US Politics XXXVIII

[The Progressive]

As to the rest, yes, the medical industry *is* in a bubble, in that costs are much higher than they would be because of insurance and medi-whatever. I said it before: many years ago, if you showed up at the ER with a relatively common injury and had neither insurance nor medi-whatever, the docs would give you the quickest and cheapest treatment they could to get you out of there, because there was no money to be made off of you. That happened to me a couple times way back when. If, on the other hand, you had insurance or were covered by medi-whatever, they'd tack in all sorts of tests and prescriptions and whatnot - at least on the billing form though not always in reality - simply because they could get away with it. I *KNOW* people this happened to - and this was in small town Alaska. A couple of them did challenge the tab - even though it was covered by insurance or medi-whatever, and had the bills drastically reduced.

Hey remember when you make all those bizarre claims based on anecdotal evidences which were subsequently debunked with simple Google searches?

Good times.

[Annelise]

Count me as one of the supporters that is bothered by this. I believed that the other party had the motto "Drill baby drill," not the side I voted for. I know Obama has indicated that expanding offshore drilling was something he would consider, but this just seems foolish. Does he really believe that this is going to be met with similar compromise by the Republicans?The ones who, you know, already said they're not going to cooperate for the rest of the year.

Politically, I think the idea is that it's one less rally point and along with his nuclear stuff, leaves Republicans with not much to say on energy.

It also may be trying to win support from Graham, Collins and Snowe, who said (after McCain's threat) they'd be willing to work with Dems on various issues this year. One of them being energy. ETA: I'm not sure though, that picture is a little muddled, as far as whether they are going to tackle it or not. I know Graham, Lieberman and Kerry had a bill they wanted to introduce and I think? Collins and a Dem Senator had another smaller one they wanted to move, but the former three indicated they had covered the latter's in theirs but it hasn't been released yet.

[Former Lord of Winterfell]

Nice false dichotomy, but nothing about insurance implies "going broke" for someone else's child....

It does if the moral choice posed becomes the equivalent of "is your money more important than someone else's life?"

As for cost control, the notion that governments are unwilling to take explicit measures toward efficiency in the billing system or to take more drastic actions (e.g. closing or merging hospitals or eliminating hospital boards entirely in favour of regional/district health authorities) is ridiculous beyond belief.

Why are you directing that towards me? I never made the point otherwise. I simply made the point that government const controls are an inherently blunter instrument than the cost saving choices people and providers would make on their own if the costs were not all borne by a third party.

[Former Lord of Winterfell]

Politically, I think the idea is that it's one less rally point and along with his nuclear stuff, leaves Republicans with not much to say on energy.

Personally, I think federally financed loan guarantees for nuclear power plants is a horrible idea. The underlying problem is why those plants can't get built privately, without federal loan guarantees. Until that is addressed, nuclear power won't be sufifciently cost effective to make a dent in our energy needs.

It also may be trying to win support from Graham, Collins and Snowe, who said (after McCain's threat) they'd be willing to work with Dems on various issues this year. One of them being energy. ETA: I'm not sure though, that picture is a little muddled, as far as whether they are going to tackle it or not. I know Graham, Lieberman and Kerry had a bill they wanted to introduce and I think? Collins and a Dem Senator had another smaller one they wanted to move, but the former three indicated they had covered the latter's in theirs but it hasn't been released yet.

Am I wrong, or did where this ban get lifted versus where it stayed in effect seem to track pretty closely the "red/blue" division of states?

[Aemon Stark]

It does if the moral choice posed becomes the equivalent of "is your money more important than someone else's life?"

What moral choice? You don't get to opt-out from forms of social insurance, whether it's the police and fire department or, indeed, health insurance. The optimal situation is not where you avoid "going broke" for either your own health or someone else's, but where no one goes broke.

Why are you directing that towards me? I never made the point otherwise. I simply made the point that government const controls are an inherently blunter instrument than the cost saving choices people and providers would make on their own if the costs were not all borne by a third party.

It wasn't directed at you.

[aeu]

My company offers health benefits, yes. However, in 2011, they are switching to a plan that I don't like, called a "CDHP" (basically, a high deductible plan). Currently, we have the option of a CDHP or a PPO. If I can find PPO coverage for less than I would pay for group health insurance with the CDHP (which actually seems likely), I will buy it.

Thanks for the answer. Does your company contribute to any PPO you can find (upto a certain limit, I assume)? If so, that's a pretty good deal.

[Former Lord of Winterfell]

He does sound like an interesting candidate, to be sure. I haven't read in depth, but I bet I certainly would consider him for Governor.

A lot of Indianans would agree with you, given the margin by which he was re-elected. :)

I like that one some of his work has been on an initiative to cover the uninsured.

