Meta-Blog

SEARCH QandO

Email:
Jon Henke
Bruce "McQ" McQuain
Dale Franks
Bryan Pick
Billy Hollis
Lance Paddock
MichaelW

BLOGROLL QandO

 
 
Recent Posts
The Ayers Resurrection Tour
Special Friends Get Special Breaks
One Hour
The Hope and Change Express - stalled in the slow lane
Michael Steele New RNC Chairman
Things that make you go "hmmmm"...
Oh yeah, that "rule of law" thing ...
Putting Dollar Signs in Front Of The AGW Hoax
Moving toward a 60 vote majority?
Do As I Say ....
 
 
QandO Newsroom

Newsroom Home Page

US News

US National News
Politics
Business
Science
Technology
Health
Entertainment
Sports
Opinion/Editorial

International News

Top World New
Iraq News
Mideast Conflict

Blogging

Blogpulse Daily Highlights
Daypop Top 40 Links

Regional

Regional News

Publications

News Publications

 
National Health Care
Posted by: Dale Franks on Monday, November 13, 2006

The Democrats, being good liberals, are already talking about health care reform, and perhaps, finally, getting America to join the Europeans in having a comprehensive health care scheme. Well, fine, that's an interesting debate to have. The devil for any such a scheme, especially in American terms, is in the details. You can talk all you want about Canada's national Health service, or the French system, but, as Jane Galt points out, the starting point for that debate raises the bar for national health care very high. There are four considerations which make most national health plans, as they exist in Europe, a complete non-starter in the US.

After all, we aren't starting from scratch with a system in which very few Americans have health coverage. They already have it, and most people like what they have. So, when you talk about reforming health care, any plan has to take that into consideration, along with four key criteria:
1) It cannot provide less, or less rapid, coverage than the typical American policy does now. Over three quarters of Americans are happy as clams with their health care now; to the extent that they support national health care, it is because they fear losing what they have. Nationalisers, therefore, cannot sell a programme by guaranteeing them that they will lose some of what they have now. Horror stories aside, most Americans, despite their copays, have much more lavish coverage than that available elsewhere, with unfettered access to their doctors, semiprivate hospital rooms, expensive machines around every corner, and so forth. In what other country would my eighty-eight year old grandmother have had her hip replaced two weeks after the doctor decided it was time? That two weeks being the period needed for my mother to arrange her schedule so she could take care of Mom. That is the baseline of care, not whatever is currently on offer in France, no matter how fond the French may be of their system. Countries with national systems set them up a long time ago, when the median voter had no insurance at all, so whatever crap the government gave you was an improvement.

2) It cannot substantially lower the wages of medical workers. They all have powerful lobbies, and they vote on their interests. Doctors in Britain may be thrilled to make 60K a year in return for the shot at someday, if they're very lucky, exiting the system for a private hospital. You will not get American physicians to take the same deal; they've already got hefty mortgages and kids in private school. Between the right of exit and the lobbying power of the unions, it will be some time before we can even eat into doctor's pay with inflation; I would expect the pay of lower level medical employees to rise (New York's experience is instructive here).

3) It cannot ration end-of-life care. The AARP is the most powerful lobby in America. Anyone who thinks that a nationalised system will ration all those dollars poured down the drain in the last few months of life is engaging in fantasy—a particularly ludicrous and risible fantasy because we already have nationalised health care for end-of-life care RIGHT NOW and we're spending like eighty shrillion dollars on it.

4) It will not cover immigrants, at least not until they are citizens. That means at least 12 million people will remain uninsured. It also means that emergency room usage will remain high, since that is where illegal immigrants tend to get their health care. Not that this really matters. It doesn't seem to me that emergency room care for routine ailments is actually more expensive to provide than clinical care; it's just that hospitals price it to cover the cost of dead, uninsured trauma patients and so forth. I don't see how a triage nurse, a doctor, and a waiting room are more expensive to provide because they're on the first floor than they would be on the fifth. But perhaps I'm missing something there.
When you talk about national health care, the average voter is apt to have two responses in quick succession:

1) Personal, universal coverage? Cool!

2) "Waiting periods"?! WTF?!

And, most likely, a third response:

"A new health care tax?! Hey, I thought this was free health care!

It should be an interesting debate.
 
TrackBacks
Return to Main Blog Page
 
 

Previous Comments to this Post 

Comments
Another difference I see rarely discussed has to do with lawsuits in many of those systems. Winning awards is much more difficult and awards are minuscule.

I can see lawyers drooling at the possibility of drilling into the taxpayers’ pocketbooks deeper than ever before. That may be the way it is at first, but when things go south, they’re going to be shutdown hard.
 
Written By: jpm100
URL: http://
Before I start, I want to point out that I do not support nationalized health care, I support private health care with nationalized insurance, AKA Single Payer plan.
I can see lawyers drooling
Doctors like single payer plans, lawyers hate them.

The greatest dollar awards in malpractice suits are for previous and future medical costs associated with the medical error. In a single payor plan, these costs to the individual or their private insurance company evaporate and are absorbed into the system (as they are now without lawyers and courts and mulitmillion dollar settlements and exorbitant malpractice insurance premiums). Malpractice costs in single payor plans is pennies on the dollar compared to our current system. Gynocologists would be free to practice their love with patients.
1) Personal, universal coverage? Cool!
Ain’t it though
2) "Waiting periods"?! WTF?!
The United States has an oversupply of health care givers, hospital beds and medical equipment. For example, the United States is estimated to have two to three times as many mammography machines as is needed to provide all the necessary mammograms for the United States population (Ann Int Med 1990; 113:547). Demand for medical care in the United States could be increased by up to 40% from the current levels before demand would equal the capacity of American medical infrastructure. It is estimated that single payer, universal health care would increase demand up to 15%. Thus, this demand could be easily met by our current infrastructure without lines. Put the other way around, Canada would have no waiting lines if its health care system were to be funded at the levels of American per capita spending.
"A new health care tax?! Hey, I thought this was free health care!
About 64% of health care is already government today, and nearly 30% of private health care costs are administrative costs while Medicare for example, has a 1% administrative overhead (on the government side). America spends about 16% of the GDP on health care, there may be a specific tax associated with healthcare, but since the overall cost of healthcare would go down, that tax would be more than offset. Health care cost distribution would of course be more progressive.


By the way, we spend almost twice as much as a percentage of the GDP on healthcare as Canada.

On a final note, when it’s cheaper for automakers to build in Canada while paying workers MORE mostly because of the costs of health insurance, we are putting ourselves at a competitive disadvantage to the rest of the industrialized world.

Single payer coverage is inevitable, whether it was back when Hillary tried it and GDP spending on health insurance was 10% of the GDP, or now while it’s 16%, or in 6 years when it is 20%, it will become overwhelming popular. The question is whether you want to be a part of the debate to determine HOW, or to stand on the sidelines and say no, free market, socialism, big government, blah, blah, freakin’ blah.

Cap
 
Written By: Captin Sarcastic
URL: http://
We got "Hillary Care Phase 1" 5 years ago. The next phase will be minor compared to the first phase which is adding over $100,000,000,000 a year to the national debt. Once you start the road to socialism it is hard to back track. With Phase 1 we are far down the road; past the "point of no return".
Probably be better in the long run to nationalize health care than the quasi government programs we now have.
Of course the best thing would have been to never pass Hillary Care Phase 1!
 
Written By: Rodney A Stanton
URL: http://
"I want to point out that I do not support nationalized health care, I support private health care with nationalized insurance, AKA Single Payer plan."
"I only want the government to gather up the moeny to pay for what I want and then hand it over to me, but you’re not going to catch me calling it ’socialism’."

I should be long accustomed to it by now, but the bloody-minded mental contortions that some people will go through in order to evade the essence of a thing never cease to astound me.

Good god.
 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
Put the other way around, Canada would have no waiting lines if its health care system were to be funded at the levels of American per capita spending.
So why don’t they? Oh yeah it’s too expensive or don’t Canadians care?
 
Written By: Joe
URL: http://
Before I start, I want to point out that I do not support nationalized health care, I support private health care with nationalized insurance, AKA Single Payer plan.
Yes Captin you support monopsony, where there is a single buyer of a good or service, as opposed to monopoly where there is a single SELLER of a good or service. Monopolies are viewed as inherently inefficient and viewed with suspicion, would you care to elaborate why a monopsony would be different?

http://en.wikipedia.org/wiki/Monopsony
 
Written By: Joe
URL: http://
"I only want the government to gather up the moeny to pay for what I want and then hand it over to me, but you’re not going to catch me calling it ’socialism’."
Yes, let’s label it and that should end the discussion. No debate, no discussion on merit, just call it socialism and walk away.

You can be one of those folks whining on the sidelines. I’ll be advocating what I consider the best of the options, fighting against those that would advocate making all medical workers direct employees of the federal government. A non-profit, government created, single payer health insurance company, with government oversight but not run day to day by the fed, is my preference. It will cost less than we spend today and be far more efficient.

I don’t disagree that any involvement of government in anything where pooled money is spent is by definition more socialist than an alternative where the community does not share the burden.

My point is that the medical relationship would be individual while the payer relationshio would be community. I consider this a better alternative to the reverse. But I am not going to pretend that this is not closer to (gasp) socialism than a totally private healthcare plan.

But what we have now is the worst of both worlds, and it’s not going to become MORE market based, so let’s get this done with as best we can.



 
Written By: CaptinSarcastic
URL: http://
So why don’t they? Oh yeah it’s too expensive or don’t Canadians care?
Great question!

When Canada began it’s healthcare plan, they did not have a fraction of the healthcare capacity that we have in the US, so it has been building up the medical infrastructure but has not kept up with demand.

We have an over-capacity, so no building will be necessary, just maintenance growth.

Cap
 
Written By: CaptinSarcastic
URL: http://
"No debate, no discussion on merit, just call it socialism and walk away."

A thing is what it is, no matter what you call it. You can call your cat Marilyn Monroe but that’s not going to change the facts. And there simply is no discussion to be conducted on the "merit" of socialism.

"I’ll be advocating what I consider the best of the options..."

That makes you an idiot. Full stop.
 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
Single payer coverage is inevitable
Says you.
But what we have now is the worst of both worlds, and it’s not going to become MORE market based, so let’s get this done with as best we can.
Not so. HSA’s provided an incentive for consumers to shop around and find the best healthcare services at the most competitive prices. What that means is, gasp!, more personal responsibility and more informed consumers. When people have a limited budget of their own making, they either wise up or lose out. That’s the free market.

