Kowalko & Jaques to file “Single-Payer” health care bill

Filed in Delaware by on June 15, 2012

This is El Somanbulo’s territory. All I know is what I read in press releases.

State Representatives John Kowalko (25thDistrict) and Earl Jaques (27th District) announced they have filed HB 392, legislation that will provide Health Care coverage to all Delaware residents.

The legislation will provide universal health care coverage access through a system that will reduce administrative costs by minimizing and centralizing the current system that requires multiple payment forms and consists of medical decisions being rendered by insurance company bureaucrats with no medical background.

Both Representative Kowalko and Jaques have been working with House attorneys for more than a year and felt that release of the bill at this late stage of the session will give the public and other stakeholders an opportunity to examine the complexities of this subject matter over the next several months before a return to session.

Kowalko stated “it is time to move this issue from the realm of theoretical to the world of reality and I hope all interested parties will take this ample time to review every aspect of this proposal over the ensuing months”.

“Representative Jaques and I agreed that while some critics may allege that filing a bill this late in session is mere political rhetoric, the complexity and enormity of the challenge facing the uninsured and the soaring costs of health care demands a responsible plan be composed now. The fact that the Federal Health Reform mandates are imminent only adds a further sense of urgency to our responsibilities” said Kowalko.

Representative Jaques stated “a piece of complex legislation dealing with such a complex issue deserves to be thoroughly scrutinized and examined by the public, our colleagues and all with a vested interest in controlling medical costs in an efficient way. Everyone will have access to this bill to critique, suggest, agree or disagree so that in January we will be prepared to move forward responsibly and rapidly”.

Kowalko and Jaques both state they do not expect this bill to be passed this session. Which is good, because it won’t passed this session. Nothing will pass so long as Obamacare’s fate is undecided.

About the Author ()

Jason330 is a deep cover double agent working for the GOP. Don't tell anybody.

Comments (176)

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  1. Delaware Dem says:

    Mitch Crane has come out in support:

    Mitch Crane, the Democratic Party’s endorsed candidate for Insurance Commissioner, announced his support for House Bill 392, a bill to implement a single-payer healthcare system in Delaware. “Health care is a right, not a privilege. For the 125,000 Delawareans currently uninsured and thousands more underinsured, this bill will provide health insurance coverage for every Delawarean. As health insurance premiums rise at unsustainable rates, this bill will bend the cost curve by rooting out wasteful health insurance spending including lobbying expenses, advertising costs, and corporate profits. I’m proud of Representatives Kowalko and Jaques for their leadership on this important issue and I will continue to support their efforts towards universal health care coverage here in Delaware. The filing of this bill should begin a long process of discussion and debate as to how a Single Payer system can be implemented in Delaware. If elected Insurance Commissioner, I look forward to participating in this process so that we can best serve the health insurance needs of the people of Delaware. ”

    “Representative Jaques and I agreed that while some critics may allege that filing a bill this late in the session is mere political rhetoric, the complexity and enormity of the challenge facing the uninsured and the soaring costs of health care demands a responsible plan be composed now. The fact that the Federal Health Reform mandates are imminent only adds a further sense of urgency to our responsibilities” said Kowalko. Representative Jaques stated “a piece of complex legislation dealing with such a complex issue deserves to be thoroughly scrutinized and examined by the public, our colleagues and all with vested interest in controlling medical costs in an efficient way. Everyone will have access to this bill to critique, suggest, agree or disagree so that in January we will be prepared to move forward responsibly and rapidly.”

  2. At this point in the legislative session, this bill is essentially a ‘shot across the bow’ for next year. I have long supported single payer and, who knows, with Mitch Crane as IC, it could well have its best chance to pass.

    Not gonna happen with only two-plus weeks left, though. Definitely gives us something to look forward to in 2013. but only if Crane is the IC.

  3. SussexAnon says:

    I hope Kowalko, et al, have a PR plan in place with talking points and spokespeople to get the word out.

    Otherwise it will be demegogued and killed on the ground before it even takes flight.

  4. Jason330 says:

    The demagoging is already on. My red neck barometer (who pays no attention to state politics) emailed to tell me that my small business health insurance premiums are going up because of this. I said that they’ve been going up by 20% per year over the last ten years, so that is nothing new.

  5. Will M says:

    More taxes and a total state take over of every aspect of our health care system. What am I missing that makes this a GOOD idea?

    If these 15 bureaucrats decide that your services aren’t covered, they’ve outlawed every other mechanism for purchasing health care services. Just like NCLB, this will be a race to the bottom. We will all be “entitled” to the same low level of care and will have no option but to go out of state to get anything different. Good call.

  6. Idealist says:

    and yet, Will, the countries with single-payer health care systems have better overall health outcomes than the United States….oh and they pay a lot less for it.

  7. Geezer says:

    “More taxes and a total state take over of every aspect of our health care system. What am I missing that makes this a GOOD idea?”

    What you’re missing are the facts. That first sentence is pure fantasy.

    “Just like NCLB, this will be a race to the bottom. We will all be “entitled” to the same low level of care and will have no option but to go out of state to get anything different.”

    There are none so blind as those who will not see. Your ignorance is no basis for a health care system.

  8. Will M says:

    Ok, so what am I missing. Please enlighten me. I see a board of 15 bureaucrats being appointed to dictate all of our health care decisions, and an addition 2.5% tax on individuals and an additional 4-9% tax on their employers to pay for it. What facts make this a good idea?

  9. jason330 says:

    Allow me to put it on the bottom shelf for you. You are already paying for people who don’t have insurance in the form of higher delivery costs.

  10. Geezer says:

    The fact that insurance companies already do the same thing, except they don’t have any 15-person board — they do it unilaterally. And that government can handle these functions far less expensively than private industry, as proved by the fact that every country that handles it through government does it for about half what we spend.

    Get your head out of your libertarian ass once in a while and read things you don’t already agree with.

  11. Will M says:

    There’s lots of them though, not just one. I expect a lot of them have more than 15 people on their boards, they’re just not political appointees. The other countries that handle it through government bank on our R&D to advance the standard of care, don’t they?

  12. Geezer says:

    “There’s lots of them though, not just one.”

    Wow, you are brainwashed. Most people have no choice; they get it from whatever firm has cut a deal with their employers.

    “The other countries that handle it through government bank on our R&D to advance the standard of care, don’t they?”

    No, they don’t. Europe is just as advanced as the US at coming up with new drugs and procedures. They just pay less for it because they don’t have governments full of libertarian dickheads who think it’s “wrong” to use the bargaining power of government against corporations.

  13. Will M says:

    I’m not defending employer purchasing of health care, and where in HB392 does it set aside any of the revenues from these new taxes for R&D?

    I read plenty of things I disagree with. I read your comments all the time.

  14. Will M says:

    Nvm, §1620(a)(4). Still concerned about how much will actually be devoted to this purpose, and don’t think 15 bureaucrats will do it better than all of the individuals in Delaware acting of their own free will. They will serve as a bottleneck to all new and alternative health care practices.

  15. Geezer says:

    “where in HB392 does it set aside any of the revenues from these new taxes for R&D?”

    Why would revenues be set aside for R&D? Insurance companies don’t spend on R&D.

    “I read plenty of things I disagree with. I read your comments all the time.”

    Yeah, but you have nothing intelligent to say in response. Libertarians are usually under the delusion that they’re rational, and you are no different.

  16. Geezer says:

    Nobody in Delaware gets their health care “of their own free will.” Even the richest people I know — I’m talking multi-millionaires — use Medicare.

    How old are you, Will? If you’re under 50, you really have no idea what you’re talking about, because you’re not looking at the inevitability of needing this health care you speak so blithely about.

  17. Will M says:

    No, they don’t, but the reimbursements they pay to medical practitioners go to that. Part of the health care industries profits are devoted to R&D, and if this 15 member board is setting the rates, their goal will be to squeeze all profits into savings for their monopolized health care authority fund.

  18. Will M says:

    I am looking at paying for it for the next 20 years though.

  19. Idealist says:

    what will happen to the cost of health care over the next 20 years if we don’t adopt a single-payer system?

  20. Geezer says:

    Will, you clearly have no idea how many moving parts the system has, or where the money you’re whining about goes. Come back when you grow up.

  21. Will M says:

    Yes, call me ignorant. Are we still playing the drinking game?

    I see there is a problem here, but this legislation is not the way to address it. In fact, it will make it worse. The problem we have in the health care system is not enough competition. Our employers buy it for us and we’re stuck with what they buy. Now we’re going to be stuck with what a group of bureaucrats buy and there will be even less competition, unless you leave the state. I’m sure lots of you would like me to leave the state, but I’m not gonna.

    Instead of this, we should have an Insurance Commissioner who will approve more plans to be sold in Delaware, and a regulatory environment that encourages people to buy their own insurance rather than have it provided for them. More competition is the answer to this, not less.

  22. Steve Newton says:

    Geezer, you do realize that this bill is verbatim Floyd McDowell’s old bill that had its last incarnation in 2007 as SB 177, and on first read doesn’t appear to have been changed even so much as by a comma?

    Among other neat things: one-third of the seats on the Delaware Health Security Advisory Board are to be permanently reserved for representatives from consumer groups that have advocated/lobbied for the passage of this particular bill for at least five years. That’s really an interesting way to run a railroad, huh?

    And so this Board, which consists of one-third legislators, one-third reps from physician licensing groups, and one-third reps for the above-mentioned consumer group lobbylists will then annually generate a list fixing the cost of every single health care service and procedure in the State?

    Have you even read this bill?

    Look at the weakness in provisions regarding your ability under this bill to go out of state if you are unhappy with the quality of the provision of services in Delaware.

    We have no competent major spine surgeons in Delaware. I will make that statement clearly and boldly–we don’t have a regional quality medical center to attract them. So spinal surgeries in Delaware are done by doctors who wouldn’t make it at Temple or Johns Hopkins. My current insurance paid with no question for my wife to go to Temple for three-level lumbar fusion.

    Would this plan? That’s not so sure.

    If this were anything–ANYTHING–other than an election-year gambit (which Mitch Crane’s quick statement proves pretty clearly), they would at least have updated the language in the bill and made it consistent with changes in law and practice that have occurred over the past five years. But they didn’t.

  23. jason330 says:

    “The problem we have in the health care system is not enough competition.”

    Look. It is impossible to not laugh at this dumb immature, uninformed, bullshit. The modern medical insurance/delivery questions have been settled and the solutions have nothing to do with more competition.

    We only need to look to other industrialized countries with better health outcomes.

  24. Will M says:

    ^^^Over 50, knows more about the moving parts, still thinks you’re an idiot. <3 Steve Newton.

  25. Will M says:

    Settled in your own mind, perhaps. How is there competition in a corporatist insurance market dominated by big businesses negotiating with each other over how to provide the cheapest care you won’t leave your job over?

