The New Republic

How the hell do people find stuff like this?

- sdemuth

July 20, 2009 at 1:07pm

I'll say this for the party of stupid: at least in one respect they truck no pretense about what they've become.

- I Majorajam

July 20, 2009 at 1:12pm

It's "still fresh today" because Ronald Reagan once said it, regardless of whether it was true or even sensible when he said it.   If Reagan said in the 1960's that the Earth was flat and revolved around the moon (which I believe he did on at least a couple occasions), Jonah Goldberg would also comment that it was "still fresh today".  On the other hand, although Robert Taft and Everett Dirksen said the same thing about Medicare in the '60s, their loopy warnings are not "fresh" today because they are not worshipped by Republicans like Reagan is.

- wildboy

July 20, 2009 at 1:24pm

Jonathan Chait reminds us what it was like in the 1960s, when Ronald Reagan fought Medicare. Ed Kilgore

- Anonymous

July 20, 2009 at 1:59pm

If Reagan is wrong and Medicare and Medicaid are running so great, why do we need more Government Healthcare?

- CRS9TNR

July 20, 2009 at 2:00pm

> If Reagan is wrong and Medicare and Medicaid are running so great, why do we need more Government Healthcare?

Just a wild guess, but I suspect it has something to do with Medicare being restricted to the over 65 set, and Medicaid being means-tested, therefore neither of them addressing the problem of the roughly 35% of the population who are under  65 and working yet unable to afford private insurance premiums. They work well for the population for which they were designed.

Another wild guess: I bet you have pretty good health insurance through your employer, right?  *You're* OK, so why's everyone else complaining?

- krlong014

July 20, 2009 at 2:18pm

CRS9TNR: Oh dear, you can't be serious about that question?  I mean, aside from what you think about public health insurance or mandates or whatever - and reasonable people differ on purpose and details - and what your ideological position is on this issue - and, again, even reasonably sophisticated people could have an ideological opposition to public health care - you can't possibly think that your question is a) intellectually coherent; b) reasonable; c) sensible; or d) remotely relevant to the debate?

Let me see.  56 MILLION AMERICANS DON'T HAVE HEALTH INSURANCE; THE US SPENDS MORE MONEY ON HEALTH THAN ANY OTHER COUNTRY AND HAS ONE OF THE HIGHEST INFANT MORTALITY RATES IN THE WORLD; HEALTH-RELATED BANKRUPTCIES ARE AHEAD OF EVERY OTHER CAUSE OF ECONOMIC DISASTER FOR AMERICANS; HEALTH COSTS ARE ONE OF THE MAJOR REASONS FOR UNCOMPETITIVENESS OF AMERICAN BUSINESSES.

And so on.  The caps are intentional, because evidently, no amount of reasonable argument has sunk in.

Medicate and Medicaid address PART OF THE PROBLEM, not all of it.  They would be running GREAT and still not deal with the issues facing an aging American population and an uncompetitive industry.  Some sort of public mandate is necessary to deal with the fundamentally dangerous - to public health and to the democratic polity - situation of having 56 million Americans one health crisis away from utter ruin.  And so on.

God, what happened to conservatism and conservatives?  Why have they become so fucking stupid?  Really - Bismarck, the archconservative Chancellor of Imperial German, invented many social programs to ensure the security of the State: you can have an army run on empty.  Surely this much you can grasp, no?

- icarusr

July 20, 2009 at 2:26pm

Crs9tnr, why are you being willfully stupid?

Honestly.

- kgrant1054

July 20, 2009 at 2:26pm

Because Medicare and Medicaid were never designed to cover everyone.

- baxterjones

July 20, 2009 at 2:30pm

CRS9TNR, I can think of the tens of millions of people who have no insurance as being a good reason. I know I am a broken record but Government healthcare is more efficient than Private. Taiwan has the lowest administrative costs in the world and full, 100% coverage. My nephew just came back from a year studying there and used the system a few times and could not believe at how good it was, and he is not a Taiwanese citizen, just an American student.

and wildboy is right, to Republicans Reagan is like Jesus and they are devout, therefore it is always fresh. Beyond that, who the hell cares so much about "fresh" anyhow? Fresh is good for entertainment, but aren't enduring truths supposed to be eternal, is Jesus "fresh"? Is Shakespeare? Republicans like Jonah crave to be thought of as modern, so now Reagan has to be transformed into some kind of cool. Give it up Jonah, you got old and Reagan is dead. You can say Reagan said things that were timeless, but please give it up on the "fresh" angle, you embarrass yourself.

