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#331342 - 24/03/2010 02:27 Re: The United States Enters the 20th Century! [Re: TigerJimmy]
wfaulk
carpal tunnel

Registered: 25/12/2000
Posts: 16706
Loc: Raleigh, NC US
Originally Posted By: TigerJimmy
When you really look at a document like the Constitution, it is a document which, above all else, seeks to protect the system from the selfish levels of moral development.

And yet you take a position that I cannot find any way to qualify other than as "selfish". From my point of view it seems to boil down to "I'm all right Jack; keep your hands off of my stack."

Originally Posted By: TigerJimmy
So was the 16th amendment.

Ooohh. You're one of those.

Can you explain to me why direct taxation is so evil? The constitution clearly calls out that clause as one that's likely to be amended (at least that's how I interpret the time restriction), so why is there so much concern over it? There's no reason that the Federal government couldn't levy an indirect payroll tax that, these days, would have basically the same effect as the direct income tax. What difference does it make that it passes through someone else's hands first? Or is your argument that there should be a regressive taxing system? Because, again, that could be implemented as either a direct or indirect tax.

Originally Posted By: TigerJimmy
I also think that I might be able to get Bitt (or people like him) to admit that what they are fundamentally doing is using force to impose their *opinions* on me, and that Bitt is smart enough to realize that HIS OPINIONS MIGHT BE WRONG, no matter how fervently he believes them.

Absolutely. That is the basis of all society, from the smallest anarchist collectives, to the largest capitalist states and everything in between. Society makes rules that state how others can behave. There are societies that exist(ed?) that didn't really have a notion of personal property, so isn't it possible that your requirement of the sanctity of personal property is also opinion?

Originally Posted By: TigerJimmy
Imagine an island with 10 inhabitants and one doctor. The 9 non-doctors get together and have a vote which decides that the doctor has to treat all of their ailments for whatever they decide is a "fair" amount to pay him. In my view of the world, the doctor is completely in his rights to say, "go fuck yourself."

I think he is, too. And while I realize that you're making a larger point about taxes, I think you're being disingenuous by using that particular metaphor. In the post-HR3962 world, no one is required to be a doctor, and no doctor is required to perform services for any payment he does not wish to agree to. (Except in emergent circumstances, which was true before.) No doctor is required to accept Medicare payment, and doctors are allowed to negotiate contracts with insurance companies, including the rejection of any such contracts. In summary, if they're not happy with the amount they're being paid, there is nothing that compels them to work for that amount.

Originally Posted By: TigerJimmy
Sadly, most people operate at the selfish level of moral development (remember, it has to be this way, we were *all* at this level once).

To be pedantic, that's a specious argument. (I'm notably not denying the basic claim, just the argument that leads you there.) To use your prior example, if we all know how to add before we know how to multiply, if we use your argument, most people don't know how to multiply. Or taken to a larger extreme, if we all know how to say individual words before we know how to speak in sentences, then most of us don't know how to speak in sentences. I think this is demonstrably untrue. (Ignoring poor grammar; it's still a sentence even if it's improperly constructed.)
_________________________
Bitt Faulk

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#331372 - 24/03/2010 14:57 Re: The United States Enters the 20th Century! [Re: wfaulk]
TigerJimmy
old hand

Registered: 15/02/2002
Posts: 1049
Originally Posted By: wfaulk
Originally Posted By: TigerJimmy
When you really look at a document like the Constitution, it is a document which, above all else, seeks to protect the system from the selfish levels of moral development.

And yet you take a position that I cannot find any way to qualify other than as "selfish". From my point of view it seems to boil down to "I'm all right Jack; keep your hands off of my stack."


It's not about that. I think I've explained fairly thoroughly that my position is not about avoiding paying taxes for morally legitimate functions of government. My position is the exact opposite of selfish, since I am saying that I don't have the right to take labor or property from others by force, no matter how difficult my personal situation. And, I personally spent just over 5 years without health insurance because I couldn't justify the expense. You can't reduce my argument to a greedy person not wanting to pay taxes. This is about people being able, as much as possible, to pursue their destiny and happiness based on their own definition.
Quote:

Originally Posted By: TigerJimmy
So was the 16th amendment.

Ooohh. You're one of those.

Can you explain to me why direct taxation is so evil? The constitution clearly calls out that clause as one that's likely to be amended (at least that's how I interpret the time restriction), so why is there so much concern over it? There's no reason that the Federal government couldn't levy an indirect payroll tax that, these days, would have basically the same effect as the direct income tax. What difference does it make that it passes through someone else's hands first? Or is your argument that there should be a regressive taxing system? Because, again, that could be implemented as either a direct or indirect tax.


The problem is that once you allow it at all, then it tends to be used for all kinds of things. The original income tax was around 1-2%, from memory, and nobody would have imagined that it would be 30+% at the time. Again, taxation is not the issue. It's the government proscribing what "good" is for people. Not killing or robbing each other? Fine. Protecting the system from foreign invasion? Fine. Forcing people to buy a product (health "insurance")? Not fine. Prohibiting people from buying useful products (Vicodin, experimental drugs)? Not fine. These things clearly fall into a category where a person should be making those decisions for themselves.

Quote:

Originally Posted By: TigerJimmy
I also think that I might be able to get Bitt (or people like him) to admit that what they are fundamentally doing is using force to impose their *opinions* on me, and that Bitt is smart enough to realize that HIS OPINIONS MIGHT BE WRONG, no matter how fervently he believes them.

Absolutely. That is the basis of all society, from the smallest anarchist collectives, to the largest capitalist states and everything in between. Society makes rules that state how others can behave. There are societies that exist(ed?) that didn't really have a notion of personal property, so isn't it possible that your requirement of the sanctity of personal property is also opinion?


Of course! But, you see, that's the beauty of my position. If I'm wrong, I haven't imposed my beliefs on others. You have. Property rights are a logical consequence of self-ownership. Self ownership means being able (among other things) to make moral decisions for yourself (that don't affect others), to eat and drink what you want, to labor and keep the fruits of your labor.

Quote:

Originally Posted By: TigerJimmy
Imagine an island with 10 inhabitants and one doctor. The 9 non-doctors get together and have a vote which decides that the doctor has to treat all of their ailments for whatever they decide is a "fair" amount to pay him. In my view of the world, the doctor is completely in his rights to say, "go fuck yourself."

I think he is, too. And while I realize that you're making a larger point about taxes, I think you're being disingenuous by using that particular metaphor. In the post-HR3962 world, no one is required to be a doctor, and no doctor is required to perform services for any payment he does not wish to agree to. (Except in emergent circumstances, which was true before.) No doctor is required to accept Medicare payment, and doctors are allowed to negotiate contracts with insurance companies, including the rejection of any such contracts. In summary, if they're not happy with the amount they're being paid, there is nothing that compels them to work for that amount.


But I am required to pay money for health insurance I might not want. And the government WILL restrict liberties to improve public health. We're seeing it already with smoking laws, trans fat laws, etc. You think that's OK, and that's the problem.
Quote:

Originally Posted By: TigerJimmy
Sadly, most people operate at the selfish level of moral development (remember, it has to be this way, we were *all* at this level once).

To be pedantic, that's a specious argument. (I'm notably not denying the basic claim, just the argument that leads you there.) To use your prior example, if we all know how to add before we know how to multiply, if we use your argument, most people don't know how to multiply. Or taken to a larger extreme, if we all know how to say individual words before we know how to speak in sentences, then most of us don't know how to speak in sentences. I think this is demonstrably untrue. (Ignoring poor grammar; it's still a sentence even if it's improperly constructed.)


