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October 11, 2007

Comments

bc:

What an idiot that guy cleaning his chimney was!

If he had won that suit, I'll bet his neighbors and their families would have rushed up to their roofs dressed in chain mail and lassoed those powerlines with belays made of paperclips and sued Office Depot.

I sure hope the taxpayer didn't have to pay for attending to his wounds. In fact, I hope his health insurer punished him further by raising his premium beyond his private ability to pay. And then I hope Medicaid turned him down, too.

He ought to go live on the streets of Calcutta where the legless scoot around on skateboards and waggle their stumps at the tourists, who, if they are Ann Coulter or Michelle Malkin, could get another incentivizing shot in by tipping his skateboard over.

That'll teach him. I'll bet he'll never gird his stumps and get up on that roof again. And I hope he's able to drag himself out of his house if he has a chimney fire, although a cauterizing of the stumps might make him fully comprehend his stupid behavior.

I'll bet a chimney sweep would take one look at that guy and immediately double his fee because he has Edward Stumpylegs right where he wants him.

Why doesn't that guy go to the hardware store and get some copper tubing and duct tape and make himself some legs, like the Founders stiputated?

Just kidding. See, I can't tell whether I'm being over-emotional or I'm extending your arguments to their logical, rational end.

Question: Aren't the uninsured charged when they visit the emergency room for their snivels because your insurance company and mine paid little more than cost in their reimbursements (grouped together socialistly, but privately, for bulk consideration) for our medical care, which we delayed until things were really expensive, given our deductibles?



"Your Mom may be a case in point."

Your point, or my point? My point was that medical services of all sorts are available to her at fairly low cost, including her MediGap coverage, but she feels no incentive at all to see the doctor, let alone demand an MRI for breast cancer in time.

Of course, she wouldn't call the fire department if SHE burst into flames and the firemen were offering $1000 bonuses for self-combustion.

Why? Good-old American self-reliance.

Arguing with Cleek and me is like trying to clean out your chimney by lighting a fire in the fireplace and pouring gasoline and throwing dynamite down the flue. That ulcer you're experiencing may or may not be covered, depending upon whether it was a pre-existing condition or not.

;)

"Stiputated"?

Yes! Paragraph 14, sentence six, in the Constitution. It's been willfully misspelled ever since.

"Why? Good-old American self-reliance."

That is a cultural thing. I think it is rather odd to invoke it as a cost saving measure while simultaneously insisting on government provided health care...

cleek: I just said HSA's turn the incentive around. I didn't say they were the entire answer. I think I said that they would provide extra dough for the truly needy if those that could afford them were required to carry them. But, since they are a lot like an IRA in the savings aspect, maybe you're right. Maybe nobody would save. We'd spend all the money on aromatherapy.

And cite me the proof that you are perfectly average!!!

I thought I'd stay out of this one because, IMO, the best possible way to respond to folks like Malkin and Coulter is to ignore them. Since the discussion has broadened a bit, I guess I'll chime in.

I don't think Coulter is an act at all. I think if she was not restrained by the law from doing so, she would shoot people she disagreed with down in the street like dogs. I think she would, personally, light the fuse on the bomb that blew up the NYTimes building. Far from being a "small government" person, she'd be delighted to see the full force of government used to crush anyone she disagrees with.

Ann Coulter is as close to a Nazi as you're going to get in this country without shaving your head, moving to Idaho, and joining the Aryan Nation. And no, due to the fact that she means every word she says, she's not very funny.

In short, to confine myself solely to clinical terms, I think she's a murderous, obsessively enraged sociopath. I don't find her amusing, and if she or folks that share her views ever find their way to expressing their bloodlust in the real world, I'll be happy to meet them blow for blow. Conservatives aren't the only ones who know how to shoot a gun.

Regarding the health insurance issue:

Folks upthread have already corrected the more egregious bits of misinformation you held regarding the Frosts. I'll just add a couple of other observations.

The Frosts weren't facing "broken arms, childbirth, braces". They were facing two kids in comas with extreme, traumatic, system-wide injury, followed by months and years, possibly lifetimes, of remedial therapy.

I hate to break it to you, but your $2MM lifetime benefit wouldn't even make a dent in that. You'd probably burn through it in a couple of months. Maybe a few weeks.

I don't know what your neighbors, church, or family are like, but for most folks that kind of situation is out of reach of those resources as well. Far, far, far out of reach.

If you were to face the situation the Frosts faced, you'd be presented with the choice of sticking to your anti-government guns and watching your kids die, or sucking up to the nanny state teat. Just like them.

Were I you considering the Frosts situation, I'd get down on my knees and thank God that my biggest problem was a $399/mo insurance payment, and then say no more about it. I'm not you, of course, so you can do whatever you like.

