What a mess of contradictions and misinformation. I love that he cites wait-time statistics from Investor's Business Daily; their in-house editorial was so right about Stephen Hawking, after all.
posted by mediareport at 9:00 PM on August 12, 2009 [8 favorites]

The possibility that this public self-humiliation could severely damage the Whole Foods franchise is the best news I've seen all day. I have NEVER shopped at Whore Foods, just as I have NEVER bought an Apple product, so I'm looking forward to seeing Steve Jobs dittoing Mackey on this issue.
posted by wendell at 9:01 PM on August 12, 2009 [4 favorites]

"Hi, I'm John Mackey. Now that Whole Foods has driven away anyone who cares about labour standards, I'd like to address the liberals who still shop here..."
posted by Pope Guilty at 9:05 PM on August 12, 2009 [50 favorites]

"Many promoters of health-care reform believe that people have an intrinsic ethical right to health care¡ªto equal access to doctors, medicines and hospitals."

You're god damn right we do.
posted by cmfletcher at 9:06 PM on August 12, 2009 [198 favorites]

A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That¡¯s because there isn¡¯t any. This ¡°right¡± has never existed in America

Eat a dick, John Mackey.
posted by boo_radley at 9:08 PM on August 12, 2009 [49 favorites]

He gets the award for Dumbest CEO of the Year.
posted by kldickson at 9:09 PM on August 12, 2009 [2 favorites]

This is an interesting counterpoint to Mackey's 2005 debate about the role of 'stakeholders' in shaping a company's decisions, not just 'shareholders'.
posted by verb at 9:09 PM on August 12, 2009 [2 favorites]

I like Whole Foods' food choices. And I like Apple's range of products. My food and technology purchases are not personality-driven.

Medicare and Social Security entitlement spending

Whoah, wait a minute there, Tex. SS is, for the foreseeable future at least, self-funded from surplus contributions over the past 25 years, here's its latest balance sheet:

1610 - INVESTMENTS IN U.S. TREASURY SECURITIES $2,301,364,808,000.00

Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren¡¯t covered by Medicare, Medicaid or the State Children¡¯s Health Insurance Program.

ah, glibertarianism at its best.
posted by @troy at 9:09 PM on August 12, 2009 [6 favorites]

I don't word it as "an intrinsic ethical right", I'd say it's a "basic human need". But then, Whole Foods is all about denying Healthy Food, another "basic human need", to anyone not able to overpay for it. So, he really is consistent.
posted by wendell at 9:10 PM on August 12, 2009 [9 favorites]

Congratulations, wendell. You've out-smugged anyone and everyone who's ever been to Whole Foods or the Apple Store, in two sentences.

On a more serious note, why are conservatives always so gung-ho for this Health Savings Account idea? When it seems like most Americans can't even get around to getting regular savings accounts?
posted by fungible at 9:10 PM on August 12, 2009 [11 favorites]

Forget the wrongness for just a moment.

How stupid is this guy, from a pure business perspective, to take such a crazy swipe at his own base?
posted by rokusan at 9:12 PM on August 12, 2009 [43 favorites]

> While we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits

Where were these deficit-hawk assholes when Bush was burning hundreds of billions of dollars of their dollars in Iraq? Oh, that's right, cheering him on.
posted by The Card Cheat at 9:13 PM on August 12, 2009 [60 favorites]

On a more serious note, why are conservatives always so gung-ho for this Health Savings Account idea?

Because it's one of the purest possible distillations of "Fuck you, got mine".
posted by Pope Guilty at 9:13 PM on August 12, 2009 [90 favorites]

why are conservatives always so gung-ho for this Health Savings Account idea

it pulls money out of the government's clutching ability to tax it, empowering consumers to get fisted personally by the invisible hand.
posted by @troy at 9:14 PM on August 12, 2009 [30 favorites]

*spits organic/fair trade/eco friendly humus all over my retro sport utility vehicle*
posted by nola at 9:15 PM on August 12, 2009 [4 favorites]

That guy has always been a libertarian jackass.

But that said, I was still shocked to see him advocating "High deductible" insurance premiums as a solution. (Solution to what?) That's just fucked up beyond words. The whole point is to screw middle class and poor people so much that just don't go do the doctor, and thus prices will go down. That was basically McCain's platform during the campaign (along with getting rid of the tax deduction, and moving everyone to private health care)
posted by delmoi at 9:15 PM on August 12, 2009 [9 favorites]

I think that with the influence that corporate lobby groups and corporations have I feel that where I spend has as big or bigger effect than voting. If I lived in the US I wouldn't spend a dime at Whole Foods because I would feel that I was supporting this point of view.
posted by troll on a pony at 9:16 PM on August 12, 2009 [1 favorite]

> Unfortunately many of our health-care problems are self-inflicted: two-thirds of Americans are now overweight and one-third are obese. Most of the diseases that kill us and account for about 70% of all health-care spending¡ªheart disease, cancer, stroke, diabetes and obesity¡ªare mostly preventable through proper diet...

...conveniently available at Whole Foods. For a price.
posted by you just lost the game at 9:19 PM on August 12, 2009 [9 favorites]

From the op-ed:

The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems.

Don't we already have this system, where people pay high premiums, then pay what insurance companies won't, and ¡ª if they are lucky enough to have access and to be able to afford it ¡ª then apply flex-spend dollars?

Health insurance should be portable.

If we had a federal single-payer system, that would solve that problem fairly neatly.

Repeal government mandates regarding what insurance companies must cover.

I would like to know what these mandates are, before listening to calls to repeal them. I find it convenient that they are not described, as if the point is not that the mandates exist, but that the big, bad government is telling poor, little insurance businesses what to do. This is dishonest on his part.

Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year

Tort reform would open up the ability for doctors and hospitals to do sloppy, life-threatening work without allowing a patient recourse to the legal system. Somehow, that seems to run counter to Mackey's philosophy that, in a capitalist system, the patient should have rights.

But then, if a patient having rights threatens profits, I can see why that would be a problem for this CEO.

Make costs transparent so that consumers understand what health-care treatments cost

I'd like to know how much of my medical insurance premiums and bills go to shuffling paper around. I'll bet it's pretty high: 40-50%. I think if people knew how wasteful and inefficient private health insurance companies are, given what they pay to these companies, they would be rioting in the streets for a public option.

Enact Medicare reform

Didn't Bush say that the system was going broke, that it was a crisis, and yet we still have Medicare?

Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren¡¯t covered by Medicare, Medicaid or the State Children¡¯s Health Insurance Program

He must be trolling us. Anyone can go to their local library, open up a web page and donate to a 503(c) non-profit of their choice.

He's got to be trolling us. That's the only logical conclusion.
posted by Blazecock Pileon at 9:20 PM on August 12, 2009 [6 favorites]

> This ¡°right¡± has never existed in America.

And if the right has its way, it never will.
posted by Stonewall Jackson at 9:22 PM on August 12, 2009 [5 favorites]

fingible: why are conservatives always so gung-ho for this Health Savings Account idea? When it seems like most Americans can't even get around to getting regular savings accounts?

Because the wealthy get a big tax deduction for contributing to their HSA. The higher your income tax rate, the more valuable the deduction.
posted by JackFlash at 9:23 PM on August 12, 2009 [7 favorites]

Hilariously un-necessary. His board of directors ought to keep an eye on this kind of unproductive CEO grandstanding.

Also, I'm sure his Canadian employees are happy to take his 'supplemental health care dollars' and spend it on orthodontics for their kids and new eyeglasses. Their fundamental health is assured by the government, and the alternative would be to deal with an insurance company *shudder*.
posted by anthill at 9:26 PM on August 12, 2009

"??Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs). The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems. For example, Whole Foods Market pays 100% of the premiums for all our team members who work 30 hours or more per week (about 89% of all team members) for our high-deductible health-insurance plan. We also provide up to $1,800 per year in additional health-care dollars through deposits into employees¡¯ Personal Wellness Accounts to spend as they choose on their own health and wellness.

Money not spent in one year rolls over to the next and grows over time. Our team members therefore spend their own health-care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in. This creates incentives to spend the first $2,500 more carefully. Our plan¡¯s costs are much lower than typical health insurance, while providing a very high degree of worker satisfaction."

This. Is. Bullshit.

Especially the part I put in bold.

I used to work at Whole Foods. There were a lot of things I liked about it, and a few things I still miss (colleagues who knew a lot about and loved food - parties held by my department (cheese, specialty meats, wine and beer) were legendary. But no one I knew who worked there was frivolously spending their health care dollars - it's not like they were out getting nose or boob jobs. Instead, they were trying to figure out how to pay for appointments for back, knee and foot pain (we lifted heavy things and spent hours on our feet); diagnosis and treatment of celliac disease; treatment for allergies, depression (meds, therapy); getting their kids assessed and treated for ADHD, autism spectrum disorder, and the usual childhood illnesses and mishaps. People got cancer and had non-work-related injuries. Needed root canals and glasses. You know. The usual.

If you live in San Francisco and you're making $12 an hour, your rent is $600-800 a month (in a house with housemates; almost certainly higher if you live along or with your partner alone and/or with your kids) and your bus pass is $50 a month, meeting a $2500 deductible before your insurance kicks in is a total fucking fantasy. "Saving" money by having it taken out of your paycheck pre-tax in order to contribute to your HSA is a goddamn joke when you're in a tax bracket where it doesn't make any difference if your taxable income is less because you're already in the bottom bracket.

The very idea that people getting paid service industry wages need to be "incentivized" (Christ how I hate that fucking word) to not "waste" their money on frivolous health care makes me incandescent with rage.

I've had the dubious honor of being in all-store meetings with John Mackey. He is an anti-union jerkface, and I might just send him this comment as a letter (minus this last sentence).

GRRAAAAAAARRRR!!

*spits, froths, tears hair, frightens cats*
posted by rtha at 9:27 PM on August 12, 2009 [191 favorites]

He's got to be trolling us. That's the only logical conclusion.

How generous an assumption about the logical abilities of the far right.
posted by kldickson at 9:27 PM on August 12, 2009 [1 favorite]

rtha, I encourage you to post your comment at the WSJ.
posted by boo_radley at 9:28 PM on August 12, 2009 [13 favorites]

> Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment

I wonder how that number compares to the number of Americans waiting to be admitted to a hospital or to get treatment because they can't afford it.
posted by The Card Cheat at 9:30 PM on August 12, 2009 [9 favorites]

This is awesome! Cambridge, MA's Fresh Pond Plaza will be a whole lot easier to get in and out of when this news hits and Bay State liberals abandon the Fresh Pond Whole Foods like it hoisted a swastika flag. Pet Smart, you have my business again because I won't have to spend 15 minutes flipping off Subarus to get back on Route 2!
posted by Mayor Curley at 9:31 PM on August 12, 2009 [4 favorites]

From what I understand, what conservatives have twisted into the 'death panel' bullshit is a proviso about counseling about end-of-life care. Which has virtually nothing to do with forced euthanasia.

The cretins (is that an okay word to use for people who apparently demonstrate an ability to comprehend simple text or feel compelled to twist it ridiculously?) apparently don't have any sort of reading comprehension.
posted by kldickson at 9:33 PM on August 12, 2009 [1 favorite]

I'm not smug. I'm just not wealthy enough to shop "labels". And when I shop for quality, I usually find something just as good or better for a lot less than the "label". And for me, Whole Foods and Apple are on the same list as Mercedes Benz and Abercrombie & Fitch.
posted by wendell at 9:33 PM on August 12, 2009 [3 favorites]

an INABILITY to comprehend simple text
posted by kldickson at 9:34 PM on August 12, 2009

How stupid is this guy, from a pure business perspective, to take such a crazy swipe at his own base?

The dude has always been like this. He's an Ayn Rand follower and pretty much hates his customers. I think he likes this. It's part of the power trip that fuels people like him. Fuck you assholes, you may hate me but you can't stop yourself from buying my products. Just try and stay away you patchouli dripping losers.

It's like people on medicare shouting about government funded health care. Some people just like to yell at things.
posted by allen.spaulding at 9:34 PM on August 12, 2009 [9 favorites]

wendell, I'm almost afraid you're going to start an OS war. :P
posted by kldickson at 9:34 PM on August 12, 2009

We also provide up to $1,800 per year in additional health-care dollars through deposits into employees¡¯ Personal Wellness Accounts to spend as they choose on their own health and wellness.

Money not spent in one year rolls over to the next and grows over time. Our team members therefore spend their own health-care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in.

rtha, I might be misreading that -- it sounds like he's claiming that Whole Foods 'fills up' a Health Care Savings Account, or something like it, to the tune of $1800 a year. Then insurance coverage kicks in around $2500. Is that incorrect?
posted by verb at 9:37 PM on August 12, 2009

The cretins apparently don't have any sort of reading comprehension.

No, they are simply being led around by "opinion leaders" who don't have a factual leg to stand on so have told a long string of lies to keep the 'cretins' voting against their best self-interest.

Now, someone who shops at Whole Foods but would never set foot in a WalMart (which has been coerced into doing a few good things for people that WF has not), is a snob and an idiot.
posted by wendell at 9:37 PM on August 12, 2009 [2 favorites]

wendell,

do you mean you would if you could?
posted by setanor at 9:38 PM on August 12, 2009

"Saving" money by having it taken out of your paycheck pre-tax in order to contribute to your HSA is a goddamn joke when you're in a tax bracket where it doesn't make any difference if your taxable income is less because you're already in the bottom bracket.

At the risk of over-generalizing, from the well-to-do libertarians I've met this is a common flaw in their thinking. They look at how much that 15% they have to pay on their $2 million of dividend income and are flabbergasted. For them, far and away, taxes are their single biggest expense. Thus, they suggest tax deductions as a way to make retirement or health care accessible for workers making $20k a year...
posted by heathkit at 9:38 PM on August 12, 2009 [6 favorites]

and Apple are on the same list as Mercedes Benz and Abercrombie & Fitch.

well, I'll spot you "Apple = BMW". I've got an OS in my face from sunrise to sunset so I'll take the one that works for me best. The MBP I'm typing this on from my couch now is easily dockable to my 24" LCD that I also overpaid for, but over its 5 year life this system's price difference over similiar if less capable Wintel competitors comes to 8c per hour of use.
posted by @troy at 9:39 PM on August 12, 2009 [2 favorites]

While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?

More? No. But we already have Food Stamps, TANF, and Section 8 in place, along with public housing and other similar initiatives.

The only thing different in this case is there's a whole industry built upon making money off of health insurance and not so much making money off of feeding the poor and underemployed.

I was in Whole Foods the other day. I'm now glad I didn't buy anything.
posted by cmgonzalez at 9:40 PM on August 12, 2009 [2 favorites]

it sounds like he's claiming that Whole Foods 'fills up' a Health Care Savings Account, or something like it, to the tune of $1800 a year

you missed the magical marketing words: "up to".
posted by @troy at 9:41 PM on August 12, 2009 [1 favorite]

Whole Foods is all about denying Healthy Food, another "basic human need", to anyone not able to overpay for it.

Huh? Whole Foods is overpriced, sure, but it's not the only place to buy carrots.

There are huge problems with the way fresh food is sold in this country, but niche-market lifestyle stores like Whole Foods are not reserving healthy food for the rich and taking it out of the mouths of the poor. That's like saying that Donna Karan is preventing poor children from having appropriate clothing.
posted by desuetude at 9:43 PM on August 12, 2009 [5 favorites]

"HealthDay News reports that the average cost of treatment for lung cancer was $39,891 as of 2002. Breast cancer costs were $20,964 and prostate cancer costs were $41,134. However, cancer costs are continuing to rise at a rate of about 15 percent a year."

Taken from this link.

Yeah, I'm sure everyone's Health Savings Accounts can cover that.

Or maybe God just wanted you to die from that cancer that you can't afford treatment for. Oh wait, you can afford that? I guess God just wants poor people to die from disease.

Can you tell I feel really fucking bitter right now?

And apologies for accidentally posting this in the wild manhattan thread...oh tabs.
posted by whimsicalnymph at 9:44 PM on August 12, 2009

I sincerely hope that this article inspires other opinionated CEOs and business owners to publish their own error-laden opinion pieces on the topic of a public option for healthcare, so that I may further whittle down the places where I choose to spend my limited disposable income in this haggard economy.
posted by contessa at 9:47 PM on August 12, 2009 [16 favorites]

verb, @troy's got it.
posted by rtha at 9:48 PM on August 12, 2009

how can we say that all people have more of an intrinsic right to health care than they have to food or shelter

Good health -- physical and mental -- is the foundational level from which all individuals find themselves able to contribute to society. It is also something that can disappear in the blink of an eye; most of us become inured to our good fortune of "being healthy" until we are blind-sided either by a health crisis; an accident or the onset of an illness.

Healthcare providers -- healers -- acquire to themselves immense income-producing capital skills, since without our health we are nothing. Left to their own devices, the healers will guild-up and artificially limit the market, and the entire health-preservation industry will become rife with rent-seeking over time. Gee, that's what we have now.

This talk of intrinsic rights and Constitutional BS though is just pure smoke. Let's ram through the amendments if that's what it takes to shut these fuckheads up, and if that effort is unsuccessful then we'll just have to re-group at the state level.
posted by @troy at 9:48 PM on August 12, 2009 [5 favorites]

Yeah, I'm sure everyone's Health Savings Accounts can cover that.

The point was that catastrophic coverage + HSA isn't a bad approach. That's currently what I have, basically, a $1750/yr max out-of-pocket plan that costs $200/mo, compared to the gold-plated plan I had via my previous employer, which would have cost $600/mo via COBRA.

Paying $7200/yr for full coverage vs. $2400/yr + max $1750/yr OOP . . . the choice was a no-brainer.
posted by @troy at 9:52 PM on August 12, 2009 [4 favorites]

So... what exactly does any of this have to do with Apple or Steve Jobs?
posted by spilon at 9:52 PM on August 12, 2009 [1 favorite]

I'd like to know how much of my medical insurance premiums and bills go to shuffling paper around. I'll bet it's pretty high: 40-50%. I think if people knew how wasteful and inefficient private health insurance companies are, given what they pay to these companies, they would be rioting in the streets for a public option.

Andrew Sullivan's blog (Andrew is on vacation) has been posting emails about insurance is actually paid for. Here's one example and another

Anyway, when I was going to look up some of them I came across This Video of Deputy White House Press Secretary Bill Burton being interviewed by Fox New's Megyn Kelly. It was shocking, because of how bad the press secretary actually handled it.

Also, be sure to check out what her Co-anchor had to say after the interview.
posted by delmoi at 9:54 PM on August 12, 2009 [2 favorites]

I enjoyed the snarky response to this editorial by Jesse Taylor over at pandagon.net
posted by vespabelle at 9:55 PM on August 12, 2009 [3 favorites]

It's not in the Constitution, therefore it can't ever be in the Constitution, or even be good! I for one place the reasoning and values of misogynistic eighteenth-century slaveowners above my own judgement and moral reasoning and can't see why anyone wouldn't.
posted by Pope Guilty at 9:56 PM on August 12, 2009 [22 favorites]

At Whole Foods we allow our team members to vote on what benefits they most want the company to fund.

Socialism!
posted by scottreynen at 9:56 PM on August 12, 2009 [5 favorites]

So... what exactly does any of this have to do with Apple or Steve Jobs?

WF and Apple are one of the few megacorps that are the personal creations of their present CEOs, and serve similar markets, the upper tranches of the middle class who aren't afraid to sacrifice some of the disposable incomes on higher-priced stuff, as opposed to taking the bargain-bin approach to their consumer lives.
posted by @troy at 9:59 PM on August 12, 2009

At Whole Foods we allow our team members to vote on what benefits they most want the company to fund.

In America, we allow our citizens to vote on what benefits they most want the government to fund. We had that vote recently. Health insurance won.
posted by scottreynen at 9:59 PM on August 12, 2009 [54 favorites]

I'd like to know how much of my medical insurance premiums and bills go to shuffling paper around.

There was a piece on the radio show Marketplace the other day (I think it was Marketplace - it might've been All Things Considered) in which they visited a doctor's office. There were six physicians in the practice, and 12 people whose job it is to wrangle insurance and billing.
posted by rtha at 9:59 PM on August 12, 2009 [4 favorites]

well, I'll spot you "Apple = BMW". I've got an OS in my face from sunrise to sunset so I'll take the one that works for me best. The MBP I'm typing this on from my couch now is easily dockable to my 24" LCD that I also overpaid for, but over its 5 year life this system's price difference over similiar if less capable Wintel competitors comes to 8c per hour of use.

I run Linux. I have invested some time into learning how to make it work EXACTLY how I want it to, on hardware that costs 75% of what Apple hardware does. I can see spending the extra money on a Mac if it did everything I wanted it to, but having an OS in my face every waking hour, I find that the ability to customize everything /just so/ is well worth the effort, and my productivity and enjoyment is greatly increased by knowing the nitty-gritty details of how everything works.
posted by signalnine at 9:59 PM on August 12, 2009 [1 favorite]

A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That¡¯s because there isn¡¯t any. This ¡°right¡± has never existed in America

Oh, for fuck's sake. This is the lamest argument I've ever seen -- anybody with a passing familiarity with the Declaration or Constitution should be able to see the problem with this guy's bullshit:

-We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.

-The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

So, um, we don't have "any intrinsic right to health care, food or shelter"... but we have an unalienable right to Life, Liberty, and the pursuit of Happiness, eh? How exactly does that equation work?
posted by vorfeed at 10:00 PM on August 12, 2009 [18 favorites]

I have NEVER shopped at Whore Foods, just as I have NEVER bought an Apple product

I don't care if you're high and mighty about buying brands or about not buying brands, it still makes you a snob.
posted by kiltedtaco at 10:00 PM on August 12, 2009 [17 favorites]

In America, we allow our citizens to vote on what benefits they most want the government to fund. which party we want to be whores for the health insurance industry.
posted by Pope Guilty at 10:01 PM on August 12, 2009 [6 favorites]

and can't see why anyone wouldn't

Well, I would like to think we have the political maturity to operate our governments by their respective constitutions.

The poster known as dios generally drew a fuckton of static from me whenever he posted, but to the extent that his argument was that the law is what it is, not what we wish it was, he made sense. If the law isn't working, we need to change the law and not just ad-hoc work around it.
posted by @troy at 10:04 PM on August 12, 2009 [1 favorite]

Fuck John Mackey and Fuck Whole Foods.
posted by wfrgms at 10:04 PM on August 12, 2009 [2 favorites]

Unfortunately many of our health-care problems are self-inflicted: two-thirds of Americans are now overweight and one-third are obese. Most of the diseases that kill us and account for about 70% of all health-care spending¡ªheart disease, cancer, stroke, diabetes and obesity¡ªare mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption and other healthy lifestyle choices.

