[Nazi reference deleted - editor.]<!- Merkley looks alot like this founder of National Socialism. Just add the moustache. Coincidence? http://img.slate.com/media/1/123125/2158911/2159086/2159087/070221_CL_HitlerEX.jpg-->

According to a new study by PNHP co-founders Drs. Steffie Woolhandler and David Himmelstein, and Dr. Andrew Wilper, nearly 45,000 annual deaths are associated with a lack of health insurance, up from the 18,000 estimated by the Institute of Medicine in 2002.(http://www.pnhp.org/excessdeaths)

That's the equivalent of 15,000 9/11's per year, until 2013 (or 2019, depending on whose "truth" you value).

"The whittled-down Senate Finance Committee plan would leave tens of millions uninsured and tens of thousands dying annually because of lack of care. Even the most liberal version of the House bill would leave 17 million uninsured in 2019 (and tens of millions more until then), according to the Congressional Budget Office." (www.pnhp.org)

Interesting study, Emmit, but your conclusions aren't really accurate. Aside from the basic math error, which I’m sure was just that. Not to worry. However, the study was based on data from 1988 to 1994. That seems to indicate that the numbers may have dropped dramatically by the 2002 estimate you quote of 18,000 deaths. And much of the conclusions interchange a lack of insurance and a lack of healthcare. Since healthcare is available to anyone in this country, exactly how will they start going to doctors under a national plan?

Also interesting to note is that nearly half (48.2%) of those uninsured in the study were under the age of 34, where dramatic numbers of those people choose not to carry insurance, even though it is available to them, both as far as cost and group purchase arrangements.

Remember about those uninsured, “About 40-50% don't want health insurance. Most CAN afford it, but choose not to buy it. More than 17 million of the uninsured make at least $50,000 per year, 8.4 million make $50,000 to $74,999 per year and 9.1 million make $75,000 or higher.”

Also, 49.8% of the uninsured in the study are also unemployed. As far as those uninsured, “Another 45% are without it but will have it within a few months due to employment transition. The Congressional Budget Office says that 45 percent of the uninsured will be insured within four months.”

People may die more often when they also don’t have health insurance, but the association between the two is tougher to make accurately. I see people every day who I’m sure are uninsured, and are living a life of poor healthcare decisions. Thinking that they will somehow make good decisions if they have insurance is a bit of a stretch, I think.

Not to say that every single life isn’t worth trying to save, but this healthcare bill will do little to save those who either don’t want to be saved or choose to kill themselves by refusing healthcare. It’s sad, and tragic, and very, very unfortunate. This bill (or these bills) won’t make much difference, I fear.

Good job, Jeff! Sen. Sherrod Brown from Ohio says they have the votes. I'm assuming he means 51 under reconciliation.

Every once in a while there is a post (not by Joe White) that takes the proverbial cake for sheer crassness and . . . how can this be expressed? "Staggeringly poor public policy acumen" is the charitable terms that come to mind.

Yes, Rick, you are hereby awarded this week's Roman Hruska prize for unwitting satire.

Let us count your oh-so-deserving ways.

(1) From a national policy perspective, of course, we don't CARE whether or not some young healthy person wants health care insurance or not, any more than we care whether or not he wants auto insurance while driving. That is the point of social insurance . . . to enlarge to pool of risk. Thus the word "mandate."

(2) Speculation over whether particular consumers can "afford" to buy coverage is just about the least precise thing I've read today, and I just spent two hours correcting student essays. Who are you or anyone else to decide if someone can "afford" coverage but choose not to? Answer: you're nobody. You know nothing of these people's lives. You are the proverbial unreliable narrator who likes to assume an unwarranted position of knowledge because it allows you to continue to indulge in your nutty little capitalist fantasies.

(3) What is this fetishization of undefined "choice?" People "choose" to go between jobs without coverage? WTF! Honest to gods, what is the methane content of the atmosphere on your planet?