Thanks -

bc: If one side puts up the Frosts, or Bill Frist, or Terry Schiavo as Exhibit A, the other side should be able to comment on Exhibit A without being called a troll.

I think it's just fine to look at the publicly available facts. What I don't think is fine is what happened with Terri Schiavo or the Frosts, where one side made up a whole lot of lies to attack the other side.

Again, can you answer my question (I don't believe you did): If you were in the same position the Frosts were in, unable to afford health insurance, and two of your children were seriously injured in a car accident - requiring long-term care, which they wouldn't get from the local emergency room - what would you do? Assume S-CHIP is available and you're qualified for it (as the Frosts were). Your children need help.

What do you do?

Sebastian: I think it is rather odd to invoke it as a cost saving measure while simultaneously insisting on government provided health care...

Government-funded health care is a cost-saving measure: and having health care not dependent on your employer (and affordable if you're self-employed and starting a new business) is the best impetus to good old British self-reliance. (We borrowed it, since you weren't using it.)

I do wonder how it is that all these decadent, self-reliance-lacking Europeans manage to avoid spending all their days crowded into their doctors' waiting rooms trying to get their share of free MRIs, vaccinations, and colonoscopies.

self-reliance-lacking Europeans

No lack of self reliance IMO. At least on the dental front they are extremely self-reliant: as in pliers and superglue. I really hope that strong spirits are involved with the pliers…

And while Canadians aren’t exactly Europeans their health system is close enough for me to snark: They’re not spending all their days crowded into their doctors' waiting rooms because it’s a physical impossibility to cram all those people in there for 18 weeks each. (This isn’t a GP visit but specialists or diagnostic and surgical procedures after getting in to see the GP.)

Quiet around here and I was starting to feel bad for bc. May as well offer a fresh target. ;)

OCSteve: "...because it’s a physical impossibility to cram all those people in there for 18 weeks each."

From the cited press release: "The Fraser Institute is an independent research and educational organization based in Canada. Its mission is to measure, study, and communicate the impact of competitive markets and government intervention on the welfare of individuals."

What more credible citation could there be, then to the solemn authority of a press release?

And from a source highly respected for its objectivity, known to have no axe to grind on the matter.

Who could argue that we shouldn't just take their word for it?

The Institute:

[...] Former members of the board of trustees include David Asper, whose family owns CanWest Global, Canada's largest media corporation; Barbara Amiel, wife of Conrad Black; and David Radler, Black's former business partner.

[...]

The Institute has attracted some well-known individuals to its ranks, such as founding member Friedrich Hayek.

[...]

Critics of the Institute and other similar agenda-driven think tanks have claimed the Fraser Institute's reports, studies and surveys are usually not subject to standard academic peer review or the scholarly method. Institute supporters respond that this view is false.

There's more there.

The problem here is that more liberal types may be apt to be skeptical of cites of work from a source that's all about libertarian solutions and analyses, and libertarians/conservatives are apt to be skeptical of cites of work from a source that's all about governmental solutions and initiatives, and the like.

Naturally, just arguing the facts is best, but we also have to agree on those first.

(That is, those who want to argue remotely productively do.)

But thanks for at least introducing figures, however arguable, since that's more than bc has brought so far, at least in terms of rigor, rather than enthusiasm.

"Government-funded health care is a cost-saving measure: and having health care not dependent on your employer (and affordable if you're self-employed and starting a new business) is the best impetus to good old British self-reliance."

Health care funded by the government and health care not dependent on your employer are not in fact identical propositions.

And as I have maintained for years--I'm all for a government minimum system with most people encouraged to go outside the government system.

In fact, since the US government ALREADY spends almost as much on health care (in percentage of GDP) as most European countries, it is odd that we don't have at least that already. It would seem to me that the government could be at the very least covering uninsured poor people with the amount of money that other countries use to cover everyone. (This suggests to me that the vast efficiency gains to be had by the US government taking over are rather overstated). Interestingly, since the US government takes less in taxes, this strongly suggests that the US already spends more as a percentage of its budget on medical expenses than most European countries, but I haven't actually confirmed that anywhere.

No lack of self reliance IMO. At least on the dental front they are extremely self-reliant: as in pliers and superglue. I really hope that strong spirits are involved with the pliers . . .

Meanwhile, true to form, American dentists are getting richer and richer while fewer and fewer Americans are getting any dental care at all.

We really don't know the exact choice the Frosts made but from the outside it looks like they in fact had a choice. It looks they chose wrong.

THerefore, let's punish their children.

John: Of course I'm talking globally. I have relatives apparently like your mother that wouldn't go to the doc if their right leg were falling off. However, we often weigh going to the doctor because of our deductible. We err on the side of safety for our children, but I can think of two or three times we would have gone in the past year and did not because of cost. I waited until I had what I thought was the flu for two months before getting diagnosed with mild asthma due to my daughter's new cat!!

