"Healthy" Debate

I wanted to submit this post here, which I had posted on Justin's blog that Dick is referring too...

Justin, great post...other than the political viewpoints, your post highlights the realities this country faces in terms of our health care system. I worked for a BlueCross BlueShield in the northeast, and I know how hard they are trying to push HSA's and other Consumer Driven Health Plans onto business and their employees, and to justify the 'control' that the employees will get with these plans, they offer 'Transparency' initiatives to inform employees better on costs, quality, etc. The reality is the information is limited, poor, or non-existent, and the decisions an employee is left to make is avoiding the doctor whenever possible, in order to maintain some funds in their HSA. Armey and others like him like to throw out terms like market-driven, the consumer as decision maker without understanding the fundamental nature of this industry which is designed to protect parties other than the consumer.
And of course they stick their head in the sand to look at those 2 critical points, about quality and costs. Again, great post.

To add to this, Dick, you refer to this in terms of government's role, either through taxation, or programs, but the reality is looking at where the rising costs are occurring, at the insurer, with the doctors, and hospitals. These parties are in an ongoing struggle to fudge their numbers to get the best possible price. Doctors like to push patients into treatments, in order to meet the regs the insurer or sets or to get a higher payment. The insurer wants to limit access, minimize exposure to sicker individuals in their actuarial pulls in order to keep their costs and payouts low. The employer wants to cut coverage, well because its a major drag on the bottom line.

So let's put it like this Dick....give one example of a truly market-oriented health care system that is equal to, or higher in quality, and accessibility to the populace as any of the other G8 or wealthy nations. So far, all the examples out there, point us - with a more market driven industry, falling very far short. But god forbid those socialist/commies get in here and try to make things better, huh?

Healthy debate is like date rape.

"By one estimate, health care regulations leave us worse off by an amount equal to 11 percent of health spending."
Please site your sources.

Chile's privatized healthcare system under Pinochet quickly realized a 64% cost-of-overhead, mostly going to the salespersons of the plans. Meanwhile, governmental Social Security hasn't missed a check in 70 years, and runs at less than 1% overhead.

A no-brainer, at least to the intelligent and the non-disingenuous.

The stupid, it burns!!!!!

"For every $100 Americans spend on health care, we pay $11 to the regulator"

Huh? Who is this regulator that Americans are paying vasts sums of money to?

Armey ignores that fact that individuals can now by health insurance for themselves -- there is a "market".

And when Mr. Armey can tell me how much that market will charge for health insurance for a family of four with a father who has a history of heart diesease, a mother who has a family history of breast cancer, one 'healthy' child, and one child with congenital birth defects that require frequent hospital/doctor visits, it will be time to take his argument seriously.

Armey DOES NOT CARE about ensuring that Americans have access to health care, because he does not even CONSIDER what a "free market" would charge for the (actually, non-hypothetical) family of four cited above.

Until then, we can assume that he's just shilling for one of his lobbying clients (a british reinsurance firm.)

So again, the solution to a system that has been beaten and bruised due to the profit-driven and less human-focused aspects of capitalism is to make the system even more capitalistic? Isn't that akin to throwing lead weights to a drowning man?

Please explain why anyone should buy into this crap when all the other first-world nations that have adopted partially socialized healthcare systems see dramatically better results than we do. Please explain how this HSA system benefits those without coverage, those with inadequate coverage, and those without the means to make meaningful contributions to an HSA fund.

"Regulation is a formidable force in the health care game. By one estimate, health care regulations leave us worse off by an amount equal to 11 percent of health spending. For every $100 Americans spend on health care, we pay $11 to the regulator, which is to say nothing of the additional costs heaped on top by frivolous junk lawsuits and medical malpractice abuse. We’re backing up to the end zone and the socialized medicine crowd has the momentum."

Whose estimate is it? What regulations are you referring to?

I'd say the whole frivolous lawsuit comment is pure right-winger drivel. It's a lie spread by right wingers to get us to adopt anti-consumer measures that will let companies kill or maim without due recompense.

And again with that competition tripe. Hello! Richard...are you actually reading the comments? You keep inferring a completely market driven healthcare system will take care of itself, but you ignore a totally free market's propensity to become a monopoly. This is a historic fact. Monopolies eliminate competition and make damn sure the costs of entry are too high for competitors to get in.

Also...you ignore a huge factor in healthcare when it comes to purchasing/bargaining power. Healthcare agents (i.e., physicians, HMOs, etc) HAVE US BY THE BALLS. It's not like other consumer goods where you don't have to buy any specific product. When you need healthcare, you really really really need it, and often don't have time to shop around. You have ZERO ZERO ZERO bargaining power.

You're not addressing any points raised in criticism. Perhaps you just need to go back to your happy place and please don't come back out.

"For every $100 Americans spend on health care, we pay $11 to the regulator, which is to say nothing of the additional costs heaped on top by frivolous junk lawsuits and medical malpractice abuse."

