The First Year of the Obama Administration: Facts, Opinions and Discussions

Okay deregulation.

Lets deregulate by allowing drugs from Canada, and allowing pre existing condition denials. Lets deregulate by allowing places to deny emergency hospital care to the uninsured.

A_G you are conflating two different types of regulation and then arguing deregulation is okay because they're both deregulation. Insurance companies all based out of the state with the fewest consumer protections they can find? Well at least we can get cheaper drugs from Canada, so deregulation works!...?

Market forces are designed to create profits, not meet needs. If your need isn't profitable, tough ****.

It is designed to pull profit out of thin air, not value.

Lets take text messages for example. Statistically, you, or anyone on this thread has likely sent hundred. Probably received hundreds. Unless you're on an unlimited plan, these cost some amount of cents to send and receive. Well the thing is text messages are the next thing to free for the company. They travel on the control link between phone and tower. It's there regardless of if you text or not. Their size is so small it is almost completely negligible during wire broadcast between towers, and their small size means the hardware needed to carry them scales much faster than even the huge growth of text messaging. Translation, it costs negligibly more to the company to carry 1 billion messages than 1 million.

So, what do they do? Well they charge exorbitant amounts for each individual message to encourage you to buy a plan that is almost pure profit.

The free market strikes again. Profit from nothing, watch as they pull another multi billion dollar quarterly statement from their hat.

Oh how about banks. Overdraft charges suck eh? I mean yeah you should avoid overdrawing, but sometimes it is unavoidable and well, why not let the banks pile on the charges when it happens? You see while you think of your charges as having a temporal quality, that is ones from yesterday happen before ones from today, banks don't see it that way. They pile them on in terms of size, so the biggest comes first, then the next smallest, then the next smallest.. then...

So while you may think that last charge put you over, the bank knows that the biggest charges comes first and you get charged fees for all of the smaller withdrawals. Temporally they may have happened when you had money in your account, but one little accounting trick and.. kaching profit! I bet the person who thought that up got a big fat bonus.

Just pile on those fees for the exact same service.

When it comes to fixing prices
There are a lot of tricks he knows
How it all increases
All those bits and pieces
Jesus! It's amazing how it grows!

But this time, this time I'm sure Lucy won't pull the ball away and deregulation will work.

You're a good man Charlie Brown. Not the sharpest spoon in the drawer, but a good man.

 

Sure I am. Maybe moreso than most. But I'm not sad or angry. Sure, there have been angry posts, but as a rule I don't post a flame and then make no point about the topic.

Usually.

And farraday, no where do I say that we should deregulate the medical industry. In fact, if you read my posts I suggest that regulating it as we have other industries is one answer, instead of exempting them from regulations that allow for fair and honest competition.

 

Yeah, ok, that could be a problem, but what is the solution to dealing with the fact that there are states that insurers have over 70% of the market? That's not conducive to better coverage, or cheaper coverage, or anything. All it leads to is monopoly pricing power, rent seeking behavior, and regulatory capture. Perhaps just "deregulating" (I'm unclear on the specific laws that cause this outcome) isn't the answer, but there has to be something that can be done to increase competition in states like Alabama, Hawaii and Maine (other than just the public option). Federal minimum consumer protections (similar to how there is a federal minimum wage, but states can be higher), perhaps?

Or do you think increased competition wouldn't do damn thing/make things worse?

 

I think there's some merit in the idea of increased competition, which can be done by eliminating the anti trust exemptions for various companies. It'll stop monopolies for sure.

However, it won't do anything to, or very little for the uninsured. If the single, monopolistic insurers find them as a liability, the new companies will see them the same way.

 

Yeah, that's true. I was more thinking of the increased competition as one way (to be clear, I don't think its any type of silver bullet) to help control costs. I realize it wouldn't due too much for the uninsured. At the margin it may make some uninsured risks worth taking for insurance companies, but that would be a small percentage of the currently uninsured.

 

Removing anti trust would certainly help increase competition, however it fails to understand what will happen. Yes, we can break up state monopolies by deregulating. Hell we broke up the baby bells and now we have a competitive national market from an increasingly small handful of companies using the same business models and profit seeking mechanisms to effectively limit competition.

Well that's so much better now, isn't it? And it's worse because insurance relies on large customer bases.

You spread out risk across a huge pool so you make more money off the healthy people than you lose off the unhealthy people. You're creating competition for the healthy people, which splits up the risk pool which means fewer unhealthy people can be covered since every company has set costs they must pay which duplicate effort across the whole system.

