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« Consolidated Confabulation | Main | Fiscal Cliff Fairness (updated) »

24 November 2012

Comments

MikeyMcD

"I would rather be exposed to the inconveniencies attending too much liberty than to those attending too small a degree of it." Thomas Jefferson

The proliferation of taxation is enough to prove the ever-decreasing personal liberty (income, property, cigs, soda, permits, fire taxes, gas tax, assessments, etc etc etc).

The average American probably breaks multiple laws every single day (everything from what milk you are permitted to drink to installing a new water heater). God forbid *they* ever get equipted to enforce all the laws on the books.

The regulations/taxes have dowsed many entrepreneurial flames (speaking for myself), it's a damn shame.

George Rebane

MikeyMcD 540pm - your point is a good one. In talking to law enforcement officers, they uniformly agree that they now have the ability to literally arrest anyone for an infraction of some code of which the victim was unaware. This is used as kind of 'banked reserve' by local district attorneys to insure cooperation and compliance from those in public who come to their attention.

Akin to this has been the practice by corrupt police departments to always carry small bags of illicit drugs and 'throw away' (i.e. untraceable) handguns in squad cars. You never know when you need to haul someone in or simply kill them, and then walk away with a justifiable cause report.

Paul Emery


George

Do you find it ironic that the countries ahead of us in the "Freedom " index are b y your defnation all socialist countries with high taxation and national health care systems?

Top 10 the UN index. They are all pretty similar.


Sweden
Denmark
Netherlands
Finland
New Zeland
Austria
Norway
) France
West Germany
Belgium

Bill Tozer

Mr. Paul E: good point. The Top 10 are all countries of Northern Europe founded on the Judea-Christian Tradition, aka Western Civilization. Wonder how France sneaked in?

George Rebane

PaulE 614pm - You're putting the question to the wrong person instead of answering it yourself. Yes, how come we have sunk so low?

Scott Obermuller

"free" according to the UN? You must be joking. Those countries are highly restrictive in so many ways. Just try to buy and use a fire arm in any of those countries. Free to wear any color of chains you chose would be more like it. George has hit the important point about being free to better your self financially - much less free now than 40 years ago. I have some books about folks that made their own homes from scavenged materials for little or nothing. Many were in California. They were works of art and safe to live in. All completely outlawed by the powers that be. Of course, once inside a dwelling, you now have the freedom to have sex with almost any object of your imagination. Which of these 'freedoms' contributes more to the well being of the average person? The middle class has cut it's own throat wide open and will bleed to death slowly. The 50's were far more free wheeling and wide open than now, even though the revisionists portray it other wise.

Paul Emery

Unless you were black in the South or Gay anywhere

Th reference the UN was from George.

" Numerous institutional indexes on economic and personal freedoms show US being downgraded over recent years. Economic freedoms decline here, and on Cato, and on Heritage, and in the UN index of personal freedoms US ranks 13th already in 1991, on the World Liberty Index 2006, and on the World Liberty Index 2012."

Bill Tozer

Freedom lost and losing freedoms. All my adult life I have had this feeling of doors closing behind me. Do something and a couple months later it is banned or a Do Not Enter sign is put up. Too many examples to bore you with. I agree with Dr. Rebane that it is not a zero sum gain. My loss of freedoms does not equate to another gaining more freedoms.

Bill Tozer

http://www.youtube.com/watch?v=qLm3HMG8IhM

Scott Obermuller

I don't care who references the UN - they are a joke. Nothing more than a bloated bureaucratic bunch of toadies squabbling over money conned out of the nations that pay into the kitty. If they ever audited that bunch, the jails would fill. The UN's notion of freedom is how much 'stuff' the govts give for 'free'. Have you ever looked at the list of govts that they put in charge of human rights? Collectively, the UN is terrified of personal freedom. Paul's reference to the 'blacks in the south' is another joke. You need to be educated, there, son. Talk to blacks that lived in the fifties in the north. And the wonderful unions that existed to block non-white males from getting jobs. Less unions=more personal freedom. Yes - we are somewhat more free now than in the fifties, but in many other ways that are important to bettering yourself financially we are far less free. Sex seems to be of far more importance to the left than a vibrant economy. And it shows. We are free to have naked folks parading in the streets, but it's so much harder to start and run an honest business than ever.

bill tozer

http://www.youtube.com/watch?v=paikyalDwl8&feature=related

TheMikeyMcD

TSA. Nuff said.


https://twitter.com/TSArants

Russ Steele

From Drudge: LAND OF THE FREE:
•Woman detained for riding manatee...
•Man Jailed Four Days for Recording Cops...
•Company fires 150 employees for not getting flu shots...
•School District Requiring Students To Wear Microchips To Track Every Move...
•Palm scanners in schools, hospitals...

Gregory

Russ, are you claiming the government should have forced that health care employer to not require influenza vaccinations provided at no cost to the employee, and all would be more free if that was the case?

Curious.

Gregory

And you are the same Russ S. who recently lambasted Telestream for not forcing their employees to pee in a cup regularly?