- blackton

July 20, 2009 at 2:40pm

I don't think Reagan had even the half of it when he said that.  If the Obama medical "reforms" come in, it'll be worse than socialism, it'll be like Ceaucescu's Romania.  Not only will doctors be forbitdden to practice where they want, and patients forced to go with whatever doctor some government bureaucrat imposes on them, but they also won't be allowed to have the illnesses they think they have, they won't be allowed to say they are feeling cold/hot as the government will control the temperature, and indeed, even if they are treated they may not even be allowed to actually recover, if they haven't met their government-imposed "sick quotient" for the year.

I'm telling you, we'll look back nostalgically on the days of the free market in health care, when every American and his/her family coud choose whether to become ill or not, and get better whenever they felt like it.

- ironyroad

July 20, 2009 at 2:40pm

kgrant: CRS can't help it; "wilfully stupid" appears to be a Republican membership prerequisite.

- icarusr

July 20, 2009 at 2:41pm

I just listened to Reagan's speech, man is it dated. It feels like the 1950's. All that was missing was a warning against the Godless Communists. Anyway, Reagan did not exactly spend his sunset years they way he imagined he would.

ick, I think the problem is most conservatives never leave the US for any length of time, maybe they go to Mexico for vacation but that is it. The reason why they are so stupid is because they choose to be. Or maybe they think the only way they can feel superior is to have others suffer needlessly.

- blackton

July 20, 2009 at 2:55pm

"Or maybe they think the only way they can feel superior is to have others suffer needlessly."

So true ... and it has ever been thus.  Reminds of one of the most celebrated political cartoons in Canadian journalism history, by Bob Bierman of a provincial minister who went on to become premier, only to resign over receiving $20 K in a brown-paper envelop.  

drawn.ca/.../cartoonist-bob-bierman-dies

The cartoon led to a defamation cast, which the cartoonist won ... you can put any self-proclaimed "conservative" politician in that pose and you would not be out of place.

- icarusr

July 20, 2009 at 3:17pm

IN A WAY, IT IS STILL FRESH TODAY.... Over at "The Corner," Jonah Goldberg highlights this 1961 clip from Ronald Reagan, criticizing Medicare. Goldberg said Reagan's criticism of the landmark health care program is, nearly a half-century later, "still

- Anonymous

July 20, 2009 at 3:50pm

blackton, you've got it backwards. It's not that most conservative people choose to be stupid. It's that most stupid people choose to be conservative. Anyone smart enough to notice that none of the things Reagan predicted 40 years ago came to pass wouldn't be a conservative in the first place.

- rhubarbs

July 20, 2009 at 4:30pm

At the risk of being called willfully stupid, I'm going to throw this idea out there.

Crs9TNR asked why we need more government healthcare if medicare and medicaid are working well. People responded by saying that medicare is for old people, and medicaid is for poor people.  We need something else for people who are not elderly, and are not poor enough for medicaid.  

Fine, but it is problematic when a sizable chunk of the middle class thinks that insurance is too expensive for them  to buy  and that since it is unethical to deny people healthcare, that someone else had better buy it for them.  For example, with S-chip, in some states eligibility was granted for households earning as much as four times the poverty threshold, or about $80,000.  In many states the cut off is three times the poverty level, or about $60,000.

Frankly, I think households earning 80 grand should be able to buy their own insurance.  And households earning 60 should get some assistance, but nearly not as much as poorer households.  Seriously, there are a lot of households that really could afford it,  but that prefer to have 8 grand a year to spend on other discretionary items.  And they are free-riding on all the responsible households that buy their own insurance, counting on society to bail them out if something bad happens.  I know people who are making this choice!

I have not followed all the details of what is involved in the current package, but I am pretty sure the word 'mandatory' is off the table.  Unfortunately that means that people who want to play it risky still will be able to, while everyone else pays for them.  The problem of the uninsured won't go away unless we require people to buy into the system-------and even when it is mandatory, as in Massachusetts, people still free-ride.

In any event, the idea that taxing  the highest earning 1% of households  is going to cover the massive outlay of mula necessary to pay for subsidizing the HUGE number of households earning less than say 80 grand (75%)------if anyone knows what the actual cut-off for being subsidized is, PLEASE correct me-----is preposterous.  Fortunately many households in that 75% already have insurance from their employer, but who knows how that will play out over time; many are predicting that  more employers will be dropping health benefits.

Basically, unless households earning over 50 grand a year (about half in 2007) are willing to have taxes rise (but progressively I grant you!) to pay for this new program, it should be scrapped.  If we can't have a voting majority agree to pay more, then it's not going to work.  