Sounds like you didn't read the Krugman article. What are the insurance company's and doctor's office's administrative costs? It's more than 11%:

****"According to the World Health Organization, in the United States administrative expenses eat up about 15 percent of the money paid in premiums to private health insurance companies, but only 4 percent of the budgets of public insurance programs... [snip]

According to the health organization, the higher costs of private insurers are "mainly due to the extensive bureaucracy required to assess risk, rate premiums, design benefit packages and review, pay or refuse claims." Public insurance plans have far less bureaucracy because they don't try to screen out high-risk clients or charge them higher fees.

And the costs directly incurred by insurers are only half the story. Doctors "must hire office personnel just to deal with the insurance companies," Dr. Atul Gawande, a practicing physician, wrote in The New Yorker. "A well-run office can get the insurer's rejection rate down from 30 percent to, say, 15 percent. That's how a doctor makes money. ... It's a war with insurance, every step of the way."****

It's not a coincidence that the Canadian system is more efficient than the US system by an order of magnitude. It's also not a coincidence that the rest of the industrialized world has chosen universal health care systems and we have not. Now, I'm not *at all* saying that the market doesn't have a role to play in this. But we've gone along with your government-has-cooties crowd long enough and would like to have a decent health care system, thank you very much. There are plenty of systems that work around the world. We can pick from the best of their systems--which as Paul Krugman points out, acheive impressive economies of scale--and also from the best of our system. (I'm probably fooling myself, though, I bet I'm just talking to some Heritage Foundation boilerplate that someone has pasted in here...)

Mr. Armey,

Your argument is compelling, enticing even, but it ignored reality. You're starting to sound like the decider and all of the other yahoo politicians on this matter.

First, lets start with a basic economic principle. Supply and demand. The demand or need for health care, health care services, etc. greatly oustrips out available supply of health care. Start with that, then we'll move on to market pricing.

You guys have the cart before the horse. Simply putting health saving accounts out there that the same 75% of America pays into so that they can make decisions on how to spend their money is a fool's game. The other 25% won't be contributing. They aren't contributing now...why will they contribute later, and since we the American people and government have decreed that basic life-sustaining health care is an inalienable right, the government (Medicare) is back right where it started. The only difference is that you will have shifted the risk of having enough resources to ensure adequate health care to teh vast majority who are already responsible with paying health care premiums.

Further, those who lose their jobs would still lose their ability to continue contributing to their health account. How does this solve anything?

The final component, I can't believe I'm saying Joe is right, is that we have regulated markets. Tylenol is more expensive here than in Mexico because we have very carefully crafted regulations which ensure the safety of the products we use. Should those be eliminated? DO you want to take that risk?

Finally, how do you reduce the cost of anything? You make it more available!! You want cheaper plasma screens....just wait till more are made. And the line about "which is to say nothing of the additional costs heaped on top by frivolous junk lawsuits and medical malpractice abuse" is so tired, it is ridiculous. Don't mention the McDonald's suit. Yeah, she got awarded $1 million by a jury and it was subsequently reduced to cover her medical expenses on appeal. Ultimately, how much of the cost of medical care is really due to junk lawsuits and malpractice abuse....the percentages are so staggeringly SMALL that no one will ever mention them in honest debate. I'll let you go to the GOOGLE and report back what you find.

I like your approach. You're looking for honest answers and genuine solutions, but you've got to avoid ritualistically falling back on talking points, has-been initiatives and red-herrings.

The real question, and nobody has answered it is how do you reduce the cost of something which is limited and for which demand far outstrips supply. You ration it. Pure and simple. We do it everyday in so many ways. America is a country of ration....choices made deciding who will receive what, how much, and when of the limited resources that we possess. Mr. Armey, at least, admit that much so that we can have an honest debate.

The whole "choice" thing is a non-starter. If you want more choice in a governmental healthcare system, simply build it in. It's no more complicated than that.

We have no choice now with an HMO system which severely delimits the doctors we can utilize. It's easy to see the possibility of much greater freedom of choice in a governmental system, and indeed, exactly that has been Europeans' experience.

people have plenty of time to shop around for health insurance. Healthcare coverage should be bought just like car, home and life insurance. As long as people are well informed about the choices, and are effected by them, the market will work. The current problem is that government and business buy 75% of the healthcare. It is ridiculously expensive to buy if you are an individual. Companies should not provide healthcare

Dear Mr. Armey,
Please stop using the term socialized, you evidently don't know what it means or you're using it to Red bait. Either way, you should stop.

And a question: I am by no means an expert on Health Care, but it seems to me that the system you describe, savings accounts, immediately leaves millions of poor Americans in the lurch. Beyond that, what happens if I make a poor decision with regard to my health insurance because I'm unaware of an underlying problem - like say a home owner who doesn't realize he lives in a flood plain and doesn't buy flood insurance - who pays for my treatment? Do I simply not get treated?

Perhaps that's a silly question.

