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April 11, 2013

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per Steven Hawking we have a 1000 years to get out of Dodge

My God, Jon, you're still chasing your tail.

I saw through Obama when he ran for President the first time. Was I the only one? It was so obvious he was a snake-oil salesman that it wasn't funny.

Now you people are fully prepared to fall for the snake-oil salesperson in the pants suit.

While I'm sorry for your desperation, Lord I wish I had a few bridges I could sell to you.

Ruben, it is obvious you haven't been reading Rogue long...

phxsunfan, Ruben makes the Rogue face to face coffee meets?

If he had been a long-time reader, he would know that Rogue, Jon, has been critical of Obama for years now. In other words, he wouldn't be selling any bridges...

Sorry I wasn't clear. The "you" in my comment wasn't directed towards Rogue, it was directed towards Democrats in general.

Guess I should have said "you Democrats". (and all the Independents who were taken in)

My apologies.

If Obama is, in fact, a figurehead of a president, then it's probably an exercise in rhetorical overkill to suggest he could have singlehandedly changed the course of our nation's history. But this is still a 50-50 nation, half mad with the idea that the "free market" will fix everything, while culture-war issues can be used to split the nation in half for the benefit of its corporate owners. Our media are mostly courtiers of wealth and privilege, tongue-bathing the power elite instead of challenging their arrogance. Its political buffers are eroded - unions, civic organizations, local business roundtables, etc. We believe different things, but are most slavishly attached to one idea: the goodness of great wealth.

Obama didn't write the ACA. He left that to Congress and they bargained among themselves and thousands of lobbyists to protect the special interests while allowing a nascent regulatory structure to be erected around health care. Does Obama have special powers to override the special interests? He's president, not dictator.

Congress bargained in a similar way about financial reform, and came up with Dodd-Frank. It's weak tea, and the Republicans have dedicated themselves to making the law weaker in its regulatory implementation. Could Obama have changed their minds? Unlikely.

Obama mentioned global warming in his inaugural speech and SOTU address, a first for any president. He is in favor of the EPA regulating greenhouse gases as pollutants. The power elite is not amused. They promise to fight Obama in the courts. And they will probably win. Their lobbyists and campaign contributions control the process. Could Obama somehow alter this reality with his magical powers? Doesn't seem that way.

The Republican Party, nihilistic and insane, is using hostage-taking to stifle government spending, partly to blame Obama for an economy they won't let recover and partly for their hypocritical devotion to balanced budgets when a Democrat is president. Obama, in a vain effort to show his centrist bona fides, offers entitlement cuts. Lo and behold, Republicans don't care. Did Obama not schmooze with them enough? Did he not invite them over to the White House for drinks and charades? Maybe not. Would this have changed anything? No.

Yes, if LBJ or FDR were president, things would be different. But the nation that elected them president no longer exists. No amount of leftist voguing can repeal the last 30 years of Reagan hagiography, globalization, culture-war madness, voodoo economics, and America's populist inversions. This preceded Obama and it will endure after he's gone. I wish Obama were a better man and politician, but I suspect he wishes we were a better nation. In the end, we get the government we deserve. Obama is not an angel or devil, just the perplexed guardian of our failed national consensus.

Soleri: it is good to have you back. You make me think with a more inquiring mind.

The writer and the painter.

Let's not forget the vote for Obama in 2012 was mostly a vote against the right wing insanity of the Republican Party.

Those with preexisting medical conditions who have been unable to get health insurance coverage should move quickly in 2014 and get it under the new law.

The law's provisions which help individuals will have a short shelf life as health provider lobbyists repeal provisions of the law which inhibit the maximization of their corporate profits.

Pay to play and stay in Americana democracy.

Many so-called 'realistic' politicians will remind us 'dreamers', that politics is the art of the possible. To which I always ask: What do you think is possible and why?

I haven't got a reasonable answer yet.

It reminds me about a specific candidate who has been touted in my state as an 'energy expert'. The only thing she's an expert at is selling out to corporate interests.

That's what she means by being realistic. She's actually proposed that large cardboard boxes be put over the solar panels of county residents who had them unless they were willing to pay the power company for using the sunlight.

