Yes, it's fascinating how for years the far right never had a kind word to say about Medicare, and now they are the Great Defenders of Medicare.

They are people without ideas, without any kind of coherent philosophy about health care. They have no vision of how health care is supposed to "work." They don't want government to pay for it (except when they do), they don't think employers should have to pay for it, and they don't think people have a right to it. If government and employers don't pay for health care, then it's up to the individual. But they have no idea of how that's supposed to work, except for "health savings accounts," that would be utterly exhausted in the event of even a moderate illness.

The GAO estimates a 50 trillion Medicaid Medicare obligation. As simple as it is to say, everyone who needs health care should get it, as many applause as it gets, no one has really answered the question of how we are going to pay for the medical care we have already promised a percent of the population. Either they control medical costs or we will go bankrupt as it is. And I assume that 50 trillion is without HMOs. Just a doctor or hospital to government transaction.

As for the right defending social security and medicare, they have to with the elderly population's voting habits much less and expanding retired population. Paying for 80 million baby boomers medicare will be like 100 million working people buying their retired parents all a house in the suburbs. Sounds nice, not so easy to do and have anything left after the mortagage and property tax.

Thank you for a smart and literate piece. I love the title of your blog - anything is possible!

Thanks, Annette; it has long seemed to me that when something worthwhile is thought impossible, people just don't try as hard. And in my experience, all the things worth thinking about and worth doing, are actually fairly well within the realm of possibility: the key factor is usually human will and how it meshes with human understanding.

WB, I understand your point on the coming wave of Medicare recipients. It's one of the few truly imponderable economic riddles of our time. However, it's not necessarily true that our only likely course is abject bankruptcy or naked social darwinism.

There are already too many people (one would be too many) literally losing their lives because the system is unable to provide care. The problem with a flawed system is that it so far hasn't seen the right fix(es).

The $50 trillion obligation, over time, is based on current standards in the American health services marketplace. Those standards of cost have to change. There is no two ways about that. An entire nation cannot be allowed to go bankrupt due to the disruptive and illogical cost models of a single industry.

Right now, fixing the cost crisis is as important as solving the uninsurance crisis, because if it comes down to wasting tens of millions of human lives and bankrupting the federal government or forcing everyone in the medical field to do more with less, any government, no matter how conservative, would opt for the latter. There are too many other fundamental values at stake.

Working now to heal the deep gashes being carved into the marketplace by exorbitant costs is the only way to prevent the problem of an unaffordable Medicare from getting worse. The private sector, under its current model, cannot and will not contribute to fixing the problem: they would cost even more.

It's a serious mess. While visiting my parents they talked me into a visit with their "fabulous" dermatologist, and since I had spent many years living in the tropics I thought maybe it was not such a bad idea. I have no health insurance. He found a skin tag that looked suspicious, sliced it off and sent it away for a biopsy. The rest of my body didn't get much attention. About a week later I received the bills, $450 in total. Thankfully no cancer but WTF! My father gave him a ring and read the good doctor the riot act, new bill was $75.

That was the last time I went to a doctor of any kind, oh except I did get a free mammogram last year because they let you do it with an anonymous system so that if you had something ucky you could try to get insurance and pretend that you hadn't gotten an ucky mammogram. Nice!

Tricare is a perfect example of government run medical insurance. It is provided to military members, their dependants and retired persons. We all pay a premium that is realitively small, in fact, very small. Active duty people do not have to pay the premium. This frees up the VA to treat the severly disabled and combat veterans. They deserve it the most. In my opinion it the best medical care available. Not perfect but exceptionally good care. If the government can manage this program they can run a public option. Our health care was supposed to be free for the rest of our lives but I am more than willing to pay for it. After all there is no free lunch.

Sorry I forgot to say I enjoyed your post. That is really what comments are for. Rated.

Great article, J.E.! Here's what I don't understand about the GOP and their doomsday rhetoric equating health care reform to the evils of socialism: If Republicans have it their way and we forget about health care reform we'll just continue down this path of driving up the national deb with increasing Medicare and Social Security spending. By the time 2040 rolls around we can all expect to pay 42% income tax just to keep the government functioning. That's somewhere in the neighborhood of a socialist state tax rate but the problem is that it won't come along with any of the benefits like schools that actually teach children and health care for everyone. Doesn't the GOP get it? Our current system isn't working. We're lazier, fatter, dumber and poorer than we've ever been. If we don't get over this fear of "socialism" and stop oversimplifying our politics we can kiss this republic goodbye.

