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Listeners from opposing sides of the political spectrum call in, pair up, and ask each other questions, in the spirit of the new bipartisan State of The Union seating arrangements.
Gary, you don't explain why other nations do just as well in terms of outcomes as we do at a fraction of the cost.
Every study I've seen says we pay far more on health care as a percentage of GDP than any other nation and do not get better results. For example, check out this chart from the NY Times: http://www.nytimes.com/imagepages/2009/06/17/business/17leonhardt.graf01.ready.html All the theory in the world is useless in the face of hard facts.
As for waiting times, they vary from country to country but overall they are no worse than here. Again, please read T.R. Reid's book for the data. He could get elective surgery within a month in France and Germany (no worse than in the US), and in a week in Japan (with their top specialist). In Canada, it would have been a lot longer. In England, they wouldn't do it at all--though he could always go out of the system. Here, the many people without insurance can't get elective treatment at all and can't pay for it out of pocket, so their waiting time is infinite--or the wait until they have to go to the ER, which passes along the cost to the rest of us.
Other nations do have competition. But they're within regulated systems, and insurance is non-profit. The non-profit nature of the system does not seem to harm the competition among insurers. And they all have a mandate which covers preexisting condition, and don't consider it "grotesque." Indeed, judging by results, it works quite well.
My examples are not inappropriate. Market competition would kill sports leagues because they bid up prices, and that's the point. You dismiss the example by claiming something about "the very nature of sports." But there may be something in "the very nature of health care" that makes a pure free market approach inapplicable (see my example below about colonoscopies: even if they were free, people still won't get more of them than they need to). And higher education organizations do compete; just because they're accredited doesn't mean they're not competing. They bid up prices by building fancier dorms, recreational facilities, and the cost of professors, but it doesn't change educational outcomes very much. I like markets, but I'm not going to ignore specific instances where they don't get the results we want. They work in most areas, but they don't work everywhere, and the evidence is clear on that point.
By the way, I don't think you need a doctor's permission to fast. It's not something you need an MD's authority to do, or insurance to pay for. And there are tons of treatments covered by insurance, treatments that patients can choose from.
To SJ from New York, NY (or others who have the info) -I'm very interested in what you said about insurance for catastrophic events only, being a choice available under the new healthcare law. I keep hearing just the opposite. I don't know what's true. Can you send me a link or some info to verify what you said? I hope you're right!
Dear dsimon from Manhattan
Peer nations do not spend less in real terms. There's a cost in obtaining treatment immediately, without waiting. That's what we want in the US and that's among the reason our costs are high. There are many other factors and analyses comparing costs in US vs Canada and UK, which you may find on AEI or Hoover institution websites. Apples and oranges cannot be compared.
One hallmark that the insurance model for minor treatment, like fixing a dental cavity or medical checkup, is bad is the fact that there's a government mandate to buy insurance. And it's a grotesque hybrid of one too. No other insurance system covers pre existing conditions. They all cover assess your risk BEFORE your need coverage. Not afterwards. High risk pools work for automobile insurance. There's no reason they can't work for healthcare.
You say that consumers CAN determine the "character" of their care? Try getting coverage to attend a fasting retreat to treat a cancer, then let me know if you still believe that contention. The only way an MD in any state can treat a patient holistically is by doing so "off code." That means their practice is set up NOT to accept any insurance coverage. patients pay out of pocket. When you accept insurance, you MUST treat X disease with Y treatment, or else the MD could be arrested for insurance fraud.
Finally, there's no competition when a third party makes healthcare choices for you. Whether its your union or your employer. With competition, prices go down, not up. Why do you think the medical establishment limits how many people can become doctors? to keep their salaries low?!
Higher education and sports are protected monopolies. Bad examples. Ask yourself why a university can keep raising prices? Can anyone start a college with acreditation? "Cost controls" in professional sports are necessary only because of the very nature of sports----so that the poorer ball clubs will have a sporting chance to win against the richer clubs. In most areas of commerce, a company is free to excell and thereby eliminate competition----by working within that field and not using other related areas of commerce as leverage. Your examples don't relate to healthcare. Competition benefits the consumer. no competition benefits the seller.
read my article:http://www.vaclib.org/basic/gk/SinglePayer.htm
comment to my email addr if you wish.