BTW Ryan's alma mater is forming the first pot institute:
http://www.bigstory.ap.org/article/college-launches-research-institute-devoted-pot

Bill Tozer

Hey, no more betting on who will be the next President or whether we will fall off the fiscal cliff, nor perhaps even a gentleman's bet for dinner or a donation to the charity of the winner's choice. It could be commodity in the bureaucratic language our public servants utter and babble endlessly. May incur the wrath of The Great White Father in Washington.

http://www.foxbusiness.com/on-air/stossel/blog/2012/11/26/government-crushes-innovative-online-prediction-market

George Rebane

BillT 1117am - Yes, they are steadily and stealthily closing in on the home of the brave and land of the free. All the idiots' happy dancing on the side, the next four years should be a doozy.

Paul Emery

Funny thing George, my friends in Denmark, Belgium and West Germany are quite happy with their freedoms. They at least don't have to worry about losing their homes if they become moderately ill.

Paul Emery

You're getting pretty desperate Russ to using Drudge as you're news source. Russ Steele | 25 November 2012 at 10:15 PM Can you find something more credible to back up you're claims

Paul Emery

Gregory

I believe we should all do voluntary drug testing. Yes, every citizen should pee in a jar and send it to Eric Holder with our name on it.

Ryan Mount

No one every complains about Humboldt State when they need their forests managed or their fisheries tended to. It's not all tree-sitters and huggers up there, ya know. There are students and faculty who actually take their mission seriously.

But I'm not surprised that HSU is embarking on a Pot curriculum. Complete with cross disciplinary Sociology units as well. I get to design the course:

Sociology 302, Altruism and dope: Hey man, it's like, ya know, we're not gonna win if everyone doesn't win. Ya know? 100 monkeys and all that stuff.

George Rebane

PaulE 1150am - That little party has been going on for too long, as EU countries who have borrowed their way into socialist happy land are now realizing. Now they are queing up for bailouts at the ECB 'Print-a-euro' window. Denmark and Norway have special problems with their brain trust emigrating; no one wants to start a new business in those countries. I wonder why.

And speaking of nationalized healthcare; anyone want to make any kind of a wager on the cost and service and inclusionary coverage of Obamacare? Those who thought healthcare was expensive before, haven't seen anything yet. Wait until it becomes the most expensive healthcare in the world with waiting lines that last into years. Black market doctoring will soon make us look back fondly on the old days of coat hanger abortions. How many physicians and other healthcare professionals do you know who are planning on retiring as soon as possible?

The measurables to keep an eye on are US death rates (leading indicator) and average lifetime. We will not have the nice cushions that the European socialists had to dull the impact of stupid public policies. As someone said, elections have consequences.

Gregory

George, I think the philosopher-comic PJ O'Rourke said it best back in the HillaryCare days:
"If you think health care is expensive now, wait until you see what it costs when it's free."

The last time I can recall a legislative body reforming an industry in its own image was when California decided to create a "market" in electrical energy. That really worked out great... for Enron and others who were gaming the very flawed system.

George Rebane

Gregory 225pm - Excellent point. If ever there was "a very flawed system" to be gamed, Obamacare is it. The whole mess will be a tort lawyers dream. And the drug wars will be joined by the healthcare wars as the feds start going after black market practitioners.

Paul Emery

George

What you visualize as the future of Europe is a theory, nothing more. There are many competing ideas with substantial details to challenge you. It works for your gallery though.

AS you know we already spend the highest percentage of our GDP of any measurable system in the world. Denmark is around 6% ours is 18 and growing. How can we brag a bout preserving what we have. Most of what you say is the future according to George. Show me one example of a health care system in the world today that is close to what you support and I'll give it a serious look.

I am not a supporter of Obamacare, It's way too messy. The only viable option is some kind of single payer insurance for all. If you want fancy stuff like a nose job, tummy tuck or detachable sexual components you're on your own.

George Rebane

PaulE 449pm - All visualizations of the future can be classed as theories, mine among them. However, I do have quite a coterie of distinguished like minded thinkers. Again, only in the hills of Nevada County are my thoughts taken as somehow fringe and speaking only to my "gallery". So be it, I cannot educate them all.

Making a healthcare system into a commons is an unsustainable solution, especially if it keeps eating up an ever greater fraction of your GDP; even as you continue borrowing money and depleting your fortunate offshore natural resources to make up your deficits. These are factors that have long been ignored by progressives - as evidence I even offer these humble pages.

Gregory

I've known a number of Nordic economic immigrants in tech, but I've not seen any great evidence that either Denmark or Norway is particularly hard hit.

One thing I have gotten from my Danish drinking buddies is a sense they'd never put up with the sort of institutional incompetence that we do; for example, primary and secondary school teachers aren't pulled mainly from the bottom half of the academic barrel.

Paul Emery

Gregory

Very true. In Denmark. where I have spent nearly 8 months playing music, public servants are the best educated and qualified among the workforce. They have very little graft or corruption and are highly respected. Teachers are honored and financially rewarded. The culture is so much different than ours. For example there is no difference between public and school buses. Kid ride to school in the same vehicles that bring people to work.

George, the health care systems in Europe have had a much more stable relationship with the GDP than ours. How do you explain that?

You believe that national health care will lead to a shortage of doctors and workers but that does not seem to be true. Can you explain your rationale for your opinion? This is not theoretical.


