Commentary: Davis – Wisconsin: Unions, Citizens United and Bears, Oh My

welcome-to-wisconsinLast year, during the heat of the debate on the budget in the city of Davis, there was a comment by Firefighters Union President Bobby Weist, comparing a proposed budget cut to Wisconsin.  There were even signs to that effect.  So it is ironic that the two issues come together, Davis and Wisconsin, this week.

The title of the editorial this week in the local paper was “Wisconsin governor wins and unions lose.”  Now wouldn’t you think that we have had an historic election in Davis, and that the local paper in their Sunday edition might want something, I don’t know, local?

Then again, understanding the anti-union tendencies of our local “liberal” media, it is not shocking that they would carry such an obviously non-locally produced editorial.

I am almost reluctant to write this piece, because I know the comment section will become another bash the union session, but I think the title of that editorial  is wrong.  What’s more ironic is that I think the person or people, who actually wrote it, agree.

What we know is that Wisconsin last year became a focal point when it attempted to, among other things, effectively destroy public employee unions.

Wisconsin this year became only the third state to attempt to recall its governor and Scott Walker became the first governor to survive this recall effort.  He won fairly handily, 53-46, against the same opponent that he defeated in 2010.

But did he really win?

The editorial writes, “Walker was uncharacteristically conciliatory, even proposing a peacemaking session with Democrats over beer and brats this week.”  He said, “I think it’s important to fix things, but it’s also important to make sure we talk about it and involve people in the process.”

The key lies in this statement: “Had he taken his own advice, much political bloodshed might have been avoided. He blindsided the state’s public employee unions by taking away their collective-bargaining rights, a move, according to The Wall Street Journal, that is already costing them members and dues money.”

Clearly, unions lost in this?

What is not mentioned, is that the Democrats won an important Senate recall election by a few hundred votes.  As the result, the Democrats have taken over the Senate.

Mark Miller, the Senate Majority Leader now, in Wisconsin: “Starting today, Senate Democrats will be a strong check on Scott Walker’s power. If Walker tries to pass extreme policies that bust unions, hurt women, or attack middle-class families, we will have one word for him: No. We will demand laws that benefit the middle class and start repairing our state.”

So who won, again?  To recap, Governor Walker was more conciliatory, perhaps one could say humbled?  The Democrats retook the Senate.  Sounds like there is a bit more of a victory there than one thinks.

The clear losers in this may be the unions.

The editorial notes, “While much of the unions’ power traditionally has been attributed to their fundraising, their true strength has always been their ability to turn out their members. This they did in Wisconsin, helping to knock on 948,000 doors and make 890,000 phone calls on behalf of challenger Tom Barrett, the mayor of Milwaukee.”

The bigger problem is regarding Citizens United, and the Supreme Court decision which has allowed “the unchecked influence of outside cash. The New York Times said that, as of late May, $45.6 million had been spent on Walker’s behalf and only $17.9 million for Barrett. It was the most expensive race in Wisconsin history.”

I am not one of these “good government” liberals who believes we need campaign finance reform to save us from the big monied interests.  I think most campaign finance laws have, at best, delayed the inevitable and in general are worthless.  They may even harm the people who are good and honest and are not trying to subvert the laws.

I do not believe the Koch Brothers saved Governor Walker, any more than I believe the attack mailer doomed Sue Greenwald.

Instead, I look to Robert Scheer, a veteran progressive writer who this week argued, “Democrats failed in Wisconsin because they failed Wisconsin.”

As he noted in creating a strawman argument, “Perhaps if the original McCain-Feingold legislation – gutted by the Supreme Court – was still the law of the land on campaign finance, the Democrats and their union base would have survived Tuesday’s election.”

But then he countered: “Certainly that is the excuse provided by what remains of the liberal media, which point to the lopsided advantage in funding for Wisconsin Gov. Scott Walker and to the high court’s Citizens United ruling in seeking reasons for this ‘billionaire’s victory’ over ‘people power.’ “

However, he added, “But the larger truth is that the spirit of populism has been perverted by the Republican tea party right and that Democrats are left defending government bureaucracy while remaining incapable of responding to America’s widespread economic pain.”

In other words, the Democrats lost because the Democrats lost their moorings.  He continues, “At a time when so many are worried about obtaining or holding on to work, it’s difficult to rally around the guaranteed job security and high pensions of some privileged government employees.”

This pulls us away from Wisconsin, and the inevitable union-bashing that will ensue, to an uncomfortable reality in our own political backyard.

As we looked more and more into the attack mailer unleashed in the Davis City Council race by James Burchill and three Sacramento-based unions, we uncovered what might prove to be an uncomfortable truth.

Our own municipal code that limits contributions to city council candidates may, in fact, be unenforceable.  No one wants to say it, we tried to get the city to spell it out, but our sources indicate that if one of the candidates had wanted to take $200 from a contributor, there is nothing the city or anyone else could have done about it.

We spent a lot of time trying to debunk this, because, after all, who wants to acknowledge that outside money could come into our fair city and impact our local races?  But we cannot deny that the two subjects of the attack mailer both were defeated last week.

I still believe the overall effect was tangential.  I believe that the voters – enough of them to defeat two incumbents – grew tired of business as usual and were looking for solid change.

But the mailer may have worked in subtle ways.

First, it may have worked by reminding voters of what they already knew and did not like.

It may have worked because the response to it was not the right one.  It may have worked because Sue Greenwald started to play the victim card, something you saw on the Vanguard comment board but also in the veiled implication that Stephen Souza was anything but an innocent victim of this mailer.

The comments by Sue Greenwald after the election suggest as much, as well.  In the end, I think Stephen Souza was the one who was right when he suggested that over the course of time, he probably angered more people with his votes than he pleased.

For Sue Greenwald, she probably angered more people, not only with her votes but with her persona, than she pleased.  Sue Greenwald did not lose because of the mailer, she lost because of herself, just as she had previously won because of herself.

—David M. Greenwald reporting

About The Author

David Greenwald is the founder, editor, and executive director of the Davis Vanguard. He founded the Vanguard in 2006. David Greenwald moved to Davis in 1996 to attend Graduate School at UC Davis in Political Science. He lives in South Davis with his wife Cecilia Escamilla Greenwald and three children.

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53 Comments

  1. rusty49

    No matter how the left tries to spin it the Walker victory was a slam dunk win for the GOP and bodes poorly for the Democrats in the Nov. election. As far as the State Senate seat loss they don’t plan to have any huge issues coming up until after the next election when the GOP knows they will win back the Senate. The people of Wisconsin have spoken and the losers were the Democrats and the unions.

  2. Steve Hayes

    Liberal “Fairness” in California: Mandatory dues paid by massive numbers of California public union members have been diverted for years to promote and fund liberal (progressive) politicians and causes. Over time, this significant economic advantage has resulted in more of these politicians being elected over the objections of fiscally conservative politicians, private sector union members, small businesses owners, and conservative voters. These liberal politicians then sit at the negotiating table with the public union leaders to negotiate new public sector union contracts. This “beat goes on” because the conservative politician, private sector taxpayer, and small businessperson are essentially denied a seat at this table.