The sad fact here is that health is a losing game. You're gonna die. The only reason this is even a debate is because the National Government already pulls huge numbers of people into the publicly funded Medicare and Medicaid and similar programs that pull enough generally unhealthy people out of the pool to allow private profit seeking entities to get a positive cash flow out of the rest. Remove their ability to discriminate and you are almost necessitating the need for monopoly structures for those that survive the free market blood letting.

You need huge health insurance companies to make widespread private insurance to work. Huge private companies always have a correspondingly large influence in government. Which means that increased competition is a temporary condition until the smaller state monopolies merge or are consolidated into semi competing national psuedo monopolies.

I do not see any situation where "increased competition" is a stable state for health insurance.

 

You know, you all are absolutely right.

However, your arguments make the need for eliminating insurance companies entirely and establishing a single-payer system seem even more necessary.

 

What makes you so sure it will work? Medicare is as close as we have to one - and it is going broke, with trillions of dollars in unfunded obligations. The government has not been able to run that limited portion of health care well, and you would give them the entire kit and kaboodle?

I don't think so.

 

Although, that's amidst charges of collusion, so in that sense, I think its arguable that that's not the free market, and I'd point out that anti-trust laws, as have been suggested, are an example of more regulation, not less.


As for the size of pools, right now where insurance companies are only going to be able to focus on a single state, then we've capped the number of people they can have. Now, lets imagine we had 15 insurance companies competing nationally, and they covered, lets say, 75% of Americans. That would be an average of 15 million per company. That large of a pool is bigger than the maximum possible in the single state rules for all but 4 states. So we'd have increased competition (from one or two companies up to 15 companies) and ALSO bigger risk pools.

 

Anti trust laws are a form of regulation, but they are not inherently the issue here since attempting to break local monopolies without opening state barriers can not work. The monopolies have formed as a result of government regulation and their anti trust exemption is partially a recognition of that. Relaxing regulation makes local monopoly fairly moot, since consolidation is inevitable. Once they start becoming national psuedo monopolies the question of anti trust becomes a hell of a lot more complicated because of the collusion you mentioned. Also, yes there are accusations of collusion, but until or unless there is an actual court decision of rewriting of the law, it is free market collusion. Arguing it isn't really a free market holds the same amount of water as saying Communism has never really been tried. In either case your hypothetical has ran ashore on the sandbar of reality. Aaying "it doesn't count" is ignoring the situation as it exists in favor of a philosophical dream world.

Moving on to the point of coverage. To me, consolidation does not involve one company spreading it's coverage across new states, but existing companies merging or acquiring operations in nearby states. So competition doesn't increase from the current local situation unless new companies move into the territory.

Lets say you have companies A and B covering your city now. Post relaxing of rules, company A is bought out by company 1 and company B is bought out by company 2. You still only have two choices, 1 or 2.

Increasing competition relies on more insurance companies getting involved, not simply consolidation of the current companies under new banners. To address that issue you have to consider how easy it is for them to provide insurance coverage in a new area. For someone like Kaiser, this is going to be a huge cost. Others face fewer obstacles. Beyond that, while employer based insurance remains the standard, you remain tied to the plans offered by your job, meaning the competition factor is at least at arms length from your own choice.

If we smashed the increasingly inadequate employer based health care system, a properly regulated system of national psuedo monopolies could work. Frankly I wouldn't mind destroying employer based health care, but setting up the competing national psuedo monopolies by letting them influence politicians into removing regulations that prevent them from forming and then watching to see who rises to the top of the following corporate cesspool doesn't scream properly regulated to me.

 

Without making a few other fundamental changes, tort reform being the first one that comes to mind, it wouldn't work. But neither will any other type of health care reform. I think we could get those changes made if we could get a leader who will actually stand up to the special interests.

 

Didn't Obama suggest tort reform in his speech to Congress?

That was something the President was willing to compromise on... in exchange for Republican votes.

 

I thought he was always opposed to it, but I would love to be wrong on that.

 

He mentioned tort reform in his joint session to Congress as a possible area of compromise

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/09/09/MNJO19KPTV.DTL

"Many in this chamber - particularly on the Republican side of the aisle - have long insisted that reforming our medical malpractice laws can help bring down the cost of health care. I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs. So I am proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine."

It was like the only time the Republicans gave him a standing ovation during his speech, that's why I remembered it.

But since Republicans never came on board, it seems he didn't push for it at all. But it's not like Obama pushed hard for the public option either.

 

OK, new subject.

Why won't the President of the United States have a press conference or at least make a friggen statement after the attempted terror atack yesterday?