Cap, what you are proposing is vaguely similar to the German national healthcare insurance system which suffers from many of the same problems as the other European or Canadian systems. Although you dismiss arguments about socialism, I’m afraid that this is a big part of the objection. Any plan that removes private, free market insurance company involvement and replaces it with governmental bureaucracy is inherently antithetical to liberty and freedom. It removes personal choice and responsibility and replaces it with government coercion. The difference between monopoly and monopsony in this case is mere semantics. The result and implementation will be the same. Another point here is that if I don’t like my current insurance carrier, I can always shop around and switch to another (assuming insurability). If we have only one carrier (the government), I have no other options assuming that I can’t stand the service I am getting.
The United States has an oversupply of health care givers, hospital beds and medical equipment.
Verifiably incorrect. Look at the admissions and scholarships pages on the websites of almost any state medical school. The demand for primary care physicians (family doctors) is vastly outpacing the retirement rate. Medical schools have been known to offer scholarships and other benefits to students who indicate that they wish to practice as primary care physicians in rural areas. A big part of the reason that med school students do not want to go into primary care practice is the red-tape of dealing with Medicare, Medicaid, malpractice issues, and lower compensation as compared to specialists. If you have to put in the same amount of time and money (relatively speaking) to be a family doctor as you do to be a radiologist or neuropathologist (both of whom make significantly higher salaries while basically avoiding patients), why on earth would you not choose the specialist track? While NYC, LA, Chicago, etc. may be brimming with up and coming young docs, the Deep South, Plains States, and more remote locations like upstate NY, Maine, etc. are badly lacking. This point also applies to male nurses.
Canada would have no waiting lines if its health care system were to be funded at the levels of American per capita spending.
Which would mean that under your system Americans’ cost for the government run insurance plan would be about what they pay now or even higher than private insurance. Canadians already pay high taxes for the system they have which just doesn’t work. If they were to spend, per capita, what we do then their taxes would go through the roof. I suspect we’d have quite a line at the immigrations office before Canadians would accept that. Why would you ask the American taxpayer (or government insurance consumer) to pay at a level that others have obviously found unacceptable?
 
Written By: The Poet Omar
URL: http://www.asecondhandconjecture.com
My point is that the medical relationship would be individual while the payer relationshio would be community. I consider this a better alternative to the reverse. But I am not going to pretend that this is not closer to (gasp) socialism than a totally private healthcare plan.

Captin you’re demonstrating wishful thinking...the relationship will be payer-doctor, the CONSUMER gets the shaft in your system. Remember the Golden Rule, "He who has the gold makes the rules."

When Chimpy McShrub or Shrillary (to be non-partisan) pay your doctor bills, you’ll go to the doctor they prescribe for you and you’ll get the services they allot you...END OF STORY.

What do parents tell their kids, "As long as I’M paying the bills in this house, you’ll do what I say." And it would be different if the government pays your bills.

(Side note) Fundamentally this is where libetarians fail, and Republicans too. We do not make the case that the GOVERNMENT can be as bad as any Evilllllll Corporation. When the government provides yur job, your housing, your healthcare, suddenly the government controls YOU. It was not simply the Gulag or the KGB, it was the threat of losing your housing, your job, your car, your kid’s chance at a good education, that provided the social coercion for the USSR.

 
Written By: Joe
URL: http://
Yes Captin you support monopsony, where there is a single buyer of a good or service, as opposed to monopoly where there is a single SELLER of a good or service. Monopolies are viewed as inherently inefficient and viewed with suspicion, would you care to elaborate why a monopsony would be different?
Absolutely, the difference is the where the relationship with the government exists, whether your doctor is a government employee, or the institution paying the bill is a government employee. I understand the argument that they are the same thing, but I disagree with it.

With private medical and public payer, there will be a positive tension to insure care (medical tension) and efficency (payer tension).

With purely public care, this tension would not exist and it would be weighted toward efficiency and care would get the short shrift.

Here’s a question for you.

You get to vote on single payer or nationalizing medical providers, you’re vote decides which way we go, and if you don’t vote, we go with nationalizing providers.

How would you vote, and why?

Cap
 
Written By: CaptinSarcastic
URL: http://
You get to vote on single payer or nationalizing medical providers, you’re vote decides which way we go, and if you don’t vote, we go with nationalizing providers.

How would you vote, and why?
Let me re-phrase that for you Captin:
you get to vote on a Nationalized Health Care System. Which doo you choose and why?

Alternatively:

You get to vote to deport the Jews and starve them to death OR
you can vote to deport the Jews and gas them, which do you choose and why?

The answer is vote "NO" to the whole thing. Single payer=NHS... Starvation=Genocide, there is no difference ergo no reason to support any of the options offered.

You seem unwilling to grasp that your Single Payer System is NO DIFFERENT than a National Health Care System, just because McDonalds and Arby’s still exist does NOT mean that there is anything like a market for lunch, IF the government pays each restaurant for your lunch....So just because John Hopkins and the Mayo Clinic would still exist wouldn’t make them any LESS socialized under a Single Payer System.
 
Written By: Joe
URL: http://
"You get to vote on single payer or nationalizing medical providers, you’re vote decides which way we go, and if you don’t vote, we go with nationalizing providers.

How would you vote, and why?"
Sweet Jesus.

Is there anybody within eye-shot of this who can begin to understand my moral objection to voting?

Bruce? For god’s sake... who does a guy have to blow to get a touch of justice around here?
 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
Doctors like single payer plans, lawyers hate them.
Doctors only like single-payer plans when the plans pay them what they want to be paid. Medicare is a single-payer plan, and there are lots of doctors that won’t accept Medicare patients.
 
Written By: steverino
URL: http://steverino.journalspace.com/
"The answer is vote ’NO’ to the whole thing."
("Once more into the breach, dear friends...")

Joe? What happens if you actually cast that ballot and then find that you’ve been out-voted by herds of beasts trampling for your stuff to be desposited in their pockets? Hmm?

The question is closed, sir. It is not to be subjected to any "vote" in the first place.

Is there anything that I can do to help make this principle clear to you?
 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
A thing is what it is, no matter what you call it. You can call your cat Marilyn Monroe but that’s not going to change the facts. And there simply is no discussion to be conducted on the "merit" of socialism.
Really? For that to be so, you would have to be complete opposition to anything socialist. If you approve of ANY of these programs, then you are simply unaware of your own aceptance of socialism. If you do not approve of any of these programs, you are so far out of whack with what Americans approve of, that you are irrelevant to the discussion.

National Highway System
Telecommunications infrastructure (including the internet)
Centers for Disease Control and Prevention
Morrill Act of 1862 established the Land Grant university system

If you agree with any of these, then you support programs that can be labeled as socialist, and therefore cannot be dismissed by your simple labelling tactic.

And if you don’t support any of these, I won’t say you are wrong, as opinions go it is just another one, but as I said, you are so far from being at the table that you are irrelevant to the discussion.
That makes you an idiot. Full stop.
Well then, it’s socialism, and I’m an idiot, case closed. Brilliant tactic, I wither to your rapier wit.

next...


Cap
 
Written By: CaptinSarcastic
URL: http://
Here’s a radical health plan. You pay for your own medical care. If you can’t and other, charitable souls are willing to voluntarily pay for it on your onw behalf, fine. If not, you have no right to force others to pay for it. I call this radical plan "Freedom." The USA should look into "Freedom." I understand there were some guys at the time of the country’s founding who thought that was what the country would be about.
 
Written By: Bilwick
URL: http://
I did not expect to be in the majority here by any means, far from it, but we have a defacto socialist system now, with the added burden of a 30% administrative overhead and a global competitive disadvantage by being the only industrialized country without universal healthcare. I am not burdened by ideology, my knee doesn’t jerk when the government might get involved in something. I just look at what is, and look at what I think will be, and make a decision on which is better.

All things being equal, I’ll choose less government, but all things are not equal now.

Cap
 
Written By: CaptinSarcastic
URL: http://
"The United States has an oversupply of health care givers, hospital beds and medical equipment."

That must be why the prices keep falling then. Oh, wait a second...



 
Written By: Unknown
URL: http://
The question is closed, sir. It is not to be subjected to any "vote" in the first place.
Now who is exhibiting wishful thinking.

Cap
 
Written By: CaptinSarcastic
URL: http://
"but we have a defacto socialist system now..."

So why not make it full on socialism then, is that it?

Have you ever fought for your liberty or is it a lifelong habit to label spinelessness as being ’realistic’ ?

 
Written By: Unknown
URL: http://
The question is closed, sir. It is not to be subjected to any "vote" in the first place.

Is there anything that I can do to help make this principle clear to you?
Sadly billy you and the Captin seem peas in a pod, unwilling to accept certain obvious truths...
IF there is only one payer, the Federal Government THEN there is Nationalized Health Care; OR

Yes Billy there WILL BE A VOTE, because this "Freedom" and "Liberty" you carp about is not Manna from Heaven nor Coal mined from the ground, it does NOT exist independent of people and their desires. IF we vote we limit your freedom, and we can...It IS SUBJECT to a vote. This is not a discussion of whether the Earth is the centre of the Solar System, where a vote is meaningless, but a discussion of an artifact of human society which IS subject to votes.

I’m sorry that you are so blind in your libertarianism that you can not see and understand this. You inability or unwillingness limits your ability to argue against alternatives. One can NOT SIMPLY KEEP SAYING NO VOTE IS POSSIBLE, when patently a vote IS POSSIBLE on the matter.
 
Written By: Joe
URL: http://
"f you approve of ANY of these programs..."
I don’t. I never ever have in my whole life.

 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
"The United States has an oversupply of health care givers, hospital beds and medical equipment."

That depends on where you live, and what type of care you need. Have you tried getting an appointment with a new doctor lately?


"and nearly 30% of private health care costs are administrative costs while Medicare for example, has a 1% administrative overhead"

I am very skeptical about these figures, particularly the 1% for a government program. I have read that the 1% is possible because the providers are forced to pay most of the costs, which is why many doctors are refusing to take new government patients. What is your source?

*************************

"So why don’t they? Oh yeah it’s too expensive or don’t Canadians care?"

It’s obvious those callous Bast***s don’t care about the children!