    I’m getting wasted over here. I told you my excuse to participate in your drinking game would get me plastered first. Good thing I don’t have to drive today.

  26. jason330 says:

    Settled empirically. Silly me. I thoughts libertarians were into rationality. You guys are simply bullshit artists. I’m done with you.

    Good day young man.

  27. Geezer says:

    “The problem we have in the health care system is not enough competition.”

    Wrong. The problem we have in the health care system is too much competition for the wrong motive. Please preach your philosophy elsewhere.

    “My current insurance paid with no question for my wife to go to Temple for three-level lumbar fusion.”

    Sorry to hear that. You realize, I suppose, that lumbar fusion surgery is exactly the sort of procedure that’s quite costly and yet not particularly efficacious, depending on the condition being corrected. I can see why you wouldn’t want to have to justify the expense. Sort of ironic for a libertarian.

    The specifics of the bill are immaterial, as it will get no hearing or activity before the end of the session. It is, as ES said, a warning shot. Will’s objections aren’t to specifics but to the whole notion of ejecting the private insurance industry from the equation.

  28. Idealist says:

    The idea that two legislators who are currently running unopposed are running an election-year gambit isn’t serious. From the press release of Rep. Jaques and Rep. Kowalko, their stated purpose is so that this bill can be “thoroughly scrutinized and and examined by the public, our colleagues and all with a vested interest in controlling medical costs in an efficient way.”

    I’d like to hear the libertarian alternative, since I think we can all agree the current system is unsustainable.

  29. Geezer says:

    What’s the game — drink every time Will types something without knowing what he’s talking about? No wonder you’re wasted.

  30. Will M says:

    How can you thoroughly scrutinize a bill in the last two weeks of the legislative session? Why don’t they introduce the bill in January of last year so we can actually thoroughly scrutinize it? It’s not like the bill didn’t exist. It was written five years ago.

    Settled empirically where? Have we TRIED giving the tax incentives to individuals instead of corporations to buy health care since 1945? Have we TRIED allowing more interstate purchasing of health care plans? Have we TRIED improving the portability of health insurance policies? Where did we empirically prove anything?

    My objections are to monopolizing the insurance industry as a political government bureaucracy. You think you’re getting rid of insurance, you’re not, you’re just giving us all the same insurance, managed by political appointees, and completely devoid of any grounding in economic rather than political reality.

    That two unopposed D legislators would introduce this makes it even more obviously an election gambit. They’re safe. They don’t care. But it gives the Ds who do have opponents something to try to beat their opponents over the head with. Mitch Crane got behind it. He’s got insurance company darling KWS to beat and then a Republican and a Libertarian who will inevitably oppose single-payer health care on many of the same grounds Steve and I do.

  31. Will M says:

    I’d have to dig up the thread for you, Geezer. You drink every time I say, “I see there’s a problem here, I just don’t think this legislation will solve it.” I drink every time you offer nothing more than an ad hominem attack or a logical fallacy to rebut me.

  32. Geezer says:

    “You think you’re getting rid of insurance, you’re not, you’re just giving us all the same insurance, managed by political appointees, and completely devoid of any grounding in economic rather than political reality.”

    It has been settled empirically by all the other countries that do it one way, with results as good as ours, for half the price we do. Meanwhile nobody wants to even try it your way — at least, nobody on the verge of needing the health care does. Once you or a close loved one is in danger of dying, you’ll be singing a different tune. You’ll just have to trust me on that.

    Your objections are based on your philosophy. Break those shackles and you might learn something.

  33. Geezer says:

    I’m offering plenty besides the ad hominem attacks. You just can’t see it because you’re blinded by your adherence to a silly, unworkable ideal.

  34. Steve Newton says:

    You realize, I suppose, that lumbar fusion surgery is exactly the sort of procedure that’s quite costly and yet not particularly efficacious

    Geezer, you are so full of shit your eyes are brown. There are mature 10- and 20- year studies on outcomes with lumbar fusion surgery.

    I can see why you wouldn’t want to have to justify the expense.

    Idiotic comment. The need for the surgery had to be justified; I didn’t say otherwise. What my insurance did do was provide for a free choice of doctors. There is no spine surgeon in Delaware with experience in doing more than a dozen major lumbar fusions; the surgeon at Temple has down over sixty, nearly two dozen of which were three-level. Nobody in Delaware has ever done three-level, but they were all willing to tell us they’d love for my wife to be their first case. Would you let a spinal surgeon try out his first time on a procedure on your loved one? Under this bill I would not be allowed to seek the most qualified physician out of state as long as there were physicians in-state who claimed to be equally qualified.

    Sort of ironic for a libertarian.

    Play that horseshit with people who give a damn about your prejudices. You don’t want to talk policy, you want pontificate, to wit:

    The specifics of the bill are immaterial

    In other words, you didn’t read it, Mitch Crane didn’t vet it, Kowalko and Jaques didn’t tell anybody they’d recycled it–you all just want the feel-good credit for bringing it up?

    @Idealist

    I’d like to hear the libertarian alternative, since I think we can all agree the current system is unsustainable.

    When you can come back to me and tell me you understand this bill, I’ll talk to you about alternatives. Unlike Geezer I have never proclaimed myself as competent to prescribe a health care solution for the entire State or country, but I do know a bad bill resurrected as a piece of electioneering when I see it.

    If this bill–that was first introduced verbatim in 2007–is such a burning important issue, why the five-year hiatus?

    Admit it, folks, this particular piece of legislation has NOTHING to do with serious health care reform, and everything to do with electing Mitch Crane Insurance Commissioner plus other electoral goodies.

    Try readig the goddamn legislation next time before you all start posturing.

  35. Jason330 says:

    Settled empirically where?

    I said I was done with you, but I assume you’ve never traveled out of the Unitede States, so I’ll take pity on you. But this is the end of my hand holding. From now on you are going to have to use your brain a little.

    “The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance. Among the seven nations studied—Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States—the U.S. ranks last overall, as it did in the 2007, 2006, and 2004. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last on dimensions of access, patient safety, coordination, efficiency, and equity. The Netherlands ranks first, followed closely by the U.K. and Australia.”

  36. Will M says:

    Your support is based on your philosophy, and I would argue a lack of consideration for economic and political reality. Break those shackles, and you too might learn something.

  37. Jason330 says:

    You are an idiot or a wingnut to link to that… probably both.

    “The NCPA is a member of the State Policy Network, a network of national and local right-wing think tanks, and of townhall.com, a right-wing internet portal created by the Heritage Foundation.”

    Or is it that libertarians are in lockstep with the Heritage Foundation on this? When I say that there is no such thing as a libertarian – you guys always prove me right.

  38. Will M says:

    Do you have a specific beef with the data or are you just running a guilt by association strategy on the source? I just googled “cancer treatment outcomes” to be honest. Your link specifically said “most” dimensions of performance, and my argument from the start has been that single-payer systems stagnate technological development, which is the most important aspect of health care in my opinion. Develop the technology, and the old treatments get cheap, and new treatments are constantly being developed to actually improve outcomes. Having a 15 member board of politically appointed hacks running the Delaware health care industry is not an environment conducive to innovation.

  39. SussexAnon says:

    Could the Libertarians (and “libertarians only when it suits them”) in the room please state what the Libertarian plan is for healthcare reform?

    Please also cite, if able, where this plan is currently in existence in the world?

  40. Geezer says:

    @Steve Newton: You’re arguing from anecdote, and you don’t know what you’re talking about. Took about 10 seconds to find:

    “Multilevel spinal fusion for treatment of low back pain is a controversial topic. In general, lumbar spine fusion has a relatively poor success rate for treatment of multi-level disc degeneration seen on MRI scans.”

    http://www.spine-health.com/treatment/spinal-fusion/multilevel-spinal-fusion-low-back-pain

    As I said, I don’t know the specifics of your wife’s case, but lumbar fusion has one of the lowest levels of efficacy of any sort of surgery for anything. I can point you to several people who will attest to that from their own experience.

    I got involved in the discussion because Will is spouting ignorant, simplistic libertarian bullshit. I generally consider you above that sort of thing, but I’m willing to be proved wrong on that.

  41. Geezer says:

    Will: You linked to an “analysis” by Betsy McCaughey, a longtime insurance industry propagandist. The basic facts are correct, but the spin is dizzying. From a more balanced source:

    “While Coleman and other epidemiologists have long known that cancer survival rates vary country by country, and even within a country, the study lends hard numbers to the fact. Still, there were surprises. “I think the surprises were that the range in global survival is really quite wide,” Coleman tells WebMD.

    “Survival in the USA is high on a global scale but varies quite widely among individual states as well as between blacks and whites within the USA,” he tells WebMD.”

  42. Will M says:

    Controversial is precisely the problem with this program. Some controversial treatments will be effective. Some won’t. This 15 member board of bureaucrats will make that determination for everyone. Based on its composition, I don’t expect them to be the “innovation promoting” type. I’m not sure any composition would be any better.

    I don’t expect a libertarian solution to be perfect, but I don’t think a 15 member board of bureaucrats serving as a bottleneck can beat about a million people making decisions for themselves. Why would you give politicians that kind of power?

    As for “our solution”, I’ve said it a few times. Stop giving the tax benefits to corporations for buying health insurance. Give it to individuals or to no one and let’s compete on a level playing field. We haven’t had that since 1945. Also, stop consecrating “insurance” as some special class. It’s just people pooling their resources to pay for each others’ health care. A bunch of people getting together and deciding to help each other out when they need it is the basis of “insurance”, but regulations out the yin yang have made it impossible for anyone not a corporate whore to get into.

  43. Geezer says:

    “I don’t think a 15 member board of bureaucrats serving as a bottleneck can beat about a million people making decisions for themselves.”

    As noted earlier, the second thing you refer to there is about as reality based as unicorn polo. One of the major problems with libertarianism is its refusal to treat the world as it finds it.

  44. Steve Newton says:

    Nice cherry-pick, Geezer. The opening lines of the site you mention are:

    While multilevel spinal fusions are a common and necessary procedure to treat many types of spinal pathology . . .

    You’re right: you did thirty seconds of research. I did six months of it before she had that procedure, and looked at, you know, real medical journals that are either gated or not on the net. If you’d like to discuss clinical outcomes, feel free. Here’s the kind of material you should be digesting if you weren’t just puffing yourself up as an authority (who calls me anecdotal and then promises to refer me to his friends for their stories)

    http://www.ncbi.nlm.nih.gov/pubmed/18458584

    I worked through about 300 of those. You did 30 seconds. Congratulations, here’s your degree.

    My point is simple, and you have hijacked it: none of you have read this bill, none of you know what’s in it, none of you knew where it came from, and none of you could cite a single study (are you listening, jason) that suggests that a stand-alone single-payer system will even work in a population below 1 million in a geographical area so limited in medical resources that large numbers of necessary and common procedures aren’t even done in Delaware.

