The part about John McCain as government dole receiver is perfectly ironic, but I wonder if it also explains a lot - McCain's notions about how insurance works would, of course, apply to himself; most people don't have the kind of fee for service coverage he still enjoys, and haven't for a long time; I'd bet he's never had to change doctors when he didn't want to, or worry about negotiating co-pays or discover that his coverage has limits (I'd bet there are no limits for Senators). That, really, would go a long way to explaining both his notion that anyone can get what they need when they are insured, and his general distant grasp on economic issues. And boy will it make for a terrific ad this fall.

Are the numbers being reported right? They're saying that by offering $2500/$5000 annual credits (and they're refundable, so almost everyone will get them) while ending the employer deduction they'll save $3.6 trillion over 10 years. That doesn't seem to add up.

which is bad enough to bring Scary McCain Face out of retirement for one last go.

Probably has plenty sufficient coverage too,
to keep his cognitive status under wraps.

I hesitate for this duplicate comment, quoting my bloody self, if y' know, but anyway here...

"A burr in my brain... can't quit thinking about it. Seems as good a place as any to ask.

A central feature to most ...cognitive senescence, eponymically --Alzheimer's, is forgetfulness.

John McCain can't keep anything straight as to what he has either said or may still believe[s].
Inconsistent, altogether.
--All the pandering flip-flops entirely aside --...

Here's the thing; another characteristic feature of that very distressing
decline is ....
Anger - a second leg to the stool in diagnosis

Can we begin to ask for specific confirmation that this old man is still
--actually --and altogether--with it...
Like before we get yet another alzheimer's in the White House???
Or a VP who's had half a dozen ischemic head hits ?

[An inquiry, broadcast virally, has some inherent value and one is absolutely justified in the asking.]

--And I'm damned near as old as Johnny boy--

[Cogitamus] Posted by: has_te | April 29, 2008 at 08:50 AM"

Would appreciate comment.
McCain IS scary on several levels.

My bad...I don't do anonymous

This:
It's 3 a.m. and your child is awake. She's been up coughing all night, fever resting between 101 degrees and, for a few scary minutes, 103. You and your husband spent hours trying to decide whether to take her to the emergency room. A couple times, you even started toward the car. But you know you can't afford a trip to the hospital. You don't have health insurance.

is a very bad example.
Why not your child is diagnosed with diabetes or severe asthma? For the above you can just call your family doctor and act on his advice which may be to bring her to the after hours clinic. You can pay with cash a credit card or work out terms.

With this emotional story you could promote any necessary service such as housing or food. However, Ezra wishes to whore only for big governnment take over of the health system.

Why does Ezra hate the homeless and the hungry?

Ezra,

A few thoughts:

-- McCain made some specific proposals in his speech yesterday that merit some consideration. I appreciate that you probably wrote most of this piece before his speech, but your assessment really only looks at his tax credit. He offered up more specifics yesterday.

-- You're mixing up a few things. Today, you're lamenting that McCain is pushing people towards an individual market. Yesterday, you praise Wyden (and chastise Obama/Clinton) for putting forth a plan that aims to control costs by... pushing people towards the individual market. Now of course, there are huge differences between Wyden and McCain. Wyden's plan recognizes the current problems with the individual market, and provides a number of features (guaranteed issue, community rating, etc.) to ensure that an individual market could function properly. Here's the problem. Your article primarily focuses on the problem of using the individual purchase of health care as a means to control costs. That's not the problem with McCain's plan, there's a very strong case to be made for an individual market being the best way to control costs moving forward, which you implicitly recognize with your praise of Wyden's plan. The problem is that McCain's implementation of a switch towards an individual market has a lot of holes. It'd be much more productive to focus on why Wyden's vision of an individual market is better than McCain's-- because the longer the Obama-Clinton spat goes on, its increasingly likely that you'll need to figure out how to more effectively critique President McCain's vision on health care if you want to blog on the topic for the next four years.

It's not quite impossible, but it's damn near it, to imagine two markets more different than McCain's and Wyden's. Wyden's is a government regulated structure, where insurance behavior is sharply constrained, and all products must be as comprehensive as the 2007 Blue Shield/Blue Cross Standard Plan in FEHBP. McCain's has none of those features. Wyden's, in other words, is a regulated group pool with a menu of options, while McCain's is a largely unregulated individual market.

And none of the specifics yesterday changed his plan. The high risk pools? he didn't even explain what they'd look like, much less how they'd work, or select.

I thought that in taking TNR to task for using the hysterical Clinton photo, you promised to stop using the maniacal McCain one. Are you flip-flopping?

it's 3 a.m. you wake up from a sharp pain in your knee. You have arthritis but our socialized health care system has taken away any incentive for anyone to find a cure. Not only that the one old drug that is available is deemed not cost effective for someone of your age (even though you are willing to forgo consumption to buy it). But wait now you remember that with a health care system like Canada's everything is alright. You are sadistically consoled knowing that the super rich suffer equally even though we are nearly all worse off. And even better costs are down since it is illegal to purchase extra health coverage.