**********************

" with government oversight but not run day to day by the fed,"

LOL.
 
Written By: timactual
URL: http://
That must be why the prices keep falling then. Oh, wait a second...
BINGO!!!

You are starting to catch on, but probably don’t know it. We have an industry that has excess capacity AND rising rates, a free market anomaly to be sure, BECAUSE IT IS NOT REMOTELY A FREE MARKET AND HASN’T BEEN FOR A VERY LONG TIME and even if it were, the economic drivers of health care are counter-intuitive to normal economic thought.

For example, in the rest of the market, demand drives supply, the more people buy, the greater the scarcity, and the higher the price. When supply is increased and/or demand is decreased as a ratio, prices go down. In healthcare, supply drives demand, there is tremendous healthcare capacity in the US, and we pay for that excess capacity as if people were using that capacity. In other words, we are paying for it anyway.

I do like the idea of pay as you go with your own money, then people will make decisions with their personal economics in mind, but somewhere along the line, you find that when people opt out of preventative care for financial reasons, the cost later can be overwhelming and in all likelihood will be borne by the taxpayers anyway.

I understand the arguments pro and con, there ARE merits to be discussed as much as some would whine about this reality, but on balance, I believe that on balance a single payer plan will be beneficial for our citizens, our businesses, and our ability to compete in the global market.

The most basic supporting factor is what we pay today and the results. We pay 40% more than ANY other industrialized nation with universal healthcare and do not better results than any of them.

Cap
 
Written By: CaptinSarcastic
URL: http://
Cap, supply drives demand in healthcare? That’s a neat trick. How exactly does that work?
 
Written By: Unknown
URL: http://
I don’t. I never ever have in my whole life.
Well then Don Quixote, keep swinging at them windmills, you are irrelvant and wholly at odds with what is absolutely, in your terms, a socialist nation.

I respect the principled stand, but that’s the best you’re going to get.
"but we have a defacto socialist system now..."

So why not make it full on socialism then, is that it?

Have you ever fought for your liberty or is it a lifelong habit to label spinelessness as being ’realistic’ ?
I choose my fights, fighting to pay $10,000 a year in healthcare costs is not a priority to me, fighting to make the system work better, whether it gets the label as more socialist or less socialist is a priority to me.

Healthcare will become a right, and I understand that when you make this a right, you supress the right of some to not pay for it, I get that. that’s really all you lose. You could still pay for private care, like you can for private education while still be taxed to pay for public education. But in the big scheme, I favor this particular exercising of the general welfare clause.

Debating ideology is waste of time at this point and I get that some just say no, anyone want to talk about how it should be done?

Cap

 
Written By: CaptinSarcastic
URL: http://
Debating ideology is waste of time at this point and I get that some just say no, anyone want to talk about how it should be done?
Sure:
1) enact a "Loser Pays" Liability Tort System;
2) either remove tax benfits for corporations that provide health care insurance OR grant them to all providing health care coverage, i.e., the self-employed;
3) more HSA’s....the Federal government to voucherize the Medicaide/Medicare system, in fact to MONETIZE the health benefit provided.

All that does not involve a monopsonistic Single Payer Plan. But of course is it "realistic" Captin? Am I being an ideologue? Isn’t the discussion of ideology/first principles FUNDAMENTAL to any discussion of public policy?
 
Written By: Joe
URL: http://
Cap, supply drives demand in healthcare? That’s a neat trick. How exactly does that work?
You are thinking economics while you have no clue about the economics of healthcare. When you understand the economics of healthcare, you will better understand the arguments for a single payer plan, whether you finally agree with them or not.

Joe Paduda posted this at his blog, he has a weblog on managed care for group health, workers compensation & auto insurance, covering health care cost containment, health policy, health research, and medical news for insurers, employers, and healthcare providers. Joe is the principal of Health Strategy Associates.

Economists, priests, and health care policy
This is getting tiresome. I am being assailed by economists who protest that they can boil health care down to supply and demand, and that demand creates supply. True on its face, but the economic devils are in the details. And they don’t want to hear the details, or they want to ignore them, or they’re just so smart ....well, clearly that’s not it.

The problem with health policy today is that too many people who style themselves as economists (including one commenter on a previous post), and therefore experts on everything, make flat out wrong statements like "Adding supply does not increase demand. The increased supply of health services over the last forty years is due to an increase in demand (due to Medicare)."

How simplistic. The reason health care costs are increasing is an aging population, medicine’s position as more art than science, a lack of control over new and expensive technology and medicines, and the US subsidizing much of the world’s pharma research. But back to demand and supply.

Here’s healthcare 101. Some may have heard of John Wennberg, MD. Here’s an excerpt from his seminal study on hospital utilization in Boston and New Haven. (Lancet, May 23, 1987)
" The populations of New Haven and Boston are demographically similar and receive most of their hospital care in university hospitals, but in 1982 their expenditures per head for inpatient care were $451 and $889, respectively. The 685,400 residents of Boston incurred about $300 million more in hospital expenditures and used 739 more beds than they would have if the use rates for New Haven residents had applied. Most of the extra beds were invested in higher admission rates for medical conditions in which the decision to admit can be discretionary. The overall rates for major surgery were equal, but rates for some individual operations varied widely. These findings indicate that academic standards of care are compatible with widely varying patterns of practice and that medical care costs are not necessarily high in communities served largely by university hospitals.

Why was utilization higher in Boston? Because they had more hospital beds, and admitted more patients with conditions such as COPD than docs in New Haven did (may not be in an economics textbook, but known to we morons in health care as chronic obstructive pulmonary disease). The supply drives demand in health care.

And that is but one reason health care is NOT like any other good or service.

Here’s another quote from a more recent Wennberg article on variation in medical utilization:

"Medicare spending varies more than twofold among regions, and the variations persist even after differences in health are corrected for. Higher levels of Medicare spending are due largely to increased use of "supply-sensitive" services-physician visits, specialist consultations, and hospitalizations, particularly for those with chronic illnesses or in their last six months of life. Also, higher spending does not result in more effective care, elevated rates of elective surgery, or better health outcomes.

There are many other reasons so-called economists’ simplistic opinions on health care are naive and ignorant - there is little to no accurate data on what procedures, facilities, or providers provide optimal outcomes so buyers don’t know what to buy; it is often impossible for the layman to determine if a symptom or set of symptoms is an indicator of something serious; the most expensive patients cost far more than any deductible anticipated by the CDHP advocates, thereby eliminating any price sensitivity on their part; poor folk can’t afford basic insurance anyway so their care gets covered under EMTALA, and on and on.

Economists talking health policy are like priests talking safe sex. They know all about it in theory, but their knowledge is purely academic, as is their understanding of the basic concept and sensitivity to the potential positive and negative outcomes. And the visual is decidedly unappealing.

 
Written By: CaptinSarcastic
URL: http://
Sadly billy you and the Captin seem peas in a pod, unwilling to accept certain obvious truths...
What obvious truth am I missing, that some people feel that using the coercive force of government to make them pay for something they don’t want to pay the government for is an unacceptable violation of their rights?

I get that.

Can we talk about healthcare?

Cap
 
Written By: CaptinSarcastic
URL: http://
No Captin, that a Single Payer Plan IS a Nationalized Healthcare System a la Canada or Britian...and I did talk health care...and no Health care economics aren’t a separate branch of Economics. Supply, demand, and equilibrium work in Health Care just like in Labour or any OTHER form of economics.

To the extent that you may see supply drive demand, is that given no cost constraint on the consumer, the consumer will DEMAND whatever s/he he says advertised and given no cost constraints on the development of medical devices, supplies, or procedures suppliers will SUPPLY...both act rationally until the money gets tight and then both gorups will seek to maximise benefits at a minimum cost...right now the consumer doesn’t bear the full cost of health care and because s/he doesn’t they buy "pporly"-bad choice of words, but I’m not writing a treatise here- and suppliers will rush in to soak up as much money as they can, given that the Fed’s "Automatically" pump 7% PER YEAR more into Medicare (Base-Line Budgeting) notice that suppliers and consumers never see the full costs of their spending decisions...admittedly Medicare is only a portion of the Healthcare Market, but A portion sees a 7-10% per year, whether required or not and that = MARKET DISTORTION.
 
Written By: Joe
URL: http://
Captain Sarcastic,

If you liked how the government caused and responded to Katrina disaster in New Orleans you will love government funded healthcare. People had the option of leaving New Orleans after Katrina, we won’t have that option once national health care is in place.

You listed the following items

National Highway System
Telecommunications infrastructure (including the internet)
Centers for Disease Control and Prevention
Morrill Act of 1862 established the Land Grant university system

You left out a few government actions

The Cherokee trail of tears
Japanese American internment
Jim Crow laws
The Tuskegee Syphilis Study

Regarding the Centers for Disease Control and Prevention here is a paragraph from the Wikipedia entry on the Tuskegee Syphilis Study


In 1966, Peter Buxtun, a PHS venereal disease investigator in San Francisco, sent a letter to the director of the Division of Venereal Diseases to express his concerns about the morality of the experiment. The Center for Disease Control (CDC) reaffirmed the need to continue the study until completion (until all subjects had died and had been autopsied).
So your vaunted CDC wanted the human subjects in the study to not receive treatment for a very curable disease in order to see how the disease progressed and killed them.

Government intervention is a blunt instrument, it is fraught with unintended consequences, and can be very dangerous. You should try and be more aware of that.
 
Written By: TJIT
URL: http://
1) enact a "Loser Pays" Liability Tort System;
That’s fine, but malpractice lawsuits account for about one half of one percent of healtcare costs, so you have wiped the sweat off the brow of the massive tidal wave of healthcare costs.
2) either remove tax benfits for corporations that provide health care insurance OR grant them to all providing health care coverage, i.e., the self-employed;
Health insurance is currently deductible for the self-employed, but if you are talking about the Federal Health Coverage Tax Credit (HCTC), I agree, there is no reason that a large corporation should get tax credits to subsidize health care while small businesses are not eligible. So yes, let’s subsidize healthcare for smnall businesses as well. But we had better address the cost.. oh yeah, single payer plan.
3) more HSA’s....the Federal government to voucherize the Medicaide/Medicare system, in fact to MONETIZE the health benefit provided.
I like a combination of HSA and FSA, either is has drawbacks on their own, but the advantages of both in one account would be nice. In either case, these account cannot touch serious illnesses, they help with minor care. For major care, we will need a medical plan, and we still need address the cost. Oh yeah, single payer plan.
All that does not involve a monopsonistic Single Payer Plan. But of course is it "realistic" Captin? Am I being an ideologue? Isn’t the discussion of ideology/first principles FUNDAMENTAL to any discussion of public policy?
You are correct that none of your solutions involve the creation of a government granted monopsony, but they also do not address the actual problem.