    Want to tell me how I’m being simplistic, old man?

    I gave you specifics from the bill: you ignored them.

    I gave you a specific weakness in the proposed law: relative competence of in-state vs out-of-state providers, You (a) gave me an internet page and (b) argued that what’s in the bill doesn’t matter.

    Quit on this one while you are behind. Your shit is weak and your insults today are tepid.

  45. Will M says:

    Which is why you’ve all made drinking game out of me saying:

    “I see there’s a problem here but I don’t think this legislation will solve it.”

    I think we need to reform our health care system in the direction of empowering more people, not less. Giving our employers the ability to make our health care decisions for us is bad. Giving 15 political appointees the ability to do it is worse. We need to give it to ourselves as individuals instead.

    PS, <3 Steve Newton, and I’d love to play polo on a unicorn.

  46. Idealist says:

    “Could the Libertarians (and “libertarians only when it suits them”) in the room please state what the Libertarian plan is for healthcare reform?

    Please also cite, if able, where this plan is currently in existence in the world?”

    I hear Somalia has a nice libertarian health care system.

  47. Steve Newton says:

    @Idealist

    As soon as you show me your example of a stand-alone single-payer system that succeeds with a population of less than 1 million and an inadequate basis of medial services.

    I’ll be libertarian or any other thing I please any damn time I please. Talk policy or STFU.

  48. Geezer says:

    With all your research, then, you are well aware that lumbar surgery has a relatively poor record of efficacy. Get a knee replaced, you have a new knee. Get your gall bladder out, no more attacks. Get your spine fused and there’s a significant chance you’ll still have back pain. That’s been true for many, many years, and I find it dishonest of you not to acknowledge it.

    As I noted, but you ignored, I don’t know the specifics of your wife’s case. You linked to a study in geriatric patients; is your wife geriatric?

    Will’s objections were not to specific elements of this bill — which I read back when it was sent to me by Floyd McDowell — beyond the 15-person panel. So I don’t get where anyone is “hijacking” your point.

    You don’t actually have anything to bitch about, because as you acknowledge you don’t know what would happen to your wife in the case you’re talking about. So you’re arguing from fear of the unknown. Don’t pretend it’s empirical.

    I, too, have a wife who might have her health care arrangements compromised by being forced to seek in-state treatment. But I’m not selfishly arguing from my own self-interest, as you are. Since the bill won’t be worked, we’re arguing philosophy, and yours — libertarianism — sucks. Sorry.

    Quit while you’re ahead, sport.

  49. Will M says:

    Oh, wow, Somalia as the libertarian paradise. Never heard that before. You want a cookie?

  50. Steve Newton says:

    Geezer,

    Even for you that’s almsot too lame to merit a response.

    But I thank you for admiting I am ahead.

    I haven’t argued a bit of philosophy–I have argued specifics from the bill.

    I’ll tell you that the only way a single-payer system can work is with a large enough population and services base to support it. Massachusetts has it, barely. Delaware doesn’t.

    You’re such a good damn researcher, find an example of similar demographic size to Delaware where it has ever worked. Hell, find one where it has ever been tried.

    If we are going single-payer, just go Medicare for all and have done with it. But, oh, it’s the President of the United State who lacked the guts to go for it, wasn’t it?

    Thank you for implying that it was selfish for me to seek the best medical treatment for my wife.

  51. Steve Newton says:

    Oh, and Geezer, just to not give you the talking point: I linked to a study, that if you read the footnotes, describes outcomes in comparable studies against middle-aged patients. You want the whole bibliograpy, go do your own research. You made a claim and supported it with a web page.

    In doing so you completely ignored the question of relative qualifications of surgeons in and out of state, but I’ll forgive me putative elders their poor memories and attention spans.

  52. SussexAnon says:

    Giving decisions to 15 gov’t appointees would allow the people to petition the gov’t and the appointees to change things they might find questionable.

    Which is better than what we have now.

    I currently pay for my own insurance and have seen my rate go up 19 to 24% every year for the last 5 years. And the “free market” leaves me with limited companies to shop around. So your empowerment theory doesn’t really work for me.

  53. Will M says:

    We don’t have a free market. The government gives a tax incentive to your employer to limit you to two or three options from the same insurance company. It’s not an economically viable solution for you to say to your boss, “Just give me the cash, I’ll go buy my own insurance from a company that won’t screw me year after year.”

  54. Geezer says:

    “Even for you that’s almost too lame to merit a response.”

    Just admit it, Steve: Spinal fusion surgery is expensive and doesn’t always work, and in fact works less often than most surgeries. You know it and I know it; why don’t you want anyone else to know it?

    “Thank you for implying that it was selfish for me to seek the best medical treatment for my wife.”

    Thank you for acknowledging that selfishness is the main ingredient of libertarianism.

    For what it’s worth, your concerns are valid, if expressed in over-the-top hysteria (“We have no competent major spine surgeons in Delaware. I will make that statement clearly and boldly.” I don’t actually know any of them, but allow me to say “fuck you” on their behalf.”

    YOUR arguments aren’t the problem here, Will’s are. But since you made it personal, I took the opportunity to point out that your wife’s surgery was expensive, did not as far as I’m aware involve anything needed to save her life, and that libertarians can’t see that spending a lot of money on such surgery increases the costs for everybody — but they don’t care because it’s not the government spending the money. Just taking the opportunity to show in exactly which ways libertarianism sucks. Hey, it’s your shit-heeled philosophy, not mine, and you don’t get to dictate what form the discussion takes.

  55. DoTheMath says:

    Somebody ought to do a rough estimate on the math and then see what they think.

    For a family of 4 making $100,000, the total premiums collected will be $11,500 (the 9% tax plus the 2.5% surtax). That is less than $1000/month — for a family that is paying. Don’t forget that the bill also covers EVERYONE. That’s not even a copper or bronze plan, no matter how much you think gets saved by lower administrative costs.

    Oh, and isn’t it nice that the state plan would include dental, eyeglasses and even acupuncture!

    It covers everything and “costs” less the average premiums being paid now for lesser plans. Over a bureaucrat or politican could ever think that would work.

    If we want “free” healthcare for everyone, no matter their situation, it’s going to take a lot more in taxes than this bill calls for.

    And, with all the employers who will leave Delaware, or simply won’t come to Delaware, the burden will only get worse for those who remain.

    This is an economic disaster, but I’m sure it makes progressives feel good.

  56. Will M says:

    So your bureaucrats would tell everyone, not just the people it wouldn’t work for the but the people it would work for also, to go screw themselves. They can “petition their government” for the privilege of spending their money as they please. Authoritarian much? How dare these selfish libertarians expend their own resources as they see fit. Why don’t they understand that you should expend their resources as you see fit? Those BASTARDS!

  57. SussexAnon says:

    Uhm, No.

    I am self-employed.

    There is no employer, no gov’t tax incentive and my limited options are the insurance companies that offer single policies.

    What I am saying is that I am living your empowerment suggestion and my rates and copays are still increasing.

  58. Will M says:

    The market conditions are dictated by the big businesses negotiating with themselves to offer employer-provided insurance. Without those regulatory and tax conditions, the single policies would be a much more developed market.

  59. Geezer says:

    “You made a claim and supported it with a web page.”

    And you’ll find that claim supported by every back surgeon and every web page devoted to back surgery. Try it and see. No spinal surgeon will guarantee you relief from spinal fusion, unless he’s somehow immune from lawsuits.

    I neither know nor care about your wife’s case, which you apparently used because it was convenient. You could actually make a far better argument with my wife’s health problems than yours, as my wife’s condition is life-threatening and there truly is no neurosurgeon in Delaware who performs the surgery that saved her life. She would have to rely on a retrained radiologist.

    So, with the weekend here, have a nice one.

  60. SussexAnon says:

    Will, try petitioning a corporation and see how far you get.

    And petitioning the gov’t for the privilege of spending money is pretty much what gov’ts v. citizens do.

  61. Idealist says:

    I agree with Steve, let’s go Medicare for all. Short of that, it falls to the states. We’ll see happens with Vermont’s proposal.

  62. SussexAnon says:

    So, Will, in your view, how much of insurance premiums, by percentage, are collusion of companies?

  63. Geezer says:

    Just by-the-by, I don’t think this bill will go anywhere even next session. Delaware will not be in the first wave of states to adopt its own single-payer plan, and for many of the reasons Steve brought up.

    But there’s no fun in arguing that.

  64. Will M says:

    I don’t petition corporations. I cancel my contract with them. I’ve tried to cancel my contract with the government, but they’re a lot less entertained by that attempt than I am.

    I’m sure there’s lots of collusion between insurance companies to set premiums. I don’t think they’d be able to do that if there were less regulation on individuals VOLUNTARILY pooling their resources to cover the health care costs of their community.

  65. SussexAnon says:

    And where in the world does this system currently exist, Will?

    A country where everyone buys their own insurance and created an equilibrium with costs and competition?

  66. Will M says:

    Not sure that it has, innovation isn’t about what’s been done before.

  67. SussexAnon says:

    Surely, if it was such an innovative and genius idea, someone would have done it.

    We have a wealth of data on the American System, and data for the various “single payer” systems throughout the world. Everyone is trying or has tried to innovate healthcare delivery.

    Yet this one has not been tried. Hmmm, one can only wonder why.

    You cite pre 1945 as a turning point. Perhaps you could shed some light on how awesome our system was pre 1945? Premiums, outcomes, amount of population covered, etc.?

  68. Will M says:

    Pre-1945 is barely relevant given the technology at the time, but it was when the IRS allowed health insurance premiums to be deducted from employer’s tax bills to circumvent wage controls. Just because no one’s tried it doesn’t mean it’s not a good idea. Our current system benefits large corporations at the expense of individuals. That’s something libertarians and progressives agree is a bad thing.

  69. Dana Garrett says:

    “Among other neat things: one-third of the seats on the Delaware Health Security Advisory Board are to be permanently reserved for representatives from consumer groups that have advocated/lobbied for the passage of this particular bill for at least five years. That’s really an interesting way to run a railroad, huh?”

    Wow, this has to be one the smuggest statements I’ve read on the DE blogosphere. Do tell us, Steve, precisely what is wrong with having CITIZEN advocates sitting on this board? Are they not elite enough for you? Perhaps we should substitute them with millionaires only. I for one don’t have the a priori assumption that you do that citizen advocates are incompetent rubes. Perhaps hunkered down in your libertarian fantasy land of only the eminently “succesful” are the most qualified, you haven’t been exposed to many citizen, publicly minded advocates. They are usually well studied in the areas they advocate for. They are EXACTLY part of the people I want sitting on this board.