    Governor Scott Walker has now reserved a seat at the table for these formerly disenfranchised people, and the State of Wisconsin is now on the road to fiscal responsibility and stability. Meanwhile, Governor Jerry Brown is asking the citizens of California to tax themselves more in November so he can spend more! Give me a break!

  3. Frankly

    Scott Walker is an American hero. He has stood up against the powerful status quo of union-powered financial ruin, and is turning his state around.

    This is not the time for nuanced politicing. It is not the time for conciliatory outreach. Our state, our cities, our country… they are all in a debt-infested financial free-fall. Public employee unions may not be the only cause, but they are front-and-center in the lineup of guitly culprits. The times requires straigt-shooting dialog and math. We require true political leadership that says the truth no matter that it hurts someone’s feelings. We require leaders of action… willing, able and capable to slash spending and grow the economy.

    The facts are that the entire US and maybe most of the world were gorging on unsustainable equity from the equivalent of investment ponzi schemes: first a tech-stock bubble and then a real estate development bubble with attached junk securities. We have been living beyond our means for 20 years or more (problem more… going back to FDR’s New Deal). The private-sector has had to significantly resturcture and reset spending back to a deflated reality resulting from global competition. Then the Great Recession hit it like a giant sucker-punch. Last, the piss-poor economic policies of a liberal government run by life-inexperienced ivy-leaque frat boys has extended that pain like a slow cut from a dull knife.

    During all this restructuring, contracting and cutting in the private sector… government employees have seen their pay and benefits continue to inflate. We are in an era of massive public debt, unballanced budgets and unsustainable spending moslty because of the union-Democrat spending spree.

    This is the next bubble.

    It needs to pop.

    Scott Walter inserted the first giant nail.

    We should all thank him for doing so.

  4. 91 Octane

    THe vanguard writes this will become another “bash the union” section….

    as opposed to what?

    bash the police section, bash the da, bash corporations? bash chamberpac? Bash bob dunning? bash Coleman Randall and anyone who stands against a school tax?

    second, I was just waiting for the vanguard to begin trying to spin the recall in favor of the democrats.

    Delusions of Grandeur.

  5. medwoman

    I do not think there is any spin needed here. It is clear that Sctt Walker won by 53-46 %.
    What I think is being lost by those who are being very self congratulatory is that 46% of the voters did not agree with this out come and these policies. These people are not evil, nor are they stupid or deluded or brainwashed. They see the world in a different way from the 53% majority. Nothing more and nothing less. What we are seeing and hearing promoted is that when one side wins, they should totally disregard the sentiments of those with a different perspective. This does not represent the best of democracy as I see it and is, for me, a very disappointing
    although not unanticipated reaction.

  6. rusty49

    Medwoman, cry me a river. Like the Democrats really cared about the sentiments of those with a different perspective when they rammed through their healthcare bill. Remember Obama’s retort, “elections have consequences”. It’s always funny how the left preaches for the right to compromise when they don’t have total power.

  7. Don Shor

    The Affordable Care Act reflected considerable compromise, rusty. The process of getting it passed involved so much horse-trading that it ended up looking very much like what Republicans had proposed just a few years prior.
    You don’t have to declare war on the unions or threaten their existence to achieve balanced budgets.

    Connecticut:
    “HARTFORD — Six weeks into the fiscal year and after a blizzard of layoff notices were sent out, Gov. Dannel P. Malloy finally got the union concession deal he needed to balance the $40.1 billion biennial budget already in place.
    The State Employees Bargaining Agent Coalition, which represents more than 45,000 state workers, announced Thursday that the $1.6 billion concession pension and health care package had been ratified by 73 percent of the membership, while the wage terms got 76 percent onboard.
    All 14 unions that had finished voting were in favor of the package, with the last SEBAC member, state police, set to count ballots Friday. Only one out of 34 bargaining units — the 400-member Correction Department supervisors — voted against the concessions, thereby losing protection against layoffs for the next four years.
    Jubilant workers gathered at a union hall to hear the results and breathe a sigh of relief that most of the 3,077 layoffs across all agencies will be rescinded, courthouses will not be closed and social services will not be drastically cut.”
    [url]http://www.nhregister.com/articles/2011/08/18/news/doc4e4d3f857781a290138645.txt[/url]

  8. E Roberts Musser

    There is a kernal of truth in many of things commenters have said:

    [quote]The facts are that the entire US and maybe most of the world were gorging on unsustainable equity from the equivalent of investment ponzi schemes: first a tech-stock bubble and then a real estate development bubble with attached junk securities. We have been living beyond our means for 20 years or more (problem more… going back to FDR’s New Deal). The private-sector has had to significantly resturcture and reset spending back to a deflated reality resulting from global competition. Then the Great Recession hit it like a giant sucker-punch. Last, the piss-poor economic policies of a liberal government run by life-inexperienced ivy-leaque frat boys has extended that pain like a slow cut from a dull knife.

    During all this restructuring, contracting and cutting in the private sector… government employees have seen their pay and benefits continue to inflate. We are in an era of massive public debt, unballanced budgets and unsustainable spending [/quote]

    [quote]What I think is being lost by those who are being very self congratulatory is that 46% of the voters did not agree with this out come and these policies. These people are not evil, nor are they stupid or deluded or brainwashed. They see the world in a different way from the 53% majority. Nothing more and nothing less. [/quote]

    [quote]You don’t have to declare war on the unions or threaten their existence to achieve balanced budgets. [/quote]

    It would seem to me that citizens in general are more in agreement than disagreement – they want gov’t to spend within its means. Politicians unfortunately are too eager to spend OTM (other people’s money) when it is doubtful they would risk their own money on such ventures as they propose. The more moderate voices have left/are leaving politics in droves, fed up with the way the political scene is devolving – into a “us vs them” mentality, w spending skyrocketing out of sight and beyond the country’s means. The only thing the Scott Walker “victory” stands for is the notion that gov’t needs to be more fiscally responsible with the taxpayers’ money. Scott Walker attempted to do that, perhaps ham-handedly, but he was rewarded for at least trying to do the right thing. But at least he recognized it was possible his “win” may have been a Pyrrhic victory, w heavy costs that need to be addressed with a more collaborative approach. Those who are smart are not those who never make a mistake, the truly intelligent make plenty of mistakes but learn from them…

  9. Frankly

    [i]The Affordable Care Act reflected considerable compromise, rusty. The process of getting it passed involved so much horse-trading that it ended up looking very much like what Republicans had proposed just a few years prior.[/i]

    I guess if you consider only the back-end of a horse looking very much like a horse, then Don you are correct.

    But there was no Dem compromising with the GOP on Obama care. GOP congressional reps were shut out of most of the substantive debate. The reason… compromise would have resulted in too small of a step toward government-run, single-payer healthcare… the continuing dream of the liberal Democrats controlling the executive and legislative branches of government at the time. They got what they wanted, but now the Dems refuse to accept responsibility for it.

    But it does not matter, because everyone knows this one is owned lock-stock-and-barrel by the Democrats. Try as they desperately might to make the GOP seem complicit, the Dems grow more desperate and frustrated lacking even a partial scapegoat. The TEA Party will continue to keep the GOP herd thinned of RINOS that stupidly take the heat for the foolish ideas of their Democrat party “friends”.

