Let's Not Hide Health Costs

[2Sheds_Jackson]

Let's Not Hide Health Costs

By Robert J. Samuelson
Newsweek
Feb. 5, 2007 issue - We are awash in health-care proposals. President Bush has one. So does California Gov. Arnold Schwarzenegger. Democratic Sen. Ron Wyden has a plan, as does a coalition led by Families USA (a liberal advocacy group) and America's Health Insurance Plans (a trade group). To some extent, all these plans and others aim to provide insurance to the estimated 47 million Americans who lack it—a situation widely deplored as a national disgrace. But the real significance of all these proposals, I submit, lies elsewhere.

For decades, Americans have treated health care as if it exists in a separate economic and political world: when people need care, they should get it; costs should remain out of sight. About 60 percent of Americans receive insurance through their employers; to most workers, the full costs are unknown. The 65-and-older population and many poor people receive government insurance. Except for modest Medicare premiums and payroll taxes, costs are largely buried in federal and state budgets.

It is this segregation of health care from everything else that is now crumbling—and the various health proposals are just one sign. We see others all the time. For example, even with employer-provided insurance, workers' monthly premiums (which cover only part of the costs) have skyrocketed. From 1999 to 2006, they doubled from $129 to $248.

Look at Massachusetts. Last year the then Gov. Mitt Romney made headlines by signing legislation to cover all the state's uninsured. The law required that everyone with incomes three times the federal poverty line buy "affordable" insurance (people with incomes below that threshold would be subsidized on a sliding scale). Romney suggested annual premiums for a single worker might total $2,400. But when insurance companies recently provided real estimates, the cost was much higher: $4,560. Is it sensible policy to force workers with a $30,000 income—about triple the poverty line—to spend nearly a sixth of their budget on health insurance, as opposed to food, rent or transportation? Good question.

The hard questions won't sit still, because health care (now a sixth of the economy, up from an 11th in 1980) is too big to be hidden. Myths abound. Contrary to conventional wisdom, the doubling of premiums for employer-provided coverage doesn't mean companies shifted a greater share of costs to workers. In both 1999 and 2006, premiums covered 27 percent of costs, says Paul Fronstin of the Employee Benefit Research Institute. It's simply the rapid rise in total health spending that's depressed workers' take-home pay.

...story continues http://www.msnbc.msn.com/id/16840065/site/newsweek/



Thought this was interesting - especially the Massachusetts plan, which was hailed as a wonderful breakthrough...but which will now apparently cost people at least twice what was planned.

My question to you bastages - universal coverage is meant to cover all people. This means that others are basically paying for your health care. Since other people are now obliged to pay for your repair and upkeep, do we have an expectation to moderate or control your behavior?

Why should a person who eats right, exercises, takes care of themselves and goes to the MD once every 5 years be footing the bill for a French-fry eating lard ass who's always at the doctor getting meds for high blood pressure etc? Why should somebody who's normal and safe and is never injured, pay for Johnny Knoxville's broken bones and scrapes for engaging in high-risk behavior? Should any new plan that forces us all to pay for each other's lifestyles include caveats such that we don't end up paying to repair the consequences of idocy?

Should we exclude illegal acts from coverage? Or what about people who voluntarily participate in unprotected high-risk ***, are thousands of times more likely to get AIDS than someone like a married middle aged woman, and AIDS treatment costs hundreds of thousands of dollars? What about whores, skanks and tramps who are alternately either a petri dish of STDs and/or pregnant - will we pay for all their abortions or for the birth of all the children...each of which in turn will require us to pay for their care as well?

We've pretty much demonstrated that we're willing to tolerate anybody's behavior . . . but now are we willing to pay for it? We're willing to let others essentially wreck themselves trying to live a consequence-free life...but are we willing to pay to keep them afloat?

I ask all this because I remember when I was active duty, we were always told that the DoD would not pay to "fix" us if we got hurt doing anything on "the list" - it included stuff like scuba diving, rock climbing etc. They said that we were free to do it, and they would take care of us, but that we'd get a bill in the mail.

[annihilation]

Good article and you made alot of good points as always. I don't know really. I know a model that is similiar to the VA should be followed as they have been able to produce some good cost cutting features and have been able to slow down if not reverse the increase in health care costs each each. We spend something like 20 cents on a dollar in administrative costs. These costs can be trimmed down if things are streamlined. Also in one article I wrote, 1 out of 5 tests are redone because the papers are lost. An electronic system much of the VA system would almost eliminate the need for extra tests.

