I also wish to point out I referred to Gingrich after 1998, not ’94; in 1998 (the election post scandal/impeachment) the Republicans were expecting a landslide and actually lost seats.

http://www.nightcitytrader.blogspot.com

Which brings me to the psyche of Americans. Middle America does not support the huge expansion of government in a way that is acceptable across the board in New Zealand. Obama is moving too far away from the political centre – Clinton tried it and was spanked. Obama will suffer the same fate unless he moderates.

Your notion that the GOP have shot their wad is ludicrous as is the comment that Gingrich was a nobody right after the 94 takeover. The Republican Congress worked well with Clinton who moved to the centre and enacted excellent fiscally sound policies that ushered in welfare reform and balanced the budget.

“Health care can only be addressed through a bipartisan process”
Any enduring policy is best addressed through a bipartisan process. But just because that is best doesn’t mean it happens. Plenty of enduring policy gets done through partisan processes – again, witness in NZ some of the changes that recent governments have introduced – the EFA, purchase back of NZ Rail, Kiwibank creation.

A big factor here is whether it is possible to have bipartisan policy. That would imply compromise from both sides, and I see no evidence of either party compromising. You also seem to be suggesting that the Republicans should mostly compromise because the Democrat policy is somehow self evidently good. I don’t see why they would – what is the benefit for them in doing so?

“if the fundamental flaws of corporate greed and selfishness are not addressed soon, Americans will continue staring down the barrel of below-average health care and unsatisfactory responses.”

This bit I don’t agree with at all. There are too many value judgements loaded into that statement to make any sense of it at all. What fundamental flaws of corporate greed. What is wrong with selfishness? Why do we think that it is impossible for a privatised system to deliver above-average health care? What unsatisfactory responses are you trying to resolve?

The issues I see with healthcare in the US at the moment I don’t believe require any nationalisation of the health system so as to be dealt with. The problems I see are uninsured people, high costs, and large disparities in access. Some of those problems are endemic to any health system, for example, in most health systems there is more demand than supply. If you believe in basic economic theory, this would suggest that the price is, in fact, too low – if the price was higher there would be more supply.

In terms of uninsured, we need to divide into categories of people:
– self insured: no problem
– too poor to insure: this isn’t a health system problem, it is an income problem. Should be dealt with through the welfare or tax system
– moral hazard – engage in behaviours that make them too expensive to insure. This isn’t a real problem, these people should change their behaviour – I see the NZ system as a failure in this regard as it doesn’t give price signals to people regarding their personal behaviours.

In terms of high costs, much of the cost is driven by the structure of the industry, the laws that forbid proper competition, the laws that reduce bargaining power of the consumers, and laws that restrict supply (some doctor registration is necessary, but many professional bodies are also artificially introducing scarcity through inappropriate restrictions), and the tort and legal system that encourage massive settlements against doctors.

None of those require govt intervention through public provision – in fact, many of them require reduction of govt intervention. To be fair, a part of the corporate system (as opposed to the capitalist system) is the rent seeking behaviour of large corporates and powerful industry lobbies (including the lawyers) – facilitated by politicians seeking donations or votes. But public provision isn’t the right answer to political weakness.

In terms of disparities of access, most of those are driven by income or by stupid laws that prevent, for example, cross-state competition. Fix those, you fix much of the problem. The remainder you deal with by encouraging providers to offer a “bare bones” coverage that provides an equivalent service as what we get in somewhere like NZ. Make sure that welfare payments and minimum wages are sufficient to allow everyone to purchase one of these if they want it. Done.

Unlikely, he’s already committed to pushing immigration reform to legalize 10 million illegal migrants, even though it will accelerate the US’s path to 2nd world status.

“Before detailing some of those analyses, we should recognize the importance of this question. If we were to discover that, say, Slovenian immigrants did not assimilate over several generations, there would be little cause for alarm. There are simply too few Slovenian Americans to change our society in a meaningful way. Hispanics, on the other hand, have risen from 4 percent to 15 percent of the American population since 1970. The Census Bureau projects that, if there is no change in immigration policy, 30 percent of the nation will be Hispanic by 2050. To avoid developing a large economic underclass, we need to confront the question of whether they will assimilate.

The children of Hispanic immigrants (the second generation) actually stay in school much longer and earn a considerably higher wage than their parents. In fact, the Hispanic rate of assimilation from the first to the second generation is only slightly lower than the assimilation rate of more successful groups of immigrants. Most second-generation Hispanics make up nearly as much ground as the children of European immigrants would if they grew up in the same disadvantaged situation.