  10. Frankly

    [i]”Scott Walker attempted to do that, perhaps ham-handedly, but he was rewarded for at least trying to do the right thing. But at least he recognized it was possible his “win” may have been a Pyrrhic victory, w heavy costs that need to be addressed with a more collaborative approach.”[/i]

    Elaine, I respectfully disagree with this. There is nothing good to come out of a collaborative approach at this point in time. See Jerry Brown for proof.

    I am thinking of my career when I worked for Pacific Standard Life Insurance and Farm Credit Bank. Both companies eventually disappeared because of the growth of competition in their industry. Collaborating with the employees during the years of downsizing would have been like letting the inmates run the asylum. Employees respond emotionally when management has to cut. But for management it is simply math… nothing personal… just business… has to be done. There is frankly nothing to be gained by negotiating terms with employees during times of contraction, because they don’t have a big enough stake in the overall financial success of the organization to be motivated to help the overall organization. Even those that can be made to understand the business problem will generally seek safety for themselves at the expense of their coworkers. They are ME INC., and maybe UNION INC. (because it serves ME INC.) That is the way it is supposed to be.

    The best management can and should do is explain it, and then make the decisions and make the cuts promptly. Then start working a plan for doing more with less.

    My sense is that Scott Walker put on a conciliatory face to help win the recall, but now he is back in the saddle he will resume fighting the fight.

    Interestingly, WI school districts that were first hit with Walker changes are laying off fewer teachers. Many have been able to prevent layoffs, and are even hiring, because of, for example, the savings from open private health insurance bidding replacing the union-mandated coverage. If Walker had compromised, it is likely that this health insurance change would not have occurred… and these WI school districts would NOT be doing more with less like they are today.

  11. medwoman

    “But there was no Dem compromising with the GOP on Obama care. GOP congressional reps were shut out of most of the substantive debate. The reason… compromise would have resulted in too small of a step toward government-run, single-payer healthcare… the continuing dream of the liberal Democrats controlling the executive and legislative branches of government at the time. They got what they wanted, but now the Dems refuse to accept responsibility for it. “

    Actually Jeff, your position is completely inaccurate because it ignores the fact that no advocate for single party payer was “at tha table” either when discussion began. Obama started the whole discussion far to the right of what I would have preferred which is as you rightly state the dream of the “far left”, socialized medicine. From someone on the inside who has seen both government provided medicine in the military and civilian provided medicine, I am well aware of what no one likes to admit, we ration medical care in this country. The right likes to take up the fear tactic that the government will institute rationing. We have that right now, today. It is called ability to pay. Immoral in my opinion, even by the standard that you have set in a previous post. For their profit, doctors, hospitals, pharmaceutical companies and equipment manufacturers are doing what you claimed as immoral, namely benefitting by causing others ( those unable to pay for even basic services) material harm.

  12. medwoman

    Jeff

    “I am thinking of my career when I worked for Pacific Standard Life Insurance and Farm Credit Bank. Both companies eventually disappeared because of the growth of competition in their industry. Collaborating with the employees during the years of downsizing would have been like letting the inmates run the asylum. Employees respond emotionally when management has to cut. But for management it is simply math… nothing personal… just business… has to be done. There is frankly nothing to be gained by negotiating terms with employees during times of contraction, because they don’t have a big enough stake in the overall financial success of the organization to be motivated to help the overall organization. Even those that can be made to understand the business problem will generally seek safety for themselves at the expense of their coworkers. They are ME INC., and maybe UNION INC. (because it serves ME INC.) That is the way it is supposed to be. “

    Now wait a minute. Didn’t you say that both of these companies failed. So it would seem that their strategy of cutting rather than trying for any kind of collaborative process with their workers failed in the end anyway. Can you not imagine a company that does not see its employees as incapable of understanding or as inmates in an asylum as you so poignantly described it, but rather as a potential source of ideas and innovation,
    using their workforce as collaborators in how to gain greater efficiency, productivity and innovation.
    Might not such a company prosper if instead of considering the employees emotional deadwood, they instead considered them as a source of ideas and collaborative partners. I certainly hope so, because the large group of which I am a part has bet much on developing a collaborative model. It would appear to me that it has led to a great deal of improvement in how we operate and we are much stronger now than we were 10 years ago.

  13. Frankly

    Medwoman: [i]wait a minute. Didn’t you say that both of these companies failed.[/i]

    Just like our cities and states are failing. That was my point.

    Actually, both were swallowed up in acquisitions and mergers from larger companies in their industry trying to achieve greater efficiencies from economies of scale. Farm Credit of Sacramento first merged with Farm Credit of Spokane, and then was merged with Farm Credit of Springfield. Pacific Standard Life Insurance Company was acquired by Southmark Corporation. Southmark filed for Chapter 11 in 1989, and the state life and health insurance guaranty associations helped arrange for Hartford Life Insurance Company to assume all the company’s policies in 1994.

    Farm Credit Bank still exists, but instead of the original twelve regional districts, there are now five.

    Farm Credit is an example of a private-public partnership – similar to the company I work for now – that I think is the ideal model for most of what government does today. The private side responds to market changes, while the public connection provides oversight and enhanced funding mechanisms.

    Collaboration with employees is not only a good thing, but it is essential for an organization to reach peak performance. However, contraction is an entirely different ball game. Separating from a company can feel almost like a divorce. It is fraught with strong emotional responses that overwhelm a level of reason and objectivity required to participate.

    To illustrate this, consider a collaborative project that did not include any risk of layoff/contraction… you would expect participants to volunteer to take on tasks and new responsibilities in support of achieving the project goals. Now consider a collaborative project to decide which team members should be given pink slips. You would not have people on the team volunteering for these tasks and new responsibilities. They would become defensive and their survival instincts would kick in.

    The best practice method for contraction is to keep the employees generally informed as to the financial situation so they are not totally surprised. However, management does not want to cause any panic and risk losing the best and brightest employees (but, some of this is unavoidable). Then management makes the decision for who stays and who goes. Then those remaining are told they have to do more with less. At this point the collaborative project can begin.

  14. Frankly

    [i]”The right likes to take up the fear tactic that the government will institute rationing. We have that right now, today. It is called ability to pay. Immoral in my opinion, even by the standard that you have set in a previous post. For their profit, doctors, hospitals, pharmaceutical companies and equipment manufacturers are doing what you claimed as immoral, namely benefitting by causing others ( those unable to pay for even basic services) material harm.”[/i]

    Medwoman: I appreciate your perspective on this. You and I want the same thing… more people able to access quality healthcare. I think the power of the free market is the best way to do it. You think that government-run healthcare is the best way to do it.

    Today, healthcare access falls and rises with income levels. You advocate for the lower income levels preferring that they have access to the same level of healthcare service as do higher income people. However, to make this happen, we would have to prevent the greater access that higher income folks can purchase (otherwise there would always be an imbalance). Today income levels provide some rationing. After you get your way, rationing would be controlled entirely by the US healthcare Gestapo.

    With all due respect, this idea of yours is just another manifestation of destructive egalitarian impulses. The problem is that you will always compare relative levels of service without any grounding baseline of service. So, until we implement a complete collectivist system that enforces equal services and benefits for all, you will never be satisfied. You will always be able to point to some person getting more than another person and claiming “that’s not fair!”