That's a great point, dailyforeclosure: the GOP, whether it will admit it or not, is responsible for the current healthcare mess, if for no other reason than they have repeatedly sought to block the necessary reforms. Bankrupting the system will be a logical extension of much of their politics related to healthcare. And if they have their way, we will have those insane tax rates, but without the benefits of universal coverage.

Obama has not been a leader on this. He said it is up to congress.
In campaign he said single payer would be best but we cant do it. Why?
He said he wanted public option and backed off.

ali b: Obama has not only been the national leader in this debate; he is the one who laid out the basic principles and overarching policy goals of healthcare reform. He asked Congress to legislate within that framework, and five committees have crafted competing proposals.

The single-payer problem is as follows: it would require a wholesale revamping of the entire tax code, all employer-based benefits plans, small business management, hospital administration and would eliminate the very lucrative private insurance sector of our economy. Doing that could generate economic chaos.

Obama has always been a principled pragmatist, who wants social justice, but wants responsible reforms that can work, as well as possible without creating harm.

He has not backed off the public option. Though he has suggested something without the public option might pass, he has reiterated that he wants a bill that includes it on his desk by the end of the year. The House says they will not pass anything that doesn't include it. It's the Senate Democrats who have "backed off" the public option, but that's not final.

mishima - Her is a coherent argument hat maybe you an understand.
I don't really give a damn what you "think" the GOP wants. So I'll tell you what this conservative wants.

First of all lets call bullshit on this notion that Obama wants a market based plan. That what he is settling for now. He is on tape so any times during his political career saying clearly he wanted a "singe payer" or "universal" health care. So why don't you liberals quit lying to yourself s? It what he really wants and he would sign it in a heartbeat. And it is what must liberals want also and you are not going to get it. PERIOD.

As for medicare I know no one that wants to do away with it or thinks health care for the retires or the disabled was ever a bad concept.
I know plenty people that HATE gov waste of tax dollars. I had no idea how bad it was until Obama started telling me how mush waste there is. The is no logic that says I cant be against single payer or PO for everyone without still caring about seniors/disabled or even impoverished people for that matter. You just like to believe we are all so uncaring and evil and greedy.

I guess it is not possible in your mind that I could not want to get rid of medicare but at the same time not want it for everyone. I guess that gives you a headache. To me it is the basic principal of take care of yourself and the gov intervenes in the most minimal way; not the maximal way.
My patents are on medicare. Of course they want to keep it. If not for any other reason, they paid in to a program that made future promises. Same as SS. But at the same time they don't want medicare for me because they know I don't want it and there is NO reason right now for me to need the gov to provide for me.

A for a PO and a market basis, that is BS and you know it. They math is simple. If the cost for my employer to opt for a PO costs even a tiny bit less than my employer pays for my insurance, my employer WILL drop me. Period. It may take time but they will do it. And Obama gives me his smart ass answer of "they cant they compete?"
Well it is obvious, is it not. the gov can out compete anyone in anything if it wants to. Its called TAXATION. Obama is not stupid but neither am I. But he hopes people cant figure this out.

You know damn well I am right about the PO. Will Obama promise in his blood that the PO will be totally self sustaining and that if it is not he will abolish to. No way. He will simply raise taxes to pay for it. PERIOD. So it is a lie to pretend otherwise.

And how about that 35% tax on insurance companies just for doing business. Is that free market. Think about the stupidity of that. How can any business afford a 35% tax on what they sell. Not a 35% tax rate on profit. A 35% tax on the cost they sell a product for.
If you make a widget for $90 and sell it for 100 how can you pay $35 tax. How can an insurance company that sells a policy for $100 a month pay $35 dollars a month in tax off the top. Do you really think they make 35% profit. That will simply makes rates for private insurance go up by 35%. There is no way to argue otherwise. It is not possible to compete under those circumstances. But of course all you liberals understand this and you love it. Because it is what you want in the first place. Anything to get to your ends of universal health care.

