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Old 07-31-2009, 01:46 PM   #11  
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Actually, I agree. If the government were to provide a public option that provided basic care for a low premium, that might actually be workable.
But what if that's not the case? What if it's a rich plan with low premiums, made possible by requiring providers to give care under Medicare rates, and/or by a taxpayer subsidy to the plan?
This is the game though isn't it? Republicans desperately want to make "Obamacare" a failure so they look good for 2010. What if, instead, they had a few dudes who decided to add some amendments to the public option to ensure it couldn't kill private insurance in exchange for their vote? In this climate there is no Republican who would dare, thus ensuring no passage (they hope) or passage (God forbid) of something way more left than it should be. If we could all just sit and talk sensibly about public option and how to ensure it does not kill private insurance maybe we could get somewhere.
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Old 08-01-2009, 05:24 AM   #12  
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I understand the point you are trying to make but there's no way that Fed Ex and UPS could pick up the slack. They are not set up to hit every residence, every day, like the USPS does. Their business model doesn't even come close to allowing that. There's really no money in delivering coupons and pizza flyers, not enough to justify a UPS guy's $30+ an hour.
I agree with you there insofar as the FDX/UPS competitors wouldn't deliver 2 pieces of junk mail to every address al over BFE. They would only deliever where they could make money.

That's one of the characteristics of the invisible hand--you don't know what it will look like when it is finished. It's a safe bet that it won't look like the inefficient government program that it is replacing.

To the extent that we are subsidizing the pizza coupon industry and rural mail delivery I am content to do without these services. If others want them let them pay what it actually costs.

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Old 08-01-2009, 05:32 AM   #13  
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Let me first say I'm not in favor of public options expanding (since the US already has 2 public options). But I see people arguing this issues from two extreme ends when the solution lies somewhere in the middle, or arguing about the Canadian "Straw Man" single payer when it's virtually impossible for us to quarter our health care spending per capita, force single payer, and end up with that system. The only good thing coming out of this is Republicans being amenable to hyper-regulation of the health insurance market, which in concert with tort reform and shifting the actual cost of health care back to the consumer would go a long way toward fixing this system.

- "Forty-five million people in the U.S. are uninsured."
Even if this were true (many dispute it) should we risk destroying a system that works for the vast majority to help 15% of our population?

Our system would not be destroyed. This is a slippery slope fallacy. There are no bills with any chance of passing that would create Canadian single payer or British governemnt owned health care. 46% of Americans are already on a public option, and it has not destroyed the private market. Yes you have to be old or poor, but those are two examples of how you can ensure the public option doesn't kill the private insurance market. Another is buy-ups, for example public option you have to share a room, private gets you your own room. Really, all you have to do is make sure a public option sucks as much as conservatives say it will and private options will stay alive and well. There are also provisions that prohibit companies from dropping their private insurance. I don't think we need a public option, but saying it will kill private insurance is a scare tactic, not a real argument. Yes, private insurance may look different, but dead? No.


- "A universal plan will reduce the cost of health care."
Actually single payer systems do slow the RISING of costs of health care simply because it's very hard to raise people's taxes en masse to improve the system. In Canada, people are older now and there are less people paying into than taking out of it when it was first introduced. Something had to give, thus the rationing. If Canadians spent as much per capita as the US, we probably wouldn't be able to use it as the health care straw man. Take Taiwan, which much more recently introduced single payer. People were already used to paying more, so the single payer costs are higher, and it is successful. For a while a while anyway, until they need to raise taxes and/or reduce care.

The bills in congress will likely raise the cost by not really addressing the core issues of consumers not really being aware of how much their health care really costs. In a way, single payer is more free market than the system we have now since single payers are a lot more aware of their higher tax bill than we are of the nickels and dimes extra we pay for everything as businesses pass the cost of employee healthcare back to the consumer.

Canadians want better care, but they don't want to pay more for it as a group. If Canada didn't OUTLAW private insurance (the only reason there are no private insurance competitors) they'd be much better off. There are 2 Supreme Court decisions that have just overturned laws that there can be no private insurance in Canada, health care there is about to get very interesting as well.

- "Congress will be strictly neutral between the public and private plans."

Again, slippery slope fallacy. Fedex and UPS may not be able to mail a letter for 50 cents, but they can provide far better customer service, and do a better job at moving bigger packages with sweet tracking systems. This could be analogous to health care where we make sure the public option sucks so you only go on it when you have to. I never stand in line at the DMV for example, I gladly pay the extra 4 bucks at a private company to do everything I can do at the DMV with better service and no wait.

- "Decisions will still be made by doctors and patients and the system won't be politicized."
Your (his) answer assumes government ownership of hospitals. Even in Canada doctors and hospitals are still private. Single payer means exactly that, only 1 insurance company, the government. Everything else is still private, and why are we even discussing this since it's so unlikely? There are more than just the two worst industrialized nation's health care systems to compare to. Switzerland or the Netherlands or Sweden or France are far better comparisons of what the US would be likely to look like, only ours would be better because it will cost at least twice as much. It won't likely be twice as good, mind you.