Our presidents have been remarkable nothings in our epoch. As to our presidential retirees, Clinton is lauded for his capitalist do-gooderism while Carter has nearly eradicated a parasitic plague, while Bush 43 doodles disturbing one-flew-over-the-cuckoo-nest paintings of himself. I'd like to be around in a 100 years to see what these rankings will be:

http://en.wikipedia.org/wiki/Historical_rankings_of_United_States_Presidents

I imagine the modern crop of flim-flam artists will make even Buchanan and Pierce look like titans. That is if there isn't a catastrophe in the next 100. Who will Obama be compared to after he's out? I'm figuring Buchanan: he was for reform but not relief, he fought with Mormans, sectional strife, deadlocked Congress, etc.

Ruben, ashamedly I voted for the O in 2008 hoping he wasn't the sellout I thought he could be, hence my refusal to vote for either Kooks or Wimps ever more.

There are two disabling traits I see in liberals. One is a kind of "process liberalism" where we must always be nice and fair even when bullies are kicking the crap out of us. The other is the perpetual betrayal syndrome where we seemingly relish ripping our leaders apart. Conservatives don't have this particular problem. George W Bush could expand the welfare state with Medicare Part D, take wars off budget, pander to Hispanics, betray a CIA operative, and squander a nice budget surplus with perpetual deficits. Did conservatives care? No. They understand politics is about power and that's primary because all politics is tribal. What does the public think when they see us? That we don't care enough about our own side to actually take it.

Is Obama a frustrating leader? Yes. Does that mean we should help conservatives and tear him down? No. Please, if you think this way, just go ahead and join that team. Vote for Ralph Nader and make some other Bush president. But don't call yourself a liberal because what you really are is a crybaby.

I don't know if this is the power of the Military-Industrial Complex or a Democrat afraid of looking weak on "national security,"...

...What is stopping him... Has the coup of the oligarchs gone that far? If so, why not tell the people?

Following his own advice, asking great questions (I refer to a recent article on journalism that Señor Talton posted elsewhere.) And such bold-stroke questions are necessary in this climate.

In another time and place, they might be hyperbolic, but not today, not here. In another time and place, soleri's characteristically intelligent and informed riposte would be the adult response, a tinfoil-hat antidote, but today, here, it reeks of the apologies and excuses of Party loyalty.

(It took me a long time to compose that last sentence - I too am extremely happy to have soleri's contributions back, and I suffer from the egoistic fear that my humble opinions might shoo him. Alas, I couldn't compose it less harshly.)

As there is a time and place for bold-stroke questions, there are times and places in history for bold-stroke leadership. This is such a time, and the measured actions of this President are far from mature, they are negligent.

(This just in:

One is a kind of "process liberalism" where we must always be nice and fair even when bullies are kicking the crap out of us...

...don't call yourself a liberal because what you really are is a crybaby.

I feel better now about "that sentence.")

This is a great conversation, made even better by the return of Soleri.

I don't want my commentary to drive him away in frustration. Yet I also have to remind all readers that I am not a partisan advocate. In my role as a columnist, one of my tasks is to hold the powerful accountable, to, as the old chestnut has it, "speak truth to power."

I did this with W. I continue to do it with Mr. Obama. I wrote uncomfortable truths about Phoenix at the Arizona Republic. I do this when necessary at the Seattle Times. (I also celebrated and backed worthy ventures, including light rail, WBIYB).

So, I do not wish Mr. Obama ill. Not am I causing the problem by raising these questions. I have a writing style that can wound. Guilty as charged there. "A pen warmed up in hell."

Jon, Obama is pretty much toast but there are some bold strokes he can still make. The supreme court is one. And becoming a strong environmentalist is one and back tracking some how on social security.

Was there a choice in voting? Prior to Obama’s election why did you really think this rope a dope pot smoking, soft shooting hoop player was any match for the military industrial complex, the CIA and all those other things he would never be able to control. If you did I don’t know where your brain has been living. Obama didn’t win his elections, his team did. Game Change in elections is one thing but even his brilliant savant electronic whiz kids were no match for the folks in DC that run the world. Get to dangerous to those folks they will just make you a drone target in some lonely place where there are no witnesses. Oswald is alive and now he is able to take the back of your head out at a mile away with ONE shot.

...why did you really think this rope a dope pot smoking, soft shooting hoop player was any match for the military industrial complex, the CIA and all those other things he would never be able to control...
Colorful as always (and - hey! - the pot-smoking was a plus for me), but this "answer" to one of the questions posed here has a definite ring of truth to it.