So to answer you statement in a general way. "we don't' want gov to pay for things except for when we do". Well you are EXACTLY right.
There are many things that need to be paid for by he gov. And many that need not be.
Similarly some people need gov help with medical treatment. Most do not. You problem is you cant see the difference when it comes to heath care are any other social program.

Have you noticed that we have food banks and food stamps. But do we have nationalized "food" or even PO food? So I pay tax for this. Do I want it to go away so there can be a nationalized food for everyone. No. I am happy to pay tax for the hungry AND to buy my own damn food whenever and when I want.
Why cant you understand that conservatives can support a non corrupt medicare?

The GOP stance has never had anything to do with health care reform. Their lone goal is to take down Obama. They don't and never have cared about the Americanpeople in my life time. How 'bout yours?

Michael - you can believe that take down Obama crap all you want. I don't want to take him down I want to take his policies I don't like and shove them up his ass. He he quits lying to me and supports a sensible solution then I could care less about taking him down.
But there is only one say conserves. can take him down. And that is if he not only pisses them off but pisses of they approx.5% in the middle that voted to give him a chance. Well he is playing right on the edge of those peoples nerves. Middlers are smart educated people that were willing to give him a chance. They are smart enough to hear his double talk and DONT like it. They can read between the lines of Obamas BS and they are insulted .

When speaking about CIA investigations he says no one is above the law. Well no one except Mr. Ghietner.
8Billion dollars slated for ACORN but Ibama says he has no idea they get much money. 8 B is a sizable portion of the stimulus and he knows nothing bout it. My ass.
Obama i s going down because he is lying and manipulating the few people in the middle that make the difference in an election and they re pissed about it.

He is done soon.and the congress sooner.


d

Joseph Cole, I'm guessing you're a doctor, based on your use of the word "patents" in a way that suggests "patients". First of all, let me say, the level of anger is over the top. Second, let me say, for someone who doesn't want people assuming anything about conservatives, you're making a tone of wild assumptions about the motivations of people you're laying into, including the president.

Third, the public option (PO, as you say) is not what private insurers or those doctors and hospitals who fear it will undercut their income levels have made it out to be. The legislation is clear, and the president has been clear. The exchange itself is oriented not toward everyone, but toward those who can't buy insurance any other way.

The public option, specifically, would be available not to everyone with the need for cheap insurance, but ONLY to those that no private plan and no government plan (like SCHIP or Medicaid) will cover. There is NO RISK of the PO stealing people out of employer-based insurance.

The real risk to insurers' bottom lines would come if they failed to participate fully in the exchange, which would make it harder for them to capitalize on that opportunity to expand their market by winning new customers with lower-cost, higher-benefit plans.

The purpose of this, if you are a doctor, is to change insurance company behavior, to make sure they actually pay you more.

As for Medicare: Medicare itself is not a giant waste of government money. It's necessary, because in the time before it existed, seniors would routinely be left without treatment, dying with untreated brain aneurisms, untreated arterial sclerosis, untreated dementia, untreated cancer, literally languishing in low-rent end of life facilities or at home, dying in agony.

Cost was the issue then as well. Medicare has over the last 40 years done wonders for that population, and has allowed us to be a little prouder as a nation about the way we treat our seniors. It has prolonged lives and raised quality of life for millions and has allowed seniors to remain active longer.

It's not a question of "I take care of myself" versus "I waste taxpayer money"; it's a question of who will pay for everyone else's older relatives. The fact is, decent as most people are, most people won't pay for all the expensive care older people need. That includes employers, who in the last 20 years have begun abandoning their contractual obligation to pay pensions and lifetime health costs.

Medicare is not something you buy into and "earn", it's something you get because you're a human being and we've decided that people should be treated humanely when they're old and infirm. Despite being a doctor who looks out for number one and "doesn't need it", you'll get it, because you're a human being, a citizen, and worthy just for that reason.

The problem of waste is to do mostly with cost distortions, subsidies to private insurers and fraud. In order to cut the cost of Medicare, one party (that likes to be "fiscally conservative" on programs that do good work but spend wildly on war) has consistently sought to cut the number of administrators and regulators that can make sure Medicare is not defrauded; the result is hospitals and other medical institutions often file requests that are fraudulent in subtle but meaningful ways, billing for two items when only one actually was provided, for instance a test and a treatment when only the test was given and the patient is out getting the treatment elsewhere.