Yes, you are absolutely correct. Research does show that 60% of Americans are operating at ethnocentric or lower morality, but that isn't a logical requirement or hierarchical development.

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#331375 - 24/03/2010 15:37 Re: The United States Enters the 20th Century! [Re: TigerJimmy]
canuckInOR
carpal tunnel

Registered: 13/02/2002
Posts: 3212
Loc: Portland, OR
Originally Posted By: TigerJimmy
Originally Posted By: canuckInOR
Originally Posted By: tonyc
Originally Posted By: TigerJimmy
PS: the fact that it's close to a Republican bill means nothing to me as the Republicans have just as bad a track record on liberty.

"Liberty" is such an abstract and loaded word that it's really not productive to debate how much "liberty" we want, or who's got a good track record on "liberty." Absent any context or clarification, it's little more than a rah-rah buzzword to rile up constituents for or against something you don't like. We all want it in the abstract, but without specifying where to draw the boxes around your liberty to swing your fist and my liberty to live without having my face punched, we're really not getting anywhere.

That's pretty well said.

You know what would mean "liberty" for me? A single-payer health system, administered by the government. I'd have the liberty to change jobs, without worrying about losing/downgrading my health care. I'd have liberty from worrying about where the hell I'm going to get the funds to pay an additional $500+ bill every month, after losing my job. I'd have the liberty to go to any doctor I want, instead of being artificially restricted to whoever my insurer dictates (yay, Kaiser HMO!). I'd have the liberty to go to the closest, least-busy hospital, when I need to. I'd have the liberty to get out-of-state medical care when I'm traveling, without worrying about how much is covered by insurance.

Having lived on both sides of the US/Canada border, it's the Canadian system (even with all its imperfections) that's more liberating, by far. Even though it's government administered. (The higher taxes thing is a red-herring -- by the time you pay for health insurance post-taxes, the difference is negligible.)

You mean it would provide you, personally, with more of what you call "liberty".

And everyone else I know, too. I know a great many people who were afraid to look for a better job, consequently improving their lot in life, because they were concerned about keeping their medical insurance. I know a great many people who are frustrated about losing doctors they liked, because they had to switch insurance. What I wrote above would provide liberty to a greater class of people than just myself.

Quote:
You aren't considering that someone has to pay that $500. That there is no such thing as a free lunch. If you aren't paying for services (labor) that you receive, someone else is. That doesn't seem to matter to you as long as that someone isn't you.

Really? I'm not considering that? When you decided that, perhaps you weren't considering that I'm somewhere above "moron" on the scale of intelligentsia? I'm quite well aware that the funding for a single-payer system comes from somewhere, and that there's no such thing as a free lunch. The notion that people in favour of "socialized" medicine just want something for nothing is nothing but an old canard.

Quote:
That is very far from the philosophical principle of liberty. In fact, it is the complete opposite, and more correctly referred to as "selfishness" or simply "stealing."

IMHO, you have it exactly backwards. By paying into a single-payer system via my taxes, I know that my funds are being used to provide anyone and everyone with medical care. Including you, if necessary. Because I believe so strongly in the importance of everyone having good access to medical care regardless of their financial situation, I'm willing to contribute so that everyone has the same liberties that I described above; so that everyone can have the opportunity to be as healthy as possible. And in the event that I need to draw on it? So be it... but so far, I put far more into the (Canadian) system than I ever took out. I pay into it so that everyone can benefit... not just me. I've paid far more into the US system than I've ever taken out, too, but here I have no confidence that any surplus funds have done anything but line the pockets of an insurance executive.

On the other hand, you seem to be arguing for your funds only being of benefit to you. And you accuse me of selfishness?

Cheers,

Edit: Trimmed incendiary comment...


Edited by canuckInOR (24/03/2010 16:02)

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#331397 - 24/03/2010 19:07 Re: The United States Enters the 20th Century! [Re: TigerJimmy]
wfaulk
carpal tunnel

Registered: 25/12/2000
Posts: 16706
Loc: Raleigh, NC US
Originally Posted By: TigerJimmy
my position is not about avoiding paying taxes for morally legitimate functions of government.

And I have asked you define what you feel are the "morally legitimate" functions of government, and you have yet to do so.

Originally Posted By: TigerJimmy
I personally spent just over 5 years without health insurance because I couldn't justify the expense.

And people who do that often end up costing the taxpayer more money than would have been spent by the individual on the insurance to begin with. Unless you feel that society has no moral imperative to take action against treatable disease and injury, which would be another way to reduce costs that you currently pay in taxes and in health insurance premiums.

Originally Posted By: TigerJimmy
If I'm wrong, I haven't imposed my beliefs on others. You have. Property rights are a logical consequence of self-ownership.

If your concept of self-ownership is wrong, then you have imposed your beliefs on others. You did not get where you are today solely through your own actions; society played a part in that, as much as you may want to believe otherwise. As part of living in this society, it is part of the social contract that we give back to the society, and paying taxes are one way we do that.

It strikes me as similar to the people who won't donate to the Red Cross, because their money won't go solely to Haiti earthquake victims. The Red Cross is going to do everything it can to take care of the needy in Haiti and everywhere else, regardless of their funding. (Obviously there have to be limits somewhere.) So when you donate to the Red Cross, you fund the Red Cross, not their operations in a particular place. When you pay taxes, you pay into the fund; you don't get to pick and choose which services you want.

That said, I still want to know what your ideal set of services is.

Originally Posted By: TigerJimmy
And the government WILL restrict liberties to improve public health. We're seeing it already with smoking laws, trans fat laws, etc. You think that's OK, and that's the problem.

Smoking affects more people than just the smoker, unless he does it in complete solitude in a place no other people ever go.

No one has banned the sale of trans fats. What has been banned is the sale of trans fats as food. People can sell rat poison all day long, but if they start putting it in Oreos, I think it's legitimate for the government to do something about it.

I will admit that I'm generally not a big fan of telling other people what to do, or being told what to do myself. I am not a fan of drug laws, nor am I a fan of the restriction of civil liberties of any nature. However, I don't see universal healthcare as a restriction of liberties, rather as an expansion of them.

That said, there are times when the needs of the many or the whole do outweigh the needs of the few. I would personally prefer universal healthcare that is paid for directly by taxes, rather than the somewhat onerous mandate to purchase health insurance independently. I recognize that as politically impossible. I gather that you would be opposed to that, as well.

I continue to claim that you are currently paying money towards other people's healthcare now, just through circuitous paths. With this bill, that money not only goes towards helping those same less fortunate people, but also gives you a personal benefit, unless you choose to reject that benefit.

As I see it, there are only a few valid arguments against universal health care:
  1. The government should not provide for anyone's health, regardless of circumstance.
  2. I'm willing to spend more money in order to make sure that the government doesn't provide any direct health benefit to anyone.
I was thinking I would come up with three or four, but I think all the other ones eventually simplify into one of those two.

Which of those do you subscribe to? Or, if there's another that I have missed, please share.
_________________________
Bitt Faulk

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#331405 - 24/03/2010 20:29 Re: The United States Enters the 20th Century! [Re: wfaulk]
hybrid8
carpal tunnel

Registered: 12/11/2001
Posts: 7738
Loc: Toronto, CANADA
At the end of the day, it's not my country and I really have no say nor stake in the healthcare issue. But I'll bring it up again, why don't we see the same people arguing about the military spending?

What is it about government-sponsored/mandated/whatever healthcare coverage that gets some people so wound up (against it)? I can see from this thread that it doesn't seem to be exclusive to people who already have coverage through their employer. Pure selfishness would otherwise be my guess as to the primary motivation for objections to universal healthcare.