THERE IS NO SINGLE PAYER BILL WITH A HOPE OF PASSING!!!!
Your point about the slippery slope fallacy is correct. There are surprisingly few things/processes about which we have suffcient information to make bulletproof predictions about the outcomes. I have been as critical as anyone about bad arguments and public policy.

I am content, however, to let this one lie. What will happen is exactly what happened with schools. I will be forced to pay for an inferior product that I choose not to use. So I am going to wind up paying twice--once for me and my family and once more for non-producers.

If a bad argument saves me from this expense, I can live with that.

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Old 08-01-2009, 06:47 AM   #14  
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Your point about the slippery slope fallacy is correct. There are surprisingly few things/processes about which we have suffcient information to make bulletproof predictions about the outcomes. I have been as critical as anyone about bad arguments and public policy.

I am content, however, to let this one lie. What will happen is exactly what happened with schools. I will be forced to pay for an inferior product that I choose not to use. So I am going to wind up paying twice--once for me and my family and once more for non-producers.

If a bad argument saves me from this expense, I can live with that.

WW
I on the other hand will take some concessions to make sure a hard working, tax paying, long haul trucker/owner with a pre-existing condition isn't just SOL when it comes to health insurance.
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Old 08-01-2009, 07:12 AM   #15  
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I on the other hand will take some concessions to make sure a hard working, tax paying, long haul trucker/owner with a pre-existing condition isn't just SOL when it comes to health insurance.
OK, let's stipulate that this trucker's health insurance is more important than my right to the money that I earned with my time and labor. Let's also recall that money is fungible.

Does this trucker, or any of his covered dependents:

--consume more calories than the RDA?
--use tobacco, alcohol, coffee, or other drugs?
--have expenses for a pet?
--have expenses for a hobby?
--have a TV, computer, or other non-essential computer electronics?
--have expenses for cable, internet etc?
--Do the live in a house that is bigger than they need?
--do they have a car that is bigger than they need?
--do they have other, non-subsistence expenses?

Are any of these expenses more important than my right to keep my own money?

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Old 08-01-2009, 11:56 AM   #16  
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OK, let's stipulate that this trucker's health insurance is more important than my right to the money that I earned with my time and labor. Let's also recall that money is fungible.

Does this trucker, or any of his covered dependents:

--consume more calories than the RDA?
--use tobacco, alcohol, coffee, or other drugs?
--have expenses for a pet?
--have expenses for a hobby?
--have a TV, computer, or other non-essential computer electronics?
--have expenses for cable, internet etc?
--Do the live in a house that is bigger than they need?
--do they have a car that is bigger than they need?
--do they have other, non-subsistence expenses?

Are any of these expenses more important than my right to keep my own money?

WW
I know what you're getting at (I'm a Dave Ramsey fan and my "hypothetical" trucker was a caller trying to get out of medical debt). The majority of people "hurting" have done it to themselves; an xbox 360 is more important than health insurance. This is not who I care about. I'm talking about a guy who can't get health insurance, not can't afford it. Wants it, but is uninsurable because of a previous heart attack. He could have that heart attack, and you and I will pay for it with higher premiums anyway. He goes bankrupt, we pay. How about we pay, he doesn't go bankrupt?

I make a very good living, I save way more than the average and after 8 years of this I have just reached the point where I can afford my first heart attack if I was denied insurance (damn Great Recession). How is this guy who might make half what I do supposed to not go bankrupt if no one will give him insurance? What's his motivation to not just give up, stop working and go on Medicaid?
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Old 08-03-2009, 03:19 PM   #17  
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I know what you're getting at (I'm a Dave Ramsey fan and my "hypothetical" trucker was a caller trying to get out of medical debt). The majority of people "hurting" have done it to themselves; an xbox 360 is more important than health insurance. This is not who I care about. I'm talking about a guy who can't get health insurance, not can't afford it. Wants it, but is uninsurable because of a previous heart attack. He could have that heart attack, and you and I will pay for it with higher premiums anyway. He goes bankrupt, we pay. How about we pay, he doesn't go bankrupt?

I make a very good living, I save way more than the average and after 8 years of this I have just reached the point where I can afford my first heart attack if I was denied insurance (damn Great Recession). How is this guy who might make half what I do supposed to not go bankrupt if no one will give him insurance? What's his motivation to not just give up, stop working and go on Medicaid?
Beans and rice. Rice and beans. I've heard him before--not a bad show, at least the couple I've listened to.

I'll get back to your trucker, by and by. There are two big problems with health insurance: one is that the government is involved in it to the extent that the market forces acting in it are badly distorted. The other problem is that health insurance isn't doing what insurance is supposed to do.

Insurance is purchased by consumers to cover big, unexpected, or necessary expenses if you become unable to pay these yourself. You take out mortgage insurance to pay off your mortgage should the collateral (your house) be destroyed. Same with auto insurance. If you finance your car you might carry insurance to repair it if it is damaged. Once you own it, you might reduce your coverage to liability only.