But the good news ends there, and two problems arise. First, the second generation still does not come close to matching the socioeconomic status of white natives. Even if Hispanics were to keep climbing the ladder each generation, their assimilation would be markedly slower than that of other groups. But even that view is overly optimistic, because of the second, larger problem with Hispanic assimilation: It appears to stall after the second generation. We see little further ladder-climbing from the grandchildren of Hispanic immigrants. They do not rise out of the lower class..

The consequences of a large ethno-cultural group’s lagging behind the majority in education and income are significant. In strictly economic terms, perpetually poor immigrants and their descendants will be a major strain on social spending and infrastructure. Health care, public education, welfare payments, the criminal justice system, and programs for affordable housing will all require more tax dollars. When pro-immigration conservatives declare that these government programs should be scaled back or eliminated entirely, I am sympathetic. But a large public sector is a reality that cannot be wished away — we will not be abolishing Medicaid or public schools anytime soon. Immigration policy needs to take that reality into account. ”

http://nrd.nationalreview.com/article/?q=YjQ4N2EyMTQ4NzZjZmNlOWQwN2RiNTZjMWZiZDY4YzQ=

We shall see what happens in November 2010 but unless the Republicans gain 8 – 10 Senate seats and 60 in the House the bubble will burst in my opinion (rather like it burst on election night 1998 and saw Gingrich washed away within days).

http://www.nightcitytrader.blogspot.com

“Health care can only be addressed through a bipartisan process – if the fundamental flaws of corporate greed and selfishness are not addressed soon, Americans will continue staring down the barrel of below-average health care and unsatisfactory responses.”

Do you agree with this or not?

If not, why not and what is the preferred alternative?

As much as I appreciate your response I believe it centered more on the factors I presented and not on the core argument of whether or not you agree that bipartisan support is the only realistic way forward in passing these health care reforms safely.
As for my assertion on universal health care agreement – forgive me for not specifying what I meant by this, it referred to the bipartisan agreement between Democrats and Republicans that current US Health care is in dire state and requires urgent attention.

American Infant mortality statistics – http://www.cnn.com/2006/HEALTH/parenting/05/08/mothers.index/

All in all I value your constructive criticisms and corrections and vow to consider them in future posts, as for Hurf Durf – please ignore her completely. We clashed earlier on and she seems to hold grudges a lot longer than normal people do around here.
I don’t appreciate being placed in a box based on very little information – it verges on the line of ignorance and narrow mindedness and it will not be tolerated.

Kind regards

As for dead peasant insurance – not sure what that is. Derivatives I know a reasonable bit about, and they aren’t a money making scheme. They’re simply a promise to buy or sell something in the future. So when you’re a farmer starting to lamb in June and I say to you “I’ll give you $50 for a lamb at Christmas”, that is a derivative. The price might go up, it might go down, so one of us will make or lose money come Christmas. However, odds are that as a farmer, if you think it will be worth $55 at Christmas, you’ll give a bit of a discount to guarantee the sale in advance. And, as the buyer, I’m happy with a bit of a discount coming to me because I made the commitment early. Derivatives in action – and as my example shows, they are actually valuable to both parties (willing buyer, willing seller). But it doesn’t sound quite so exciting when I personalise it – hard to demonise normal people going about their business.

but seem to think that it would be preferable that we all be poor

I doubt there is many in this category. Sure, the poorest are nowhere near as poor as they were less than a century ago, but the wealth gap keeps widening and that has been shown to be unhealthy too. There is a heck of a lot of unproductive money making. It may just be a natural cycle of civilisation, where the top end becomes so bloated it eventually self implodes.

As for the Republicans health care plan – not a big fan of that either. I was OK with Mitt Romney’s plan – which dealt specifically with the uninsured without destroying the health system for the rest of the population. And I strongly believe that the current legislative limits on competition in the health care industry should be lifted. It is ludicrous to produce a govt funded insurance scheme to supposedly deal with competition when the federal law is one of the largest barriers to competition.

Well it’s only anecdotal but as someone who has consumed health care in New Zealand, Australia, UK, China, Italy and the US, the US is so far ahead it’s not like they are even in the same game.

Where the House Democrats’ bill would expand coverage to an estimated 36 million of the uninsured, the Republican alternative would cover only 3 million, leaving the same proportion of the population uninsured as now. And while it’s fair to criticize House Democrats’ legislation for not doing enough to control the growth of health costs, the Republicans’ version does even less and takes some steps in the wrong direction.

http://www.washingtonpost.com/wp-dyn/content/article/2009/11/08/AR2009110817875.html

Profit and greed are the drivers of the capitalist system. The most effective system ever devised by man for creating wealth. There is a reason that America is so damn wealthy.