This guy's head-up-the-ass obtuse narcissism is almost miraculous in its impenetrability. It's not as if Whole Foods sells nothing that contributes to the medical problems that he lists.

It's somewhat laughable that the same "healthy lifestyle choices" that he touts are also a feature of one of the "ObamaCare" Senate health reform bills. The bill would allow deductions of up to 50% for "employees who improve their health habits by eating well, losing weight and quitting smoking ... from companies offering group health insurance."
posted by blucevalo at 10:05 PM on August 12, 2009 [1 favorite]

I have invested some time into learning how to make it work EXACTLY how I want it to, on hardware that costs 75% of what Apple hardware does.

How much time, and what do you make per hour, roughly?
posted by device55 at 10:05 PM on August 12, 2009 [1 favorite]

desuetude, I'm sorry, I wasn't trying to say that; "denying" was the wrong word. I know there are plenty of other places to buy good carrots. I shop at 3 of them regularly. But so many Whole Foods customers are shopping there because they feel they have to pay too much to get something good. And if @troy's "food and technology purchases are not personality-driven", he's in the minority in WF's and Apple's customer base. I don't consider it "bargain bin" approach, I call it not getting conned and ripped off. I'm just glad @troy doesn't claim you're actually getting much more for the extra you pay at Whole Foods (although Apple has extra features, just rarely the ones I want, and always bundled with ones I don't for a shitload more money).

And what OS war? I've never participated; you can't have the Apple OS without paying through the nose for everything else Apple. I split my time between Windows XP and Ubuntu Linux for whatever computing I do. And I proudly quit paying for AT&T anything when alternative home phone service became available a long time ago (and I remember when it wasn't... that's what made Apple's iPhone a giant step backwards...) And nothing makes me feel more schadenfruede than the stories of iPhone users getting crappy service from AT&T. Yes, maybe that makes me smug. But when you call a refusal to buy overpriced brands marketed to snobs being a snob, that's Glenn Beck-style arguing.
posted by wendell at 10:06 PM on August 12, 2009

Not that I shopped there much before, but my last visit to Whole Paycheck was indeed my last visit.
posted by telstar at 10:06 PM on August 12, 2009

I have invested some time into learning how to make it work EXACTLY how I want it to, on hardware that costs 75% of what Apple hardware does.
How much time, and what do you make per hour, roughly?

I considered how much time it would take to make Apple hardware work EXACTLY how I want it too, but couldn't find the square root of NEVER.
posted by wendell at 10:09 PM on August 12, 2009 [2 favorites]

whole foods... isn't that the place where you can buy individually-plastic-wrapped organic apples?
posted by klanawa at 10:12 PM on August 12, 2009 [2 favorites]

Can the people who want to talk about their computers instead of Healthcare please take it to PMs, MeCha, or MeTa?
posted by Pope Guilty at 10:12 PM on August 12, 2009 [33 favorites]

How exactly does that equation work?

The great failure of glibertarianism is the failure to understand that constitutional freedoms require adequate public infrastructure -- a commons from which to draw the elements that go into wealth-creation. Without this public commons, libertarianism becomes all the freedom/liberty/justice you can afford, and not one drop more.

Back in the 18th century, there was still good, productive land free for the taking, plus only white property-holding men were full citizens so it was easier to parcel out this "life, liberty and the pursuit of happiness" invisible backpack to them.

100 years ago it became apparent that the frontier was filled in, and thus the libertarian laissez faire order was NOT compatible with democratic egalitarianism, and a brief Progressive Age dawned, only to get crushed in the catastrophe of WW I and rise of radical international socialist front of soviet-style totalitarian (and athiestic) communism. The capitalist/christianist Establishment swung itself into a life-or-death defense against this new threat to its position in society, to the great loss of what were Progressivist/small-s socialist ideals.
posted by @troy at 10:14 PM on August 12, 2009 [44 favorites]

Corporations are why we can't have nice things.
posted by parudox at 10:16 PM on August 12, 2009

Corporations are why we can't have nice things.
posted by @troy at 10:17 PM on August 12, 2009 [1 favorite]

Can the people who want to talk about their computers instead of Healthcare please take it to PMs, MeCha, or MeTa?

True. Sorry.
posted by device55 at 10:18 PM on August 12, 2009

A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That¡¯s because there isn¡¯t any. This ¡°right¡± has never existed in America

This also struck me as completely ridiculous and totally nonresponsive. It's something that a little kid yells out when he knows he's doing something wrong.

A bully pushes down another child. The children gather around and tell him to stop, that it's time that people stopped bullying and that everyone ought to be able to play without getting hurt like that. It's time for change, it's been to long, this is something that needs to happen. And so on. In response, the bully yells "it's a free country!"

Then a billion-dollar conglomerate busses in a bunch of elderly people to yell about death panels.

I can't wait for the time when someone can say "it's a free country" without it being ironic or problematic. Maybe the day when we've eradicated homelessness and crushing poverty, insured the sick and improved our schools while providing opportunities for all to have employment, oh what the fuck am I talking about. Let's just buy our giant fucking SUVs, bomb another poor country into the ground, and burn us a gay or three. USA USA USA.
posted by allen.spaulding at 10:22 PM on August 12, 2009 [5 favorites]

Corporations are why we can't have hate nice things.
posted by mwhybark at 10:22 PM on August 12, 2009 [1 favorite]

"gold-plated plan"

dude, you are a talking point troll. begone.
posted by mwhybark at 10:26 PM on August 12, 2009

Corporations are why we can't have are hopelessly in debt for our nice things.
posted by wendell at 10:27 PM on August 12, 2009 [2 favorites]

How much time, and what do you make per hour, roughly?

It's hard to answer that outside of the context of the work that I do for pay. I probably have invested hundreds of hours into learning how to make Linux work better, but that's largely WHY I make as much money as I do, which is hourly not quite triple digits, as a Linux systems administrator.
posted by signalnine at 10:27 PM on August 12, 2009 [1 favorite]

"Many promoters of health-care reform believe that people have an intrinsic ethical right to health care¡ªto equal access to doctors, medicines and hospitals."

Why don't I have a right to health care? Just what would I have to do to earn the right to basic care from another human being? What do I have to prove, to be worthy of equal treatment? Or even access to equal treatment?

Put another way, if my house is on fire, the Fire Dept. comes and puts it out. If I'm being robbed, raped, harassed, or otherwise harmed, the police come and help. They don't stop and ask me if I'm covered for these things. They don't half-assed put the fire out or refuse treatment based on some third-party contract I've signed. They just fucking do it, because their job is to ensure personal safety and well-being of the citizens of this country. Why the hell does my physical and mental health not fall into this category? Why is access to all direct pathways to my well-being intercepted by a profit driven industry? How can I expect that my health will be their number one priority? And I don't understand why anti-health-reformers care soooo much about the possibility that this will bankrupt the country. It's as if they're more concerned about the economic health of this country than the actual health of its citizens. As if that idea was the most noble expression of their patriotism and capitalist altruism, all bundled up in this strong symbol of freedom called America. Don't they realize that America is made of people?

Also, I'm really sick and tired of 'government' being a dirty fucking word.
posted by iamkimiam at 10:31 PM on August 12, 2009 [112 favorites]

i can't stand it anymore

at a local meeting that my local newspaper reported on, a few anti-health care people were bringing forth their usual talking points and a man interrupted them with the following words of wisdom

"what's your solution?"

he was apologetic about shouting this later, but clearly felt frustrated - as far as i'm concerned, he hit the nail on the head

you don't like obamacare? - or national health care?

what's your solution?

there are 40 - 50 million people in this country without health insurance

what's your solution?

there are millions of people who are uninsurable because of "pre-existing health conditions"

what's your solution?

the cost of health care is going up far greater than inflation is

what's your solution?

the price of prescription drugs are also skyrocketing

what's your solution?

all the blather about socialism and death boards and rationing of health care means nothing if you can't answer this question -

what's your solution?

stop arguing with these damned people and ask them flat out

what's your solution?

this is what we need to do to win the health care debate in this country
posted by pyramid termite at 10:31 PM on August 12, 2009 [84 favorites]

A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That¡¯s because there isn¡¯t any. This ¡°right¡± has never existed in America

I've just carefully read both the Declaration of Independence and the Constitution and my reading did not reveal any explicit right for Jack Mackey to not be kicked in the balls. Who's thinking what I'm thinking?
posted by Justinian at 10:33 PM on August 12, 2009 [19 favorites]

this is what we need to do to win the health care debate in this country

Or would be, if they weren't totally unashamed of their answer being

¡°Are there no prisons?¡± asked Scrooge.

¡°Plenty of prisons,¡± said the gentleman, laying down the pen again.

¡°And the Union workhouses?¡± demanded Scrooge. ¡°Are they still in operation?¡±

¡°They are. Still,¡± returned the gentleman, ¡°I wish I could say they were not.¡±

¡°The Treadmill and the Poor Law are in full vigour, then?¡± said Scrooge.

¡°Both very busy, sir.¡±

¡°Oh! I was afraid, from what you said at first, that something had occurred to stop them in their useful course,¡± said Scrooge. ¡°I¡¯m very glad to hear it.¡±

posted by Pope Guilty at 10:34 PM on August 12, 2009 [3 favorites]

"We the People of the United States, in Order to form a more perfect Union, establish Justice, ensure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.

If only knuckleheads like Mackey cared as much about the general welfare of the country as they did about the common defense. Healthcare isn't specifically mentioned in the constitution? Neither is the Air Force.
posted by pashdown at 10:34 PM on August 12, 2009 [19 favorites]

Pyramid termite, I wish that would work, but for the people I know who don't think health care is a human right, the solutions tend to be: not get sick in the first place, don't be poor anymore, pull yourself up by your bootstraps. Privilege in action!

I'm not a nice person, but I honestly hope that a lot of the people who are actively spreading disinformation lose their health care and then get cancer food poisoning. Some people only learn when they get their noses rubbed in it.
posted by sugarfish at 10:36 PM on August 12, 2009 [2 favorites]

From what I understand, what conservatives have twisted into the 'death panel' bullshit is a proviso about counseling about end-of-life care. Which has virtually nothing to do with forced euthanasia.

You know, I'm not sure that this is the case.

In my experience, there are a significant number of conservative types who view DNR's and end-of-life planning as being euthanasia in all but name.

I mean, look at Terri Schaivo. Her husband wanted to withdraw nutrition to allow natural death to occur in accordance with her previously stated wishes and a significant portion of this country thought that she was seriously being murdered -- even calling for the President to send troops to her "rescue".

So it's really not surprising that they would see OMG DEATH PANELZ when you enact a federal law requiring people to be informed of their DNR options. They're so convinced that God has a Special Plan for all of our lives which Must Not Be Interfered With that they're willing for granny to sit on a ventilator for 4 weeks in the ICU while her organs slowly shut down instead of, you know, just letting her go.
posted by Avenger at 10:40 PM on August 12, 2009 [9 favorites]

I must have totally imagined that time when the founding fathers pledged that this nation was founded upon the basic principals of granting the citizens the rights to "Life, liberty, and the pursuit of happiness."

Yeah, that never ever happened according to this douchebag.
posted by GavinR at 10:40 PM on August 12, 2009

Sorry I started it, but if you'll look at my history, this is the first time I ever Apple-bashed, but somebody once called Whole Foods "the Apple of apples" and it stuck in my head, getting truer all the time.

And talking about the arguments against bringing REAL HEALTH CARE to America is just a matter of checking off (_)misrepresentation (_)BIG LIE (_)narrow self-interest (_)one of the 3 or 4 real good things with the current system compared to the THOUSANDS of BAD THINGS. I really don't think there is any further benefit in arguing about it because the other side will either never admit or realize they're hurting and killing people.

So, we must consider the source, and the CEO of Whore Foods is such an icon of corporate greed...
posted by wendell at 10:41 PM on August 12, 2009

I must have totally imagined that time when the founding fathers pledged that this nation was founded upon the basic principals of granting the citizens the rights to "Life, liberty, and the pursuit of happiness."

Those basic principals applicable ONLY to white, male, property owners. The founding fathers where clearly superior to the King of England and his Royal Court, but in today's world, their U.S.A. would rank among the 25% LEAST free countries.
posted by wendell at 10:45 PM on August 12, 2009

About the only talent conservatives have is a talent for obfuscating.
posted by kldickson at 10:45 PM on August 12, 2009

principals instead of PRINCIPLES? my godlessness, I'm as bad as the RightWing BigLiars!!!
posted by wendell at 10:46 PM on August 12, 2009

Pyramid termite, I wish that would work, but for the people I know who don't think health care is a human right, the solutions tend to be: not get sick in the first place, don't be poor anymore, pull yourself up by your bootstraps. Privilege in action!

then you tell them that they don't have a solution and they have nothing to offer the debate

the key is to show them up for the utterly selfish, negative and un-civic-minded people they are and make them try to justify it

keep at it until they damn well have to start talking about solutions, even if it's double talk, just to be taken seriously

the key words - constructiveness and civicmindedness - positive ideas vs "i don't wanna"

"how is having 50 uninsured americans the best thing for the country?"

"how can letting tens of thousands of americans die yearly through inadequate health care be patriotic?"

hit hard, hit dirty, and keep after them for a solution - and let them know that if they do defeat it this year, that's only round 1 as we won't give up
posted by pyramid termite at 10:50 PM on August 12, 2009 [4 favorites]

Yeah, I made the same spelling error.....whatever, it is too late at night to worry about it.
posted by GavinR at 10:51 PM on August 12, 2009

Let's go over each of his proposals:

1. Equalize the tax laws so that that employer-provided health insurance and individually owned health insurance have the same tax benefits.

I agree with this. I know it's a thorn in the side of unions who have fought hard fights for their health insurance, and I'm sorry, but employer-provided health insurance is stupid on toast in so many obvious ways. It shouldn't even exist, let alone be given a subsidized advantage. Good start, Mr. Mackey!

2. Repeal all state laws which prevent insurance companies from competing across state lines.

I can buy this. I think we have a more fundamental problem with "tax haven" states and we'll just see insurance companies relocate to the state with the most lax consumer protection standards and the best corporate tax rates... but on the other hand this would give the federal government a lot more license to put the interstate commerce smackdown on these companies when they get out of line.

3. Repeal government mandates regarding what insurance companies must cover.

No. Dumb. This only follows from a common false assumption about health care: that the consumer will be Informed in the classical capitalist sense. "Consumers can be trusted to evaluate their insurance options and choose the one that covers what they need" is the refrain... it's bullcrap. Consumers don't know what they need, and they can't be expected to know what they need because even if they knew what diseases they'll get down the line (which they can't), they would have to go to med school to know what procedures need to be covered to treat it.

Government mandates come about based on the advice of smart, medically-educated people. And because of this kind of fallacious posturing, they tend towards lowest-common-denominator procedures -- the type of stuff you'd insist your insurance cover if you knew enough to insist upon it.

4. Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year.

Semi-reasonable, but a red herring. There's ill will on both sides of this particular issue; trigger-happy patients and their mustache-twirling Trial Lawyers on the one hand, reckless or abusive doctors who want to be able to fuck up with impunity on the other. Oh wait, neither of these things really exist in statistically significant numbers. It's really just good people getting caught up in out adversarial culture and hit by our out-of-control legal costs. Nevertheless, it is a problem, I admit that much.

But it's a distraction because there's nothing stopping us from also doing that. We can switch to a single-payer system for all the really great reasons we've provided, and then if we still have a malpractice "crisis" we can do all the tort reform you want, sweetheart.

What's hilarious is that the most direct way to address "tort reform" on malpractice issues would be a fully socialized system where doctors work for the government. Then we could set explicit limits on why doctors can be sued and for how much. And hell, we could also control those pesky malpractice costs by being the socialized single-payer solution for malpractice insurance! Trotsky would be proud of that complaint, Mr. Mackey!

5. Make costs transparent so that consumers understand what health-care treatments cost.

Okay, let's go over this again. Consumers of health care do not know what that health care entails. It sure would be nice to know that my dialysis cost a thousand bucks, but since I don't have a damn clue what it entails I don't know if that's a reasonable amount.

Itemizing costs is like telling people that a black box costs $100 and expecting them to know if that's a good price without looking in the box.

(oh, and as an added perk, this is another thing we can still do even if we switch to a nationalized system)

6. Enact Medicare reform.

Thanks for the tip, Captain Specific. Of course, the fiscal difficulties of Medicare are overwhelmingly due to two things: the skyrocketing costs of health care due to the insanity of the private insurance market (can you guess the easiest way to solve that?), and the demographic shift of the baby boomers retiring -- which is happening regardless of who provides the health care. If this isn't a Medicare crisis then it's a crisis of the private market or a crisis of lots of uninsured old people clogging up our emergency rooms.

7. Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren¡¯t covered by Medicare, Medicaid or the State Children¡¯s Health Insurance Program.

BWAAAAAAAAAAAAAHAHAHAHAHAHAHAH! HAHAHAHAHAHAHA! OH, OH MAN. HAHAHAHA oh shit you're serious.

As pointed out earlier, nothing's fucking stopping you from doing that now, dipshit. For the most part I thought you were trotting out the tired old mistaken-but-apparently-reasonable-as-long-as-you-don't-think-too-hard "solutions". But this one is just disingenuous tripe. You don't entrust the common welfare to the generosity of strangers -- especially strangers who are grumpy and cost-shy because they're in the middle of preparing their taxes.

And hey, to continue the theme: if you're really so eager to add complexity to our tax system, how about we switch to government health coverage and then do this anyway. Just put a spot on the forms to increase your taxes by $Nm to be assigned specifically to the new nationalized health insurance system.

I'll say this for the guy, he sure managed to check almost everything off the list of anti-reform talking points in a pretty clear and concise manner. Of course, almost none of them stand up to even light scrutiny... but people have busy lives, and we have a national drought of critical thinking, and The Wall Street Journal still has some vestigial reputation left over from before it became (solely) a right-wing propaganda rag. The idea that the average person reading this will scrutinize it is sadly laughable.

So, though I don't normally do this, I'm now off Whole Foods. I knew it was overpriced and that I could get better organic food elsewhere, but it was convenient and reliable and I didn't know my dollars were helping to support this sort of idiocy at the executive level.
posted by Riki tiki at 10:51 PM on August 12, 2009 [31 favorites]

Also, don't forget conservatives are stuck in the 1980s. This is part of why they're all WHARRGARBL SOCIALISM.
posted by kldickson at 10:52 PM on August 12, 2009 [3 favorites]

I don't really agree with some of Mackey's points and certainly not with his apparent conclusions, but this is at least a step up from Conservatourette's Support Group meetings where people shout "death panels" and "socialism" at random intervals.

I'm also not sure I get the hate-on for HSAs. I agree they're not a solution for people who are struggling to meet basic living expenses, but as @troy points out, if you can sock away the deductible, the premiums are considerably more affordable than for a lot of plans with more first-dollar care. Even if you don't save the deductible amount, making payments on medical bills of less than $2-3k plus premiums in the event of a need might still be cheaper. If I really trusted insurance companies not to play weasel with that out-of-pocket max or with what's covered, I might be pretty gung ho about them for the middle class myself. That's before you consider any tax benefits.

The idea that individual plans should have tax breaks that are equivalent to the tax benefit an employee gets also seems pretty reasonable to me. Again, not something that's going to solve the industry's problems, but not crazy.

I also kindof agree with him that the idea that health care is a "right" is pretty tenuous; I think wendell's phrasing about it being a "basic human need" is probably more apt than this language about rights. I also agree that a mutually beneficial exchange is probably a good thing to shoot for. Of course, I'm pretty sure even if we had a socialist single risk pool we'd still be involved in a mutually beneficial exchange, and since the private insurance markets aren't strongly organized by informed individual choice, option of consumption, and competition, I'm not sure that there's any compelling argument available that private industry is generally more likely to be effective, so this doesn't change my mind.

And the rest of his points all have problems. I particularly look at:

"Repeal all state laws which prevent insurance companies from competing across state lines."

and I wonder how many people realize the effective consequence of this would be that individual states would no longer have the right to regulate the insurance industry. I highly value geographic portability, not even just as much as the next guy, but probably 10x more. But there's no way I'd trade away state regulation to get it, because I don't have any faith that the industry has what it takes to provide trustworthy service without more than a few watchdogs at all kinds of levels. Not after some of the shenanigans I've already seen pulled.

Finally:

revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance

While we're on this topic, I've often wondered: if the hardcore conservatives truly believe in philanthropy and competition, and in the ability of private charity to out-administer government efforts, why don't they simply out-do our welfare and entitlement programs?

Nothing would be as convincing a case that our public spending is misplaced. I'd certainly consider a vote to end Medicare if there were large private charities providing credible alternatives to a critical mass of seniors.

True, true, with the tax burdens the wealthy face now, we can't expect their philanthropy to cover everybody. So if I were in charge, I'd offer a challenge that gives them a big advantage: take your 60% remaining tax-lopped salaries (and 85% somewhat shaved capital gains), and fund a philanthropic effort that covers a mere 1/3 of the people medicare supports, at similar levels of benefits (and with the naturally leaner, more cost-effective operation you'd expect from private enterprise), and we'll talk additional tax benefits alright. Maybe even medicare elimination and the end of public initiatives in general.

Heck, I might even bet the social contract that such an arrangement couldn't cover 20%.
posted by weston at 10:58 PM on August 12, 2009 [3 favorites]

then you tell them that they don't have a solution and they have nothing to offer the debate

Ah, but see, here you are entering the world of logic. For many people, logic doesn't enter into the equation. Once you equate Obama with Hitler for wanting people to be able to go to the doctor, like I heard someone do at one of the townhalls on NPR, logic is off the table.

I am consistently frustrated with the progressive movement's inability to reframe a debate. Conservatives have been doing it for years! There have been books written about it! I have no idea why we can't do the same damn thing, except with the truth.
posted by sugarfish at 11:00 PM on August 12, 2009 [2 favorites]

Corporations are why we have want nice many things.
posted by Huck500 at 11:01 PM on August 12, 2009 [1 favorite]

7. Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren¡¯t covered by Medicare, Medicaid or the State Children¡¯s Health Insurance Program.

BTW, has Steve Jobs put any money out there so others not as rich as he is can get a Liver Transplant too? He did pay extra to put himself on the organ waiting list, didn't he? (Damn, there I go back to Apple)
posted by wendell at 11:05 PM on August 12, 2009

I just thought I'd point out that there wasn't any such thing as health care at the time the Constitution was written. It was the medical dark ages even during the Civil War, as you could tell by going to any civil war historical site or museum with a Civil War section and learning about how soldiers were treated (bullets to bite, liquor for anaesthetic). The Framers had no conception of "health care" as we know it. It is, however, clearly a right that should entail more responsibilities (changing eating habits if you're hurting yourself, quitting smoking, paying what you can afford, etc.). I'm not a political philosopher/theorist, but surely someone has worked on this!
posted by raysmj at 11:13 PM on August 12, 2009

sugarfish, i've been calling wrong-wing thinking. just for fun.

and thank you, riki tiki, for that amazing analysis.