- kerFuFFler

July 20, 2009 at 5:40pm

A few responses here.

Yes I have healthcare through work.  Most people if they have any coverage, have it through their employers.  That's the way it was set up 60 years ago.  Unfortunately health care obligations are one of the contributors to my companies recent backruptcy.  So now the UAW heathcare trust fund owns 30% of my company and I work for the hourly employees.  I know why people are complaining.  I've known for 15 years.

If you beleive 56 million americans will get healthcare with a new Governement Program, I don't think any thing any one says will have any inluence on you.  Typical coverage costs about $ 2,000 per year.  If you think there is any extra $ 100 billion that will magically appear and provide healthcare for all, God Bless you.  Your faith is greater than mine.

Regarding willfully stupid, I have paid $ 20,000 into Medicaid, and my Employer has paid $ 20,000 into Medicaid.  I think $ 40,000 is a lot of money.  Do you know how much you have paid into Medicaid?  In addition, I have saved $ 50,000 for my Retiree Health Care in a Medical Savings accout, even with promises of retiree health care and Medicare.  Most people would not consider this stupid.  Someone is stupid here, I don't think it's me.

Medicare and Medicare were not designed to cover everyone, but employer paid health care was designed to cover everyone who worked.  There were big tax benefits and an insurance industry to manage health care.  Why isn't the current system working?  There are a lot of reasons.  But in 1950 they beleived this would solve all the problems.  Having a realistic look at the current system forces one to doubt the governement could do any better.

If you think the governement can manage healthcare, do you also beleive the Post Office is the best way to send a package?  If the Post Office reported their business like a normal corporation, their health care costs would have cut benefits years ago and probably been in banckruptcy this year.

There are huge healthcare obligations out there to local, state and Federal Governments.  My school district is firing teachers every year because of rising health care costs.  State Goverment has had furloughs.  The federal goverments does not know how much it's total obligation is.  The best estimates of just retiree health care for the Federal Government is about a trillion dollars.  

I recently returned from Canada where everything is 10-20% higher costs.  They have free health care, but if you buy anything you pay more.  The local GST & PST Taxes are 10% on top of everything.  With their VAT on manufacturer's that's another 10%.

An honest look at Medicare and Medicaid would admit their are a lot of problems and the system is ultimately a failure without larger increases in funding.  You can neglect this, but it will be really hard to get Universal Health Care without and honest discussion of where we are and the mistakes we made along the way.

- CRS9TNR

July 20, 2009 at 6:05pm

In most countries on a par with us, the population as a whole is covered (whether via public or private entities), and the general coverage widens the risk pool considerably.  In fact, the whole term "insurance" is a bit of a shaky concept when it comes to the health care issue.  When you buy car insurance, you may never have an accident in your whole driving career.  But you or your family members are going to get sick, without fail, as that is part of human life.  We would be far better off embracing the unavoidability of illness, and working out how to treat people preventatively if possible, than imagining that we can be "insured" in any real sense.  Clearly, the current vast discrepancy between health care outlay and results in the U.S. is the equivalent of going into a restaurant, totalling up the prices on the menu, paying out that sum, and leaving with a soup and sandwich while others need a truck to cart away a 15-course meal.  The Republicans have no answer to the question, how are we managing to pay out so much and have results that put our life expectency lower than almost anywhere in Western Europe?

- ironyroad

July 20, 2009 at 6:26pm

kerFuFFler, a couple of problems, for one, in Pa. at least, for people who make 80,000 they have to pay $195.00 a month premium per child with co-pays for services. That is not free.

www.chipcoverspakids.com/.../2009_income_guidelines.pdf

So the people earning 80,000 would be paying for insurance for their kids. Check the guidelines.

Now do you honestly think $195.00 a month per child is cheap? In fact, people eanring 54,000 with one child have to pay $195.00 a month, and that only covers the child.

Another huge problem with your argument. You seem to think the uninsured equal untreated, in fact what happens is the emergency room becomes the treatment of last resort, at which point things that could have been treated with little cost blow up to huge costs, with the costs passed on to the insured. Your premiums are so high because the hospitals factor in the costs of treating the uninsured. Now you argue against taxes, but are you in favor of paying high premiums? Or do you think hospitals should turn away the uninsured, to let them die in the streets as a lesson to not be poor in America. Any rich who tried to free ride would ruin their credit so only a fool of a rich person would go uninsured. The middle class who go without generally go because they have to choose between that and a mortgage, but they themselves risk ruining their credit too. The poor have no credit to ruin and can not afford insurance, but they still get treated at a higher cost than would occur than if they have access to reliable care.