I don’t disagree that ideology is a fair starting point, but I get it, how much do we need to beat this horse? Ideology as a starting point is fine, but to ask yourself the ideology question and end all thought there is a bit simplistic and thoughtless.

Ideologically I AM opposed to a universal health plan, but upon further consideration, I believe it is the best policy for America. Do you think that there should be no further consideration beyond ideology?

Cap
 
Written By: CaptinSarcastic
URL: http://
National Highway System
Telecommunications infrastructure (including the internet)
Centers for Disease Control and Prevention
Morrill Act of 1862 established the Land Grant university system


And thus each encroachment is used as a justification for the next.

Just how many of my rights are you going to need before you’re done? I’m asking because I don’t see any end in sight here, and I’m wondering if you’ve thought that far ahead.
 
Written By: Shamus Young
URL: http://www.shamusyoung.com/twentysidedtale
Government intervention is a blunt instrument, it is fraught with unintended consequences, and can be very dangerous. You should try and be more aware of that.
Absolutely valid point and the reason why serious people with genuine concerns about over-reaching engage in this discussion rather than let the big government liberals create the policy top to bottom and say inane things like "The question is closed, sir. It is not to be subjected to any "vote" in the first place.".

My view is that the current system is broken, I have two choices, argue and fight for a return to a totally private system, or fight and argue for a universal plan with the best protections against abuses that we can up with, knowing full well the law of unintended consequences. I also believe that universal healthcare is a foregone conclusion, and I guarantee that within the next 10 years, we will have such a system. The American people will be screaming for it when healthcare costs reach 25% of the GDP.

I want to be part of the process to make it as good as it can be.

Cap
 
Written By: CaptinSarcastic
URL: http://
In healthcare, supply drives demand, there is tremendous healthcare capacity in the US, and we pay for that excess capacity as if people were using that capacity. In other words, we are paying for it anyway.
Assuming that this is true, do you have evidence that this is not caused by:
BECAUSE IT IS NOT REMOTELY A FREE MARKET AND HASN’T BEEN FOR A VERY LONG TIME
 
Written By: err
URL: http://
Just how many of my rights are you going to need before you’re done? I’m asking because I don’t see any end in sight here, and I’m wondering if you’ve thought that far ahead.
You may be right. While I consider universal healthcare to be a good thing, I understand your point, and am not happy with other, different encroachments and as a nation, there is certainly erosion along some lines. Not sure where to go with this though, without the highway system and telecom infrastructure, we certainly would not have become the economic behemoth we have become. Not sure that it is good thing though.

I’ll take the 10 enumerated in the Bill of Rights.

Do you think an AP plan might violate number 10? perhaps.

If it is found to violate 10 however, within 10 years, there will be support to amend the Constitution and make healthcare an enumerated right. It would be better than a gay marriage amendment.
Amendment X
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.
 
Written By: CaptinSarcastic
URL: http://
Assuming that this is true, do you have evidence that this is not caused by:
BECAUSE IT IS NOT REMOTELY A FREE MARKET AND HASN’T BEEN FOR A VERY LONG TIME
I am not going to try and argue that there is no relationship, however, there is evidence that when you have excess capacity, it get’s used for less signifcant conditions than scenarios where the capacity is less. This is not a result of care being free, but rather of medical practicioners being as proficient medically as the facilities allow.
Here’s healthcare 101. Some may have heard of John Wennberg, MD. Here’s an excerpt from his seminal study on hospital utilization in Boston and New Haven. (Lancet, May 23, 1987)
" The populations of New Haven and Boston are demographically similar and receive most of their hospital care in university hospitals, but in 1982 their expenditures per head for inpatient care were $451 and $889, respectively. The 685,400 residents of Boston incurred about $300 million more in hospital expenditures and used 739 more beds than they would have if the use rates for New Haven residents had applied. Most of the extra beds were invested in higher admission rates for medical conditions in which the decision to admit can be discretionary. The overall rates for major surgery were equal, but rates for some individual operations varied widely. These findings indicate that academic standards of care are compatible with widely varying patterns of practice and that medical care costs are not necessarily high in communities served largely by university hospitals.

Why was utilization higher in Boston? Because they had more hospital beds, and admitted more patients with conditions such as COPD than docs in New Haven did (may not be in an economics textbook, but known to we morons in health care as chronic obstructive pulmonary disease). The supply drives demand in health care.

And that is but one reason health care is NOT like any other good or service.

Here’s another quote from a more recent Wennberg article on variation in medical utilization:

"Medicare spending varies more than twofold among regions, and the variations persist even after differences in health are corrected for. Higher levels of Medicare spending are due largely to increased use of "supply-sensitive" services-physician visits, specialist consultations, and hospitalizations, particularly for those with chronic illnesses or in their last six months of life. Also, higher spending does not result in more effective care, elevated rates of elective surgery, or better health outcomes.
 
Written By: CaptinSarcastic
URL: http://
CaptinSarcastic,

Why the rush to a big government program? Not every problem requires a huge government intervention to fix. Why not look at things like health savings accounts, and greater tax deductions for individuals who pay for health insurance?

For example, a big factor in health care expense, that needs more attention, is illegal immigration. In Texas emergency room care for illegal immigrants is a huge expense. I am sure this is also a problem in many other states also.
 
Written By: TJIT
URL: http://
If someone had predicted this conversation back when this whole third-way, "NeoLibertarian", umm... thing... was getting started, it would have been dismissed as over the top sarcasm and ankle-biting. Then again, some of us did predict something almost just like this.

Do y’all ever wonder about just how power (or the quest for it) corrupts, and how the people being corrupted can move along it inch by inch without ever realizing what it is they are slouching towards? Or away from? Sad thing is, some people have (or had) much further to fall than others.

 
Written By: Kyle Bennett
URL: http://www.humanadvancement.net
If someone had predicted this conversation back when this whole third-way, "NeoLibertarian", umm... thing... was getting started, it would have been dismissed as over the top sarcasm and ankle-biting. Then again, some of us did predict something almost just like this.
Uh, what Kyle ... that people that opposed libertarian principles would come over here and pitch for things like nationalized health care.

Yeah, that only happens here, doesn’t it?
 
Written By: McQ
URL: http://www.qando.net/blog
people that opposed libertarian principles would come over here and pitch for things like nationalized health care.

Are you referring to Dale?
 
Written By: Kyle Bennett
URL: http://www.humanadvancement.net
Why was utilization higher in Boston? Because they had more hospital beds, and admitted more patients with conditions such as COPD than docs in New Haven did (may not be in an economics textbook, but known to we morons in health care as chronic obstructive pulmonary disease). The supply drives demand in health care.
How is this supply driving demand? Also, this is from 1982. Do you consider this outside the window of:
BECAUSE IT IS NOT REMOTELY A FREE MARKET AND HASN’T BEEN FOR A VERY LONG TIME
BTW,
"Medicare spending varies more than twofold among regions, and the variations persist even after differences in health are corrected for. Higher levels of Medicare spending are due largely to increased use of "supply-sensitive" services-physician visits, specialist consultations, and hospitalizations, particularly for those with chronic illnesses or in their last six months of life. Also, higher spending does not result in more effective care, elevated rates of elective surgery, or better health outcomes.
Isn’t Medicare a single payer system?
a global competitive disadvantage by being the only industrialized country without universal healthcare
Competitive advantage?
 
Written By: err
URL: http://
How is this supply driving demand? Also, this is from 1982. Do you consider this outside the window of: BECAUSE IT IS NOT REMOTELY A FREE MARKET AND HASN’T BEEN FOR A VERY LONG TIME
The answer to this question is in your next question.
Isn’t Medicare a single payer system?
Yes, I am not saying that supply will no longer drive demand, it will, it is just the economics of healthcare. I am just saying that one needs to understand this if they want to be able to have an intelligent discussion about healthcare.
 
Written By: CaptinSarcastic
URL: http://
As an employer I’d love to see a change in American health care. I’m not sure what that change should be, but I can’t believe that I’m the only business owner who’s sick of dealing with it.
 
Written By: Davebo
URL: http://
How simplistic. The reason health care costs are increasing is an aging population, medicine’s position as more art than science, a lack of control over new and expensive technology and medicines, and the US subsidizing much of the world’s pharma research. But back to demand and supply.
Aging population no doubt drives up demand and costs, but technology and medicine drive down costs.
Why was utilization higher in Boston? Because they had more hospital beds, and admitted more patients with conditions such as COPD than docs in New Haven did (may not be in an economics textbook, but known to we morons in health care as chronic obstructive pulmonary disease). The supply drives demand in health care.

And that is but one reason health care is NOT like any other good or service.
Huh!? This isn’t any different than any other good or service. And the supply really isn’t driving the demand. Rather, demand is present and an expanded supply can potentially meet that demand.

It does show that there is an elastic element to healthcare demand. It in fact suggests that healthcare would respond well to market forces.



 
Written By: Don
URL: http://
Yes, I am not saying that supply will no longer drive demand, it will, it is just the economics of healthcare. I am just saying that one needs to understand this if they want to be able to have an intelligent discussion about healthcare.
You have yet to prove that supply drives demand, and decades of government involvement in the market does not invalidate economic principles or support further involvement.
 
Written By: err
URL: http://
Why the rush to a big government program? Not every problem requires a huge government intervention to fix. Why not look at things like health savings accounts, and greater tax deductions for individuals who pay for health insurance?

For example, a big factor in health care expense, that needs more attention, is illegal immigration. In Texas emergency room care for illegal immigrants is a huge expense. I am sure this is also a problem in many other states also.



This has not been a rush by any stretch of the imagination, it has taken me years of consideration to arrive at my current opinion. Twenty years my position on this would be indistinguishable from most of the people I am arguing with now.