How much is it going to cost to pay for all this anyway? Half the price of a single aircraft carrier? A couple of months worth of killing civilians in the middle East?
_________________________
Bruno
Twisted Melon : Fine Mac OS Software

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#331408 - 24/03/2010 21:52 Re: The United States Enters the 20th Century! [Re: hybrid8]
wfaulk
carpal tunnel

Registered: 25/12/2000
Posts: 16706
Loc: Raleigh, NC US
There is a strong sentiment in the US against the federal government overreaching its power. The US Constitution explicitly states what powers the federal government has and what powers the states have. (The original Constitution consisted of the main article, plus the first ten amendments, which are collectively referred to as the Bill of Rights.)

One of the things that is explicitly defined as a federal power is the power to form a military. There are other vaguely worded clauses that some people interpret very conservatively and others interpret very liberally, as well as everywhere in between. For example, the Constitution states that the federal government is to "provide for the … general welfare of the United States". Liberals believe that providing healthcare can be reasonably seen as providing for the general welfare. Conservatives seem to believe that general welfare doesn't comprise much beyond the prevention of dissolution. In general, liberals see the Constitution as a "living document" that must fit with the times, while conservatives see it as set in stone and uninterpretable, meaning nothing more than what it denotatively says.

Originally Posted By: hybrid8
How much is it going to cost to pay for all this anyway?

For the federal government, predictions are that it will reduce the deficit. For those that don't currently have health insurance, it will cost them a payment they're not making already. I imagine that the majority of those people don't have health insurance because they can't afford it, and will likely be subsidized. The people who get "screwed" are those that can afford health care, but choose not to have it anyway. My opinion is that those people are being selfish. Few people can afford to pay outright for cancer treatment, so those people are willing to chance that they won't get cancer against someone else picking up the tab. (Cancer being a standin for any expensive illness.) There are also increased taxes on the wealthy (those that make over $200,000 a year individually or $250,000 as a family) to pay for the subsidies given to the poor. (Also, people don't like redistribution of wealth, unless it's to generate a greater income disparity. "You're taking my hard-earned money to give it to some lazy slob!")

The estimated total "cost" of the bill in higher taxes and repurposing of Medicare funds is just under one trillion dollars over ten years, but that doesn't include any cost reduction estimates. A Nimitz-class aircraft carrier is about $4.5 billion.
_________________________
Bitt Faulk

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#331410 - 24/03/2010 22:14 Re: The United States Enters the 20th Century! [Re: wfaulk]
hybrid8
carpal tunnel

Registered: 12/11/2001
Posts: 7738
Loc: Toronto, CANADA
Ok, maybe not an aircraft carrier, but the US is spending money at a faster rate in Iraq... Shame.

http://costofwar.com/

Thanks for the details Bitt. I'm glad you guys are getting some reform finally. It's been a long time coming.

I hate to pay taxes as much as the next guy, but I do have a sense of priorities for where that money should go. Healthcare is pretty high up there.
_________________________
Bruno
Twisted Melon : Fine Mac OS Software

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#331431 - 25/03/2010 17:41 Re: The United States Enters the 20th Century! [Re: wfaulk]
TigerJimmy
old hand

Registered: 15/02/2002
Posts: 1049
Originally Posted By: wfaulk
There is a strong sentiment in the US against the federal government overreaching its power. The US Constitution explicitly states what powers the federal government has and what powers the states have. (The original Constitution consisted of the main article, plus the first ten amendments, which are collectively referred to as the Bill of Rights.)

One of the things that is explicitly defined as a federal power is the power to form a military. There are other vaguely worded clauses that some people interpret very conservatively and others interpret very liberally, as well as everywhere in between. For example, the Constitution states that the federal government is to "provide for the … general welfare of the United States". Liberals believe that providing healthcare can be reasonably seen as providing for the general welfare. Conservatives seem to believe that general welfare doesn't comprise much beyond the prevention of dissolution.


I'll answer your other post when I have some more time, but I seem to recall reading a response to the General Welfare clause by Thomas Jefferson where he explicitly states that the clause is NOT intended to give the federal government the authority to provide services not explicitly given in the rest of the Constitution, but rather that it gives them the authority to tax for those powers specifically granted.

The constitution is not vaguely worded, no matter how much the central planners (right and left) would like to believe. It states very unambiguously as the 10th Amendment:

Quote:
The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.


Health care is not specifically "herein granted" the federal government by the Constitution. Period.

You see two philosophically different points of view between me and Bitt. Bitt (it seems to me) is a collectivist, who sees the function of government to increase the welfare of it's citizenry through central planning. I believe that the function of government is to maximize individual liberty as much as possible so that individuals can pursue their welfare as they see fit.

Bitt says he doesn't support dirigibles for 13 year olds because there is no "social value". Says who? Says him, of course. That's the whole problem.

To suggest that self-ownership may be a flawed philosophical concept is to place the value of the collective above the value of the individual. This is the core issue. The mainstream political parties in America place the collective above the individual (differing in how they define "social value"), the libertarian rejects this notion.

Either one of us could be wrong, I suppose, but there is absolutely NO QUESTION which the Founding Fathers believed. The collectivists will respond that these are dated ideas, which is why the Constitution needs to be a living document. The libertarian will say that the Constitution is based on philosophical principles which are just as valid today as they were 200 years ago.

To answer Bitt's question directly: which do I consider to be morally legitimate functions of government? It wouldn't be my *exact* list, but I could live with those functions *explicitly* granted in the Constitution. This would eliminate the vast majority of our federal government.

From a practical point of view, I promise to eat my hat if this reduces the deficit or health care costs one iota.

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#331433 - 25/03/2010 18:07 Re: The United States Enters the 20th Century! [Re: TigerJimmy]
hybrid8
carpal tunnel

Registered: 12/11/2001
Posts: 7738
Loc: Toronto, CANADA
I think what's needed here is a time machine. Folks who feel that everything should be by the precise letter of the constitution would be given the opportunity to travel back in time for a spell to see how they enjoyed living in that period.

Doesn't the "or to the people" sort of invalidate the notion that this is something the government can't do? I mean, the government represents and was put in office by the people. In fact by a majority of people. A majority of people who want healthcare reform. So while these people can't necessarily all get together in the same place to hash all this out, their representatives can. Oh... And have.

You don't need to worry about the social order. The poor will still be poor at the end of the day and the rich will still be rich. The middle class will still be there too. Your nation can afford it. Easily.
_________________________
Bruno
Twisted Melon : Fine Mac OS Software

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#331436 - 25/03/2010 18:19 Re: The United States Enters the 20th Century! [Re: TigerJimmy]
wfaulk
carpal tunnel

Registered: 25/12/2000
Posts: 16706
Loc: Raleigh, NC US
You're casting me as one of these anti-libertarian types, and, while I see where you get that impression from this particular discussion, I can assure you that that's not true.

I think that this legislation is seriously flawed. However, I also believe that the country is significantly better off with it than without it. I understand your point about individual liberties, and when taken without context, I agree 100%. When taken in context, I agree about 95% of the time. (Assuming that your notion of the individual does not extend to non-natural persons.)

However, I believe that there are times when the practicality of the liberty of the group has to trump the liberty of the individual. I am definitely not a "central planner". I merely believe that the government has a responsibility to provide needed services to its citizens. What services are needed may change over time. I believe that access to healthcare has become one of those needed services.

Originally Posted By: TigerJimmy
The constitution is not vaguely worded

Yet you prefix that with Thomas Jefferson providing clarification on a particular clause. If you have to provide clarification, it is vague. I do not believe that it was unintentionally vague, either. Certainly Jefferson and Adams had very different ideas about the role of government, and I'm sure that much of the phrasing was due to compromise. I have no doubt that Thomas Jefferson's ideals for government match yours, but Thomas Jefferson is not the final arbiter of what the Constitution says.