@troy, thanks for your level-headed and eloquent input, too.
posted by lapolla at 11:15 PM on August 12, 2009

Even in countries like Canada and the U.K., there is no intrinsic right to health care. Rather, citizens in these countries are told by government bureaucrats what health-care treatments they are eligible to receive and when they can receive them. All countries with socialized medicine ration health care by forcing their citizens to wait in lines to receive scarce treatments.

What nonsense. Our doctors tell us what treatments we need, and we receive them in order of urgency, and the vast majority of the time those treatments are perfectly timely and appropriate. Those wait lists you hear about? My mother's on the list for a hip replacement, and has been for about six months, because she doesn't really need one yet. Her name's just in the system, flagged, as it were, until next summer when she has the time to schedule the operation and recovery. Should she break her hip, or her condition suddenly deteriorate-- and her doctor's keeping a close eye on how she's doing, sending her for regular bone density scans and the like-- she would get her hip replacement very quickly.

Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment, according to a report last month in Investor¡¯s Business Daily.

And where did these statistics come from, these terrifying numbers? Why, from that bastion of factual reporting, Investor's Business Daily. The same place that a couple of days ago opined, to howls of laughter in the UK and elsewhere, that if Stephen Hawking had been British he would never had survived the cruelties of the NHS. Leading Hawking to make a statement in the Guardian today that the situation was in fact exactly the opposite.
posted by jokeefe at 11:17 PM on August 12, 2009 [17 favorites]

"We will have to kill them manually"
posted by wendell at 11:19 PM on August 12, 2009 [1 favorite]

Jesus Christ, I don't mean to be repetitive, but this

Even in countries like Canada and the U.K., there is no intrinsic right to health care

is such an ass backwards lie that I don't even know where to start. Health care is a human right, and that this is taken seriously in Canada and elsewhere is proven by the fact that we have universal fucking health care. This makes me so angry I can hardly see straight, particularly the part about how the masses are suffering by having to line up and beg for "scare" health care. Unlike America. Right.

But then, the America he's thinking of doesn't include poor people, only the rich who are damn well not going to see any of their money go to some undeserving fat slob who lives in a trailer. God. I need to take some deep breaths or something.
posted by jokeefe at 11:23 PM on August 12, 2009 [10 favorites]

Ah, but see, here you are entering the world of logic.

yes and no - it's not just a matter of offering rational solutions but of portraying the opposition as nay-sayers, as negative people who have nothing to offer to the country and it's problems

what we want to do is to label them as people who do nothing but whine and complain and have no ideas to offer

it shouldn't be that hard to do, as they do a fair job of that themselves
posted by pyramid termite at 11:27 PM on August 12, 2009

You guys keep mentioning the Investor's Business Daily and Stephen Hawking... If he's so British, then where's his birth certificate?
posted by qvantamon at 11:34 PM on August 12, 2009

Put another way, if my house is on fire, the Fire Dept. comes and puts it out. If I'm being robbed, raped, harassed, or otherwise harmed, the police come and help. They don't stop and ask me if I'm covered for these things. They don't half-assed put the fire out or refuse treatment based on some third-party contract I've signed. They just fucking do it, because their job is to ensure personal safety and well-being of the citizens of this country.

I think this is a great idea for a commercial. Seriously. Your house is on fire, and you have to fill out a bunch of forms, wait for approval, etc, and at the end there's nothing but ashes and embers.

The people who don't see healthcare as a right are the ones who can easily afford whatever healthcare they want, or think they can until calamity strikes them personally. I really just don't get this at all.
posted by me & my monkey at 11:37 PM on August 12, 2009 [25 favorites]

I'm also not sure I get the hate-on for HSAs.

There is a free rider problem. Healthy people select the high deductible HSA health plan because they don't have any health expenses, but when they become sick or older, they switch to a lower deductible plan. It's like buying auto insurance after you have a wreck.

HSAs are also a subsidy to the wealthy. The higher your tax bracket, the more the tax deduction is worth. It also makes their out of pocket health expenses deductible while other people's are not.
posted by JackFlash at 11:43 PM on August 12, 2009 [1 favorite]

"My house's on fire!"
"Yeah... we had to cancel your coverage"
"WHAT? My children are burning!"
"Yeah... when you moved in, 15 years ago, you didn't tell us you had bad wiring in your basement..."
"But that has nothing to do with anything! it's a fucking statewide forest fire that reached my house!"
"Yeah... we don't have to put it out so we won't."
posted by qvantamon at 11:44 PM on August 12, 2009 [39 favorites]

raysmj: "98I just thought I'd point out that there wasn't any such thing as health care at the time the Constitution was written ... The Framers had no conception of "health care" as we know it. It is, however, clearly a right that should entail more responsibilities (changing eating habits if you're hurting yourself, quitting smoking, paying what you can afford, etc.)..."

From what I understand about those times, people had a perfectly good, working concept of health care. When people were unhealthy, other people were designated to come and take care of them. In some ways, health care back then was probably far superior and efficient to what we have today. People and even doctors!! came to visit fellow humans in their homes, nurtured them, prepared meals and medicines. And you know what, that care was practically free!

In many parts of the world today, health care is a given. It's what the community members do, every day, no questions asked. Even in primitive societies that may not have words for this practice.

We really need to rethink this notion of what health care is and what it means. It's not an institution or a set of procedures and treatments. It's not our ability to perform miracles or our advancements in medicine and technology. It's not even a noun really, its more verby, or at least it should be. The fundamental concept of health care is quite simple...it is the act of caring for your fellow human beings to promote their health and well-being, using the best resources and knowledge you have. We should start there and build on that idea.
posted by iamkimiam at 11:45 PM on August 12, 2009 [5 favorites]

Wait, wait, wait, there are people in the United States who didn't think Stephen Hawking is British?

LOLOLOLOLOLOL
posted by kldickson at 11:46 PM on August 12, 2009 [2 favorites]

"but this is at least a step up from Conservatourette's Support Group meetings where people shout "death panels" and "socialism" at random intervals."

Yeah, but one step up from the rock bottom of the basement still leaves us almost entirely in the basement.
posted by StrangeTikiGod at 11:52 PM on August 12, 2009

I've been trying to keep an open mind on health care reform, until a more or less final proposal emerges from the House/Senate conference committee. Perhaps, even, a legislative compromise that is endorsed by the White House, for an up/down consideration by the American people, prior to final action in Washington.

But, having read Mackey's editorial piece, which aligns closely with my own experience with HSA/high option insurance, and then, all the comments in this thread in its entirety, y'all have convinced me:

I'm dead set against ObamaCare.
posted by paulsc at 11:56 PM on August 12, 2009

I've been trying to keep an open mind on health care reform... posted by paulsc

Oh come on, nobody's going to believe you.
posted by Pope Guilty at 12:14 AM on August 13, 2009 [12 favorites]

"Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment"

The number sounds completely nonsensical; it's like 1 in 30 odd people. I wonder if includes everyone (like me who made an appointment for today yesterday) waiting to see their family doctor? Considering the equivalent statistic for California is conveniently missing thereby making comparison impossible I'd be really interested to see how big the number is, even just for the people who actually have insurance.

"[...] Apple are one of the few megacorps that are the personal creations of their present CEOs, "

Metafilter's own The Woz might take exception to that description if he wasn't such a nice guy that he wouldn't take exception to anything.
posted by Mitheral at 12:22 AM on August 13, 2009 [1 favorite]

From what I understand about those times, people had a perfectly good, working concept of health care. When people were unhealthy, other people were designated to come and take care of them. In some ways, health care back then was probably far superior and efficient to what we have today.

The average lifespan in 1776 was somewhere between 35-40, about what you see now in places like Malawi. You really want to argue this point?
posted by raysmj at 12:27 AM on August 13, 2009 [1 favorite]

I agree with wendell.

Well, except for the bullshit faux-populist thing.

I've never been a big WF customer, and John Mackay's shitheadery has ensured I never will be, but WF isn't really overpriced. It's expensive, good food. I go there when for one reason or another (usually guests in town) I'm willing to pay to be able to make an excellent meal. Normally, eh, I just don't care enough to pay more.

I spend a lot more time on the computer than I do eating, so I'm more willing to buy into the bargain with Apple. But it's the same deal -- what you get for the price is pretty fair, it's just that the price is never very low.

In Seattle there are alternatives to WF -- PCC is probably the closest, but Metropolitan Market is closer to my comfort zone. (Call it the BeOS of supermarkets.) So John Mackay can eat shit and die, I'll take my business elsewhere. But the belief that shopping at WF (or buying Apple) is just an expression of political or personal identity is, I think, just an expression of political or personal identity.

Sigh. I really thought I hated hipsters, but the I'm-so-independent-look-how-much-I-hate-hipsters thing just bugs me so much more.
posted by bjrubble at 12:28 AM on August 13, 2009 [1 favorite]

Haha, hilarious PR failure.

Some fun facts from this month's Harper's Index:

Percentage change since 2002 in average premiums paid to large U.S. health-insurance companies: +87
Percentage change in the profits of the top ten insurance companies: +428
Chances that an American bankrupted by medical bills has health insurance: 7 in 10.

For-profit health care systems are hideously immoral, and a civilization that tolerates them deserves what it gets. I'd love to say I'm not shopping at WF anymore, but it would be a lie. I quit shopping there a while ago. Trader Joe and I are going steady.
posted by mullingitover at 12:40 AM on August 13, 2009 [9 favorites]

"Wait, wait, wait, there are people in the United States who didn't think Stephen Hawking is British?"

Pshaw. He's a famous scientist isn't he? He must be American.
posted by Mitheral at 12:55 AM on August 13, 2009 [1 favorite]

"...Oh come on, nobody's going to believe you."
posted by Pope Guilty at 3:14 AM on August 13

Why not? I take this issue every bit as seriously as Rahm Emmanuel's brother Ezekiel, the noted medical ethicist, and Administration advisor does:

"... Emanuel, for his part, plans to continue his work, which is focused on finding the most equitable and ethical way for this reform to be carried out, even if he has opted against returning from [his week long vacation in] the Italian Alps. ..."

posted by paulsc at 1:00 AM on August 13, 2009

There is a free rider problem. Healthy people select the high deductible HSA health plan because they don't have any health expenses but when they become sick or older, they switch to a lower deductible plan.

Why would people with health care expenses necessarily avoid or migrate away from an HSA plan?

If the math works out as @troy pointed out -- on plans where your premiums on an HSA are lower than a first-dollar coverage plan by an amount that's greater than your out-of-pocket max -- it doesn't matter how high your deductible is. Even on years in which you entirely lose the health care cost lottery and have to pay the entire OOP max... you're still paying less in premiums + expenses than you would have with the first-dolar plan on premiums alone. It wouldn't make financial sense of any kind to switch to something else.
posted by weston at 1:01 AM on August 13, 2009

Wow, paulsc, good job. Way to take a quote out of context, from an article about people taking quotes out of context. *Golf clap*
posted by mullingitover at 1:06 AM on August 13, 2009 [12 favorites]

Because the math doesn't work out as posited by @troy. More realistically:

This seems like a great, common sense reform. High deductible health insurance with a significant contribution towards the deductible. I mean, if you ignore the fact that high deductible insurance often doesn¡¯t cover common conditions like pregnancy, have incredibly strict in-network requirements, high coinsurance rates even after deductibles are paid which far outstrip an $1800-a-year contribution, place strict limits on the allowable prices for common procedures and are tied to hour-per-week work requirements that it¡¯s incredibly easy for companies to work around, it¡¯s pretty much like perfect.

I¡¯m also not aware of this reckless pack of health care spenders, wantonly running around under a $250 deductible having their feet repeatedly examined by podiatrists and getting thryoid tests done because they slept poorly last night. What it did make me more likely to do was go to the doctor before I got pneumonia (as happened this year under a high-deductible health insurance plan that didn¡¯t cover the visit). And there was that time that my doctor found the polyps in my colon under a low-deductible plan, a visit that I likely would have delayed if I¡¯d been earning the same amount and had to pay for a colonoscopy out of pocket. I must say, though, bleeding out of my ass and not breathing properly are small prices to play for the ineffable satisfaction of true capitalist freedom.

posted by Mitheral at 1:11 AM on August 13, 2009 [2 favorites]

Barack Obama's Health Care Plan [pdf]

I hadn't read it yet and figured that some you might want to as well.
posted by clearly at 1:12 AM on August 13, 2009 [2 favorites]

It's not a new concept (FUD) but it's a different word:

agnotology - the study of culturally-induced ignorance or doubt, particularly the publication of inaccurate or misleading scientific data.

"People always assume that if someone doesn't know something, it's because they haven't paid attention or haven't yet figured it out. But ignorance also comes from people literally suppressing truth¡ªor drowning it out¡ªor trying to make it so confusing that people stop caring about what's true and what's not." - Robert Proctor

Rather than react (and be split into the customary 50-50 divisions that disempower us), we can choose to observe what's being done and who benefits.

One of the great things about the Net is that, if we've got the time, we now have front row seats on the spectacle of the manipulation of public opinion. These desperate cockroaches are out in the light, doing what they've always done, for everyone to see.

It's all they've got. When we cease to respond, they become powerless.
posted by Twang at 1:17 AM on August 13, 2009 [4 favorites]

"Wow, paulsc, good job. ..."
posted by mullingitover at 4:06 AM on August 13

It wouldn't have have been a "job" at all, good or bad, but for Emanuel(?)/Ezekiel's(?) earlier actual quote, here reproduced in context:

"By this point, Emanuel, who has a sister who suffers from cerebral palsy, had arrived in northern Italy, where he planned to spend a week on vacation, hiking in the Dolomites. Instead, he found himself calling the White House, offering to book a plane home to defend his name. "As an academic, what do you have? You have the quality of your work and the integrity with which you do it," he said by phone from Italian Alps. "If it requires canceling a week's long vacation, what's the big deal?"

posted by paulsc at 1:21 AM on August 13, 2009

Because the math doesn't work out as posited by @troy.

I don't think his example was theoretical. Perhaps I'm wrong, but it sounded to me like that wasn't just a posit but a description coverage he actually has.

I also believe I've seen plans as he described in the wilds of California. I went shopping last year for the insurance I don't have and saw plans that looked much as he described. Assuming HealthNet, Blue Cross, and Blue Shield (BC and BS are different in CA) were advertising their products in good faith, there were indeed plans that had no or low coinsurance rates past the deductible, that were no more restrictive than a typical PPO plan, and seemed to cover a range of treatments comparable to their first-dollar plans. As these were individual plans rather than employer-offered, they weren't tied to any hour-per-week requirements. And I did the math on several of them and found much the same result that @troy described.

This isn't to say that there aren't HSAs that suffer from the problems listed in the linked article, and because the insurance industry isn't trustworthy, nobody really knows how coverage holds up until they start making claims using the policy. But my personal research suggests that HSAs such as those @troy described aren't mythical beasts.
posted by weston at 1:30 AM on August 13, 2009 [2 favorites]

It's kind of strange when a previously respected Mefite, over a period of years, slowly becomes more and more aggressively trollish. In real life, it would perhaps be the harbinger of senility or some other kind of organic brain disease.

If anything, I think it underscores the need for widespread access to healthcare, to catch these horrible diseases before they become too far advanced to treat effectively.
posted by Avenger at 1:35 AM on August 13, 2009 [4 favorites]

you can't have the Apple OS without paying through the nose for everything else Apple

Of course you can. With a little patience - in my experience, far less than that required to get Windows or Ubuntu working properly - OS X can be made to run on just about any x86 hardware.
posted by kid ichorous at 1:37 AM on August 13, 2009 [1 favorite]

The average lifespan in 1776 was somewhere between 35-40,

FWIW, the average age at death of the signers of the Declaration of Independence was 66; 67 if you don't count the youngest two who died of misadventure.
posted by @troy at 1:41 AM on August 13, 2009 [1 favorite]

paulsc, I think the most telling quote from your own linked comment is this:

The HDHP is what most people think they won't like about this combination, going in. But actually, it works well for well people, and for their doctors.

My emphasis added. Most for-profit healthcare systems work just great for people who are lucky enough to be healthy. Healthy people, not incidentally, normally find it easier to work, which pays for their 'piece of mind'.

Chronic illness, depression, inherited disorders, cancer, car accident, the list goes on. Any of those happen to you, you're very probably fucked. You mentioned also in that comment that you had a $500,000 lifetime limit. I predict with the exorbitant costs of the US healthcare system, you'd burn through that pretty damn fast, and then you'd be utterly, utterly screwed. Try finding health insurance or getting another high deductible plan with a chronic condition. Job loss and bankruptcy would loom pretty quickly.

I wouldn't wish any of this on my worst enemy. I've said it again and again and again. In the UK, my National Insurance contributions basically boil down to ?250 a month. Healthcare is free at the point of delivery. There are no bills, no paperwork and ?6.85 for any prescription, whether it's penicillin or a ?500-a-pill wonder drug. People pay what they can afford through their taxes and NI contributions. People go to the doctor when they need to. Sure, it's got its problems, but the NHS never sends debt collectors after me or tells me I have to pay ?100 just to see a doctor. And I can sleep at night because I know there is no-one in this country facing bankruptcy because they had the misfortune to get sick, or get hit by a car.

I know whereof I speak - my wife is American, and never stops praising the NHS, after years of avoiding doctor visits because of her high deductibles. Oh yeah, she had one of those HSAs as well, which would have been great, except the one she had hassled her for six weeks to provide receipts and authorisation forms when she dared to actually use the fucking thing. The combined total of medical bills and debt her friends and family in the US is a walking nightmare. After a while, the numbers fail even to make sense anymore. How in the holy fuck can someone charge $20,000 to a couple to delivery a baby with a straight face?

Your system is inhuman, degrading and immoral. Just because you're not sick and have had a good experience does not mean that what works for you would work for even a fraction of the uninsured and chronically sick.

And this is what boggles my mind. I pay less in National Insurance contributions than even the cheapest catastrophic coverage I've seen available in the US. And that covers me for 99% of my medical needs. If I wanted to, I could get private health coverage if I didn't want to wait for the (minimal) wait times for non-essential operations. As an example, I had my tonsils out about three years ago. I could have waited for an NHS op, which had about a six month wait. But since I had coverage in my old job, and it was 100% covered, I thought I'd go private. The total bill was ?6,000 and I didn't pay a penny for it. I signed precisely one form. I paid ?12 for painkillers out of pocket.

How can this be? No co-pays? No deductibles? No recission? No hassle? Actual private healthcare coverage worth the (?50 a month) premiums?

I'll tell you how it can be - it's that magical 'rising tide lifts all boats' effect conservatives are always banging on about. The rising tide in this case is high quality, universal healthcare for everyone, with some waits for non-urgent procedures. Private healthcare in the UK is competing with an effectively free alternative, so they have to make it actually worth having.

If I wanted to, I could get private insurance again. I could have the supposed all-important side benefits of private care, and quality healthcare for everybody in the country.

Seriously, my most fervent wish is that this period in American public policy is looked back on as an abberant barbarism of the past, like segregation or slaveowning. It's disgusting.
posted by Happy Dave at 1:47 AM on August 13, 2009 [117 favorites]

but it sounded to me like that wasn't just a posit but a description coverage he actually has.

Yes, under my group plan through my former employer the COBRA would have been $600/mo (through Blue Shield).

This was double the COBRA I was paying for a similar plan in 2002-2003 so I shopped around and found the Essential 1750 PPO-esque plan from Blue Shield. In the year I've had it it covered a $6000 visit to the emergency room (for $500 OOP IIRC), a $1000 urgent care issue (for $200 OOP IIRC), a related consultation with a surgeon for $30 OOP, and a dermatology visit also for $30 OOP.

I think the present PPO excludes pregnancy coverage, which I don't need.
posted by @troy at 1:50 AM on August 13, 2009

Barack Obama's Health Care Plan [pdf]

Let's summarize by searching! Barack Obama and Joe Biden will:

• invest $10 billion a year over the next five years [in health information technology]
• expand and support...efforts to lower costs and improve health outcomes
• require that plans...utilize proven disease management programs
• support providers to put in place care management programs
• require hospitals and providers to collect and publicly report measures of health care costs and quality
• require providers to report preventable medical errors
• accelerate efforts to develop and disseminate best practices
• establish an independent institute to guide reviews and research on comparative effectiveness
• tackle the root causes of health disparities by addressing differences in access to health coverage and promoting prevention and public health
• strengthen antitrust laws to prevent insurers from overcharging physicians for their malpractice insurance
• prevent companies from abusing their monopoly power through unjustified price increases
• allow Americans to buy their medicines from other developed countries
• repeal the ban on direct negotiation with drug companies
• guarantee affordable, accessible health care coverage for all Americans
• require that all children have health care coverage
• expand eligibility for the Medicaid and SCHIP programs
• work with schools to create more healthful environments for children
• expand funding to ensure a strong workforce
• ensure that all Americans are empowered to monitor their health
• increase funding to expand community based preventive interventions
• prioritize all of these activities, to ensure a 21st century public health system and healthy America

posted by The Tensor at 1:57 AM on August 13, 2009 [3 favorites]

"Assuming HealthNet, Blue Cross, and Blue Shield (BC and BS are different in CA) were advertising their products in good faith, there were indeed plans that had no or low coinsurance rates past the deductible, that were no more restrictive than a typical PPO plan, and seemed to cover a range of treatments comparable to their first-dollar plans. As these were individual plans rather than employer-offered, they weren't tied to any hour-per-week requirements. And I did the math on several of them and found much the same result that @troy described."

No doubt great plans like that exist. I wonder how available they are (both money wise and available period) to someone with say Cystic Fibrosis, Late Onset Tay-Sachs, Peroneal Muscular Atrophy, or Neurofibromatosis. Especially individual plans. I'm going to go out on a limb here and guess not. You aren't going to see the benefits available in plans aimed at people with those genetic disorders, if the plans even exist, advertised on TV.

@troy writes "FWIW, the average age at death of the signers of the Declaration of Independence was 66; 67 if you don't count the youngest two who died of misadventure."

I'm guessing but I think it's a fair bet few of the signers lived in poverty their entire life. Or even spent the bulk of their lives performing hard or dangerous labour. Few if any coal miners, ocean fishermen or sailing ship riggers. And of course it's a widely held misconception that people didn't live into their 60s and 70s in that time period, especially rich people. It's the 1 in 5 or more not making it out of infancy and early childhood that skews pre-modern medicine life expectancies so low.
posted by Mitheral at 1:58 AM on August 13, 2009 [1 favorite]

Considering that good health care means more stupid people live longer, and the majority of stupid people tend to vote conservative, you would think that the conservatives would actually be in favor of keeping their base alive and healthy for as long as possible.