As far as illegal immigrants, that is a problem and must be dealt with in the larger context of the immigration problem itself. There may be insurance cards that give you access to universal healthcare, but they will be counterfeited as easily as anything else. One estimate is that ALL immigrants legal and otherwise receive about $1200 in healthcare per year. Assuming 12M illegals, that would be about $14B annually or about 8/10 of 1% of the total $1.7TRILLION spent on healthcare every year. Pretty much a drop in the bucket, but not one that I would suggest ignoring.

I would agree that this bucket is made of an awful lot of drops with many of them having little to do with healthcare for insured Americans, but we all pay for it anyway.

Cap
 
Written By: CaptinSarcastic
URL: http://
"wholly at odds with what is absolutely, in your terms, a socialist nation." - ’Captain’ Sarcastic
Gee. You say that like you think it’s a Bad Thing.
 
Written By: Ironbear
URL: http://oldwolves.co.uk/
Why was utilization higher in Boston? Because they had more hospital beds, and admitted more patients with conditions such as COPD than docs in New Haven did (may not be in an economics textbook, but known to we morons in health care as chronic obstructive pulmonary disease). The supply drives demand in health care.
Sorry Cap, that blurp and everything you said did not demonstrate that supply drives demand, esp. if you mean demand from healthcare consumers. What it does appear to show is that healthcare consumers defer to their providers directives without question and have little to no financial incentive to do otherwise. Why aren’t the patients in New Haven demanding hospital admissions for COPD? Because there are not enough beds? Why aren’t the patients in Boston demanding fewer and less costly admissions? Because the beds are available? No to all; it’s because they don’t know any better and don’t have any incentive to know better. That isn’t going to change with single payer.

Stop coming around here and telling everyone they don’t know what the h*ll they are talking about. You could stand to apply some brain power to your own dogmatism.
 
Written By: Unknown
URL: http://
"I am not going to try and argue that there is no relationship, however, there is evidence that when you have excess capacity, it get’s used for less signifcant conditions than scenarios where the capacity is less. This is not a result of care being free, but rather of medical practicioners being as proficient medically as the facilities allow."
Cap, I find your conclusion specious. It makes far more sense that providers have a financial incentive to hospitalize and order tests. It’s not about being medically proficient; it’s about making money and reducing liability. To the extent that end consumers don’t care about what’s being done, its financial impact and the medical risk of the action, there is little to check this behavior.
 
Written By: Unknown
URL: http://
"I also believe that universal healthcare is a foregone conclusion, and I guarantee that within the next 10 years, we will have such a system....I want to be part of the process to make it as good as it can be. "
Translation: We’re going to have a turd on our hands, but I want to make it the shiniest turd possible.

 
Written By: Unknown
URL: http://
Gee. You say that like you think it’s a Bad Thing.
No, it’s just a thing.

I am at odds with the world on some things, just not everything.
 
Written By: CaptinSarcastic
URL: http://
Translation: We’re going to have a turd on our hands, but I want to make it the shiniest turd possible.
Okay, fine, I want a shiny turd.

You just hold your nose and let folks like me design it.

Personally I’d prefer input from people that despise the idea, other than, "The question is closed, sir. It is not to be subjected to any "vote" in the first place."

Cap
 
Written By: CaptinSarcastic
URL: http://
Okay, fine, I want a shiny turd.

You just hold your nose and let folks like me design it.

How about instead, we call a T@rd a T@rd and let neither you nor anyone ELSE design it.

Your "realism" is the rhetorical Realism of many people, "This is inevitable...."Translates into: "Don’t argue with me, agree with me."
 
Written By: Joe
URL: http://
I will give the Captin this he has carried this thread to 50-plus postings and No Scientologists have been hurt in this thread’s making...Hat’s Off to Captin "It’s Your Destiny" Sarcastic on a bravura solo performance for his side.
 
Written By: Joe
URL: http://
I despise the idea. Here’s my input:

No one in favor of single-payer, nationalized HC has shown any significant signs that he has thought through all the reasons why we have the system we have and, especially, the intertwined role of government and special interests getting us there. Exploration of this might lead one to alternative solutions, but instead the argument typically boils lazily down to "all the other industrialized countries are doing it, so we should too."

You’ve all made up your mind that this is the correct path and only look for information to support that view. There is very little honest, critical thinking from proponents and fevered dismissal of anyone who points out all the negative possibilities. A response of "it’s inevitiable, we might as well make the best of it" is particularly deserving of scorn. Thank God enough of the 18th century colonists didn’t feel the same way about living under the rule of England. There are a lot of things people didn’t have back in the 1700’s, but mettle wasn’t one of them.



 
Written By: Unknown
URL: http://
I will give the Captin this he has carried this thread to 50-plus postings and No Scientologists have been hurt in this thread’s making...Hat’s Off to Captin "It’s Your Destiny" Sarcastic on a bravura solo performance for his side
Gracias... I think
 
Written By: CaptinSarcastic
URL: http://
Healthcare will become a right, and I understand that when you make this a right, you supress the right of some to not pay for it
Here is where you lose me Cap... how is it a RIGHT to take something from someone else? Money, time, effort, etc?

You could still pay for private care, like you can for private education while still be taxed to pay for public education.
Correct me if I am wrong, but hillarycare addressed this issue and sogght to make it illegal to seek out or provide private healthcare.
 
Written By: meagain
URL: http://
You could still pay for private care, like you can for private education while still be taxed to pay for public education.
Oh and that whole Public Education thing is working ut so well isn’t it Captin? Not your best example.
 
Written By: Joe
URL: http://
That’s fine, but malpractice lawsuits account for about one half of one percent of healtcare costs
Yikes Cap - you missed the point here, how much does malpractice insurance cost??? And how many providers are kept of the industry because the cost barriers to entry?
 
Written By: meagain
URL: http://
"Uh, what Kyle ... that people that opposed libertarian principles would come over here and pitch for things like nationalized health care.

Yeah, that only happens here, doesn’t it?"
It requires a swift kick in the teeth when they do, Bruce. They could do it in safety of ’tolerance’ over at that ’Jane’s’ place.

(shrug)

A couple of weeks ago now, I went off on a rant here about voting, and with my characteristc incision, I wrote about "decreasing eccentricity of orbit around socialist principles". It’s interesting: I was in a phone discussion the other day when I pointed out what’s happening, with that exact phrase. The guy I was speaking with stopped me and made me repeat it very slowly. He had to sound it out one word at a time in order to understand it. This is not a stupid person who I’m talking about, but I was struck with how hard it was for him to integrate what is, after all, only plain English.

It’s what’s happening, Bruce, and the whole reason for that is because there simply isn’t anything like enough of an explicit defense of individualist principles in this country necessary to even slowing it, let alone stopping it.

Hell, man: it’s like pulling tiger-teeth just to fit it into discussion anymore.

 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
"No one in favor of single-payer, nationalized HC has shown any significant signs that he has thought through all the reasons why we have the system we have and, especially, the intertwined role of government and special interests getting us there."
Pay attention to this in the ordinary daily run of yur life: see if you can find a single person you know who understands that there was no such thing as a "health-care crisis" before Lyndon Johnson’s "Great Society".
 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
Yikes Cap - you missed the point here, how much does malpractice insurance cost??? And how many providers are kept of the industry because the cost barriers to entry?
Medical malpractice payouts are less than one percent of total U.S. health care costs.All “losses” (verdicts, settlements, legal fees, etc.) have stayed under 1% percent for the last 18 years.

Medical malpractice premiums are less than one percent of total U.S. health care costs.Dropping for nearly two decades, malpractice premiums have stayed below 1% of health care costs.

Together, they are less than 2%.

A bigger problem that illegal immigrants, but still tiny.

Cap

 
Written By: CaptinSarcastic
URL: http://
It requires a swift kick in the teeth when they do, Bruce. They could do it in safety of ’tolerance’ over at that ’Jane’s’ place.
I thought the folks would love to have something more entertaining to comment on.

If I wasn’t here, here is what the comments on this blog post would look like...
Hillarycare sucks

Yeah, it sucks
Those socialists are so dumb
Yeah, they’re dumb
We need less government and more guns
Yeah, more guns
When are the jackbooted Stalinist Democrats going to leave us alone?
Yeah, leave us alone
I gave you a great opportunity to express your opinions in a rational discussion with a rational person who disagrees with you.

I don’t think y’all did very well, but I am not terribly objective on the subject of me anyway, so it’s left to those that peruse the site to decide.

Cap

 
Written By: CaptinSarcastic
URL: http://
"I gave you a great opportunity..."

And we are so grateful that you choose we miserable slobs to grace with your perfectly rational self.


"I don’t think y’all did very well..."

And I don’t think you bothered to think about, and respond to, the points made by several people including myself. Your adept at tuning out what you don’t want to consider. Here’s an accurate characterization of the conversation with you:

Someone, anyone: But what about this and that issue?

Cap: Nope, it’s inevitable, we’re going to have nationalized health care. (We also need public election financing.)

Someone else: Have you thought about this?

Cap: Nope, it’s inevitable, we’re going to have nationalized health care. (We also need public election financing.)

Another sadist: Then there is this flaw in your reasoning...

Cap: Nope, it’s inevitable, we’re going to have nationalized health care. (We also need public election financing.)


 
Written By: Unknown
URL: http://
"Medical malpractice payouts are less than one percent of total U.S. health care costs."
You have no way of knowing that. Let me illustrate:

In the mid-80’s the last orthopedic surgeon in a town called Cortland, N.Y. closed his office, got on his Harley, and rode out of town. For a long time, fractures on the local ski-hill and farm-hands getting limbs tangled in their tactor PTO’s hand to be taken all the way up to Syracuse. The explicitly stated reason for this man’s retirement was malpractice insurance premiums — not payouts — which were running a high five-digits on him, per annum.

Now, go figure that sort of thing into your costs, nationwide. Good luck.
 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
And I don’t think you bothered to think about, and respond to, the points made by several people including myself.
In 60+ posts, being the only person on this side of the debate, I answered as many as I could. Many of the one’s I did not answer were points that had previously been made in one form or another.

I’ll tell you what, pick any one or two points that I did not respond that you feel was a compelling argument and I will address them. Fair enough?
Cap: Nope, it’s inevitable, we’re going to have nationalized health care. (We also need public election financing.)
Would you feel better if I said it was not inevitable, but it is still the plan I support instead of the current mess we have or some libertopian ideal of getting the government to just shut down medicare and all government involvement and spending in health care so we can have a perfect market driven healthcare system?

Fine, pretend I said that it is not inevitable.