That has become routine in the Medicare billing system, because there's no easy way to oversee it. Electronic medical records will help with this, because it makes it possible to easily cross-check, and an EMR-enabled billing system can catch such "errors" before they are sent on for reimbursement, stopping fraud at the source.

Another major area of waste are huge subsidies that are given to insurers, essentially to bribe them to provide affordable supplementary insurance to the elderly. Numerous economists have said for years that those subsidies are a huge waste of money, hundreds of billions of dollars of taxpayer money, that actually produce nothing, because the insurers should respond to the market incentive to offer new plans anyway.

Whatever your ideas about Obama or Democratic political philosophy, the fact is, Obama has pushed this Democratic Congress to come up with the MOST market-based healthcare reform solution ever proposed. The public option does not infringe on this reality, but actually reinforces it.

If we look at the healthcare market, we have high-end and low-end customers. At the high end are the wealthy, and the well-employed, whose benefits packages are out of this world and cover everything. There are even some who cannot be dropped for pre-existing or chronic conditions. These are the lucky few.

In all, only about 35% of the population is actually covered exclusively by private insurance. Across the entire spectrum, we have Medicare doing its part to cover the elderly. The benefit of this is universal; everyone in the system benefits from the fact that Medicare patients will not have their Medicare coverage dropped. The whole system would collapse if those tens of millions of people had to fend for themselves, because out of control costs mean they simply can't have earned in their lifetime enough money to pay for the care they need.

At the low end of the income ladder, we have people who are too poor to find insurance of any kind other than Medicaid, which covers the poor. SCHIP covers poor children. There are people in the military who would not be poor enough for Medicaid but could never afford private insurance, and they have insurance through the government. After their service, they may have VA.

This leaves all the people who have to fend for themselves. Most people cannot buy private insurance on the open market. Because insurers refuse to offer anything within their budget. Literally. Refuse is the correct term here. There are at least 52 million, probably more, after a year of layoffs, who have ZERO coverage of any kind.

Remember, private insurers cover only about 35% of the population, and they don't WANT to cover any more, because they see the rest of the population as too poor or too "risky", in terms of need for health services.

They can say they desire a market where everyone can pay an arm and a leg for coverage that gives them nothing in return and drops them as soon as they need care, but that market will never materialize, because people are smart enough not to keep throwing their money down the drain.

This, frankly, is why many people support a single, national system for handling reimbursement, aka "single payer". What people fail to understand, due to inflamed ideological rhetoric and emotional reactions to keywords, is that most single-payer systems, like France, for instance, actually have a very competitive, very vibrant healthcare marketplace, where major research, major drug innovation, major scientific breakthroughs are all possible, with corresponding megaprofits, and where doctors are also part of an open market, and do very well for themselves, are significantly wealthier than the average citizen.

Single payer is not anti-market, it's anti-insurance-market, and it comes about, in every case, because insurers have refused to continue meeting their obligations. Period.

The reason Obama is not going that road with his framework proposal and has demanded a market-based solution, is that the goal is too pressing to do something that requires such a massive overhaul of the system, and he has to compete with the insurance lobby, which would spend relentlessly to stop such a change.

In order to stop the healthcare cost crisis from bankrupting the government, thousands of businesses, millions of families, and the economy itself, costs need to be reined in, and that can only happen once the system securely insures everyone.

Looking at the income ladder, a few paragraphs above, where the wealthy and the well-employed have total coverage with relative security. Others have good coverage with less security. Then Medicare, Medicaid, SCHIP, the Defense Dept. and VA cover many millions more (47% of the population among them), we are left with about 17% of the population (52 million people) who cannot get insurance of any kind.

The proposed reforms would bring some of those people into private insurance, through the low-cost exchanges, and would expand the reach of Medicaid for some more of them. This would still leave anywhere from 1% to 5% of the population with no insurance. For those people, a "public option", meaning simply a plan that is legislated, government managed, non-profit and self-sufficient, which is low-cost and will not drop anyone, to handle reimbursements.