And I'm sorry I didn't clarify that my stumpy legs story was not an analogy. I was only REMINDED of stumpy legs.

But, if we use Stumpy as an analogy . . .:

Although i would not be opposed to providing government benefits to Stumpy despite his stupidity (so long as he was truly needy), I would also not put up Stumpy as the poster child for why we need to provide free health care. Here we have a really bonehead move by the parents creating a need for help. I don't think the Frosts were needy before the accident. They climbed up on their roof with copper pipe.

Now, given where they are, if they truly are needy it's a different question. I hear the left arguing that they had no choice but to clean the flue with a copper pipe!! There was absolutely nothing they could have done short of selling their Volvo to pay for health insurance. I'm not sold, although I still have an open mind.


As for the ER question, I think the problem is the uninsured obtaining services then not paying at all. Yes, we may get a break on the ER charges vs. the "cash" price because we are insured, but we also pay the cost of all those uninsured who do not pay. And if you have to provide services as a matter of law, the costs for all of us go up.

russell: Sorry, I didn't think I had not answered your question. Your question presumes: a) the Frosts couldn't afford health care insurance BEFORE the accident. I do not assume that at all. But assuming for the purpose of argument, certainly I would apply. I don't fault the Frosts for applying now, but I would certainly kick myself very hard for not having insurance in the first place.

Now, taking the assumption out of the equation, I in fact bought insurance. If I didn't make what I do, I would have gotten another job before going without. Maybe I had my learning experience earlier (daughter had to have open heart surgery at age 3). Don't think I talk glibly without thinking.

By the way, I qualified for WIC around the time that daughter was operated on and probably qualified for government-subsidized health care. I bought my own (actually paid the extra $500-600 my employer required for family). The surgery was a huge hit for me at the time ($7-8k out of pocket). We all make choices.

If the Frosts truly did not have a choice pre-accident, then fine, they should have gotten help. Again, it isn't clear to me that was the case.

And, yes, I do thank God I can afford insurance. My basic point is this: if that was truly not the case with the Frosts, then fine. But if they could have afforded it (as it still appears to me they could have) then they are not the proper poster family for SCHIP. Almost every contrary argument so far today starts with the assumption they could not afford it. That is an assumption that is not reasonable with the facts as known (although, again, I hold out the possibility that it could have been that way).

Now, given where they are, if they truly are needy it's a different question.

OK, let's run some numbers.

Mrs. Frost hit some black ice while driving and two of her kids ended up in the hospital with severe traumatic injuries for more than five months.

Five months is 150 days, more or less.

I've been trying to pin down a hard number for ICU cost per day, and it looks to be, conservatively, north of $2K a day. The figures I've found are from a few years ago, it's probably more now, but let's say $2K a day for an ICU bed.

Two kids, $2K per kid per day, 150 days. 2 x 2 x 150 = $600K, purely for the ICU bed. No surgery, no special medications, no physical therapy, no physician consultation. Just an ICU bed.

Graeme had to learn to walk and speak again. His sister requires ongoing therapy -- from 2004 until now, and probably continuing for years -- to help her deal with the results of her brain damage.

Even though your post was signed "John", I'm assuming this is bc again.

Your (bc's) insurance has a 2 million dollar lifetime limit. You criticize the Frosts because, unlike you, they didn't have insurance coverage. Assuming that that is, in fact, true. It's unclear to me from the coverage I've seen.

What I want to point out here is that, in the face of what the Frosts were confronting, your coverage is basically nothing. You'd burn through it in a few months, max.

The Frosts could have sold their house. They could have sold the commercial property that provides them with some income. I guess they could have sold their cars. They'd have nothing left, not a dime, and not even come close to paying for their kids' care.

They are, in fact, truly needy.

You, bc, would be a couple of months ahead of them, and then you'd be selling your house and your car. And you'd not even come close to paying for your kids' care. A patch of black ice, and you're broke, no home, and no chance in hell of ever getting insured again.

Are you getting the message?

I'm glad you were able to find a family policy that will cover the bases for your family for $399/mo, as long as nothing really bad happens. Maybe the Frosts could have found something like that and just decided to blow it off so they could eat filet mignon and play the ponies. Maybe a plan like that just wasn't available to them. I don't know, and neither do you, so it's foolish to speculate about it.

In any case, the only difference between them and you is that you are luckier. One patch of black ice, and you're in the same boat.

Your $399/mo insurance policy is basically one tiny finger in a big, big dike.

And that, my friend, is the point.

Sh*t happens. If you're lucky and/or rich, maybe you have the resources to weather the storm. If you're neither, you need help.

What happened to the Frosts could happen to any one of us. That's why, in most places in the world that have the kind of resources we do, folks just pony up and make sure that nobody has to suffer like hell if they happen to draw the short straw.

And, as it turns out, in virtually all of those places, folks are, on the whole, better off, while paying less for it.