Health insurance, as it is used today, is used to pay for routine checkups, innoculations, simple prescriptions, etc. What if car insurance paid for your full service oil change (with just a $15 copay)? And the government, through the motorcaid program paid seniors oil changes at no expense to them. How much do you think the jiffy lube would be charging?

This model is imperfect as people, and their bodies, are not cars. But I think the economic point here is valid.

I'll try later to suggest what I would do to improve this system.

WW
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Old 08-03-2009, 05:38 PM   #18  
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This is the game though isn't it? Republicans desperately want to make "Obamacare" a failure so they look good for 2010. What if, instead, they had a few dudes who decided to add some amendments to the public option to ensure it couldn't kill private insurance in exchange for their vote? In this climate there is no Republican who would dare, thus ensuring no passage (they hope) or passage (God forbid) of something way more left than it should be. If we could all just sit and talk sensibly about public option and how to ensure it does not kill private insurance maybe we could get somewhere.
Where to start? As a mod it is my job to kill partisan posts, but this is such a good example of the failure of partisan politics that I thought it best to let it stand.

What many of us don't understand is that both sides have dwelt in a fantasy of high debt and the extreme fantasy of unlimited resources. Of course the congress critters have their very own special retirement and medical plans, so they can't be counted on for an honest judgement.

Looking at the actual numbers, the US spends more money on health care as a percentage of GDP than any other country. You need to talk to some real Doctors to find out why this massive injection of taxpayer funding has driven medical costs through the roof.

First, government has no money, any money they get is derived from the productive sectors of society. Many equate "free" with government funded, and have only a primitive concept of money as a symbol of the generation of wealth. The ultimate goal of government health care is to eliminate competion and jobs in the private sector. Ask yourself how this worked for the post office, social security, public education, and medicaid. The results were dismal and no rational person would buy the product.
Elimination of profit is really elimination of value.

We could eliminate the illegal drug trade overnight by killing the profits and living with the human loss. An industry destroyed, but at what value? In this case an artificial value has been created by law and government intervention, much like the intervention in health care and other sectors.

Second. We need to understand that everyone can't have everything. The uninsurable will run out of money under any plan, a plan to serve the common denominater will provide less to half and more to half, but ultimately will fail to provide the unlimited resources you imagine.

The solution. We all have to live within our means, more government monopolies reduce competition and weaken the economy. Freedom of choice by reasonable humans will always result in better solutions. Ultimately it is a strong economy and the strength of our productive endeavors that strengthen this country, not government programs to confiscate and redistribute.

Last edited by jungle; 08-03-2009 at 06:04 PM.
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Old 08-03-2009, 07:24 PM   #19  
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Where to start? As a mod it is my job to kill partisan posts, but this is such a good example of the failure of partisan politics that I thought it best to let it stand.

What many of us don't understand is that both sides have dwelt in a fantasy of high debt and the extreme fantasy of unlimited resources. Of course the congress critters have their very own special retirement and medical plans, so they can't be counted on for an honest judgement.

Looking at the actual numbers, the US spends more money on health care as a percentage of GDP than any other country. You need to talk to some real Doctors to find out why this massive injection of taxpayer funding has driven medical costs through the roof.

First, government has no money, any money they get is derived from the productive sectors of society. Many equate "free" with government funded, and have only a primitive concept of money as a symbol of the generation of wealth. The ultimate goal of government health care is to eliminate competion and jobs in the private sector. Ask yourself how this worked for the post office, social security, public education, and medicaid. The result were dismal and no rational person would buy the product.
Elimination of profit is really elimination of value.
Imagine going to the MVD and the person behind the desk actually got paid by how many services they performed? Think they would would all take their breaks with 50 people waiting anymore? Unfortunately, pay for performance is rare and getting fired for lack of performance is less likely than being promoted for it - but does it really have to be this way?

Public schools where I live are great, by the way, as was the one I grew up going to. Not surprisingly, public school performance correlates very well with the numbers of unbroken families attending and wealth in the system.

As far as the "government leeches off producers and doesn't produce anything" argument (paraphrased). No, government does not produce anything material, but it does provide services - preferably only services that the private sector does not have incentive to provide.
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Old 08-03-2009, 07:42 PM   #20  
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As far as the "government leeches off producers and doesn't produce anything" argument (paraphrased). No, government does not produce anything material, but it does provide services - preferably only services that the private sector does not have incentive to provide.
Actually, the only way incentive is removed is by creating a monopoly and by killing any motive to conduct business with profit. It is blatant folly to proclaim that a government run monopoly created by fiat takes the place of honest competition.

Government has a function, unfortunately it has expanded that function well beyond all reasonable bounds and stiffled the private sector in direct proportion to it's expansion of monopolies. Many states have allowed private MVDs with very good results.

What we are seeing is redistribution and confiscation, not an honest effort to provide better service. Your public schools may be fine, but are all held to the same standard, is performance and merit equal to cost across the system? Could a private option do better? Why limit the right to choose?


How many of us would buy into the Social Security plan if not forced into it? How fast would the private company that offered such a plan be convicted of a felony and shut down?

Last edited by jungle; 08-03-2009 at 08:10 PM.
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