    This approach is not the American system, and has never been the American system. The American system is one that EVERYONE can grow prosperity to purchase higher levels of service from the free market. You want more, then work more. That is the way it works. Better doctors, better medical technology, elective procedures… these things all cost more. If we ration out 100% of all available services… including all the premium services… then we eliminate the market incentives for these things and they will decline. We will innovate less.

    The US currently serves the entire world with advances in medical technology. These innovations are funded by people that can actually pay their medical bills. If we go to government-run healthcare, we impact the entire world with lower quality healthcare options.

    The right to pay for healthcare services is exactly why Danny Williams, the Premier of Newfoundland and Labrador Premier of Newfoundland and Labrador, after getting his heart surgery at a Miami Beach clinic, told the Canadian Press: “I did not sign away my right to get the best possible health care for myself when I entered politics.”

    One last point… if the US shifts to a government-run single-payer healthcare system, access and quality of care will decline for the middle class and increase for the poor, and the wealthy will travel to other countries that will offer them premium services. SO, your next step would be to demand that the US government pays the travel expenses for the poor to have access to these same premium services. It just never stops with you people. 😉

  15. Don Shor

    There are many models in other countries of combined single-payer with market health care.

    [i]With all due respect, this idea of yours is just another manifestation of destructive egalitarian impulses.[/i]
    And the opposite approach has hundreds of thousands, probably millions, of people with inadequate or nonexistent health care, causing personal bankruptcies and earlier mortality.
    If I have to choose between the two philosophies, I’ll take medwoman’s.

    A significant percentage of Americans already have publicly financed health care. [url]http://www.ourfuture.org/blog-entry/2009031006/goverment-funded-health-care-were-already-23-there[/url]

    [i]This approach is not the American system, and has never been the American system.[/i]
    This is a cheap and fallacious rhetorical device. Please don’t presume, as an American, to tell another American, what being American is. Social Security and Medicare and veterans’ health care are American. Americans have a long history of seeing a need among the less-fortunate and dealing with that need. I’m tired of right-wing fringe Tea Party adherents questioning the “Americanism” of those they disagree with. I believe that was aptly described by Samuel Johnson as “the last refuge of a scoundrel.”

  16. Frankly

    [i]”And the opposite approach has hundreds of thousands, probably millions, of people with inadequate or nonexistent health care, causing personal bankruptcies and earlier mortality.
    If I have to choose between the two philosophies, I’ll take medwoman’s[/i]

    Sure you would Don… because your “save the poor” glass is generally half empty like medwoman’s. The “opposite” approach is to get the hand of government less in the business of healthcare… to reduce administrative costs and unleash the power of the free market for people to purchase health insurance as needed.

    As an example of the destructive cause-effect from asinine government-run healthcare, Obamacare has already caused many colleges to eliminate student health insurance because of the cost increases for mandated coverage levels.

    I was once poor, and now I am middle class, and I will be damned if I will let you or others ration my healthcare because there are people unwilling to work as hard as me to earn enough to pay for their healthcare. I do support public contributions to affordable catastrophic healthcare insurance… especially for those with pre-existing conditions. But healthcare is a service. And we all pay for service. And those that can afford it can pay for premium service. Those that want premium service can work harder to earn enough to pay for it. That is the American way. Free markets are not perfect, but in this country they have proven infinitely better than almost anything run by central government control.

    I would be open to government chartering low cost healthcare clinics in a private-public partnership. I am also open to health insurance exchanges. As long as we involve free-market incentives in these service structures, I am open to government involvement to help improve access and lower costs.

    The ONLY problem with healthcare in the US is the high cost. So, let’s focus our solutions on reducing the cost, not using it as leverage for the socialist and Marxists to win the ideological war.

  17. Don Shor

    [i] But healthcare is a service.[/i]
    My values are that health care is a right.

    [i]The ONLY problem with healthcare in the US is the high cost.
    [/i]
    No, the ability of health insurance providers to cancel insurance is just one of the other problems.

    [i]not using it as leverage for the socialist and Marxists to win the ideological war.
    [/i]
    You need to stop using ideological buzzwords and stop labeling people, and perhaps stop seeing everything as a war.

  18. rusty49

    “not using it as leverage for the socialist and Marxists to win the ideological war.

    You need to stop using ideological buzzwords and stop labeling people, and perhaps stop seeing everything as a war.”

    Don, maybe you should follow your own advice:

    “I’m tired of right-wing fringe Tea Party adherents”

  19. Frankly

    [i]”My values are that health care is a right.”[/i]

    Sure you do, but that is too simplistic a statement to be worth anything.

    What?

    When?

    Who?

    Where?

    Are all these attributes a right? Should poor people be allowed free breast augmentation and hair transplants at the hospital in Beverly Hills? What about a sex-change operation… should we cover that cost? Where do you draw the line Don between what is fair and what is a service you have to work hard to afford? What if someone makes poor life choices and eats and smokes to excess and then needs all your free healthcare to extend his life compensating for his own poor choices. And, he takes up a bed that the person who ate healthy and exercised needs… but are in short supply because of government rationing?

    [i]”You need to stop using ideological buzzwords and stop labeling people, and perhaps stop seeing everything as a war.”[/i]

    I do/will when they demonstrate that they are objective and not stuck in a particular ideology or worldview. We are in a culture war Don. You might not see it just as many Europeans have not paid attention to the same in their country.

    Here is the problem with liberalism in a nutshell. You run out of other people’s money and cannot figure out how to enslave the producers to keep feeding the belly of the beast. So, the logical next step is state-controlled industry. Healthcare is a right, so we need government-run healthcare. Home ownership is a right, so we need CRA, Freddie and Fanny. Food is a right, so we need food stamps and trillions of entitlement spending. Everything is a right. Everything needs to be fair. Nobody should be allowed to earn more and spend more than some limit set by elites in control of the government decision apparatus. This is the “progress” we have come to expect from the liberal-progressive mindset. Progress that leads us to greater and greater unsustainable entitlements of equal outcomes and fairness with a growing disconnect for what is earned.

    That is why a culture war is required against those with a liberal worldview. Liberalism is an inevitable step toward collectivist forms of governance like economic socialism and Marxism. This thinking that we can save everyone from themself is the antithesis of the American way. It is this thinking that will destroy the country from within like Europe.

    You want more, then work more. That is the American way.

  20. E Roberts Musser

    [quote]The best practice method for contraction is to keep the employees generally informed as to the financial situation so they are not totally surprised. However, management does not want to cause any panic and risk losing the best and brightest employees (but, some of this is unavoidable). Then management makes the decision for who stays and who goes. Then those remaining are told they have to do more with less. At this point the collaborative project can begin.[/quote]

    Actually other methods of contraction with a more collaborative approach have worked. It seems to me I remember at least one airline company worked w its employees to take a pay decrease to keep everyone working, which worked quite nicely – until about 3 years later when the workers found out the top level management was giving itself outrageous bonuses while the workers will suffering under their pay cuts. Nevertheless the collaborative approach worked quite well to save the company and the jobs of the workers. I think collaboration is worth a try, before the axe has to be used…

  21. Frankly

    [quote]On the heels of Wisconsin Gov. Scott Walker’s history-making recall victory, the governor of nearby Indiana with his own record of curtailing union benefits suggested public-sector unions are past their prime and should be abolished.