RLewis, let's take the issues one at a time in a linear fashion, shall we?Your initial comment rather laughably dismissed the "why is the GOP against socialized health care and not socialized public safety services" with an argument that basically implied that the answer to that question is "because hanging out in the hospital on the government dime is so much more fun than getting arrested or setting your home on fire that everyone would do it if it were free." That's an absurd argument and I dismissed it as such.I'm assuming you've conceded that point in the greater discussion since you've moved on to another issue. However the uniquely republican argument that we can't address the health care issue because people smoke and are fat and therefore prone to expensive illness is equally absurd. You accurately acknowledge an impending problem. Your solution: ignore the problem. Brilliant!
Gary, I don't think your reasons for the high cost of health care are correct. The governments of many of our peer nations control prices, and they spend far less than we do. They use an insurance model, and they spend far less than we do. And your fourth claim, that consumers don't determine the "character" of their care, doesn't seem supported by the facts that I know of.
I also disagree with your characterization of our present system as a government controlled "monopoly." There are plenty of doctors and hospitals competing for business, though within certain guidelines. Without those guidelines, prices could be bid up even further, not brought down. Free markets don't always result in lower prices (see what's happened with higher education tuition, or professional sports with the advent of free agency--all leagues have adopted some kind of cost controls to preserve their very existence).
Other nations have competition within a regulated system, and they do just as well as we do while spending far less. I suggest reading T.R. Reid's book "The Healing of America" for a look at the many ways that other countries have successfully structured their comprehensive systems.
Seven justices relied on the consensus of "Equal Protections" as a basis for striking the FL supreme court's decision. Most legal scholars scoff at that rationale, and instead cite as the correct basis---which a minority of the Justices mentioned----the allegation that the FL Supreme Court acted in "Ultra Vires" (in excess) of the existing FL ballot and voting statutes.
I just heard the last caller - who complained about people going "for every sniffle to the doctor" if they had "Obama care". This rediculous arguments just make me crazy.1) where do Americans go for every sniffle currently? The emergency room! I know several emergency physicians who constantly complain about the wastefulness of this arrangement. People going to the ER for a sore throat and getting the whole ER workup. This is NOT less expensive than going to your own doctor! And who do you think pays for this in the end? Yes you are right - the taxpayers.2) actually people should go more often to the doctor - so major illnesses can be recognized at an earlier stage which again makes the treatment less expensive.
So please stop whining about European or Canadian health care - especially if you have never experienced their health care system and get all your info from right wing talk radio....
Just caught caller Keith's claim that "socialized medicine" doesn't "work" because not having to pay out of pocket leads to over-use which increases costs.
But this is demonstrably false. First, the only peer jurisdiction which offers a truly socialized system is Britain. But more significantly, just about all of our peer nations cover everyone and get comparable health outcomes, and yet they spend a third less to half as much as we do--so their costs are far less than ours. Their "socialized" systems spend less, not more. Why don't the facts conform to the ideology?
Free market principles don't apply to health care because we don't consume health care services like other items. Keith said if you make something cheaper people will consume more of it, but if you make colonosopies "free" I'm not going to go get more of them. There are plenty of disincentives to see doctors regardless of price; it's time-consuming, inconvenient, and you may get news you don't want to get and require actions you don't want to take. On the flip side, there are those who should be seeing their doctors but are put off by the price, allowing problems to fester and leading to more expensive treatment in the ER which costs all of us more.
Those who attempt to apply free market principles to health care ignore what seems to me to be clear evidence to the contrary. I have nothing against markets, but that doesn't mean they're the solution to every problem. Evidence has to take precedence over ideology.
Why do republicans want less government "interference" in some cases (health care except Medicare/-caid), but *more* government "interference" in others (abortion rights)? Republicans think that we should have options and choices, unless that option or choice is to terminate a pregnancy?