Conversely, you would think liberals would be dead set against decent health care since the main people it would benefit are the poor and stupid who vote conservative.

This seems to prove to me that liberals actually care more about the poor, stupid people who vote Republican year after year than the Republicans do.
posted by Joey Michaels at 2:15 AM on August 13, 2009 [3 favorites]

"... You mentioned also in that comment that you had a $500,000 lifetime limit. I predict with the exorbitant costs of the US healthcare system, you'd burn through that pretty damn fast, and then you'd be utterly, utterly screwed. ...
posted by Happy Dave at 4:47 AM on August 13

Having watched more than $780,000 worth of medical billings come in, amounting to a stack of paper more than 5 and 1/2 feet thick, for the last 7 months of my mother's and father's lives, whom I visited every day that they were in hospital, I can say with some confidence, that I would be well and truly screwed to let myself burn through $500,000 worth of medical care, in any country. There is a time to die. There is a way to do that, with dignity, and without tremendous medical cost, and my parent's Medicare/BCBS supplement plans insulated them from making such choices. They went to the hospitals of their choice, with Medicare and the best supplement insurance their money could buy, and died accordingly.

So long as this society does not make individual end of life choices a reasonable care alternative, for those who face the inevitable, they will get, in the best hospitals in the world, what my mother got, at an average cost of $5,100 a day: MRSA infections, pneumonia, bed sores so deep you could see the white of her pelvic bones when her dressings were changed, and maximum doses of Xanax and morphine, at the very end. Or, they will get what my father got, at $3,700+ per day: oxygen, palliative care, 2 radiation treatments for Stage 4 lung cancer, minimal respiratory therapy, and Xanax and morphine, at the very end.

I'm not going out, like they did.

"... Your system is inhuman, degrading and immoral. ..."
You have absolutely no idea the horrible, disgusting truth of your accusation, when our hospitals get a patient with, essentially, a blank check, because of top line, federally operated, privately supplemented, paid up health insurance.

No dog in any pound in America dies as badly.
posted by paulsc at 2:19 AM on August 13, 2009 [4 favorites]

We're never going to fix it, are we?
posted by maxwelton at 2:26 AM on August 13, 2009 [2 favorites]

No doubt great plans like that exist. I wonder how available they are (both money wise and available period) to someone with say Cystic Fibrosis, Late Onset Tay-Sachs, Peroneal Muscular Atrophy, or Neurofibromatosis. Especially individual plans. I'm going to go out on a limb here and guess not.

I'll step out on that limb with you with few worries about falling off. But as near as I can tell, that issue is orthogonal to any issues with HSAs -- this is a problem with individual plans of all kinds, first or last dollar (something I suspect is true for most of the HSA criticisms leveled in the thread), and with the fact that for some reason we don't have any other common means of creating groups in this country other than employment and the odd professional association.
posted by weston at 2:32 AM on August 13, 2009

I am very sorry for your loss, but I'm not sure I understand what you're saying. Are you saying that Medicare failed your parents despite enormous cost, and that universal healthcare would fail more people than the current system?

Are you saying that end of life care failed your parents because they didn't have the option to choose DNRs?

My argument was based on your assertion, in this and other threads, that high deductible + HSAs were a viable method of providing quality healthcare, and could work within a privatised, for-profit healthcare system. I'm sure they are, for you, but my assertion is that a) they really aren't suitable for millions of people and b) I don't understand why nobody in the US looks at universal healthcare and thinks, 'hey, that system costs less on average per person and produces better results'.

Again, I'm sorry for your loss, but I'm not sure why you are focusing on end-of-life care. The problem is with all care, for all people, at any stage of life. Being born costs a fortune. Breaking your arm as a kid costs a fortune. Getting glandular fever in high school costs a fortune. Any number of catastrophic injuries or illnesses costs a fortune and will effectively make you uninsurable. Most people in the US are paying through the nose for something they never use. Those that do have to use their insurance often find it's not worth anything like what they thought it was.
posted by Happy Dave at 2:32 AM on August 13, 2009 [4 favorites]

I note that he also raises the socialism bogeyman. I'm sitting here in the UK 60 years after the introduction of the NHS, and I'm still waiting for the Workers Paradise that the Conservatives promised me would follow forthwith.

The document is total FUD, raising the already debunked scare-points of socialism, higher cost and waiting times. One can only hope that this brainfart has a similar effect on Mackey's livelihood as Gerald Ratner's infamous "crap" speech some years ago, when he joked that his company sold crap and immediately wiped ?500m off of his company's stock value.
posted by Jakey at 2:37 AM on August 13, 2009 [1 favorite]

that I would be well and truly screwed to let myself burn through $500,000 worth of medical care, in any country

you are confusing end-of-life care with the typical catastrophic care that returns someone to at least better health while they still have the years in them to enjoy it.

I'm not going out, like they did.

Why not? That's how the hospitals can afford to treat the indigent to the extent they do.

For my one hour in the emergency room the hospital billed over $5000, of which Blue Shield picked up $2000, and left me on the hook for $100 plus two random co-pays of diagnostic services.

Part of the problem is the rentierism going on with our quasi-private health care system. 60 years ago the British said "fuck it" and just nationalized the sector outright. Canada and other systems went for more hybrid mandated single-payer exclusive semi-public system. The Japanese have 20% copay required gov't-administered insurance.

Complaining about the status quo isn't going to fix it. ObamaCare is a step in the right direction AFAICT.

On preview, what HD said ^.
posted by @troy at 2:42 AM on August 13, 2009

"... Are you saying that Medicare failed your parents despite enormous cost, and that universal healthcare would fail more people than the current system? ..."
posted by Happy Dave at 5:32 AM on August 13

Not even close, Happy Dave. The cost to my parents for their health insurance was, even for them, as low level ex-military and Federal retirees, very affordable. The effective limits for their Medicare and supplemental policies were far above what they actually were billed, before they died. Their insurance worked great.

Their doctors and hospitals, not so much. People do die, despite the best treatments possible.

Throwing money at health care is not always the way to better outcomes. It is not always even the best way to handle the health problems of young people, with simple issues. As you yourself say:

"... Most people in the US are paying through the nose for something they never use. Those that do have to use their insurance often find it's not worth anything like what they thought it was. ..."

The problem with ObamaCare, or your own vaulted NHS, is that outcomes can't be guaranteed, for the money spent, even across broad swaths of population. Accordingly, in an uncertain world, there remains a place for individual choice, and specific outcomes against those choices. Why is that so hard to recognize?
posted by paulsc at 2:45 AM on August 13, 2009

I'm happy to remain in Korea until my country starts acting like an adult. If it never happens, so be it.

I haven't needed to see a doctor here other than my initial health check/HIV screening (mandatory for people like me on work visas who aren't married to a Korean), but if I did, no biggie. Bad cold that needs some meds? I could pay by rummaging through my change-bowl. Something more serious? It would suck obviously, but I'd be taken care of. I'd probably even spring for hiring a private nurse, since your basic level of hospital-stay care here is pretty bare-bones. But they won't let you die, and the doctors are very good.

As a foreign national I have a monthly deduction into the South Korean health-care system. It's about 40 bucks.

This is what life in a first-world country is like. It amuses me to no end when relatives ask me what it's like living in a nation "less advanced" than the US.
posted by bardic at 2:45 AM on August 13, 2009 [9 favorites]

I'm also not sure I get the hate-on for HSAs.

For most people, they're sucker bets -- you gain very little if you work them right, you stand to lose a great deal if you work them wrong. In particular, if you change jobs and get a real health care plan, you then find that HSA distributes like an IRA -- as taxable income that year plus a 10% penalty. Basically, if there's an HSA at your job, it means you'll never get a real health care plan, because if you did, your HSA would screw you.

Sucker bet #2 is the IRA to HSA roll. "Let's drain your retirement account to pay for your health care."

The whole point of HSAs is to take healthy people out of the insurance pool. HSAs are a joke if you're dealing with any long term issues, but look great if you visit the doc once a year and get eyeglasses later.

The tax advantages? Really, they aren't worth much at all to most people. It seems like a good deal, until you do the math and figure out what your taxes are at the end of the year, noting the deductibility of health care expenses. And, of course, there's the cost of time factor in many HSA, as you deal with the paperwork to make sure that your expenses come out of the HSA.

Finally, they kill people. HSAs mean HDHP -- High Deductible Health Plans. HDHPs directly act to encourage you to avoid health care services. Thus, you don't take advantage of preventative medicine, you don't go to the doctor until your really sick, and thus, you're in worse shape.

The stats on this are remarkable and clear -- the HDHPs that are *mandated* to have when you have a HSA result in the patient spending much more money, much worse satisfaction rates, and much worse patient outcomes than comprehensive plans.

The only thing they're good at is saving corporations money, which, of course, is why they're so popular -- with employers.
posted by eriko at 2:46 AM on August 13, 2009 [12 favorites]

"... Basically, if there's an HSA at your job, it means you'll never get a real health care plan, because if you did, your HSA would screw you. ..."

Perhaps, to the tune of $595, max, this year (10% penalty on $5950 max HSA contribution). Easily negotiated with virtually any new employer, except for hourly jobs, at the very bottom of the pyramid. And that, of course, is only if you use nothing of your HSA, and contribute the max in 2009.

The FUD never stops in this thread.
posted by paulsc at 2:57 AM on August 13, 2009

The problem with ObamaCare, or your own vaulted NHS, is that outcomes can't be guaranteed, for the money spent, even across broad swaths of population. Accordingly, in an uncertain world, there remains a place for individual choice, and specific outcomes against those choices. Why is that so hard to recognize?

There is individual choice, even in the NHS. I assume you missed the part about how private insurance here is actually both pretty cheap, relative to costs in the US, and worth the money you pay for it, in that everything is covered, pretty much. It's actual insurance, rather than the bait and switch that many US plans are. And it has to be, because it's competing with free.

Even on the NHS, you can choose your doctor, choose the hospital you want to go to for most ops and so on.

I'm afraid I really don't get your point. 'Outcomes can't be guaranteed, for the money spent'? What does that mean? They are far from guaranteed in the US system either. My wife put thousands of dollars into her healthcare plan, and when she needed it, it was still incredibly expensive.

There is a big outcome you're missing in universal healthcare - everybody gets the care they need, nobody needs to worry, nobody goes bankrupt and people don't get tied to one particular company or place for fear of losing healthcare. That's an outcome that is guaranteed, and the benefits that flow from these outcomes, for any society that has implemented universal healthcare, are legion.
posted by Happy Dave at 2:58 AM on August 13, 2009 [10 favorites]

Perhaps, to the tune of $595, max, this year (10% penalty on $5950 max HSA contribution). Easily negotiated with virtually any new employer, except for hourly jobs, at the very bottom of the pyramid. And that, of course, is only if you use nothing of your HSA, and contribute the max in 2009.

The FUD never stops in this thread.

My emphasis added. Hmm, I wonder what socio-economic segment the vast majority of the 47 million uninsured in the US come from... perhaps those 'at the very bottom of the pyramid'?

But fuck 'em, right? If they don't want to work harder, they don't deserve to see the doctor from the chronic back pain from standing, lifting and straining eight hours a day.
posted by Happy Dave at 3:03 AM on August 13, 2009 [4 favorites]

"The problem with ObamaCare, or your own vaulted NHS, is that outcomes can't be guaranteed, for the money spent, even across broad swaths of population. Accordingly, in an uncertain world, there remains a place for individual choice, and specific outcomes against those choices."

As far as I can tell Paulsc, your solution is that we all become philosophy majors.

Of course we can't "guarantee" a person won't get sick. But we can make the system offer more quality for less price, which is exactly what the systems in Canada, England, France, Korea, etc., do, albeit in different flavors of government vs. private insurance. But at the end of the day if you get sick, you won't a) die in the street or b) have to go bankrupt.

Why is that so hard to recognize?
posted by bardic at 3:09 AM on August 13, 2009 [1 favorite]

"... That's an outcome that is guaranteed, and the benefits that flow from these outcomes, for any society that has implemented universal healthcare, are legion."
posted by Happy Dave at 5:58 AM on August 13

Nice bit of rhetoric, Happy Dave, but you're very short on the specifics of your claim. What I meant by saying "Outcomes can't be guaranteed, for the money spent." is exactly that. You suggest that nobody need worry, with NHS, but people in the UK still worry about health care (at least care home level health care), and its costs, as your own BBC reports.

I suggest that individual results, for individual choices and provisions, may be at least as comforting, as political rhetoric, taxes, and promises by monolithic National Health Services to "work closely with local authorities to protect the welfare of residents."
posted by paulsc at 3:11 AM on August 13, 2009

That's a bit disingenous, paulsc. You're quoting from a report on funding costs for private homes for the elderly, and equating that to 47 million people who can't afford to see a doctor?

I'd suggest having a look at #WeLoveTheNHS for a broader view than a single report from the BBC on a fringe issue to our entire healthcare system, which works pretty well for nearly all of us (as opposed to fully 1/6th of your population with zero access and who knows how many paying through the nose for, by your own admission, less than stellar care and overpriced drugs).

As far as I can make out, your entire argument boils down to 'universal healthcare isn't perfect, ergo we must stick with what works for me, right now, while I'm healthy?'

Surely I've got that wrong.
posted by Happy Dave at 3:18 AM on August 13, 2009 [2 favorites]

"... Why is that so hard to recognize?"
posted by bardic at 6:09 AM on August 13

Perhaps because the 2008 PBS Frontline documentary "Sick Around the World" didn't find a single one of the national health care systems in the countries they visited to be working with both sustainable cost and payment structures, and high satisfaction by patients and physicians, alike?

And of course, we're all now in a world with less money, than we were in then, and the same or greater demand for healthcare.
posted by paulsc at 3:19 AM on August 13, 2009

Paulsc, the article you link to is something of a red herring. Yes it's about a health issue, but it's housing and care for the elderly. It's no wild secret that since people now live longer, this is a relatively new issue that all countries have to deal with and that full-time care is, by its vary nature, very expensive and complicated.

But from a short perusal my first thought was damn, the elderly in England actually get help with their full-time care from the government? Because I can tell you for a fact that even getting into a nursing home for long-term care is a luxury that many Americans, and not just poor ones, will never experience.
posted by bardic at 3:22 AM on August 13, 2009 [1 favorite]

Of everybody here who is in favor of health care reform (please don't refer to it as "Obamacare"), who is willing to work for it? Those opposed to reform are obviously doing their job by spending tons of money, encouraging citizens to fight civil discourse and generally being dicks. At this point they're pretty organized and it shows.

Maybe we should turn the discussion to what we are willing to do. What have you done to support this cause? Will you write congress, contribute money to pro-reform groups, fight misinformation, or show up at town hall meetings in support of reform?

Because trust me, talking about it on an online community where nearly everybody agrees with you won't change a damn thing.
posted by SteveInMaine at 3:22 AM on August 13, 2009 [3 favorites]

The Japanese have 20% copay required gov't-administered insurance.

The 20% figure is for infants; people between 3 and 69 have a 30% co-pay (capped with monthly maximums), and for the elderly it's 10%.

There are many nifty twists to our health insurance over here. One little-known detail is that if your injury was caused by a 'brawl or drunkenness', you're on your own ...

Interesting English-language outline of the Japanese health insurance policies is here.
posted by woodblock100 at 3:22 AM on August 13, 2009

The perfect is the enemy of the good, paulsc. And what America's got right now as a health system? It's far from good.

Canada, France, England, Korea, any other first-world nation in the world? It's better. It's cheaper. And they live longer.
posted by bardic at 3:26 AM on August 13, 2009 [4 favorites]

bardic: "Canada, France, England, Korea, any other first-world nation in the world? It's better. It's cheaper. And they live longer."

Ouch, funny how everybody shuts up about France when it comes to health care. They might not be known for military conquest but they utterly dominate the US in life expectancy. Merde.
posted by mullingitover at 3:32 AM on August 13, 2009 [2 favorites]

The point was that catastrophic coverage + HSA isn't a bad approach. That's currently what I have, basically, a $1750/yr max out-of-pocket plan that costs $200/mo, compared to the gold-plated plan I had via my previous employer, which would have cost $600/mo via COBRA.

@troy, I hope you're still reading this because that actually does sound like a reasonable option, but I'm really curious about the specifics. Is your catastrophic insurance from the individual market or from an employer?

Thankfully, I've never had to shop on the individual market for insurance, but I've heard a lot of horror stories. It surprises me that you could find a $200 monthly plan with a $1750 deductible. What's the catch? What's the lifetime payout limit?
posted by heathkit at 3:38 AM on August 13, 2009

"... You're quoting from a report on funding costs for private homes for the elderly, and equating that to 47 million people who can't afford to see a doctor? ..."
posted by Happy Dave at 6:18 AM on August 13

Nope. You're equating that, Happy Dave. I'm just calling you on your own overly broad rhetoric. As for your mis-quote of my comments, I doubt I ever said anything about "who knows how many paying through the nose for, by your own admission, less than stellar care and overpriced drugs."

My parents got the very best medical care that top flight, accredited U.S. hospitals could provide. Their drug costs were paid 100% as "comparable and reasonable" by the U.S. government's Medicare system, and by a top rated supplemental insurance carrier, beyond that. Nobody, not them, not me, spent even 1 hour discussing or disputing any aspect of their care, on cost grounds.

They went to doctors they chose, hospitals they chose, and flashed their Medicare and supplemental insurance cards and that was it. They were cared for, because they paid.

But, they still died, in pain at some moments, and in a drug haze otherwise.

If I understand your argument, you suggest that they should have paid more, so they'd get the same outcome, but others would get, perhaps sub-optimal outcomes, and still others might get reasonable outcomes, from some yet to be described, yet to be deployed, U.S. version of NHS. You'd like me to pay more than I do, so that people I'm not acquainted with can go to a doctor whenever they have a cold (which no doctor on earth can do a thing to alleviate), or want a day off work. You think that is a superior system, and you think I'm a cretin for disagreeing in the slightest.

You are welcome to your opinion. I don't expect to change it with facts.
posted by paulsc at 3:39 AM on August 13, 2009

HDHPs directly act to encourage you to avoid health care services. Thus, you don't take advantage of preventative medicine, you don't go to the doctor until your really sick, and thus, you're in worse shape.

My high-deductible plan covers in-network visits to specialists for $40 co-pay (up to 3 times per year). Here's a recent event:

OUTPT CONSULT performed at Physician's office or independent lab
Billed: $287.00
Allowed: $116.22
Amount Paid by Blue Shield: $76.22
Patient Copayment: $40.00

No complaints here . . I also get one annual physical per year for the $40 co-pay.
posted by @troy at 3:40 AM on August 13, 2009

This is why I only go to Whole Foods to graze on free chips and cheese cubes and leave without buying anything, TAKE THAT MACKEY.
posted by The Straightener at 3:44 AM on August 13, 2009 [4 favorites]

So paulsc loves his health care plan with its $500,000 lifetime limit and doesn't seem to care that significant numbers of the population have no health insurance. If I were him I wouldn't be so smug. Get the wrong illness or injury and that lifetime limit will be looking pretty small.
posted by caddis at 3:44 AM on August 13, 2009

"But, they still died, in pain at some moments, and in a drug haze otherwise."

I'm sorry paulsc. I've lost a parent myself. But this is strange because no amount of health-care is going to prevent death from being horrible.

I'll leave it at that. To become such an incurable fatalist over the (admittedly) saddening death of your parents, while failing to consider the situation of, say, a 30 year old girl in her prime getting diagnosed with a terrible but also treatable form of cancer is, IMO, insane.

Just what is it that you hold dear about the American system that allowed your parents to die in agony? Honestly, listen to yourself. Your argument boils down to "Shit happens, so why bother?"
posted by bardic at 3:45 AM on August 13, 2009 [11 favorites]

What's the catch? What's the lifetime payout limit?

$6 million. The catch is you've got to stay within the Blue Shield PPO network or costs go up 5X or more, up to the $8000/yr OOP limit. Details here. I'm also cheating since where I live you can't throw a rock without hitting a healthcare professional.
posted by @troy at 3:47 AM on August 13, 2009

You'd like me to pay more than I do, so that people I'm not acquainted with can go to a doctor whenever they have a cold (which no doctor on earth can do a thing to alleviate), or want a day off work.

Most Americans don't go to doctors whenever they have a cold, and most working Americans don't have the luxury of taking a day off work, regardless. The truth is that these realities would not change with the proposed healthcare reform.
posted by Blazecock Pileon at 3:49 AM on August 13, 2009

That sound you hear is a million Priuses going elsewhere for groceries. And rightly so. This guy's a fucking asshat.
posted by littlerobothead at 3:50 AM on August 13, 2009 [1 favorite]

"... Get the wrong illness or injury and that lifetime limit will be looking pretty small life may not be worth living."
posted by caddis at 6:44 AM on August 13

FTFM. (Fixed That, For Me.) In the real world, some choices are valid, even if they wouldn't be yours. And compelling others to pay for your choices, when those choices don't have guaranteed outcomes, seems horribly unfair, at a basic level.
posted by paulsc at 3:50 AM on August 13, 2009

Just what is it that you hold dear about the American system that allowed your parents to die in agony?

it's the fear of SOCIALISM. At least in our present private system you have the theoretical ability to change who you do business with. With the dysfunctional gummint-controlled system our friends on the right expect to encounter, they fear being subsumed into the matrix of USPS/DMV + whatever other conservative bugbears inhabit their pointy heads.

Plus with this SOCIALISM direction they perceive themselves to be at risk of losing their present place in the system. My mom falls into this category; even though Medicaid-level health care in central California is completely third-world in availability, she resents the access that immigrants have to it and fears that TEH SOCIALISM will screw it up even more.
posted by @troy at 3:56 AM on August 13, 2009 [1 favorite]

If I understand your argument, you suggest that they should have paid more, so they'd get the same outcome, but others would get, perhaps sub-optimal outcomes, and still others might get reasonable outcomes, from some yet to be described, yet to be deployed, U.S. version of NHS. You'd like me to pay more than I do, so that people I'm not acquainted with can go to a doctor whenever they have a cold (which no doctor on earth can do a thing to alleviate), or want a day off work. You think that is a superior system, and you think I'm a cretin for disagreeing in the slightest.

You are welcome to your opinion. I don't expect to change it with facts.

I'm afraid you've completely misunderstood me. Let's take this point by point.