This guy does nothing to make us feel safe.

 

What would be the point?

I realize that he wasn't in Amsterdam doing security pat-downs himself, but maybe cut him a break. Obama has continued a majority of the Bush administration's anti-terror policies, whether you agree or disagree with them (or him).

 

If your sense of safety is dependent upon someone holding your hand and saying, "Don't worry, everything's gonna be all right," I recommend building a bomb shelter and living in there for the rest of your days, because clearly you're unable to feel safe outside of there. So that's my recomendation. Then when the Communist/Nazi/Muslim were-rats come for you you'll be prepared.

 

Yeah.

Also, I fell and skinned my knee yesterday, and Obama didn't even kiss it and put on a Mickey Mouse Band-aid for me.

Come on.

 

I think you guys are forgetting how Obama positioned himself though- more as a confidence inspiring, charismatic leader. For a while now, Obama has been displaying a lot of the ivory tower syndrome that plagues all Presidents. It's nothing that really isn't their fault either, because it almost has to be that way by design of office. Unfortunately for Obama, the office itself is negating most of his perceived advantages.

But I think, if nothing else, the current administration is adding a lot of perspective to the previous administration, and not just in policy areas as KW mentioned. Maybe this is also how it should be as well. The scales aren't the same, but hey? Remember how the previous President was savaged for simply "flying over" Katrina and "only" delivering a TV response? Should it have mattered that the President didn't personally go down and use the bathroom in the New Orleans Superdome, or similar example..? But yet, it did.

I could only imagine the backlash that would have resulted around here if anyone tried to give him a pass from the reverse position-"If your sense of safety is dependent upon someone holding your hand and saying, "Don't worry, everything's gonna be alright..." FID, I could see you posting about the opposite of how you just did above- that at the very least, it's the President's job to reassure the public...or the buck stops with him...etc... It's just funny to see the new levels of forgiveness being directed toward the office from some of its greatest critics.

 

It's been a single day, and not all the information is clear yet on who this was, what his motivations were, what his possible connections to which terrorist networks he might have had?

If Obama has shown anything, it's that he doesn't like to speak or decide until he has all the information.

Besides, it happened on Christmas, delivering a speech about an attempted terrorist attack the day of or after Christmas would only do precisely what the terrorists want: make people senselessly afraid. Most Americans probably haven't even heard about it yet. We'ren ot sure exactly what was going on, if he could have even succeeded or not.

Also, personally, I do not want the President to make me "feel" safe.
-First, I'd rather he just do it and handle national security without theatrics. Which Obama has, he raised air security measures, which was reported in the news. Actions are stronger than words.
-Second, unless you want a police state there is ultimately nothing the President can do to ensure everyone's safety. We have to depend on local police, airport security... and people like that courageous passenger who tackled the man and burned his own hand doing it. It is our neighbors we really depend on, and who we must be good neighbors to in turn.

 

Nonsense. He's said plenty without full information. The situation where he said he didn't have the full information but still said the police acted stupidly in arresting a Harvard professor back over summer comes to mind.

I don't see any difference to Bush, really. I mean, Bush is lambasted for staying in the classroom on 9/11 for several minutes, even though had he left the classroom, he couldn't have realistically done anything, yet the president suddenly running out of a room could also be viewed as just causing panic without doing anything.

 

I agree with KW and Ghost. I'd rather the President do something than just have a press conference and talk about it. He may very well have a press conference about it in the next few days but it's true that talking about terrorism on the day after Christmas would be exactly what the terrorists wanted.

FWIW, I don't think Bush should have been lambasted for not running out of a second grade classroom screaming when he heard about the 9/11 attacks. And with Katrina, the problem for me wasn't that he didn't personally use the bathroom in the SuperDome, it was that he appointed a total incompetent to head FEMA and therefore New Orleans didn't get the assistance it needed, when it needed it. I've heard the tapes of Nagan absolutely begging for more transport to get people out of there. But again, no direct blame on Bush; I blame Michael Brown.

 

On Katrina, I've felt the greatest blame for how the situation was handled was on the state and local governments. I think Brown dropped the ball, but he dropped the ball after utter failure from the people that should've been responding first and evacuating people from the first place, which was the city of New Orleans and the state of Louisiana.

 

When did 'inspiring confidence' get confused with making people feel safe? Was this terrorist attack not stopped?

 

I'm wondering where the calls for speeches were following the shoe bomb, the liquid mixing, and all that. Why the double standard with regards to an isolated incident that rests solely on the Netherlands in terms of security failings?