It is not an NHS, and it is not a takeover. It's just an option for that last segment of the population for whom no other option is made available by the private sector. Insurers would be free to offer competitive plans.

As a doctor, you would benefit from having this vastly expanded marketplace from which patients (clients for you) might emerge, actually able to pay their bills, stabilizing your revenue flows and guaranteeing a more steady clientele. What about that makes you so angry?

As it stands, private insurers are only willing to cover about 35% of the population, but as they force people out, by denial of care or massive cost increases, that population is shrinking by the day. You say most do not need government help with medical care, but in fact, as things stand, unless these reforms go through and insurers are driven by market conditions and new regulations to provide better low-cost no-dumping plans, most do need that help.

Absent that help, costs are defrayed by massive price increases that are paid through the private sector, by everyone else who does have insurance. And Medicare is not corrupt; people who seek unfairly high compensation from it are corrupt. Start a movement among your peers for more ethical billing, better adversarial action against stingy private insurers, and in opposition to parasitism by private insurers who seek to extract money for nothing via Medicare.

On two other points: 1) the Republican party has consistently fought to strip funding from Medicare; it is proposed every year, and 2) food stamps are "PO food".

The reforms under consideration are in fact market-oriented. They aim to use pragmatic solutions to achieve the best fix possible for a broken system, in a way that would strengthen the logic of market dynamics in the healthcare system.

Right now, private insurance in the US is an anti-market (driving up costs and eroding product quality — not the care, but the access to care, the reimbursements); the reforms aim to return our system to market dynamics, which lower costs and increase quality.

Also, Mr. Cole: on the question of wanting to kill healthcare reform to "break" Obama, this is a statement that has been made by numerous Congressional Republicans. Over 160 Republican amendments have been added to the 5 bills under consideration, and yet not one Republican has voted for them, and they continue to falsely claim that there has been no effort to listen to their ideas. THEIR IDEAS ARE BEING INCLUDED. Their no-votes are partisan and have nothing to do with favoring a different kind of reform.

(Their "voucher" idea and their "tax cuts for everyone" idea can't fill the gap, not even halfway; they are not serious proposals, which is why the Republicans themselves never passed them in their time dominating both houses and the White House.)

As far as stimulus money and ACORN: ACORN doesn't get billions of dollars. Not one dime of stimulus money was "earmarked" for ACORN. In fact, the ARRA was the first major piece of legislation that didn't have a specific entity earmarked to receive funds. The billions that might go to community-level projects could in some ways have ended up seeing ACORN involved in some level of community outreach, which is what they do, but that's not a billion-dollar enterprise. There's no stimulus-ACORN connection.

JE - I am not a doctor. Actually I am a very ill patient. I am simply a bad typist.
Yes is is clear you and may are anti insurance. That is the whole debate isnt it. I also clearly said I had no problem with medicare except for thr fraud and waste. And of course as usual that I see here you answer none of my questions directly. You simply refuse to accept that the gov can use the PO to simply out compete any insurance company if it wants to. You trust tho gov not to do that.
I don't. Why should I. Obama, liberals and even you just told me it is what you want. So why should I believe that it wont come to pass. Obama has lied more times than I can count. You don't care because you want his lies to work for your end. I don't want his ends.

As for legislation and what it says, what legislation are you talking about? Which one. What was Obama referring to to congress last week when he kept saying "this" legislation. Which one is "this".
There are many. The latest one has now lifted the 35% tax to 40 % and includes no PO. If there is no PO then where is the 40% tax going to.

Also you seem to confuse a moral imperative of medicine for seniors (which I agree with ) with the implementation. It is not a service that everyone receives like nation defense even if they never paid taxes in their life. It is a specific tax paid by everyone earning an income with a promise for medical care in return.
That is the difference from single payer which get all the free medicare you want even you you never paid a penny for it.

And you fail to address my argument about other basic services.
People need food clothing and housing. We give that to people who need it. But we dont put everyone on food stamps and in a gov house do we? Why is medicine different.
Ill say it one more time. If you cant afford it, then fine for the gov to help. If you can afford it, then pay for it.