• You suggest that they should have paid more, so they'd get the same outcome, but others would get, perhaps sub-optimal outcomes, and still others might get reasonable outcomes, from some yet to be described, yet to be deployed, U.S. version of NHS. No, I don't at all. I was asking why you thought that the standard of palliative care for your parents through Medicare is an indicator of anything, especially your assertion that HDPD+HSA is a good idea for the vast majority of today's uninsured.
• You'd like me to pay more than I do, so that people I'm not acquainted with can go to a doctor whenever they have a cold (which no doctor on earth can do a thing to alleviate), or want a day off work. Leaving aside your judgement of these hypothetical people you've never met and their choices in accessing healthcare, I'm making the opposite argument. It costs less. I make a good wage, and pay more taxes and NI contributions than many. But it's proportional and based on my income, and I don't miss it, and I don't worry about the cost of healthcare. I 'spent' ?3000 or so in NI contributions on healthcare last year. I've spent more time talking about US healthcare on Metafilter than I've ever given to thinking about where or how I receive or pay for healthcare in the UK. Also, I'll note that this is a polite version of saying 'fuck you, I don't know you, you can die in the street for all I care' to the rest of the population of the US.
• You think that is a superior system, and you think I'm a cretin for disagreeing in the slightest. You are welcome to your opinion. I don't expect to change it with facts. Yes, I think it's a superior system. No, I don't think you're a cretin. Selfish, short-sighted and dressing up 'fuck you, got mine' with endless subject-changing and cod-philosophy yes. Also, I fail to see many facts in your arguments. A lot of anecdotes about and extrapolation from your own experiences, and a lot of cherrypicking in your examples of my health system, but very few facts.

posted by Happy Dave at 4:01 AM on August 13, 2009 [16 favorites]

"... Honestly, listen to yourself. Your argument boils down to "Shit happens, so why bother?"
posted by bardic at 6:45 AM on August 13

I don't think I've said that. I think I've made the point that money spent on health care does not equate, as much as most people in this thread seem to assume it does, with quality of life outcomes.

If a federally operated system of health care or even health insurance could guarantee me a 10% lower cost of health care, for the choices I make, than if no such system were in place, I'd probably support it, even with uncertain outcomes. But, no such cost limit guarantees are forthcoming, or even in discussion. There are some vague promises to oversee private insurers. There are some hand wavy assumptions about how universal access to health care is going to lower total health care outlays. But none of those things are guarantees of improved outcomes, and none of them are enforceable guarantees to me, or to anyone, of lower costs.

I think sincere skepticism is warranted.
posted by paulsc at 4:01 AM on August 13, 2009 [1 favorite]

Sincere skepticism noted!
posted by @troy at 4:06 AM on August 13, 2009 [1 favorite]

List of intrinsic human rights:

Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

If only we cared enough about these things enough to make the declaration legally binding...
posted by l33tpolicywonk at 4:10 AM on August 13, 2009 [1 favorite]

And compelling PAULSC to pay for NOT PAULSC choices, when those choices don't have guaranteed outcomes FOR PAULSC, seems horribly unfair FOR PAULSC, at a PAULSC basic level.

FTFEE (fixed that for everyone else). The rest of humanity recognizes that the world isn't fucking fair, but at least strive to make the playfield level.

I'm sorry for your loss.
posted by YoBananaBoy at 4:20 AM on August 13, 2009 [2 favorites]

But, no such cost limit guarantees are forthcoming, or even in discussion.

You're somewhat mistaken. President Obama did discuss reining in costs with insurance companies several months ago, and they reneged on their promises.

Nonetheless, the alternative is to continue with the status quo, where we allow private insurance to continue to increase costs without limit.

There may be no guarantee that the government can reduce the costs by x% of its own offering (even though it plans a 1.5% cost decrease) but you can get a guarantee that the health care industry will keep raising costs as nothing continues to be done.
posted by Blazecock Pileon at 4:21 AM on August 13, 2009 [1 favorite]

I pay less in National Insurance contributions

Point of order: National Insurance is nominally there to pay for various forms of Social Security, not healthcare. The NHS is funded out of general taxation.
posted by cillit bang at 4:24 AM on August 13, 2009

Please write Whole Foods and tell them why you just quit shopping there. I am and I did.

HEALTH CARE IS A RIGHT, NOT A PRIVILEGE. ALL OTHER INDUSTRIALIZED NATIONS UNDERSTAND THIS.

The USA is the richest nation on earth yet we are 37th in the health of our citizens.
posted by hooptycritter at 4:27 AM on August 13, 2009 [6 favorites]

"... It costs less. I make a good wage, and pay more taxes and NI contributions than many. But it's proportional and based on my income, and I don't miss it, and I don't worry about the cost of healthcare. I 'spent' ?3000 or so in NI contributions on healthcare last year. ..."

So, you've spent more than 2x more, last year, on health insurance, than I did. You've spent more than @troy did, too. Why do you think I should be impressed by that? By your own figures, your system isn't costing you less, as you asserted it did, it's costing you more than mine does me, or that @troy's coverage costs him. You could argue that should you wake up a quadrapeligic, that you'd be well taken care of, and I'd be left to die, after some months.

You ignore the assertion I make, that I would prefer, in a similar instance, to die right away, without waiting months, and that by capping health insurance limits electively, I may have helped to assure that outcome, sooner rather than later, if I can do nothing else.

You believe, but can't prove, that the difference in costs you are incurring, may improve outcomes for someone, but you can't say who. I hope, for your sake, when your time comes, it will be you. You seem to be OK if it is, instead, for someone you never met.

"Selfish, short-sighted and dressing up 'fuck you, got mine' "

How about "sorry Bub, paid for mine" if you can get off your rhetorical hobby horse for a minute, Happy Dave? I do live in a capitalist society, still. The rules may be under discussion, and we may be moving towards a socialist health care model, but until that day arrives, I'm playing by the established rules for my society. And, as far as I can see, a socialist model system like yours is going to cost me, not save me, money, against the promise that some greater good will result.

Interestingly, part of the extra costs your system would seem to require, if adopted here, would probably have to come out of my annual charitable giving, some of which goes to organizations which provide indigent care here. I think a lot of other Americans would have to cut back voluntary charitable giving, to afford national health care, too.

But, we're not talking about those kind of offsets, either.
posted by paulsc at 4:29 AM on August 13, 2009 [1 favorite]

Sincere skepticism operated on for free, patient makes full recovery. Everybody happy.
posted by ciderwoman at 4:32 AM on August 13, 2009

My high-deductible plan covers in-network visits to specialists for $40 co-pay (up to 3 times per year). Here's a recent event:

OUTPT CONSULT performed at Physician's office or independent lab
Billed: $287.00
Allowed: $116.22
Amount Paid by Blue Shield: $76.22
Patient Copayment: $40.00

So, the uninsured would pay the provider $287.00, but the insurance company only pays $116.22, of which you pay $40. Which is awesome right up until the point you realize that the reason your provider is trying to get you in and out so fast is to make sure they make enough cash to function. And, of course, if you don't have insurance, or you are on an individual plan that doesn't have a good agreement, you pay much more.

And then, if you really get sick, there's that fourth visit. That's now into the deductible. And that's when your HDHP makes life really fun.

See, the *whole fucking point* of insurance is it protects you from the big hits, and HDHPs are rapidly evolving away from that. Indeed, the idea of Health Insurance in this country really isn't Health Insurance at all. If you lose your job, you start paying the vastly higher CORBA rates, when that runs out, it gets even worse.

If you were really sick? It becomes impossible. You get sick, can't work, you lose the insurance and you can't get it back. You are *fucked*.

That's the system you're espousing. It's one that bankrupts people every day. It's one that carefully selects *against* preventative care. It's one that costs more, per capita, than most in the world, and it offers *horrible* outcomes in comparison. Oh, it's great if you're in the top 30% and have a real health plan. The middle 40% do much worse. The bottom 30%? They're fucked. They don't get health care.
posted by eriko at 4:34 AM on August 13, 2009 [7 favorites]

paulsc, I'm withdrawing from this discussion with you. You keep coming back to palliative care and your personal decisions about that, when it has absolutely no bearing on whether the citizens of your country can equitably access and share the cost of healthcare.

As cillit bang noted above, I'm wrong on NI being NHS focused, so let's just say that, paying the tax I do, which is based on how much I earn, I'm happy that everyone in this country gets healthcare, and nobody goes bankrupt.

I will gladly pay taxes to that end. And I'd much rather money was spent on hospitals and doctors than nearly anything else. We may disagree how and where the money is spent, but that's what politics and elections are for.

This basically comes down to a difference in world view. You can't see why I believe it is a right and good thing for everyone to have equal access to healthcare. I can't see why you think that it's acceptable that millions of your fellow countryment don't get decent healthcare, and millions more go bankrupt paying for it.

But you clearly do think it's acceptable, because you've 'paid for yours'. The difference is that here, we all pay for each other's, and we all get it, and nobody suffers because they can't pay.

My children will be born dual US/UK citizens, but I'll be damned if they'll grow up in a country that can't provide healthcare to 1/6th of its citizens.
posted by Happy Dave at 4:40 AM on August 13, 2009 [9 favorites]

When you think of what a nation needs to protect its people from fire, you don't talk about putting out fires when they happen as much as you do about preventing fires through building codes and fire inspections, and through having regular citizens take some responsibility through fire drills and first aid training. You want to prevent the installation of faulty wiring rather than try to save people from a fire caused by installing the wrong type of wire. You don't want to pay for giant fire houses stuffed with multimillion-dollar high-tech fire engines and waiting teams of super-specialized fire fighters ready to get called for very specific sorts of fire rescue operations, and you certainly don't want to need gigantic burn care facilities in every town. You just want fewer fires, fewer burns.

Any national health care plan should put most of its money into prevention through diet, exercise, and checkups. Guarantee universal access to healthy food at prices that beat fast food and processed boxed crap, even if that means subsidizing good (fresh, unprocessed) foods and taxing the hell out of shit foods, maybe putting everybody on food stamps. Regulate organic/alternative/bogus health foods, concoctions, and treatments like any other type of medical care so people don't misdirect so many billions of health care dollars to ineffective self-medication. Create strong incentives to exercise, such as tax incentives for people who exercise X hours a week (and can prove it) and thus lower the probable long-term cost of their health care, and build being outdoors and walking back into the civic landscape. Make periodic medical checkups mandatory -- you must get your checkups (at no extra cost, and with a paid day off work) when you are scheduled or you lose your (no extra cost) medical coverage while continuing to pay for it through taxes.

Do that and the rest of the problem -- what to do with people who still get sick -- will be a lot easier.
posted by pracowity at 4:43 AM on August 13, 2009

I can hardly believed that this point has been argued: "compelling others to pay for your choices, when those choices don't have guaranteed outcomes, seems horribly unfair, at a basic level."

Correct me if I'm wrong: isn't that precisely how privatized health care works? You pay for others' care, not only your own. And when it's privatized, that health care company can dump you any time they feel that you're costing them too much; good luck finding another insurer. You have little to no say in it. How is that democratic?

It's been quoted goodness knows how many times, but here it is again (this particular article dates from 2005, but of course more recent statistics are available and the situation has not changed): The US Spends More on Health Care than Any Other Country.

Quotes from that article, emphasis mine:
"We can¡¯t blame the United States' higher health care costs on limiting procedures in other countries or the elevated number of law suits filed in the United States," said Peter S. Hussey, PhD, co-author of the study and a recent graduate of the Bloomberg School of Public Health¡¯s Department of Health Policy and Management.

"As in previous years, it comes back to the fact that we are paying much higher prices for health care goods and services in the United States. Paying more is okay if our outcomes were better than other countries. But we are paying more for comparable outcomes," said Anderson, who is also the director of the Johns Hopkins Center for Hospital Finance and Management.
posted by fraula at 4:51 AM on August 13, 2009 [1 favorite]

Easily negotiated with virtually any new employer, except for hourly jobs, at the very bottom of the pyramid.

You have yet to address this.

Coward.
posted by Civil_Disobedient at 4:54 AM on August 13, 2009 [1 favorite]

"... The difference is that here, we all pay for each other's, and we all get it, and nobody suffers because they can't pay. ..."
posted by Happy Dave at 7:40 AM on August 13

Bullshit, Happy Dave.

"... A new study by scientists at The University of Nottingham's Children's Brain Tumour Research Centre, funded by the Samantha Dickson Brain Tumour Trust, shows that prolonged and slow diagnosis can make long term survivors of childhood brain tumours up to 10 times more likely to suffer disability. 450 children in the UK are diagnosed with a brain tumour every year. The average time between the onset of symptoms and diagnosis in children in the UK is between two and three months, that's up to three times longer than the rest of Europe and the USA. ..."

(emphasis added)

If it comes to it, you might want to re-think where your kids get their healthcare. I hope, for your sake and theirs, it doesn't come to that.
posted by paulsc at 4:57 AM on August 13, 2009

I have a chronic disease and my life is still worth living. I want to keep working, and I need healthcare to do so.
posted by hydropsyche at 5:03 AM on August 13, 2009 [4 favorites]

"You have yet to address this. ..."
posted by Civil_Disobedient at 7:54 AM on August 13

Address what? That many people who use HSAs can manage them so that they don't take any hit, when changing jobs, regardless of income level? That the maximum 2009 hit an individual could be subject to, if they made the maximum $5950 contribution, and left it all in an HSA, would be $595, if eriko's penalty and math are even right? That there is no reason why folks in lower income brackets shouldn't save on health insurance by using HSA plans with appropriate insurance, if it is available to them?

I just thought it was simple math, if you read the links.
posted by paulsc at 5:07 AM on August 13, 2009

This piece is a beautiful refutation of the effiencient market hypothesis. Mackey is hurting his business by publicly taking this anti-healthcare position. His largely liberal customers aren't going to like it and he would actually save money on healthcare if the whole country had a more efficient healthcare system.

So Mackey is acting economically irrationally in order to advance the position that markets are rational. It's rather wonderfully ironic.
posted by afu at 5:12 AM on August 13, 2009 [6 favorites]

paulsc: nobody suffers because they can't pay - I don't see how a general issue with the diagnosis time is related to that.
posted by edd at 5:14 AM on August 13, 2009

"Correct me if I'm wrong: "
posted by fraula at 7:51 AM on August 13

OK. That's not how all health insurance works, and certainly not how all health care works. Group health insurance charges premiums based on group health care costs, and is heavily regulated in most states, but private plans can operate differently. Many people can choose to change individual plans for something as basic as lower cost premiums, or differing benefits, to suit their needs and budgets. And democracy doesn't yet have much to do with health insurance costs, or general health care, in the U.S. It may, in the future, but it is not at all clear that politicizing either health insurance or health care guarantees lower costs, or better care.
posted by paulsc at 5:16 AM on August 13, 2009

"I don't see how a general issue with the diagnosis time is related to that."
posted by edd at 8:14 AM on August 13

From the quote I posted:

"... A new study by scientists at The University of Nottingham's Children's Brain Tumour Research Centre, funded by the Samantha Dickson Brain Tumour Trust, shows that prolonged and slow diagnosis can make long term survivors of childhood brain tumours up to 10 times more likely to suffer disability. ..."

(emphasis added)
posted by paulsc at 5:19 AM on August 13, 2009

Another cherry-picked example of a single issue in a system which covers everybody. How surprising.

Like I keep saying. It's not perfect, and I'm not claiming it is. But it's better than 1/6th of your population with no access to healthcare and millions taking on needless, incredible debts.

Address what? That many people who use HSAs can manage them so that they don't take any hit, when changing jobs, regardless of income level?

No, address your statement that health insurance can be 'Easily negotiated with virtually any new employer, except for hourly jobs, at the very bottom of the pyramid.'

Which is the very constituency that would be most helped by national healthcare.

Right, enough. Goodbye.
posted by Happy Dave at 5:20 AM on August 13, 2009 [2 favorites]

HSA's are OK if you're healthy, or if your illness pops up after you've built up some funds. It didn't work so well for me when I didn't get onto my company's healthcare HSA + catastrophic plan until just after I developed asthma. Each month I was paying $200 for Advair and $100 for allergy medications from my own $1000/month pay check. If it weren't for an expensive allergy test, I still wouldn't have met the $2K deductible until July.

Luckily, now I'm covered by my wife's "government" healthcare.

As for Whole Foods, one opened up a block away from our local health food shop, as such I've never bothered to go in.
posted by drezdn at 5:25 AM on August 13, 2009 [1 favorite]

Someone needs to summarize this in clear concise wording and stand outside of whole foods passing out summaries of Mr. Mackey's vision for the future of your well being.
posted by Kid Charlemagne at 5:28 AM on August 13, 2009 [2 favorites]

I sure could go for a teriyaki salmon fun bowl from the hot bar at my local Whole Foods?

I wouldn't. As soon as I finish reviewing the Constitution and Declaration of Independence to make sure the don't specifically prohibit my peeing on the hot bar at my local Whole Foods, I've got an errand to run.

I mean Christ - show me in the Constitution and Declaration of Independence where it says you get to keep both your eyes. That's the kind of logic you use when you're goal is to be declared unfit to stand trial.
posted by Kid Charlemagne at 5:33 AM on August 13, 2009 [1 favorite]

paulsc: you didn't get my point did you - or Happy Dave's. The point is that there is noone in the UK getting poor treatment because they can't pay. That's different from us all getting lower quality treatment regardless of whether we can pay or not.
posted by edd at 5:36 AM on August 13, 2009

The average lifespan in 1776 was somewhere between 35-40, about what you see now in places like Malawi. You really want to argue this point?

Health care shouldn't be measured in life expectancies (especially across different time periods). It should be measured in the amount of basic, human care we provide to our fellow humans, using the resources and tools we have at the time. People in 1776 didn't know jack about medicine, but they took better care of each other, and they didn't charge for it.
posted by iamkimiam at 5:38 AM on August 13, 2009

Interestingly, part of the extra costs your system would seem to require, if adopted here, would probably have to come out of my annual charitable giving, some of which goes to organizations which provide indigent care here. I think a lot of other Americans would have to cut back voluntary charitable giving, to afford national health care, too.

Gosh. Just to get that in perspective, how many of the 47 million uninsured Americans do your charitable contributions currently provide coverage for?
posted by Combustible Edison Lighthouse at 5:44 AM on August 13, 2009 [4 favorites]

"Another cherry-picked example of a single issue in a system which covers everybody. ..."
posted by Happy Dave at 8:20 AM on August 13

Happy Dave, you keep saying Goodbye, but you keep coming back, with one dismissive rhetorical flourish after another. So, how many "cherry picked" examples of the failings of your vaunted NHS would you need to admit that it is not only "not perfect," but worse in some measures than the health care system you've so actively derided in this thread? That's right, not better, but worse than a system you've selected some figures you don't like to harp on? Would 5 more examples suffice? How about 10?

"No, address your statement that health insurance can be 'Easily negotiated with virtually any new employer, except for hourly jobs, at the very bottom of the pyramid.' "

I don't know what there is to address. That low wage jobs are often short term, entry level jobs held by people who are covered by spouse or parent's insurance currently, and wouldn't be interested in health insurance at any price? That workers in low wage service jobs have the right to organize, and that those who do have recently won free health insurance in collective bargaining?

"... On Thursday, July 23rd the InterContinental Chicago O'Hare will become the latest hotel on the River Road corridor to sign a union contract. Unite Here Local 450 and the InterContinental Chicago O'Hare have reached agreement on a collective bargaining agreement covering nearly 100 housekeepers, banquet service staff, culinary workers, and other guest service providers, providing fair wages in line with industry standard, guaranteed significant wage increases, pension, pre-paid legal services, and free health insurance.

In the middle of the deepest economic recession in this country in 50 years, the employer of the hospitality workers at the InterContinental Chicago O'Hare hotel will sign a union contract that guarantees substantial wage increases and benefits, including free health insurance to workers. ..."

posted by paulsc at 5:44 AM on August 13, 2009

That low wage jobs are often short term, entry level jobs held by people who are covered by spouse or parent's insurance currently, and wouldn't be interested in health insurance at any price?

You are suggesting that minimum-wage earners do not require insurance because they do not want it. Or they are already covered.

Perhaps you could document this claim with some evidence. Because that sounds like bullshit.

That workers in low wage service jobs have the right to organize, and that those who do have recently won free health insurance in collective bargaining?

John Mackey fires Whole Foods workers who attempt to organize, as does Walmart, McDonalds and other minimum-wage employers.

Paulsc, I think you do not know what you are talking about.
posted by Blazecock Pileon at 5:53 AM on August 13, 2009 [13 favorites]

Paulsc, I think you do not know what you are talking about.

That's something of a tautology.
posted by aramaic at 5:54 AM on August 13, 2009

"... The point is that there is noone in the UK getting poor treatment because they can't pay. That's different from us all getting lower quality treatment regardless of whether we can pay or not."
posted by edd at 8:36 AM on August 13

I suppose you've got a point, edd, but it's a hard one to sell as a benefit, particularly if the poor care you get makes it 10 times more likely you'll be disabled for life. :-)

For most people, outcomes matter, as do costs.
posted by paulsc at 5:55 AM on August 13, 2009

It's not only that the US spends more on healthcare than any other country - with the most recent figures I've seen (2005 IIRC - certainly before Bush's healthcare expansion came into effect), the US spent more per head in taxes on healthcare than Britain did for our NHS. The whole structure of US healthcare is criminally wasteful - absurdly bureaucratic, massively profiteering, and unnecessarily exclusionary. It's almost at the level where the best thing to do is shoot the whole system and start afresh.

Good, Fast, Cheap. Pick two. (Britain went for cheap and good and is fixing fast at the expense of some of our cheapness). It works in healthcare as in many other places. Unless you are dealing with the US, when if you win a birthright lottery you might have good and fast - anyone else is screwed.

And even if you think you have good healthcare (unless you are a public employee) you probably don't. Recision affects only 0.5% of the insured population - but only 5% of the insured population spend more than they pay into healthcare per year and the companies don't try to recise while making a profit. In short, if you actually need healthcare your chances of not being insured for practical purposes are at least 10%. And the majority of medical bankruptcies happen to patients who started off with insurance.

From an international perspective, all of Western Europe, Canada, Australia, NZ, et al are human systems with their issues, and all of them want to steal aspects from each other. And any time people who try to organise any of them are feeling disspirited at waste, ineffectiveness, or other reasons, they just take a look at the steaming turd that is the American system and feel either better or angry at the murderous levels of barbarism that that system results in. (Or wish they could rake in the money as effectively).
posted by Francis at 5:57 AM on August 13, 2009 [3 favorites]

Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment, according to a report last month in Investor¡¯s Business Daily.

Hunh. I am again reminded that any statement is true as long as you are allowed to redefine the terms. I suppose for non-urgent care there is a wait time. (Canadian here, btw.) I have had three or four MRIs in my life to monitor the progress of my MS. Each time I waited a couple of months from the time it was booked to when I went in the machine.