Oh, and we need publically financed elections so we can elect some people to pass universal healthcare.

I guess being reality based is really unpopular in the libertopian based world.
Now, go figure that sort of thing into your costs, nationwide. Good luck.
Damn, checkmate!

I should never have ignored the rule, never argue with a Sicilian when death is on the line.

How can I possibly argue with a powerful anecdote like that. Should I ask the guys name and hire a PI to find out if he was forced to quit because he was giving prostate exams to 12 year old girls and just STATED that malpractice insurance was his reason for quitting?

WTF?

Cap
 
Written By: CaptinSarcastic
URL: http://
"I guess being reality based..."

Whatever you want to call it dude.
 
Written By: Unknown
URL: http://
Medical malpractice payouts are less than one percent of total U.S. health care costs.All “losses” (verdicts, settlements, legal fees, etc.) have stayed under 1% percent for the last 18 years.
But payouts cost insurance companies... and, though you may not like it, they
are in the business to make a profit.


From the insurance info institute -

AUGUST 2006

Medical malpractice insurance covers doctors and other professionals in the medical field for liability claims arising from their treatment of patients.

The cost of medical malpractice insurance began to rise at the beginning of this decade, after a period of essentially flat prices. Rate increases were precipitated in part by the growing size of claims, particularly in urban areas. Among the other factors driving up prices was a reduced supply of available coverage as several major insurers exited the medical malpractice business because of the difficulty of making a profit.

New research suggests that premium increases may be moderating but for any turnaround to take root significant reforms in the delivery of medical care and in the liability system need to occur, industry observers say.
So they are raising premiums to cover their costs and maybe they can become profitable again. Guess what that means though??? It means Billy will have more stories to regale you with about docs who left town because they couldn’t raise their rates enough to cover the insurance.
 
Written By: meagain
URL: http://
I guess being reality based is really unpopular in the libertopian based world.
You mean claiming your reality is the only reality possible and refusing to engage any other at a serious level?

I’m sorry Cap ... while you have a way with words, for some reason I always remembered your arguments to have a little more depth that "this is all we can do and that’s reality".

The reason you’re feeling so smug right now is you’ve essentially blown of any serious disagreement as not feasible (and claiming only your "argument" is possible). A page from the Erb playbook.

You can’t ’argue’ anything with someone like that.
 
Written By: McQ
URL: http://www.qando.net/blog
"How can I possibly argue with a powerful anecdote like that."
You don’t have to. What you should do is your bloody homework. This article is quite representative. I found it by putting on a blindfold and throwing a dart at the Web.
"Should I ask the guys name and hire a PI to find out if he was forced to quit because he was giving prostate exams to 12 year old girls and just STATED that malpractice insurance was his reason for quitting?"
You should account for the fact that my mother worked in the OR with him for more than ten years and knew his practice in & out (to include his work on her knee and ankle), instead of casting thoroughly sick aspersions on a man about whom you know absolutely nothing, from a reflexive skepticism warranted by no fact on earth except your own rotten outlook.

Punk.
 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
I was going to post another response for CaptinSarcastic but decided I would read through all of his comments first. This was educational but probably not in the way cap thought it would be.

After reading all of his comments in one pass it became clear that much of what he writes is filler that either said nothing relevant to the discussion or made if any sense.

Obviously this is a personal opinion so I pasted a bunch of his comments below to make it easy for the rest of you could go through the same process. Have fun

Begin CaptinSarcastic section
Absolutely, the difference is the where the relationship with the government exists, whether your doctor is a government employee, or the institution paying the bill is a government employee. I understand the argument that they are the same thing, but I disagree with it.

With private medical and public payer, there will be a positive tension to insure care (medical tension) and efficency (payer tension).

Really? For that to be so, you would have to be complete opposition to anything socialist. If you approve of ANY of these programs, then you are simply unaware of your own aceptance of socialism. If you do not approve of any of these programs, you are so far out of whack with what Americans approve of, that you are irrelevant to the discussion.

I did not expect to be in the majority here by any means, far from it, but we have a defacto socialist system now, with the added burden of a 30% administrative overhead and a global competitive disadvantage by being the only industrialized country without universal healthcare. I am not burdened by ideology, my knee doesn’t jerk when the government might get involved in something. I just look at what is, and look at what I think will be, and make a decision on which is better.

All things being equal, I’ll choose less government, but all things are not equal now.

For example, in the rest of the market, demand drives supply, the more people buy, the greater the scarcity, and the higher the price. When supply is increased and/or demand is decreased as a ratio, prices go down. In healthcare, supply drives demand, there is tremendous healthcare capacity in the US, and we pay for that excess capacity as if people were using that capacity. In other words, we are paying for it anyway.

I understand the arguments pro and con, there ARE merits to be discussed as much as some would whine about this reality, but on balance, I believe that on balance a single payer plan will be beneficial for our citizens, our businesses, and our ability to compete in the global market.

I choose my fights, fighting to pay $10,000 a year in healthcare costs is not a priority to me, fighting to make the system work better, whether it gets the label as more socialist or less socialist is a priority to me.

Healthcare will become a right, and I understand that when you make this a right, you supress the right of some to not pay for it, I get that. that’s really all you lose. You could still pay for private care, like you can for private education while still be taxed to pay for public education. But in the big scheme, I favor this particular exercising of the general welfare clause.

Debating ideology is waste of time at this point and I get that some just say no, anyone want to talk about how it should be done?

You are thinking economics while you have no clue about the economics of healthcare. When you understand the economics of healthcare, you will better understand the arguments for a single payer plan, whether you finally agree with them or not.

I like a combination of HSA and FSA, either is has drawbacks on their own, but the advantages of both in one account would be nice. In either case, these account cannot touch serious illnesses, they help with minor care. For major care, we will need a medical plan, and we still need address the cost. Oh yeah, single payer plan.

You are correct that none of your solutions involve the creation of a government granted monopsony, but they also do not address the actual problem.

I don’t disagree that ideology is a fair starting point, but I get it, how much do we need to beat this horse? Ideology as a starting point is fine, but to ask yourself the ideology question and end all thought there is a bit simplistic and thoughtless.

Ideologically I AM opposed to a universal health plan, but upon further consideration, I believe it is the best policy for America. Do you think that there should be no further consideration beyond ideology?

My view is that the current system is broken, I have two choices, argue and fight for a return to a totally private system, or fight and argue for a universal plan with the best protections against abuses that we can up with, knowing full well the law of unintended consequences. I also believe that universal healthcare is a foregone conclusion, and I guarantee that within the next 10 years, we will have such a system. The American people will be screaming for it when healthcare costs reach 25% of the GDP.

You may be right. While I consider universal healthcare to be a good thing, I understand your point, and am not happy with other, different encroachments and as a nation, there is certainly erosion along some lines. Not sure where to go with this though, without the highway system and telecom infrastructure, we certainly would not have become the economic behemoth we have become. Not sure that it is good thing though.

I’ll take the 10 enumerated in the Bill of Rights.

Do you think an AP plan might violate number 10? perhaps.

If it is found to violate 10 however, within 10 years, there will be support to amend the Constitution and make healthcare an enumerated right. It would be better than a gay marriage amendment.

I am not going to try and argue that there is no relationship, however, there is evidence that when you have excess capacity, it get’s used for less signifcant conditions than scenarios where the capacity is less. This is not a result of care being free, but rather of medical practicioners being as proficient medically as the facilities allow.

The answer to this question is in your next question.

Yes, I am not saying that supply will no longer drive demand, it will, it is just the economics of healthcare. I am just saying that one needs to understand this if they want to be able to have an intelligent discussion about healthcare.

I gave you a great opportunity to express your opinions in a rational discussion with a rational person who disagrees with you.

I don’t think y’all did very well, but I am not terribly objective on the subject of me anyway, so it’s left to those that peruse the site to decide.

Would you feel better if I said it was not inevitable, but it is still the plan I support instead of the current mess we have or some libertopian ideal of getting the government to just shut down medicare and all government involvement and spending in health care so we can have a perfect market driven healthcare system?

Fine, pretend I said that it is not inevitable.

Oh, and we need publically financed elections so we can elect some people to pass universal healthcare.

I guess being reality based is really unpopular in the libertopian based world.

Damn, checkmate!

I should never have ignored the rule, never argue with a Sicilian when death is on the line.

How can I possibly argue with a powerful anecdote like that. Should I ask the guys name and hire a PI to find out if he was forced to quit because he was giving prostate exams to 12 year old girls and just STATED that malpractice insurance was his reason for quitting?
 
Written By: TJIT
URL: http://
since i haven’t jumped into a comment thread in a while, i’ll add the following even though the thread is getting kinda long:

Problem 1: Emergency rooms are overcrowded.
who cares? everyone should. accidents can hit anybody.
why are they overcrowded? One reason is that they are tremendous money-losers, so hospitals are closing them. Another is that they are the sole point of contact to the US medical system for a lot of people, including illegal aliens, the very poor and the working poor. (the reason that ERs are money-losers is that many of the people who use them cannot pay.)

solutions? already a tough problem. since it’s federal law (i think) that ERs must treat everyone without regard to ability to pay or immigration status, one solution is that the feds should cover costs. but we are the feds.
not treat the poor / illegals? maybe some of the people who read this blog would support that idea, but it won’t get 50% +1 of the vote.

Problem 2: Medicare / Medicaid consume very large chunks of the budget.

who cares? taxpayers.
why so expensive? one reason is that we are a rich enough country that people now think of health care as a basic attribute (i’m trying to avoid using words like "rights" and "privileges") of society. also, the feds provide care to the most expensive members of society on a health care basis — the poor and elderly.
solutions: eliminate medicare / medicaid. first, you’ll need to amend the constitution to make those programs plainly unconstitutional, because no political party would survive that decision.
expand the risk pool — bring low-cost citizens (young and healthy) into the coverage pool.

Problem 3: the current system of employer-based insurance provides a strong disincentive to labor mobility.

who cares? people who hate their jobs. people who care about american entreprenurial spirit and productivity growth.
why the disincentive? because insurers are allowed to not cover for pre-existing conditions. so people who want to purchase their own coverage can find out that it is incredibly expensive or simply not attainable at any price.
solutions: end employer-based health care. create markets for affordable insurance that covers catastrophic events only. create tax-advantaged schemes.
or, solve two problems at once and use the end of employer-based health care to establish very large, uniformly priced, risk pools.

etc.

it appears that many readers here are young, healthy and relatively affluent. that’s a large portion of people who blog, but a tiny portion of the populace. Soc. Sec.’s financial problems are much farther off than medicare/medicaid and the President had tremendous political power following 9/11. Yet SS reform went nowhere, because SS is, in fact, tremendously important to a large number of people who vote.

