Didn't know where to put this so why not here.

Disease Threat From Immigrant Children Wildly Overstated; The Central American kids arriving in Texas are likely to be better-vaccinated than children in Texas.

TomatoPie wrote:Of all the things wrong with American health care, the notion of employer as the provider of health insurance may top the list. Seemed like a good idea to start - a tax-advantaged option to attract and keep good workers. But it led to an absurd sense of entitlement, and fostered the notion that "someone else" ought to pay for my health care. And when the consumer of a service does not pay for the service, he becomes an indiscriminate and inefficient user of the free services. Would you drive a Kia if your employer's benefits package provided you a Lexus?

The premise of ObamaCare - getting health coverage/insurance to as many Americans as possible - is one we should all embrace. The methods, OTOH, were designed to fail. A cynic would suggest that the planners knew this, and see ObamaCare simply as a step on the path to sole provider nanny state government provided health care or health insurance. A different type of cynic would suggest that the designers of ObamaCare were ignorant of market forces.

At the end of the day, how can anyone bless a system in which employers are forced to provide health care insurance for employees? There may be less efficient and less damaging-to-the-economy ways to do so, but I can't think of any. American companies must compete globally, and it's going to drive jobs overseas to nanny states where employers aren't on the hook for health insurance, or third world countries where wages are low and there are no mandated fringe bennies.

There are two possible solutions to ObamaCare. One is to go all in, move left, and just make medicare cover everyone.

The other would be to get government out of health care as presently engaged. If you look at the two elements of American commerce where costs have spiraled above inflation for many decades, it is health care and college costs. Not coincidentally, those are the two areas where the federal government has responded to rising costs by pouring in taxpayer dollars. The influx of new funds has, ironically, had the opposite of its intended effect. It makes providers become grossly inefficient, costs balloon, consumers don't price shop because the cost is borne elsewhere.

Thinking liberals and conservatives can agree that we want every American to have the best health care possible. And that the poorest Americans are going to need a collective solution.

We have good models for that. The vast majority of Americans provide their own housing and the food for their tables. We have a good - if imperfect - set of safety nets to provide housing and food for poor Americans. That should be the model for health care. Get employers OUT of the equation, get government OUT of health care for average Americans, and concentrate taxpayer monies on helping those who most need it.

{Sigh}

I agree with the general theme of the 1st sentence.

A lot of the rest is really totally absolutely jaw-droppingly messed up.

1) "it led to an absurd sense of entitlement"
the tax advantage made, and makes, offering health benefits more attractive to employers. It doesn't "entitle" anyone to anything. Employers introduced health benefits because a) workers like the financial peace of mind they provide b) the employer they're competing with down the street & across the country might offer them, so to be a competitive competitor -that's what we do here in the USofA, Ivan - employers offered health coverage c) yeah, the tax favored treatment was & is pretty sweet.

2) "and fostered the notion that "someone else" ought to pay for my health care."
Nonsense - health benefits are compensation, and "everybody knows that". They're subject to bargaining and everything. They're "earned", as much as anyone really earns anything like what they wind up enjoying (sure, sure, Jeff Bezos has earned being a gazillionaire because he's built a company that basically rarely "earns" any profits - explain that and so many others to me again, uncle Pie).

3) "when the consumer of a service does not pay for the service, he becomes an indiscriminate and inefficient user of the free services"
People are not lining up unnecessarily for cancer care, or lung transplants, or delivery of 1-pound premies - the kinds of treatments that, y'know, actually cost a Paul Bunyan pantload. This elementary-school model of how supply & demand works is useful in very narrow, mostly artificial situations - not at all for health treatments.

4) "A cynic would suggest that the planners knew this, and see ObamaCare simply as a step on the path to sole provider nanny state government provided health care or health insurance. "

5) "A different type of cynic would suggest that the designers of ObamaCare were ignorant of market forces."
A different sort of individual - say, someone with a competently instructed grade-school education - is aware that "designed" legislation seldom reaches enactment without plenty of hasty additions, erasure marks, and shit scribbled in the margins. Someone with a memory would suggest that enough members of a diffident-going-on-feckless congress were persuaded to cast a corrupted version of the initial statutory model to achieve passage - y'know, like a lot of legislation takes form.