A link to the Krugman column (links, Dr. Armey, that's what the Internets are made of):

http://tinyurl.com/8zlf2

"Please site your sources."

and expose himself for the lying shill that he is?

"According to one estimate" is code for "somebody on wingnut welfare threw together everything that could possibly be defined as regulation -- including courts, certification of medical professionals, drug testing, etc -- and managed to come up with 11% of health care costs."

This is the kind of crap that means that no one should take Armey seriously. The ONLY response from Klein or Fox should be yours...

Posted by JJ
June 5, 2007

According to the World Health Organization, in the United States administrative expenses eat up about 15 percent of the money paid in premiums to private health insurance companies, but only 4 percent of the budgets of public insurance programs... [snip]
Ouch, that would make a thinking person reconsider their position. So I'm sure it has no effect on you.
Look. The majority of people posting here are smarter than the wingnut crowd that you are used to addressing. Just because you make a statement doesn't make it true. Point to the research done to support your position, or just go away.

thenekkidtruth: "We have no choice now with an HMO system which severely delimits the doctors we can utilize."

That same HMO/Insurance system also determines which drugs your doctor is allowed to perscribe as well. The majority of your perscriptions are made through a negotiation process involving your doctor and your insurance company with your local Pharmacist acting as the mediator.

Ask your local Pharmacist what most of their day is spent doing. They will tell you it involves being in the phone with insurance companies.

Hey rmrd0000, that'd be one them thar efficiency of scale thingies, wouldn't it?

It's probably worth pointing out that it seems that Americans are not asking for a perfect health care system, but a better health care system. More of the same doesn't sound like a path to either.

**** Off-Topic ****

Libby update: 30 months, $250,000 fine.

Hey, Dick, time to put your money where your mouth is. I am challenging to give up your group insurance, and give up your future with Medicare, and come on out here in the uninsured world. Hey, yeah, the water's cold, and there are lots of sharks, but if you think individuals can "compete" and "choose wisely" and "cut down on the services they use" and "select for market reasons," you try it.

About 60 million of us--- uninsured or inadequately insured-- do that every day. And maybe before you tell the other 200 million Americans to join us, you ought to ask one of us how we like it.

Answer: We don't.

There is no competition. Insurance companies don't want us, so they don't compete for us. Hospitals don't want us. Doctors don't want us. No one is trying to get us to come use their medical services. When we do, they tend to double their prices, precisely because we cannot work as a group to have an advantage the way insurance companies do. Individuals are sorely penalized here in the real world of "free market" (ha!) medical care. I go to a doctor and I'm charge TWICE what the person over there on Anthem pays. Yep. The uninsured-- who tend to be the poorest-- pay more. Do you know that? Why do you think it will be different under your... well, I can't call it a plan. Under your principle? Without government regulation?

Your precious medical savings account. I had one of those. I scrimped and saved to put money into it, got a little tax credit back... but remember, this is my own money. First spinal tap I had to diagnose the condition that has since rendered me uninsurable.... $2800. There goes my savings account! Now what? My inadequate insurance covered none of these tests or my expensive medication. What do you suggest I do now? The "free market" would suggest that I forgo any treatment because it's too expensive and there's no way for me, an individual, to make it cheaper, and your Republican party has made it very hard for Americans to actually bargain with pharmaceutical companies. Impossible, in fact, so every other consumer in the world gets lower prices than we do, because their governments actually can bargain with the providers. We can't. Ooops.

So let's say I just go without treatment, which is the only economical decision that makes any sense under your, um... not plan. Hmm. Vision. I go without treatment and I'm disabled in a year. Hey! Then I go on SSI and get Medicare! Hurray! Now I can actually get medical care!

Oh, right. You've eliminated Medicare. You probably got rid of SSI too. Shoot. Now what do I do? I know. If I die, along with all the other sick people in this country, then maybe your vision will work.

Hey, it's cold in here! How about you join us, huh? Give up your group policy and your chance at ever collecting Medicare, and join us in the "Free market". Try to find an insurer that will take someone your age, with all the ills you have accumulated, even those long cured. Try to bargain with a drug company all by yourself. Try to pay for one single operation with your health savings account. Try to finance your retirement without Medicare.

What's that you say? You think not? You think you'll keep your insurance? That's what I was afraid of. Then why on earth would you expect the rest of us to accept your vision, huh? We who actually KNOW what it's like without group insurance, not that you care, all want some kind of group health care, whether it's done by the government or mandating insurance companies to accept us into existing groups at a group rate. You simply don't live in the real world if you think individuals have any standing in the health care world.

(Actually, government *does* have cooties these days, but that's a whole other story.)

"frivolous junk lawsuits and medical malpractice abuse"

So more regulation for individuals and no regulation for international corporations. I'm shocked, SHOCKED to find this out.

Economists also have a fancy term called oligopoly. It's one reason why your plan ends up making American health care more expensive.

I do not think you know what "socialized costs" means. Does this mean that you are against the concept of insurance completely? Or did you just mean it as meaningless trype meant to attack anyone who disagress with your corporate championship?