- blackton

July 20, 2009 at 6:31pm

CRS9 says, "If you think the governement can manage healthcare, do you also beleive the Post Office is the best way to send a package?"

I'm getting kind of tired of this knee-jerk reach for the USPS as a sort of universal example of how "government" can't do stuff.  What is the basis for the assumption behind your question?  The US Postal Service accepts your bunch of papers, CDs, a book, whatever, in a priority mail envelope, takes a standard $4.85 off you, and delivers it to an address anywhere in the United States within three days (mostly within 48 hours).  It is one of the few national organizations left that really knit the country together and work for the public good rather than for corporate profit.

For all normal purposes, I haven't met anything better.  And may I remind you that the armed forces are also "government."

- ironyroad

July 20, 2009 at 6:36pm

CRS9TNR "If you think there is any extra $ 100 billion that will magically appear and provide healthcare for all, God Bless you.  Your faith is greater than mine." This is the fundamental fallacy of Republicans. That $100 billion is already being spent by you by way of your health care premium to cover the cost of the uninsured who use hospital waiting rooms as doctors offices.

And do not mention Canada, or I will bury you with information about Japan and Taiwan, which both have UHC with  better outcomes at significantly lower costs. If you can tell me what is wrong with the health care system of Taiwan, and why it can not work in America, then please do so. You should learn from the systems that work and try to replicate it, not from systems that do not (except maybe for what to avoid) Taiwan took one look at our system and laughed.

- blackton

July 20, 2009 at 6:37pm

Just to clarify,

I want there to be a universal healthcare program,  but the track record of the US gov really gives me pause.  For example, ALL (!) of the money that each of us has been paying into medicare through our payroll taxes, and all of the matching funds our employers have paid, ALL of that is already gone.  The "savings" that were supposed to have built up in the medicare fund to offset the increased expenses of the boomers hitting retirement is entirely wiped out.

Sure, universal programs seem to work in other countries.  But just maybe those other countries have citizens who are willing to pay to make the system work.  Unfortunately in our country, if you say "raise taxes", you are not going to get elected.  So our grubby representatives in Congress have, for DECADES, voted to override the "automatic" adjustments in medicare spending and withholding.  Even though increased longevity and new treatments have increased the expected spending, Congress has failed to act responsibly, and voters have voted irresponsibly.

As a Nation we spend about 17% of our national income on healthcare, but what percentage of Americans would want to spend that much on insurance or healthcare.   What percentage would be happy to spend half that?  My guess, not many.

- kerFuFFler

July 20, 2009 at 7:01pm

kerfluffler,

Your friends  are badly mistaken if they think they're getting a "free ride" when something bad happens.  It's true that hospitals won't deny emergency care, but they still charge for it, and without insurance, those costs can be crushing.  If you make enough to absorb those costs, then you take a huge financial hit, but don't really affect everyone else because it comes out of your pocket.  If you don't make that much, then you still take a huge financial hit and wind up bankrupt, which is bad for everybody. No, they don't bear the full cost, and that's a real problem (which is why I support having a mandate), but from the perspective of somebody who can afford insurance, there's still every reason to buy it.

- AlanSP

July 20, 2009 at 7:06pm

blackton,

I agree that our current system is awful, and that many other countries have enviable programs.  My concern is that because rather than starting over and making something smart that willing citizens are happy to pay for,  an unwieldy compromise is being cobbled together for political reasons, .  Sadly the "healthcare is a right" rhetoric seems to have left a lot of our citizenry thinking that it is unfair to tax people to pay for it.  

- kerFuFFler

July 20, 2009 at 7:09pm

Blackton's right.  Incidentally, Canada's health care system is nothing remotely like the horror stories that Republicans like to describe (neither is Britain's).  Yes there are waiting times for certain things, but that's by choice because they spend so much less on health care than we do.  If they spent anything remotely approaching what we spend, those waiting periods would not exist.  In addition to Japan and Taiwan, there's also France.  I know Americans (and Republicans especially) love to hate the French, but they have an excellent health care system.

There are other countries with good systems as well, but the point is that there are plenty of real world examples to look at instead of the horrors imagined by Ronald Reagan.

- AlanSP

July 20, 2009 at 7:18pm

blackton,

I'm sorry, I missed your earlier response with all its points, so I am responding out of sequence.