  70. Steve Newton says:

    Dana,

    What is wrong is reserving spots–permanently!–only for organizations that lobbied for this specific bill. That’s what it says and it is ridiculous.

    I have no problem with informed citizen input and membership. I have a problem with that 5-year restriction.

  71. Dana Garrett says:

    “and none of you could cite a single study (are you listening, jason) that suggests that a stand-alone single-payer system will even work in a population below 1 million in a geographical area so limited in medical resources that large numbers of necessary and common procedures aren’t even done in Delaware.”

    This is a typical Steve Newton rhetorical move. Arbitrarily invent a criterion–a hoop–that must be satisfied. Actually, since single-payer systems work well in many places in the world, the onus of proof is on YOU to show why this invented criterion is even a relevant consideration. Where is your study showing that a single-payer system will necessarily fail if the population is under 1 million. You have to pass the relevance test before you invent criteria others must satisfy.

  72. Dana Garrett says:

    Oh, by the way. Vermont has a single-payer system and they have a population that is smaller than DE’s. So Steve I suggest you get all arbitrary on us and now insist that we must come up with evidence that shows that a single-payer system will work on a population that is more than Vermont’s population and less than 1 million people. That criterion would be just as “relevant” as your first contrivance.

  73. Steve Newton says:

    Dana,

    It is a reasonable question–has anybody ever done this before as a stand-alone system below 1 million people and without the necessary medical infrastructure? I looked–it was not a rhetorical question. Massachusetts is actually the smallest example I could find. You show me–I can’t find an independent unit doing single-payer that is smaller than about 15 million people.

    I’m looking at the tax base–I don’t see any critical impact study of how much this tax would generate. If you will recall, much different economic conditions prevailed when Dr McDowell first wrote this. A business tax seemed like a good funding mechanism. Now?

    If you want to attack me instead of actually discussing the plan, Dana, that’s fine. I’ll take your “economic libertarian monster” shots even though you can’t justify them against me.

    But don’t pretend you’re offering anything substantive to the discussion.

  74. Dana Garrett says:

    “What is wrong is reserving spots–permanently!–only for organizations that lobbied for this specific bill.” Yes, heaven forbid we should place people on this committee who actually know how single-payer systems work because they have studied them for years.

  75. Dana Garrett says:

    I offered you Vermont, Steve. How is that single-payer system not working?

  76. Steve Newton says:

    @Geezer

    We got confused into an argument that neither of us wanted to have–large part my fault.

    I initially mentioned my wife’s case as simply an example of what happens when the relevant level of expertise is not available in DE. I just used her example to provide a real case, not to argue my own anger. (Although I will stand by the statement, based on examination of the stats, that there is nobody in Delaware I considered qualified to do three-level fusion on anybody, my wife or yours.)

    You answered back with what appeared to be a shot at me for wanting an expensive procedure with accountability–which wasn’t what I was trying to argue in the first place–but you’re right, I got pissed when you implied (or I inferred) that this was some kind of unnecessary procedure or whatever (I’m not going back to look). So then we got side-tracked into arguing lumbar fusion, which honestly neither of us should be arguing, and yes I took that personally.

    The fact that I will manipulate any system in order to get the best care for my family hasn’t got a thing to do with libertarian philosophy, and I suspect you know that.

    But I was trying to make the point that this whole introduction was being treated as something heroic and innovative, when it’s not. It’s a return to a plan that hasn’t been updated (or even proofread) in the past five years.

    If that’s the best we can do in terms of taking care of health care, we’re doomed.

  77. Steve Newton says:

    I didn’t see the Vermont comment, Dana. Sorry. I’ll take a look at it. It was not a rhetorical question by the way, but a serious one, and maybe there’s an answer.

    Do you have any sites with stats on Vermont or do you want me to do it myself (as pennance for missing the comment)?

  78. Steve Newton says:

    Uh, Dana, according to Mother Jones, Vermont has passed but not yet enacted single-payer, and cannot until 2017 or 2014 with a waiver.

    http://www.motherjones.com/politics/2011/05/vermont-single-payer-health-care

    So I guess we don’t know how well it works there, because it hasn’t started yet.

    Vermont will also be an interesting case because apparently they haven’t exactly worked out how to pay for it yet.

    http://swampland.time.com/2011/05/27/why-single-payer-in-vermont-isnt-a-game-changer/

  79. Earl Jaques says:

    DoTheMath: Your comment that somebody ought to do a rough estimate on the math and then see what they think. Rep Kowalko and I did. We had both the Sec of Finance office and the Controller General’s office check the numbers. They took into account the size of employers across the state to determine who has to pay 4% and who would pay 9%. Then they used last year’s tax numbers to determine the 2.5% factor. Then we added in the money which will be included in the pot from various federal programs,i.e. medicare, etc. Guess What? The numbers in the bill work!!

  80. Steve Newton says:

    Then let’s see the math, sir.

    And let’s see how the math projects forward three, six, ten, and twenty years.

    Let’s also take into account that amounts the state receives for Medicare et al may change dramatically depending on which party controls Washington.

    Let’s see whether you have used optimistic or pessimistic projections.

    You are trying to make the case for a State takeover of a massive segment of the economy, so I suggest that the burden of proof is on you.

  81. Jason330 says:

    Ignore the Republucan internet Trolls Sir.

  82. Steve Newton says:

    Mr Jaques, the question should actually be WHEN did you do the math?

    You say, We had both the Sec of Finance office and the Controller General’s office check the numbers. They took into account the size of employers across the state to determine who has to pay 4% and who would pay 9%. Then they used last year’s tax numbers to determine the 2.5% factor.

    But the fact of the matter is that the percentages for each level of business you use in HB 392 are EXACTLY THE SAME as the percentages used in SB 177 five years ago. Given the fact that the state population, economic condition, number of businesses, number of uninsured persons, and the amount of money the state receives from Federal sources ARE ALL DIFFERENT than they were five years ago, what are the odds that the numbers for precisely the same funding mechanism would have matched up so well?

    I’d say it was damn near impossible. Occam’s Razor would suggest that most of this analysis is old.

    If I’m wrong, since Rep Kowalko also co-sponsored SB 177 back in 2007, he should have access to the Controller General’s report from 2007 (when presumably the same study was done before introducing the bill) and you could show us how two different sets of circumstances led to exactly the same funding structure.

  83. Jason330 says:

    I have to say that the insurance companies must be freaking out. I’ve never hear a more clamorous and unified reaction from Republucans. Online and off.

  84. Steve Newton says:

    Shorter jason: I didn’t read the bill, either.

  85. Jason330 says:

    You are a republican academic. I’m a small business owner with health are premiums rising by 20% per year. I’ll welcome the help while you play your Republican academic games.

  86. john kowalko says:

    Mr. Newto,
    There was no study involving Sec. of Finance and Controller Generals office done on SB 177. Rep. Jaques and I felt that the first and most difficult order of business was to see what amount of revenue would be accumulated by HB 392 and what amount of money was being spent to provide Health Care to Delawareans. Nothing was contrived or hastily arrived at and the revenue neutrality of the proposal is represented by the recently calculated facts. The analysis is NOT old and is very current and Rep. Jaques and I delayed this filing to ensure that there would be NO artificial optimism or pessimism in the calculations and projections. Since you’ll have a number of months to intimately scrutinize each characteristic of this proposed legislation I would suggest that you spend more than a few hours thinking about it to try to verify your pessimistic reasoning so that Rep. Jaques and I can seriously consider any legitimate concerns you may have. If you’ll read the press release you’ll see that we intend to seriously and responsibly take into account each suggestion, criticism, critique and “fact based” challenge to the numbers we (and others) have spent an awful lot of time accumulating and verifying.
    John Kowalko

  87. Steve Newton says:

    Mr. Kowalko

    You write, Since you’ll have a number of months to intimately scrutinize each characteristic of this proposed legislation I would suggest that you spend more than a few hours thinking about it to try to verify your pessimistic reasoning so that Rep. Jaques and I can seriously consider any legitimate concerns you may have.

    That would be a legitimate point, except for the fact that this is not truly a new bill, but almost word for word exactly the same bill (with exactly the same funding mechanism and exactly the same percentages) that was introduced as SB 177 five years ago. I’ve had plenty of time to examine it, because none of those parts have changed.

  88. Jason330 says:

    Legitimate concerns… Ha. These Republucan academics like Newton and tge CRI never created a single job, never had to meet payroll and the only customers they ever have to deal with are the wealthy benefactors who pay them to bullshit endlessly.

  89. Steve Newton says:

    shorter jason: don’t ask questions, anyone.

  90. Jason330 says:

    Shorter me: Republucan jagoff academics are full of shit.

  91. Steve Newton says:

    even shorter you: i can’t answer the questions

  92. Will M says:

    If we are going to have a number of months to continue scrutinizing this five year old bill, is that a promise that this bill will NOT be worked under a suspension of the rules on June 30th?

    I will also be very interested to see what the incomplete fiscal note looks like. Is it going to be completed? If all of these studies have been done, will they be made available to the public so we can scrutinize the work that has already been done instead of starting from scratch? Have you factored in the long term effects of increasing the taxes on every one in the state? What about the effects of creating a monopsony in Delaware’s health care market? How will Delawareans travelling out of state get care? What about Delawareans who need to go out of state for procedures without a native Delawarean expertise?

    I wish I got paid to bullshit, as it is, I have come around here and make you all look silly for free.

  93. John Young says:

    Jack Markell will veto this bill this year, or next year, or the year after that, or whenever, if it ever passes.

  94. Will M says:

    Btw, the Republicans are a bunch of pussies. They aren’t fighting this at all, they’re leaving it to the Libertarians to fight their battles for them. They ARE actually being paid off by the insurance companies, but they won’t engage on this. They don’t even have a candidate in the 25th or the 27th, which is probably the only reason Jaques and Kowalko think they can get away with introducing this mess. Osienski doesn’t have an opponent either and Ennis is such a fixture in the 14th SD he might as well not have an opponent.

    Maybe if the Republican Party wasn’t such a bunch of wusses they’d step up and do their job.

  95. Conservative says:

    Wow!!! After reading all the responses, I can tell who the liberals and Democrats are… They are the ones who are calling everyone names and acting like little children.

  96. Will M says:

    Did I win the internet or did all of you go to sleep?

  97. heragain says:

    You won. The trucks will deliver it in the morning.

  98. This is a terrible bill. Government being in charge in anything usually leads to nothing good.
    You are pay more if you work for a company that hires more people….that is just absurd.
    This bill stinks plain and simple.

  99. Dave says:

    I wonder if there was a financial analysis accomplished in relation to this bill. I.E., how did they arrive at 2.5% income tax increase? Why not not 3.0% or or 2.79%? One of the things that is troubling to me are the numbers. Is 2.5% too little or too much?