    “I think, really, government works better without them,” Indiana Gov. Mitch Daniels told “Fox News Sunday,” when asked whether public-worker unions should even exist.[/quote]

    This is where we need to go. Complete abolishment of public-sector unions.

    Case in point… Unionized Chicago teachers are threatening a strike for demands of a 30% pay increase and smaller class sizes. This as Chicago schools are recognized as being some of the crappiest in the country and the state of Illinois is heading toward bankruptcy. So, again, what good are public employee unions? Absolutely nuthin’.

  22. E Roberts Musser

    In so far as our health care system is concerned, there is no way on earth that the country can afford to provide everyone with the health care they need as a “right”. It is an idealistic view impossible to attain. It is like saying everyone should be provided a 3 bedroom house and car as a minimum standard. What has to be done is determine a base line of care that everyone is entitled to, and go from there. But try and determine a base line of care – good luck w that. Example: Some elderly will do anything to stay alive, and demand all sorts of extraordinary services to stay alive despite extremely advanced age and/or extreme medical conditions, when ordinarily they would expire. To what extent do we as a society cater to such demands for extraordinary health care? On the other hand, who are we to decide when a person should die? Shouldn’t that be an individual’s choice? There are no easy answers to the health care crisis in this country, but health care rationing is inevitable and necessary, like it or not, no matter what health care system we invent…

  23. David M. Greenwald

    “In so far as our health care system is concerned, there is no way on earth that the country can afford to provide everyone with the health care they need as a “right”.”

    I think we probably pay far more not providing people health care than we would providing people health care. The only difference is that the cost is more diffused right now so you don’t see the full impact.

  24. Frankly

    Elaine, I generally agree with all that you wrote except a point related to your last sentence:

    [i]”There are no easy answers to the health care crisis in this country, but health care rationing is inevitable and necessary, like it or not, no matter what health care system we invent…”[/i]

    First, I don’t think we are in crisis. The US still has the best healthcare system in the world. Those that want government to take over our health care industy have branded it with the “crisis” label. It simply is not true.

    The ONLY problems are three:

    – Health care and health insurance costs too much for low and moderate income people
    – Catastrophic health issues can cause financial ruin
    – Pre-existing conditions prevent affordability and access

    It is true that there are no EASY answers, but there is a rational approach that will take care of most of these three problems.

    That approach is to:

    1. Replace our “The private sector is doing fine” President with a new one with understanding of how the real economy works, so that we get more people working so that they can afford their own health insurance.

    2. Repeal Obamacare.

    3. Focus on anything and everything to lower the consumer cost of health care services and health care insurance while requiring people to pay for what they require or want. This means reducing regulation, and opening health insurance offerings across state lines. Use the free market to its fullest potential. Include public-private partnerships to open up low-cost healthcare clinics in areas that need them.

    4. Implement no-fault coverage guidelines for carriers. For example, health care coverage with pre-existing conditions should be offered at rates not to exceed a percentage over baseline premiums for all other actuarial criteria as long as the health issues are not the fault of the covered. Accidents are no-fault.

    5. Implement at-fault coverage guidelines for carriers. For people at fault, they should still be able to purchase health insurance, but at higher rates. A doctor should determine fault. A second doctor should be required to confirm the first doctor’s assessment of fault. There should be an appeals process.

    6. Provide a unique catastrophic health-related bankruptcy law that protects certain assets and relieves catastrophic health care related debt.

    Note that Obamacare has not helped reduce the number of uninsured.

    [img]http://www.cscdc.org/miscjeff/uninsured.jpg[/img]

  25. Don Shor

    [i]Note that Obamacare has not helped reduce the number of uninsured.
    [/i]
    Note that most provisions of the Affordable Care Act have not been implemented yet. Key to reducing the number of uninsured is the development of the health insurance exchanges. [url]http://www.healthcare.gov/law/timeline/full.html[/url]

  26. Don Shor

    [i]This is where we need to go. Complete abolishment of public-sector unions. [/i]

    The problem is the way contracts are negotiated, as we can see right here in Davis. I’m not sure how employees would be represented in establishing wages, salaries, and benefits in the public sector without unions. Unions exist and function to benefit their members — not the public, not the employer. So negotiations have to be conducted by professionals who have no conflict of interest, and the negotiation and arbitration process has to be adhered to.

    There is no need to abolish unions. The right of people to gather in organizations and elect leaders to speak on their behalf is pretty fundamental in the form of right of assembly. The problem isn’t at the union end, since management can impose the “last, best offer.” Public unions are aware of the harm that can be caused by public employee strikes — notice how rare they are.

  27. Don Shor

    By the way, Jeff, here’s the chart for the one demographic for whom the Affordable Care Act actually has taken effect:
    [url]http://www.gallup.com/poll/153737/Uninsured-Rate-Year-Olds-Plateaus.aspx[/url]

    “The uninsured rate for 18- to 25-year-olds first began to decline in the fourth quarter of 2010 after the provision went into effect in September, falling to 26.3% from 28.0% in the third quarter of that year. It then declined further to 24% in the first quarter of 2011 and has remained at about that level since, with the exception of a slight temporary increase the third quarter of 2011.”

  28. wdf1

    “The uninsured rate for 18- to 25-year-olds first began to decline in the fourth quarter of 2010 after the provision went into effect in September, falling to 26.3% from 28.0% in the third quarter of that year. It then declined further to 24% in the first quarter of 2011 and has remained at about that level since, with the exception of a slight temporary increase the third quarter of 2011.”

    Jeff, I think in past comments you’ve said that your kids fall within this demographic. How do you feel about this provision?

  29. Frankly

    [i]”I’m not sure how employees would be represented in establishing wages, salaries, and benefits in the public sector without unions.”[/i]

    Don, the same way it is done in the private sector… the HR department. HR best practices include subscribing to salary survey data that is used to set pay quartiles and step grades by role for geographic areas. I do the same for my company. My board had it done for me.

    [i]”Jeff, I think in past comments you’ve said that your kids fall within this demographic. How do you feel about this provision?”[/i]

    wdf1, a healthy young adult is not very expensive to insure unless there are pre-existing conditions that drive up their risk, or mandated coverage drives up the cost. The cost of my employer’s health care insurance went up 15% last year. We had to cut to a higher deductible plan or employees would have had to contribute premiums, or we would have had to reduce the company retirement contribution. It is assumed that the costs for insurance companies having to insure all these additional young people on company group policies was responsible for some of this rate increase. So, I don’t feel too good about the change.

  30. Don Shor

    [i]wdf1, a healthy young adult is not very expensive to insure unless there are pre-existing conditions that drive up their risk … t is assumed that the costs for insurance companies having to insure all these additional young people on company group policies was responsible for some of this rate increase. So, I don’t feel too good about the change.[/i]

    I can assure you, speaking from direct experience, that the health insurance industry can define “pre-existing condition” to include nearly anything, including normal conditions in “healthy young adults,” and that this was one of the driving factors in moving toward greater regulation of the health insurance industry. Less regulation of the health insurance industry will simply allow them to return to those practices. So your costs would go down as more people, young, healthy, or otherwise, would be thrown off of insurance policies.
    That is why public opinion polling indicates that this is one of the many specific aspects of the Affordable Care Act that is popular with the public.

