Obama does not deserve our respect or our votes. He has fucked us all with his back room deals and lies…a corporate humpin political pussy in it only to help his corporate backers.

Nice going Obama…thanks for all your help.

From the department of actions speak louder than words:

“When it comes to cost risk benefit analyses, the cardinal rule is always to pawn the costs & risks off on others while reserving the benefits for yourself.”

Robert Rubin, former chairman of Goldman Sachs & U.S. Secretary of the Treasury

http://www.pbs.org/wgbh/pages/frontline/warning/

agree with the rest of your comment.

Healthcare is not a business and the sick are not customers or consumers, they are beneficiaries of care and have no choice in needing to receive it.

this is a really good point. thanks for making it. agree with the rest of your comment also.

My only qualm is one that relates to whether it is best to insist on a single payer system at this point rather than for a PO which if implemented adequately will in time lead to a single payer system, My inclination is to make the transition by way of a PO and to assure that it has the elements needed to succeed.

i know this is a difficult question, and i respect that different people will come to different conclusions on the best way to proceed. imo by challenging each other (po advocates and sp advocates) to justify our thinking, arguments, etc we will, both of us, strengthen our understanding of both policy and strategy…. and maybe even how we can best work in synergy.

p.s. i apologize if my comment above is too harsh. i’ve od’ed on hearing others (hcan reps in particular) conflate the po with single payer, but that is no reason to take it out on you.

The PO is in essence is a single payer system in miniature

no, No, NO!

a public option is most certainly not a single payer system in miniature. it is an addition to a multi payer system, which remains a multi payer system. it can not capture all or even most of the efficiencies of a single payer system. it is funded by premiums, just as private insurance is (where there are subsidies, the subsidies apply also to the private insurance programs the po will have to compete with).

please, stop conflating the po with single payer. it’s just not true. and advocating for a po is NOT advocating for a single payer system unless you can show how the transition would occur (there are good reasons to think that a po is dead end and will NOT lead to single payer).

a po may be viable (here i agree with you that if it can offer better coverage for lower premiums and cost sharing, it will succeed and grow if not limited by regulation. but there are good reasons to doubt it will be able to do that.)

Few appreciate that the financial crisis is an existential crisis for the current corporate form and thus for Westerns governments themselves. And the crisis is not over, by a long shot.

I am a little sketchy on how to characterize the Chinese model. There corporations are strong but there is no pretense that they are independent of government or in opposition to it. In some ways this is a healthier model as the pretenses and delusions about our situation lead to things like the bankrupting of the Treasury on military adventurism and taking corporate risk directly onto its books. (an ongoing process as virtually every mortgage is now being taken on by the GSE’s)

There is an almost universal consensus among the financial cognoscenti that America is in relative and absolute economic decline. This is part threat and part opportunity for the corporate model. Threat to the extent so many major corporations are US based but opportunity because corporations are essentially stateless.

As a partial aside the James Kunstler model of devolution and dystopia is based upon the idea that corporations will collapse, and then too so will government. At least government as a source of money, as we know it. There is in part in these types of views a desire for such an outcome because of a hatred of the corporate form of government and how corporations shape every single part of our culture. I am agnostic on this to the extent that government has not covered itself with glory the last 10,000 years and today they threaten to blow the whole world up with nukes.

We are only at the beginning of this financial/economic crisis. The jury is out on the outcome. There is no plan B if the financial giants collapse. Which is why Obama had to choose plan A, bail bail and bailout some more. If he were to try to lead another way there would be nobody among the elites to follow. It might be said if he even had a vision of something different he could not possibly have risen to the presidency.

Since its inception it has never served as an impetus for a general extension to a tax based single payer system for lack of public demand not because it is undoable.

Whether the PO will be sustainable depends on how it is implemented. The PO is in essence is a single payer system in miniature. Even if it draws a disproportionate amount of costlier participants it could remain viable by drawing a sufficient amount of lower risk participants. Because it is more efficently run than private insurers the ultimate premiums the PO would offer may still be lower than that of the private insurers. And therefore draw more of all participants regardless of their risk and cost.

The issue of subsidies is irrelevant, since if there is a mandate to have everyone covered, all those who are unable to meet their premiums will be subsidized, no matter who provides that coverage.

I don’t see the PO as an end. To advocate for it is to in fact advocate for a single payer system that will expand as long as it continues to offer lower premiums than private plans. I think that at this point since it is the only thing under discussion it may serve as a transition.

One can of course argue that we should advocate instead for a comprehensive single payer system now, but that task is much harder.

My only qualm is one that relates to whether it is best to insist on a single payer system at this point rather than for a PO which if implemented adequately will in time lead to a single payer system, My inclination is to make the transition by way of a PO and to assure that it has the elements needed to succeed.

This won’t happen. Medicare has had decades to transform into Single-Payer, and with yet another “market-based” approach to reform foisted onto us, it is no closer today to making that transformation than it was the day it was established.

Additionally, a hodge-podge Public Option that is bound to failure by becoming a dumping ground for the sick and/or poor (requiring subsidies) is only going to create the same climate we’re already seeing with the stimulus. We all knew the stimulus was too small, and argued that you weren’t going to be able to go back to the well for more, because once it didn’t accomplish everything it should have (if it were bigger), the opposition was going to call the whole thing a farce and a failure.

Healthcare is not a business and the sick are not customers or consumers, they are beneficiaries of care and have no choice in needing to receive it.

A much better analogy is when businesses collude to elevate prices you need to break them up in order that services are provided at a fair price. The above analogy fails miserably for the simple fact that insurers and others are currently doing just fine they are under no distress at all. Their profits couldn’t be higher.

It is the waste by insurers primarily, as you point out, and their monopoly as middlemen that are at the root of the problem. By what reasoning should patients have to do without because the system they are under is inefficient. This line of reasoning is just completely off base and it is no wonder. Once you start working from a faulty premise it is just downhill from there.

Your points are convincing and straightforward, the level of current health expenditures is more than enough to meet the health care needs. It is a matter of spending it wisely and efficiently to the detriment of insurers, drug makers and others but certainly not to the detriment of patients.

My only qualm is one that relates to whether it is best to insist on a single payer system at this point rather than for a PO which if implemented adequately will in time lead to a single payer system, My inclination is to make the transition by way of a PO and to assure that it has the elements needed to succeed.