    Are there any studies that contain data identifying the costs and how the funding sources are estimated to offset the costs? Is the 2.5% assessed against the AGI or against the gross? Would everyone be paying something, even if it is miniscule? I’d like to see some data.

  100. Earl Jaques says:

    John Machurek wrote: This is a terrible bill. Government being in charge in anything usually leads to nothing good.

    John do you know what are the most sucessful medical programs in our country? It’s Medicare, Medicad and Tricare all run by the Government. Just recently in a national report the number one healthcare provider was the VA. So much for your factless statement!

  101. Jason330 says:

    As much as pretend libertarians hate government there are times whn it is nessicary. A nessicary evil if you will. To. Hold the Erie Canal. To defeat Soviet Russia in the cold war. To build an infrustructure to compete with other modernized countries. I know you live in a world of pure thought, but I am telling as someone who live in the real world, making real world decisions about where to invest that have implications for real families here in Delaware – that health insurance needs the attention of the government

    I know that means nothing to you, again because you dislike taxes and reflexively hate government, but that’s how it is.

  102. Earl Jaques says:

    Dave – Rep Kowalko and myself questioned the numbers contained in Dr. McDowell’s bill. We wanted to know if they were real or just pulled out of the air. So we took the numbers and asked both the Secretary of Finance and the Controller General to run the numbers.
    Their report back to us was yes the numbers would in deed provide healthcare according to the bill to one million people. Now will those be the percentages when the bill gets introduced next year? I don’t know – we will have to see what comes out of the public meetings and what changes will be made to the bill. I expect there will be several. I have already heard back from many senior citizens who want to keep their present healthcare, which was provided to them by their company at retirement. They would like single payer to just be one of several options that a person could chose. I think this idea warrants discussion.

  103. Jason330 says:

    Mr. Jacques, these ideogues are impervious to reason, logic and common sense. I’ll urge you to leave this thread to thier infantile ratings, as I will after this last comment.

  104. Dave says:

    @Earl,

    I am happy that someone asked about the numbers. I would be even happier if the data were examined by someone else such as myself and anyone else who has a analytical background or interest.

    Bottom line is that without that data, I have to take someone’s word that the data exists and that it was used to arrive at the result contained in the bill. Before this bill is passed, this data should be placed in the public domain. Transparency and all that.

  105. Podium says:

    Interesting. What are the odds of such a bill passing, Markell signing it in 2013 or 2014? Delaware is a small market. Would a progressive state like Maryland be interested in forming a regional insurance market? New Jersey isn’t an option right now for one obvious reason…

  106. Will M says:

    Medicare and Medicaid are going broke due to demographic changes, Tricare’s quality of service is being reduced on a regular basis, the veterans who can’t get to a VA hospital might disagree with your assessment of their efficacy, and I agree 100% with Dave. Show us the numbers.

    What’s the QUALITY of the health care that can be provided by this bill? What about Delawareans travelling out of state? What about Delawareans who need to go out of state for their treatments due to a lack of native capability? I’m not impervious to reason, but at over 100 comments I’ve yet to see any from this bill’s advocates.

  107. Mitch Crane says:

    The purpose of filing HB 392 is not to get it passed in this Session, or even to see it enacted as written. The sponsors ( and I ) support the concept of Single Payer Health Insurance. Some form of Single Payer exists in most every democracy but ours. That even includes countries much poorer than the USA or those in Western Europe. Costa Rica has single payer!
    Because this is a controversial subject and because there are many issues that need to be resolved, it is important that there be open debate and dialogue until general consensus is reached. There are changes I would like to see in this bill. For one I believe the Insurance Commissioner’s office needs to be involved.
    My position has been that I do not know if a state the size of Delaware can enact a successful single payer program. Vermont has enacted a modified program and is awaiting waivers from the federal government to go forth. If Vermont’s program goes live and if it works, then Delaware can learn from it.
    There are many valid questions that need to be asked and answered. I do know that Medicare is a “single-payer” system and it works ( and would be very solvent if the treasury did not use the surplus that existed). The success of Medicare and the VA system means that a health insurance program for all is possible-but it must be done right.

  108. Judy says:

    You know it’s a bad bill when the sponcors can’t answer Mr. Newton’s most basic questions.

    John is passing 5 year old numbers that are worthless.

  109. Will M says:

    It wouldn’t matter if the treasury burned the surplus if it was demographically capable of maintaining a surplus without huge tax increases on those still working.

  110. john kowalko says:

    Will M.
    Unless you’re one of those inbreds that names all their children the same I count almost 30 of your posts among the 100 and you might wish to see if you suffer from dyslexia since I count many “different” advocate comments.
    Judy,
    Refer to previous comment I made re cost analysis for the rebuttal of your accusation
    John K.

  111. Will M says:

    Wow, Rep Kowalko. The best you’ve got in response to my questions is to imply that I’m inbred and dyslexic? Honestly, I expected better from you. I’m going to give you the benefit of the doubt, I think, and assume this is sock puppetry until I actually speak to you in person next time I see you at Leg Hall.

  112. Will M says:

    PRECISELY what I meant about the lack of reason from the advocates.

  113. Geezer says:

    @Steve: The fault is at least half mine, and probably more.

    And the point you raised with your example is an important one, as I should have made more clear. Delaware’s health care system is based on the real-world fact that both Philadelphia and Baltimore are regional centers for all sorts of medical specialties, and our population is considered part of the Philadelphia region (and as I’m sure you know, Hopkins in Baltimore serves parts of Delaware the same way). This is the real-world result of Delaware’s low population and geographic location between two major cities.

    You are correct, I am not arguing any of the specifics of this bill. I was arguing against Will’s comments, which at the beginning were more about the whole idea of single-payer. Partly this is because I do not believe this bill will pass, and that it certainly will not pass in its original form, and partly because I don’t know enough to know whether its particulars are flawed or not.

    But I do think we can save a lot of money without sacrificing quality of care by adopting a system that every other industrialized country has adopted. Their costs rise, too, but not as fast as ours and from a much lower base number. And I think ultimately it will benefit business and create more jobs if we divorce health care from employment.

    The challenge the US has, which other countries did not, is that we now have an entrenched patchwork system with various interests in play, making a political solution almost impossible. But it’s worth chasing anyway, for the simple fact that, if our health-care costs per capita equaled Germany’s (which uses a private entity, not government, to administer its program), our current budget would be in balance.

    To me, that seems a worthy goal.

  114. kavips says:

    This is a much too complex topic to be discussing on such a nice weekend.

    I actually read the threads, this time and now, am kicking myself because during my absence from outside, a cloud popped up in my sky.

    You all are familiar with the beach ball theory? Right? You form people in a circle, place a giant beach ball in the center, and then ask, what color it is. You get quite an argument and no one seems to agree, yet all are basing their opinions off reality… It is what they see!

    If you work close to health care, you see one side very clearly. If you are an employer, you see one side very clearly. If you are an employee on your employers health care plan, you see one side very clearly. If you have no insurance, you see one side very clearly. If you are on Medicare, you see one side very clearly. If you’ve lived in a different country, you see one side very clearly.

    What these (blog with comment) forums are suppose to do, is allow all that perspective of being transported to point directly above the beach ball (continuing the metaphor), so then. each can see that the others perspectives come from their not seeing the unit as a whole….

    And the only objective study I know on this problem is located here.

    And that study comes to the same conclusion as this thread, that what we need is a vehicle to lower our medical expenses nationally yet still allow Steve’s wife to receive the surgery she needs.

    My recommendation, is for all participants to read the homework, and report back here for discussion on Monday (when it is supposed to rain)…

    At that point, everyone at least will be arguing their case from the same starting point….

    I mean without reading, anyone can be a polar bear expert. (an inside joke for the old timers) :)

  115. Jason330 says:

    Indeed it it too nice a day to engage a fraud Libertarian who no doubt still lives under his parents roof, and another that makes his living in the uncompetitive fantasy world of academia.

  116. judy says:

    Name calling aside, I’m still waiting for Earl Jacques to answer Steve’s questions from 10:23 and 10:53.

    By Mr. Jacques and Mr.Kowalko’s silence I think we know the answer.

  117. Idealist says:

    probably enjoying a beautiful day.

    btw, it’s jaques, not jacques.

  118. Earl Jaques says:

    Judy – Just for you! Steve’s 10:23 Question: Then let’s see the math, sir. Answer: We have told you that we had the numbers checked by two seperate agencies and we feel confident that the numbers in the bill will work. However, we need to have public meetings to review the bill because based on those meetings things could change which will change the numbers. Apparently you don’t believe the numbers we have provided. Therefore, Steve, you claim to be such an expert – the numbers are in the bill – so you work it out. Can you disprove our numbers or not? Waiting to hear from you!!!

    Steve’s 10:53 Question: This bill is five years old. Answer: Most of the bill is from the original SB 177 bill. We have made some minor changes. Both Rep Kowalko and myself had concerns regarding the money aspect, therefore we had the numbers checked and rechecked. I have several questions regarding single payer myself that’s why we need to start having a conversation about healthcare in our state and need serious public discussions. I promise you that this bill will not be run this year!!!!

    This is just too nice of a day to be on this blog – so I’m signing off for the day!!!

    Oh Judy, if you bothered to read my postings – maybe you would have noticed that I spell my name J-A-Q-U-E-S (no “C”)…

  119. Looks like my next statement was made, that medicaid and medicare are going broke.
    Carry on lowering the value of medical care….

  120. Will M says:

    “And I think ultimately it will benefit business and create more jobs if we divorce health care from employment.”

    Geezer, I agree with you there 100%.

    Jason, I’d invite you to my apartment, but I don’t like you.

    Rep Jaques, can we SEE the numbers from the study you did?

  121. tom says:

    here is a question i have not seen asked so far in this thread.

    What are Mr. Kowalalko & Jaques trying to misdirect our attention away from by filing such a controversial bill two weeks from the end of the session, when they claim to have no intention of acting on it until it is reintroduced next year?

  122. Dave says:

    @Earl,

    I still want to see the data that the two unnamed agencies analyzed. Please let us know where we can access the data.

    Thank you.

  123. Idealist says:

    Show me a country that has implemented single payer health care and is now trying to get rid of it. You can’t. That’s because it works.

    You guys want to defend the status quo, good luck, but 125,000 Delawareans don’t have health insurance.

  124. Will M says:

    Not defending the statist quo at all, just not willing to turn over my health care decisions to an unelected, unaccountable group of political hacks appointed by a governor I most likely didn’t vote for or pay a 6.5-11.5% tax for the privilege of doing so.

    “I see there’s a problem here, but I don’t think this legislation will solve it.”

  125. Idealist says:

    That is unless you agree with me that the problem is the fact that we have 125,000 uninsured Delawareans. This legislation will solve that problem.

  126. Will M says:

    Insurance =/= care. If we all have the same crappy insurance, none of us really get care.