Even at the height of his powers, the President couldn’t reform SS. Medicare/Medicaid aren’t going anywhere except up ... unless we fundamentally change how we pool health care risks in this country.
 
Written By: Francis
URL: http://
(So, I was spittin’: "Punk.")

...

Look; just stop being a punk, "Captin" whoeveryouare. Jeezis. It’s not like you don’t have to be like that. Stop just rolling over for nonsensical crap, and get some facts straight if you wanna talk about "reality" and know what you’re talking about.

There’s no good reason for any of this.
 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
Look; just stop being a punk, "Captin" whoeveryouare. Jeezis. It’s not like you don’t have to be like that. Stop just rolling over for nonsensical crap, and get some facts straight if you wanna talk about "reality" and know what you’re talking about.
Nonsense?

You live in a fantasy land, you seem to think you’re John Galt, you seem to think that the sheer power of your ideas is so great that no one should dare question your nonsensical ravings.

You actually wrote this, "The question is closed, sir. It is not to be subjected to any "vote" in the first place."

That sentence alone precludes you from ever calling the ideas or assertion of anyone "nonsense".

You know exactly how the world SHOULD work, and you will not accept anything less, except that you have exactly none of what you want and no part of the world is listening to you.

I may be a punk, but at least I willing to try to make things better, and perhaps fail miserably, but your libertopian ideas have exactly zero chance of changing anything.

You want to fight against a national healthcare plan, go for it, you’ll have a lot of company, just try and ignore the elephant in the room that IS OUR CURRENT NATIONAL HEALTH, with every element of socialized medicine except for any coherent structural efficiencies which would be the ONLY benefit that a national healthplan can provide.

As I said before, I respect your principled stand, but that’s all you get.

Cap

 
Written By: Captin Sarcastic
URL: http://
I respect your principled stand, but that’s all you get.
"...that’s all you get" being euphemism for "...but I’ll take the stuff stolen money bought anyway, even if it came from *you*."
 
Written By: Mike Schneider
URL: http://
I may be a punk, but at least I willing to try to make things better, and perhaps fail miserably, but your libertopian ideas have exactly zero chance of changing anything.

Spare me. When we took the Medicare dime back in ’65, it was on exactly this basis.

Pore through the Compliance Manuals. (Yeah, you get to buy them.) Highlight the parts that lead you to the inescapable conclusion that every physician who accepts Medicare assignment is an unindicted felon. (Example: Make an unintentional mistake anywhere, on any patient in your Medicare-mandated Evaluation and Management documentation and the Office of the Inspector General can lead you away. In cuffs.)

Increasing health care costs? How about a full-time staffer (in my solo practice) just to answer coding, compliance and chart auditing issues to appease the bureaucracy?

We lost sight of what we are (namely, traders) long ago. Fee-for-service and charity are dead and buried. What you see now is the practical result of the betrayal of principles and profession, decades in the making. We are all incredibly screwed and you’re not even vaguely aware of how badly or how utterly impotent you are to "make things better."
 
Written By: RDH
URL: http://
20 more posting and you guys can join the big leagues...cone on you can DO IT!

Let me help:

1) Scientology is Bunkum a fraud a hoax perpetrated on teh unwitting
2) Cynthia McKinney was RIGHT to strike that cop!
3) McQ’s an IDJIT for advocating Pelosi for Speaker!
4) Captin your Mother Sews Socks that Smell...AND you’re punk! So there!

Surely someone can expound onthese for another 5-10 postings at least?
 
Written By: Joe
URL: http://
Hitler wanted nationalized health care and look where it got him.

Sorry Joe, thread over.
 
Written By: Unknown
URL: http://
D@MN Unknown I was going to unload on puppies next and what wonderful energy drinks they make..heh.
 
Written By: Joe
URL: http://
4) Captin your Mother Sews Socks that Smell...AND you’re punk! So there!
Where are you getting all this personal information, did someone find my Myspace page?
AND you’re punk
Johnny Rotten LIVES!

But not Sid Vicious.
 
Written By: CaptinSarcastic
URL: http://
They have nothing to say to you, RDH. You don’t count. You’re just a resource to burn through, and you’d better remember this when they sit there and type the word "reality" and then laugh it up.

I can’t wait for the day when they look around in blank X-eyed wonder, trying to figure out where you went.
 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
You don’t count.
Pretty much
trying to figure out where you went
postal is my guess
 
Written By: CaptinSarcastic
URL: http://
That’s adorable. Thanx.

Okay, let’s review the bidding: we have here a person who’s down for socialism just because it’s the prevailing trend, who was happy to advance conjecture on sexual crimes by a man he knows nothing about, and who’s adept at cracking wise over the destruction of doctors.

Can anyone here explain to me one good reason why this person should be taken seriously?
 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
Can anyone here explain to me one good reason why this person should be taken seriously?
Because he CARES? That’s the usual thing I hear....
 
Written By: Joe
URL: http://
"Can anyone here explain to me one good reason why this person should be taken seriously?"
No, no - it’s because he’s a member of the reality-based community.
 
Written By: Unknown
URL: http://
"Can anyone here explain to me one good reason why this person should be taken seriously?"
No don’t take me seriously, there won’t be a healthcare debate in America, it will never come up for a vote in Congress, Billy said so. This was just a rhetorical exercise.

All the insults directed at me aside, I learned quite a bit. I haven’t changed my mind, but I was made aware of some issued that would have to be addressed in order to gain my support for a plan.

Cap



 
Written By: Captin Sarcastic
URL: http://
I was made aware of some issued that would have to be addressed in order to gain my support for a plan.

Hey, it’s going to happen anyway. What makes you think your support matters?

There is one condition that would get my support for the plan: that it be voluntary - both sides of it, payment and service. Any objections, Cap’n?

There’s your reality for ya.



 
Written By: Kyle Bennett
URL: http://www.humanadvancement.net
But what we have now is the worst of both worlds, and it’s not going to become MORE market based, so let’s get this done with as best we can.

...

I haven’t changed my mind, but I was made aware of some issued that would have to be addressed in order to gain my support for a plan

You should learn what the issues are. Spend a week with a private practice biller or hospital coder and come back when terms like ICD-9, deselection, CPT, COBRA, HCPC, OIG audit, ABN, DRG, EOB, E&M, 99214, HIPAA, CMS CERT, RVU, downcoding, HCFA and Box 32 start to make some sense to you.

Then perhaps someone might take your "plan" seriously. Up to that point you’re bantering on about nothing of value. This profession is circling the drain and the best and brightest are looking elsewhere. There is no credible evidence to suggest that anyone is going to improve matters with more governmental intervention, though I’m sure it will be tried.

Enjoy the results.

 
Written By: RDH
URL: http://
Correction: It wasn’t "your ’plan’", merely a plan that you might support.

The rest stands.
 
Written By: RDH
URL: http://
You should learn what the issues are. Spend a week with a private practice biller or hospital coder and come back when terms like ICD-9, deselection, CPT, COBRA, HCPC, OIG audit, ABN, DRG, EOB, E&M, 99214, HIPAA, CMS CERT, RVU, downcoding, HCFA and Box 32 start to make some sense to you.
My wife did this for a living for 20 years retiring as a VP at a medium size indpendent life and health insurance agency, her experiences are a big reason I support a single payer plan, making all of this stuff go away and reducing the administrative costs to less than 5% from the current 30% or $500 billion a year.

Do you think any of the items above would need to exist in a single payer environment?

Do you want to be a doctor or an administrator?

Imagine the easiest insurance company a doctor deals with, now imagine that is the only insurance company a doctor deals with, and every patient that walks in is on their plan.

My sister-in-law teaches a HIPPA Compliance, I had a life and health insurance license in Florida. I have been away from it for a while, but I know it hasn’t gotten less complex.

The odd thing here is that for the same reasons you DON’t want a single payer plan, I DO want a single payer plan.

I guess the difference is that I believe it can be done better than you believe it can.
though I’m sure it will be tried.
Careful there, people are going to accuse you of suggesting it is inevitable.

Cap



 
Written By: Captin Sarcastic
URL: http://
There is one condition that would get my support for the plan: that it be voluntary - both sides of it, payment and service. Any objections, Cap’n?
Objections, no, you don’t even have that NOW as you are likely paying for medicare and you probably can’t even use it. But obviously you are being facetious and you won’t support a single payer plan. I have no objections to that, I just disagree with your stance on it.
There’s your reality for ya.
It’s funny, ever since the Bush folks expressed disdain for people who live in teh reality based world, a lot of their supporters seem to have attached themselves to a disdain of anyone who uses the word.

Are increasing healthcare costs a reality?
Is government involvement in healthcare a reality?
IS government’s certain continued involvement in healthcare a reality?

So what part of reality have I been inaccurate about? That as time marches on we will not see the government become less involved in healthcare but ratehr more involved?

Is this not reality?

Is something people don’t want to happen but certainly will happen somehow taboo now, the unspoken unspeakable truth?

Is there anyone here who has not written at some point that we are heading inexorably toward more government involvement in everything and there may be breaks and stalls, but it just never, ever goes backwards? Is this the thing that libertarians want to pretend isn’t real?

I have read on this blog and several others this exact same point made, but somehow when I make it becomes less real?

Cap

 
Written By: Captin Sarcastic
URL: http://
Can anyone here explain to me one good reason why this person should be taken seriously?

The same reason you should take Herpes ’seriously’. His very existence makes ours worse.
 
Written By: Tex
URL: http://whackingday.com
I could deal with that, Tex.

I am swiftly coming to a complete loss over what to do about creatures like him.
 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
Come on thre more postings, just THREE more TINY postings... so morsel thin and tasty...

Puppies suck and all need to be euthanized....under a FEDERALLY funded program, financed by a tax on rich white Republicans...it is inevitable the only question is when, how much will it ultimately cost and will we adopt anything close to humane methods for puppy euthanasia?

Thank you for all your so far.
 