I do think, that as whole society pays then some input for the well being of each person should be considered. People shouldn't be denied helathcare coverage but exceptions in premiums should be made. Why not have a physical test done at the end of the year. Those who pass pay a less of a premium than those who don't. My brother in law once mentioned that something else that can be done to cut down costs is that at the terminal stage (only 3 months left ot live) that all treatment should stop and the patient should be just given drugs not to feel the pain in the last few days.

[Abolith]

where I live the costs are thanks to illegals and white trash using the ER as a GP. Two weeks ago I broke my wrist in a car wreck and I was taken to the ER (cali law, airbag deployed so I had to be taken) where i waited for 6 freaken hours while the lady with a kid who had a fever was seen and given cough meds, or the mexican who had a kid who was barfing...these things are not what an ER is for... think about what ER stands for, programs like the ones proposed are not going to help, only drive up the cost higher and higher... [/Rant]

[Calanen]

The problem of modifying behaviour is always a thorny issue. I agree that smokers should not expect free treatment for their lung cancer, and as far as fat people go, it's pretty hard to effectively police. That is, do you report for exercise duty a few times a week, get your card stamped and then you are OK - do we rely on people's word? What if your weight fluctuates? Maybe you could have people attend a physical once a year, and if they failed the physical, their health care coverage was reduced...it would not be popular with the electorate however.

The problem with the cost of health care in the USA also needs to be addressed by smashing the HMOs and drug companies who fix artificially high prices. A hospital may charge an HMO $200 for an outpatient visit. They will charge a person who is paying and paying cash, perhaps $320 for that very same visit, with the same service. Why? Because the HMOs and hospitals have agreements about what they will pay, and it is way less than the cash price. How is it fair that a person who is footing the bill themselves, has to pay way more than a large corporation for the same service?

Drug prices are also artificially inflated. The same drugs, the same chemicals, the same testing, the same brands go to Mexico for far far less than they are sold in the USA. The reason is that people in Mexico could never afford the cost, so they sell them for less. Why shouldn't Medicaid be able to source its drugs from Mexico. The drug companies love to say how 'You can't be assured of safety...' but the drugs are the same, especially brand names. In the USA it might cost $300 for the same drug that costs $20 in Mexico. You could easily deal with it by having a panel of experts who bought drugs from an external supplier - tested the batch, then certified that this supplier is OK. The safety issue is a furphy. Literally billions could be saved by Medicaid sourcing foreign drugs.

The drug companies, doctors, and HMOs need to brought under control as part of the whole reform of the US health system. And yes, dare I say it, tort reform is another part of the system improvements needed.

[annihilation]

I was listening to the radio this morning and an economist who wrote a good book called "the rich get richer and the poorer get poorer and you can never buy a good used car", said that the world benefits from the drug prices in the US. The US pays so heavily that it makes an incentive for drug companies to come out with new products and that the rest of the world benefits from that as a side effect. I do agree we pay to hefty compared to what other pay. Hell the VA can negotiate for a discount price and do get it, paying far less than medicare can. The new democrats haven't even changed it. They pass that there will be negotiations but there is still a small clause that says they will still buy the drug if the company refuses.

[phoilme]

The real problem lies in American's expectation to have boo-boo's, black eyes, physicals for soccer or sore muscles covered by insurance. That's like expecting your auto insurer to cover oil changes and tune-ups.

Only in America do the fat, lazy indolent ones spend a fortune destroying their bodies and then complain about the cost of treating their diseases.

Like AIDS, most medical problems can be prevented by personal action (in the case of AIDS it's NO action).

[dedgod]

where I live the costs are thanks to illegals and white trash using the ER as a GP. Two weeks ago I broke my wrist in a car wreck and I was taken to the ER (cali law, airbag deployed so I had to be taken) where i waited for 6 freaken hours while the lady with a kid who had a fever was seen and given cough meds, or the mexican who had a kid who was barfing...these things are not what an ER is for... think about what ER stands for, programs like the ones proposed are not going to help, only drive up the cost higher and higher... [/Rant]

I have three children, and have to take them to the ER. You know why? Because after 5:00 p.m. there is no other choice. Period. Some clinics have an after hours service , which is more expensive , but is still cheaper than going to the ER.