Sorry I can't find the attribution at the moment, but I remember reading about a key "briefing" at the beginning of the first term wherein Obama was warned in no uncertain terms about getting too "creative" with reforming our FIRE economy. In "Oswaldian" terms, you might say.

I recall that
it was not A warning
it was a clear an obvious THREAT.

I would never call myself liberal.

Beg pardon. The "intervention" was on prosecuting torture but, as ties between the CIA and Wall Street are (or should be) relatively well-known, I might be excused for the confusion. And frankly the President would conceivably get the wider point (my bold):

Then Dean Chris Edley volunteered that he’d been party to very high level discussions during Obama’s transition about prosecuting the criminals. He said they decided against it. I asked why. Two reasons: 1) it was thought that the CIA, NSA, and military would revolt, and 2) it was thought the Repugnants would retaliate by blocking every piece of legislation they tried to move (which, of course, they’ve done anyhow).

Afterwards I told him that CIA friends confirmed that Obama would have been in danger...

Insider Tells Why Obama Chose Not to Prosecute Torture

We, of a certain age, already know what a CIA "revolt" looks like.

One of my frustrations with blogs and comments was distilled in my mind last year by one of my favorites, James Howard Kunstler's Clusterfuck Nation. He's a wonderful writer, dazzling and astute. But he is also the centerpiece of his own cult where wide-eyed doomers and survivalists congregate to issue forth party-line comments ("great job, Jim!"). And the effect of this particular epistemic closure is all-too evident. Kunstler writes the same column, more or less, every week. It's not that he couldn't write something different but that if he did, he would shake his own little fiefdom of absolute certitude. It's a nice gig but a worse trap.

Rogue Columnist is, in my opinion, a much better blog. The writing is not simply an excuse to say the same thing, week end, week out. But there's this danger where opinions issued like edicts suck the air out of the conversation. In fairness, I notice this in myself as well, which is probably why I react the way I do when notice others doing it.

What I want from Talton (and all writers I admire) is enough space to allow some crucial ambiguity. For all our certainty, we can't know everything absolutely. Journalistic authority always needs to be tested, which is why we tend to be engaged in the piece as a conversation. And if the comments are pale reproductions of the blogger's, then the creativity tends to suffer along with the conversation itself.

We shouldn't kid ourselves: we are all partisans. If you're here, you feel some things very deeply. You look to have your opinions validated, of course, but also to learn new things. We come here at least partly from a wounded sensibility along with a need to express this pain from our individual vantage points. But what we do for personal reasons shouldn't disguise the overarching need to ask: is this true? Because reality-testing the perceptions of others will also help us test our own.

What I want here is not just vivid writing but a writer who knows knotty reality well enough to avoid simplistic prescriptions. I know that Phoenix is a failing city in many respects. But I also know its story is not really unique so much as complex. I know that Obama is a pale imitation of a forceful leader, but also that the political circumstances make his governance extraordinarily difficult (as in not-so-subtle racism from an opposition party that compulsively swims in that fetid swamp). I appreciate caveats because they serve to keep the conversation open. There are few absolutes but there are many ways to advance the conversation and our understanding of complex reality.

I spent my first four years here with feet firmly planted in the Amen Corner. I started losing faith when I noticed I was simply repeating myself. Even when I goosed myself with righteousness I couldn't quite get away from that stale odor of sameness. I realized that I was performing a ritual, an agreement fantasy to bolster my own ego through association with authority. And it was then I began to question what I was reading and even challenge it in the comments. We must learn new things, not simply repeat what we already know. If I'm a prodigal commenter (as opposed to merely prodigious), that's why.

I second everything soleri just said and will take some of that admonition to heart, where it may apply.

Point taken, Soleri, and a good one. Among the many reasons I'm grateful you are commenting again. I don't have all the answers. I do try to start conversations.

If we live in an economy that is transforming to a financial model of capitalism rather than the largely production based model that we had for much of the 19th and 20th centuries, perhaps our educational institutions should concentrate a lot more on teaching the skills of finance both basic and advanced rather than computer science and arcane technicalities.

We don't need another FDR.

Who needs a bridge architect in a society that doesn't build or maintain bridges?

I should have voted for the Green Party candidate as I originally intended. People -- included many Rogue readers -- scolded me and said I would be wasting my vote -- and that I should vote Democrat. Huh. Looks like I wasted my vote anyway.

I'm here for the conversations, the learning and the coffee. But especially the learning.

Thank you all.