(4) And then we get into the very entertaining "When bad health choices happen to otherwise good citizens" section. Who ARE you? Kreskin? You know these peoples' lives? You know nothing, not about these people, and, obviously, not about public policy. These are the people who need insurance. Public policy cognoscenti want them in the system because - apart from ethical concerns, toward which you seem either completely innocent or actively hostile - it is tremendously less expensive to treat the effect of their "choices" before they get to the quadruple bypass level. In the emergency room. At 3 a.m.

What, did you think they are going to evaporate conveniently because you did not approve of their "choices?" Sadly, that turns out not to be the case.

So, here's your award. Your assignment is to read ("re-read" is probably optimistic) Swift's "A Modest Proposal" and write an essay on what changes single payer health care might have made on Swift's economic model.

Thank God for Merkley! Now, bring Ron Wyden on to fight as hard for the public option!

Meanwhile, Max Baucus has finally, finally achieved bipartisan consensus. Both Democrats and Republicans agree that his proposed bill SUCKS!

Count on this: There will be a nice-paying, cushy job for Max Baucus at some insurance lobbying firm - or the Republican National Committee - next time 'round when he is defeated for reelection as surely he will be - as surely he must be..

It's people like poor old Max that are the walking, talking personifications of why I left the Democratic party over a decade ago. They have forgotten that they are (or were) the party of Franklin Delano Roosevelt. Pity.

www.tomdegan.blogspot.com

Tom Degan, Goshen, NY

Ed Schultz told his national radio show audience that "Medicare is not broke. It's very efficient. It's just underfunded".

Now how does this mesh with the Obama line that $600 Billion can be cut from Medicare to pay for half the public option?

It doesn't and this is yet another reason why the push for Universal Health Care/public option has no credibility with conservatives.

And I'm sure you'll quickly obfuscate this to mean nothing.

Joe Hill wrote:

"we don't CARE whether or not some young healthy person wants health care insurance or not, any more than we care whether or not he wants auto insurance while driving."

Apples and oranges, JH.

You are required to carry auto insurance in case you injure OTHERS.

You are not required to carry auto insurance on any damage you might do to yourself.

If a young healthy person wants to forgo health insurance, it should be his right to do so.

Joe Hill wrote:

"Who ARE you? Kreskin? You know these peoples' lives? You know nothing, not about these people, and, obviously, not about public policy. These are the people who need insurance."

Funny how you trash Rick for 'not knowing peoples lives' but then you just KNOW that these people NEED insurance.

No, just because they don't have it, doesn't mean they NEED it.

Oh I understand if you're an insurance salesman you want everyone to believe they NEED it.

But the fact is that these adults have decided for whatever reasons of their own NOT to buy insurance.

You don't know their lives any better than Rick does, so don't tell us what you think they NEED.

You may NEED their premiums added to the pool to lower your own, but that's a different matter. In the old days we called that 'covetousness'. You know, 'wanting something that belonged to someone else'?

Let them spend their money and you spend yours and we'll get along just fine.

Looks like Joe Wilson is owed an apology by Obama.

It appears that it is his intent to give illegals health care after all.

How?

By simply calling them legal.

A nice semantic game by Obama. Offer amnesty so that illegals will be 'legal' and then you can give people who came here illegally the health care that you denied you were going to give them.

Carla Axtman wrote:

"So if those who are here illegally do what they're supposed to do to become legal..."

You mean go back home and apply to come in legally?

I'm in favor of that.

I think we should greatly increase the number of LEGAL immigrants we will accept.

But there are people who are already waiting in line, going thru the process legally to stay here and get citizenship, and Obama wants to push illegals to the head of the line, give them priority and diss those who did it the right way.

No.

I have a good friend who came here from Central America. Legally.

He applied and waited for a visa. While he was here, he met a girl and fell in love.

Then his visa expired and he had to leave.

He did, while waiting for a new visa.