US wealth is very unevenly distributed. The richest 1% of the American population owns as much as the combined wealth of the bottom 90% (http://en.wikipedia.org/wiki/Distribution_of_wealth).

The US has become driven (and possibly will be driven into the ground) by capitalist gambling on a huge scale – crapitalists. They have money making schemes like derivatives and “dead peasant insurance” that do nothing for productivity – they simple relocate more wealth to the relatively few who are rich.

1. WHO is not an authoritative source. As you say, they are mostly ranking on “fairness” and “access”. I explicitly ignored those in saying “those who have money or access.”

2. Infant mortality is “no doubt” highest in the industrialised world. Hmm. Was your argument not strong enough without making things up? I usually find that adding weak arguments tends to make your overall case weaker, not stronger. Logically it shouldn’t, but it does.

3. At least 15% of the US population is completely uninsured. I quote from the wikipedia article you presumably used for this claim “It has been estimated that nearly one-fifth of the uninsured population is able to afford insurance, almost one quarter is eligible for public coverage, and the remaining 56% need financial assistance (8.9% of all Americans).[8] An estimated 5 million of those without health insurance are considered “uninsurable” because of pre-existing conditions.[9] A recent study concluded that 15% of people shopping online for health insurance are considered “uninsurable” because of a pre-existing condition, or for being overweight. This label does not necessarily mean they can never get health insurance, but that they will not qualify for standard individual coverage. People with similar health status can be covered via employer-provided health insurance, Medicare, or Medicaid.” http://en.wikipedia.org/wiki/Uninsured_in_the_United_States

Sorry, people who are too fat to be insured I don’t see as a problem. One quarter of them are eligible for public coverage already. 20% can afford insurance and choose not to have it. In short, that 15% is a large overstatement.

4. There is not universal agreement on anything anywhere in the world. That is a strong claim. More importantly, of those who do agree there are flaws, I doubt there are even a majority that would agree on one particular set of flaws. Witness that they cannot get a majority in the Senate for reform. Some people think the flaw is a distorted market, particularly through govt involvement in Medicaid and Medicare. Others think the flaw is private involvement. Others think the tort system is the flaw. Using a broad statement to imply agreement where there is none is intellectually dishonest.

5. Public assisted healthcare is not an option that people can opt out of. In NZ, having private providers for ACC would be an option – people could choose whether or not to use them, and choose whether or not to fund them. Having a public insurer in the US would offer the choice of whether to use them, but not the choice of whether to fund them. All taxpayers have to pay for that public insurer, and there is an expectation that the insurer would use that govt funding to undercut existing players – in other words, to price below the market and drive companies out of business. When other countries sell below cost we call it dumping, and specifically impose sanctions. Why would we want the government offering a service below the cost of providing that service? Will not the bankruptcy of those insurance companies increase unemployment?

6. Why the need to blanket label republicans based on the actions of a few? Do you think that all republicans think that Obama is the antichrist? Really? Have you actually ever met a real life American? A real life Republican? Were they actually eating a baby when you met them?

7. On your personal opinion. I think you are right. The republicans aren’t keen to use taxpayer subsidies to create a public insurer which will operate below cost, and thereby drive many insurers out of business. Leaving them with an inefficient monopoly provider supported by taxes – kind of like we have in NZ. I can see why they wouldn’t want that. You do understand what being right wing entails, don’t you? Are you surprised when right wingers believe right wing things? Or do you think it is just an act we put on when we are finished eating babies?

8. Profit and greed are the drivers of the capitalist system. The most effective system ever devised by man for creating wealth. There is a reason that America is so damn wealthy.

9. Off-shoring. Do you believe that the third world needs our help? Do you understand that most environmental problems are driven by poverty – that the environment almost universally improves in wealthier countries, that birth rates drop in wealthier and educated countries? Would you rather we prevent third world countries from having jobs and industries, then give them crumbs as “charity” (in the US’s preferred manner through “charity” that is really dumping of surplus American products, further distorting world markets and harming the poor). Or through letting them have jobs at which they can earn an income and educate their children, climbing the same ladder of success that the Americans, NZers, Japanese, Koreans, and now Chinese are climbing? How do you reconcile your dislike of “off-shoring” with your concern for the poor of the world?

The reason that Hurf picked you as a early-20s Labour activist was your argument style and your logically inconsistent positions. You’re reasonably new around here, so I’ll spend some time on it. But if you want to continue to argue in that lazy way, most will ignore you.