Maybe we should be a little more suspicious about radically reforming one of the best health care systems in the world. If you look at the past 50 years the US market (i.e. consumers) and drug companies have created a unprecedented level of innovation. I am not saying reform is not necessary (it is) only that be careful or you could end up like us in Canada. Here we actually prevent people from buying health care. The limited health care we do have is rationed. That means for certain effective but expensive drugs we actually have a lottery. Cost are kept low by denying care to the elderly and limiting peoples freedom. Sure our life expectancy is higher but that is easy when we are stealing Americas innovation.
The real question America needs to ask is how to redistribute money fairly and effectively. Once everyone has a more equitable amount of the "pie" then people should be free to make the choice to have Bill Gate's quality coverage or none at all. This attack on insurance companies is merely a guise by a bunch of closet socialists who see freedom as problem.

This:
It's 3 a.m. and your child is awake. She's been up coughing all night, fever resting between 101 degrees and, for a few scary minutes, 103. You and your husband spent hours trying to decide whether to take her to the emergency room. A couple times, you even started toward the car. But you know you can't afford a trip to the hospital. You don't have health insurance.

is a very bad example.
[....] For the above you can just call your family doctor and act on his advice which may be to bring her to the after hours clinic. You can pay with cash a credit card or work out terms.

In what universe does an uninsured family have a "family doctor" who is willing to return a late-night phone call (or indeed, any phone call at all)? Hell, I have insurance, but because I'm a "new patient" to every doctor in town, I can't even get an initial appointment in the next 8 weeks (and half my "in-network" doctors don't even bother returning my phone calls asking whether they're accepting new patients). If you don't have insurance, you probably haven't been taking any family member to routine appointments that allow you access to a doctor for an emergency. And you certainly don't have access to the "nurse-line"s that many insurance companies staff to help you figure out whether what you're experiencing is an actual emergency.

It's not quite impossible, but it's damn near it, to imagine two markets more different than McCain's and Wyden's. Wyden's is a government regulated structure, where insurance behavior is sharply constrained, and all products must be as comprehensive as the 2007 Blue Shield/Blue Cross Standard Plan in FEHBP. McCain's has none of those features. Wyden's, in other words, is a regulated group pool with a menu of options, while McCain's is a largely unregulated individual market.

That's a great start. I think a more detailed piece that further explains why McCain's individual market would fail and where Wyden's succeeds would be great. And if in fact McCain does become President, further thinking on what compromise could be struck between the two that could satisfy the McCains and Wydens would be extremely helpful. As I said earlier, there's a decent chance this will be the only constructive conversation on health care reform to have after January 2009.

And none of the specifics yesterday changed his plan. The high risk pools? he didn't even explain what they'd look like, much less how they'd work, or select.

Well, there's a price tag associated with it, which actually provides more detail on the high risk pools idea than Clinton has provided on mandates. So if you've spent 100 posts or so on mandates without any clarity on "what they'd look like, much less how they'd work" I think you could do one on McCain's GAP proposal and what are the assumptions associated with the dollar figures. The dollars are presumably associated with a number of covered lives that are currently uninsured-- so what's the number?

ITS THREE AM:

You wait for the phone call, but this time its a knock on the door, its the Health Care Nazis looking for your money to pay for rich peoples health care. Why should the Edwards pay more, when we can threaten you with jail to soak you for the money. People get raped in jail you know...so pay up.

"while McCain's is a largely unregulated individual market."

Said the uninformed blogger that never heard of State Insurance commissioners or Departments of Insurance. Who obviously has never applied for a license or tried to get an insurnance product approved to sell in any State.

Are you trying to sound stupid or do you really know this little about insurance? Every State has minimum levels of coverage for different policies in addition to reqirements that certain conditions and illnesses be covered and paid at specified levels. ERISA exist solely as a relief from onnerous State regulation. To call the individual market unregulated has to be one of the dumbest comments you have made in regards to insurance.

I've always felt that McCain looks less "scary" in that photo and more like he's falling backwards out of his chair.

"As I said earlier, there's a decent chance this will be the only constructive conversation on health care reform to have after January 2009."

I agree that it deserves real investigation and not instant dismissal, which just looks partisan. Down the road it's "why should voters believe you?" If it's a bad idea, then having a well developed argument can only be a good thing.

I also think that if elected, if McCain and cronies can be dissuaded from jumping right into making it especially appealing for businesses to drop coverage, then it stalls the change and you also don't get shell shocked families eager to snap up coverage at any price. If he's sincere about controlling costs for the public, he won't rush to throw his white collar supporters to the snapping dogs, because initially I really that's what you would get-- (even more) predatory insurers.

In terms of costs coming down over time-- I don't know if I see that, because healthcare (like education) is labor intensive. It's not like a technology bust where the wide screen TV manufactured in China goes on sale at BestBuy. It's more like ballooning costs in the higher education market.

I think that's key to his "competition cures all ills" theory-- what kind of market are we really talking about?

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