Why can a republican say, for example, "a woman knows best what health care she needs and the government should not force her to buy insurance she doesn't want/need" BUT ALSO say "a woman cannot be allowed to make this one health care choice that she knows to be best for her." Do they really just want the government out of our lives UNLESS it's my womb or my marriage? Is it that simple?
I think this is a great segment, awkward as it may appear to be. The fact that this shows how much or how little the general public really understands what is going on is, to me, a first and important step to true discourse.
I think this is a segment that should return once a week - even if it is painful for some to hear those who are misinformed, overtly partisan, or on the same page.
Someone from Factcheck.org or some sort of political wonk with some bonna fides should be on hand to dispell myths and correct those who don't have a full grasp of the facts, and therefore educate the listeners and TRULY answer questions and settle any grey areas.
This would be a great community service and keep conversations going, rather than stifle discourse. It is the backbone of our democracy and society.
Bush v Gore Question [Sorry caller I didn't get your name]: Here is my answer if I got your question: It was not about Bush or Gore--it was not about what Gore argued before the Florida Supreme Court, it was all about every vote being counted. If Gore had his way and there was a selected recount, Bush would have won that recount. BUT if the voters had their way (i.e., every vote is counted), Gore wins according to the coalition of Newspapers that reported their count under every method in the Fall of 2001.
It is all about every vote being counted.
That segment demonstrated the root of most of our political problems - voters who are so woefully uninformed they can't even discuss public policy coherently. That was painful.
The Dem strategy to recount 'key counties' was a mistake but their backs were against the wall, first w/ the cert. deadline and then Fla's own safe-harbor law.
The Dem strategy SHOULD have been to count ALL of the disregarded machine votes - UNDER VOTES and OVERVOTES - in which a determination of the voters intent could be reasonably made. Gore was the winner. Bush lost.
[or in a perfect world, Justice Thomas' recuses himself -- Ginny had been taking money from conservative sources and he had been misrepresenting it since '96! -- SCOTUS splits 4-4 and the lower court decision stands. The recount goes on, the Fla legislature steps in to give their electoral votes to Bush who is made President but a Dem (probably Gore) wins in a walk in 2004. We're out of Iraq in '05, out of Afghanistan by '07. The oil games of '08 are short-circuited and the recession NEVER occurs. How's that for wishful thinking?
This is a waste of airtime. The truth of the matter is that many of us are genuinely far apart on the issues, and that's a reality that cannot be wished away. What I crave, from intelligent hosts such as Brian, are segments featuring experts on the issues, who can actually teach me something I don't know, not touchy-feely exercises in futility.
Frank thinks we all have $30,000 cars? Who does he know that actually works for a living?
Tony, thanks for being so snide, but unforturnately that does nothing to address the problem, while millions of people continue to smoke and obesity continues to rise in folks who's very expensive end-of-life care will be paid for by you and I.
I am listening to this call in and I hear this guy who is going on about the 2000 election and how Gore was inconsistent. It was a long time ago and it is hard to remember the particulars but one thing I do seem to remember is that there is a law that if the vote is really close that there was supposed to be a recount for the whole state. The Supreme Court ignored that and selected Bush as the president. If there were a higher court (and one that wasn't selected by Bushes) they might have seen that as a questionable decision and overruled it. I also remember that the week of 911 Newsweek had prepared a cover story by former Los Angeles DA Vincent Bugliosi in which he argues that the Supreme Court acted illegally in its' decision. You may remember Bugliosi as the DA who tired Charles Manson.
The Democrat in the first paring asked why Republicans do not want government-run healthcare? She cited the US postal service, but in retrospect, I'm sure she wishes to take back that example!
Republicans have advocated a departure from the current system. There has never been a failure of the free market in healthcare, because there has never been a free market in healthcare. Obamacare merely continues the pathologies of the current system. It's been a government controlled and regulated monopoly, with third parties purchasing healthcare with our dollars.