Those are the facts.

Thanks -

russell: Yes that we me. I was addressing it to John. As you say, we don't know. I am only saying IF they could afford it they should have. You (and others) keep talking about now versus before the accident. I am talking exlcusivley before the accident. Now, I don't have a problem with them getting help. But please dont' point to Graeme and say "He's so hurt you unfeeling conservative dingbat you can't criticize the Frosts" even in a POLICY debate.

As for my coverage, saving the taxpayers $2Million is no small thing, even though you think it is. I said that in my earlier post-anyone exhausting the limits of coverage and meeting reasonable income requirements should be covered, after you have performed your duty as a citizen.

And as for the black ice thing, that happened in a lesser sense to us. Read my earlier post. That would have been economically catastrophic had we not had insurance.

So if you don't know, Russell, why are you criticising me for simply saying they should have had insurance at the time of the acccident if they could have afforded it?

And I am not totally convinced others are better off where there is universal insurance paid for by the state. Why do they come here for services? Maybe you want to go to Cuba, but I don't! My daughter had one of the best surgeons in the world.

So if you don't know, Russell, why are you criticising me for simply saying they should have had insurance at the time of the acccident if they could have afforded it?

I don't know if they had insurance or not. Do you?

If they did not, I don't know if that was because they simply could not afford any of the available plans, or not. Do you?

If you don't know, your point is academic. And, in light of the actual damage they had to deal with, your point is also academic.

I appreciate that you'd like to save us all two million bucks, but the Frosts may not have had that option. I don't know, and apparently neither do you. You're making assumptions about them based on your own experience, which may or may not be relevant, at all.

And I am not totally convinced others are better off where there is universal insurance paid for by the state.

I invite you to look up the percentage spent on health care in any other OECD nation, either per capita or as a percentage of GNP, and compare to us. Then, I invite you to look up how any OECD nation compares with us as regards any measure of public health that you care to choose.

You may then draw your own conclusions.

Thanks -

russell: Actually, it looks like they had CHIP insurance at the time. So, in light of that fact, the only debate would be whether we should be providing insurance to those that may be able to afford it anway.

I agree that picking apart the Frosts personally is not the same under these facts and my criticism is much muted if not gone entirely since they did obtain insurance for their kids. I understood they did not have insurance and my arguments were regarding what appeared to be their choice to be uninsured. That was apparently not the case and I stand corrected.

I still think that they are fair game to an extent. For example, I think it is a legitmate debate whether people with their resources should be receiving health care assistance. But since I don't know their exact situation, I can't fully comment. I still think trashing those that question whether they should have access to government provided insurance or the extent of that access is wrong. But I stand corrected on my main points.

KCinDC: I do wonder how it is that all these decadent, self-reliance-lacking Europeans manage to avoid spending all their days crowded into their doctors' waiting rooms trying to get their share of free MRIs, vaccinations, and colonoscopies.

Hey, being decadent is hard work, you know. It's not all lazing around on a bed of peeled grapes drinking freshly-squeezed mango juice and having wild sex.

More seriously: bc, thanks for your contributions to this debate.

Somewhere up thread, someone mentioned the fact that they had not taken their children in when they might have, because of insurance, and I've certainly heard stories about that all the time, but I wonder if anyone feels comfortable in a country where taking care of children is a matter of rolling the dice. While no one said 'yeah, that's the kind of system I like', the absence of anyone mentioning how problematic that it makes me think that a lot of the problems of the health care and insurance system have been internalized to such an extent that an attempt to really solve the problems would fail.

lj: the absence of anyone mentioning how problematic that it makes me think that a lot of the problems of the health care and insurance system have been internalized to such an extent that an attempt to really solve the problems would fail.

I think any serious attempt to really solve the problems would fail regardless of how many individuals find it problematic. The beneficiaries of the system, the health insurance companies, have considerable lobbying power to prevent any serious legislative attempt to set up a decent health care system. With government alternating between a right-wing party and a far right-wing party, and with the electorate having no way to vote in a left-wing party, there is no reason for politicians to ignore powerful lobbyists in favor of the people who vote for them. Add in the fact that right now US elections are basically screwed anyhow, and I think that - like the UK in the 1930s - the US would need something as massive as WWII to overcome the entrenched resistance of money, right-wing government, and rigged elections.

OTOH, if the US goes on as is - that is, if the 2008 presidential election is rigged like the last two, putting some RNC insider or son of an insider into power for the next 8 years, then I think the US is likely heading for a crash of some kind in the 2020s. This isn't schadenfreude. It's an extremely disturbing thought.

Totally agree with your analysis of Coulter and Malkin. The other thing about Malkin that's annoying is that she seems to have the tone of a schoolchild in a hissy fight all the time... you half expect to hear "i'm rubber, you're glue..."

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