Someone wearing a tinfoil hat can imagine an all-powerful brown man who simultaneously is incapable of actually getting much of his secret muslim agenda implemented just the way he wants it. Surely that's only because he's been foiled by such bound-for-Mt Rushmore patriots as Eric Cantor, Mitch McConnell, etc etc.\

6) "At the end of the day, how can anyone bless a system in which employers..."
It' pretty difficult to find a more multifaceted example of Walt Kelly's maxim that "...the enemy is us" than our health coverage "system".

But the dire consequences posited to result from more comprehensive health coverage are ... well, let's just call them the product of confused thinking. One example: following the "logic" of the assertions made in that paragraph, those 3rd world countries that will get all of OUR jobs would also get all the jobs from the socialistic communists in european countries that do a much more comprehensive job than we do of providing health coverage.

7) "...get government OUT of health care for average Americans"
Can we The average spending on health care for well over half of working age americans & dependents is under $300/year. That's spending on their care, from their own and any other sources. Hard to believe, Harry. Also true. Why? Because most people, most of the time, are mostly healthy.

We spend most of our health care dough on a slender fraction of the total population. And the kind of care we're spending it on is unaffordable, without "group" support by employers and/or governments, by all but a very slender fraction of the total population. Let's put it this way - neither you nor I could readily cover the tab for big-ticket cancer care out of our own pockets.

And oh, by the way, any competent management of any competing US employer will ALWAYS have a stake in supporting its employees' health - particularly in a services-skewed economy, where the "product" is generated by people, people showing up for work marginally more often, and in marginally better health, than those competing firms an employer is competing with, competitively. Sure, an effective health strategy MIGHT just happen by accident - but most effective competitors form some kind of plan for what they're going to do. To compete, to succeed, to win. I suppose Phillies phans might be excused for not appreciating this....

Pie, you're a smart individual, you've provided plenty of evidence. Does spewing all of the doctrinaire unthinking bullshit you mixed in with the nuggets of irrefutable wisdom you've posted earn you any points in some club of mouthbreathing reactionaries somewhere? Because man, you do NOT want to remain a member there.

drsmooth wrote:Does spewing all of the doctrinaire unthinking #$!&@ you mixed in with the nuggets of irrefutable wisdom you've posted earn you any points in some club of mouthbreathing reactionaries somewhere?

Although I have a little more scorn for Democrats than I do for the GOP, my political opinions are my own. Both parties are deeply wrong on most important issues - health care, immigration, taxes, scope of government.

There is, in human and political and social arrangements, some balance of individual and collective efforts. "Every man for himself" is rarely ideal -- but you don't need a weather vane to see how top-down collectivism has brought more misery than any robber baron could ever hope for.

It's not a complicated view -- but even the Libertarians don't quite get it. I'm fully Libertarian in my outlook for the competent. But the Libertarian view cannot fully account for the incompetent. There will always be some segment of society that cannot house and feed itself, let alone provide medical care, cell phones, and HBO Go. That is where we need a collective effort.

The right has failed to recognize that we have - at a minimum - a moral obligation to collectively care for those who cannot provide for themselves. And they remain idiots on most social issues, longing for a 1950 they never knew.

The left has failed to recognize that collective solutions serve as a disincentive to work, to grow, to improve, to become self-sufficient. This is why ObamaCare has a giant fluorescent FAIL stamped on its forehead. A clumsy attempt to force a "solution" on persons needing no help, and a willful disregard of market behaviors. It imposes perverse incentives on insurers and potential insureds. The more one thinks about it, the harder it becomes to think it was not designed to fail. Not even Democrats can be this dumb, can they?

do you have a newsletter

pacino wrote:do you have a newsletter

workin' on it. PM me your email and paypal account info to be on our subscriber list

The uninsured rate is down to 13.4 percent and cost growth has slowed dramatically. I think the Heritage Foundation and Governor Romney should be very proud of the successes of market-based healthcare reform.

TP, I get that doc pissed you off, but...

The left has failed to recognize that collective solutions serve as a disincentive to work, to grow, to improve, to become self-sufficient. This is why ObamaCare has a giant fluorescent FAIL stamped on its forehead. A clumsy attempt to force a "solution" on persons needing no help, and a willful disregard of market behaviors. It imposes perverse incentives on insurers and potential insureds. The more one thinks about it, the harder it becomes to think it was not designed to fail. Not even Democrats can be this dumb, can they?