Written By: Joe
URL: http://
Captin Sarcastic wants to make all the regulatory jargon, BS, loopholes, favoritism, contradictions, and other assorted debris that are the necessary result of the state ownership of the means of production to go away (by advocating...the state ownership of the means of production).

He says, Imagine the easiest insurance company a doctor deals with, now imagine that is the only insurance company a doctor deals with, and every patient that walks in is on their plan. Further up in the thread, he favorably quoted someone who thought "economists talking health policy" is dumb, partly because "there is little to no accurate data on what procedures, facilities, or providers provide optimal outcomes."

(seasoned libertarians ought to know where this is heading)

Captin, of all the silly assumptions you’ve made regarding this "plan," probably the silliest is that the state of human affairs will remain static over time. That’s the foundation, acknowledged by you or not, for your belief that the state can become an easy-to-deal-with insurer by mimicking easy-to-deal-with insurers and remain easy-to-deal-with as people grow old, change their values, move around, have accidents, develop new technology, give birth, and so on. You assume the state can keep up with the tremendous changes flowing through society and not generate whole wastelands of arduous reading and onerous rules. You assume the state can acquire accurate data "on what procedures, facilities, or providers provide optimal outcomes" in order to make the millions of tiny decisions necessary each day to run a monolithic health care agency.

There’s a discipline I’ve heard of that deals with the how and why people work, save, spend, invest, and make choices...isn’t it called Economics? I think you need a lesson in it.

But worst of all, you assume people don’t have a right to their own property and that it can be legitimately taken from them by force in order to accomplish some goal. Here’s the reality that some of us want you to understand: what happens to the person who decides to "opt out" of his "contribution" to some future Federal Health Insurance Tax into a system he does not use? That poor guy gets harassed by the government up to and including arrest and asset seizure.

You can pose ten questions in response to Mr. Bennett’s simple one, but that doesn’t mean you’ve answered him.
 
Written By: Charles Hueter
URL: http://www.drizzten.com
But worst of all, you assume people don’t have a right to their own property and that it can be legitimately taken from them by force in order to accomplish some goal. Here’s the reality that some of us want you to understand: what happens to the person who decides to "opt out" of his "contribution" to some future Federal Health Insurance Tax into a system he does not use? That poor guy gets harassed by the government up to and including arrest and asset seizure.
The classic libertarian argument, taxes are theft at the point of a gun. It sounds great, much better than the social contract argument, but is simply invalid.

The constitution and the laws are our written contracts with the government. You don’t like them, you can opt out of ALL of it, but you cannot pick and choose.

I for example do not approve of the spending of hundreds of billions of dollars currently in our budget, let’s say for example 28%. This does not mean that I have the option of witholding 28% of my taxes without consequence.

There are things that could happen in this country that might make me consider opting out of the whole contract and finding a better contract, and I can also try to affect the contract itself through voting and other means, you have the same opportunity, but you do not have the opportunity to avail yourself of the things you like and withhold payment for the things you don’t like.

You may disagree with the policies, but do you actually disagree that the nature of the agreement described above is inaccurate?

Cap

 
Written By: CaptinSarcastic
URL: http://
Cap - nothing you just wrote invalidates that taxes are forced takings enshrined in law. Nothing.

Let’s say your neighbor and I get together and ’vote’ that you should pay an extra $1000 in taxes this year because we want a brick sidewalk instead of concrete on our street. You don’t want it. Too bad, we voted 2-1. Yeah, that’s the ’contract’, but it doesn’t mean the ’contract’ isn’t forced theft of your property. Best of all, you get to go to jail if you object. Nice.


 
Written By: Unknown
URL: http://
"Imagine the easiest insurance company a doctor deals with,’

I don’t think that includes Medicare or Medicaid.
 
Written By: timactual
URL: http://
Cap - nothing you just wrote invalidates that taxes are forced takings enshrined in law. Nothing.
The point is and always will be that taxes (forced takings) are part of the social contract, you can try to influence the contract, or you can opt out of the contract, but you cannot pick and choose.

Your argument that taxes are forced taking is irrelevant, of course they are, so what, it does not relieve you of the contract when you don’t like parts of it.

Taxes are forced, water is wet, so what?

Cap
 
Written By: CaptinSarcastic
URL: http://
"’Taxes are forced, water is wet,...’ Jews burn and blacks belong on the plantation, so what?"

"The social contract" is a bloody fraud, and so are you. You ought to be ashamed of yourself. The sick thing is that you’re proud of yourself.
 
Written By: Billy Beck
URL: http://www.two—four.net/weblog.php
One thing’s been accomplished. The Cap’n started this whole thing with his ever so coy "what, l’il ol’ me?" coquettishness about just doing the best he can in a bad situation. "I’d shure ’nuff love to stop this nasty ol’ thang, but the least I can do is make it nicer for y’all libertarians —blush—".

Now he’s lecturing on the social contract just like an unabashed socialist. The closet door is swinging open on your ass, Cap’n, why not step all the way out into the light?

And before you write me off as a Bush supporter, and suggest I opt out of the WHOLE thing, why don’t you check that little link under my name. You’re a day late and a dollar short. Then again, I’m sure you’d be happy to pilfer the dollar from my wallet, and the day too, if you could find a way.
 
Written By: Kyle Bennett
URL: http://www.humanadvancement.net
"The social contract" is a bloody fraud, and so are you.
Try and break it.

As I said before, you live in a fantasy land of what you wish were the way things worked, but don’t.

Good luck in your libertopia, maybe you could start in Mogadishu, that’s as close as we have in the world today, so a good place for you to set up shop.

No social contract at all there, just live and let die.

Cap
 
Written By: CaptinSarcastic
URL: http://
Oh, My . . .

Beck nails the vacuous thinking in this thread, but it exceeds rational comprehension to read the words of those willing to deny themselves, others, and freedom in the name of a "social contract" that the side other than individuals has never lived up to or, in reality, acknowledged.

Government doesn’t give a flying flip about individuals, rarely if ever considers itself subject to the concept of a social contract, replaces one leech with another in elections, and exhorts us to choose between the various and sundry leeches, all the while extending its hand into our pockets and purses.

Voting is a joke. Casting ballots for subjugation to self-serving idiots. Only thing that scores higher on the stupid scale is defending the process.

"Dumb as rocks" might be applied, but that is to insult rocks. The American political system has somehow managed to apply the "Stockholm Syndrome" to virtually all of the citizenry, and the few voices in the wilderness are considered fringe, or worse.

Then again, freedom is "fringe"—if even that much, anymore.

Heil, Comrade! :-)

LOL
 
Written By: jb
URL: http://
Beck nails the vacuous thinking in this thread, but it exceeds rational comprehension to read the words of those willing to deny themselves, others, and freedom in the name of a "social contract" that the side other than individuals has never lived up to or, in reality, acknowledged. Government doesn’t give a flying flip about individuals, rarely if ever considers itself subject to the concept of a social contract, replaces one leech with another in elections, and exhorts us to choose between the various and sundry leeches, all the while extending its hand into our pockets and purses. Voting is a joke. Casting ballots for subjugation to self-serving idiots. Only thing that scores higher on the stupid scale is defending the process. "Dumb as rocks" might be applied, but that is to insult rocks. The American political system has somehow managed to apply the "Stockholm Syndrome" to virtually all of the citizenry, and the few voices in the wilderness are considered fringe, or worse. Then again, freedom is "fringe"—if even that much, anymore. Heil, Comrade! :-)


Heh, I thought the Unibomber was dead or on the World Poker Tour.

It’s fun to step away from what is and point at it in disgust, you don’t have to take any responsibility for anything, you can clain prescience when something doesn’t work out well, and of course your influence on policy and events is zero.

You’re not on the fringe, you are just not in the arena at all.

Cap
 
Written By: Captin Sarcastic
URL: http://
Cap

And your defense of the indefensible somehow gives you a ticket to the big game? Maybe, they might let you come down from the stands and run a play or two?

I don’t go to the arena—Comedy Central is on the lobotomy box—no need to fight the traffic problems due to cliff-bound lemmings.

Heh.

 
Written By: jb
URL: http://
Billy Beck wrote:
They have nothing to say to you, RDH. You don’t count. You’re just a resource to burn through, and you’d better remember this when they sit there and type the word "reality" and then laugh it up.

I can’t wait for the day when they look around in blank X-eyed wonder, trying to figure out where you went.
Then be prepared to wait an eternity, for two reasons:

1) There’s always plenty of fresh meat.

2) The predators in question will happily lord over a destitute, famine-stricken nation (like Kim over the PDK), because they’re more interested in POWER than MONEY (and they know, unlike various delusionary "grow our way out of it" economists, that Force [not money] = Power). I.e., socialists couldn’t care less if government-run health-care bankrupts the country (an event they’ll merely view as "the rich are finally paying their fair share" anyway) as long as they think they’ll get to be in charge of deciding who’s ticker gets fixed first.

Speaking of Kim, I’m reminded of the blog I read awhile back from the guy who visited PDK and saw the state musuem showing various gifts to the dictator, one being a car which the blogger remarked looked like one his suburban neighbor owned — yet which demonstrated remarkable and seemingly unattainable wealth to a North Korean.

— The solution (retreat) of "Galt’s Gulch" in "Atlas Shrugged" is all wrong; the proper solution to evil is confrontation, not retreat — because evil will happily smother the face of the globe in a new stone-age which evolutionarily favors stupidity and docility via "de-selection" of contrary traits.


Blog comment-forums like these are just "pressure-release" valves on boiling-over rage — they encourage one to vent righteous fury in a frenzy of useless typing to buffoons like Cap rather than something truly exilerating and constructive, such as keying the local council-critter’s car or leaving a flaming bag of dog-poo on his step.
 
Written By: One-Eyed, One-Horned Purple People-Eater
URL: http://

 
Add Your Comment
  NOTICE: While we don't wish to censor your thoughts, we do blacklist certain terms of profanity or obscenity. This is not to muzzle you, but to ensure that the blog remains work-safe for our readers. If you wish to use profanity, simply insert asterisks (*) where the vowels usually go. Your meaning will still be clear, but our readers will be able to view the blog without worrying that content monitoring will get them in trouble when reading it.
Comments for this entry are closed.
Name:
Email:
URL:
HTML Tools:
Bold Italic Blockquote Hyperlink
Comment:
   
 
Vicious Capitalism

Divider

Buy Dale's Book!
Slackernomics by Dale Franks

Divider

Divider