On Sundays. Nope. Nothing. If my chidl has a severe earache..what can i do? Nothing... no OTC medication is available...I can't even call a freakin doctor...ok i can call a nurse on standby..but rarely the doctor.

Which is why the ERs are flooded with people who really shouldn't be there. They have no where else to go.

There have been ver y few dissapointments after coming to the US and health care (and government waste) to me are the biggest.
The health care in the US sucks. Even when compared to 3rd world countries.
I would say that there are a lot of 3rd world countries where , in general, the reach of the health care system is faster , and wider than in the US. Which is a shame. (NOTE: I am *not* comparing the quality of the care, and neither am i talking about complicated brain surgeries..the US is unparalleled in that...i'm talking about everyday ailments like the common cold, and stomach viruses - you really don't need to be a brain surgeon to reat those :-) ).

In most Asian countries, you can have a family doctor who you can call on weekends. Doctors are available 24/7 and not just in the ER. Most government hospitals have free health care for the poor.

In my opinion, the pharmaceutical lobby in the US, has a stranglehold on prices..how else can you explain that drugs that are acceptable in Canada are supposedly not accceptable in the US? That and the ridiculously high insurance costs..

[2Sheds_Jackson]

The real problem lies in American's expectation to have boo-boo's, black eyes, physicals for soccer or sore muscles covered by insurance. That's like expecting your auto insurer to cover oil changes and tune-ups.

Only in America do the fat, lazy indolent ones spend a fortune destroying their bodies and then complain about the cost of treating their diseases.

Like AIDS, most medical problems can be prevented by personal action (in the case of AIDS it's NO action).

Well I dunno about this- don't people in the UK or elsewhere in Europe where medical stuff is covered go to the doctor to fix everything that broken? And isn't it covered? I mean, if some kid in the UK is playing wrestler in his back yard with his friends, and hits them over the head with a chair, don't the good citizens of the UK pay to fix that?

Calanen - about prices paid by HMOs' - my experience has been different. I've paid my own way for a while and found that you can get service for less than what HMOs or PPOs agree to pay. The problem is, that if an HMO says "I will pay up to $50 to fix a broken nail" - guess how much it will suddenly cost to fix a broken nail? Whereas, if I walk in and say, I have a broken nail, and I have $20, they'll do it for $20.

I want to know why the hell I should have anything at all to do with a for-profit insurance company. Every dollar that every one of the thousands of employees of that company makes, every dollar of the billions of dollars of profit that the company makes every year, every one of the hundreds of millions of dollars that their CEOs make, is a dollar that I overpaid for medical services. It's simple math.

[Ordie]

I appreciate the problem, but I don't have a solution.

But here are my observations and hope it generates some comments:

The drug companies charge a lot to get the maximum amount in return to cover the R&D cost. Since drug patents last only 10 years, drug companies are under pressure to get the product out to market as fast as possible before the patent runs out and becomes generic. Since there is no cap, they take advantage of charging an arm and a leg.

Blaming the undocumented is easy and a copout for almost all issues in society (They can't defend themselves). The real problem is the system as a whole. Medical care is focused on speciality and dealing with the latter stages of a disease, illness and injuries. Very little is done on prevention.

It is far more cheaper to open free clinics for acute and familiy care than to keep the ER open for non-emergencies. The key is mitigating the cost early on.

[Kaapeli]

I think it's an absurd idea that people stop caring for their health if they don't have to pay for healthcare. No sane person will intentionally destroy his health no matter how cheap or free healthcare is. And when people do take risks that could affect their health I guarantee you that they don't stop to think how much it could cost them, because all the money in the world is worthless next to your health.

And if you refuse prostitutes AIDS treatment you'll pay for it tenfold when she goes out and infects 100 other people to pay for her AIDS-medicine and then THEY appear in the ER with their AIDS-related diseases that you're forced to pay for too.

Refuse a fat person his bloodpressure medicine then you'll be paying for his emergency bypass surgery and a month of recovery in the hospital when he gets a heartattack and that too is going to cost you much more than the simple bloodpressure medicine that could have prevented it.

[2Sheds_Jackson]

Blaming the undocumented is easy and a copout for almost all issues in society (They can't defend themselves). The real problem is the system as a whole. Medical care is focused on speciality and dealing with the latter stages of a disease, illness and injuries. Very little is done on prevention.