Mandating Health Care will be a Fraud.
All We'll get is HOLLOW HEALTH CARE: huge deductables, Huge monthly fees for very little in actual medicine.

What America needs is a Constitutional admendment that Heath Care is the right of all Americans.

Let's cut the private sector, which has failed out of Health Insurance. Oh They'll cry and stomp their feet and spread fear. But where will they (private sector Ins.) go? Every other country has Universal Medicine. So let these blood suckers cry.

All this talk of socialism prompts me to look at Dick's bio.

Master's degree from state school.
Ph.d from a different state school.
First teaching job at a state school.
Spent 18 years earning his paycheck from the government.

Posted by pva
June 5, 2007
Hey rmrd0000, that'd be one them thar efficiency of scale thingies, wouldn't it?

What's really sad is that Armey is considered a Consevative intellectual. YMM, p_lukasiak, JJ and others are taking him down as an afterthought, probably while eating a Krispy Kreme or drinking a cup of coffee.
Maybe they'll get Joe Lieberman to guest blog on his military expertise.
Dick Armey, an example of Time magazine's Affirmative Action Program for Conservative economists

Land grant universities--Socialism!!!!

One of the silliest points of your argument, Rep. Armey, is this:

"Look at the healthy components of our health care system. What they have in common is a large measure of independence from government subsidies and price regulation. For example, eye surgery centers, fertility specialists and cosmetic dental surgery. Costs have fallen dramatically, innovation abounds and safety improves."

I am not sure if you realize this but each of the medical procedures you bring up would be considered ELECTIVE. Those who wish to receive this type of care are, typically, volunteering to undergo the procedure. They have the luxury of shopping around to find the best price, and if they don't find a price that suits them, can opt out of the procedure with no serious consequences.

I suppose our health care system would work better if everyone could afford to sit around and find the best deal. Unfortunately, someone sick with pneumonia or suffering from cancer cannot weigh their options carefully. The type of care they need is immediate and will only worsen if they decide to shop around.

"What's really sad is that Armey is considered a Consevative intellectual. YMM, p_lukasiak, JJ and others are taking him down as an afterthought, probably while eating a Krispy Kreme or drinking a cup of coffee"

i don't know about the others, but I did it while following FDL's live blogging of the libby sentencing (even sweeter than Krispy Kreme donuts!)...and drinking coffee :)

"...What they have in common is a large measure of independence from government subsidies and price regulation. For example, eye surgery centers, fertility specialists and cosmetic dental surgery..."

Interestingly, these areas are rife with fraudulent claims, hidden costs, and under-reported problems. Almost as if the practitioners are trying to, for some reason, prevent the consumer from having enough information to make informed decisions. Odd, that.

Seriously, you're holding up elective procedures performed on gullible yuppies as the model for our health care system? Oh, sure, I'll be fine with that when we can take the time to pick the best value for my wife's boob job, but it might be problematic when her chemotherapy has eaten through our life savings.

A note for the other swampland posters: What have we done to deserve having this intellectual lightweight foisted upon us? It demonstrates a serious lack of respect, just as I thought we were all starting to work together...

I find it interesting too that Armey's examples of good unregulated health treatments are elective procedures. When I start seeing ads on the train for $99.99 leukemia treatments, then I'll believe there's a free market for health care.

Mr Armey ignores the failings of the current system, the uninsured, the sick denied care because the insurance companies are there to profit not to care.

Dick Armey makes the standard ideological laissez faire arguments that can be made for just about any product. But health care is not just any product, it's as necessity of life and laissez faire markets are not appropriate.

Further, Armey ignores the massive corporate bureaucracies that exist to deny care in order to boost profits. We have the most bureaucratic health care system in the industrialized world, more than single payer systems. And, apparently, Dick Armey likes it that way.

i don't know about the others, but I did it while following FDL's live blogging of the libby sentencing (even sweeter than Krispy Kreme donuts!)...and drinking coffee :)

"Out West, where you vacation, the aspens will already be turning. They turn in clusters, because their roots connect them." - Lewis "Scooter" Libby

"Look at the healthy components of our health care system. What they have in common is a large measure of independence from government subsidies and price regulation. For example, eye surgery centers, fertility specialists and cosmetic dental surgery. Costs have fallen dramatically, innovation abounds and safety improves. "

Dick Armey is cherry-picking these examples. All of these are elective and/or cosmetic procedures that are primarily used by the wealthy. I wonder if HMO's even cover some of these procedures.

Mr Armey, please show us how the market is working to provide basic health needs, preventive care and other basic human needs, instead of luxury services.

Would anybody care to comment on the effect of adult literacy in a 'market driven' health care system?

http://nces.ed.gov/naal/ (key findings)

Given Armey, PhD's regular imprecise use of vocabulary, I would suggested that in the world of medical terminology he would be an unarmed consumer in a free market health care system.