Anything new happening?
I got lost for a while in downtown Winesburg Ohio.

Please wake me in a couple of months. If we have a bi-partisan deal on gun control and immigration, I will believe that we're turning a corner. Between now and then, anyone is welcome to call me Alice in Wonderland!

Well, hello there, Alice.

It seems like the two major parties are too comfortable. They control the national debate-literally-with the collusion of mass media. They know that most will just vote against the other guy, rather than enthusiastically for them. I watched the "alternative debates" on C-SPAN, and tried to picture Obama and Romney wedged in there, fighting for their political lives. And that Calvin Goode dude was a hoot, but the others all made some fair points. I wonder, if a movement arose to convince Americans to register as unaffiliated (even in closed-primary states), and to not respond to polls, and if by some fluke it was successful, if the sense of certainty and comfort enjoyed by our leaders would evaporate. Do they really deserve that comfort? How would they react to its absence? It would be tough to figure out to whom to pander. Anyway, that's why I have long been registered unaffiliated,and shut the door on canvassers, bless their well-meaning souls.

VIRGIL Goode. I'm senile. And I can't believe I even remember Calvin Goode.

The meaning of "True Liberal".


Today a true liberal is a "leftist" in US polical discourse. There was a time and place when that was not the case. When a true political left existed in the US a true liberal was a politician who maintained the political status quo by offering window dressing legislation rather than structural change.

Obama is a true liberal. Why people expected anything else is a misunderstanding of the American political process. The process of pay to play allows and requires large corporations to maximizing profits by making sure no laws are enacted which threaten the individual corporation's profits. Collectively then no legislative change can occur which threatens large corporate interests.

Obama is not allowed to enact the structural changes needed especially related to economic inequality because US democracy won't permit it. Voter choices within our system are limited within the overriding corporate veto.

Obama was the best option in 2012 given the limited choice that the American political system allows. The individuals who express great surprise and dissappointment about post election Obama suffer from the illusion that the American system is a great democracy where the rank and file have a say in how the country is run.

Soleri makes a keen point about the power of political solidarity.

However, there is a big difference between shooting down a less than ideal candidate for office who nevertheless represents the lesser of two evils and the best chance we have, and criticizing someone who has already attained office for failing to live up to his potential.

I think that some of the criticism here stems not so much from the sense that Obama failed to accomplish certain things, but that he didn't try hard enough. Perhaps, behind the scenes, he tried like hell. Somehow, though, his public persona left me with the impression that he is first and foremost a politician whose principles are shaped by party pragmatism, which sits on a shifting ground composed of institutional lobbying, donor contributions, focus groups, and the latest poll data.

A leader who fights like hell but, in the end, concedes the inevitable to forces beyond his control, is one thing. I never had the sense that Obama was leading the charge of the Light Brigade. I never heard any public explanations (much less excoriations) of the forces supposedly thwarting his higher aspirations. Is this a naive expectation?

I'm inclined to disagree with the assertion that conservatives don't have the infighting problem. I think that liberals see liberal criticism of Obama because they regularly read liberal commentary, but tend not to notice conservative criticism of "RINOs" because they don't regularly read conservative commentary. And current conventional wisdom holds that conservative infighting and sectarianism is precisely the problem with the Republican Party and a "primary" reason (pun intended) for recent political failures. The Tea Party is in fact the face of conservative criticism of Republicans, not of Democrats.

That said, the discussion is enhanced by multifaceted arguments and realism. The only way this will occur is if someone offers it. So, I would urge Soleri to fill that function (and fulfill himself) by offering counter-criticism and realpolitik as a proposed corrective. Opting out, instead of speaking up, won't address the problems you perceive; and I know that Mr. Talton and many others admire and respect your writing talents. So have at it.

Mr. Talton wrote:

"Socialism? If President Obama has brought socialism to these once-bright shores of liberty, as the crazies of the right would have it, where the hell is my universal health coverage, free college education, subsidized vacations, early retirement, child-care for working families and high-speed rail?"

Don't forget guaranteed housing, guaranteed employment (with the federal government the employer of last resort), a guaranteed living wage for the employed, and the kind of profit sharing which insures that the productivity gains are shared with labor.

Beyond that, why should the nation's banking system and money supply be controlled for private profit? Why should the nation's energy, mineral, land, timber, water, and other reserves be plundered for private profit?