Originally Posted By: TigerJimmy
Bitt says he doesn't support dirigibles for 13 year olds because there is no "social value". Says who? Says him, of course. That's the whole problem.

And you say that there's no value in universal healthcare. If you can come up with a reason why universal dirigibility is good for the country, I'm more than willing to listen, and we can come to a decision together.

Originally Posted By: TigerJimmy
From a practical point of view, I promise to eat my hat if this reduces the deficit or health care costs one iota.

As I've said before, my concern is far less with the cost than with doing our best to make sure that everyone has the best opportunity to live and be able to pursue happiness.

That said, I'll ready the steak sauce.
_________________________
Bitt Faulk

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#331438 - 25/03/2010 19:35 Re: The United States Enters the 20th Century! [Re: hybrid8]
tfabris
carpal tunnel

Registered: 20/12/1999
Posts: 31563
Loc: Seattle, WA
Originally Posted By: hybrid8
I think what's needed here is a time machine. Folks who feel that everything should be by the precise letter of the constitution would be given the opportunity to travel back in time for a spell to see how they enjoyed living in that period.


That was a great Duckman episode. Wish I could find the clip on Youtube for you.

The vague gist was: Thomas Jefferson (voiced by Ben Stein, IIRC) appears through a time wormhole and says, "Freedom of speech applies to everyone. No exceptions. And we didn't mean that every Joe Sixpack should have a gun... we're not stupid."
_________________________
Tony Fabris

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#331447 - 26/03/2010 01:26 Re: The United States Enters the 20th Century! [Re: TigerJimmy]
maczrool
pooh-bah

Registered: 13/01/2002
Posts: 1649
Loc: Louisiana, USA
Originally Posted By: TigerJimmy

From a practical point of view, I promise to eat my hat if this reduces the deficit or health care costs one iota.


As Bitt suggests, you better prepare to eat that hat. Uncle Sam has a stellar track record of fiscal solvency and restraint which is never compromised by political interests. If history for some reason doesn't repeat itself, this new bill will create a national surplus, raise the life expectancy to 1000 years, and slash the unemployment rate to 0% (as you know every bill that comes from this Congress is really about creating jobs; the other benefits are secondary).

You really should learn to take comfort in the fact that Big Brother has your back and wants and knows what's best for you far better than you yourself could ever know!

Stu
_________________________
If you want it to break, buy Sony!

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#331454 - 26/03/2010 03:46 Re: The United States Enters the 20th Century! [Re: maczrool]
wfaulk
carpal tunnel

Registered: 25/12/2000
Posts: 16706
Loc: Raleigh, NC US
Is it that you're opposed to providing healthcare to those who can't afford it? Because that's the only real governmental outlay here: subsidies for the poor to afford health insurance. Otherwise, the entirety of actually providing medical payments is going to be done through the insurance companies that you already know and love.
_________________________
Bitt Faulk

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#331469 - 26/03/2010 21:24 Re: The United States Enters the 20th Century! [Re: wfaulk]
maczrool
pooh-bah

Registered: 13/01/2002
Posts: 1649
Loc: Louisiana, USA
Originally Posted By: wfaulk
Is it that you're opposed to providing healthcare to those who can't afford it? Because that's the only real governmental outlay here: subsidies for the poor to afford health insurance. Otherwise, the entirety of actually providing medical payments is going to be done through the insurance companies that you already know and love.


As I've said in other threads I am not opposed to treating the disadvantaged, as if this bill is some magical absolute with no other alternative. Why must we dismantle the free market insurance system just to get 30-40 million people insurance and treat pre-existing conditions? A small fraction of the price tag of this thing could buy private insurance and where needed cover those that get dropped or excluded. There are already plenty of programs to treat people with chronic health conditions and perform general health care anyway. This bill is just a pathetic excuse for the libs to get their clutches into our every day lives and tax us to oblivion.

Everything is not as cut and dry as you try to make it out to be. We'll gradually lose private insurance until we have no other option but government health coverage. Once the profit is gone from the industry do you really think innovation will continue? Do you honestly think health care will be just as available to those that already have it once everything is fully implemented when medical personnel pursue other more lucrative less opressed fields? We'll be paying more and getting far, far less. I can only hope some of our states with some balls decide to opt out of this disgrace of a bill that has been forced on us.

Stu
_________________________
If you want it to break, buy Sony!

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#331472 - 26/03/2010 22:22 Re: The United States Enters the 20th Century! [Re: maczrool]
wfaulk
carpal tunnel

Registered: 25/12/2000
Posts: 16706
Loc: Raleigh, NC US
Originally Posted By: maczrool
Why must we dismantle the free market insurance system just to get 30-40 million people insurance and treat pre-existing conditions?

While I'd not be opposed to that, I see nothing of the sort in this bill. The bill applies restrictions as to how insurance companies can treat their customers (minimal coverage, pre-existing conditions, recission, etc.), and allows the general populace to act as a group for the same sort of collective bargaining that existing groups (employees, etc.) currently do.

Can you be explicit about what sort of free-market dismantling you're referring to?

To be clear, there is no provision for any government-run health plan in the bill.
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#331475 - 26/03/2010 22:28 Re: The United States Enters the 20th Century! [Re: maczrool]
tonyc
carpal tunnel

Registered: 27/06/1999
Posts: 7058
Loc: Pittsburgh, PA
Quote:
as if this bill is some magical absolute with no other alternative.

Here's the thing. Republicans did offer various "alternatives", but they were all "here are our ideas, take them or leave them" proposals. That's how they're used to negotiating, and they haven't adjusted to life in the minority. The minority party in Congress doesn't get to set the starting point for negotiations.

Republicans were more than welcome to provide serious ideas and proposals for changes to the bills as they were being drafted in committee, but that's not what happened. Instead, all of their proposals, including the Paul Ryan plan that got a lot of attention at the end, involved tearing the Democratic bills up and starting over with a purely Republican bill.

Despite this, as I said, the final product had over 200 Republican amendments in it. Democrats *did* water down the bill and made it more friendly to the existing system. There's no single payer. No truly universal coverage. No public option. No immediate effect on the employer-based system, and only a moderate effect on it a decade from now.

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Why must we dismantle the free market insurance system just to get 30-40 million people insurance and treat pre-existing conditions?

If the "free market insurance system" wasn't leading to exploding costs, maybe there'd be no need to reform it. This isn't just about covering the 30-40 million without coverage, it's about putting downward pressure on costs for those who do have coverage. Tell me how the current free market system is working when costs are skyrocketing. Or if you acknowledge it's not working to control costs, tell me how you'd prefer to control them.
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A small fraction of the price tag of this thing could buy private insurance and where needed cover those that get dropped or excluded.

Total bullshit. The bill's cost over ten years, negating cost savings, is around a trillion dollars. With the low-ball estimate of 30 million uninsured, that's around $3500 per year per uninsured. Show me the insurance plan for *healthy* folks that costs that much, let alone a plan that someone with a pre-existing condition could get. Your statement has no basis in fact.
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There are already plenty of programs to treat people with chronic health conditions and perform general health care anyway.

Name them.
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I can only hope some of our states with some balls decide to opt out of this disgrace of a bill that has been forced on us.

Last I checked, the team that ran on health-care reform won overwhelming majorities in congress. If people didn't want it "forced" on them, they would have voted for the other team.