On the other hand, both of my senior-citizen Canadian parents were in the hospital last month, in both cases in pain and requiring prompt care, but neither one in imminent danger of mortality: my dad after breaking some ribs in a car accident in rural Alberta and my mom due to a sudden serious gastrointestinal ailment. Each was waiting for as long as it took the ambulance to arrive after a phone call: under an hour in each case. They are both fine now: the death panel (in French: comit¨¦ de la mort) decided not to euthanize them.

If I want to see a doctor today, there are a dozen clinics in my city which I could walk into. According to the website which lists the current wait times at each one, I would be in the waiting room for anywhere from 45 minutes to 1 hour 20 minutes.

So we have wait times about like Lenscrafters customers. Whoop de do.
posted by ricochet biscuit at 6:12 AM on August 13, 2009 [6 favorites]

InfoFilter -
Hey can someone debunk the statement that the reason our healthcare is so expensive (prescriptions and hardware) is because we subsidize the rest of the world?

It sounds like another classic "We're #1!" talking point, but I'm unsure about the veracity..
posted by Lord_Pall at 6:17 AM on August 13, 2009 [1 favorite]

"... A new study by scientists at The University of Nottingham's Children's Brain Tumour Research Centre, funded by the Samantha Dickson Brain Tumour Trust, shows that prolonged and slow diagnosis can make long term survivors of childhood brain tumours up to 10 times more likely to suffer disability. 450 children in the UK are diagnosed with a brain tumour every year. The average time between the onset of symptoms and diagnosis in children in the UK is between two and three months, that's up to three times longer than the rest of Europe and the USA. ..."

I'd just like to point out that this example only points to problems with the British system and not government controlled universal coverage in general. In case you forgot, "the rest of Europe" also has such coverage.

I'd like to now cherry-pick an example of how bad the alternative is. Thanks.
posted by Pollomacho at 6:21 AM on August 13, 2009

One inefficiency in the US system that blows me away is the amount of time Americans have to spend thinking about health care, filling out forms, arguing with call centers, arguing with doctors, arguing with spouses around the proverbial 'kitchen table', mulling it over while floating in Walden Pond...

It's a gigantic transaction cost, across the entire nation. How many hours are spent performing this magical free market 'informed choice' that libertarians approximate as costing nothing and performing perfectly? Given the documented amounts insurance companies spend on administration and denying claims, I'm very curious to see what the cost becomes when you add in the un-billed 'work' done by people seeking health care.

Me? I'm alive because of open-heart surgery competently provided by socialized health care when I was 3 years old (and to my credit hadn't had a chance to solve it by shopping at Whole Foods). Now I have a chance to become a high-income-tax paying productive member of society. And I don't have to worry about it at all.
posted by anthill at 6:29 AM on August 13, 2009 [5 favorites]

It's really time for Americans consumers to start affecting some fucking change around here by exercising free will at the cash registers of business' like this. I've never been much of a protester type of guy but enough is fucking enough. Americans need to start boycotting these unethical business' and corporations. Same with banking. I don't give a fuck what you call the political system, socialist, capitalist etc. Any bird brain that finished grade school ought to be able to distinguish between the social compact that Americans have with their government and the relationship we have with business as consumers. If capitalism means free choice and free markets then any argument guys like Mackey make, are based on an obvious misrepresentation of the facts. I've read the constitution with my 12yr old lately. And you know, making a profit from your business doesn't seem to be guaranteed anywhere in that document either. I think nothing short of a nation wide boycott of some of these business will get the attention of the politicos. Also, y'all better remember who those "conservative democrats" are. Those fuckers had the power to affect change that is good for citizens and they chose to side with business instead. Remember them when it counts most, at the polling place.


Face it, were a bunch of fucking sheep and when we realize we've been had, it's too fucking late.
posted by gigbutt at 6:35 AM on August 13, 2009 [1 favorite]

FWIW, the average age at death of the signers of the Declaration of Independence was 66; 67 if you don't count the youngest two who died of misadventure.

It shouldn't really be surprising that a group of wealthy white landowners, some of whom were literally the richest men in America, significantly outlived the average. Of course, the horrible child mortality rates at the time skewed things downward quite a bit; it's only in the last hundred years that we've pushed the average lifespan out of the mid-thirties.

For what it's worth, I get my health insurance through Whole Foods (my wife works there) and we're incredibly happy with it. I don't know that it's a workable solution for everybody, but we get a debit card with enough money on it to cover our deductible, and then the insurance kicks in. We don't have copays at the doctor's office, and once we're past the deductible, it pays for most prescriptions. Mackey makes a number of asinine points in this op-ed, but he's right that his employees are well-covered.

(As far as the Whole Paycheck thing goes: as far as the processed food and the meat go, that's absolutely right. But a lot of stuff there isn't any more expensive than it would be in another grocery store. Quite a bit of their produce is comparable, and I can't find milk anywhere that's as cheap as it is at our WF.)
posted by EarBucket at 6:37 AM on August 13, 2009

Also, don't forget conservatives are stuck in the 1980s. This is part of why they're all WHARRGARBL SOCIALISM.
posted by kldickson at 10:52 PM

Can we add the WHARRGARBL SOCIALISM tag to this post?
posted by Demogorgon at 6:44 AM on August 13, 2009

"In the middle of the deepest economic recession in this country in 50 years, the employer of the hospitality workers at the InterContinental Chicago O'Hare hotel will sign a union contract that guarantees substantial wage increases and benefits, including free health insurance to workers."

Good for them. But 'free health insurance' is pretty vague. Who knows how good that is? But perhaps more vexing is that there's still a flaw in this. What if these workers want new jobs? They lose their current insurance which for some people is not an option. What if the company downsizes and the worker gets laid off and they have to find a new job that doesn't provide insurance but pays better, but they now have a pre-existing condition?

Problem still not solved.
posted by Green With You at 6:44 AM on August 13, 2009

I work extremely close to a Whole Foods - I very much want to print out about 50 copies of this drivel, and leave it under the windshield wipers of cars in their parking lot.
posted by god hates math at 6:48 AM on August 13, 2009 [1 favorite]

The problem with ObamaCare, or your own vaulted NHS, is that outcomes can't be guaranteed, for the money spent, even across broad swaths of population.

yeah, why go for a new system in which you MIGHT die broke, desperately ill and given second rate care when you have a system that can GUARANTEE you will?
posted by pyramid termite at 6:57 AM on August 13, 2009 [3 favorites]

So long as this society does not make individual end of life choices a reasonable care alternative

We tried doing that in the current bill, but then your side started foaming at the mouth about death panels and sending granny off to the ice floes, so that will probably be gone.
posted by dirigibleman at 7:07 AM on August 13, 2009 [2 favorites]

For-profit health care systems are hideously immoral.

It's really that for me.

The entire health care industry in the USA disgusts me, from that perspective alone. It's the underlying rot beneath everything from the insurance racket to drug patents. The way people are left bankrupted with seven digit bills because a loved one dies in an unfortunate and drawn out way? That's beyond Dickensian evil.

Death panels? Fuck, better than death profits.
posted by rokusan at 7:14 AM on August 13, 2009 [11 favorites]

I work extremely close to a Whole Foods - I very much want to print out about 50 copies of this drivel.

Just print the URL to this thread. Saves more trees.
posted by rokusan at 7:15 AM on August 13, 2009

Hunh. I am again reminded that any statement is true as long as you are allowed to redefine the terms. I suppose for non-urgent care there is a wait time. (Canadian here, btw.) I have had three or four MRIs in my life to monitor the progress of my MS. Each time I waited a couple of months from the time it was booked to when I went in the machine.

It's around this point in the discussion with Death Panelists that I usually lose it. Month-long wait-times for non-critical procedures, you say? Good heavens! We'll have to scrap the whole idea and rebuild from the ground up! Except this time, with five times as many doctors, which we shall summon from the aether. And they'll sit idle 60% of the time, because there isn't enough demand to keep them busy. But, hey, anything to make sure you don't suffer the indignity of having to wait for a procedure that isn't essential to your immediate health, you precious little snowflake you.

Not to mention the fact that I, as a red-blooded 'Merkuhn with pretty much the gold standard in health insurance, have made appointments at several times in the last few years for non-critical procedures and to see specialists for non-critical medical problems. How long after I make the call can I get in to see them, you might ask? Why, one to two months! Exactly the length of time being decried as socialism! Because it turns out that doctors are actually pretty busy seeing people who will die if they aren't seen, no matter who's paying for their care!
posted by Mayor West at 7:16 AM on August 13, 2009 [4 favorites]

Demogorgon: "Can we add the WHARRGARBL SOCIALISM tag to this post?"

Hell, I want it on a t-shirt.
posted by octothorpe at 7:18 AM on August 13, 2009

So let me get this right: Whole Foods (via Mackey) opposes the employer mandate for insurance, but Wal-Mart supports it?

I need to lie down.
posted by dw at 7:19 AM on August 13, 2009 [2 favorites]

I was laid off a few months ago. I have chronic health problems that make me uninsurable or subject to the highest rate that an individual can be charged in Georgia on the individual-plan market. My unemployment insurance provides about $1100/month; my COBRA payment is $660, reduced temporarily to the low $200s through the Obama stimulus COBRA reduction. (Thanks, Mr. President.) Luckily, I'm back in school, in large part so I can qualify for student health insurance which will keep me continuously insured until I find a new job.

When I was making $75K/year, Whole Foods was my grocery. I shopped there weekly for nearly ten years. I like their meat, I like their cheese, I like the wine and beer options, and - with some careful price booking - I can match or beat prices with my local non-elitist chains pretty well on everything else I buy, which made affording the meat and cheese easier.

I am lucky to have the savings to shop at WF still. However, as of today, I don't.
posted by catlet at 7:21 AM on August 13, 2009 [2 favorites]

FWIW, the average age at death of the signers of the Declaration of Independence was 66; 67 if you don't count the youngest two who died of misadventure.

It shouldn't really be surprising that a group of wealthy white landowners, some of whom were literally the richest men in America, significantly outlived the average.

And now a few words on STATISTICS:

When you plot the average age of death, particularly in the past and in poorer environments, you get a huge draw down, mostly due to infant mortality and childhood diseases, with some additional reduction due to women dying in child birth and young men dying in wars or in horribly unsafe workplaces. (Not that the work relegated to women was cushy - it was just more repetitive stress horrible than kill you outright horrible. Mostly.)

If you lived long enough to be an adult, were done having kids and/or have gotten yourself a cushy job (one where a giant gear or some such isn't trying to decapitate you for twelve hours a day) chances are you'd significantly outlive the average.

Back on the argument at hand, here's the deal - if everyone who had a brain tumor just instantly died, how much more of a train wreck would it be than what we have now? The article cited said what, 450 children every year? That's on the order of deaths from appendicitis in the US in the average year. My grandfather's appendix burst, at sea, during WWII and he lived to be eighty something. This is not the sort of thing we should be dropping the ball on in the 21st century. And I just looked at appendicitis because it's real easy to treat and was the first thing that came to mind - how many people are dying of similar, easily treatable shit because they don't believe they can afford a trivial levels of health care?

The UK is a wonderful model of how not to run nationalized health care because they spent pretty much the whole of the eighties trying to lowball costs (Thanks Maggie - and isn't it ironic that he starts his editorial with a Thatcher quote.) never considering that doctors require considerable training and you can't just pick up a few at corner shop when you run low and can no longer staff your hospitals.

Arguing, "think of the children" is pretty disingenuous when your poster child is saying, "Nothing in the Constitution saying I can't tell the children to literally fuck off and die!"
posted by Kid Charlemagne at 7:32 AM on August 13, 2009

You have absolutely no idea the horrible, disgusting truth of your accusation, when our hospitals get a patient with, essentially, a blank check, because of top line, federally operated, privately supplemented, paid up health insurance.

No dog in any pound in America dies as badly.
posted by paulsc at 2:19 AM on August 13

"people shouldn't have healthcare because my parents suffered at the end because they had healthcare"

basically what you're advocating is that your parents should have been kicked out on the street to die

fuckin hardcore
posted by Optimus Chyme at 7:33 AM on August 13, 2009 [17 favorites]

Christ, what an asshole.

Find a food coop near you. Or, start one up.
posted by mkultra at 7:36 AM on August 13, 2009

Metafilter, posts like this one remind me how happy I am to be a part of the MeFi community. Long live Obamacare!!!!!!!!
posted by satori_movement at 7:38 AM on August 13, 2009

Thanks for posting Whole Foods' stock price, georg_cantor. It'll be interesting to watch as the day goes by.
posted by Demogorgon at 7:41 AM on August 13, 2009

To avoid the fate of paulsc's parents you need to get a living will and make some decisions about how far you want end of life care to go. This is regardless of what kind of health care system you have and who pays. Don't wait until you are old to do this. Bad things sometimes happen to younger people.
posted by caddis at 7:44 AM on August 13, 2009 [3 favorites]

WSJ: Will you get rid of the unhealthy items? You have aisle after aisle of absolutely delicious looking candies and chocolates and fudge and cakes and then you'll have someone up front at a kiosk looking through cookbooks?


Mr. Mackey: "Customers, we hope, are going to vote them out. You're just seeing the most tentative efforts at this point because the details are not ready for public release. You need to be fair. I've got to plan the revolution."

I think one thing that libertarians miss is that government isn't the only threat to liberty. John Mackey wants to take away my organic fair trade biodynamic candy bars.
posted by melissam at 7:46 AM on August 13, 2009 [1 favorite]

You know, I have not yet read the whole Healthcare bill. I imagine I will find some issues with it; I know of very few long documents that I think are 100% perfect. However, it doesn't matter if it's the worst piece of legislation ever written because nothing would justify that elitist, wrongheaded, ill-informed garbage.

Goodbye to those fabulous cheeses and the salad bar. I won't be shopping at WH anymore
posted by pointystick at 7:50 AM on August 13, 2009 [1 favorite]

Just print the URL to this thread. Saves more trees.

That's why we need a URL shortener!
posted by roll truck roll at 7:51 AM on August 13, 2009

I can't turn away from these U.S. health care threads. To say I read through them in slack-jawed awe and dismay would be severely understating the case. I can't even imagine living in a country where "solutions" like this* are seriously bandied about, and the lengths opponents of health care reform go to to misrepresent the realities of our system is heartbreaking. Anyway, you Americans can and will argue this back and forth until you're blue in the face, and I hope you work it out, but me...I Wouldn't Take A Million Dollars For A Single Maple Leaf.

* (sample quote: "In sum, the proposal says to the person who prefers not to obtain insurance: ¡°Your government will not fine you for failing to buy health insurance. But if you are unlucky enough to run up a big medical bill that you can¡¯t pay from your assets, you will be paying a piece of it off every year at tax time, possibly for the rest of your life. Are you sure you wouldn¡¯t prefer to invest in a high-deductible insurance policy with limited mandates, with a cap on out-of-pocket payments, and with your own tax-free Health Savings Account?¡±) whut
posted by The Card Cheat at 7:53 AM on August 13, 2009

Wow. Didn't expect this. My third link didn't even work.
posted by georg_cantor at 7:54 AM on August 13, 2009

From what I can see, the core concern that some people have (without saying it) is that they will end up paying for someone else's care. But, you see, here in the US, we end up doing that anyway.

Folks with no insurance end up in emergency rooms. Yes, really, they do. And, they are cared for at a higher expense because emergency rooms are the most expensive place to receive care. Then, after the services are provided, the folks with no insurance either cannot pay, or go broke paying and declare bankruptcy. This is insane.

Everyone foots the bill when some folks don't have insurance - it's just hidden from view in lots of cases.
posted by mightshould at 8:08 AM on August 13, 2009 [5 favorites]

I don't know, I sit on one of the Death Panels up here in Canada and it seems to work fine. We really see it as a civic duty- everyone should work together to help lower the cost of health care. Plus it gives me something to do on a Thursday evening.

Oh that's right, they're not real.

Seriously, when did Abe Simpson become the standard for policy debate in the US?

With regard to quality of care, while my Grandmother was dying from a lingering terminal illness here in Canada, our health care system ensured that she could be comfortable at home, to the point of having a special bed moved into her house and making at home carers available to her. She died in a great deal of pain, but her doctors and care providers did everything they could to mitigate her suffering. My Grandfather died in the US under similar circumstances, and his quality of care was nearly identical. The only difference was that when my Grandmother finally passed on, people came to get the special bed she had been provided with so that it could be used elsewhere. And we didn't receive a huge bill afterwards.

(of course, in my Grandfather's case, all of his excellent care was covered by his federal employee retirement benefits and the VA, both of which are federally managed programs)
posted by TheWhiteSkull at 8:11 AM on August 13, 2009 [2 favorites]

Your third (fourth, actually) link did work, but whether you know this or not it's a totally skeezy SEO-template pit that adds nothing to the post. It's the sort of site we see posted here every once in a while from linkfarming spammers. I don't have any reason to think that has anything to do with your posting, for what it's worth, but I removed it from the post, and I've removed it from your comment as well.
posted by cortex at 8:13 AM on August 13, 2009

Mackey probably bit off more than he can chew with this one. This is a lightning-rod issue, especially with middle class professionals (largely self-employed, or wish they were) and bohemians (who spend what little disposable income they have at places like Whole Foods).

We're two hundred comments into this, and it's not even lunchtime.

His customers aren't going to turn a blind eye to his conservative/libertarian activism, not this time, because the issue is a lot more charged and universally supported by the left and center-left.

Boycots and outright picketing are in Whole Food's future, and as this would help the local indie grocer, I'm all for it.
posted by Slap*Happy at 8:15 AM on August 13, 2009 [4 favorites]

Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment, according to a report last month in Investor¡¯s Business Daily.

Now that's a fucking laugh. Is he really bragging about the countless US citizens who aren't currently waiting to be admitted, because they simply can't afford treatment?

Oh, big bad socialist Canada has almost 1 million of people waiting for care! The US is so much better, if you can't afford treatment, you don't get put on any waiting list, therefore our system works better! Huh-rah!

What a fucking joke this "debate" is. Everyone is entrenched in their position, no one will change their mind, and god fucking forbid anyone actually talks about the bill instead of throwing around whatever their favored pundit said yesterday on their show, or whatever bullshit they wrote on the internet. Death panels! Forced parent re-education! Rationing! Rah rah rah!

Your health care system ain't going to be fixed, because a lot of you are perfectly comfortable with having millions uninsured, with insured people being denied coverage and with insurance companies making record-breaking profits off the backs of the sick and the dying. Some of you may not agree, but those that do sure as hell are numerous enough and vocal enough that they'll either get their way (no reform) or force a toothless, ineffective compromise. But hey, that's OK, it's nice to see so many entitled dicks reveal themselves for what they are, so I can remove the US from consideration as a place to live or even maybe visit. A bad apple spoils the barrel, but half a barrel of spoiled apples may as well be rotten to the core.
posted by splice at 8:15 AM on August 13, 2009 [4 favorites]

Wow, someone at NRO is proposing indentured servitude for people who can't afford healthcare. What a great idea!
posted by Mister_A at 8:19 AM on August 13, 2009

*Stand Alone Comment*

Repeal all state laws which prevent insurance companies from competing across state lines.

Late in my Middle School years and deep into High School my mind flirted with the conservative philosophy. I even did a presentation on the Republican party in my Sophomore year.

Ideas like the above IMHO come from thought experiments in a really constrained field (or a really small petri dish if you would like to put it that way). Everything must be just so, and any deviation would kill the idea. Of course, taking into consideration any possible deviations would greatly strengthen a proposal or change into something better as far as we care.

So let's take this proposal, and reverse engineer to it's theoretical template:

Repeal all [insert level of government here] laws which prevent [insert group type here] from competing across [said level of government] lines.

Your theocratic arch enemy Darwin and the most basic form of the survival of the fittest doctrine FTW in favour of the 'unfairly' equipped group of said group type. Competition, as originally intended (or not), would not exist, or would be heavily in favour of the fully equipped player.

So your proposal (or at least this part), and frankly one of the base selling points of Republican philosophy, is dead and in flames like alkaline metal in water: in a flash.

Great discussion here btw.

*End Stand Alone Comment*
posted by JoeXIII007 at 8:21 AM on August 13, 2009

desuetude, I'm sorry, I wasn't trying to say that; "denying" was the wrong word. I know there are plenty of other places to buy good carrots. I shop at 3 of them regularly. But so many Whole Foods customers are shopping there because they feel they have to pay too much to get something good.

wendell, I'd posit that the people buying their carrots at Whole Foods because they believe that this is the only place to buy good carrots are people with the disposable income to do so. It's a convenience choice for a particular demographic. That said, I can't condemn people too roundly for being a little lazy and giving in to feel-good marketing. But that's what the place is. Shiny happy soothing marketing.
posted by desuetude at 8:29 AM on August 13, 2009

It seems that Mr. Mackey feels that giving more control to the very companies who created this crisis is the solution. This seems a bit like someone saying that wolves are the best candidates to oversee hen houses.
posted by reenum at 8:37 AM on August 13, 2009

They went to doctors they chose, hospitals they chose, and flashed their Medicare and supplemental insurance cards and that was it. They were cared for, because they paid.

posted by paulsc at 4:39 AM on August 13 [+] [!]


This is what I don't understand and it may be because I'm Canadian and are unfamiliar with the US style of health insurance, but could one of you Americans answer some questions/make clarifications for me?

1. Medicare in the US is basically the same as Medicare in Canada except in Canada everyone gets it, not just people who are 65 and over. Is this correct?

2. US Medicare is essentially universal health care for people over age 65?

3. paulsc is arguing against universal health care for whatever reason but is in favour of US Medicare?

4. paulsc is actually for universal health care but just doesn't realize it?

I'm confused.
posted by chugg at 8:38 AM on August 13, 2009 [1 favorite]

Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment, according to a report last month in Investor¡¯s Business Daily.

And 28,000 of those 830,000 are Stephen Hawking!
posted by Flunkie at 8:41 AM on August 13, 2009 [3 favorites]

arguing against universal health care for whatever reason but is in favour of US Medicare?

To be fair, old people are feeble and helpless which somewhat mitigates one's disgust at them for being poor.
posted by Combustible Edison Lighthouse at 8:50 AM on August 13, 2009

Even though, I assume (perhaps erroneously), that everyone already knows this:

The current American health care system HAS WAITING LINES FOR ADMITTANCE. And I'm not just talking about your 4 hour + wait in the Emergency Room. Do these people never go to the doctor? Or do they have some kind of free pass to bypass all the administrative hassle that the rest of us have to deal with?