Well just becasue they can't defend themselves doesn't mean they're not a problem. I mean, I could get hit on the head by a chunk of falling frozen toilet water from an airplane, it can't defend itself, but it still hit me. Granted they're only a small part of the puzzle, but they're still a valid problem IMHO.



It is far more cheaper to open free clinics for acute and familiy care than to keep the ER open for non-emergencies. The key is mitigating the cost early on.

Free clinics? Heh heh - there's no such thing as free. But you're right, in urban areas I bet it would be cheaper to staff some kind of 24/7 family care clinic vs. having those people going to the ER.


I have three children, and have to take them to the ER. You know why? Because after 5:00 p.m. there is no other choice. Period. Some clinics have an after hours service , which is more expensive , but is still cheaper than going to the ER.

I've got kids too, but have never had to take them to an ER except for things like broken bones. Dunno, maybe I've been lucky, but if they're getting sick, they go to the doc before it gets too bad. Or they wait until he's open again. They've never been so sick so suddenly that I had to go to the ER. I know people who routinely take their kids to the ER as if it was just another office visit. Frankly, I think a lot of that is because when you have both parents working, the only time they are with their kids, and therefore able to take them anywhere, is during the time that doctors are closed. :-(

[vryhpyammoadded]

I for one am not happy with the mission creep that is our government. If I wanted to live in some neo-feudal, serf/lord relationship where I serve the whims of my master, I’d move to North Korea but I see no way to avoid some measure of this social engineering what with the corruption of the masses, abusing the current system. The bulk of Americans, acting like spoiled, irrepressible kids, are bringing this doom upon themselves and dragging me down with them.

A person, who lives healthy, fits the right profile and lives according to his insurance policies lifestyle suggestions should get a break on premiums just as the person who doesn’t should pay higher premiums or out of pocket. Auto insurance works this way and so do some medical insurers, why can’t all company policies do the same and defer high risk costs to the higher risk clients.

As for a “vice or hobby” list preventing coverage, I’m in agreement that illegal actions should result in non coverage but not necessarily grounds for complete termination. Maybe instead, substantial rate increases? If the criminal chooses not to pay then I see no problem with termination and a life time of leans and garnishment of wages, even repossession in some cases for services rendered.
A similar action should occur for risky lifestyle events. If you think a ten anniversary balloon ride would be cool but got hung up in high tension power lines, your insurer should better dam well increase your premiums for a few years to compensate but I sure as hell don’t agree with sudden termination, forcing the Docs to take back those skin grafts they were applying.
Now, if they found out you were into Great White shark wrestling or in the professional Russian roulette circuit, I could understand abrupt termination.

As for the uninsured, I’m really unhappy with all the options being discussed on Capitol Hill and haven’t a clue as how to treat the problem other than get the government further out of mucking with this issue. Mostly I think the issue should be left to charitable organizations with the government staying very far away from it, event to the point of eliminating medicade, SS and the income tax, replacing them with a national sales tax letting people take there own risks with there wealth.

To me it appears that every mandated nanny government idea always turns into a racket that costs us more. This tells me get the government out of nanny regulations and legislation and quit providing a breeding ground for corruption.

[annihilation]

To me it appears that every mandated nanny government idea always turns into a racket that costs us more. This tells me get the government out of nanny regulations and legislation and quit providing a breeding ground for corruption.

Does that have to do with the government or every damn lobbyst that pays off a senator to put in that extra single line in the where clause.

Case in point the part where medicare could not negotiate with drug companies for bulk rates.

[Moledet]

You can't monitor all the citizens behavior. There was a proposal here that citizens will pay health tax according to their BMI, but this is also not correct since there are muscular healthy people that have high BMI compared to skinny computer geeks that have low BMI but yet are not as healthy.

I'll throw in another bone, what about life extending medicines? Should they be included in the health coverage? After all, they will not save the patient's life but only extend them in a few months-years and they cost tens of thousands of dollars per week.

[StukaJr]

To some extent, all these plans and others aim to provide insurance to the estimated 47 million Americans who lack it—a situation widely deplored as a national disgrace. But the real significance of all these proposals, I submit, lies elsewhere.

The estimate of course fails to account that some of these individuals choose not to get health insurance even if they can afford it. A lot of my colleagues in the entertainment industry opt for "contractor" positions which shed these "benefits" and various state imposed safety net taxes in exchange for higher salaries... For employees being 20 something, companies would do better simply depositing those premiums into the interest bearing saving accounts - at the rate "industry standard" insurance stacks up in their coverage. It's great - take something that not everybody wants and mandate everybody to have it by law. Bloody brilliant!