Oh, and your point about doctors hating this bill and wanting to leave the medical profession because of it? The AMA supported the bill. Thanks for playing.
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#331480 - 27/03/2010 01:04 Re: The United States Enters the 20th Century! [Re: maczrool]
jimhogan
carpal tunnel

Registered: 06/10/1999
Posts: 2591
Loc: Seattle, WA, U.S.A.
Stuart says:
Quote:
We'll gradually lose private insurance until we have no other option but government health coverage. Once the profit is gone from the industry do you really think innovation will continue? Do you honestly think health care will be just as available to those that already have it once everything is fully implemented when medical personnel pursue other more lucrative less opressed fields? We'll be paying more and getting far, far less.

Stuart, based on the work that you have done on Empegs, I long ago concluded that you are way smarter than me, but I don't get this. We have a bunch of Canadians on this BBS, just a short hop away via Boeing 737 or Airbus 320, who seem to be surviving the oppression of "federally"-funded single-payor health care without any serious Orwellian side effects so far as I can tell. OK, there are issues raised about waiting lists for brain transplants and such, but aren't Canadians' life expectancies and health outcomes the same if not better?

I planned a vacation in February/March in a *Socialist* republic (Vietnam) in part just to avoid watching news coverage of this mess, but I came back and it hasn't stopped!

It just kills me that discussion of such a basic issue should turn in to a debate about the merits of Alisa Zinov'yevna Rosenbaum's objectivist philosophy or Marx's spin on the fruits of labor. I often don't think of myself as an exceptionally nice guy, but the grim grumbling about "property" makes me feel like a pretty cheery dude. Bitt, I admire your patience. TigerJimmy, I have concluded that you must be a robot.

OK, I jest, I exaggerate, but I just don't get it. I feel like the American body politic is essentially antisocial. There is no sense of the commonwealth. Republicans aren't *for* anything, just against. Democrats pretend to be *for* something and talk about putting insurance companies in their place while taking exceptional care to please special interests (like insurance companies and pharma).

I won't ever vote for a Democrat or Republican again, but I have to say that it concerns me to no end when Republican demagogues spout bullshit about how they have the will of the American people behind them. Goddamn proto-fascists and a bunch of freaking maladjusted children. They lost a few elections but seem to have conveniently forgotten their lessons in Democracy 101. If I wasn't going to be dead within 15-20 years I would be hugely concerned.

And it is a total riot. The teabaggers and wingnuts with whom I would expect TigertJimmy to make common cause are railing about the "Socialist!" Obama and his evil designs when, in fact, Obama has turned out to be the most miserable, ineffectual, middle-of-the-road-to-nowhere, Harvard-trained tool of special interests that I can recollect.

But he's a socialist smile

Stuart, was the Canadian single-payor initiative just a pathetic excuse for the (Canadian) libs to get their clutches into their every day lives and tax (Canadians) into oblivion? Or was there maybe something more to it?
_________________________
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'Tis the exceptional fellow who lies awake at night thinking of his successes.

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#331487 - 27/03/2010 10:10 Re: The United States Enters the 20th Century! [Re: jimhogan]
peter
carpal tunnel

Registered: 13/07/2000
Posts: 4172
Loc: Cambridge, England
Originally Posted By: jimhogan
But he's a socialist smile

At best!

Peter

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#331488 - 27/03/2010 11:14 Re: The United States Enters the 20th Century! [Re: wfaulk]
maczrool
pooh-bah

Registered: 13/01/2002
Posts: 1649
Loc: Louisiana, USA
Originally Posted By: wfaulk
Originally Posted By: maczrool
Why must we dismantle the free market insurance system just to get 30-40 million people insurance and treat pre-existing conditions?

While I'd not be opposed to that, I see nothing of the sort in this bill. The bill applies restrictions as to how insurance companies can treat their customers (minimal coverage, pre-existing conditions, recission, etc.), and allows the general populace to act as a group for the same sort of collective bargaining that existing groups (employees, etc.) currently do.

Can you be explicit about what sort of free-market dismantling you're referring to?

To be clear, there is no provision for any government-run health plan in the bill.


When you tell a business what sort of products it can offer and in fact what sort of product its customers 'shall' buy, it fails to be a free market system. I suppose you believe the insurance companies have exclusions and limits simply because they are greedy inhumane assholes with no concern for human life. The problem is, they are businesses whose purpose is to make money; they owe this to their stockholders/owners. They have low margins as it is. If you increase their costs by applying restrictions, forcing them to take on customers that they know from the start will lose them money they could very easily be forced out of business.

Stu
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#331489 - 27/03/2010 12:08 Re: The United States Enters the 20th Century! [Re: tonyc]
maczrool
pooh-bah

Registered: 13/01/2002
Posts: 1649
Loc: Louisiana, USA
Originally Posted By: tonyc

Here's the thing. Republicans did offer various "alternatives", but they were all "here are our ideas, take them or leave them" proposals. That's how they're used to negotiating, and they haven't adjusted to life in the minority. The minority party in Congress doesn't get to set the starting point for negotiations.

Republicans were more than welcome to provide serious ideas and proposals for changes to the bills as they were being drafted in committee, but that's not what happened. Instead, all of their proposals, including the Paul Ryan plan that got a lot of attention at the end, involved tearing the Democratic bills up and starting over with a purely Republican bill.


No truly universal coverage. No public option. No immediate effect on the employer-based system, and only a moderate effect on it a decade from now.


There is none of that yet. Obama and the rest have said that's what they want and that this is just the beginning. They've definitely laid the groundwork to make this happen all on its own with all the onerous regulations and profit squeezing.

Quote:

If the "free market insurance system" wasn't leading to exploding costs, maybe there'd be no need to reform it. This isn't just about covering the 30-40 million without coverage, it's about putting downward pressure on costs for those who do have coverage. Tell me how the current free market system is working when costs are skyrocketing. Or if you acknowledge it's not working to control costs, tell me how you'd prefer to control them.


I think the insurance industry needs to get back to actual insurance and doling out payments for the truly unexpected rather than paying for routine office visits and minor medical procedures. Tort reform needs to be in place to reduce defensive medicine and we need to nationalize the insurance market rather than limit it to state by state offerings.

Quote:
The bill's cost over ten years, negating cost savings, is around a trillion dollars. With the low-ball estimate of 30 million uninsured, that's around $3500 per year per uninsured. Show me the insurance plan for *healthy* folks that costs that much, let alone a plan that someone with a pre-existing condition could get. Your statement has no basis in fact.

I've never paid that for private insurance. Sorry... You know I've never been that great at math, but using your assumption is roughly a 10th of the advertised cost of this bill.


Originally Posted By: maczrool
There are already plenty of programs to treat people with chronic health conditions and perform general health care anyway.

Quote:
Name them.


As I've stated in other threads, I used to work at an HIV clinic. The vast majority of those patients were free care. They weren't out in the gutters dying as Obama and the dems would lead you to believe. The clinic was funded patially by the state and partially with federal grants. One of these was called the Ryan White grant.


Originally Posted By: maczrool
I can only hope some of our states with some balls decide to opt out of this disgrace of a bill that has been forced on us.


Quote:
Last I checked, the team that ran on health-care reform won overwhelming majorities in congress. If people didn't want it "forced" on them, they would have voted for the other team.

And last I checked, this BBS' residents not withstanding, the majority of people are against this bill. They voted for reform but like this.

Quote:

Oh, and your point about doctors hating this bill and wanting to leave the medical profession because of it? The AMA supported the bill.

This may surprise you, but not all doctors share its position.

Stu
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#331491 - 27/03/2010 12:43 Re: The United States Enters the 20th Century! [Re: jimhogan]
maczrool
pooh-bah

Registered: 13/01/2002
Posts: 1649
Loc: Louisiana, USA
Quote:
Stuart says:
Quote:
We'll gradually lose private insurance until we have no other option but government health coverage. Once the profit is gone from the industry do you really think innovation will continue? Do you honestly think health care will be just as available to those that already have it once everything is fully implemented when medical personnel pursue other more lucrative less opressed fields? We'll be paying more and getting far, far less.