I would also suggest that the sports analogy that is appropriate for the current USA health care system is an unregulated wrestling match. The consumer is a 14 year old 95lb. freshman in a match with a 19 year old 240lb. senior with Mr. Magoo for a referree.

In order to have a truely market driven health care system we would have to be able to make all the decisions, right? I get all the relevent information and choose which is best for me?

If so, explain how it works in this situation:
I'm on vacation in Orlando and a drunk driver crashes into my car and knocks me out. The parametics arrive. How do I decide which hospital I am sent? How do I make the best, free-market based decision?

I have one insurance company, Mr Army. I get to go to one doctor. Where is this competition that saves me money? Where do I get to "shop around" for the best price, Mr. Army?

I agree 100% with Matt.

Free markets, to a large extent, do not work well when it comes to health care.

Let's say you have a loved one who is diagnosed with breast cancer. Are you going to take a lot of time to comparison shop for doctors? Are you looking for the cheapest doctor you can find?

When the consumer does not have access to the data to make and informed decision then they assume, much like with wine, that "the more it costs the better it must be".

"Let's say you have a loved one who is diagnosed with breast cancer. Are you going to take a lot of time to comparison shop for doctors? Are you looking for the cheapest doctor you can find? "

what's even more fun is that Armey is opposed to both regulations (like doctor certification) and malpractice lawsuits. Thus, unless you are well-off, the doctor you are most likely to be able to afford will be some drug-addicted hack....

"Government already purchases 45 percent of health care in America. To keep with his football metaphor, that takes us 45 yards in the wrong direction."

Looks like you've already assumed that ANY government regulation is bad. What was the point of your rhetorical question to start out with then?

"Regulation is a formidable force in the health care game. By one estimate, health care regulations leave us worse off by an amount equal to 11 percent of health spending. For every $100 Americans spend on health care, we pay $11 to the regulator, which is to say nothing of the additional costs heaped on top by frivolous junk lawsuits and medical malpractice abuse. We’re backing up to the end zone and the socialized medicine crowd has the momentum."

Does that study consider what the costs might be WITHOUT any regulation? They might end up as $111 for the same care that $111 gets us now... except that extra $11 goes straight into the pockets of the insurance company.

By the way, what do "frivolous junk lawsuits and medical malpractice abuse" have to do with government regulation of health insurance being bad? If anything, this would want for more legislation to be passed to reduce the liability of doctors in those cases.

"Look at the healthy components of our health care system. What they have in common is a large measure of independence from government subsidies and price regulation. For example, eye surgery centers, fertility specialists and cosmetic dental surgery. Costs have fallen dramatically, innovation abounds and safety improves."

Obviously, since these are all elective procedures that are prime money-makers for doctors. It pays to be good at these things. It doesn't pay nearly so well for other things (especially preventive procedures).

p_lukasiak: "what's even more fun is that Armey is opposed to both regulations (like doctor certification) and malpractice lawsuits. Thus, unless you are well-off, the doctor you are most likely to be able to afford will be some drug-addicted hack...."

Oh don't worry about that. After that Doctor kills a dozen patients, word will spread that he's a bad doctor and no one will go there. See, the Free Market works! Sucks if your son/daughter/wife/husband is one of the people who have to die though.

But, that's the way it is. It's just like buying a car.

Maynard: "...Oh don't worry about that. After that Doctor kills a dozen patients, word will spread that he's a bad doctor and no one will go there..."

No, no, no. That's coming perilously close to slanderous accusations of malpractice. What should happen is that the doctor is question should lower his prices, to reflect the Wal-Mart nature of his quality.

That way, people who can afford good care will go to the doctors with a lower kill ratio, and low-income people can see Dr. Nick.

See? Wins all around!

How in the heck do you "comparison shop" for healthcare? I never know what tests I'm going to need or prescriptions until I've already gone to the doctor. I can barely get an appointment, and I'm supposed to call around and ask for pricing?

This post is a terrific example of the central unifying thread of Rebublican philosophy: the answers to complex questions are always easy as long as they mostly apply to somebody else.

The stupidity!! It burns!!

Anyone who suggests that people are better off with individual medical insurance plan rather than company provided plans has never tried to get an individual medical insurance plan. I want to switch plans, but the time to fill out an application is prohibitive. I started on one and it required that you list every doctor visit for the last two years. My family of 4 has been to the doctor 63 times in the last year. We went to the doctor even more times the year before as my wife had a high-risk pregnancy then. I have high cholesterol and allergies. My wife has high blood pressure and problems with her back and feet. Nothing big as long as we seek preventative care, but the frequency with which we seek preventative care makes filling out applications a nightmare. Some insurance companies want seven years of history.

Proponents of more government involvement can point to many countries that get better results than the US at a far lower cost. They can also point to the VA system being the best medical system in the country. Mr. Armey, can you point us to a private medical system that you think should be the model for the US?

Mr. Armey,

For someone who claims to believe in the "magic of the market," you display very little understanding of how markets actually work, particularly health care markets.