He went to Canada. She went there too, and they married there.

Their attitude was, we are together.

He waited til he could legally re-enter, did so and went thru a multiyear process applying for citizenship.

He has been a citizen now for about 10 years, and Obama would push people like him aside in favor of law breakers.

No. Let them do it legally, or not at all.

In the modern G.O.P., they'd rather have people paying $5000+ per year for their health insurance, and have that be inadequate coverage, than pay in the neighborhood of $3000/year if a few undocumented workers might, somehow, get coverage.

It's Republican Math!

fbear wrote:

"a few undocumented workers "

Estimates of the number of illegals range from 7-20 million.

I guess that is 'a few' in Democratic math.

lol

No, Joe, I'm talking about the few who might find a way to beat the system, those are the one's that seem to bother the G.O.P.

And even if it is 20 million people, is it really so important to deny them health care (and, hey, you know if they get sick and aren't properly treated, it could make YOU sick) that you're willing to continue with our broken health care system?

Does the saying "cutting off your nose to spite your face" mean anything to you?

"To all our Republican and Mangy Dog friends, I ask a simple question: why did your beloved Bush impose socialist Nazi policies on Iraq? I thought he invaded to give them peace, freedom, and the wonders of American capitalism. But Mark Dorlester has this, at the Huffington Post:"

Article 31 of the Iraqi Constitution, drafted by your right-wing Bushies in 2005 and ratified by the Iraqi people, includes state-guaranteed (single payer) healthcare for life for every Iraqi citizen. Article 31 reads:

"First: Every citizen has the right to health care. The State shall maintain public health and provide the means of prevention and treatment by building different types of hospitals and health institutions.

Second: Individuals and entities have the right to build hospitals, clinics,or private health care centers under the supervision of the State, and this shall be regulated by law."

Thank you Rick for not berating me for my math error. (It's deaths equal to 15 9/11's per year that are associated with a lack of health insurance and not 15,000.)

The lack of health insurance of the many affects us all, however, and not only because it increases the costs for those of us who have it. Disease is transmitted from those without treatment, and that lack further incubates the organisms that spread the disease, creating more virulent strains.

Furthermore, I'm a nurse, and I know that health care is not readily available to all those without insurance in our system (or with it, for that matter). Triage in emergency rooms is ineffective, even if all emergency rooms were accepting all patients (which they are not), since appropriate care has been deferred.

Freedom is participation in power, and the majority of us who have wanted universal health care like that in Canada for decades therefore have been deprived of our freedom. Only those with a contempt for democracy could oppose Medicare for All, including Merkley, whose position I do not support any more than you do.

To Joe Hill,

Thank you for your response. I know, it’s a strange answer to a post filled with attacks, (ie crass, poor acumen, unwitting, ‘nobody’, unreliable, unwarranted, nutty, fantasy, fetishization (?), hostile), but my intent isn’t to convince anyone. I do try to clarify some of the issues and the differences between political and ideological sides.

To that end, the specific point I was making was; the assumption that we need a complete change in the healthcare system to cover a relatively small number of people is a stretch. Identifying the specifics is helpful, but not everything. And it is understood that there are flaws in the current system. But the changes to the system in the original bill(s) introduced were poorly thought out and would cause substantially more harm, in a global personal sense, than they would cure.

I understand that the left doesn’t CARE if someone wants to pay for insurance for all, without choice. Law, or law disguised as “public policy”, carries a lot of weight and if laws are passed to force undesired subsidy of someone’s healthcare, then we lose more freedom than I am comfortable with. I understand, really I do, that we are different. And I believe that the socialized medicine solution to the flaws in our current system is wrong. It doesn’t make the other side evil in my eyes.