Has President Obama proposed legislation designed to accomplish any of this? Has he even proposed to outlaw the usurious payday and title loan businesses which proliferate in poor neighborhoods and batten off the sweat of the poor like blackflies?

Side-note: one new reply in the Hair On Fire thread.

We could do away with welfare at a stroke if: (1) everyone was guaranteed employment; (2) everyone was paid a living wage; (3) everyone was guaranteed affordable housing; (4) everyone was guaranteed free healthcare and education.

No more unemployment insurance. No more food stamps. No more cash assistance. No more tax credits. No more Medicaid subsidies. No more student loans.

Make that two new HOF replies (and a typo correction makes a third).

Socialism: when an average retired couple uses Medicare benefits that far exceed their previous contributions. There's plenty of data out there to verify. Quietly, President O. & Co. are advocating means testing to help curb the costs. Long overdue IMO. Would also help if retirees knew what their "procedures" were costing Medicare. Then, maybe we can attack tort reform if we can saw our way through the med mal attorneys' almost incestuous financial influence over the Democrats.

Medical malpractice claims add perhaps 1% to overall health-care costs. In other words, screwing people who were screwed by medical malpractice won't solve this problem.

Medicare per se is not the real issue. It's the total cost of our health-care system, which has been immune to real market pricing and government regulation (at least up until the full implementation of Obamacare). Means-testing Medicare is not a bad idea, of course, but single-payer would solve many of our problems almost instantly without complicated fixes. So, why don't we do it? Because people have been hypnotized by right-wing propagandists into thinking that their Medicare is good but Medicare for others would be SOCIALISM!!!. Somehow, every other advanced nation on Earth has universal health care without gulags and death panels yet we can't do it because we're "exceptional".

The reason we have Obamacare instead of single payer is that in this very special nation of ours, a weak fix is the best we can do. But that doesn't mean we can't, over time, improve the regulatory structure so health-care costs don't bankrupt us. But will do it? I have my doubts. There's something remarkable about a people who purport to be Christian, thinking it's somehow God's way to deny people health care because the compensation packages of hospital and Big Pharma execs are more important. When Jesus laid down with Ayn Rand, the mutant offspring took up residence in what we once called our souls.

The health-care system doesn't work like other products in the free market. The economic literature on this is abundant, but the best book for the layperson I can recommend is Maggie Mahar's "Money Driven Medicine."

As long as we have this for-profit health system, costs will continue to skyrocket and thus costs for Medicare and Medicaid continue to so the same. Most of the money taken in doesn't go to develop better treatments or for research, much less to pay for the actual cost-basis of services rendered. On top of all this, American health care outcomes come in well below that of other advanced nations, even though we have the most costly system in the world.

The primary reason why the right advances the notion of "tort reform" is to give people -- who know how screwed up the system is -- a villain. But Soleri is correct. The best peer-reviewed studies show that malpractice suits, etc., play a very small part in the problem. And if you have a loved one who is killed or maimed by a greedy, careless "healthcare provider," I don't think you want to discover the GOP Legislature has taken away your recourse to sue.


The health-care system doesn't work like other products in the free market.
In addition to Jon & soleri's comments, I'd like to add that a basic rule-of-thumb: Anything that is a human need should be, for lack of a better term, "socialized." Leave the free market to the spoils of disposable income, TVs, electronics, designer clothing, pretty much everything but food, shelter, health, utilities and basic clothing - payed for by the communal tithing known as "taxes."

We can still preen and play "keep up with the Joneses" class-warfare with our toys, without the content of our children's bellies part of that game.

(Even though transportation is arguably a "necessity" due to our effed-up social organization, one hopes to see this as a "spoil" as well, eventually. Until that happy day, free public transport is firmly in the "socialize it" category.)

Maltus is back
"millions starve to death scientists say"

Tallinn, Estonia (Pop. 420,000) just began offering free public transport this year. Commuter trains and regional buses are excluded.

Wikipedia actually has an article specific to free transit together with a list of cities that offer it:

http://en.wikipedia.org/wiki/Free_public_transport#List_of_towns_and_cities_with_area-wide_zero-fare_transport

morecleanair wrote: "Socialism: when an average retired couple uses Medicare benefits that far exceed their previous contributions."

So, is it "socialism" when a retired couple uses private insurance benefits that far exceed their previous policy payments?

Is is socialism when the average driver uses public roads far in excess of his previous contributions through the gas tax? How much would roads cost if they were all privatized, by the way, assuming that any private company or group of companies had both the investment capital and the inclination to build a nationwide/statewide/local network of interstates and roadways?