I never said S-chip was free.  It is subsidized (which I only implied but never said directly).Basically I think the cutoff for the subsidy should be a bit lower.

I am just not sure that at an income of $80,000 for a family with two kids that a subsidy should be required.  In fact if more of the people in that mid range would consent to contribute appropriately, we could more even more generous to people earning 45 to 55 grand  not to mention the people in medicaid.

You also say I am against taxes!  Nothing could be further from the truth!  But I believe that the taxes should be applied to a broad base of the citizenry.  It is silly to try to squeeze all of it out of 1% of the population.  In Europe, the citizenry expects to be taxed at a high rate, and they seem to 'get it' that they are paying for those benefits.

I certainly agree that the emergency room approach to check-ups is wasteful and expensive.  But changing that is not going to fund the sweeping reform you would like to implement. Frankly,if solidly middle class families earning eighty grand are going whimper about paying the full rate to insure their kids, than I suspect we are going to have a difficult time convincing Americans to embrace a truly universal system.

- kerFuFFler

July 20, 2009 at 7:37pm

I live in Canada.  Almost all my friends are physicians so I know about the health care system.  I am a tax payer in a "health surtax" bracket, so I know about its costs.  And I have had two catastrophic illnesses in my family in the last two years.  Wait time, for life-threatening illnesses is nonexistent.  There used to be issues with MRIs, but now imaging centres are running 24/7 and that has been resolved. (Yes, it means that if you want to have your toes CAT-Scanned, you might have to show up at midnight.  Big deal.)  Coverage is 100% AND we spend less on health care than in many other countries, including the US.  We're damned proud of it.

There are problems, to be sure.  There is a shortage of family doctors - it means, at worst, that you go to walk-in clinics and wait for an hour to see a family physician.  But, you know, life in a society is about making collective choices.  We realise the price we pay in waiting times, especially for elective surgery, but the prospect of a system that denies basic care to 1/6 of our fellow citizens is simply unthinkable.  

- icarusr

July 20, 2009 at 9:42pm

I have zero problem with the tax angle, as I said, it is either higher premiums or higher taxes with the upside of the higher taxes being that it would lead to greater efficiency. I disagree with your contention that $195.00 per child per month is a subsidy, and there are co-pays as well. Now if you can run numbers by me that it truly costs more than that, then I concede your point, but from the numbers I come across, it seems fine with me, but I will also concede the quotes I see from private insurers maybe are bogus, that they will deny care where the public plan doesn't.

- blackton

July 20, 2009 at 10:23pm

Blackton,

if S-chip is not subsidized, then why is it their cheapest option?  Why do we have rules limiting enrollment in S-chip if it is not subsidized.   Just because it's subsidized doesn't mean its gonna be cheap.

- kerFuFFler

July 20, 2009 at 11:44pm

blackton,

the S-chip price ($195+copays permonth) does seem high.  It is high.  

The reason it is high is that S-chip cannot charge more for previous conditions (state by state the rules vary so it is hard to generalize).  That means that more and more often, people with healthy kids cross their fingers and opt out, leaving a pool with a much higher that expected levels of illness buying the insurance.  So the price goes up and more people opt out.  It is a pricing death spiral.

That is why if you want to be able to keep insurance affordable for everyone------including people with preconditions------everyone needs to get the insurance.  It needs to be mandatory.

- kerFuFFler

July 21, 2009 at 8:50am

Listening to Reagan's wizdumb never fails to give me cheer.

- Bukharin

July 21, 2009 at 8:58am

I just watched 2 Republican Senators (and also physicians) on Morning Joe.  While both admitted Jesus (Yes, Jesus - Scarborough had to ask) wouldn't approve of the health care system in the USA they both went on to blabber the same song and dance ensuring the current sad state's continuation.  What the hell?  Are conservative and Christian antithetical?

- Bukharin

July 21, 2009 at 11:17am

Bukharin: Conservative and Christian are not antithethical. I am conservative, rich, and believe in Jesus; therefore, Jesus approves and I am saved. Now if all of the poor really believed, then they would become rich and saved and able to afford whatever health care they desired.

- tpinter

July 21, 2009 at 8:53pm

This proves that Ronald Reagan was one of the True Genesiuses of the 21st Century.

- BFichthorn

July 21, 2009 at 11:01pm

CONTEXT MATTERS, EVEN WITH REAGAN.... During last year's debate for the Vice Presidential candidates, Sarah Palin paraphrased a famous Reagan quote: "It was Ronald Reagan who said that freedom is always just one generation away from extinction.... We

- Anonymous

August 17, 2009 at 12:49pm