If I sound angry it is because people here seem so hard headed. I have a best friend tha is leberal ans wupporst most of Obamas policies. I walk with hime every day. We have friendly arguments but not angel. Why? Because we both listen, we don't spin to each other because we both are to smart to buy it. When I tell explain to him how the PO could out ultimately out compete and insurance company and motivate employers he can see that. He may actually like that fact but he doesn't deny it. When I point out that Obama recently magically changed the uninsured number from 46 million to 30 he doesn't really care but he recognizes it as clever wording to achieve his goal.

As for ACORN, you miss the point again. The point is not exactly how much they are getting or technically if goes through ACRON or not. the point is Obama lying. He said is is not paying attention to whether they are getting a lot of money or not.
Bullshit he is not paying attention.
I doubt you believe all Obamas spin or lies. You just don't care.
Anything to achieve your end.
Well time will tell. As I said, most here will support anything he and liberal congress want. Most conservs. wont. But the middle is who matters. And I say it again, it is a small % in the middle that only need to change their mind to oust the liberals in congress.
And I happen to believe the middle pissed.

Joseph, Thank you for clarifying that you are not a doctor. I'm sorry you're ill and please don't think for one minute that doesn't matter to me. I myself have chronic health issues that are challenging, but liveable, and I have cared for someone dying of terminal cancer and seen first hand how the system works, or doesn't.

I care. Believe me.

On this point that you make: "I doubt you believe all Obamas spin or lies. You just don't care.
Anything to achieve your end. "

You are making unfair assumptions, and you are generalizing. Any politician might say things in language meant to make their own policies more appealing, but Obama is not lying about healthcare. The one thing that irks me is the 30 million number. He's actually saying "over 30 million", because he's trying to get the number right when he says "American citizens". This is based on the problem of there being roughly 52 million officially recognized as uninsured, with many suggesting that anywhere from 12 to 18 million might be undocumented immigrants.

To avoid including those 12 to 18 million, he now says "over 30 million Americans". My analysis suggests the 52 million does not actually include undocumented immigrants, but this is something no one in Congress or in the news media seems very clear about.

On the issue of, as you say, showing what I want: I don't have any ideological agenda. I don't want government to run everything; I'm not laissez-faire. I just want things to work, I want a fair system, where democracy is what governs and where people are able to make responsible choices for themselves. In the current system, a very distorted insurance market keeps us from living in that kind of system, at least as related to healthcare.

That's a position, sure, and I acknowledge holding firm to that position, and I think change has to happen, and it has to alter the way insurers do business... but it doesn't have to box them out and it doesn't have to force anyone to change insurance plans.

My explanation of the public option is not about spin or about being duped by spin. I understand the logic of the claim that a government-backed plan could out-compete private plans. Indeed, it is designed to do something they can't or won't. But it would only apply to a specific subset of the population that has no other way of buying insurance. And, it would be self-sustaining... it would not draw on massive government spending to out-compete anyone. It would simply have to do more with less. That's good for everyone, and it won't eat away at the private insurance markets the way some ideological opponents of the plan claim. They're either more afraid of that eventual possibility than they are concerned with the facts, or they're just misreading the proposals.

On Medicare... you suggested that fraud and waste is what irks you and that you agree it's a good program, in theory. As far as what specifically will be done to do better with fraud and waste, all of those specifics are in the 5 various proposals pending in Congress.

And, I'm sorry, but I believe that if you start paying taxes at age 64 and become eligible for Medicare one year later, you will receive Medicare just like any other eligible senior. It's not a savings account, not an investment account, not a retirement account. It's a social safety-net. Yes, you pay a tax to help fund it, but that's not what guarantees you get it; it's your humanity that entitles you to it.

I'm not proposing Medicare for all, and I'm not specifically proposing anything... I'm just explaining the realities of the debate. My hope is we will stop putting ideology before people and get this unconscionable crisis fixed so people don't have to keep suffering the way I've seen people suffer who can't afford care.

JE - you started your post my being critical of conservs. because they want to preserve medicare. You were sounding if now they were being hypocrites. I was simply was pointing out that one can support social programs for some without the same program for all . And I don't think too many people start their first job at 64.