Two years ago I had the flu, like mean 103 degree temperature flu, and I called my doctor to get an appointment. I had insurance. They told me they could see me in THREE WEEKS. I didn't go, obviously, and resorted to mental toughness, something I hear works great for minor illnesses, but would have killed me had I not gone to the hospital when I later had fucking PNEUMONIA, and had to make a trip to the emergency room because I had put off going the doctor for so long because it was so fucking expensive. This little visit, despite the fact that I had insurance, still cost me over $1500 out of pocket. I was separately billed for 1) Emergency Room Visit 2) X-Ray 3) Meds 4) Seeing a doctor. Why in the hell is seeing the doctor not an automatic part an emergency room visit? Why the hell else would I be there?

End of rant two.
posted by whimsicalnymph at 8:55 AM on August 13, 2009 [14 favorites]

Your third (fourth, actually) link did work, but whether you know this or not it's a totally skeezy SEO-template pit that adds nothing to the post. It's the sort of site we see posted here every once in a while from linkfarming spammers. I don't have any reason to think that has anything to do with your posting, for what it's worth, but I removed it from the post, and I've removed it from your comment as well.

Yikes. Sorry about that. Seemed legit to me.
posted by georg_cantor at 8:55 AM on August 13, 2009

Oh, and thanks. :)
posted by georg_cantor at 8:57 AM on August 13, 2009

I'm glad their UK operation is close to bust, now. Not that I actually needed Whole Foods Market before then - if I want to pay 22p for a slice of cucumber, I'll go to Harrods and sample perfume at the same time.
posted by mippy at 9:06 AM on August 13, 2009 [2 favorites]

Regarding the BCBS HSA plan being discussed above - it really is a pretty decent plan, if you can get on it. I cannot imagine that is easy to do, as I was declined, as a healthy 25 year old nonsmoker, because I listed that I had broken my ankle (and fully recovered) when I was 18 on the application. This is not conjecture. They cited it in the denial letter.
posted by Nothing at 9:14 AM on August 13, 2009 [3 favorites]

paulsc is actually for universal health care but just doesn't realize it?

i know this is hard to believe and it really didn't make sense at first but it appears paulsc is arguing against "unlimited" health care because it kept his parents alive










yeah
posted by Optimus Chyme at 9:18 AM on August 13, 2009 [3 favorites]

But, but it cost a LOT! And he didn't have to pay anything towards his parent's bills, but inevitably, down the road, all those other people's parents dying would cost him A GREAT DEAL OF MONEY. And he doesn't know all those other dying people. And they would STILL be dead, or who knows, even worse than dead. So there. Better not to spend too much on them.
posted by NekulturnY at 9:37 AM on August 13, 2009

"Perhaps, to the tune of $595, max, this year (10% penalty on $5950 max HSA contribution). Easily negotiated with virtually any new employer, except for hourly jobs, at the very bottom of the pyramid. And that, of course, is only if you use nothing of your HSA, and contribute the max in 2009."

For those hourly jobs, especially if they are making minimum wage for whom $600 is a couple weeks wages, $595 is a serious chunk of change. Heck it's better than a weeks wages for someone making over $100 dollars a day. I can't imagine how much one needs to be making where losing $595 is of little concern essentially equivalent to pocket change.

"My high-deductible plan covers in-network visits to specialists for $40 co-pay (up to 3 times per year). Here's a recent event:

"OUTPT CONSULT performed at Physician's office or independent lab
"Billed: $287.00
"Allowed: $116.22
"Amount Paid by Blue Shield: $76.22
"Patient Copayment: $40.00

"No complaints here . . I also get one annual physical per year for the $40 co-pay."

$40!? So better than a full day of take home for someone making minimum wage. Can you not see where that could be a problem for people?

Nothing writes "I was declined, as a healthy 25 year old nonsmoker, because I listed that I had broken my ankle (and fully recovered) when I was 18 on the application. This is not conjecture. They cited it in the denial letter."

So no chance if you have CF then.
posted by Mitheral at 9:39 AM on August 13, 2009 [2 favorites]

The UK is a wonderful model of how not to run nationalized health care because they spent pretty much the whole of the eighties trying to lowball costs (Thanks Maggie - and isn't it ironic that he starts his editorial with a Thatcher quote.) never considering that doctors require considerable training and you can't just pick up a few at corner shop when you run low and can no longer staff your hospitals.

On the contrary. The UK is a wonderful model of how to run nationalised health care (well, other than PFI). It survived the best efforts of the Iron Lady. It does most things right because until recently there was no way to afford doing them wrong. But even with Labour pouring money into it since 1997 the doctor shortage is sufficient that it couldn't spend the money. Also even with the levels of money labour has been pouring in, we are still probably the cheapest national healthcare system going in a developed country. I don't believe a single other healthcare setup would have survived the levels of deprivation Maggie forced on the system. And now it's just cheap rather than on a shoestring, the outcomes are getting better (and always were better than the American ones - which is how bad the American system is).
posted by Francis at 9:40 AM on August 13, 2009

can't afford to shop at Whole Foods, anyway.
health care bills are too high.
posted by Baby_Balrog at 9:50 AM on August 13, 2009 [1 favorite]

Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment, according to a report last month in Investor¡¯s Business Daily.

I'd like to know what they are waiting to be admitted for. In Sweden you get sent to the back of the queue for middling health problems. My boyfriend had some middling sore throat he got checked out and he got queued. By the time he saw a doctor it was no longer a middling sore throat and he had to be hospitalized for several days. A simple swab test without even having to see a doctor would have prevented this.

But let's not blame this on socialism...let's go back in time to me in the US with a middling urinary tract infection a few years ago. I didn't have insurance and I had trouble getting an appointment at the local low-cost clinic. By the time I got seen I had a full blown kidney infection. Again, a simple swab test without even having to see a doctor would have prevented this.

I guess my point is that we don't just need monetary reform, we need health care that makes sense. Neither of us really needed to see doctors, but we were forced to wait and see them in order to get proper treatment. I do hear they are hiring lots and lots of physicians assisstants, which is a step in the right direction since a PA can treat things like this so doctors can focus on cancer/broken bones.
posted by melissam at 9:51 AM on August 13, 2009 [3 favorites]

PaulSC- you keep bringing up specific conditions for which the current US system is better. So What? Virtually every study I have seen confirms that European single payer systems provide better outcomes at lower cost. These systems spend less to achieve greater health for their whole population. I'm sure that in some cases, for some diseases, better outcomes are possible. But are you really arguing that since children with brain tumors don't do as well in the UK, our system is better?
posted by HighTechUnderpants at 9:51 AM on August 13, 2009

I'd like to know what they are waiting to be admitted for.

And I'd like to know where IBD got those numbers, considering they can't even get Stephen Hawking's nationality and place of residence correct. They have no cites in their editorial.
posted by rtha at 9:56 AM on August 13, 2009

Just so this is clear, are Americans allowed to use private insurance if they can pay for it, even if healthcare becomes socialized federally?
posted by kldickson at 9:59 AM on August 13, 2009

> Because some of what is being said is just so extreme you just can't believe that the people saying these things could actually believe it themselves.

Greetings from Idiot America
posted by you just lost the game at 10:00 AM on August 13, 2009 [1 favorite]

It disgusts me that most conservatives seem to be so egocentric that the reasoning they use in deciding what they think should be is so horribly distant from what actually IS.

I wonder if they've ever met anyone with a chronic condition who's lost their insurance.
posted by kldickson at 10:02 AM on August 13, 2009

Interesting: the original thread in the whole foods forums page referenced in the post, has been closed. Other threads started in the forums are referencing the closing of the thread and deletions of posts in other threads on the topic. The final count on the closed thread was 156 about an hour ago, and it's now dropped to 150.
This is going to get uglier than it already is.
posted by 8dot3 at 10:34 AM on August 13, 2009 [2 favorites]

Because some of what is being said is just so extreme you just can't believe that the people saying these things could actually believe it themselves.

This is probably true in many cases. The simplest protesters are there to have fun causing trouble for a guy and a party (and maybe a class and a race?) they don't like, and they aren't all that concerned about telling the 100 percent unexaggerated truth, while the brains behind these things (the organizers with the money and the strategy) are hoping to break up any rational debate they could lose, to throw lots of shit at Obama and make some of it stick, to make viewers consciously and subconsciously associate Obama and his policies with discomfort and dissent, and to slide the Overton window a little to the right so that less wild right-wing claims will seem rational by comparison.
posted by pracowity at 10:38 AM on August 13, 2009 [2 favorites]

$40!? So better than a full day of take home for someone making minimum wage. Can you not see where that could be a problem for people?

I'm thinking mandatory savings -- usable for medical bills, education, retirement -- might not be a bad idea.

Nothing writes "I was declined, as a healthy 25 year old nonsmoker, because I listed that I had broken my ankle (and fully recovered) when I was 18 on the application. This is not conjecture. They cited it in the denial letter."

Funny thing is that a BS/BC did deny me in 2004 for a similar self-insurance plan since I had visited a specialist for severe knee pain in the past year. Learned my lesson there.
posted by @troy at 10:45 AM on August 13, 2009

Here is another argument. We already are paying for health care. A kid in Washington DC dies because his family is on a waiting line for basic medical care. A problem that could have been fixed with an $80 extraction (and possibly prevented with yearly checkups) now has a $250,000 bill for failed critical intensive care. Who ends up paying that? When costs of preventative treatment skyrocket and families go bankrupt over emergency care, providers are forced to push those costs onto people who do pay. The end result is a highly inefficient system that costs twice as much and has significantly worse outcomes than either the British NHS or the Canadian systems.
posted by KirkJobSluder at 10:47 AM on August 13, 2009 [1 favorite]

Apologies if I missed this above, but the forums over at the Whole Foods site are lit up about this. Commenters seem...angry! Unsurprisingly, the thread is closed to new comments.
posted by rtha at 10:50 AM on August 13, 2009

My favorite so far, from the Whole Foods recipes forum:

Ingredients:

1 rich, heartless CEO
1 Wall Street Journal
10 cups of idiocy
22 Tablespoons of Cluelessness
52 cups Not KNowing or Caring Who Your Customers Are
A heap of I've Got Mine So Screw Everyone Else
5 Bunches of Ass Backwardness

Take CEO, add rest of ingredients and mix thoroughly. The tasty result? Tends of thousands of pissed off customers and one enormous boycott! Enjoy!!!!!!!!

posted by peeedro at 10:54 AM on August 13, 2009 [7 favorites]

Having watched more than $780,000 worth of medical billings come in, amounting to a stack of paper more than 5 and 1/2 feet thick¡­ You have absolutely no idea the horrible, disgusting truth of your accusation, when our hospitals get a patient with, essentially, a blank check, because of top line, federally operated, privately supplemented, paid up health insurance.

Wait, you're pissed at Medicare¡­ because they prevented you from being personally responsible for $780,000 in medical bills? And the most evil thing about government health care is that it¡­ doesn't ration care enough¡­ and doesn't euthanize people against their will? And you're vehemently against the health care reform bills¡­ which would cover end-of-life counseling to help other people avoid the fate of your parents? And instead we should stick with the system we have, which you hate?

Do I have that all straight?
posted by designbot at 11:02 AM on August 13, 2009 [14 favorites]

kldickson: "Just so this is clear, are Americans allowed to use private insurance if they can pay for it, even if healthcare becomes socialized federally?"

Correct. If you already have health insurance you are happy with, through your employer or whatever, you can keep it if you like, under the "Obamacare plan".

It will also offer a public, affordable option to the ~50 million who are completely uninsured.

Also, unrelated, I just thought this: [paulsc: "That low wage jobs are often short term, entry level jobs held by people who are covered by spouse or parent's insurance currently, and wouldn't be interested in health insurance at any price?"] needed a formal

what
posted by pineapple at 11:06 AM on August 13, 2009 [1 favorite]

designbot: "Do I have that all straight?"

A picture is worth a thousand words.
posted by mullingitover at 11:11 AM on August 13, 2009

mandatory savings -- usable for medical bills, education, retirement -- might not be a bad idea

Isn't this just a tax by another name? It's another involuntary burden on marginal income workers. Minimum wage is $6/hr, actually it's $5.50 after "health savings" invested on your behalf by BigHedgeFundCo^TM for only a small management fee, no doubt.

It can only be spent on health care, it can't be accessed by the "saver", presumably even during bankcruptcy, except of certain "allowed" activities. It has a (very small) payout. In short, it has almost all of the disadvantages of "insurance" (execpt, perhaps arbitrary recision) and none of the risk-pooling benefits. In what way is this a good idea?
posted by bonehead at 11:11 AM on August 13, 2009 [1 favorite]

"Wait, wait, wait, there are people in the United States who didn't think Stephen Hawking is British?"

Well, he doesn't have an British accent, now, does he?!?!
posted by tristeza at 11:17 AM on August 13, 2009

Apologies if I missed this above, but the forums over at the Whole Foods site are lit up about this. Commenters seem...angry! Unsurprisingly, the thread is closed to new comments.

What a joke, locking the reasonable thread in progress without any closing commentary from the Whole Foods mod(s). Sure, I'm spoiled by MetaFilter, but this kind of reactionary nonsense will irk even more WF customers.
posted by porn in the woods at 11:32 AM on August 13, 2009 [2 favorites]

Immigrating to Canada is hard.
posted by designbot at 11:32 AM on August 13, 2009

The wingnuts are not the problem; the entities that spend hundreds of millions of dollars (which, perversely, amounts to a fraction of a percent of their profits) to motivate the wingnuts are the problem.

That the non-wingnuts end up focusing on the people holding the misspelled signs with swastikas on them is a masterwork of subtlety, in my opinion.
posted by Pragmatica at 11:37 AM on August 13, 2009

Update on the WF forums: they just killed all of the threads about the article. Not closed - deleted. Unreal.
posted by 8dot3 at 11:37 AM on August 13, 2009 [1 favorite]

To Megami:

We (lefties) haven't up and left because we still love this country. For me that means: Our gorgeous national parks, late night diners serving cheesy hashbrowns, being able to head west and feel the possibilities of myself expand with the horizon, public libraries, and cook-outs in the backyard. There are more reasons, but those are the ones that come to mind this instant.

Many of us happen to be related to some of those wing-nuts, and just cause they're nuts doesn't mean they're not family. And if we can help it, we'll hopefully make sure that they have affordable health care in spite of themselves, so that when they're old, and sick, they won't have to worry about losing their house, or those antiques they love, or bat an eye as they head to "heaven."
posted by whimsicalnymph at 11:38 AM on August 13, 2009 [2 favorites]

I just noticed Whole Foods Market deleted the entire forum we are discussing. I guess I'll have to become a shareholder.
posted by parmanparman at 11:39 AM on August 13, 2009 [4 favorites]

They're censoring their forums just as fast as they can. Hit F5 and another one disappears. Before they all go down he memory hole, some recent 'Latest Post' titles from the Whole Foods forums:

Latest Post

4 minutes ago by gbj100 in What is the recipe for Right Wing Extremist Chili?

8 minutes ago by gbj100 in Boycott Whole Foods!

11 minutes ago by Peter 23 in Product Request: New CEO

2 minutes ago by gbj100 in A "socialist" boycotting Whole Foods

5 minutes ago by stefan06 in No more Whole foods for me-anti health care?

24 minutes ago by Simian in MacKay's Anti-Healthcare Reform Editorial a Slap In the Face

I don't think they realize that some people will just see this as a challenge.
posted by mullingitover at 11:40 AM on August 13, 2009 [1 favorite]

I'm thinking mandatory savings -- usable for medical bills, education, retirement -- might not be a bad idea.

And how exactly does that square with the old Freedom of choice USA! Screw the Commies! sort of thing?
posted by jokeefe at 11:44 AM on August 13, 2009

Whole Foods Market Forums

We are sorry, the page that you are looking for is no longer available.

Click here to return to where you came from.

Well look at that.
posted by R. Mutt at 11:45 AM on August 13, 2009

A new facebook group calling for the boycott of Whole Foods seems to be gaining members quickly.
posted by whimsicalnymph at 11:53 AM on August 13, 2009 [1 favorite]

It is funny - just the other day I noticed a new sign at the entrance to my local WF. It said something like Whole Foods is now on FaceBook !

In more ways than they anticipated:

Boycott Whole Foods
posted by R. Mutt at 11:54 AM on August 13, 2009 [1 favorite]

"... Get the wrong illness or injury and that lifetime limit will be looking pretty small life may not be worth living."
posted by caddis at 6:44 AM on August 13

FTFM. (Fixed That, For Me.) In the real world, some choices are valid, even if they wouldn't be yours. And compelling others to pay for your choices, when those choices don't have guaranteed outcomes, seems horribly unfair, at a basic level.
posted by paulsc at 3:50 AM on August 13 [+] [!]

Holy shit, THAT'S where the "death panels" noise is coming from! It's not Obama, but paulsc who gets to decide who lives and who dies!
posted by FatherDagon at 11:54 AM on August 13, 2009

One thing to keep in mind is that HSAs provide no prescription coverage and that prescriptions that you pay for do not contribute to the out of pocket maximum. The amount you can spend on prescriptions is unlimited. For healthy people, an HSA is a great deal. As they become older or sicker and require expensive prescriptions, they are inclined to change to a comprehensive plan with prescription coverage, hence the free rider problem.
posted by JackFlash at 11:58 AM on August 13, 2009

WHY DO WE HAVE FORUMS ON OUR WEBSITE?

So our customers can share information with each other! Ever strike up a conversation in the aisles with a fellow shopper? We learn a ton from our customers and want to provide a place where you can talk to each other about food, recipes, special diets, healthy eating, products and everything else that has to do with food in our world. We may add our two cents to conversations from time to time, but the forums are mainly a place for you to chat amongst yourselves.

UNLESS IT'S CRITIQUING US YOU UNGRATEFUL SHITS

WHERE ARE YOU GONNA GET YOUR PRECIOUS YAK CHEESE AND ORGANIC HEMP TEA NOW? THE FUCKIN CONOCO? FOOD CITY? GOOD LUCK ASSHOLES YOU'RE GONNA BE BALLS DEEP IN FUCKIN LIPTON AND ORANGE "CHEESE PRODUCT" SO I HOPE YOU'RE HAPPY
posted by Optimus Chyme at 12:03 PM on August 13, 2009 [22 favorites]

I love that they've just endorsed taking that conversation off their forums and 'into the aisles'.
posted by iamkimiam at 12:05 PM on August 13, 2009 [1 favorite]

Whole Censorship
posted by dirigibleman at 12:11 PM on August 13, 2009 [1 favorite]

Okay that's enough fucking around for me - I'd like to see Whole Foods' bottom line actually suffer for this and grousing about it with a bunch of nerds here isn't the most effective tactic. I'm going to be one of those irritating left-wingers handing out flyers and shit in front of my local Whole Foods market.

What, in your collective opinion, is the best way to distill this into a short message that can fit into fewer than a dozen words so I'm not handing people like, TimeCubeesque tracts and having to spit a bunch of words at them?
posted by Optimus Chyme at 12:13 PM on August 13, 2009 [3 favorites]

While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?

Am I the only one who had a red flag go up at this statement?

And I don't mean the "oh, what a stupid thing to say" kind of red flag. I mean the "wait, is he trying to subtly insinuate that we should start subsidizing healthy food markets instead?" kind of red flag. cause then he says:

Unfortunately many of our health-care problems are self-inflicted: two-thirds of Americans are now overweight and one-third are obese. Most of the diseases that kill us and account for about 70% of all health-care spending¡ªheart disease, cancer, stroke, diabetes and obesity¡ªare mostly preventable through proper diet

and

Recent scientific and medical evidence shows that a diet consisting of foods that are plant-based, nutrient dense and low-fat will help prevent and often reverse most degenerative diseases that kill us and are expensive to treat.

and

We are all responsible for our own lives and our own health. We should take that responsibility very seriously and use our freedom to make wise lifestyle choices that will protect our health.

I mean, the guy's clearly a fucking whackjob, but I think he's the kind of whackjob that would sabotage his entire customer base for the chance to catalyse a movement to take the focus off of healthcare and onto the government giving him money to encourage people to buy from his stores.
posted by shmegegge at 12:34 PM on August 13, 2009 [1 favorite]

I'm not sure why conservatives are whining when they can keep their private insurance if they want.
posted by kldickson at 12:36 PM on August 13, 2009

What, in your collective opinion, is the best way to distill this into a short message that can fit into fewer than a dozen words so I'm not handing people like, TimeCubeesque tracts and having to spit a bunch of words at them?

"If you don't use enough words, people think you don't have anything important to say." (David Ogilvy)

But whatever. You might want to start by saying something like.

"Dear Whole Foods Shopper,

As you are aware, president Obama is trying to ensure that every American gets access to affordable, high quality medical care. America is the richest nation in the history of mankind, with some of the best doctors and hospitals in the world. And yet, more than forty million people are uninsured, leaving them without access to this high quality medical care. President Obama needs our support to set this right.

Mr. John Mackey, the CEO of Whole Foods, disagrees with the plans of president Obama. Mr. Mackey feels that no one has a "right" to affordable healt care, because he can't find it in the Constitution. Maybe he will start to think things over if you show him how strongly you feel about healthcare reform.

You will notice that nowhere in the Constitution does Whole Foods have a "right" to a customer base. Vote with your feet and don't shop at Whole Foods.

Together we can make a change."
posted by NekulturnY at 12:40 PM on August 13, 2009 [15 favorites]

I'm grumpy and pissed off. But to me, it's pretty obvious that the problems regarding obesity and diet have as much to do with suburban design, government meddling in agricultural markets, labor factors, and biased food distribution networks as personal willpower. Furthermore increased government attention to preventative health care and early childhood assistance can go a long way towards promoting healthier habits.
posted by KirkJobSluder at 12:56 PM on August 13, 2009

What, in your collective opinion, is the best way to distill this into a short message that can fit into fewer than a dozen words so I'm not handing people like, TimeCubeesque tracts and having to spit a bunch of words at them?

Maybe a bunch of different flyers, each one with an outrageous quote from the CEO -- with the CEO credited -- and underneath, the pithy message: "Don't buy his views? Then don't buy his products."
posted by EmpressCallipygos at 1:05 PM on August 13, 2009 [3 favorites]

I'm in the process of drafting a letter to Mackey (it sounds so awesome in my head, when I'm out walking around, but as soon as I sit down at the computer....pfffft!....which is very annoying) telling him what I think (politely) and informing him that I will no longer be shopping at Whole Foods, and I will CC the store team leader of my local WF.
posted by rtha at 1:12 PM on August 13, 2009 [1 favorite]

Burhanistan - one can do both. It's not a zero-sum game.
posted by rtha at 1:13 PM on August 13, 2009 [2 favorites]

I sometimes wonder why everyone on the left end of the political spectrum has not upped and moved to Canada.