This is from Forbes. http://www.forbes.com/2009/09/02/healthcare-spending-europe-business-healthcare-gdp.html
"A look at how the U.S. ranks against 10 of the top health care spenders in Europe shows that America, with its heavily privatized health care system, spends roughly one-third more than some of the most free-spending European systems. But the U.S. stills has fewer practicing physicians per 1,000 people than many Continental European countries. We based our numbers on 2007 data from the Organization for Economic Co-operation and Development, except where specified........The French and Germans visit doctors more often than in the U.S. or U.K. The average number of annual doctors' visits is 6.3 in France and 7.5 in Germany, compared to 3.8 in the U.S. and 5 in the United Kingdom, according to the OECD."

Gregory

Paul, the Danes are an old and homogeneous culture with their own strengths and weaknesses.

Take education: I remember my late first wife, after she'd earned her credential to teach math in California secondary schools, after a career in applied math and engineering, being told by Nevada County's beloved County Education Superintendent Terry McAteer in a group meeting for new teachers that the local schools like their new teachers "young and stupid". Somehow, I can't see such a mendacity being thought in Denmark, let alone uttered and tolerated.

Why American bureaucracies like education tend towards dysfunction is beyond my desire to pontificate over at the moment, but giving them more money and power is like giving whiskey and car keys to teenage boys.

Michael Anderson

Paul is on the right track here. Lack of efficiency is the biggest problem with healthcare delivery systems in the US today. It is not a results oriented system. This is the main reason we pay almost twice as much as every other first world country.

We had to involve the insurance companies in some kind of solution to the efficiency problem (which is primarily due to the insurance industry--irony alert!). Thus, PPACA. But single payer is the ultimate goal, and don't let a healthcare reformer tell you otherwise.

We're making great progress so far, after many years in the desert.

Todd Juvinall

Trial lawyers and defensive medicine techniques. Whiny, sue happy Americans, baby boomers afraid to die. Our system was the best but the above have made it costly and unworldly. Oh, and the thousands of rules and regulations our beloved governments place on the insurance companies and the deliverers. These are the reasons it is so expensive. But hey, if you lovelies on the left think the very source of the problems (government) is the solution then I suggest you go try and move through the DMV lines for a new license. The blinders on the leftwing are super glued on.

Ryan Mount

Why should our government be any less beholden to the Peter Principle?

http://en.wikipedia.org/wiki/Peter_Principle

Our government (the military is a good example of this) has attempted to mitigate the Peter Principle with the extensive use of contractors. So now we have the PPACA, legislation that was ostensibly written by the Insurance Industry. It's a "partnership," if you will, between government and big business. And if we are indeed on our way to a single payer plan (I believe as most do that we are), then we the Peter Principle will be in full swing with the government.

The comparisons or Northern European countries, as an example, to ours is really a non-starter for the what Greg mentioned above: these societies are basically homogenous. The USA is a gorgeous mess malcontents. Do note that as these same countries have liberalized their populations, they are experiencing significant fiscal and cultural tensions. France is a good place to start the discussion.

George Rebane

RyanM restates the point made countless times here. Things change for the worse when multi-culturalism results in an unassimilated population. Europe is beginning to experience this in spades, and national leaders now regularly point this out after Merkel had the guts to speak out.
http://rebaneruminations.typepad.com/rebanes_ruminations/2010/10/merkel-mulitkulti-doesnt-work.html
http://rebaneruminations.typepad.com/rebanes_ruminations/2010/10/multikulti-and-people-like-me.html

An excellent view of how the British socialized medicine works is seen in the very entertaining BBC series 'Doc Martin'. A little thought while watching, and the light comes on quite brightly why the National Health Service and every other European socialist healthcare system is headed for a Soviet style wreck.

Gregory

Another entertaining series is on Netflix, "Lillyhammer", created by a couple Norwegians joined by E Street Band and Sopranos actor Steven Van Zandt. Not much reality (everything breaks Gianni "Johnny Boy" Henrikson's way after Witness Protection sends him to Lillehammer at his request) other than a look at the petty misuse of coersive power by minor government employees that I'm guessing rings a bell with the locals.

One Danish friend of mine moved back to Copenhagen for a couple years with his American wife. Their kid didn't speak much Danish at 5 years old but not to worry. No bilingual ed there, they were thrown into a Danish immersion like everyone else and did OK. The Danes like hearing Danish on the streets.

Paul Emery

George

You continue to ignore the fact that European health care systems offer more comprehensive care than we we currently have here. Despite your grim theories about the future with Obamacare those ramblings don't match up with current reality. Please revisit my earlier posting.

Paul Emery | 27 November 2012 at 06:20 PM

By any standard our system does not match up and you offer no alternatives that are practiced anywhere in the modern world.


themikeymcd

I will be 'that guy' that points out that our health care system is already 'nationalized' due to the fact that Medicare is HUGE (approx 1/3 of a multi-trillion dollar mkt).

So is education... don't get me started.

George Rebane

PaulE 219pm - I think that this exchange is fast coming to an end since it is a much circled barn. You talk of "more comprehensive care" that is being rolled back everywhere as the unsustainability of current programs is now apparent to (almost) eveyone.

The "grim theories" that you continue to attribute to me alone are shared now by millions of aware and thinking people around the world. And I don't need to offer any of additional alternatives that I have offered here many times before, and that you continue to ignore. Opposing a cobbled together a fly-by-night monstrosity that is Obamacare, does not automatically encumber the critic to having also present a fully-fleshed alternative that is subject to a thousand questions, none of which can yet be answered by the proponents of Obamacare.

JesusBetterman

George Rebane | 24 November 2012 at 06:03 PM

Most realistic description of reality ever by George!