As for the 30M number of course is was changed to exclude illegals.
The point is Obama did not say why it changed. That is spinning.
It was obvious to me what it was. In fact he all but said so. I have listened to many of his previous speeches. His exact words in the past have been "46M uninsured Americans" . In the speech to congress it was "30 million American citizens. The key point is he for the first time said "citizens". He and his writers chose their words extremely carefully. And while the congressman was out of line to disrupt the speech in the halls of congress, he later explained that either the house or senate, I cant remember, explicitly voted to exclude language to require rigid citizenship verification. So did Obama lie in the speech; no. But why did he not tell the whole truth.
We all know that lack of verification is a damn near guarantee it will happen. Maybe you call this political language. I call it hoping it will fool some of the people. It is not honest.
Do you accept that kind of double talk in your interpersonal relationships with your closet family and friends?
Then why should the people accept it from Obama.
You did agree the the PO could unfairly compete with private insurance, but it will be contained and limited. The difference between you and I is that I don't trust Obama or the liberal congress to not violate that.

Obama had a chance to at least moderate my feelings, but he did just the opposite. days after in office, I saw him on TV talking to his staff and promising an ethical administration. And he immediately violated it by putting Geithner in. Why could he not stand on principal. Geithner was not irreplaceable.

His spin on non taxation also disgusts me. Does it not insult you that he will tell you no raised taxes on you, but he is taxing everyone you buy things from which will cost you. technically not a tax but it is costing you and me. And even worse costing people that otherwise might not pay any or very little tax. take a low income tax employee who gets insurance via employer insurance.
This 40% tax on insurance companies will have to cost that person more.
Same for cap an trade. these end up being what liberals hate most. Regressive taxes.
My issue with Obama is not just that I disagree with his ideas, but that he is misleading people about his ideas. I just want honest talk.
And he is not being honest. I simply don't believe his promises.
I also predict that when insurance gets to expensive, he will raise my taxes to put people on PO for no charge. I think that when energy skyrockets and we determine that the poor cant afford it (and rightfully so) and I will not only pay my skyrocketing costs but for others also. Again the issue is not only that I don't like that, but more that he wont say that this could be the likely outcome.

I am an engineer. Why i debate designs with my colleges, we don't intentionally spin and hide what we know could be unintended consequences. In act we freely acknowledge them. We approach everything as if it is mostly right in the first place but always look for the flaws. I want the same from Obama. We all know the goodness of medical care for everyone. So why keep shoving that down my throat like I don't know it or don't care. Why not take that for granted and tell me it is complicated, and we should take all the time necessary to really figure it out. Not just to satisfy everyone ideologically, but practically and economically.

Obama could win my respect by doing one very simple logical thing.
He could do some kind of emergency coverage for everyone that is uninsured at the moment. It could be a combination of a lot things.
Subsidize COBRA (already doing), use TARP money, use stimulus money, declare an emergency like a Katrina. My point is go ahead and spend some tax dollars to cover the needful for about a year.
In the mean time he and congress can earn my trust. Him by finding that medicare fraud money that he claims is there and can pay for a lot of this. Set up a task force to put a lot of crooks in jail.
He can also make a simple statement to the public.
And congress can earn my respect by actually slowing down, listening to each other and the people. and getting really smart economists and people in the medical billing, insurance and medical profession to find a true solution designed by experts not politicians.

If Obama did this I think I would not need insurance. I think I would drop dead of a heart attack right away.

It's funny, because so much of what you wish Obama were doing, he is doing. For instance: "And congress can earn my respect by actually slowing down, listening to each other and the people. and getting really smart economists and people in the medical billing, insurance and medical profession to find a true solution designed by experts not politicians."

This spring, Pres. Obama called together over 60 different stakeholders, including Congressional leaders, economists, patients' rights advocates, doctors' advocates, pharmaceutical and insurance company advocates, hospital administrators, etc., and asked them to begin discussing the pros and cons of specific reform ideas.

Orrin Hatch was at the table and said it was the most important summit ever held to discuss meaningful healthcare reform. It was out of those discussions that Obama crafted a framework for Congress to base its reform proposals on.

About the tax on expensive health plans and/or medical device companies: that is Max Baucus, not Barack Obama. Obama consistently opposed this idea throughout the presidential campaign, while John McCain promoted it. McCain, however, wanted every single plan, no matter how cheap, to be taxed, as income.