  31. Frankly

    I agree that we need some rules related to pre-existing conditions. I would like to see us separate them into fault and no-fault. This is one time where the free market and social needs are at conflict. It is disappointing to me, but I get why. I think some carriers might take the moral high road for this if health care costs hadn’t sky-rocketed. Since a small percentage of chronic sick people can drive up utiliztion and costs for a large group, it makes sense that carriers want to avoid providing coverage to them.

    If insurance companies had to accept a percentage of people with pre-existing conditions, and were limited in what additional premiums they could charge, I think young people should get private insurance and get off their parent’s company policy.

  32. E Roberts Musser

    [quote]First, I don’t think we are in crisis.[/quote]

    I respectfully disagree. I ran a support group for the disabled with a certain type of disease, and saw too many cases of people who could not obtain proper health care, even if they had insurance. I have taken too many seminars involving the legal aspects of health care, that discuss things like hospital costs for the insured and indigent w/o insurance, where the list of rates charged for services are completely different and higher for the uninsured indigent. Nonprofit hospitals are required to have special programs for the indigent, then game the system by putting roadblocks in the way to make sure the indigent patient doesn’t access the mandatory indigent program. And on and on it goes. Our health care system is most definitely in crisis for those who cannot access the care they need.

    Do I favor Obamacare? Not particularly. But I also know that health care reform is very necessary. I would have preferred staying w the system w had, and tweaked it quite a bit. But I wouldn’t want to guarantee that would have worked either. There are no easy answers to our health care crisis, and for every solution I can assure you I can point to a myriad of problems w it…

    But ultimately I do know it is neither realistic nor practical to assume that some form of rationing is not going to be required…

  33. Don Shor

    [i]Don, the same way it is done in the private sector… the HR department. HR best practices include subscribing to salary survey data that is used to set pay quartiles and step grades by role for geographic areas.[/i]

    And then when a significant percentage of the employees get together and swap notes about their pay, and come back and demand more money or better working conditions, you fire them all?

  34. Frankly

    [i]”And then when a significant percentage of the employees get together and swap notes about their pay, and come back and demand more money or better working conditions, you fire them all? “[/i]

    Don, that kind of thing just does not generally happen in the private sector for several reasons.

    First, related to working conditions. There are a tremendous number of labor laws and regulations protecting employees and ensuring workplace safety. There are whistleblower laws. These days, many employees in the private sector complain about their work being too restricted with workplace regulations.

    Related to your point about employees swapping notes about their pay… it just does not work that way. It is interesting hearing these types of arguments, because it confirms my sense that public-sector workers operate at a lower level of trust of their manager and employer. Private-sector companies compete for a limited supply of human resource talent. The managers of these companies need good employees to succeed. They don’t want any valued employee to feel under-compensation. However, they also do not want to over-compensate any employee.

    In my career, I have had very few employees complain about their pay… and none of my top employees. I learned very early in my career how my job as a manager would be in jeopardy if I didn’t hire and retain the best people I could afford. I worked with my HR people to make sure the job pay scales were frequently marked to the job market.

    In my role as a manager, I was/am my staff’s servant… providing them what they need (but not always what they want) to be successful at their job. Their success helps the company succeed and helps me succeed. Why would I want to under-compensated them? Paying them market rates for their role, experience and level of demonstrated skills… they know that the only way to make more is to do more, and advance within the company (or outside of the company in cases where their job market is hot). I am always assessing their performance, their development progress and their value to me and the company, and advancing them or coaching them as warranted.

    But, there is more to what most employee value in a job than just their level of pay. In fact, employee retention studies usually put compensation at #3 or #4. Doing work that makes a difference and good management typically come in at #1 and #2. Having good friends to work with sometimes comes in at #3. Great companies leverage this fact by creating a great employee work environment. Some pay a bit lower than average so they keep their expenses low to help them better-compete in their industry. Nugget Market and VSP are two local companies that have done well with this strategy. In both companies, the HR division wields a lot of decision power.

    Unions tend to screw this all up. They create an environment of labor versus management. They destroy trust and make management lazy in the ways of employee motivation. In terms of employee recognition, performance matters much less than longevity. The employees stop expecting #1 and #2 above, and make compensation their focus. What gets measured gets done, so with unions we end up with weak management and a higher percentage of marginal and low performing employees – all of them over-compensation – waiting for their retirement to kick in.

    Unions serve their members a raw deal… unfortunately, many union employees don’t know any better not having worked for a quality private-sector company. Now many will be forced to do so with lay-offs. They might very well be the lucky ones.

  35. Frankly

    [i]”Our health care system is most definitely in crisis for those who cannot access the care they need.”[/i]

    From Wikipedia:
    [quote]“A crisis (from the Greek κρίσις – krisis;[1] plural: “crises”; adjectival form: “critical”) is any event that is, or expected to lead to, an unstable and dangerous situation affecting an individual, group, community or whole society. Crises are deemed to be negative changes in the security, economic, political, societal or environmental affairs, especially when they occur abruptly, with little or no warning. More loosely, it is a term meaning ‘a testing time’ or an ’emergency event’.[/quote]
    Again, I don’t think our health care system is in crisis. It is still the best in the world by many measures. However, I can accept that we have reached a critical point where too many access to the care they want.

    If you see this as a crisis, then I have to ask what has changed? Our healthcare system has sustained us for many decades. How did the poor get their care before the crisis? What has changed that they cannot get that same level of care now?

    My thinking on this is that the level of care provided the poor has not really changed too much; however, the level of care available has changed drastically. So the feeling of crisis is a relative thing… it is from measuring the gap between what is available and what a person has access to. For example, many poor would NOT have had access to a hip replacement or heart bypass surgery a few decades ago? However, now, with these procedures more commonplace, access would be expected even though the costs to perform the procedures are astronomical.

    Taking this to a philosophical level, what if a new complex drug protocol was discovered tomorrow that would reverse and stall the aging process to extend life expectancy by an average of 25 years. However, the new drugs used in this complex protocol cost $100k per user… and any mistake in taking the drugs in the prescribed sequence (three times daily over 24 months, with six “rest periods” of seven days between dosage changes) would cause them to be ineffective and require another 100k and a repeat of the protocol.

    Would the poor lacking affordable access to this treatment be considered a crisis at some point?

    If I am correct about the change being relative to the level of available care, then we are going to be in perpetual crisis unless we just stop advancing healthcare science. Just take everyone back to the dark ages of medicine where doctors would bleed elites, wealth and nobility no different than they would a beggar. Crisis solved… we are all the same.

  36. Don Shor

    [i]”Don, that kind of thing just does not generally happen in the private sector for several reasons.”
    [/i]

    We aren’t talking about the private sector. My question was, if they do organize and appoint representatives to bargain for themselves, should they be fired? Do you believe forming public employee unions should be illegal?