If Canada were south of the US it'd be a lot more attractive. For this California kid, Canada = the small coastal floodplain of the Fraser River.

The US of A isn't that screwed up if you live in a Blue State, though things are still in the balance and progress is uneven if not rearguard in nature.

The pendulum swung nicely in 2006-2008, and it remains to be seen if we can continue this arc into the next decade, or if the forces of idiocy regather themselves and make another go at it like they did 1994-2004.
posted by @troy at 1:13 PM on August 13, 2009

And of course Whole Foods' stock price went way up today. This stupid country.
posted by dirigibleman at 1:15 PM on August 13, 2009

I see no reason to boycott WF. Dude just stated his opinion. Other than lumping SS in with Medicare, I saw no grevious misrepresentations, just a difference of policy opinion and the usual glibertarian candycoating of reality.

This is actually different from my reaction to the godaddy CEO thing, where I didn't feel it was wise to send my money to a fucking whackjob who posted his idiocies directly onto his corporate blog; here's what I wrote back then:

"Thanks Bob, for giving me the opportunity to flex what little fucking power I enjoy these days. [You're] entitled to your wrong-headedness, but posting them as a heading on your corporate website that I regularly do business with crossed the fucking line."
posted by @troy at 1:19 PM on August 13, 2009

Forum deletions piss me off more than the article. When will corporations learn that it is IMPOSSIBLE to silence people on the internet. Instead of hosting a single hot conversation, now they're going to face a thousand angry fires.

Stacking up the stupid...
posted by letitrain at 1:20 PM on August 13, 2009

I see no reason to boycott WF. Dude just stated his opinion.
posted by @troy

maybe the boycott is because i don't really feel like making an evil rich asshole richer by ignoring the evil assholish shit he says

call me crazy i guess
posted by Optimus Chyme at 1:24 PM on August 13, 2009 [8 favorites]

Burhanistan, yes, facts and sanity are necessary, but it's really not enough.
posted by kldickson at 1:38 PM on August 13, 2009

@troy: "I see no reason to boycott WF. Dude just stated his opinion."

Because Dude was only prominent enough to have a national platform for his bad ideas because of Whole Foods. Every dollar ever spent in a Whole Foods before yesterday partially subsidized this editorial by making this guy so successful that people might care what he thinks.

That wouldn't necessarily be enough, in and of itself, for me to boycott them. But he went on to use Whole Foods as an example in his editorial. The CEO of Whole Foods appealing to Whole Foods' policies to make a point? That essentially makes this an official position statement on behalf of the company unless the company explicitly indicates otherwise (and if they do, I will consider ending my boycott).

Until and unless that happens, the company is tacitly throwing its hat into the ring on this issue, and on the wrong side. That's their prerogative, just as it's within my rights to take my business elsewhere.
posted by Riki tiki at 1:39 PM on August 13, 2009 [5 favorites]

the evil assholish shit he says

I don't see anything evil in his statements. Unlike the Bob Parsons thing, where the CEO was using his private company as a soapbox to repeat the stuff he hears on talk radio.

Dude has experience running health care coverage through his company. I value his input into the discussion.
posted by @troy at 1:44 PM on August 13, 2009

Wow, another fun fact. For years, John Mackey used a pseudonym to trash Wild Oats on Yahoo Finance, prior to acquiring them. Classy.

His posting history is still there.
posted by mullingitover at 1:46 PM on August 13, 2009 [3 favorites]

I see no reason to boycott WF. Dude just stated his opinion.

On the contrary -- that's exactly the reason for a boycott.

Stating his opinion is perfectly within his right. And, likewise, we also have every right to state our own opinion of his opinion by not giving him any more money.
posted by EmpressCallipygos at 1:52 PM on August 13, 2009 [1 favorite]

"Health care is a service that we all need, but just like food and shelter it is best provided through voluntary and mutually beneficial market exchanges. A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That¡¯s because there isn¡¯t any. This ¡°right¡± has never existed in America"

If you don't think that's evil assholish shit, then we'll have to agree to disagree, because I'm not budging. Fuck him and fuck Whole Foods.
posted by Optimus Chyme at 1:54 PM on August 13, 2009 [2 favorites]

Oh, I agree if you want to redirect your spending to more socially-positive enterprises, knock yourself out.

Free-marketeerism is just claptrap, but I don't consider it evil, since it is opinion and is self-consistent as far as it goes. "Stating the Truth" is the perfect defense against charges of libel, treason, or assholery.

The CEO's position that there is no intrinsic right to health care is correct, but irrelevant. The founding fathers had this debate 200+ years ago, and Hamilton's Big Government idea won and the minarchists lost.

The joke on us is, of course, that big money -- Investor's Business Daily, WSJ OpEd page -- wants us to forget that We The People have the power, if not the right, to structure society such that it works better for all citizens, largely at big money's expense.
posted by @troy at 2:08 PM on August 13, 2009

There is no intrinsic right to healthcare, nor to police protection, public education, etc. Saying that something is not a "right" so thus you shouldn't have it is just silly.
posted by caddis at 2:32 PM on August 13, 2009 [2 favorites]

When will corporations learn that it is IMPOSSIBLE to silence people on the internet

Without wanting to add snark, the simple answer is when the internet means something. A bunch of random people saying 'I'm not going to shop there' means nothing because some will while most won't.

Go and stand outside the store and maybe they'll listen (though when in the 80's we tried boycotting banks who supported apartheid - and how fucked up does that look in hindsight?- it took AGES before they listened), though chances are they'll still make enough money from people who really couldn't care less.

But still, you want to make a difference? Get off the internet. For discussion it's great, but beyond that it's just noise.
posted by ciderwoman at 2:39 PM on August 13, 2009 [2 favorites]

20% crazies. Gotta shut 'em down. They've been given too much opportunity to influence one another and the gullible.
posted by five fresh fish at 2:41 PM on August 13, 2009

I had missed this part previously:
Recent scientific and medical evidence shows that a diet consisting of foods that are plant-based, nutrient dense and low-fat will help prevent and often reverse most degenerative diseases that kill us and are expensive to treat.

My expensive degenerative disease will not kill me and is not in any way affected by diet. But a $400 shot a week treats it very well. I'd rather have the shot than this guy's vegetables.
posted by hydropsyche at 2:48 PM on August 13, 2009 [3 favorites]

I see no reason to boycott WF. Dude just stated his opinion.

At least Mackey didn't go under a false identity to do so. Bonus points for finally being honest enough to put his own name to the piece.
posted by Blazecock Pileon at 2:55 PM on August 13, 2009 [3 favorites]

Yesterday, an eight-day free clinic opened at the Forum in Inglewood. About 1,500 people got treated by volunteer doctors, nurses, dentists, optometrists, the works. People started lining up Tuesday night, and hundreds were turned away.

Another 2,000 are probably going to show up today, and Christ knows how many over the weekend.

I would love to see John Mackey go down there and tell everyone who'd been standing in line that they don't have a right to health care.

Fuck him, and fuck his store.
posted by RakDaddy at 3:37 PM on August 13, 2009 [6 favorites]

It looks like they moved all of the health care threads to a new forum "Health Care Reform" at the top of the Forums page.
posted by Combustible Edison Lighthouse at 4:09 PM on August 13, 2009

Update on the WF forums: yes, they did move some of the messages to a Health Care Reform thread. This was after they deleted the entire original thread and cherry picked criticism out of a bunch of the other threads.
Now, all of the forums are gone. Instead, on the forum page, there is this:
"Whole Foods Market Forums
Our Forums are for our customers to exchange recipes, share special diet concerns, and interact about food and environmental issues. If you have a question for Whole Foods Market directly, please do not post on our forums but instead email [email protected]."

Bravo, Whole Foods. Truly brav-fucking-o. Well done. Obviously we'll just shut up and disappear now.
Dicks.
posted by 8dot3 at 4:53 PM on August 13, 2009

From Facebook (Whole Foods Market's official page)

Response Statement: John Mackey¡¯s Op/Ed in the Wall Street Journal
Today at 6:19pm
We would like to thank our customers and shareholders who have let us know their thoughts regarding John Mackey¡¯s op/ed in the Wall Street Journal. Many people, including John, feel passionately about this important issue.

First off, whether you agree with John or not, our 50,000+ Team Members who live and work in your communities will continue to work hard every day to bring you the best natural and organic products available. We hope you will continue to give us the opportunity to serve you.

While there are differing points of view on this issue, John believes certain aspects of the current proposals before Congress would jeopardize our company¡¯s ability to continue providing our sustainable health insurance plan. Whole Foods Market pays 100 percent of the premiums for our full-time (over 30-hours) Team Members, about 89% of our workforce. Additionally, those Team Members get to vote for their new plan options every three years. John does not want to see that changed.

Finally, John absolutely does care about his fellow citizens who do not have health insurance, and he is in favor of health care reform. He believes that the proposals he put forth will provide access to sustainable health insurance for more people.

We recognize that there are many opinions on this issue, including inside our own company. As we all sort through this together, we thank you for sharing your opinions with us.
posted by emelenjr at 5:17 PM on August 13, 2009

8dot3 "Now, all of the forums are gone."

Easy now. They're still there, but the table takes a while to load.

I'm really not even mad. It's amazing to see a company so utterly incompetent with PR at the highest level. Some poor bastard at Whole Foods is paid to ensure the company's image is not allowed to be damaged, and is now watching this whole trainwreck unfold in one browser tab while searching the job postings in another.
posted by mullingitover at 5:22 PM on August 13, 2009 [2 favorites]

caddis: I actually appreciate your reference to police protection. If there's no intrinsic right to police protection (i.e. protection from crime), how do you expect police protection to be allocated?

In my mind, making health care dependent upon one's income is as silly as making people pay for police protection (otherwise known as a mob racket).
posted by l33tpolicywonk at 5:22 PM on August 13, 2009 [2 favorites]

Whole Foods Market pays 100 percent of the premiums for our full-time (over 30-hours) Team Members, about 89% of our workforce. Additionally, those Team Members get to vote for their new plan options every three years. John does not want to see that changed.

And why would WF not be able to pay 100% of the extended health premium for their full-time Team Members? Which, of course, they get to vote on every time the group health insurance plan comes due.

Meanwhile, the basic health premium ¡ª ie. universal healthcare ¡ª is provided not only to WF's employees, but everyone else as well.

I fail to see why universal health care worries this man. I suspect he must be a douchebag.
posted by five fresh fish at 5:25 PM on August 13, 2009 [4 favorites]

"As we all sort through this together, we thank you for sharing your opinions with us" translates in my cynical little mind as "HOLY JESUS SHITBALLS CHRIST, MACKEY'S GONE OFF THE BOAT AGAIN FFFFFFUUUUUCK LOOKIT THE FORUM TRAFFIC."
posted by fairytale of los angeles at 5:25 PM on August 13, 2009 [1 favorite]

But come to think of it, universal healthcare would make it easier for small business owners to compete against WF. And WF is rather predatory about competing.
posted by five fresh fish at 5:26 PM on August 13, 2009 [6 favorites]

One of the funnier results of this is that WF is now getting a bunch of vocal glibertarian fans on Facebook and their forum. The idea of some dude who used to poo-poo WF as the home of wheat-grass-chugging, latte-swilling vegan hippie freaks now pledging to shop there to support one of their Randian brethren amuses the hell out of me.

Or maybe that was the plan all along: break the back of the liberal elite by overcharging them for hummus, then put them out of their misery so only the True Free Market Saved will shop at WF.
posted by RakDaddy at 5:29 PM on August 13, 2009 [3 favorites]

I think FFF nailed it. Mackey's already come out as an anti-competition, anything-for-the-bottom-line dick, and universal health care would remove a pretty hefty barrier for, say, a small local produce stand or charcuterie.

...oh, Christ, where am I gonna get salumi now?
posted by RakDaddy at 5:33 PM on August 13, 2009

I've never been prouder to have never shopped at Whole Foods.
posted by tkchrist at 6:11 PM on August 13, 2009

Am I the only one who is astounded by the fact that the people most likely to champion the "competitive free-market" are the most likely to not see how dismally it works in real life?

As for WF, Mackey is stupid but the forum moderator ("Winnie") on their web site is a full-blown ignoramus. Deleting comments wholesale and posting a truly insincere apology/explanation will only multiply their problems going forward. I truly hope they reap what they have sown.
posted by Benny Andajetz at 6:12 PM on August 13, 2009 [3 favorites]

Mmmm crunchy granola.
posted by Phssthpok at 7:09 PM on August 13, 2009

I'm thinking mandatory savings -- usable for medical bills, education, retirement -- might not be a bad idea.

I can think of several reasons why that would be a problem, particularly for people without a lot of income, such as those who do not make enough to save and might be in the hole in the first place. I can't think of a single good reason why we need to prop up the insurance industry, however.
posted by krinklyfig at 7:42 PM on August 13, 2009 [1 favorite]

Or maybe that was the plan all along: break the back of the liberal elite by overcharging them for hummus, then put them out of their misery so only the True Free Market Saved will shop at WF.

I think it's great. Some of my Randian acquaintances are looking a little chubby lately....maybe they'll adopt a diet of handcrafted raw vegan organic fair trade hummus and whole wheat stone ground animal-free pita bread.

And the liberal yuppies? Well, forced to shop at the Seven-11, neighborhood bodegas, and McDonalds, they will succumb to diabetes soon enough.
posted by melissam at 9:03 PM on August 13, 2009

Considering that good health care means more stupid people live longer,

how is unhealthy equivalent to stupid? People can be really dumb and never have health problems, and people can be really smart and have tremendous health problems. Remember that famous american scientist steven hawking?! it seems like an equal number of smart and stupid people will live longer.

I just can't see a correlation - even making dumb health choices isn't indicative of natural intelligence, just bad judgment with regard to your body. But that can be caused by all sorts of things, including being more concerned with ideas than physical well-being. Do you imagine the most athletic and most in shape people are also the most intelligent? Seems a strange assumption.

And plenty of health problems have little to do with choices. I have epilepsy and was treated for lymphoma in my 20s - does that make me stupid? I usually just think I've been pretty unlucky in terms of health, because I don't know what choices I could have made, though there may be things discovered at a later date - for all I know, if I never ate eggplant, or got a tattoo, or wore silver jewelry, things would've been different. But it could be chemicals released into the water supply, or genetic randomness, or some bug that bit me when I was a kid. And perhaps we'll never know... (It wasn't because I ate too much or voted republican though.)

And the liberal yuppies? Well, forced to shop at the Seven-11, neighborhood bodegas, and McDonalds,

There's still Trader Joe's! right? I used to like the salad bar at whole foods but never liked their brands and it was always too expensive, so I rarely shopped there anyway, but this is the camel killing straw...
posted by mdn at 10:46 AM on August 14, 2009

And the liberal yuppies? Well, forced to shop at the Seven-11, neighborhood bodegas, and McDonalds,

I don't know about yuppie, but as a liberal with a vegetarian wife, I'm lucky I live in an area where the other chains (Lowe's Foods, Harris Teeter, etc,) have enhanced their product lines to compete with WF, so I don't really need to shop there anyway. Now and then I run in there for some specialty item, but it's crazy to go there to buy things like OJ and diapers. Now I have one less reason ...

Bonus: I remember years ago when Whole Foods bought out our smaller chain, Wellspring Grocery. I didn't think much of it then because I was a starving musician and couldn't afford to shop there under either name, but i but it was better before it changed. Luckily there was and still is the excellent Weaver Street Market, a real local, non-chain whole foods market. I'm sad I live in a neighboring town and can't shop there any more, but the difference between it and WF is like night and day.
posted by freecellwizard at 1:28 PM on August 14, 2009 [1 favorite]

I've never been able to stomach Whole Foods. Something about the place is deeply repellent. Every time I've visited one it's made me feel like a quantifiable non-entity in an over-thought, cynical consumer maze waiting to be euthanized. And although I consider myself a liberal, it makes me despise my cohort for being such spoiled, entitled, happy shiny mindless lemmings. My GF doesn't understand my aversion to the place and laughs at it, but I swear if Soylent Green ever exists, it will be available at Whole Foods.

Trader Joe's isn't too much better, but is a tad bit less nausea inducing. Anyhow if this is the beginning of the end for WF, I say more power to it. Whole Foods and Mackey and Ayn Rand can suck my balls.

Now let me tell you how I really feel....
posted by Skygazer at 1:29 PM on August 14, 2009

Looks like Mackey's trying to walk back some of his editorial.
posted by zarq at 2:42 PM on August 14, 2009

Mackey: "An editor at the Journal rewrote the headline to call it ¡°Whole Foods Alternative to Obamacare,¡± which led to antagonistic feelings by many. That was not my intention - in fact, I do not mention the President at all in this piece."

/facepalm.

Yeah, that's our problem with it. It hurt Barack's widdle feelings. All those people who thoroughly, logically, and passionately debunked your points were just using that as a smokescreen. What we're really upset about is that you defamed our sacred lord.

Also, how many levels of grammatical indirection do you have to put before your acknowledgment of the problem? "Led to antagonistic feelings"? That makes it sound like we were the antagonists.

Maybe that's what he believes, but in that case I'm only more resolved to avoid giving this guy a single penny in the future.
posted by Riki tiki at 4:31 PM on August 14, 2009 [2 favorites]

What we're really upset about is that you defamed our sacred lord.

News flash: people who spent eight years shouting that Bush was a patriot! and a true American! and guided by God! do not understand people who aren't rooted in daddy-complex hero worship.
posted by verb at 4:55 PM on August 14, 2009 [7 favorites]

And to clarify, yes, I realize that was painting with a broad brush, etc etc. But I've reached the point where even noting on my own blog that, hey, you know, there are no death panels brings out swarms of people shouting, 'Obama is a liar, too! See? He compromised with Republicans on Issue X!'

The health care debate has me really, really despairing about the state of the country, and whether or not it will survive for more than a few decades. Not because legislation I like is circling the drain, but because blatant shit-eating liars are poisoning it by telling people the evil man wants to kill your parents.
posted by verb at 5:41 PM on August 14, 2009 [2 favorites]

If there's no intrinsic right to police protection (i.e. protection from crime), how do you expect police protection to be allocated?

Police are a waste of public funds. The people who matter have walls and dogs and private security guards.
posted by rokusan at 6:18 PM on August 14, 2009

I want to expand a bit on end of life counseling which now seems fated for elimination from health care reform due to some floozy from Alaska. We have on the one hand all the crazies from the right wing stirring fears of death panels and forced euthanasia seniors. It won't happen. It isn't on the table and it is so politically unpalatable that it won't likely ever happen and certainly will not happen in this generation. This health care reform is not about that.

However, when we approach the end of our lives we need to make decisions. I feel sorry for paulsc and what he and his parents suffered. I know too many people who have suffered this fate. It sucks. Watching someone you love lie in a coma, or near coma, often suffering in pain, and often for weeks or even months, is awful. It is not nice for the person dying. They are in pain, they are drugged when awake, barely able to think and communicate. There is some comfort in still being able to hold their hand and hug them. Yet, they are without dignity, they are not living what we consider the good life, they merely exist.

Many of us, perhaps most of us, would not ever want that fate to befall us or to befall our parents or other loved ones. Yet, far too few people take the steps necessary to approach their end with dignity. They live in denial and never execute a living will. They fail to plan for what they want when they may not be able to communicate their desires. If you fail to make your feelings known, and often this means if you fail to do this in a well witnessed document, the medical community will take great steps to keep you alive, even if you are essentially already gone, even if you are in great pain. My mother just passed from cancer this summer. It was extremely hard on her and us as she declined, but I am so glad that she was able to stay at home and avoid going into the hospital and being hooked up to machines and existing in pain for months at her end. This is what she wanted and it was best for her. For someone else it might have been better to get every possible measure right until the end. Perhaps if she was 12 rather than a senior that would have been desired. The point is we need to decide and everyone may make different decisions and we might change our minds. Make a decision, write it down, get someone you trust to shepard that decision and then don't be afraid to change you mind. The end is important to approach and not avoid. You know the funny thing, when that final moment came for my mom, she had a huge smile, she was ready I guess.

I am sad that fear has managed to eliminate funding for end of life counseling, that it probably means many more people will suffer the fate of paulsc's parents, will not get to make other choices because they just won't think about it. That is sad.
posted by caddis at 9:28 PM on August 14, 2009 [4 favorites]

Looks like Mackey's trying to walk back some of his editorial.

Not only that, but the comments are ¡ª without a fault ¡ª like reading fucking Pravda. Like communists, capitalists can't handle criticism, apparently.
posted by Blazecock Pileon at 10:56 PM on August 14, 2009

caddis, well said. Really, really well said. It is truly a shame that a pragmatic portion of the bill that deals with making one's wishes known, planning for the inevitable and dying with dignity has been turned into such an ugly football of lies by opponents of health care reform.

Sorry for your loss, but so glad that your mother got a "good death" and not what befalls so many others who never get the chance (or the choice) to exercise their final rights.
posted by contessa at 11:20 PM on August 14, 2009

"... The people who matter have walls and dogs and private security guards."
posted by rokusan at 9:18 PM on August 14

And publicists, doppelgangers (expensive, but worth every penny), insurance policies, heavy duty safes, hardened video and infrared surveillance systems, motion detectors, guns, accountants, lawyers, lobbyists, wills and estate plans, and Scientology. Among their many levels of preparation.

Not that I'm giving anything important away.
posted by paulsc at 12:44 AM on August 15, 2009

The health care debate has me really, really despairing about the state of the country, and whether or not it will survive for more than a few decades. Not because legislation I like is circling the drain, but because blatant shit-eating liars are poisoning it by telling people the evil man wants to kill your parents.

Similar reaction here. I'm hopeful that the reality-based community can just steamroller the bullshit, but I'm not as confident in this outcome as I was a week ago.
posted by @troy at 3:30 AM on August 15, 2009

There are some good comments at the CEO blog. I enjoy the idea that Mefites have probably written a bunch of them.
posted by cybercoitus interruptus at 1:26 PM on August 15, 2009

Oooh, yah ¡ª I remember this guy. He's been previously infamous. He harassed a competitor under a pseudonym. Not sensible CEO behaviour.
posted by five fresh fish at 5:58 PM on August 15, 2009

There are some good comments at the CEO blog.

A lot of the pro-Mackey comments have the whiff of astroturf.
posted by krinklyfig at 9:15 PM on August 16, 2009

Via a posting on the now nearly 19K-strong Boycott group on Facebook:

On August 6, six days before the op-ed was published, John Mackey and two other executives sold over $1.7 million dollars of WFMI stock. That's the most any of them has traded in a year and a half.

Seems possibly fishy.
posted by parudox at 8:32 PM on August 19, 2009 [1 favorite]

The innocuous explanation would be that it relates solely to the August 5 jump in the price.
posted by parudox at 9:16 PM on August 19, 2009