Oh those BAD Unions and their discriminations!

Care to examine all of the race clauses implemented by builder developers and realtors that existed in California all the way up into the 1950's?


George Rebane

JesusB 537pm - what is your point about the past advising our present - revenge?

Gregory

George, there is no point.

Mikey, between Medicare and Medicaid, health care has been over 50% socialized for awhile, and the escalating costs for the young and non-indigent are partially due to government paid care being "negotiated" to a point below the cost to provide.

Paul Emery

George

We are talking about very real human needs here not some kind of luxury. There are millions of uninsured men woman and children with no health care other than the emergency room who cannot own a home without risk of losing it after a medical emergency. We are talking about people who cannot start a business because they are dependent on insurance from a current job that they will not be able to have if hey go into business on their own due to pre existing conditions.

You don't offer even an approximation of a plan based on any system in the entire world and you claim that is a popular belief that all national health care systems are unsustainable and that is apparent to "almost everyone". Really ! Can you at all document that or is it just another theory? Did you at least read the Forbes article cited earlier ?

http://www.forbes.com/2009/09/02/healthcare-spending-europe-business-healthcare-gdp.html

Recently an unemployed friend of mine lost their last $20,000 in savings because they had an emergency ambulance ride and one night in the hospital. That was the bill and their entire savings was drained. That's our system as it exists today and there is not one country in the modern world whose citizens would receive such treatment.

Go on and on with your theories but this is real and happening in our community. Can you not offer some ideas that may provide relief?

Gregory

Paul, being tied to an employer for healthcare isn't a result of a free market, it's an unintended side effect of health care benefits not being wage controlled during WWII wage and price controls, and not being a taxed "fringe benefit" in the seven decades ever since.

It's been government that's been cocking it up for the better part of a century.

Preexisting conditions could be handled like any other insurance... if you were covered when you were diagnosed, it's covered going forward. And if it wasn't for California not allowing insurance being sold without coverage for that preexisting condition, you could still buy affordable insurance for everything else.

Imagine risk pools being the size of congressional districts, not small businesses.

George Rebane

PaulE 840pm - apparently you didn't read to the last paragraph of your own link - that's where the unsustainable part comes in. The current status of doctor visits per year etc are meaningless in this discussion. As meaningless as your confusion of the overall fiscal strategy for supporting nationalized healthcare with the typical (and somewhat tedious) recounting of the inevitable anecdotal miseries.

Among the most curious aspects of your reasoning is the requirement that any new approach to solving an unsolved problem requires that there exists precedent for its solution. And absent that, any suggested new solution will therefore not work. My field and career would have been impossible with those self-imposed impediments in place.

For the new reader, I maintain that there is no extant feasible solution for sustainable healthcare that adheres to the acceptable standards to which we have become accustomed. Obamacare in full bloom is an atrocious attempt at aping the worst of socialized medicine.

Without wholesale regulatory rollbacks, massive revision of our tort laws to dampen predatory litigiousness, AND a total rewrite of our tax code, there will be nothing that approaches sustainable universal healthcare in America. Attempts like Obamacare just accelerate the destruction of our national fisc.

And the denigration of these thoughts as being idle and isolated "theories" while Obamacare (or any other European socialized healthcare) is some sacrosanct solution engraved on stone tablets is beyond ludicrous, as the deluge of daily evidence on international bankruptcies continues to pour in, and America's real debt (as reported in my post) is yet to be plumbed.

JesusBetterman

George 6:09 pm I was referring way back in this thread to:

"And the wonderful unions that existed to block non-white males from getting jobs. Less unions=more personal freedom. Yes - we are somewhat more free now than in the fifties, but in many other ways that are important to bettering yourself financially we are far less free. Sex seems to be of far more importance to the left than a vibrant economy. And it shows. We are free to have naked folks parading in the streets, but it's so much harder to start and run an honest business than ever.

Posted by: Scott Obermuller | 25 November 2012 at 08:38 AM "

Paul Emery

RE: Gregory | 28 November 2012 at 08:39 PM

You can add to the government tab retired military and government (federal, state and local) workers. It's the self employed and unemployed that cannot afford current insurance if it's even available. Gregory, if government paid care is "negotiated" to a point below the cost to provide why is health care 18% of the GDP, the highest in the world. Who is making all the money?

By the way tort reform is not an issue in most countries with national health care. It is virtually impossible to sue providers. It is an essential ingredient in any national health care system.

Paul Emery

So George, in the meantime its emergency room or bankruptcy health care for over 40 million Americans.

Of course I read the end of my link. The article presents a pragmatic view of the challenges and strengths of national health care systems in Europe but in no way presents the draconian view you espouse. Of course all healthcare for all is not sustainable but reasonable healthcare is. This is the quote that you claimed stated unsustainability. Where does it say that?

"As faster medical development occurs, the more pressing issue is the question of who is going to pay for it and who will benefit," says Mazda Adli, director of the Mood Disorders Research group at Charite-Universitatsmedizin in Berlin. Charite is hosting a World Health Summit next month. Among the many topics to be discussed: How do health care systems cope with medical progress?"

TheMikeyMcD

Paul, your faith in government regarding government health care is scary. You of all people must see the atrocities provided by government (war on drugs, medicare's negative impact on existing health care system, war in general, piss-poor educational system, etc).