Stuart, based on the work that you have done on Empegs, I long ago concluded that you are way smarter than me, but I don't get this. We have a bunch of Canadians on this BBS, just a short hop away via Boeing 737 or Airbus 320, who seem to be surviving the oppression of "federally"-funded single-payor health care without any serious Orwellian side effects so far as I can tell. OK, there are issues raised about waiting lists for brain transplants and such, but aren't Canadians' life expectancies and health outcomes the same if not better?


Thank you for that (I think wink ). Yes suppose they are about the same, but I have to ask, why, if it so wonderful has there been talk of scaling it back for more private options and how do you explain away the waiting lists and residents that come to the US for treatment because their lives depend on it? If it is so effectual and efficient should it not have vastly better outcomes? Ostensibly they don't have the 'greed' and evil 'profits' that stand in the way of patient care.

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Bitt, I admire your patience.

As if there is but one side to a coin???

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Stuart, was the Canadian single-payor initiative just a pathetic excuse for the (Canadian) libs to get their clutches into their every day lives and tax (Canadians) into oblivion? Or was there maybe something more to it?


The US is not Canada and it is not Europe. I'm saying in this case that is what is at play here. It seems rather hard to believe that it is mere coicidence that some of the most far reaching tax increases and other 'goodies' don't come into effect until after Obama's potential section term. Just because everybody's doing it does not mean it's the only way. The US was founded on the freedom of the individual, not the collective. Let's leave that to Europe where people seem to love it.

Stu
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#331496 - 27/03/2010 15:29 Re: The United States Enters the 20th Century! [Re: maczrool]
tonyc
carpal tunnel

Registered: 27/06/1999
Posts: 7058
Loc: Pittsburgh, PA
Originally Posted By: maczrool

When you tell a business what sort of products it can offer and in fact what sort of product its customers 'shall' buy, it fails to be a free market system.

Then there has never been a free market system in the history of any nation no this great Earth. By your definition, telling a pharmaceutical manufacturer they can't sell methamphetamine is a restriction on the "free market." As is making people buy car insurance so they can drive a car. As is *any* form of taxation -- after all, mandatory payment into the Social Security fund is just forcing people to purchase a form of "retirement insurance", isn't it? (I reckon you're probably in favor of privatizing that, too.)

Look, I agree that markets are very good for many things, but health-care isn't one of them.
Quote:

There are two strongly distinctive aspects of health care. One is that you don’t know when or whether you’ll need care — but if you do, the care can be extremely expensive. The big bucks are in triple coronary bypass surgery, not routine visits to the doctor’s office; and very, very few people can afford to pay major medical costs out of pocket.

This tells you right away that health care can’t be sold like bread. It must be largely paid for by some kind of insurance. And this in turn means that someone other than the patient ends up making decisions about what to buy. Consumer choice is nonsense when it comes to health care. And you can’t just trust insurance companies either — they’re not in business for their health, or yours.

This problem is made worse by the fact that actually paying for your health care is a loss from an insurers’ point of view — they actually refer to it as “medical costs.” This means both that insurers try to deny as many claims as possible, and that they try to avoid covering people who are actually likely to need care. Both of these strategies use a lot of resources, which is why private insurance has much higher administrative costs than single-payer systems. And since there’s a widespread sense that our fellow citizens should get the care we need — not everyone agrees, but most do — this means that private insurance basically spends a lot of money on socially destructive activities.

The second thing about health care is that it’s complicated, and you can’t rely on experience or comparison shopping. (“I hear they’ve got a real deal on stents over at St. Mary’s!”) That’s why doctors are supposed to follow an ethical code, why we expect more from them than from bakers or grocery store owners.

You could rely on a health maintenance organization to make the hard choices and do the cost management, and to some extent we do. But HMOs have been highly limited in their ability to achieve cost-effectiveness because people don’t trust them — they’re profit-making institutions, and your treatment is their cost.

Between those two factors, health care just doesn’t work as a standard market story.


How do you explain away these problems, keeping in mind that costs have exploded during a time when the insurers faced very little regulation?

Originally Posted By: maczrool

I suppose you believe the insurance companies have exclusions and limits simply because they are greedy inhumane assholes with no concern for human life. The problem is, they are businesses whose purpose is to make money; they owe this to their stockholders/owners.

And that's exactly the problem with using for-profit institutions to insure the the health and well-being of our citizens. I would not *expect* a corporation to have my health as its primary concern when there are profits to be had. As Krugman alludes to above, it's not as simple as "if an insurer screws over its customers to make money, people will go find another insurer." We have very few choices from our employers, and even on the individual market, one or two players dominate each region, and they're all just about as stingy when it comes to paying claims. I recognize those exclusions and limits are there to ensure they make money -- I just don't think that should be my primary concern when I have just had an expensive life-saving medical procedure and then they deny my claims because I didn't "shop around."
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#331497 - 27/03/2010 16:30 Re: The United States Enters the 20th Century! [Re: maczrool]
tonyc
carpal tunnel

Registered: 27/06/1999
Posts: 7058
Loc: Pittsburgh, PA
Originally Posted By: maczrool

There is none of that yet. Obama and the rest have said that's what they want and that this is just the beginning. They've definitely laid the groundwork to make this happen all on its own with all the onerous regulations and profit squeezing.

How on Earth is telling a company that provides *insurance* that they can't take away a policy as soon as they are required to pay out a claim on it "onerous regulation?" How is insurance "insurance" if it's rescinded as soon as it's needed? The standard free market answer to this is that insurers who don't do right by their customers will lose market share -- but again, with so few competitors in any given market, that doesn't happen. The health insurance industry is a complete failure of the free market, and you can't explain that away by complaining about onerous regulations when those regulations are the only thing keeping the companies from paying out on any claims at all.

Quote:

I think the insurance industry needs to get back to actual insurance and doling out payments for the truly unexpected rather than paying for routine office visits and minor medical procedures.

So, your solution to skyrocketing medical costs involves making preventative care less affordable? Really?

Quote:

Tort reform needs to be in place to reduce defensive medicine

Jury awards and defensive medicine account for less than 2% of medical costs. Show me a state that's implemented tort reform that has significantly decreased medical costs. The idea that lawyers are pushing up costs is just not borne out by the facts.

Quote:

and we need to nationalize the insurance market rather than limit it to state by state offerings.

Right, then they just move to the states that does the least regulation, the way credit card companies are all in South Dakota and Delaware. Because we all know the credit card companies are doing such a good job of serving customers...

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You know I've never been that great at math, but using your assumption is roughly a 10th of the advertised cost of this bill.


Are you saying math is wrong? $1 trillion / 30 million uninsured / 10 years is about $3400. I know you're trying to make a distinction between what the experts at the CBO say it will cost versus what you think it will cost, but I don't get what you're saying about my assumption being 1/10th of the cost.

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I've never paid that for private insurance.


The average cost for individuals on the non-employer market is around 3 grand a year. At worst, this bill costs a little more than that per uninsured person, but it's also reforming the system for the hundreds of millions who do have insurance. Your original statement that this amount of money could pay for everyone's care is just false, Stu, and vague accusations about how it will really cost more than that aren't persuasive if you don't have supporting evidence.

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The clinic was funded patially by the state and partially with federal grants. One of these was called the Ryan White grant.

Okay, that's one program in Louisiana for people with a specific condition. Do you really believe if programs were available for every condition, that people wouldn't take advantage of them? And how about people who are sick but haven't been diagnosed with a specific condition yet? Generally, the piecemeal programs for specific illnesses are designed to fill gaps in our system. I don't think they're a legitimate answer for health-care overall.