There are 4 basic reasons why healthcare is expensive today: (1) government control of price and resource allocation, (2) no competition through government regulated monopoly, (3) using an insurance model for non-catastrophic care---which drastically inflates the cost of routine therapies/drugs, (4) Currently, and under Obamacare, the consumer and purchaser of healthcare is not the one who decides the character of the medical care, or whether it should even be mainstream allopathic, drug-based medical care to begin with. By contrast, personal healthcare accounts would provide this greater span of choices for consumers, in addition to the power to ration their own healthcare options, as opposed to third parties using preexisting broadbased templates.
It's hard to believe that any elected official thinks that Americans are used to $30 cars and therefore can afford to buy their "choice" of medical providers. I don't know why I'm surprised because this week in the NY Times an op ed piece reports the discovery that a home is a basic need for veterans who homeless before that person can be 'rehabilitated." Perhaps this is a reflection that those who've survived extreme poverty don't run for office. I remain stunned at the ignorance evident in elected officials who are stunningly distant from the realities of most Americans' lives.
We need national heath care.
It's that simple.
RLewis you're absolutely right. There's a disincentive to use police and fire services, but everyone wants to hang out in hospital emergency rooms. Sometimes I like to stop by my local emergency room and hang out for 8 or 9 hours just to see what kind of bug I can pick up and the free Jell-o.No way should the government pay for that kind of recreation.
My question to the GOP:
Why should anyone believe that the party that pushed a budget that was in surplus into deficit with 1) tax cuts, 2) unfunded wars and 3) an increase in drug benefits be trusted to do anything that is fair to the middle class?
What are your bona fides?
The answer to the first R's question on health care about deductibles is this. The Obama plan said if you had insurance already, nothing changes (except the ins company can't drop you and all that). So your deductible is your deductible before and after Obama's plan kicks in (in three years. )
This segment is a disaster. Nice illustration of how political discourse in this country has completely broken down. What a waste of air time.
This is the worst idea for a show Brian has ever had! It is ignorance questioning ignorance with the predictable level of answers. Please try to bring some kind of enlightenment, even if it is only people who are knowledgeable about their own points of view.
The answer about the health care question from Frank -
I studied the health care reform program pretty in depth in a graduate school class this past fall. (As an aside, I think it's a great plan, after looking at it carefully -- something most politicians I don't think have done.)
There is indeed a significant amount of choice in the plan. In fact, there will be something called catastrophe insurance available to people who would like to pay a large deductible (which is hopefully most of their yearly healthcare) and have insurance kick in only when something major happens (like cancer). This will be one of the cheapest insurance options available, and it's geared toward young and healthy people who don't use much health care and therefore probably don't get their money's worth when paying for a full expensive insurance plan.
Yosif, I could be wrong, but I think that the answer to your question is that the reasons for using fire and police dept's have built-in disincentives not to use them; whereas lazy people who don't want to pay their own way, if allowed, will use doctors and hospitals any chance they got and then leave the rest of us to pay for it.
Is the resurrected abortion issue by the Republicans are not an intrusion of BIG Government into our bodies (and minds) ??The government intrusion is the big mantra by the Reps -- why doesn't it apply to such a personal segment of peoples' lives?
Do Republicans care about the people of this country?
Oh I love the irony! A public option is unacceptable to Frank, but now he demands to know why there are no "options". Hilarious.
We need national health care!
Like every other first work country.
Geneve - the answer is that Republicans like Frank don't care. They can afford big houses, like he said, so that's that.
What is it in "the nature of the beast" that causes republicans, when elected, to "seize" power and democrats, when elected, to reluctantly "accept" power ?
wondering why conservatives are not opposed to socialist fire and police departments but are against similar institutions to protect our bodies. What makes cancer or TB different than a fire or crime?
Matt, Repub's could care less about union corruption; what there care about is that unions cost businesses more in higher wages. It's strictly business.
Would Dem's ban late-term abortion and would Repub's allow fed' funding for abortion as a way to come together on this difficult issue?
I'm really curious:
Do Republicans not like unions because they have a history of corruption? Or is there another reason that's inherent in workers working together?
please note that there are more than 2 parties in this country. so lets here from everybody- ok?
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