At some point, logic must consider at what level anything being represented as critical in this debate is affordable. If you make 50k a year, and spend 50k a year on your lifestyle, but can’t afford food, is food for you “not affordable”? It’s true, the right believes that people have a personal responsibility to care for themselves. And if that means not enjoying some things to afford healthcare, then most of the right believes that is a price we need to pay. Please don’t assume that I think that the truly poor are in this group. My response is specifically aimed at your assertion that I can’t ever assume that people can afford health insurance. I think it’s intellectually dishonest to say that the 34.5% of the uninsured who make more than 50k a year cannot be assumed to be unable to afford insurance. I said “most” of them can afford it. I stand by that statement.

As far as your statement “People ‘choose’ to go between jobs without coverage? WTF!”, I never said anything like this. Again, the point is that changing the entire system means we need to deal in facts. And the fact is, a great number of the uninsured will be insured again very soon without national health insurance. I have lost health insurance when I was laid off. I then found another job and started again. I have used COBRA as well. Should we fix some of the issues around the temporary loss of insurance, like cost and such? Yes! But not with this sledgehammer of a change.

And the point about people who make bad healthcare decisions costing a lot of money is mostly irrelevant, as you are assuming that those with insurance would stop making bad choices about their health. I’m not saying that healthcare isn’t able to help them make better choices. I’m saying that they may not be willing to make those choices anyway.

You should note (and this may be a big part of your motivation for the vitriol in your post), that I am comfortable dealing with less than specific assertions, with the understanding that they don’t apply to everything or everyone. I hope you can do the same. To say that the facts don’t apply because they can’t possibly apply to everyone is a conversation killer and feeds directly into a perception that people can’t disagree and still discuss.

(hopefully this isn't a duplicate post)

Joel,

These articles, and Mr. Dorlester’s statements, are a fairly clear example of the confusion on this issue between “right to healthcare” and “right to health insurance”. Nothing here says that Iraq will support, nor supply, government paid (through taxes, of course) health insurance. Again, healthcare is currently available to anyone in this country, legally or illegally, by law. Saying that it isn’t “available enough” or that people “don’t trust the system” would prove the point that government run healthcare won’t solve the problem.

But to say that this is different from the US is just false, it appears. Healthcare is the care supplied, insurance is how most people pay for it. Are we currently paying for insurance for the uninsured through our premiums? Yes! I pay more for my insurance, and they pay more to healthcare workers and companies, to pay for those who can’t afford care or insurance. I’m against the feds getting involved.

This is an apples and oranges argument.

Uh, Rick, the feds are involved already. WTF do you think Medicare is? Or the Veterans' Administration healthcare system?

Joel,

Be fair. We're talking about a dramatic change. Apples and oranges again.

Or, perhaps more accurately, to use Twinkies, this plan compared to Medicare and the Veterans system, "would be a Twinkie thirty-five feet long, weighing approximately six hundred pounds". To quote Egon Spengler.

I'm not being silly. The feds NEED to be involved. That's not what we are talking about. And to say that I didn't know they were involved is..... (sigh) I can only try to talk with you reasonably.

Joe White wrote:

"Looks like Joe Wilson is owed an apology by Obama.

It appears that it is his intent to give illegals health care after all.

How?

By simply calling them legal.

A nice semantic game by Obama."

Joe your spelling is off. The first president to play this game was Reagan.

Looks like the "O" is supporting Obamacare. http://www.oregonlive.com/opinion/index.ssf/2009/09/obamas_fullcourt_press_on_heal.html

And looks like Oregonians are too.

It appears that it is his intent to give illegals health care after all.

I will again suggest that the reference to "illegals" is simply shorthand for dehumanizing an entire group of people.

Call them undocumented aliens. Call them illegal aliens.

Just drop the "illegals" crap.

Rick, it interests me that all make assumptions as to the relative robust health of "twenty-somethings" who opt out of health care. I am not sure this is a true picture of things.

I needed health care as a 20-something, but could not afford the amnt taken from the pittance I earned. Or could not afford to USE the care if I opted in and paid my pittance out of my pittance. I fell thru all the cracks when seeking care as an unemployed/uninsured/or impoverished working teen and 20-something. They told me, and I quote,"If you get pregnant, we can get you some coverage, then you can have an abortion and be covered for a little while longer". End quote, circa early 80's.