Soleri and Rogue: consider that med mal awards are not the issue; it is the threat of them that causes docs to prescribe a proliferation of tests and procedures out of an abundance of caution. Suggest you might talk to some docs on your own, 'specially ob/gyns and surgeons. Their "E&O" (errors and omissions) insurance can run into the hundreds of thousands, driving some out of the practice. Guess how these costs affect their rates and filter down through the system . . .

Emil: many retirees are getting Medicare benefits way in excess of their contributions and tend to be clueless about this imbalance because the media neither understands nor reports it.
The study I just read capsulizes it pretty well by stating that a "typical person paid around $64,971 in Medicare payroll taxes over his lifetime. Likewise, after netting out Medicare premiums, he’ll receive around $173,886 in lifetime Medicare benefits. The net? He can expect to receive around $108,915 more in benefits than he paid in taxes over his lifetime. David Brooks touched on this back a few months but I was slow to realize the significance.

How much would roads cost if they were all privatized...?
More, of course, to answer your obviously rhetorical question... and not only because they would have to pull a profit just to be into the venture.

There's also the externalities of vehicle damage and interrupted travel due of cost-cutting (again, in the name of profit) in the areas of maintenance.

O, the added layer of cost to anything supplied by the Invisible Hand!

morecleanair, the only thing I have to say to such hand-wringing is that the whole point of getting together and having a society is for quality of life. Profit is a chimera, that brings no benefits to anyone if we are not taken care of. If that means putting every spare penny we have into our quality of life, well then so be it.

Fortunately, it's never that dire (except perhaps in our current energy contraction, but that's an historical anomaly, and we deserve it to boot - hello, Malthus). We can live just fine if we subtract the covetous greed that has come to grip us.

Interesting discussion: can someone please explain to me how the present Medicare cost/revenue balance is sustainable? Social Security seems to be a whole 'nother thing. There's a more affordable Medicare model evolving that involves an increasing percentage of nurse practicioners and physicians' assistants. I can relate to these practicalities better than more philosophical discussions.

Phoenix and Tempe have some free transit...Tempe has a more complete system with the Orbit lines and Flash. Phoenix has the downtown DASH and the neighborhood circulators. Avondale and Glendale had free ciruclator service but they now charge for rides ($0.50 and $0.25 respectively).

morecleanair, I apologize for waxing philosophical - it's a reflexive position for me.

I'll respond by referencing a drum beat constantly by Robert Scheer in the "Left, Right & Center" broadcasts by KCRW at Truthdig, and which never seems to be directly answered in those discussions - that health care costs would be significantly reduced if we had a single-purchaser of medications and treatments. Costs are high because the insurance model enables price escalations, even more than the obvious layer the profit-motive brings to healthcare.

@morecleanair
You might want to consider that the $64,971 in payments was made in 1960's, 1970's etc dollars and the Medicare payments will be made in 2010's etc dollars. If you take into account cost of living increases, you about break even.

I think there is a fundamental misunderstanding about how insurance works, whether public (Medicare) or private.

True, a private health insurance company pays the benefits which the privately insured receive, but where does the company get its money? From the premiums it collects from the whole pool of individuals it insures, not from the past premiums paid by those who get sick. The only reason that is possible is because most of its premium payers are healthy. In effect, the sick are being subsidized by the healthy, and the company charges enough for premiums so that they cover not only the healthcare benefits of the sick but also make the company's owners and executives rich.

The average elderly person is sicker than the average person in the insurance pool, so naturally they draw a disproportional amount of benefits. The same is true for non-elderly chronically ill. This is why private insurance companies developed an elaborate system of screening and disqualifying patients seeking coverage, and discouraging those they could not eliminate outright with punitively large insurance premiums and bureaucratic headaches and delays. They wanted to keep as much of the premiums as possible, instead of paying out health benefits, and sick people cost a lot of money.

Now, you can say that this still isn't "socialism" because the premiums are paid voluntarily by individuals choosing to enter into private contracts, not taxpayers, but health insurance isn't really voluntary. If you get sick and don't get medical treatment you might get so sick that you can't work and lose your job and home (because you no longer have an income). Or you may lose your life (literally or figuratively). Very few individuals can afford to pay 100% out of pocket for serious medical costs. So, some sort of insurance, either public or private, is a practical necessity, and thus premium payments, whether public or private, are coerced. The only question is how much it costs.