...this is almost a parody of talk-radio silliness. For one thing, having health insurance is probably a good enabler--maybe even an "incentive"--"to work, to grow, to improve, to become self-sufficient"; even if you're sneering at the Takers (those greedy fucks, working their $12/hour jobs and living it up on their SNAP), how about the college grad in her late 20s with a chronic but not debilitating condition, who no longer has to stay at a job she hates and that doesn't allow her to utilize all her talents and energies because it has insurance? For another, what do you think insurance OF ANY KIND is, if not a "collective solution"?

(Or any government action. Maybe the fact that the city picks up my trash, runs buses and subways, keeps my streets (sort of, sometimes) clean and (more or less) safe has made me lazy, self-satisfied and dependent. Or the country's armed forces are giving me a false sense of security and making me act more belligerent toward, I dunno, Russians. So be it.)

And while I wish Obama, or any Democrat, were smart enough to come up with something "designed to fail" so they could push through something more progressive (mostly because that kind of fiendish genius probably would mean we'd have jet packs, or other cool shit), they aren't. Nobody is. Occam's Razor suggests that this reform was chosen because it sat in the relative sweet spot between what was politically achievable and what would work best. I wish, like David Frum and others, that the Republicans had actually engaged in the process rather than embracing massive resistance; we might have gotten tort reform, for one thing, and if hating Obamacare and its fluffing of the Takers hadn't become a requirement for good standing in Tea Party Nation, perhaps more states would have accepted the incredibly good deal of Medicaid expansion and millions more working poor Americans would now have some protection against health-related financial disaster. But they didn't, it is, and they don't.

And you've yet to explain why the policy is failing, other than somethingsomethingmarkets. One point doc made that's inarguable is the irrelevance of "market models" to healthcare, because it's not a "normal good"; you don't get an MRI or a colonoscopy for kicks. Most people, anyway.

edit: Re-reading your original post, I realize I have absolutely no idea what sort of healthcare system you propose. You wish to get government (including Medicare? Medicaid?) and employers out of healthcare, leaving... ? Insurance companies?

I'm not sure what that would look like, and I doubt you are (though if you do have a clear idea, I'd love to hear it). Insurance companies, of course, are in business to make profit, which means that the poor and sick aren't likely to access decent, affordable coverage anyway. You could regulate the insurance market, but that of course brings back in the dadgum gummit, which you assert is the problem in the first place.

If you were to suggest that we should have "universal coverage" against disaster--a high deductible for everyone, beyond which the taxpayers cover it--that at least would make some logical sense (and I think it's close to what we occasionally hear from the "Reformicons" when they suggest alternatives to Obamacare). It would cause enormous disruption (the avoidance of which is why Obama didn't pursue single-payer, or so he said... a good small-c conservative justification), and a lot of human suffering, but it might work over the long term.

dajafi wrote: how about the college grad in her late 20s with a chronic but not debilitating condition, who no longer has to stay at a job she hates and that doesn't allow her to utilize all her talents and energies because it has insurance?

You covered a lot of ground, so I will tackle these one at a time.

This one, you can throw out the window. Of all the wonderful things I've learned on this board, the only one that tops "TINSTAAPP" is "the plural of anecdote is not data"

For each 20-something with a chronic syndrome, there are 500 20-somethings being over-charged in ObamaCare for insurance they don't want in order to subsidize boomers and dying people using up health care dollars.

You and I agree that we need a collective solution for those like your anecdotal victim. What we don't need is a one-size-fits-none solution that drags in the great majority who are capable of making their own choices.

You could talk me into a program by which ObamaHome pays her rent, too. But not if ObamaHome requires people who already have homes to participate in yet another mismanaged bureaucracy. And not a system that asks your young victim to overpay for her ObamaHome so that boomers who need more space can have subsidized large homes.

Insurance is a collective solution

Government insurance is, yes.

Private insurance is not. It is a voluntary pooling of risk.

What is the purpose of insurance? It is to preserve your financial stability by paying for unforeseen loss events that would otherwise have a catastrophic effect on your finances.