As other have pointed out, you don't seem to understand the difference between elastic and inelastic goods. Your examples of "healthy" components of our system beautifully illustrates this basic ignorance. These "healthy" components you refer to all involve elective procedures. Market pressures help control costs in those areas precisely because they are elective. When it comes to goods and services that people don't really need, they'll shop around for the best price, and if the price is too high, they won't buy it. The same is not true for most medical procedures. When you need heart surgery, you need surgery; there's no negotiation.

Moreover, when it comes to most health care needs, people lack the knowledge and choice to create competitive pressure. Most people aren't doctors and simply get the procedures their doctors tells them to get. They are also not very well equiped to judge who are the best providers of those services. For this reason (and for geographic reasons) most people simply go to the nearest hospital.

More importantly, though, you clearly have no clue what is actually driving up costs in the system. The problem is not lack of competition or overconsumption of care. Quite the contrary. Far too many people, even those with insurance, don't get necessary preventative care. People hate going to the doctor and many have high deductables and copays. So they put off getting treated until the problem is much worse and much more costly to deal with. Encouraging health saving accounts and high-deductible policies only exacerbates this problem. It makes costs go up and it leads to worse health outcomes.

If you want to talk intelligently about health care policy, you need to take a step back and learn some basic facts about health policy and about the health care market generally.

Right now you're like a parrot spouting complex phrases that you don't really understand.

Re: "For every $100 Americans spend on health care, we pay $11 to the regulator"

I guess I should congratulate you for sorta being empirical instead of reciting empty platitudes or circular arguments (Clinton "is no moderate" because "she is no moderate"). But I was hoping you'd use real facts rather than made up facts.

Americans spend a little over $2 trillion a year on health care (about 16% of GDP). 11% makes $220 billion (or almost 1.8% of GDP). That's how much you tell us "the regulator" whoever that is collects from Americans. By way of comparison, that's about 40% of the discretionary, non-defense federal budget. So I think we would have heard of this line item before if it wasn't a figment of your imagination. Once again, I have to ask: Do you really think anyone is going to fall for this demagoguery?

And by the way that 16% is by far the highest of any industrialized nation, despite America being alone with significant numbers (47 million) uninsured. By way of comparison, "health care spending accounted for 10.9 percent of the GDP in Switzerland, 10.7 percent in Germany, 9.7 percent in Canada and 9.5 percent in France" according to the OECD.

Source:
http://www.nchc.org/facts/cost.shtml

Dr. Armey,

Anonymous Liberal welcomes you appropriately here:

http://www.anonymousliberal.com/2007/06/welcome-to-internets-mr-armey.html

= FREE SCOOTER LIBBY =

"Plame called on to explain varied accounts
Wednesday, May 30, 2007
Richard Willing
USA Today

Former CIA officer Valerie Plame should explain "differences" in her various accounts of how her husband was sent to the African nation of Niger in 2002 to investigate reports Iraq was trying to buy uranium there, the vice chairman of the Senate Intelligence Committee said.
Plame's differing versions have furthered "misinformation" about the origins of the case that roiled official Washington beginning in July 2003, said Sen. Kit Bond, R-Mo. Plame gave those accounts to the CIA's inspector general, Senate investigators and a House committee in March.

A February 2002 CIA memo released last week as part of a study of pre-Iraq-war intelligence shows that Plame suggested her husband, former State Department official Joseph Wilson, for the Niger trip, Bond said. That "doesn't square" with Plame's March testimony in which she said an unnamed CIA colleague raised her husband's name, Bond told USA TODAY.

Here are Plame's three versions of how Wilson was sent to Niger, Bond said...

•She told the CIA's inspector general in 2003 or 2004 that she had suggested Wilson.

•Plame told Senate Intelligence Committee staffers in 2004 that she couldn't remember whether she had suggested Wilson.

•She told the House Oversight and Government Reform Committee in March that an unidentified person in Vice President Cheney's office asked a CIA colleague about the African uranium report in February 2002. A third officer, overhearing Plame and the colleague discussing this, suggested, "Well, why don't we send Joe?" Plame told the committee.

CIA officials have been unable to verify Plame's March version, Bond said. Paul Gimigliano, a CIA spokesman, said the "public record on the matter is extensive, and, at this point, I can't add anything to it."

Plame's identity as an undercover CIA operative was revealed after Wilson accused the Bush administration of ignoring his Africa findings. The disclosure of Plame's status led to a federal investigation that culminated in former White House aide Lewis "Scooter" Libby's conviction on charges of perjury and obstruction of justice.

Libby is scheduled to be sentenced next Tuesday. In court papers made public last weekend, prosecutors recommended he be sentenced to 30 to 37 months in prison.

A spokeswoman for Sen. Jay Rockefeller, chairman of the Senate Intelligence Committee, said she's not sure whether Rockefeller would support having committee investigators interview Plame. The priority for Rockefeller, D-W.Va., is finishing the committee's investigation into Iraq war intelligence, Wendy Morigi said.