Either way, a lot of healthy individuals are subsidizing a few sick individuals who take more in medical services than they've paid in. That's the nature of insurance, whether public or private.

Medicare at least has the advantage of being non-profit, and administrative overhead is around 2% instead of 15% to 20% or more as is commonly the case for private health insurance companies; and Medicare reimbursement rates are far lower than those paid by private insurance companies, which is why a large number of doctors refuse Medicare patients: they can make a lot more, per visit, for the same services, from privately insured patients. So the idea that Medicare coverage is spendthrift simply because the government is involved, is also mistaken.

expr, I thought of that myself, but I wondered if perhaps those figures weren't already adjusted for that. And I'm too lazy to do that kind of research. Unlike Emil. :)

The Congressional Budget Office conducted two studies of tort reform savings, one in 2009 and one during the Bush administration. The cost of defensive medicine, not just the cost of actual malpractice awards, was also included in their cost estimates.

"The direct cost of malpractice insurance premiums and court verdicts, plus the cost of defensive medicine, together account for less than 2 percent of overall health-care spending, according to a 2009 study by the non-partisan Congressional Budget Office, which came to a similar conclusion when it reviewed the idea during the Bush administration. Tort reform might cut those costs by 0.5 percent, saving roughly $11 billion of a total $2.5 trillion annually—barely making a dent in overall health care costs."

http://news.consumerreports.org/health/2010/03/would-medical-malpractice-reform-fix-our-healthcare-system.html

I would never call Obama a liberal either. Maybe a mutant offspring tho. Sounds like Jesus, acts like Dick Cheney.

Here's a good introduction to a different thinker, Richard Wolff:

http://billmoyers.com/episode/full-show-taming-capitalism-run-wild/

The Consumer Reports link is worth clicking on to read. The article is short, and it makes some interesting additional points. For example, it notes that individual states (like Texas) which have passed some of the strongest tort-reform laws in the nation, still have big problems with overutilization of tests and other procedures, and still have high health care costs.

The New Yorker article linked to within the Consumer Reports article is long, but a real eye-opener and well worth the read. The article interviews a number of doctors and surgeons, and doesn't just quote the ones who support the thesis; but the bottom line seems to be this:

"Local executives for hospitals and clinics and home-health agencies understand their growth rate and their market share; they know whether they are losing money or making money. They know that if their doctors bring in enough business—surgery, imaging, home-nursing referrals—they make money; and if they get the doctors to bring in more, they make more."

http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all

Folks: I paid into Medicare over almost a 50 year period so who knows how these contributions are to be weighted? To me, the point is that it cries out for fundamental re-engineering of how health care is delivered to retirees. Obamacare tries but turns into a 2000 page dog's breakfast. Wish Kyrsten Sinema had time to capsulize the plusses and minuses for us laypeople. One thing I DO know for sure is most of us will be the beneficiaries of electronic medical records (EMR) that make a huge step forward vs. the woeful lack of integrated medical care between the primary doc and the specialists. If EMR had been up and running 6 years ago, for example, I would not have lost my wife of 48 years.

Bottom line: the lack of coordinated care is both criminal and costly. Without the Obamacare mandate, many of the less-enlightened specialists would still be unwilling to emerge from the comfort of their dumb-ass paper records and fax machines a la 1985.

I wish someone would construct a historical cost-of-living study concentrating on things like health care, housing, utilities, and transportation. I've already determined that the cost of having a baby took up far less of the income of someone making minimum wage many decades ago, than it does today. I think it's great that we now have I-Phones that do everything but scratch your ass, and that computer memory and speed has increased vastly (more value for money), but not everyone can afford discretionary luxury purchases whereas everyone has to obtain the basics.

On the subject of electronic medical records:

"...electronic records do not address the fact that doctors and hospitals reap the benefits of high volumes of care.
"Many experts say the available systems seem to be aimed more at increasing billing by providers than at improving care or saving money. Federal regulators are investigating whether electronic records make it easier for hospitals and doctors to bill for services they did not provide and whether Medicare and other federal agencies are adequately monitoring the use of electronic records."

http://www.nytimes.com/2013/01/11/business/electronic-records-systems-have-not-reduced-health-costs-report-says.html?pagewanted=all&_r=0

Let's hope that the Obamacare provisions change some of this.