  37. Don Shor

    [i]How did the poor get their care before the crisis? What has changed that they cannot get that same level of care now? [/i]
    More people have less money.
    More people have no or limited access to primary care and preventive care.
    More people rely on emergency services because they have no primary or preventive care and no insurance.
    More people are bankrupted or wiped out financially because they are underinsured or uninsured.
    More people are thrown off of insurance policies because of pre-existing conditions.
    More people find they don’t have coverage for medications they need (I have a $200/month prescription that is never on an insurance formulary).

  38. medwoman

    Jeff

    “The best practice method for contraction is to keep the employees generally informed as to the financial situation so they are not totally surprised. However, management does not want to cause any panic and risk losing the best and brightest employees (but, some of this is unavoidable). Then management makes the decision for who stays and who goes. Then those remaining are told they have to do more with less. At this point the collaborative project can begin.”

    What you just said is in direct opposition to what you stated, on an earlier thread, that you told an employee who said that you had power over her. You said that she actually had power over you since she could always quit. Not true in this economy unless she is also willing to make the decision to stop eating.

  39. medwoman

    ERM

    “In so far as our health care system is concerned, there is no way on earth that the country can afford to provide everyone with the health care they need as a “right”. It is an idealistic view impossible to attain. It is like saying everyone should be provided a 3 bedroom house and car as a minimum standard. What has to be done is determine a base line of care that everyone is entitled to, and go from there. But try and determine a base line of care – good luck w that. Example: Some elderly will do anything to stay alive, and demand all sorts of extraordinary services to stay alive despite extremely advanced age and/or extreme medical conditions, when ordinarily they would expire. To what extent do we as a society cater to such demands for extraordinary health care? On the other hand, who are we to decide when a person should die? Shouldn’t that be an individual’s choice? There are no easy answers to the health care crisis in this country, but health care rationing is inevitable and necessary, like it or not, no matter what health care system we invent…”

    The point that you are making is accurate if we continue a fee for service model of care with profit as the major goal.. However, I do not believe it would be true if we adopted a model that did not incentivize doctors, hospitals, drug companies….to endlessly perform more and more needless procedures in order to maximize profits and minimize lawsuits. And the interesting thing is that we don’t have to invent it. It already exists. It is called the military health care system, or the Public Health Care System, or the Kaiser model, or the Mayo clinic. To variable degrees all are using strategies that involve spreading risk over a broad population, prepaid care at established rates, an emphasis on prevention with incentives to doctors to keep people healthy rather than spend extraordinary amounts of money to “save them” once they become ill and in some instances of very forward thinking strategy, incentivizing patients to follow behaviors that improve health. Right now we are catering to demands for extraordinary care. What I would like to see us focused on is avoidance of the perceived need for extraordinary care in the form of prevention and societal recognition that death is a normal and desirable part of life. Take heart, I have seen definite trends in these directions in my 30 years in medicine.

  40. Frankly

    [i]”What you just said is in direct opposition to what you stated, on an earlier thread, that you told an employee who said that you had power over her. You said that she actually had power over you since she could always quit. Not true in this economy unless she is also willing to make the decision to stop eating.”[/i]

    medwoman, no it is not the opposite, it is the same. If I value an employee and want to keep her, I will work hard to do what I can to keep her satisfied with her job. However, she always has the power to quit and go work somewhere else. Sometimes employees hit a wall where they cannot be made happy in their job. In that case, they should find another job and quit. They always have the power to do that.

    Yes it is more difficult to get a job in this economy. However, if you are good at what you do, there are jobs. You might just have to work a little harder to land one.

    Don: [i] More people have less money.
    More people have no or limited access to primary care and preventive care.
    More people rely on emergency services because they have no primary or preventive care and no insurance.
    More people are bankrupted or wiped out financially because they are underinsured or uninsured.
    More people are thrown off of insurance policies because of pre-existing conditions.
    More people find they don’t have coverage for medications they need (I have a $200/month prescription that is never on an insurance formulary).”[/i]

    Interesting. I’m not sure I agree with all this being so different from 25-30 years ago, but assuming I do for the sake of argument, you still didn’t really answer the questions I asked. Why is there a different between then and here and now?

    You mention that you have a $200/mth prescription. Did that drug exist 25-30 years ago? If not, what would have been your options back then for treating the same health issue?

    Of course the answer is that medical advances have provided us with marvelous and expensive new treatments. We are paying more for a better service that increases our life expectancy and quality of life. Other than the fact that health care employee costs have increased greater than the rate of inflation (unions again), the primary culprit in increased healthcare costs is that everyone, including the poor and their advocates, demands the new Rolls Royce instead of the good old Chevy. We have two choices… either we find a way to help the poor get access to the reliable Chevy, or we ration the limited number of Rolls Royce among everyone rich and poor.

    There are not enough doctors, not enough beds, not enough money… to give everyone Rolls Royce care. But the poor have a choice. They can work harder and make more money to purchase higher level health care service. However, if the government takes over and rations care, nobody will have a choice. But the rich will find a way. It will be the working middle class that sees their access impacted by changing healthcare services from a pay-for-service model, to government-run system of rationing.

    One last point. If we had a more robust economy with more people working, then fewer people would be without the means to pay for health insurance.

    Don: [i]” We aren’t talking about the private sector. My question was, if they do organize and appoint representatives to bargain for themselves, should they be fired? Do you believe forming public employee unions should be illegal? “[/i]

    Yes to the last question. The first question is irrelevant in that case.

  41. Frankly

    The rise in the number of uninsured in the US is certainly attributable to the rising costs of health insurance and global competition causing more private employers to have to cut and drop health care insurance coverage.

    However, in 2010 first generation immigrant population reached 40 million… the highest number in the nation’s history. Illegal immigration also exploded to an estimated 12 million of the 40 million. The US immigrant population essentially doubled since 1990. Latin America accounted for 58% of the immigrant growth… Mexico counted for 29% of all immigrant growth. A high percentage of Latin American immigrants are poor and uneducated.

    The US Census Bureau shows 13% uninsured in 1987. In 2009 the percent uninsured was 16.7%. How much of the 3.7% increase is attributable to the explosion in immigration of poor from south of the border? How much is attributable to illegal immigration? Of course there is a correlation.

    When asked their choice for paying more for their landscaping or risking that their parents could die younger waiting for rationed medical procedures, I think most people would pay more for their landscaping.

  42. Don Shor

    Perhaps the fact that illegal immigration has been declining will persuade you that your analysis is faulty.
    [url]http://www.cbsnews.com/8301-503544_162-20015373-503544.html[/url]

  43. Don Shor

    [i]You mention that you have a $200/mth prescription. Did that drug exist 25-30 years ago? If not, what would have been your options back then for treating the same health issue? [/i]
    When I treated it 25 – 30 years ago, I used an over-the-counter medication. All medications for this condition now are prescription, and non-generic. I’m sure medwoman has similar stories to tell.

  44. Don Shor

    So unionization should be criminal? I believe people have the right to free assembly, specifically and explicitly provided for in the First Amendment.

  45. Frankly

    [i]”Perhaps the fact that illegal immigration has been declining will persuade you that your analysis is faulty.”[/i]

    Only the last year or two. Interesting though. One reason is that birthrates in Mexico have about crashed. There go those good Catholic family values!