Bond said he has written to the CIA for permission to re-interview Plame.

Plame has "always been very consistent that she is not the person responsible for sending Joe Wilson" to Africa, said Melanie Sloan, Plame's attorney.

Questioning Plame's truthfulness now, she said, is an attempt to draw attention from the "real wrong here — a White House that outed a covert operative and undermined national security."

Wilson, a former ambassador to Gabon, said later that he had found nothing to support the report that Iraq was trying to buy uranium for a secret nuclear program from Niger.

In July 2003, Wilson wrote a column in The New York Times accusing the Bush administration of twisting prewar intelligence by including the erroneous report in the president's State of the Union address the previous January — two months before the war began.

Days later, Plame's CIA employment was revealed by syndicated columnist Robert Novak. Plame and Wilson said the implication that she had used her CIA status to arrange her husband's Niger trip was false. The disclosure, they argued, was meant to discredit Wilson and his findings by suggesting that the trip was merely a junket"

........

www.scooterlibby.com

One more point, Mr. Armey.

I too hate the fact that health care is tied to employment, but you don't seem to understand the role that employer-based health care plays in keeping insurance rates down and allowing people to have insurance. Employers, particularly large ones, have the ability to buy in bulk and therefore negotiate lower rates. They are also more sophiticated entities, so they have lawyers and purchasing agents negotiating on their behalf. This helps reduce the cost of insurance dramatically.

Individuals will never have this kind of collective bargaining power in a private insurance system (unless the government steps in and offers a competitive alternative product).

Moreover, when employers buy in bulk, they are able to insist that insurance companies cover all their employees. That makes it harder for those companies to weed out people they don't want to cover. Individuals lack the same sort of protection.

In short, our employer-based system sucks, but there's a reason we have a system based on employer-based insurance instead of indivual insurance.

If you want to institute portability, you need to find a way to get the cost benefits of employer based insurance and help prevent the cherry-picking behavior insurers will inevitably engage in. Accomplishing this will require greater regulation and most likely some sort of government sponsored insurance product.

Again, your proposal would make costs go up, not down.

Gawd, first Halperin and now this idiot.

Is there an entire floor in the Time-Warner building where these troglodytes hang around trading GOP spin-points and drooling on the WSJ editorial page?

Seriously, you can't even engage in substantive debate with this kindergarten crap, though Joe gets kudos for his attempt.

Good comments Anonymous Liberal / A.L. It is amazing that such basics have to be explained to someone who is touted as one of the leading lights of the conservative movement in this country.

Perhaps the scare quotes in the title are appropriate. I'm increasingly coming to the opinion that a healthy debate with Dick Armey is not possible.

"To move the ball downfield, we must put control of health care spending in the hands of individuals...."

s/individuals/corporations/ and you have it. I have less respect and more contempt for your sanctimonous bought-and-sold idea of journalism by the day. If you don't have anything helpful to contribute, stfu.

We are sick and tired with this lame attempt to disguise your corporatist distortaions by appeals to "individual" freedoms. If you are a real person, or know a real person, who is sick, or has a sick child or parent, then you know the system is a joke. Giving Pharmaceuticals and Insurance companies MORE power at the expense of these people is not even worth responding to.

To move the ball downfield, we must put control of health care SYSTEM back in the hands of DOCTORS and PATIENTS.

If I want to buy a pizza or a swimming pool I will rely on the private market to provide these products.

However when I need health care I trust the government to act as a universal single payer of doctors and hospitals for my care so I don't have to pay a cent for something I did not wish for in the first place.

Also I seek those who do not like the crap Medicare Part D program to make some phone calls to help repeal Medicare Part D and replace it with a simple prescription drug benefit in part B with no extra premiums, no extra yearly deductible, no means test, no coverage gap, go to

http://medicare.dmocrats.org

This Armey guy is funny. I hope this is an on going series. That way we can look forward to the former house majority leader exposing his ignorance on a new topic each week!

Let’s do tax policy next! I can’t wait to hear how cutting taxes increases government revenue through the magical power of pixie dust according to these statistics I just made up and won’t provide a link for.

I know that the logical predicates "possesses intellectual integrity" and "is a corporate lobbyist" are mutually exclusive, but I wonder just how an educated person such as Mr. Armey can possibly ignore the empirical evidence?

The facts have shown that societies that have implemented some form of universal health care have have seen economic benefits across the boards. Industries have a healthier, happier, more productive work force, and significantly reduce their operating costs. Individuals have more security. Entrepeneurs are able to assume more risk. Medical care providers reduce their administrative overhead.

In fact, the only segment that suffers is the insurance industry.

I wonder who's been signing checks to Mr. Armey?

Following Mr. Armey's logic, we should outlaw mutual funds and make people pick their own stocks for their retirement dollars. Think of the increased competition! Why should my company limit my investment opportunities to a few mutual funds when I could spend all my time at work researching investment opportunities!