  127. tom says:

    But is that a real problem?

    125,000 is Floyd McDowell’s number from 2007. How was it calculated? Why hasn’t it changed? Would HB392’s sponsors have us believe that the percentage of uninsured has improved relative to population growth during the economic disaster the past 5 years have been?

    Assuming we suspend our disbelief and accept the number 125,000 as a fact, how many of those 125,000 are uninsured voluntarily? (for example: because they are young, healthy, and have chosen to allocate their money elsewhere) Why are the remainder not already covered by the State’s Medicaid programs?

  128. Will M says:

    I’m voluntarily uninsured.

  129. puck says:

    “If we all have the same crappy insurance”

    Are you really advocating that some people should have zero insurance, so that others can have slightly better insurance? Which is a false premise anyway, but that’s at the root of what you are saying.

    Nothing will stop you from buying better insurance if you want, just like now. There’s no ceiling, but at least there will be the same floor for everybody.

  130. Steve Newton says:

    @puck: Nothing will stop you from buying better insurance if you want, just like now.

    So you haven’t read the bill, either.

    §1622. Insurance Reforms.
    Insurers regulated by the Delaware Insurance Department are prohibited from charging premiums to eligible participants for coverage of services already covered by the Health Security Authority. The State Insurance Commissioner shall adopt, amend, alter, repeal and enforce all such rules and regulations and orders as may be necessary to implement this section.

  131. puck says:

    You are right Steve; the bill is so unlikely to get traction I have no intention of reading it.

    That provision is a little odd for a universal health care bill. Just like I don’t care if you send your kids to private school, as long as you pay your school taxes.

    I don’t get the rationale. I would hope that would get amended out in the unlikely event this bill ever passed.

    On the other hand – if the plan requires that provision, maybe there is something wrong with the underlying funding mechanism.

  132. Idealist says:

    You’re right, the voluntarily uninsured don’t have a problem…..until they get really sick.

    “Why are the remainder not already covered by the State’s Medicaid programs?”

    Are you going to tell me you’re a proponent of expanding Delaware’s Medicaid program?

  133. tom says:

    absolutely not.

    but for now, let’s deal with the world as it is rather than arguing the merits of HB392 vs some mythical desert island w/ free market healthcare. Delaware’s Medicaid program exists. No one has demonstrated that the vast majority of the alleged 125,000 uninsured persons cannot either afford health insurance (but chose not to purchase it) or qualify for Medicaid.

    The burden of proof rests on those who want to use the coercive power of the State to make 785,000 people substantially worse off for the benefit of 125,000 others. but no, they can’t even demonstrate that most of the beneficiaries exist.

  134. Idealist says:

    “The burden of proof rests on those who want to use the coercive power of the State to make 785,000 people substantially worse off for the benefit of 125,000 others.”

    I’m not willing to concede that somehow public health insurance is worse than private health insurance. I remember the debate over the public option where Republicans argued out of one side of their mouth that public health insurance would be terrible and nobody would want it but out of the other side of their mouth that somehow, if there were a public option, everyone would flock to it and we’d essentially have a single-payer system.

  135. Will M says:

    Screw Republicans. You’re talking to libertarians here. Yes, I am saying that people should be free to buy insurance, and if some people can’t afford it, they should rely on the safety net that already exists, rely on private charities, or go without.

    You don’t get to take away 6.5-11.5% of everyone’s pay to pay for your fanciful government insurance managed by 15 politically appointed hacks and prohibit them from doing anything else to take care of themselves, especially when there’s no provision for people to get care when they’re on vacation or business out of state or are forced to go to Philly or Baltimore for care because Delaware lacks the native expertise. That’s what I call crappy care.

    Let’s get the IRS to decouple our health insurance from our job, and get paid more so we can buy actual health CARE out of pocket or buy health INSURANCE for the things that actually warrant insuring against. Why didn’t the PPACA do THAT? Then it might have been worth the 3000+ pages it was printed on.

  136. Jason330 says:

    You Republicans crack me up. Out of touch academics and children who have never lived int he real world they all have a grudge against the big bad government. If you had half the contempt for the unaccountable corporate suits that raise my health care premiums by 20% year, that you have for your fantasy bogeyman, we could get somewhere.

  137. heragain says:

    Will, I’ve often be in an income group that made me uninsured. I can’t say that was exactly voluntary, but I was young and mostly healthy. The part that WASN’T healthy, however, had long term consequences.

    For example, my husband, 38, died suddenly of cancer. And the good news was, he died suddenly. If you’ve never been in the position of being grateful that a person you love dies in 3 months from diagnosis, because then you only lose the house, but not everything your baby will ever make, you don’t really understand the issue. And he WAS insured. When he died I hadn’t finished paying off the bill from my child’s birth… and that ding on my credit meant I couldn’t get heating oil delivered in Delaware. Couldn’t pay cash, couldn’t get it delivered. They wouldn’t open an account. Took me 3 months to find someone who would.

    That baby is now an adult, more or less your age, but not finished school. He’s still on my insurance, thanks to Matt Denn and “Obamacare.” Ever try to get a doctor’s appointment without proof of insurance? Don’t.

    I do’t know if this is a terrible awful bill, a well intentioned but completely stupid bill, or a whoddathunkit it’s not completely moronic bill. Introduced in June, I figure I’ll have time to think it over. I paid for home births (which aren’t covered by anyone’s insurance plan, btw) because that was a priority for me. I’m not afraid to buck the plan. I won’t be afraid to seek care outside this one, if passed. But you aren’t sounding very smart when your “solution” consists of “Buy insurance no matter what anyone choses to sell it for,” “Use the “safety net” we know nothing about but hate, ” ‘find out if a church is interested in your problems” or “Just stinkin” die.” You went to school largely at my expense, my being a taxpayer, and all. So you can take YOUR turn, and help out people who need it.

  138. choochoocharlie says:

    I thought Ennis was also a sponsor?

  139. Will M says:

    Jason, still not a Republican other than in name only. RINO and proud of it. Lived in the real world and still do, know the gov’t is full of crap every day. Not sure how that fact has evaded you.

    heragain, genuinely sorry for your loss, but know the government can’t save anyone without screwing someone else. There’s no such thing as a perpetual motion machine. It may sound lovely to just pay a bit (a lot) more in taxes and have the government take care of everything, but ain’t shit for free. 6.5-11.5% in additional taxes and an insular group of 15 political appointees accountable to no one CAN NOT solve this, no matter how many names Jason calls me.

  140. heragain says:

    But Will, to whom are you accountable? You boast (on your website) that you won’t function as part of a party, and that you didn’t know what you were doing last time you ran. You assure us you’ll make mistakes.

    Well, hats off for candor. You’re making one now. I’m not suggesting a perpetual motion machine. I’m saying you have an ethical responsibility to “pay it forward” for the benefits you have already reaped via your government. You’ve grown up with virtually unlimited access to safety, education and recreation. You know that if someone breaks into your house you can ask the government for help, that the majority of people driving down the road with you have had their driving skills approved by a state authority and are legally required to carry insurance, and that if you wind up in jail the burden of proof is on the prosecutors, not you. You know that the building you live in was constructed by methods, and from materials, deemed safe. You know that if you travel to rural areas they will have electricity, even though it wasn’t “economic” to install it. You know that if you contract an obligation with someone in Delaware, Maryland will take that seriously, even if they move. You live your ENTIRE life securely supported by the work of military, police, firefighters, road crews, teachers, and social workers who are hired by tax dollars… because the “free market” did not hire them.

    You want to be part of the government. That’s what ‘running for office” is, you know. And the people you say you will represent will depend on YOU to help them get their fathers’ or mothers’ military headstones, because headstones are expensive. Or to get registered for services. Or to have their potholes fixed. They will have you as their access. And I swear to God, if those people place their trust in you and you give even one of them a sanctimonious lecture about how ‘Government can’t fix anything” I will PERSONALLY come and slap you upside your privileged little head.

    I just found out my nephew is spending the next 2 years in Teach for America. Go look up where he’s living in Mississippi and tell me “government can’t do anything.”

    Government, on the contrary, MUST.

  141. Pencadermom says:

    John Kowalko, nice comment. These blogs are enlightening to me, glad I stumbled onto them. You’re kinda bullyish, eh?

  142. Geezer says:

    “I’m voluntarily uninsured.”

    Which means that, if you are involuntarily in a serious auto accident that requires, say, $200,000 worth of care to repair (you, not the car), those of us who are insured will pick up the tab.

    You can call your silly little philosophy whatever you like, Will, but it’s just relabeling what we’ve known it as for millenia:

    Selfishness.

  143. Geezer says:

    “medicaid and medicare are going broke.”

    Yes, because unlike your private insurance company they don’t get to raise their premiums (your taxes) every year.

  144. No legislative bill presented our state legislature and Governor in our state’s history has as much research-documented program and cost effecive evidence as the single payer, nongovernment run House Bill 293. Introduced by Representatives John Kowalko and Earl Jaques
    in June gives ample time for Delaware voters to fully understand this Bill’s contributions to every current and future citizen, our state’s economic/job development and add millions annually to our state’s budgets. Our supportive Delaware Health Security Coalition is proud of Representatives Kowalko and Jaques for their informed, cedible and motivated leadership in sponsoring this desperately needed act. The Delaware Health Security Act is discussed on the Health Care page of our nonprofit, nonpartisan deinformedvoters.org web site. Also listed on our Health Care page are the 31 statewide Delaware organizations who support single payer universal health care coverage. They either endorsed our Delaware act in direct meetings with me or they are state affliates of national organizations that strongly endorsed single payer universal health care in the past. In poll after poll, at state and national levels, approximately 70 percent of citizens polled support single payer health care systems.

    Twenty eight of the developed, industria;ized nations cover all of their citizens with a single payer system. Three with a modified single payer system. All do this at one-half the cost of our costly system and all have much better health care outcomes. I once was the sole US representative at an important worldwide health conference at the World Health Organization (WHO) in Geneva and have great respect for that organization. On health care indicators, the WHO ranks our nation as 37th, or behind every developed nation and six undeveloped ones.

    Every line in House Bill 293 will stand up in any court If requested at my email address (flydmcdwll@verizon.net), I will email you the following to adequately inform you and your family members about the importance of this Bill: a long list of national and state (includes Delaware) single payer research studies and findings prepared by the Physicians for a National Health Program (PNHP.ORG), our nation’s top single payer advocate organization; a copy of House Bill 293; and other relevant single payer information.