It saved money over the Medicaid alternative. But he just wrote a piece for the Wall Street Journal in which he said the new federal plan now means that the Indiana plan is probably going to fall by the wayside. He's always been a pretty moderate guy rhetorically even though he governs as a fiscal conservative, but the health care bill may be the straw that broke his fiscally-conservative back. It seems to have energized him and made him reconsider his opposition to a Presidential run. I weigh a guy like him against Palin, or Gingrich, or just about anyone else out there, and it doesn't even seem close to me.

I've never understood why health insurance "reform" is something that had to be done on a federal level. Massachusetts went one way, Indiana went another, and there are things the feds could have done to force more competition within and between states. We'd have had our reform eggs in 50 baskets instead of one, greatly reducing the risk if we "got it wrong" nationally.

http://online.wsj.com/article/SB10001424052748704094104575144362968408640.html

And that infrastructure project looks interesting, plus the balanced state budgets of course (the glance at his tenure in the Bush admin isn't very good, I would have to read more).

The problem for him with Bush is that he wasn't the one making the decisions.

I posted something previously about the HSA's he instituted for state employees in Indiana. It's been incredibly successful, lowering state costs AND putting more money in the pockets of state workers. Essentially, it encourages individuals and providers to spend their health care dollars efficiently because they get to pocket the money in the accounts they don't end up using. But that may be toast now.

http://www.cbsnews.com/8301-503544_162-6259808-503544.html

I don't know where he is on the social stuff, I would love a socially moderate republican.

From what I gather, he tends to hold socially conservative positions personally, but doesn't push them legislatively. For example, some of the conservative Chrisitans in his state were ticked that he wouldn't help push for a state same-sex marriage ban.

I'm not sure how well he'd sell to the conservative base though.

He would not be a "favored" candidate for the socially conservative wing of the party because he won't push that agenda. But I don't think he'd generate "over my dead body" type of opposition either. In terms of the conservative base that isn't focused on economic issues, he's getting a lot of buzz. Very favorable profiles in the Wall Street Journal and some other places.

http://online.wsj.com/article/SB10001424052970204488304574431100758568602.html

He's exactly the type of Republican I think the majority of the party would support, and who could make a formiddable opponent for Obama in 2012. But the primaries are tough because that's where the ideologues tend to dominate, and I'm not sure he'd have enough of that support to get going. But I think if he could make it to being one of the top 3, he'd probably win it.

[Altherion]

Personally, I think federally financed loan guarantees for nuclear power plants is a horrible idea. The underlying problem is why those plants can't get built privately, without federal loan guarantees.

Because for certain very obvious reasons, that particular industry is regulated to the nine hells and back. You'd be insane to touch this if the government is not on-board. On the other hand, if the government is on board, then it is effective enough.

Until that is addressed, nuclear power won't be sufifciently cost effective to make a dent in our energy needs.

We get 20% of our electricity from nuclear power right now. Cost effectiveness is not the issue here.

[Former Lord of Winterfell]

Because for certain very obvious reasons, that particular industry is regulated to the nine hells and back. You'd be insane to touch this if the government is not on-board. On the other hand, if the government is on board, then it is effective enough.

But the "government" acts through more than just loan guarantees. The rest of the regulatory environment, laws, and ability of third parties to file suit stopping construction is unchanged. So saying the government is "on board" really isn't accurate. All you've got are these loan guarantees, which in fact were purusant to legislation passed in 2005 under the Bush Administration. To me, the incredibly small scale of this whole thing suggests that the Administration is not really on board except to the extent it can claim to be for political advantage.

I'm not opposed to reasonable safety regulation, but damn, the hodgepodge of bizarre enforcement mechanisms and private rights of action make the whole regulatory process far more fragmented and inefficient than it needs to be. France seems to do it through a standardized design process that permits expedited approval. Not sure why we can't try something along those lines.

We get 20% of our electricity from nuclear power right now. Cost effectiveness is not the issue here.

The cost effectiveness of building new plants is precisely the issue. That's why government-funded loan guarantees are required. The 20% we currently get is primarily from older plants heading towards retirement. The current pace of building isn't even enough to replace that. We haven't started any new plants since the 1970's. And during the 80's and 90's, 100 or so planned plants were cancelled because of regulatory issues.

http://www.nytimes.com/2010/02/17/business/energy-environment/17nukes.html

I think nuke is a good way to go, but I don't think its a smart idea to go in that direction via the route of loan guarantees. Either figure out a way to streamline the regulatory process so that they can be built in a cost-efficient manner by private money, or don't bother.

[TrackerNeil]

I've never understood why health insurance "reform" is something that had to be done on a federal level. Massachusetts went one way, Indiana went another, and there are things the feds could have done to force more competition within and between states. We'd have had our reform eggs in 50 baskets instead of one, greatly reducing the risk if we "got it wrong" nationally.

Maybe because only one of those baskets - namely, Massachusetts - had any eggs at all, while the rest of the nation was going hungry.

[Former Lord of Winterfell]

Maybe because only one of those baskets - namely, Massachusetts - had any eggs at all, while the rest of the nation was going hungry.

Other states were free to follow suit. Why didn't they?