Speaking of informed decisions:

http://en.wikipedia.org/wiki/FreedomWorks#Unconventional_fundraising_and_member_recruitment

"FreedomWorks has earned over $638,000 and about 16,000 members through the sale of insurance policies. When someone signs up for insurance through "Medical Savings Insurance Company", they are also automatically signed up for FreedomWorks without their knowledge. Their information is subject to be rented out as Medical Savings Insurance Company feels fit, which is not uncommon for many groups who obtain client contact information. The dues they pay also pay for FreedomWorks projects.

Critics see the effort as a way for this group to inflate their membership rosters, and more exactly, by taking dues from people with no interest in the groups' politics."

http://www.washingtonpost.com/wp-dyn/content/article/2006/07/22/AR2006072200683_2.html

No wonder Dick Army wants a more expensive health care system. He wants a bigger piece of the pie.

This bit is pure, unadulterated up-is-downism:

"When individuals take ownership of their medical care ... the information asymmetries that worry Fox begin to subside."

Health care and health care economics are complex. Insurance companies with staffs including doctors, accountants and so on are going to have a better handle on relative prices and the efficacy of various treatments than ordinary citizens. That should go without saying. That Armey would assert the opposite is just bizarre.

"which is to say nothing of the additional costs heaped on top by frivolous junk lawsuits and medical malpractice abuse"

What Dick isn't telling you is that all malpractice costs account for less than 1/2 of 1 percent of all money spent on health care.

Disgusting, disgusting little man.

Posted by FREE SCOOTER LIBBY
June 5, 2007
.......Anything

We must come to the sad realization that those who define themselves as GOP Conservative/Libertarians do not have the genetic capacity for deep thought. QH and her cohorts demonstrate by their writing styles and labored attempts at rational discourse, that they just cannot be expected to reach even a minimal level of intellectual development.
They define themselves by soundbites. Even one of their "best and brightest", Dick Armey, argues by simply making a statement with no supporting data.
We thought we were being kind to these people by not forcefully addressing their lack of mental rigor. Unfortunately our kindness has resulted in a downward spiral within their community. They have come to glorify illegal behavior as the norm. They hold fund raising events for peolpe who have committed treasonous acts. They go through contortions to explain away breaking the law. Until we force GOP Conservatives/Libertarians to come to grips with the pathology within their own community, the entire country will suffer. They have to address the crack epidemic of bowing to uncontrolled corporate greed at the expense of the health, military might, and overall welfare of the country. The golden coins that the Conservative crack dealers receive in payment does not cover the overall societal losses.
As I noted above China has an uncontrolled (free market)corporate culture. The result has been a delayed response to Avian flu along with a plethora of tainted products damaged the health of animals and humans.
We can no longer be idle. We must, alas, call a spade a spade.
Mr Armey. You have no clue.
QH and Free Scooter Libby, you and the 150 Regent University Law school graduates who stole slots at DOJ from more qualified individuals from higher tiered schools will no longer be allowed to benefit from GW Bush's Affirmative Action For Conservatives Program. You like, Mr Armey are ill-informed. The gravy train for your ilk stops now! Pull yourselves up by your own bootstraps. Be strong, you can do it.

See Dick run! See Dick open his mouth! See Dick put both feet in his mouth! See Dick lose every ounce of credibility he ever had! Sad very sad! I wonder if Dick even remembers when he sold out to the insurance companies?

Armey is still putting ideological imperatives ahead of the facts. Every other industrialized nation in the world has some form of single payer, public *NON-SOCIALISt* health insurance. Most of them spend less than half as much per capita as America, all of them have much lower administrative and overhead costs, and all of them have comparable or better outcomes.

This insistence on clinging to an outdated, inefficient system flies in the face of reason, not to mention compassion.

Why do Americans insist on electing people like Dick Armey who believe government is evil? Hiring someone who hates government to run the government is like hiring someone who hates children to run a daycare. it's just a bad idea...

John: "That's coming perilously close to slanderous accusations of malpractice. What should happen is that the doctor is question should lower his prices, to reflect the Wal-Mart nature of his quality."

I'm sorry, you are correct. Last thing we would want is make some kind of slanderous statement. Oh well, guess that means more dead people.

Maynard: "Oh well, guess that means more dead people."

Dead *poor* people, so it doesn't really matter. They're all going to die, anyway, aren't they?

"Government already purchases 45 percent of health care in America"

That's right. About half of US expenditures per capita come from the government. 92% of health expenditures in France come from the government. And government spending per capita, in dollar terms is greater in the US than in France.

And then we double it with private expenditures. The US spends twice as much as Europe for health care, per person. And US citizens get worse care. By pretty much any measure you choose, from infant mortality to diabetes incidence, US health care is worse.

Throwing around some fairy dust, saying "socialism bad market good" works about as well as Bullwinkle pulling a rabbit out of hat.

You work for the insurance industry, don't you?

And you get free health care because you convinced a bunch of wing nuts to elect you.