    Common sense every Delaware adult and elected state official involved in health care decisions should ask to realize civic/political responsibility I fought for in WWII and the Korean Conflict as an enlisted man and officer alog with millions of others to both reserve and improve an informed democracy. What does a profit making insurance company contribute to a physician’s office, hospital or any health care provider? These totally unnecessary brokers contribute nothing of value, not een a Band-Aid. Yet research documents they waste over thirty percent of our health care funds through administrative/overhead costs (profits, unnecessary paperwork, advertising, lobbying, etc,) compared to 1.5 percent overhed cost in our Medicare single payer system Pure insanity that physicians and other health care professionals waste many hours each week helping interpret insurance company restrictive small print and having to call company bottom line protectors for permissions to practice needed medical and health care needed. The 30 percent savings in HB 293 alone will provide comprehensive health care coverage to EVERY Delaware fellow human being weithout ANY extra insurance, co-payments or deductibles. HB 293 will basically use our existing health care funds to cover every current and future Delaware citizen and all Delaware workers and their families who live out of state.

    HB 293 include other savings of health care funds. At least 10 percent will be saved by controllng fraud via the fraud control strategy included in the Bill. Negotiating for lower prescription drug prices, as the single payer Veterans Administration single payer system does, will reduce this huge cost by 50 percent. Many other savings such as early preventive and intervention treatments
    instead of more costly hospital emergency room health care, relief of chronic stress by the uninsured and underinsured, etc.

    This is a litmus test of ALL voting citiens moral character and civic/political credibility. The research-documented program and cost effectiveness evidence of single payer, nongovernment run is readily available. Only requires a few hours of research and study. Even high school drop-outs are required by law to spend oer 10,000 hour in formal school settings. I urge you to take the time and effort to ecome competently informed about this HB 293 which is so important to you and your family members. This is especially true for every canidate for our State Legislature and Governor’s office. Any elected state official who does not strongly support HB 293 is being hypocritical when he/she prclaims they’re interested in your health, our state’s economy/job developmen and future state budgets. here should be a law requiring the wear a big PP on their garb for the Political Prostitutes they are in representing corporate special health care interests instead of citizen’s funds. Sixty-five percent of health care funds come from various taxes, 20 percent from citizen out-of-pocket expenses and 15 percent from employers. Under HB 293, all private employers will pay less for health care coverage than they now pay.

    Here’s one more important value within HB 293. We all have important women and younger females in our families. Mothers, Grandmothers, Wives. Children, Etc. I have a research report from the national Women’s Policy Research Institute that ranks our Delaware women 48th among the states on health and wellness issues. And anyone familiar with our ranking on infant mortality or well babies knows we’re also in the “Thank God for Mississippi” ranking on that issue so important to our wonderful, caring women.

    One final warning. This Bill will return our health care funds to those who serve our health care needs for all health care decision-making. If anyone dishonestly says, “This is guvment run health care”, you’re listening to an uninformed person needing to excrete green stuff from his/her pores, someone benefitting from our ineffective special interest owned health care nonsystem, a pathological liar or some combination of the above list.

  145. SussexAnon says:

    I applaud HereAgain.

    EXCELLENT posts

  146. Dave says:

    @Dr. Floyd McDowell, Sr

    “The 30 percent savings in HB 293 alone will provide comprehensive health care coverage to EVERY Delaware fellow human being weithout ANY extra insurance, co-payments or deductibles.”

    “I urge you to take the time and effort to become competently informed about this HB 293 which is so important to you and your family members.”

    And I will be able to become compently informed when I get to see the data. I urge those who have to the data to provide it to us so that we can do what you urge.

  147. Josh says:

    Rep. Jaques, and Rep. Kowalko, what effect would this have on tricare?

  148. John Galt says:

    Several people has asked Steve and Will how would Libertarians fix health care. Let me offer the following:

    When I was a child my father worked for DuPont’s. We had what was considered the best health insurance around. It didn’t cover doctor visits, it didn’t cover eye exams, it didn’t cover any dental. What it did cover was 50% to 80% of major medical procedures.
    My parents chose their doctors based on cost and the quality of the care.

    In the early 1980′s we were told that if had health care instead of health insurance cost will come down due to early detection of diseases. Now, most companies (mine included) have health plans that cover eye exams, glasses, all dental procedures, 100% medical coverage with a co-pay.

    Last week I took my kids in for their eye exam. As I waited I noticed women had picked out a pair of frames she wanted. The doctor looked at her insurance and informed her that her insurance pays for scratch guard and tinting; the women shrugged her shoulders and said “OK”. If she was paying for this out of her own pocket I highly doubt she would OK’d the additional $200.00, now times that by a million and you start to get the picture.

    What if we were told that the cost of owning a car would be greatly diminished and the resale value would greatly be enhanced if car insurance would cover all maintence cost. Would you shop around for the best deals on tires or just purchase the best since you’re not really paying for them? Then as the cost of car insurance skyrockets, would you call for the government to step in and compete against GEICO?

    Food is certainly as important as health care. What if had food insurance? Would you clip coupons, buy only what was on sale or buy in bulk to save money? Or would you just throw lobster tails and filet migon in the basket since your not really paying of it.

    We currently do not have a free market in the health care industry.

    Image a 24 year old male fresh out of college. He gets a job with a company and he gets the one size fits all health insurance policy his company offers. Now of course this policy covers hysterectomy’s and gynecological exam’s, neither of which he has any use for. Or he can opt out of this insurance and take the dollar equallivent and put the money in a medical savings account.

    Say his employer puts $4000.00 a year into his MSA that he “owns” and he puts in $2000.00 a year. By the time he is 40 his MSA has over $120,000.00

    He would certainly need some type of heath insurance, something that would pay 50% to 80% of major medical with a $5000.00 deductible. In today’s dollars what would that cost? Can we agree somewhere around $100 a month?
    And of course you “own” your MSA, if you passed away in an accident you can leave your MSA to a family member or a friend or to a charity.

    Nothing Mr. Kowalko or Mr Jaques is proposing will bring down the cost of health care, only the free market can accomplish that.

  149. Podium says:

    Hey John Galt, how did the free market treat the Atlas Shrugged (Part I) movie? Are you guys going on strike from making movies now?

  150. cassandra_m says:

    Now, most companies (mine included) have health plans that cover eye exams, glasses, all dental procedures, 100% medical coverage with a co-pay.

    Actually, this isn’t true for most companies. Starting with the fact that there are restrictions and exclusions on most health plans, most people with employer-provided insurance certainly do not have 100% medical coverage — with or without co-pay.

    Now I find myself asking the question that none of you free market geniuses can address: How is someone supposed to make the kind of decisions that a free-market requires if you or someone you care for is having a heart attack or stroking out or has a burst appendix? And you need to explain this process in some detail.

    Health care is alot more vital, alot more urgent and alot more complicated than buying a flat screen tv.

  151. Steve Newton says:

    @Earl Jaques:

    Apparently you don’t believe the numbers we have provided. Therefore, Steve, you claim to be such an expert – the numbers are in the bill – so you work it out. Can you disprove our numbers or not? Waiting to hear from you!!!

    1. You provided no numbers in the bill, only a funding mechanism without estimates of what it would raise or what number you were using as the per capita per annum cost of individual health care under HB 392. So it is disingenuous to say “The numbers work!” when you have not given any.

    2. Nonetheless, fair’s fair. So I ran the numbers as nearly as can be done without having your baseline assumptions, but following the various information that Dr. McDowell has provided over the years, and filling out the missing parts with data from governmental and foundation stats. What I get is a first year minimum funding cost of $8.12 Billion just to cover health care for all eligibles in the plan (and not counting the other goodies you promise, like capital construction help). Between your Health Security Income Tax, your payroll tax, Medicare, and Medicaid funding, I estimate you would raise $8.06 Billion–or that you would fall about $60 million short the first year. I will spot you that $60 million as a rounding error. That means if you massage the figures with every possible optimistic outcome you can break even the first year. Barely. By the skin of your teeth.

    However, even without looking at Medicare and Medicaid cuts that both President Obama and Governor Romney have promised will be coming down the pike, the normal cost annual 2.5% cost increase of a single-payer plan (I used Medicare) will give you a program that in its 6th year will require $1 Billion dollars in additional tax money from Delaware citizens to fund.

    That is the most optimistic scenario.

    You want to see my numbers and how I arrived at them, fine. They are here

    http://delawarelibertarian.blogspot.com/2012/06/counting-cost-hb-392-will-not-pay-for.html

    So now I’ve given you numbers. If you want to contend I’m wrong, you’ll actually have to show yours.

  152. Jason330 says:

    Newton claims to be a Libertarian and yet taxpayers like myself pay 20 -50% of his health insurance premiums. I wonder what Ms. Rand would say about that situation?

  153. Steve Newton says:

    shorter jason: oh shit now earl will have to produce his numbers

  154. Jason330 says:

    Have another suckle at the government tit, then come back here with you libertarian nonsense about how bad the government is. Your hypocrisy is amusing to me.

  155. Steve Newton says:

    jason again: if I launch bullshit personal attacks nobody will notice that jaques hasn’t provided the numbers

  156. Jason330 says:

    Spoken like the ivory tower academic that you are. You had better watch out. As a taxpayer I might start buying you government is evil bullshit and you’d be kicked out of the ivory tower on your ass.

  157. Steve Newton says:

    look dweeb: quit whining. earl asked for the numbers. i provided them. if he can prove me wrong you get your orgasm. all he’s got to do is show the work he says has already been done.

    simple. like you.

  158. Jason330 says:

    Ill leave all of that to you and him. In the meantime ill keep reminding everyone that they are engaging a Republucan fraud who makes his living from the very government that he holds in contempt. Get a real job that is vulnerable to market competition and I’ll change my tine.

  159. Steve Newton says:

    jason if i hasn’t occurred to you before i don’t give a shit what your line is. so feel free.

    your therapist told me that he encourages this sort of acting out on the blogs so that you will stop exposing yourself in public. i’m just glad i can fill that void in your life.

  160. Jason330 says:

    Touched a nerve, I see. Translucent book worms like you should understand the importance of context better than most.

  161. Will M says:

    heragain, if my constituents come to me to solve problems that are not government’s to solve, that’s exactly what I’ll tell them. I will direct them to existing programs, and try to walk them through the proper use of them, but I won’t be running around inventing new government programs to address things that government cannot adequately address. I will certainly not be putting 15 unaccountable bureaucrats in charge of their health care and charging them 6.5-11.5% MORE in taxes on top of everything else for the privilege.

  162. Jason330 says:

    In every industrialized country other than ours, the government has solved the problem of health insurance. Someone claiming to be qualified to run for office should know that.

  163. Jason, you have to be kidding me that every industrialized country has solved healthcare. Just look up north to see a failing healthcare system.

  164. Jason330 says:

    Look up north to see half the population of Florida fleeing back across the border every six months for fear of losing thier right to participate in that failed system.

    For the record, I hate talking about this with people who have never traveled more than 30 minutes away from thier birthplace.