[vryhpyammoadded]

Does that have to do with the government or every damn lobbyst that pays off a senator to put in that extra single line in the where clause.
Case in point the part where medicare could not negotiate with drug companies for bulk rates.

Both are to blame. It's the politico/lobby handshake to the detriment of all going on so often that ticks me off.

[12thMan]

we should get rid of medicare, medicaid and social security.

[annihilation]

You can't monitor all the citizens behavior. There was a proposal here that citizens will pay health tax according to their BMI, but this is also not correct since there are muscular healthy people that have high BMI compared to skinny computer geeks that have low BMI but yet are not as healthy.

I'll throw in another bone, what about life extending medicines? Should they be included in the health coverage? After all, they will not save the patient's life but only extend them in a few months-years and they cost tens of thousands of dollars per week.

Instead of testing there BMI, as you mentioned above (skinny fat), instead they should do a physical. That you can't lie, well not as easily.

There is no easy answer to the problem. I do think that the VA has a system that we should incorporate to streamline things and make it more efficient in order to reduce waste.

Also ever notice that it seems like medicine is more into making money than healing. People go on certain medications but its not a one time cure or treatment, its more instead of a life long use. But thats me just ranting.

[StukaJr]

Instead of testing there BMI, as you mentioned above (skinny fat), instead they should do a physical. That you can't lie, well not as easily.

There is no easy answer to the problem. I do think that the VA has a system that we should incorporate to streamline things and make it more efficient in order to reduce waste.

Also ever notice that it seems like medicine is more into making money than healing. People go on certain medications but its not a one time cure or treatment, its more instead of a life long use. But thats me just ranting.

What if the person is a hypochondriac and runs to the doctor every time he or she reads another illness definition in the medical dictionary? There is no way to determine how ****e a person is to run up his medical bill, just by straight physical profiling. Leave alone the fact that every insured field has its share of scam rings raking up bogus claims and non-existent procedures...

I think some are missing the point of Universal insurance coverage - it's meant to be a blanket coverage, peaks usage of some patients are absorbed by minimal usage of others... Obviously, it's not so noticeable when my employer pays X amount of dollars and it's out of sight/out of mind... If one expects to pay exactly for the medical service they receive, then might as well stick with one's pocketbook...

Finally, I don't believe any nation with working Universal Coverage system can boast low taxes or the low cost of goods and service that US can offer... I don't understand why US is trying to fix one of the appealing factors that draw such an enormous influx of labor from the Nations with "Free" Healthcare?

[Calanen]

Calanen - about prices paid by HMOs' - my experience has been different. I've paid my own way for a while and found that you can get service for less than what HMOs or PPOs agree to pay. The problem is, that if an HMO says "I will pay up to $50 to fix a broken nail" - guess how much it will suddenly cost to fix a broken nail? Whereas, if I walk in and say, I have a broken nail, and I have $20, they'll do it for $20.


I paid for my own stuff seemingly because the company I worked for self-insures, so you would pay cash for the treatment and then get reimbursed. A doctor tipped me of to the fact that I was paying twice what any of the HMOs charged, and he went into bat for me and bargained it down - saying, look he should pay the same price you are charging the HMOs. They eventually agreed to that. Also, I'd physically have to have the cash in my hand to wave at the medical centres and hospitals, as they were getting ready to hit the eject button and call security when I could not produce an insurance card. They would already start the script for the non-insured as I would be waving bills.

So I would say, I want to pay cash upfront for my treatment - and have bundless of 100s in my hands as I came to the counter...to head off 'the speech'.

[Calanen]

we should get rid of medicare, medicaid and social security.

Seems pretty harsh. I think that everyone should have basic health coverage. I worked a really good job in the USA, and I could not afford to seek medical treatment unless it was covered by my insurer. A dude working in 711 would have no hope. Is that a good way to have a society, that no one gets medical treatment until they are on death's door? Or at all? Do we want people driving to Mexico whenever they need their teeth fixed? Seems that priorities are backward.

I am all for user pays, but the cost of healthcare is so great in the USA, that realistically, no regular people could ever pay for it. I was on an attorney's salary, and I could afford the cost of my own treatment *for a while* but ultimately not.