For the life of me I cannot find ANY reason to trust the largest, most corrupt, mismanaged, most bureaucratic entity on the planet with the power you are eager to relinquish to the US government. I certainly don't want government central planning my health (physical and financial).

George Rebane

PaulE 1047am - Amen to Mikey's 1058am, to which I would also point you to my 918am comment on 'Owing $100T+ ...'

Meanwhile all Europe's countries are continuing to define down "reasonable healthcare" as they face mounting deficits and bankruptcies. You and yours do actually remind me of someone sending out invitations and organizing a string quartet on the afterdeck of the Titanic as its bow is already low in the water. Your inability to understand unsustainability is the common denominator of what has gotten all collectivized enterpises that ignore the commons into trouble.

JesusBetterman

Piss poor educational system comes from kids attending who are raised in piss poor families, by parents receiving piss poor wages, from stinking rich employers. Any further questions?

Paul Emery

George

Is emergency room healthcare for 48 million Americans sustainable? Is bankruptcy for minor surgery sustainable? What did the Repubs propose when they held the cards?

Ryan Mount

Paul-

I've been interested in a response from Conservatives regarding the "Hospital as primary care" meme for the underprivileged. I've been waiting for a straight answer on how to solve this. If you don't have any money or income, is it wise to use the ER as your PCP?

1) Is the answer as my Scottish Mom would say: "Tough titty." Time to die. I think not. I hope not. Note: my Mother would never say "time to die" even in her most Braveheart moments

2) Is it, "we'll just bill you and you maybe can pay it off in 40 years with interest"?

3) Is it, "let the market decide"? Whatever that means (that means #1)

4) Do we just extend medicare and raise taxes?

I think the answer is probably a measly socialized heath care service for the underprivileged, and private supplemental and higher quality care for more affluent folk.

After that, what's likely to happen is the quality of care and/or access to it for more affluent people will probably decline and become more expensive for twice-told reasons here and elsewhere. As I mentioned over on RL's blog, the un and under-insured will have long lines and grouchy doctors (probably Nurse Practitioners or similar), but at least they won't die or at least have a chance some basic/limited care.

George Rebane

PaulE 1141am - that's a tired argument. Whatever was then was then. The point is that the Dems have rejected the only possibility for something sustainable that was (and continues to be?) proposed by the Repubs. All your arguments center around now is revenge - the Repubs didn't solve the problem then, so now we also get a free pass on screwing things up even more.

And the 'emergency room healthcare' argument is more than tired, it's expired. No one is proposing continuing what we have now; it is only a strawman that liberals like to (re)construct, and then demolish with great fury and high dudgeon.

Ryan Mount

George-

Then what do we do with the ER visits and the uninsured? Same old/Same old? And have the government pick up some of the costs, and the hospitals write-off the balance? (the latter just means it increases costs on those of us who do pay)

And medical bankruptcies? Just let them happen? I'm guessing that most people who go through medical bankruptcies didn't have it coming to them because of reckless behavior. But then again, bankruptcy is better than dying.

George Rebane

RyanM 204pm - For some reason, I don't think anyone is listening. Let me posit a rule (in the event no one has beaten me to it) - 'That which can't happen, won't.'

You sound like the chorus that believes somehow the ER visits and the treatment for the uninsured will continue. It can't, it's unsustainable and so is Obamacare, so it won't. Unless the solution I have outlined is put into effect, people will die, and the poorer people will die first. That's reality and we can't bullshit our way over, under, or through it. 20th century Communist governments tried and failed miserably, in the process killing untold millions of their own citizens.

For certain problems there are very few solutions, for others no solution at all. The sooner we understand that, the sooner we will find workable solutions for those problems that admit them.

Paul Emery

George

Emergency rooms as an option were proposed by Romney during the campaign so from that view it's entirely contemporary unless you consider last spring old history.

“Well, we do provide care for people who don’t have insurance,” Romney told interviewer Scott Pelley. “If someone has a heart attack, they don’t sit in their apartment and — and die. We pick them up in an ambulance, and take them to the hospital, and give them care. And different states have different ways of providing for that care.”

The majority support Obamacare as reflected by the Dems romp in the Presidential and Senate races so dumping it is not a popular option and will not happen.

Paul Emery

RE George 29 November 2012 at 02:15 PM

Wow. You are far more cynical than I thought. So in your view there will be a kind of controlled burn of poor people. This is truly a line in the sand between the have and the have not's. If you are fortunate enough to have insurance or are on welfare you will be able to survive illness or injury if not you will be left on the streets to die after whatever money you and your family have accumulated is looted by the collection agencies of the medical industry. Unless, of course we follow George's path which no country in the civilize world has adopted or considered.

No George, I believe there are greater ideas that will prevail. Caring for our fellow human beings and the earth are what makes us human beings and different from animals.

Ryan Mount

George, I beg your pardon for my denseness. And I apologize for getting in between you and Paul on this discussion.

Isn't it possible that there will be a gradual, maybe rapid I dunno, decrease in medical service* coupled with an increase of cost** as we (that is, we as Americans) move to provide health care for the underprivileged?

I'm not saying I like this, for the record. I do not find it rewarding paying taxes out of my ass to not really reap any (very few) of its benefits. (It's that zerohedge link Greg provided in another thread that has me steaming still. I might do better to be a terrible farmer and get bailed out by the Federal Government, according to www.benefits.gov)

Or maybe look at it this way: the underprivileged will finally will have some formal care, and the more privileged will have less of it and probably pay more. To that end, *some* people will be *less* free at the expense of the collective.


