple illness and injury."
I think there is a lot of truth to this. The American Medical Association has strict limits on the number of med. students that AMA certified schools can admit each year. This limits the number of available doctors for the country and keeps the wage for doctors very high. There are lots of very bright and capable people who have their heart set on being a doctor who are forced to choose a different profession. At the same time, you have millions of Americans who are desperately in need of care. I am sure there is a lot more to this story, but I think it is a conversation that needs to be had in the public sphere. I am sure there are lots of other things of the same nature that we are not aware of.
Finally, someone else who thinks that The overwhelming majority of what doctors should be doing is basic maintanence and treating essentially simple illness and injury.
In addition to the above, we need to increase the number of outpatient clinics and find ways to contain the costs of hospitalization. Since, there will be far fewer hospitals dedicated to serious illnesses/injuries a single payer - multi agency system will work out well.
I work in medical education. You obviously have no idea what you are talking about.
I was referring to TXProgressive March 13th, 2009 2:48 pm.
Is that not true? The AMA does not have any say on the number of applicants that are accepted into a medical school? Lets take the state of Nevada. There are no forces inhibiting the number of applicants accepted at the one school in the state? They could turn out as many doctors as they want--so long as these doctors do what is required for a degree? When I was an undergraduate, there were a lot of bright students who wanted to be a doctor and they had to work ultra-hard for the few precious slots available each year. Why is that? Why are there so few spots available when demand for doctors is so high.
You are right-I don't know how it works exactly. It is possible that I picked up some bad info about how the AMA works. Now since you have volunteered yourself as an expert in these matters, explain why so few doctors are admitted to med school. Are those who are denied really just deemed incapable of being a medical professional?
Usually a bottleneck in education is the number of instructors available to teach. That is a big problem in nursing, too few people with Nursing PhD's available to teach new nurses.
That is strange because I think most people view the lifestyle of a university professor as very desirable. I know that in physics and there are way more people that want academic positions than there are positions available. Either way, it seems like it should be a simple fix by offering more money for the position. Who knows though.
Heh, I wonder if there are teachers that make more than a doctor does...even a teacher of doctors.
It is most definitely not a simple fix, and money has almost nothing to do with it.
Lets have the discussion--which is what I advocated originally. There is a fundamental problem when there are many willing and capable med school applicants who are turned away and massive need for health care professionals.
Hey get me the money, and I'll get you the teachers of doctors and even some doctors. Remember that we do not need to train a boatload of brain surgeons. Most illnesses are curable by a healer, someone who can set bones, sew a few stiches, deliver babies, and can recommend/dispense medication.
Lets keep the major institutions to train the surgeons, research, and other advanced techniques.
The Liaison Committee on Medical Education, which is composed of the AMA and the Association of American Medical Colleges, accredits medical schools. One of the criteria for accreditation is class size relative to resources. The real bottleneck in medical education is not at the med school level, but at the residency level. Even if med schools could accommodate more students, there'd be no point without a concurrent increase in residencies. Current reality is informed by projections made 15 or more years ago, and much can change, and change unexpectedly, in that length of time.
Most of the students who are denied admission to medical school would make fine physicians, and as it turns out, instead of a glut, as projected back in the early 90s, there is a shortage. My school recently added 10 spots, and will add another 10 in the next couple of years. Unfortunately, there aren't 20 additional spaces in the new anatomy and histo labs ...
I take particular offense at dammerung's suggestion that doctors are little more than "body plumbers" - a suggestion with which you seemed to agree. We are not training only general practioners, after all, and it would be a total waste of potential to "track" students into general practice before their abilities and proclivities are apparent.