    [i]”So unionization should be criminal? I believe people have the right to free assembly, specifically and explicitly provided for in the First Amendment.”[/i]

    I think public-sector unions are in a unique enough situation that a case can be made that they should not enjoy the same application of First Amendment rights. They are part of government, and as such, other parts of the Constitution and Bill of Rights should supersede that which was intended for private citizens. Public sector unions provide an unfair individual political advantage for determining government spending priorities. Public union representatives have a direct seat at a government negotiating table that private citizens do not have. It corrupts the democratic process. It causes damage to society. It should be outlawed.

    I have no problem with private-sector unions. However, they are shrinking for very good reasons.

    [i]”When I treated it 25 – 30 years ago, I used an over-the-counter medication. All medications for this condition now are prescription, and non-generic. I’m sure medwoman has similar stories to tell.”[/i]

    Interesting. I was taking Aciphex until I realized that it was about $6 per pill. Now I take Protonix which is about $.20 per pill. Certainly drug companies are complicit in manipulating the availability of competing lower-cost drugs, but I find generics or alternatives are available for most common health issues. It is the new and improved drugs that tend to drive prices up. Some of them are no better than the old standards… but they are pushed by drug companies and the doctors prescribe them like expensive candy to all their zero deductible HMO policy carrying patients. Others are miracle drugs that we are lucky to have… and we have them mostly because there are enough well-off people that can afford to pay the price that funds the R&D that leads to their discovery.

  46. medwoman

    Jeff

    You have stated a number of times that you consider it unethical for someone to profit by harming another materially. This is frequently what our health care system does.
    I will give you one example. I was being treated in an ER for a fairly common but excruciatingly painful condition. I had no copay and no costs because of my position and was taken in and treated immediately.
    Admitted to the next bed was a day laborer who I anticipate works just as hard if not much harder than I do, but at a job that our society has arbitrarily decided to compensate less than I am compensated. He was in obvious pain, but before they would even start treating him, they demanded to know how he was going to pay his $500.00 copay. I don’t know about you, but in my book, this is material harm, and by your own standard, unethical, but it is standard practice in health care.

    In this country, it is not true that you can just work harder to get yourself out of poverty. It is not true that even the best of workers can just go out and find another job. It is simply not true that anyone who works hard enough can buy insurance. And it is not true that even if you can, your insurance company will be there for you when needed.
    As someone who has worked in the field for 30 years,
    I can attest that your views of the “only problems” with health care are simplistic to say the least.
    In my opinion, we do not have a health care system at all. What we have had is a free for all where pharmaceutical companies can make minimal modifications to existing drugs, market them in highly duplicitous ways, and charge exorbitant amounts for drugs that are essentially no different than their predecessors and almost, but not quite lie, to the public who buy into the myth that the latest is better. We have doctors who encourage people to have surgeries that they do not need and are supported by hospitals whose “free market”
    policies and profit motive definitely cause “material harm”. Insurance companies join in the fray with their refusal for pre existing conditions and refusal to cover for patients “falsifying” their past history by forgetting to
    list such conditions as acne or a yeast infection when filling out their application. I have seen people denied coverage for cancer based on review of their records for “accuracy” after having paid into their insurance for years. OK, I could go on and on with regard to the “finest health care system in the world”. Although by most public health measures we rank well below most of our European counterparts and other comparably developed countries.
    This is not a matter of “seeing the glass half empty”. It is a matter of knowing from first hand experience what we could be capable of, but what we will not do because we choose to treat health care as though it were a commodity to be purchased by the wealthiest and only dreamed of the those less fortunate. I am sorry, but to me this is not the American way. At least not the American way that I envision and love. Like Don, I simply do not believe that you have a monopoly on what it means to be an American.

  47. wdf1

    JB: [i]However, in 2010 first generation immigrant population reached 40 million… the highest number in the nation’s history. Illegal immigration also exploded to an estimated 12 million of the 40 million.[/i]

    Healthcare was so much cheaper in this country before the Europeans arrived. 😉

    [img]http://newsfornatives.com/blog/wp-content/uploads/2008/02/native-cartoonimmigration1.gif[/img]

  48. Don Shor

    I suppose we didn’t need any further evidence of the extraordinary radicalism of today’s Republican party, but apparently for public employees — uniquely among Americans — the First Amendment doesn’t apply. Wow.

  49. Frankly

    [i]”I suppose we didn’t need any further evidence of the extraordinary radicalism of today’s Republican party, but apparently for public employees — uniquely among Americans — the First Amendment doesn’t apply. Wow.”[/i]

    Sure Don. It was only in the 1970s that public employees were allowed to unionize. Prior to that I guess the First Amendment did not apply to them… and both Democrats and Republicans agreed. What a damn radical mistake that was to change it.

  50. medwoman

    Jeff

    A few more historical markers for you to consider:
    1) 1870 – Black men get the right to vote
    2) 1920 – Women gain the right to vote
    3) 1964 – Civil Rights act ends segregation in public facilities
    4). 1967 – Loving vs Virginia ends anti- miscegenation laws
    5). 2010 – Repeal of “don’t ask, don’t tell”

    As a country, we have a long tradition of inequal treatment under the law and of applying our constitutional rights selectively. This, in my opinion is not one of our finer traditions. To me, one of the finest points about our constitution and system of laws is that it is supposed to apply to all equally. I refuse to believe that one of the finest principles of our country, equal protection and treatment under the law could be brushed aside so easily because some feel a group to be inferior or do not approve of their actions.

  51. Frankly

    [i]”You have stated a number of times that you consider it unethical for someone to profit by harming another materially. This is frequently what our health care system does.”[/i]

    Medwoman, I find it interesting that I am in the position of defending your profession while you criticize it. In other discussions I defend my profession (banking) while you criticize it. I think I am seeing a pattern here!

    Seriously though, I understand your points about our healthcare system being imperfect. There isn’t a perfect system in existence. If we were to adopt another country’s system, we would just trade one set of problems for another. But in response to your examples of “harm” caused, all I can say is that life is inherently unfair.

    For example, my mother was lucky enough to be able to afford healthcare after living her early life in poverty, but she had two cerebral aneurisms; one at age 38, and another at age 58. She died from brain cancer at age 67 after a two year fight following surgery that, along with chemo and radiation treatments, wiped out her short-term memory and cognitive functions.

    Here she is at age 18 dressed for her senior ball… the prettiest girl to every come out of McCook Nebraska.

    [img]http://www.cscdc.org/miscjeff/momprom.jpg[/img]

    This beautiful woman (beautiful inside and out) was hit by the equivalent of lightning three times. How fair is that? There are many other stories of her life that would just pile on the unfairness.

    Your day laborer lacking a $500 copay might have had it significantly better than my mother as it relates to the riches of health and health care. Poor is a temporary state that a person has significant control over. You can be poor and happy just as easy as you can be rich and unhappy…. because being happy is a choice you make. However, life is unfair. Some people will live a long life without many health complications. Some will have a little setback here and there and recover.

    I’m sure my mother would have given up all her wealth for the health that the day laborer enjoyed after his physically and financially painful little setback. But, if you have your way, her problems would have been exacerbated by rationed health care. I cannot accept that at all.

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