* fewer specialists, longer waits for appointments, shorter appointments
** higher taxes, higher premiums

George Rebane

RyanM 326pm - You are as much a part of this discussion as anyone Ryan. But to be a contributor to it we must get past the 'caring for our human beings' and 'this is what makes us human' platitudes. It is these that have cost over 200 million government inflicted non-war related deaths during the last century.

We will not be able to do anything for our fellow man save we have the wherewithal to do it - aka a roaring economy, a lukewarm one will no longer do. Then the better ways to healthcare will probably be private charities that will be funded mostly by the upper two quintiles. (My family benefited from such a system after arriving in America.) The devising of a bottom-of-the-bucket safety net that doesn't invite the behaviors of a commons will be tricky. But make no mistake, in any society being poor and poorest has its consequences that platitudes (of socialism) will only make worse.

And because otherwise reasonable people like PaulE refuse to face reality, we will soon have to wallow in another kind of reality. In the final analysis that is why we are no longer one nation - one side believes the other to be insane beyond redemption, and that side returns the compliment by believing its opposite to be heartless and greedy beyond redemption. Both should live peacefully in environments where they can implement and savor their own belief systems.

Ryan Mount

I just want to know who's gonna pay for the people who show up at the ER with no ability to pay. I think in the mid to long term, you're (George) are saying it's gonna be nobody, because there ain't gonna be nothing. Probably true at this rate. In the short term, Paul is saying somebody's gotta pay for it, which would be the hospitals with write downs, and I'm assuming Medi-Cal/Medicare for small amounts. PPACA certainly ain't gonna fix it.

When we eat May's wheat in April, eventually May comes around I suppose.

I'm not against paying more [some 5% more? 10%? Not sure. That would certainly mean less spending in my family] taxes if I think it will do good. The problem is, I don't see any good coming out of this current mismanagement. I'm gonna ask some of my doctor friends for their opinion on this healthcare issue. The PPACA is a sham and the long game is for single payer anyway. Boil the frog slowly as they say. Cynical, but effective.

Paul Emery

So George in your view it's morally correct to spend trillions of dollars of revenue for military adventures and security and not spend what is necessary to ensure the health of our citizens. To you that becomes a step on the path to totalitarianism but military spending does not. Can you explain that.

George Rebane

RyanM 456pm - I have talked to about ten physicians about practice under Obamacare, and 1) they all believe it to be the biggest sham in healthcare they have ever seen, and 2) they will quit practicing medicine as soon as they can (five of them will retire instantly). PaulE sent his crickets to respond to the Gallup poll of 54% of Americans who believe government should play no role in providing healthcare.

PaulE 505pm - I have not been talking about morals, but only fiscal realities. Our military spending has NEVER threatened our sovereignty or our constitutional governance - in fact they are the constitutional defenders of both. But collectivist fiscal irresponsibility has taken down a number of countries either into destitution, revolution, or unspeakable tyrannies. From that you can figure out your own morals.

Russ Steele

We have been talking to our Doctors and two of the three are going to retire before 2014. The third is still evaluating his options, and my go into full time teaching and not take patients. We are looking a grim reality, a mandatory health care system with no doctors to provide the care. ObamaCare has removed the incentive for being a doctor, being a government slave labor just does not cut it!

Paul Emery

George

All 20 countries on the freedom index you quote have national health care except for the US at least until Obamacare takes effect. Are you saying that all those countries will all fall into "destitution, revolution, or unspeakable tyrannies"?

Also am I correct assuming that the military, police and fire departments area commons we are justified in supporting but national health care as a commons is not.

Paul Emery

Russ

How do you explain that in Europe they seen to have no problem providing doctors and health care workers and in fact spend more time with their patients than they do here?

Ryan Mount

I know two doctors personally. Both specialists. Both have a hard time understanding how they are going to be able to stay in their practices over the next 5 years without moving into a hospital's organization. I haven't had a chance to ask my local PCP for an opinion on all of this, but I will in a few weeks when I see her.

This is not about "they don't like change." This is about them running the numbers and not being able to keep their practices open.

When prices are high, everyone bitches about inflation. So then we price-fix goods and services (think recently: Hurricane Sandy and gasoline shortages), supply goes down. And then everyone predictable complains about shortages. It's not rocket science. Or brain surgery.

https://www.youtube.com/watch?v=THNPmhBl-8I

Paul Emery

So Ryan where does all the money go considering millions have n coverage? 18% of GDP is no chump change. In Denmark they cover everyone on less than 7%. I respect your views so give me a little help with this.

TheMikeyMcd

Someone please hold me, like my momma should. Paul neglected to comment on my question(s).

29 November 2012 at 10:58 AM

Russ Steele

Paul,

Rationing and ignoring the aged In the UK. Here are some of conditions not being treated:

• Hip and knee replacements only being allowed where patients are in severe pain. Overweight patients will be made to lose weight before being considered for an operation.
• Cataract operations being withheld from patients until their sight problems “substantially” affect their ability to work.
• Patients with varicose veins only being operated on if they are suffering “chronic continuous pain”, ulceration or bleeding.
• Tonsillectomy (removing tonsils) only to be carried out in children if they have had seven bouts of tonsillitis in the previous year.
• Grommets to improve hearing in children only being inserted in “exceptional circumstances” and after monitoring for six months.
More details here: http://blog.heritage.org/2011/08/01/could-britains-health-care-rationing-come-to-the-states/

Michael Anderson

Russ, if people have these conditions shouldn't they (or their parents) be able to pay for it? They have no options under the present system.