It seems I've lost a posting. I'm going to repost it - if it's a duplicate I apologize.

TWO THINGS, LADIES & GENTLEMEN:

FIRST, the numbers on the Medicare (imbalance) benefits illustration I used earlier in these posts come from methodology used by "The Non-partisan Urban Institute: C. Eugene Steuerle and Stephanie Rennane, 2011. All amounts are in constant 2011 dollars, adjusted to present value at age 65 using a 2 percent real interest rate. Each calculation assumes survival until age 65 and then adjusts for chance of
death in all years after age 65. It also assumes that benefits scheduled in law will be paid even if trust funds are exhausted. Workers are assumed to work every year from age 22 to age 64 and retire at age
65. An average-wage worker earns the average wage in the economy every year, based on Social
Security’s measure of the “average wage.” The low-wage worker earns 45 percent of the average wage, while the high-wage worker earns 160 percent of the average wage. The tax-max wage worker earns at
the taxable maximum every year. Medicare numbers are net of premium, other than the new premium tax on some high earners.
(pls pardon the picky exactitude . . I was just a Liberal Arts grad and this is foreign to me)

SECOND: Emil, the EMR gives your primary doc info about your overall situation by accessing reports from whichever specialists or diagnostics are relevant. Example: my primary doc just pulled up my cardio doc's most recent tests on his computer to understand why some meds were tweaked . . . couldn't have done that a few years ago, when he'd have to have someone dig out the information. These results are also shared with my oncologist and my radiation dermatologist. This kind of info has helped to me alive against some pretty daunting odds, so I relate to it in a very personal way. (A relative in a similar cohort is basically in the dark about whether his docs are collaborating and far as I know, he's not proactively goosing any of them to tell him.)

Yes, most of us know Obama is a puppethead with an ample supply of natural gas. Leaving a noble legacy is the least of his plans, as he likely will be following in Bill Clinton's or Robert Rubin's footsteps. Those who voted for him again deserve the name "sucker".

Doctors point to defense against potential lawsuits to justify their providing unnecessary medical procedures. These additional procedures however also increase their income so how much of the explanation is self serving?

With all the allegations which support tort reform, why are tens of thousands of patients injured or killed each year by preventable mistakes of doctors and hospitals?

Doctors in the US are trained and endoctrinated to be well paid mechanics. The concept of being a healer has been substituted with being a highly compensated professional. Combined with the profit seeking of publicly traded health industry companies it is not surprising how poor the patient outcomes are relative to GDP allocated to health care in the US.

Gaylord i agree Chapo was the best choice

homeless: we laypeople tend to know or care very little about medical economics, including the cost of our various "procedures".
Read Time magazine's recent "Bitter Pill" feature, which 'splains a lot. You'll learn that chief hospital administrators' annual salaries are in the MILLIONS even in so-called "non profit" hospitals, but it gives no clue about why their board thinks they're worth that much. Also, you'll learn that all docs are not rolling in dough . . the primary care docs are often lowest on the pay scale. Obamacare puts huge pressures on this area, which is why there's a silent push to grow more Physicians' Assistants and Nurse Practicioners. In my long years of med experience, they're often more thorough and attentive than the docs who give you the wham-bam 15 minute appointments.

In short, most of us can probably agree that the medical system in the US is horribly inefficient and the business practices are archaic. Time for us to become more knowledgeable patients I think.

All good points morecleanair.

Thank you, morecleanair, for the technical clarifications on the subject of Medicare "imbalances". The part about constant 2011 dollars suggests that inflation has indeed been adjusted for. But I find the reference to a "real 2 percent interest rate" puzzling. Also, the assumption that workers will retire at age 65 seems antiquated, given post-Great Recession circumstances. Don't apologize for the "picky exactitude". The devil is in the details, as they say. I can't comment further on the estimates you quote without examining the study you cite in depth, and at the moment that won't be possible.

I think it's remarkable how much of the information we cite is conditional. I saw a letter in the Arizona Republic recently describing the Obama administration as Orwellian because of the proposed revision from regular CPI to chained CPI (excluding certain programs). The letter writer seemed scandalized by the idea that the "reality" of inflation could be defined away by a simple technical adjustment to the definition of inflation. But this ignores the fact that the original definition of inflation is itself a construct of federal statisticians. I don't, incidentally, say this to defend the revisions. I just think that there is considerable confusion as to what constitutes "reality" to begin with.

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