Why should insurance, or Obama, or anyone pay for your boner pills? For your happy pills, for your birth control pills? For your chiro visits? Which unenumerated right is that? Can you cite a reason that boner pills should be paid for in a collective solution, but not my food, my house, my car?

TomatoPie wrote:For each 20-something with a chronic syndrome, there are 500 20-somethings being over-charged in ObamaCare for insurance they don't want in order to subsidize boomers and dying people using up health care dollars.

Please don't feel like you need to respond to the rest of my points. Based on this, and your evident lack of understanding of how insurance works, it won't be a good use of time for either of us.

I'm genuinely sorry I responded to you, and would be happy to delete all my posts in this conversation. I shouldn't be so stupid after so many years.

dajafi wrote:

TomatoPie wrote:For each 20-something with a chronic syndrome, there are 500 20-somethings being over-charged in ObamaCare for insurance they don't want in order to subsidize boomers and dying people using up health care dollars.

Please don't feel like you need to respond to the rest of my points. Based on this, and your evident lack of understanding of how insurance works, it won't be a good use of time for either of us.

I'm genuinely sorry I responded to you, and would be happy to delete all my posts in this conversation. I shouldn't be so stupid after so many years.

You're not stupid - but this post is. Petulance is not your typical style.

And as smart as you generally are, you are in zero ways qualified to lecture me about insurance. If you want to start over, I'd be glad to help you understand the basic principles. But right now you've got your hands clapped over your ears.

it was hard for a gif to eclipse Michael's, but the Gus one did

TomatoPie wrote:

dajafi wrote:

TomatoPie wrote:For each 20-something with a chronic syndrome, there are 500 20-somethings being over-charged in ObamaCare for insurance they don't want in order to subsidize boomers and dying people using up health care dollars.

Please don't feel like you need to respond to the rest of my points. Based on this, and your evident lack of understanding of how insurance works, it won't be a good use of time for either of us.

I'm genuinely sorry I responded to you, and would be happy to delete all my posts in this conversation. I shouldn't be so stupid after so many years.

You're not stupid - but this post is. Petulance is not your typical style.

And as smart as you generally are, you are in zero ways qualified to lecture me about insurance. If you want to start over, I'd be glad to help you understand the basic principles. But right now you've got your hands clapped over your ears.

This isn't petulance. This is cutting of losses. We've been down this road before and it's neither pleasant nor interesting enough to me to walk it again.

It's difficult if not impossible to have a discussion without basic agreement on what certain words--insurance, collective, incentive, government--mean. We don't have that, and we won't. So I'll leave you to your ideological certitude, and remain grateful that millions of our fellow Americans now have some access to healthcare.

Horse, water.

unicorn, hi-c

snorlax, rare candy

housh, crack

TP, I apologize if I gave offense. I meant it when I said I shouldn't have responded. But if you'd like to share your fully thought out, rational, logical, achievable solution for healthcare reform that doesn't involve employers or government, and doesn't disadvantage "the competent" while providing for the neediest and being more or less revenue neutral, I sincerely would like to hear it.

I'm guessing you can't, because a lot of people much smarter than either of us haven't been able to. As I tried to suggest, "Obamacare" is essentially a Republican idea, the early '90s Heritage Fdn alternative to Hillarycare. It's as incremental and non-disruptive to existing arrangements (primacy of employer provided coverage) as they could make it. Whatever you think of those existing arrangements, I suspect you'd agree there's value to not just blowing stuff up.

It does create winners and losers, like any redistributive policy. I'm pretty sure it does this in a way where far more Americans win than lose, and in a way that constrains costs better than the alternatives and creates positive economic externalities. But if you have evidence to the contrary, please share it.

I get that it rankles ideologically. So, again, I'd love to hear your alternative.

TomatoPie wrote:....you don't need a weather vane to see how top-down collectivism has brought more misery than any robber baron could ever hope for.

can you run us your short list of "top-down collectivists" relevant to a 21st-century contemplation of effective political arrangements?

TomatoPie wrote: The more one thinks about it, the harder it becomes to think it was not designed to fail. Not even Democrats can be this dumb, can they?

You're putting me on. You do realize that ACA's guts were concocted - "designed" - by Cato/Heritage rightwingers, right?