These issues are NOT AT ALL what we are talking about, we are talking about BASIC COVERAGE. After that, do whatever the hell you like!!

Treating people in the ER makes me pay, as a small businessman, WAY TOO MUCH. Stop the madness. Get efficient.

Sorry Russ, your experience comes from another century; it is neither relevant, pertinent, important, nor significant. It has no value.

Your rationing boogeyman is bullshit, and I reject it wholeheartedly.

Paul Emery

Mikey re 29 November 2012 at 10:58 AM

You didn't really ask a question it was more of a statement. I will repost it here for convenience

"Paul, your faith in government regarding government health care is scary. You of all people must see the atrocities provided by government (war on drugs, medicare's negative impact on existing health care system, war in general, piss-poor educational system, etc).

For the life of me I cannot find ANY reason to trust the largest, most corrupt, mismanaged, most bureaucratic entity on the planet with the power you are eager to relinquish to the US government. I certainly don't want government central planning my health (physical and financial)."

To answer your non question I can only say that most European health care systems allow private options for those that can afford and want them Everyone else gets basic coverage. I personally consider basic health care to be a necessary utility for all persons. We do live in 2012 for goodness sake. My view is that we fund universal health care with the same necessity that we support police, fire protection and yes military. Of course we must have tort reform to cut out the legal leeches. By creating a single option insurance plan you also eliminate excessive executive gluttony which at the same time denies coverage to those with pre existing conditions and unfortunate hereditary conditions. I have no confidence that there are free market options for a necessity that is akin to air, water and food.

Yes Russ there may be rationing and limits. Currently nearly 50 million Americans don't have any options except the emergency room which is rationing to the max.

Todd Juvinall

I am with PaulE and MikeA on the right of the government to take over the medical needs of all Americans. And while we are at it, how about the government taking over the music industry PaulE makes his living at and the electronics industry (or whatever industry) MA is making his living from. I think they should be the peons of all encompassing government just as they propose all the doctors, hospitals and medical suppliers, insurance companies etc. sould be. Hey fair is fair. So, you two lovelies rush down to BiG G and sign over all your life's work so some DMV type can tell you what to do. What a hoot!

Ryan Mount

Paul I understand your argument against wasteful spending as is impacts both health care inflation and ironically a lack of service for the under privileged. I am perfectly willing to sacrifice some admitted luxuries (we really don't need 300 DirecTV channels) in my family's lives in the form of higher taxes if we can rationally provide the uninsured with care.

Someone just needs to tell me (us really) how we're going to do it. Will somebody step-the-hell-up and lead on this issue? PPACA isn't gonna do it, Medicare/Medicade is ostensibly broke beyond belief. Who is going to pay for the $300 15 minute PCP doctor visits? Or the $1000 ER visits?

And as a rhetorical question, when we decrease supply, as in reduce or prescribe (via regulations) payments to doctors, what effect does that have?

Paul said> I can only say that most European health care systems allow private options for those that can afford and want them Everyone else gets basic coverage.

That's what I said above is coming to 'Merika. And that makes privileged folk pay more and arguably receive less service for what they're paying And in their minds, that means "less free." So to George's topic, some are probably *less* free. You can also make a somewhat specious argument that the privileged are more free because they *can* buy supplemental private insurance to augment a single payer system.

On the the other hand, the poor are less free to die. So that's a problem.

Russ Steele

Paul and Michael I am wondering what is your experiences with government run medical systems. I spend 20 year under a military run health care and I was one of the elites in the system being an aviator. However, my family was served by a system which rationed the medical care based on the availability of doctors. They had no choice over the doctors, it was who ever was on duty. Some were better that others, many were immigrants that had accepted government money to attend medical school and had to serve in the military, and some struggled with the english language, the deep accents made them hard to understand at times. Our biggest concern was not having a choice. It was who every was on duty, and when there was a doctor shortage, the wait for appointments could take weeks. Officers families were often give priority over enlisted families, not a matter of policy, but that is just the way the system worked. Flyers were a higher value asset.

Anyone that thinks when doctor shortage exist that some will be treated differently than others based on station in live are ignorant of how government run systems work. We have family members living in Canada and one had tumor behind the ear. It was causing pressure on the brain, which was painful and cause some behavior problems. She had to wait months for appointments and it was almost two years before the Doctor would operate, and during that two years the tumor grew larger. Finally an emergency room doctor demanded something be done immediately, the operation was scheduled, and then canceled when a higher priority medical emergency needed the operating room. It was a month before she was rescheduled. There are more MRI machines in the city of Sacramento than all of BC. Canada health care is free, but rationed.

We were in Omaha NE, station at Offutt AFB, which had a joint nuclear planning staff with officers from NATO Countries. The cocktail conversation was often about the wonder medical care that the officers and their families were getting in the US, especially dental and eye care that was rationed in their home countries. One family we know extend their stay so the children could have their teeth straightening completed. A service not available in the home country.

Now there is my experience, perhaps you can share yours?