[Kaapeli]

Finally, I don't believe any nation with working Universal Coverage system can boast low taxes or the low cost of goods and service that US can offer... I don't understand why US is trying to fix one of the appealing factors that draw such an enormous influx of labor from the Nations with "Free" Healthcare?

Of the Top-10 GDP per capita (Purchase Power Parity adjusted for the prices of goods and services) all but two (USA and Hong Kong) have universal healthcare. This includes the two nations that have higher GDP (PPP) per capita than the USA.
So you could reason from this that universal healthcare doesn't do much for the purchasing power of people.

[Calanen]

Universal health care surprisingly does not cost that much - here we pay an income tax of 1.5% for it. There are probably some top ups from consoldiated revenue from that however on top, but lets say its 3% - not a big deal. It would be even cheaper if they ran it better.

Doctors also hold the thing to ransom with very high rates. For public patients, you can knock the rates down a fair bit. They do it to the lawyers for legal aid recipients, and people still take the work.

People coming to the USA and not being in a position to pay for health care are taking the gamble that they wont need to. Problem is, we will all have to, probably at some stage.

[Calanen]

I for one am not happy with the mission creep that is our government. If I wanted to live in some neo-feudal, serf/lord relationship where I serve the whims of my master, I’d move to North Korea

My view is that these days, nearly everyone is living in neofeudalism. Gone are the days of capitalism proper, where in the 1950s and 1960s, your dad worked 40 hours a week, made a good enough living to own a house, 2 cars, go on occassional holidays and his wife did not have to work.

Now in many families they dont own their property, they rent, they may own one vehicle barely, both spouses have to work to even barely get by. They do not own their land anymore, which makes it more akin to feudalism than capitalism. People also have to work not 9-5 (unless you are in the Civil Service) but 8 - 7 or later these days as a minimum, as well as on weekends.

I really think you are already there at neofeudalism instead of capitalism. That's pretty radical I know, but Im still a right winger. Just believe in nationalism and the people more than I believe in the people being enslaved by corporations.

[Moledet]

Instead of testing there BMI, as you mentioned above (skinny fat), instead they should do a physical. That you can't lie, well not as easily.

There is no easy answer to the problem. I do think that the VA has a system that we should incorporate to streamline things and make it more efficient in order to reduce waste.

Also ever notice that it seems like medicine is more into making money than healing. People go on certain medications but its not a one time cure or treatment, its more instead of a life long use. But thats me just ranting.
I meant medicines that are taken by terminal cancer/AIDS patients in order to extend their life in a just a few more months.
The solution Israel found is that it tries to pay for most life extending medicines, those that aren't included in the list are being handled by a non profit organization that contacts the patients, and according to the number of patients interested it buys a large stock of medicines, this way the patients pay a lot less but still a lot of money.

[Violet Fashion by Mindy]

Personally I think the US needs a number of changes implemented into it's system because the way things are heading things are starting to up **** creek.

IMO a universal health care system needs to be implemented. This system will cover the basic ER's and provide the treatments for the poor. And a 2nd teir private system that people can choose to take out for the more selective type health matters.

Empoyers paying pension plans is also a big mistake the US went down. Although at the time it seemed like a good idea. But an idea that was not thought out to well. What they should of done was only make employers pay a percentage of a persons wage to a retirenment fund whilst they are working for them. Once a person leaves thats it.

The Australian superannuation scheme implemented by the ALP is a system of pure genious. At present employers pay 9 percent of a persons wage into a scheme where the money is invested and what not. Plus employees can pay additional funds. In the 15 years since Australia has had this scheme we have saved over 1 trillion AU for a persons retirenment. At present for a worker who started work after the system was implemented who earned an average of 50k will earn 20k once they retire. Combine this with pensioner discounts and what not and a pensioner should be able to live reletivly comfortably.

[Mastermind]

2-Sheds asks some questions that our "cradle to Grave" gvt is already attempting to do. This all started long ago in various States with the seat belt laws...then it moved to the motocycle helmet laws and then the "smoking ban" laws...although it started as a "safety" issue, it is now exactly as 2-Sheds questions suggest...that the Nanny state now has assumed it can demand we quit doing certain behavior because the state now has taken on the responsibility for paying for that behavior.

As the gvt takes on more of this responsibility, it is only natural it will demand more and more changes in personal behavior of it's "child" charges. Look how NY is banning trans-fat cooking oil in restaurants. So, what is to stop them from entering our homes and confiscating our ice cream and potato chips? Would it not follow they could demand we all have to pass an annual fitness exam..run a mile in 8 minutes, do 20 push-ups and meet weight to height requirements? What about mandatory daily gymnastics?