  165. I guess you are trying to say I’ve never been more than 30 minutes away from my house which is pretty hilarious. I’ve been to Canada, they said what of them do is come over the border and then they have a ‘medical emergency’ while they are here.
    Then they can get service and it is billed back to Canada and then they don’t have to wait.
    Even the father of the Canada system said it was a failure.

  166. Jason330 says:

    Your friends are Impatient cheaters some of whom no doubt also cheat at golf and on thier wives. Your loser friends are your problem. They, and your wingnut anecdotes, have little to do with the overall health outcomes that they get in Canada vs the health outcomes that we get here, and they has even less to do with the cost of the outcomes.

    I’m sure there are surveys of larger cross sections of Canadanians which ask them what they think of thier system. You are too lazy to look up the facts. Again, thats your problem. Not mine.

  167. I don’t know where I said they were my friends, I simply stated that while in Canada I talked to Canadians (not Canadanians).
    Just check out http://www.globalnews.ca/thousands+of+patients+wait+too+long+report+gives+improvement+efforts+b+grade/4294970772/story.html
    In case you don’t want to read it:
    “Nearly 10 years and billions of dollars later, Canadians still experience lengthy delays in accessing a wide range of necessary care,” said alliance chairman Lorne Bellan.

    “The data show that the system is barely functioning as a system at all, as too often patients are languishing in hospitals instead of receiving the appropriate level of care they need.”

    Sure seems to run efficient huh?

  168. tom says:

    In his lengthy post above, “Dr. Floyd McDowell, Sr.” tosses out some interesting statements and even a few numbers. While he is probably the only supporter of HB392 on this thread that has actually read the bloody thing, his statements should still be taken with a few grains of salt, if only because he consistently mistypes the Bill number throughout his article, because he accidentally or intentionally makes a mathematical error favorable to his argument, and last but not least because he characterizes anyone who disagrees with him as a “Political Prostitute”, mutant, corrupt special interest, or pathological liar.

    He generously offers us access to his research:

    “I will email you the following to adequately inform you and your family members about the importance of this Bill: a long list of national and state (includes Delaware) single payer research studies and findings prepared by the Physicians for a National Health Program (PNHP.ORG), our nation’s top single payer advocate organization; a copy of House Bill 293; and other relevant single payer information.”

    Thanks Dr. McDowell, but we already have access to the text of the bill in question (which is actually HB 392) and so far only the opponents have bothered to read it.

    And “a long list of national and state (includes Delaware) single payer research studies and findings prepared by the Physicians for a National Health Program (PNHP.ORG), our nation’s top single payer advocate organization” should be viewed with as much suspicion as the large body of research proving that cigarette smoking is harmless, prepared and funded by the Tobacco Lobby.

    “Common sense every Delaware adult and elected state official involved in health care decisions should ask to realize civic/political responsibility I fought for in WWII and the Korean Conflict as an enlisted man and officer alog with millions of others to both reserve and improve an informed democracy.”

    How is this relevant? Is it even comprehensible English?

    “What does a profit making insurance company contribute to a physician’s office, hospital or any health care provider? These totally unnecessary brokers contribute nothing of value, not een a Band-Aid”

    This is a very dishonest statement Dr. McDowell. You cannot possibly be so ignorant that you fail to understand that Insurance is a contract in which one party assumes financial responsibility for some risk in return for payment of a premium. But you are hoping that most of your audience is that stupid and will hate the evil insurance companies for wanting to make a profit.

    “Yet research documents they waste over thirty percent of our health care funds through administrative/overhead costs (profits, unnecessary paperwork, advertising, lobbying, etc,) compared to 1.5 percent overhed cost in our Medicare single payer system … The 30 percent savings in HB 293 alone will provide comprehensive health care coverage to EVERY Delaware fellow human being weithout ANY extra insurance, co-payments or deductibles.”

    Uh Floyd, that’s 28.5% savings, assuming we can believe your 30% waste & 1.5% overhead numbers.

    And what is currently stopping people paying cash out of pocket from benefiting from the 30% they are saving the doctor in paperwork & collection costs? Why can’t my doctor just offer me a 30% discount for paying cash? Oh yeah, because charging different prices for the same service would be rate discrimination and that’s illegal. so this 30% savings comes from “fixing” a problem that the government created.

    Another thing that would dramatically reduce insurance costs is eliminating Delaware’s required coverages. When I as a non-autistic, non-diabetic, adult male who doesn’t use drugs and has no kids, want to buy a health insurance policy, I must pay for certain mandatory “benefits” including:

    Autism
    Blood lead poisoning
    Breast reconstruction
    Cervical cancer and HPV screening
    Clinical trials
    Colorectal and prostate cancer screening
    Contraceptives
    Diabetic supplies
    Drug abuse treatment
    Emergency services
    Mammography
    Maternity stays
    Newborn hearing screening
    Off-label drug use
    Coverage for newborn children under the parent’s policy
    Coverage for continuation dependents under the parent’s policy
    Coverage for dependent students under the parent’s policy.

    And even though there is zero chance that they will ever need to pay for most of these benefits, they still must charge me the same premium as someone who will actually use them. Once again, to do otherwise would be rate discrimination, and that’s illegal. Yet another example of this bill proposing to “fix” a problem that the state caused.

    “At least 10 percent will be saved by controllng fraud via the fraud control strategy included in the Bill. Negotiating for lower prescription drug prices, as the single payer Veterans Administration single payer system does, will reduce this huge cost by 50 percent.”

    Isn’t fraud already illegal, Dr McDowell? How will this bill magically eliminate something that the state is currently failing to prevent?

    And why not just allow people to buy less expensive drugs? For example, they could buy heavily discounted drugs from the Internet Pharmacies that the General Assembly banned in their last session.

    “Sixty-five percent of health care funds come from various taxes, 20 percent from citizen out-of-pocket expenses and 15 percent from employers. Under HB 293, all private employers will pay less for health care coverage than they now pay.”

    First of all, the bottom line is that 100% of health care funds come out of the consumer’s pocket. They may be spent voluntarily, or taken in the form of taxes or lower wages in return for health benefits, but every dollar comes from the consumers.

    Second, you say here that the state already directly controls 65% of the healthcare market and heavily regulates another 15%. If the government is going to produce all of these fantastic savings, why can’t they keep costs down now when they already control 80% of the market? Or do you actually expect us to believe that it is the remaining 20% — individuals paying out of pocket for treatments and drugs — that are driving up costs through wasteful spending on unnecessary procedures and failure to seek the best deals available?

    Too much government caused this problem. More government is not the solution.

  169. puck says:

    I must pay for certain mandatory “benefits” including…Colorectal and prostate cancer screening

    Are you sure you don’t have an asshole? Why don’t you check and get back to us. Hint: It’s probably wrapped around your thumb.

    And when you do come down with colon and prostate cancer, you might wish you had paid for clinical trials coverage.

  170. kavips says:

    Ah, it’s Monday. What a great weekend.. I think it would be safe to assume that those who continued this thread over this past weekend of marvelous weather, can be easily dismissed as being people who have nothing worthwhile to do, therefore making them people of no consequence… who therefore, because of what they are, would have opinions, likewise, bearing no consequence?

    Just two examples, are Tom above who brags outlandishly: When I as a non-autistic, non-diabetic, adult male who doesn’t use drugs and has no kids, want to buy a health insurance policy, I must pay for certain mandatory “benefits” including… which I think we can all agree, is saying: “I don’t use it, why should I pay for it…” I think another commentator earlier on rightly pointed out the selfish nature of such a statement.

    Obviously Tom is young. Probably 15 from his diction. So we are taking advice, from a 15 year old who swore allegiance to that invisible Republican (Bachmann, lol) who sent him an email and “now, it’s to hell with the fact that Berlin is falling, to hell with the fact that all the older, wiser soldiers have deserted Republicanism and surrendered, to hell with the fact that nothing the Fuhrer says makes remote sense,I,I, will stand off and defend the entire invading Russian Army with my pistol; the entire future of the Reich which will last 1000 years, will hold with me…. ” Of course one artillery shell out of the millions lobbed into Berlin, ends that dash of bravado. Probably never even find the body.

    Tom. Do you have parents? Do they pay from their own income all 100% of their own expenses leading up to death itself? Oh horror! ? What? They don’t? …..

    End of Tom.

    Insurance spreads risk. Those who never use the benefits of insurance cover the costs of those who do.. That is in both private and public insurance systems.

    Likewise, Will continues his talking point…(same Bachmann email?) about 15 people deciding who does and who doesn’t get benefits. .. Let’s see, math time… Delaware’s population of 976,000 divided by 15 people, means each will handle 66,466 peoples health insurance needs. Assuming each person only had one doctors visit a year, if that oversear worked with no days off, he would handle 165 claims each day. Assuming that person worked 24 hours every day, he would be handling between 6-7 claims an hour… which means, your very important health decision which will determine whether you live or die, …. gets an 8-10 minute review by someone who’s never slept since he’s been employed….

    Will is silly for bringing that up. What he fails to bring up is that in for-profit insurance companies, one’s claims are being handled by people who’s only qualifications are how well they lick their superiors assholes and whether their superiors liked it (metaphorically speaking, of course)… So who is better?

    Obviously I’ll take my chances with the guy with toothpick wired eyes stamping approved, approved, approved, approved, (like that’s really gonna happen) than someone dependent on the asshole of another, and that another, keeps yelling: “you’re spending too much fuckin’ money!” (which really IS gonna happen)…

    Point is: the side “for private health” care is trotting out little boys so they can still pretend they are fighting a war.

    Sad part of life. Sometimes little boys are exploited for the benefits of insane, old men…….

  171. Somalian Road Corporation says:

    What I got from the above is that the some of the most, let’s just say, vigorous big mouths who want to control your life in the name of their progressive/socialist/pseudo-compassionate “good” intentioned loadofbull are some really nasty shallow uninformed bullies who have no substantive responses or arguments to offer.

    What a shock they want to run the world, no questions asked. Clueless how they come across: ‘Can’t you see how we want to help you and raise you up, our fellow humanoids, SO SIT DOWN AND SHUT THE F**K UP YOU IDIOTS’.

    No wonder the country is about to deal them another hard kick in the ass out the door as all their power fantasies come unraveled.

    This bubble they have created for themselves in which they can act like petulant, profane thugs blathering the same irrelevant garbage ad nauseam (“Somalia! Boooosh! Koch Brothers! Rethuglicans!”) is their death trap.

  172. tom says:

    puck translated: I have no rebuttal. You’re an asshole. I hope you get cancer & die.

  173. tom says:

    @kavips,

    I am stunned and amazed by your dead-on accurate assessment of my character. You must be psychic.

    Please explain this to Eric Dondero. He suffers from the delusion that I’m one of your commie-liberal ilk.

  174. Jason330 says:

    I love how frantic this bill is making wingnuts. We need much more of this from leg hall.

    Comments are now closed. Move along troll.