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And last I checked, this BBS' residents not withstanding, the majority of people are against this bill. They voted for reform but like this.

The Republicans did a great job sowing doubt and misunderstanding of the bill, with their "death panels are going to kill your grandma" rhetoric. Despite that, opinion prior to passage was just barely in opposition to the bill, but in favor of all of the individual provisions. Post-passage, public opinion favors the bill.

Quote:
This may surprise you, but not all doctors share its position.

Let's be real here... Is the AMA in the business of favoring policies it thinks will harm physicians, or that aren't supported by a majority of its members?
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#331504 - 28/03/2010 14:45 Re: The United States Enters the 20th Century! [Re: tonyc]
maczrool
pooh-bah

Registered: 13/01/2002
Posts: 1649
Loc: Louisiana, USA
Quote:

How do you explain away these problems, keeping in mind that costs have exploded during a time when the insurers faced very little regulation?


A lot of it has to do with this notion that EVERYTHING must be paid for by insurance. It's something that has evolved over time and it basically removes any incentive for the health care consumer to control costs. What does it matter if they run 5 tests or 10, if I go to the doctor everytime I have a hangnail, etc, etc? Routine stuff should be out of pocket, period. There's also the rising fraud in the industry and new technologies which happen to cost money. And of course there is defensive medicine and the staggering cost of malpractice insurance. I realize you like to marginalize this and low ball the hell out it but I've seen figures as high as 34% of expeditures go towards defensive medicine. Cost of Defensive Medicine.


Quote:
I would not *expect* a corporation to have my health as its primary concern when there are profits to be had. As Krugman alludes to above, it's not as simple as "if an insurer screws over its customers to make money, people will go find another insurer." We have very few choices from our employers, and even on the individual market, one or two players dominate each region, and they're all just about as stingy when it comes to paying claims. I recognize those exclusions and limits are there to ensure they make money -- I just don't think that should be my primary concern when I have just had an expensive life-saving medical procedure and then they deny my claims because I didn't "shop around."


I might be okay with some government safety net to cover those that slip through the cracks but this premise that bodies pile up in the street for lack of treatment is blown way out of proportion by those trying to sell this. If it really was just a safety net that's one thing but the bill is structured to put the insurance companies out of business so that those paying for all this (that's you and me) will be forced into the government plan- no thanks.

Stu
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#331505 - 28/03/2010 15:48 Re: The United States Enters the 20th Century! [Re: maczrool]
hybrid8
carpal tunnel

Registered: 12/11/2001
Posts: 7738
Loc: Toronto, CANADA
I've been reading along, and I have to applaud a few people in here for not losing their cool. Even though the positions against healthcare reform are presented intelligibly and are from otherwise intelligent people, I'm sorry, but some of the drivel being written shows predominantly the desire to toe the anti-government line and nothing more. I don't really think the specific topic matters - this line of argument is always going to be the same and from the same people.

I've really had to hold back from being judgmental, but some of the comments in here are precisely the type of ignorance that fuels the disdain for the US around the world. It really does help paint the US as nothing but a cesspool. Luckily I know that's not the case and that this is not even the voice of the majority.

Quote:

Routine stuff should be out of pocket, period.


You know, routine stuff like TB, chicken pox, pneumonia, cervical cancer, etc. Did you slip out this weekend to get a medical degree? Most of the population hasn't had the time to do that either, so self-diagnosis and treatment is likely not in the cards. I'm not sure how well medical-roulette would play out as a policy. Maybe in Vegas. I can see someone sitting on the exam table... "Come on big money, no whammies, no whammies..."

Nothing is routine until it's been diagnosed as routine. And anything "routine" can have complications and dire consequences from time to time. You'd think people were out trying to get their cock-enlargement surgeries covered by insurance or something.

I think reasonable people, especially those from other countries, are going to see this argument having two distinct sides, a right and a wrong, I'm afraid.
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#331506 - 28/03/2010 15:49 Re: The United States Enters the 20th Century! [Re: maczrool]
tonyc
carpal tunnel

Registered: 27/06/1999
Posts: 7058
Loc: Pittsburgh, PA
That Jackson Healthcare study is from an online poll of doctors reporting their own ideas of what defensive medicine costs them. "Defensive medicine" itself is a catch-all term that can basically describe any test that's done on someone that doesn't have a confirmed diagnosis. Given that doctors have a financial interest in over-reporting how much of their work is "defensive" in nature, that 34% number is not even remotely credible.

I found this blog post on the subject of "defensive medicine" from an ER doctor very persuasive.
Quote:
So when the WSJ reporter asked me why I made the defensive decision -- wasn't it just the fear of getting sued? Nope. It's a fear, and a significant one. But it's possibly the least likely of all the bad things that happen when you are wrong. If you've been sued, especially if you thought it was frivolous, or you lost, or if you know someone who's lost big, that fear is magnified beyond its real probability. But it's just one disincentive among many, and even if you eliminated the possiblity of getting sued (or reduced it greatly, as they have in Texas), there are still so many "punishments" for an "error" that I suspect that the cost of Defensive Medicine will change little.


In other words, there are a lot of other reasons other than lawsuits that doctors order tests or provide treatment that someone might find unnecessary, and those don't go away once you eliminate junk lawsuits.
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#331507 - 28/03/2010 16:15 Re: The United States Enters the 20th Century! [Re: hybrid8]
maczrool
pooh-bah

Registered: 13/01/2002
Posts: 1649
Loc: Louisiana, USA
Quote:
I've been reading along, and I have to applaud a few people in here for not losing their cool. Even though the positions against healthcare reform are presented intelligibly and are from otherwise intelligent people, I'm sorry, but some of the drivel being written shows predominantly the desire to toe the anti-government line and nothing more. I don't really think the specific topic matters - this line of argument is always going to be the same and from the same people.

I've really had to hold back from being judgmental, but some of the comments in here are precisely the type of ignorance that fuels the disdain for the US around the world. It really does help paint the US as nothing but a cesspool. Luckily I know that's not the case and that this is not even the voice of the majority.

It's funny how the left always resorts to name calling and insulting of one's intelligence as some sort of valid argument against the naysayers of their policies (in addition to violence). They are the enlightened, elites and the do gooders, while the opposition are the lackwits, the ignorant redneck slobs and haters of the world.

Quote:
You know, routine stuff like TB, chicken pox, pneumonia, cervical cancer, etc.
I was referring to check-ups if you are so inclined.

Stu
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#331508 - 28/03/2010 16:17 Re: The United States Enters the 20th Century! [Re: tonyc]
maczrool
pooh-bah

Registered: 13/01/2002
Posts: 1649
Loc: Louisiana, USA
Quote:
How on Earth is telling a company that provides *insurance* that they can't take away a policy as soon as they are required to pay out a claim on it "onerous regulation?" How is insurance "insurance" if it's rescinded as soon as it's needed? The standard free market answer to this is that insurers who don't do right by their customers will lose market share -- but again, with so few competitors in any given market, that doesn't happen. The health insurance industry is a complete failure of the free market, and you can't explain that away by complaining about onerous regulations when those regulations are the only thing keeping the companies from paying out on any claims at all.


If they are in breach of contract of course they should pay. But generally there is a reason for their actions. If you become too great a risk then yes they will drop you but the decision can't legally be made in lieu of payment if the policy covers that person's condition. I realize this happens and sometimes you have to fight to get what's coming but guess who leads in denials of care, why it's your hero the federal government!

Quote:
So, your solution to skyrocketing medical costs involves making preventative care less affordable? Really?