Russ Steele

Reality Check: Paul and Michael The Daily Mail reports on path ways to death in the UK:

Sick children are being discharged from NHS hospitals to die at home or in hospices on controversial “death pathways.”

Until now, end of life regime the Liverpool Care Pathway was thought to have involved only elderly and terminally-ill adults.

But the Mail can reveal the practice of withdrawing food and fluid by tube is being used on young patients as well as severely disabled newborn babies.

One doctor has admitted starving and dehydrating ten babies to death in the neonatal unit of one hospital alone.

Writing in a leading medical journal, the physician revealed the process can take an average of ten days during which a baby becomes “smaller and shrunken.”

The LCP – on which 130,000 elderly and terminally-ill adult patients die each year – is now the subject of an independent inquiry ordered by ministers.

The investigation, which will include child patients, will look at whether cash payments to hospitals to hit death pathway targets have influenced doctors’ decisions.

Medical critics of the LCP insist it is impossible to say when a patient will die and as a result the LCP death becomes a self-fulfilling prophecy. They say it is a form of euthanasia, used to clear hospital beds and save the NHS money.

You can see why the concept of “death pathways” and “death pathway targets” is handy in a government-run system of health care. We have a lot to learn about ObamaCare and the built in "death panels"

TheMikeyMcD

The only solution to health care is the free market.

Health care is not a right and is not as essential as air or water. Folks lived more hapilly than us without giving health care a thought for centuries.

Ryan Mount

Mikey-

http://healthcare.procon.org/#pro_con

That sums up most of the entitlement debate (and the Great Divide) over health care.

There are two core arguments from the Pro crowd we should note:

1) If we don't take care of sick people, then we risk harm to ourselves. This is the collective "herd" argument, and frankly not a bad one. Vaccines are a good example of this.

2) Everywhere else has universal coverage except here. (this is Paul's argument to some extent). Many [somewhat irrelevant] correlations and assumptions follow this one like "heath care is cheaper when it's socialized" and "the economy will get a boost because of more health dollars" etc. This, of course, is also a Argumentum ad Populum fallacy. Often called the "bandwagon" fallacy. Because it assumes that popularity equals truth. Or 50 million Elvis fans can't be wrong. The fact of the matter is our health care economy, and our economy in general is vastly different that other 1st world countries. Lots to say about that.

The Con arguments can best be described as this:

1) It's not in the Constitution. And legislation is misinterpreting the Constitution. To put a finer (and hair-splitting) point on that, the Constitution has things like "Promote" the general welfare, not provide it. This maybe technically true, but since the 1960s Civil Rights and subsequent Acts, no one give a shit about the Constitution in that way anymore. That is, until one is unlawfully searched by an asshole cop. Then suddenly s/he are suddenly very interested in the 4th Amendment.

2) [Artificially] increasing the demand (lit. more patients) for healthcare, will increase costs, lower service and de-incentize research/development even as it brings more people into the fold. This is probably a true statement, even if there are fiscal savings made from things like a single payer system. The well does not have an infinite supply of water, so to speak.

Paul Emery

Mikey

"Folks lived more happily than us without giving health care a thought for centuries. "

Sure they did Mikey for an happy average age of about 40. Let's go back to the good old days of witch doctors and shamans and traveling quacks with rusty saws.

Russ

The Daily Mail is a rag akin to the National Inquirer. Aside from that it's easy to pot shot any system through google so have at it. I was raised in the military for 16 years and don't recall any problems with doctors or medical treatment.

Again in most European systems there is no doctor shortage. This is astonishing. The US is 47th in the world in doctor to patient ratios just ahead of Moldovia !!!! Most European countries are way ahead of us.

http://www.nationsencyclopedia.com/WorldStats/WDI-health-services-physicians.html

JesusBetterman

" Folks lived more hapilly than us without giving health care a thought for centuries. " ~Russ~

You might try calling up their spirits and see what they had to say about ingrown toenails, toothaches, and appendicitis. And broken bones and pneumonia.

JesusBetterman

That was Mikey, not Russ.

Ryan Mount

Paul-

http://economix.blogs.nytimes.com/2009/07/15/how-much-do-doctors-in-other-countries-make/

Doctors make more here, almost double the global average. Is that a supply and demand issue? Perhaps.

Also the nationsencyclopedia report assumes that the medical community and its support and liability apparatuses are equal. They're obviously not. So a simple question: What if US doctors are more productive than say ones from Cuba due to more automation and skill? This chart does NOT address any assumptions like that. Is the North Kprean Army more powerful than the US's army because they have more soldiers?

Anyhow, let's assume this is correct (it might be). Is the solution to supply more doctors to drive costs down then? How does something like a single payer address this? And who's gonna pay the liability premiums for these doctors when we cut their salaries by, say, 1/3 to match the Netherlands?

JesusBetterman

A doctor here has higher expenses, and supposedly more rigorous and thorough training. Likewise, teachers and programmers.

Paul Emery

Mikey

So in your view the poor should celebrate they have the freedom to die or live with illness or injury because there is no government healthcare options. Libertarian thought has to be inclusive of all people or it will just be another elitist group like the Republicrats.

TheMikeyMcD

Paul, I know that the advances in medicine that blesses the world today come from capitalism and not government central planning. I know that the largest impediment to affordable/quality health care in the USA is government. To expect better for anyone (rich or poor) we need less government regulations, tort reform and free enterprise systems (insurance, etc).

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