I did not take the option offered.

I submit to you that MANY of these youthful non-subscribers you refer to and assume to be in fine fettle are also the same folks who, in their forties, begin showing the regrettable results of NOT having had healthcare appropriately and timely in their youth.

I am one such, I've met others in the course of work and life. We have to be philosophical about it.

But the fact is that many endured early lack of health services, basic health services, and reap the later reward not so very late in life. There are youth who opt out not realizing that later in life they will be living with the consequences. So just because they are relatively healthy and survive or overcome injuries and conditions by dint of youthful plasticity does not mean they did not need the care! It may mean they really could not afford to buy it or use what they bought; or did not understand the impact it will cumulatively have.

I think longitudinal studies of overall health outcomes should be parsed in this light.

It was not just the six minute miles I ran year round. It was not the firefighting in the mountains, nor the other interesting endeavours. It was other common healthcare needs I will not detail here - unmet, they have created a substrate of basic vulnerability that I must manage.

"...one of the immutable laws of politics in the U.S. Congress is that progressives will always be screwed by their own leaders, as soon as the opportunity presents itself." (Matt Taibbi)

Wrench: what's your point?

I previously posted, on another thread, about how I couldn't figure out how the government could guarantee an affordable option when the government itself says it will not subsidize that option. And now I read something which seems authoritative which says that the government is really not providing an option, even under House Bill 3200:

http://pnhp.org/blog/2009/09/13/sullivan-publicoptionin3200unlikemedicare/

So, after all this struggle and gnashing of teeth, all we get is some ill-defined program wherein the government contracts out to the private sector? This is what we are fighting for?

I hope the Democrats who promised to vote against any bill without a genuine public option will be held accountable to do so.

But they probably won't be.

No Joe: they probably won't be. They tend to be lacking in that characteristic that could be known as utter, dogmatic inflexibility. They are likely to "cave", erm.... collaborate to get a start somewhere, anywhere, on the road to a fix.

The danger: that cave to the powers that are busy being powerful, namely, insurance.

Oops, completing the thought.

... could become a codified mess that cannot be undone efficiently and timely. Kind of like those stupid Mandates Without Funding such as No Child etc.

in response to rw,

I appreciate your note and the tone of it. :-)

I agree that there are many people of any age who need health care. I was one as well. I have an affliction (for lack of a better word) that first surfaced when I was in kindergarten. Now, 40+ years later, it still is with me and needs constant (daily) care.

And you probably read earlier in this thread that I am not so much interested in arguing with others as I am in clarifying differences. I fully agree that many of those who do not want health insurance would benefit from it. And perhaps they are unwilling to recognize that may be the case, and perhaps they are unwilling to seek out the advice of those like you and me. But they still don't want it.

I don't understand, but am very willing to point out, that many here seem set on forcing things on individuals that those individuals don't want. It seems strange that this approach of "it's better for all of us to force you to do this" is a value of the left. I always thought that, until about 30 years ago, the left was the party of individualism and non-compliance. And those qualities can be very valuable, IMO. And "healthcare choice" is still a tenet of the left in some very well-known cases.

Nevertheless, there are certainly individual cases that make the case, for either side. But the suggestion that this is the solution is very suspect. If our president (yes, my president too!) says that 600 billion dollars of the cost will be covered by ending wasted expense in healthcare, then why isn't he fixing that? I've said before, if he fixes Medicare and Medicaid (and now adding the "waste" he says exists), then I will support a plan for the rest. He has no history of success, and the plans currently in place are failing financially and in other ways. Fix them, then tell us you will now do it for the rest.

I can appreciate that some are willing to follow someone who says they will do it. I'm not. He hasn't given me a reason to trust him, nor have his supporters.