There's a saying, you might have heard it before- you can lead a horse to water but you can't make him drink. You seem to assume that just because it's there everyone will be clamoring to go get their (as you seem to see it) God-given preventative care). I fail to see that the poor and often uneducated will see fit to take part in that just because it's there.

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Jury awards and defensive medicine account for less than 2% of medical costs.


See my answer in the previous response above.

Quote:
Right, then they just move to the states that does the least regulation, the way credit card companies are all in South Dakota and Delaware. Because we all know the credit card companies are doing such a good job of serving customers...


You've proven my point actually. Of course they ar going to go where they stand the best chance at making a profit. It's just common sense. Regulations limit profits and push businesses not only out of state but overseas too.

As far as the credit cards, well they are a business too. They are not a welfare entity. People need to learn to read up on things and what they are getting into before they use their cards irresponsibly, but I guess that will never happen because the liberals take them by the hand make it all better before they learn from their mistakes. We are seriously getting to the point where no one is responsible for anything anymore. The answer to everything is not more government. Why can't people be permitted to fail and make mistakes? Isn't that how we achieve greatness and excel in life? If all our choices are the 'right' ones because the chance to choose poorly has been eliminated, are we really free anymore? With no risk, there is no reward.

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Are you saying math is wrong? $1 trillion / 30 million uninsured / 10 years is about $3400. I know you're trying to make a distinction between what the experts at the CBO say it will cost versus what you think it will cost, but I don't get what you're saying about my assumption being 1/10th of the cost.


You are right, missed a zero in there. Such a simple analysis is really far removed from how insurance works anyway though. The CBO has to crunch whatever numbers it's given, no matter how bogus or fraudulent they are. Garbage in garbage out.


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vague accusations about how it will really cost more than that aren't persuasive if you don't have supporting evidence.


Why not? Obama makes his straw men arguments all the time in speeches. Seems to work for him.

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Okay, that's one program in Louisiana for people with a specific condition. Do you really believe if programs were available for every condition, that people wouldn't take advantage of them? And how about people who are sick but haven't been diagnosed with a specific condition yet? Generally, the piecemeal programs for specific illnesses are designed to fill gaps in our system. I don't think they're a legitimate answer for health-care overall.


It's a national program but whatever. Many people who qualify for things don't join. Medicaid being one of them. What about them? You can't force them to the doctor. They'll go to the ER when it worsens and nothing will change that. It's well documented that Medicaid patients use the ER far more than any other group. I cited one example but they are other programs and grants that are more far reaching. There are community health clinics- yes, even for your panacea preventative care.

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The Republicans did a great job sowing doubt and misunderstanding of the bill, with their "death panels are going to kill your grandma" rhetoric. Despite that, opinion prior to passage was just barely in opposition to the bill, but in favor of all of the individual provisions. Post-passage, public opinion favors the bill.


Funny, they took what was actually written in the bill and pointed it out, cutting through the legalese that obfuscates the true intent. Just because you label it "sowing doubt and misunderstanding" doesn't make it any less true. That's fine too if you want to cherry pick your polls. It's understandable that with such a PR opportunity as the bill passage that there would be a bump in support, but most polls show that opposition remains. In fact, 55% support its repeal.

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Let's be real here... Is the AMA in the business of favoring policies it thinks will harm physicians, or that aren't supported by a majority of its members?


The AMA has its political agenda like any large organization. Not every physician is a member and certainly not everyone who is is in support of the bill. I have yet to meet one who is, but I suppose they are out there.

It's been fun debating you guys, but this is like the water boy taking on the football team in a brawl. I don't have the energy or the time to keep up with this. I'm glad you take comfort in big government being in every corner of your life. I myself but faith in my own abilities and believe in the freedom not only to succeed but to fail. A big government that has an answer to everything stands in the way of this. I have come to terms with the fact that there is suffering. We can do what we can to help. I am as eager to help people as the next guy, but there is only so much out there in terms of financial resources. Not everyone will be in perfect health and be independently wealthy. It's just not possible. True we can dilute the wealth and health of everyone so everyone is more or less equally poor and unhealthy, but where then is our incentive to improve and to move our society forward? If I work and work and the fruits of my labor are all just going to the government, why should I make an effort to create the next life saving gizmo? This is where your big government policies will lead us and it is an afront to the priniciples on which the US was fonded. The alternative has been tried in other countries and brought about untold suffering, I pray it never happens here.

Stu
_________________________
If you want it to break, buy Sony!

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#331509 - 28/03/2010 17:41 Re: The United States Enters the 20th Century! [Re: maczrool]
hybrid8
carpal tunnel

Registered: 12/11/2001
Posts: 7738
Loc: Toronto, CANADA
Name calling and insulting intelligence? In fact I said that opposition was coming from some otherwise intelligent people. I was thinking of people in this forum when I used the word intelligent.

It's also coming from some people that I would not consider intelligent, like Sarah Palin. But I don't need to call out any such lack of intelligence or anything about the woman, she does fine on her own letting everyone know what's she's all about. The international image problem of the US has been caused by people who share some of the same opinions as Palin. Recently the people trying to make a lot of noise. It's name calling to point this out? These folks sully the US image and someone who points that out is to blame? it's funny because I've always found it to be the other way around. The name calling and labeling coming from buttoned-up conservatives. You did it yourself by calling me a leftist. Maybe next you can call me a socialist. And then I can call you a fascist and then we can share a dance.

Anyway, this rant is all the same old same old. Some people don't want progress and the title of this thread is completely apt.

Even found an Op-Ed in the (today's) NYT that agrees:

http://www.nytimes.com/2010/03/28/opinion/28rich.html


Referring to check-ups...

Oh, like the check-ups that may find prostate cancer, lime disease, lupus, heart disease/defect or maybe communicable stuff like hep, herpes, mono, HPV, etc... Like I said, roulette is for Vegas, not the doctor's office. If you want to play the odds and self-diagnose before going into the doctor on the chance you may or may not have to pay, good luck with that.
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Bruno
Twisted Melon : Fine Mac OS Software

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#331514 - 28/03/2010 19:09 Re: The United States Enters the 20th Century! [Re: hybrid8]
TigerJimmy
old hand

Registered: 15/02/2002
Posts: 1049
Originally Posted By: hybrid8
I think what's needed here is a time machine. Folks who feel that everything should be by the precise letter of the constitution would be given the opportunity to travel back in time for a spell to see how they enjoyed living in that period.


This is a "post hoc, ergo propter hoc" logical fallacy. There is no question that the conditions of life were harsh in that period. But it does not follow that the reasons for that were that they lacked the kind of central planning we "enjoy" today. In fact, I would argue the opposite -- that the conditions of liberty that prevailed at that time gave rise (eventually) to the tremendous wealth of our society today. That's the major reason why I wish to protect those conditions.
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Doesn't the "or to the people" sort of invalidate the notion that this is something the government can't do? I mean, the government represents and was put in office by the people. In fact by a majority of people. A majority of people who want healthcare reform. So while these people can't necessarily all get together in the same place to hash all this out, their representatives can. Oh... And have.


No, what you end up with then is simple majoritarianism, or mob rule. Many people today think that majoritarianism is the same thing as democracy, but this is not the case. As I've said earlier, our system was set up specifically to protect against this, and it is always the minority opinion that needs protecting (as you eloquently demonstrate). The US system was set up for the express purpose of preventing the majority from squashing the minority with their view of the good life, so that we can all define that for ourselves.
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You don't need to worry about the social order. The poor will still be poor at the end of the day and the rich will still be rich. The middle class will still be there too. Your nation can afford it. Easily.


If you think that is my concern, then you don't understand my arguments at all. It's fine that you disagree with me, but try to understand what I'm saying.

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