Sure, that all sounds absurd now...but, you know, I thought I would never live to see the State come into private businesses and tell them what they have to use to cook meals with or order restaurants to ban customers from smoking.

They do it with our idiotic blessing...well, after all...it is for our own good! MM

[annihilation]

order restaurants to ban customers from smoking.

They do it with our idiotic blessing...well, after all...it is for our own good! MM

I like the ban of smoking inside resturants and bars. It saves me a **** load of stinky clothing.

[Mastermind]

Yes...I also like sitting without some one puffing smoke in my area...but, it still is not the gvts duty to order such a thing....consumers should demnad it. For example, there is a reason restaurants generally ban people from entering without shoes or no shirts...how many times have we seen that sign "No shirt-no shoes-no service"? That is a restaurant ban...not a government ban. I am merely saying, the government has no business in my business!

For example..now, in Nevada, USA Restaurants and bars that serve food must prohibit smoking in their extablishments by Law. What if I wanted to open a bar/restaurant that catered strictly to smokers? That, by law is not allowed! And that is WRONG!MM

[Kaapeli]

consumers should demnad it.

We DO demand it. But still there are practically none. I have like 10 nightclub/restaurants within my range and none of them is non smoking. And this is even when majority of the population is calling for non smoking restaurants according to polls!
The problem is that smokers (and people who aren't bothered enough to boycott) make up so significant part of the clients that it's better business to let them smoke. Most non smokers like me will go to smoking restaurants because we simply don't have a choice if we want to go out.

I think cigar-restaurants/coffeeshops should be allowed also because they are a tradition. They could apply for a separate permit.

And the law around here will not stop restaurant smoking entirely. It will just require an airconditioned booth for smoking. I think that's a fair compromise, right?

[Moledet]

Yes...I also like sitting without some one puffing smoke in my area...but, it still is not the gvts duty to order such a thing....consumers should demnad it. For example, there is a reason restaurants generally ban people from entering without shoes or no shirts...how many times have we seen that sign "No shirt-no shoes-no service"? That is a restaurant ban...not a government ban. I am merely saying, the government has no business in my business!

For example..now, in Nevada, USA Restaurants and bars that serve food must prohibit smoking in their extablishments by Law. What if I wanted to open a bar/restaurant that catered strictly to smokers? That, by law is not allowed! And that is WRONG!MM
You can't do anything you like and say "f*ck society", selling drugs is banned. If some citizens want to do drugs why not let them?

There are certain implications of smoking on society as a whole, smokers kill many people every year (here it's about 7000 and we are only 7 million people) since this is the case there should be some restrictions on smokers. You can't ban smoking because unlike drugs it's rooted deeply in modern society but you should protect non smokers that don't always have the nerve to tell the smokers to stop smoking around them.

[Big D]

where I live the costs are thanks to illegals and white trash using the ER as a GP. Two weeks ago I broke my wrist in a car wreck and I was taken to the ER (cali law, airbag deployed so I had to be taken) where i waited for 6 freaken hours while the lady with a kid who had a fever was seen and given cough meds, or the mexican who had a kid who was barfing...these things are not what an ER is for... think about what ER stands for, programs like the ones proposed are not going to help, only drive up the cost higher and higher... [/Rant].

at Texas Children's Hospital, you always have to go through the ER, no matter what. so if your kid has a cough/fever/whatever, you are going to sit in that ER reception room for several hours. everyone has to.

edit: replied to wrong person.

[StukaJr]

Of the Top-10 GDP per capita (Purchase Power Parity adjusted for the prices of goods and services) all but two (USA and Hong Kong) have universal healthcare. This includes the two nations that have higher GDP (PPP) per capita than the USA.
So you could reason from this that universal healthcare doesn't do much for the purchasing power of people.

Considering that at least 3 Nations of the Top Ten have a shameful discrepancy between its majority of poppulace living below the Poverty level and a minority having unregulated control of most of the wealth - I really don't see how this PPP applies to what one would call "quality of living".

Lots of Americans will pay cash for their medical procedures outside of the country for fractions of what they would have to pay as part of their insurance co-pays and deductibles. It's predominantly the problem of US Healthcare industry cash cow being overly inflated and would quickly bankrupt the system if the Healthcare was all of a sudden given on the National Level.