The only reason that idea is in the Baucus bill is because the Republicans have consistently demanded that employer-based plans be taxed as income, preferring such a tax, that would include people who have union plans, to one that increases the burden on capital gains.

Pres. Obama never lied about taxing the middle class. He always said he would raise taxes (by reversing Bush's tax cuts) on those who earn over $250,000 per year. That has been pushed back by the recession. And the number one opponent of taxes on health plans that middle class people have has been Obama.

When talking about or trying to identify spin, one has to be extremely careful not to fall into the intellectual trap of assuming that Obama's opponents are NOT spinning.

As far as listening to other people's ideas: why do you think Obama asked Congress to craft the legislation, instead of dictating to them what they had to pass? He gave them a framework, with goals and principles, and so far the Democratic Congress has added 160 Republican amendments to 5 bills, none of which have won Republican support.

On the issue of whether or not conservatives like Medicare, what I said at the beginning of the article is: "The most aggressive argument Republicans are now making about healthcare reform is that it would allegedly "gut Medicare and Medicaid", two government-administered health insurance programs that provide treatment coverage for the elderly and the poor, respectively. The irony that emerges from the incoherent oppose everything Obama wants strategy being used by Republicans, shadowy front groups paid for by individuals linked to the insurance lobby, and conservative PACs, is that they are actually now arguing in favor of 'socialized medicine'."

I am not referring to you and to conservative citizens, I am referring to the Republican party, it's political leaders, and I mention "conservative PACs", political action groups that are essentially strategic rhetoric engines for the Republican party's agenda. This is about how they are strategizing to spin and to attack Obama, not about what you personally believe.

And that's exactly the point... there's nothing particularly "conservative" about what they're doing... they're just spinning and lying in order to kill legislation that they don't want to pass, and they don't want it to pass, because they want to hurt Obama and use failed healthcare reform as a springboard to win seats in 2010.

This is not a mystery; I'm not inventing this. Every major Republican party strategist says the same. The point I'm making is that the spin became totally logically incoherent, when the same individuals, elected officials and/or political propaganda groups, that have overtly and very vehemently opposed Medicare (however much you like it, some ideological Republican officials really do dislike it and do actually fight to eliminate it) are now saying that Obama's planning to take away people's Medicare.

They're lying, of course; he's not. And they may not really care if he did, because in the past these individuals have not been fans of Medicare. But the point is they are simultaneously arguing against what they erroneously call "socialized medicine" (the PO would not be that) by arguing that Medicare should not be cut or trimmed or fixed, its too dangerous (and Medicare is what they call "socialized medicine", even though really, its just socialized insurance and the Medicine remains market-based).

The problem I'm pointing out, other than unscrupulous spinning and logical incoherence, is that this undermines the Republican party's future efforts, and there will be future efforts, to talk against anything resembling Medicare. Because, in order to make Obama look bad, and in order to sell the lie that he's trying to kill Medicare, they're talking up the virtues of Medicare, something that runs fundamentally contrary to their larger rhetorical argument.

It is an interesting theory you have when you say that Obama has framed all of the debates. If he has, well, I have to say he has done it subtly and deftly - for the Republican noise machine has blown longer and harder than anything out of the WH.

Obama is pacing himself. All he originally suggested was the need for healthcare reform - he then kept mum for months. It seems to me that by waiting out the initial emotional noise that first came with the suggestion of health care reform, the WH is now able to lay out arguements that even angry voters might listen to during the lull afterwards. I've noticed good ideas tend to take longer to grab the publics attention.

I do agree that the Republicans are sending contradictory messages over the airwaves. Sure the smart people will clue into this quickly, but it may be a pleasant surprise when the laggards also clue into the inconsistencies. In this sense, the risk of attacking FOX for misleading coverage may draw dittoheads and hardcore FOX viewers into briefly listening to outside sources; surely a positive for Obama (note how the WH waited for the worst noise to be over before calling out FOX). Angry people can only stay angry for so long - and can only be feared for so long before they are spurned.

Despite what may appear as smart strategy, Obama still has to contend with Congress. I don't see any voting group larger than reconciliation passing the bill and there is a good chance that bad legislation will be pushed along with the bill.