[Mastermind]

You can't do anything you like and say "f*ck society", selling drugs is banned. If some citizens want to do drugs why not let them?

There are certain implications of smoking on society as a whole, smokers kill many people every year (here it's about 7000 and we are only 7 million people) since this is the case there should be some restrictions on smokers. You can't ban smoking because unlike drugs it's rooted deeply in modern society but you should protect non smokers that don't always have the nerve to tell the smokers to stop smoking around them.

I completely agree on the dangers of smoking and smoke itself...Clearly, this stuff is no good. I could even go so far as to say, since the market place did not take care of the matter, it was up to gvt to step in. However, I still detest the gvt interfering with private enterprise.

AS for the drugs...there we also have gvt stepping in on the individual. In Mexico, no one needs a dr prescription to buy drugs...yet, they have not had a problem with drugs for their people. It is the highly addictive drugs the gvt seems to want to regulate..yet, the most deadly and addictive drugs they leave alone...nicotine and alcohol...I don't understand that gvt double standard. Thus, it seems to me, I should be allowed to make my own decisions regarding what I want SO LONG AS I AM NOT HURTING ANYONE ELSE.
MM

[martinexsquaddie]

here in the collapsing socalist hellhole that is the UK sliced me hand open ice skating had it stiched up within 10 minuties of going to casuality did'nt even have chance ot sit down
cost nada not a penny.
brother whose a nurse reckoned the US system was great but way more expensive had lots more paperwork and very very wasteful while not covering everybody.
the NHS is far from perfect but everybody gets a gp and everybody gets hospital coverage

[ViktorNavorski]

here in the collapsing socalist hellhole that is the UK sliced me hand open ice skating had it stiched up within 10 minuties of going to casuality did'nt even have chance ot sit down
cost nada not a penny.
brother whose a nurse reckoned the US system was great but way more expensive had lots more paperwork and very very wasteful while not covering everybody.
the NHS is far from perfect but everybody gets a gp and everybody gets hospital coverageHere in the U.S., the demagogues aren't interested in fixing the wheel we already have. They're trying to reinvent the wheel at taxpayers expense.

[dacanadianbomb]

A typical corporate mentality though, realise we have been doing stuff wrong for years, now lets make sure we fix those holes, by making more mistakes, that we can repent on again in a few years.

[Moledet]

I completely agree on the dangers of smoking and smoke itself...Clearly, this stuff is no good. I could even go so far as to say, since the market place did not take care of the matter, it was up to gvt to step in. However, I still detest the gvt interfering with private enterprise.

AS for the drugs...there we also have gvt stepping in on the individual. In Mexico, no one needs a dr prescription to buy drugs...yet, they have not had a problem with drugs for their people. It is the highly addictive drugs the gvt seems to want to regulate..yet, the most deadly and addictive drugs they leave alone...nicotine and alcohol...I don't understand that gvt double standard. Thus, it seems to me, I should be allowed to make my own decisions regarding what I want SO LONG AS I AM NOT HURTING ANYONE ELSE.
MM
Nicotine and Alcohol are indeed dangerous drugs. Though, Alcohol exists for thousands of years in our culture and Nicotine for hundreds of years, they are part of our culture and we can't simply ban them. You already tried banning Alcohol, all it got you was stronger organized crime. It simply doesn't work.

[Calanen]

Even banning drugs really hasn't worked.

[Mastermind]

Even banning drugs really hasn't worked.
An excellent point. But, banning "illicit" drugs has managed to evolve a super-police force within an otherwise freee society. To give police the powers they need to stop something people gnerally want, the gvt has given them extraodinary powers they never would have gained if they were not going after millkions of people using illegal drugs. Their right to bash into my home wihtout warning, their right to confiscate my property without due process, their rights to spy on me, penetrating my privacy are all things they never were able to do before the so-called "war on drugs", They not only have extra-constitutional pwoers, they also now have a massive size, expanding their presence in our society expotentially since the 1950's. When one considers all the periferal crimes associated with the criminality of drugs, such as robbery, murder, prostitution and assaults, that have to be policed along with the illicit drug trade, we see there really is no end in sight to this police power expansion.

It seems the more they try to be successful, the larger the problem gets and thus they police must become ever more powerful.

For every law our law makers dream up, there must be an enforcement and thus another reduction in liberty.
MM