patrick.net

"I’m saying that the top two tiers were removed from the tax structure some years ago"

Fair enough. The top bracket is still 35% while the bottom is 10%. A progressive structure is still well in place. It might not be as high as you think it should be, but that is just another possible philosophical disagreement.

"My position is that some people argue that “socialism” in any form is evil, yet support many socialistic programs without even realizing it. Or maybe they do realize it, but like socialism when it benefits them."

So you don't agree with the fairly extreme example I put down? If no, then I can understand what your saying. There are plenty of similar examples on the other side as well. Human/individual self-interest doesn't quite care about political boundaries, despite which side is waxing poetic about the other side's self interests.

Paralithodes says

So you don’t agree with the fairly extreme example I put down? If no, then I can understand what your saying. There are plenty of similar examples on the other side as well. Human/individual self-interest doesn’t quite care about political boundaries, despite which side is waxing poetic about the other side’s self interests.

I'm not sure I understand your example. My problem is that people argue against some programs like government run health care solely because it would be government run, or socialistic. Implying that any government run program is de facto bad. When, in reality, this is simply not the case and most everyone is in favor of some government run programs.

If "conservatives" argued that government run health care wouldn't work becaue of x,y, and z well thought out reasons, then I'd have more respect for them. Not death panels. Not Big Brother stealing your medical records. Not--the US is on the road to socialism. But real arguments why this program wouldn't work as opposed to other successful government run programs. And why the US program can't implement a program like the rest of the civilized world. Then we could have a real debate. Instead we get fear mongering and end up with a crappy bill.

Are there any valid objections, in your opinion, to the current legislation?

Paralithodes says

Generally speaking, socialism refers to the means of production owned by the “state,” which conducts the economic planning.

I frequently hear countries like Sweden, Canada, etc referred to as socialist because of their healthcare.

And yet, none of those countries has "means of production owned by the “state,”" with central conrol and economic planning as you put it. NeoCons today use the word "socialism" to raise the specter of waiting in line to buy toilet paper, in a deliberate attempt to instill baseless fears.

I believe you are thinking of Marxism, or Fascism, or some other "-ism".

To the current legislation--yes, many. I'm not completely up to date on what actually is in whatever bill is left. But, I know it's been so watered down and bargained away that what's left is not an answer.

Hi Vincente! Read the Patriot Act yet? It would be good if you did. Then you wouldn't have to lie about having read it next time someone asks you!

....you wouldn’t have to lie about having read it next time someone asks you!

The name is Vicente, not Vincente. Isn't this the wrong thread for Patriot Act and baselessly calling people LIARS? You could claim to have read the Bible and War & Peace every day of your life, and I wouldn't call you a LIAR about it unless there were pretty damning positive evidence of that which seems unlikely.

I marked your post as "impolite".

Paralithodes says

Are there any valid objections, in your opinion, to the current legislation?

Yeah, that it's a bill system that isn't actually going to fix anything because it doesn't change anything meaningful. At best 30M more people might get coverage, but there's no evidence that the cost of health care is going to go down whatsoever.

I want an up or down vote on single payer, with the bill simply being an expansion of medicare to all citizens. Enough people know how medicare works to speak honestly about it without having to distort the arguments.

Once that's in place, medicare itself can be fine-tuned, mostly by eliminating unnecessary third parties that don't bring any additional value to the equation.

nomo,

>>some people may get health care who the opponents feel do not deserve it or are otherwise unworthy. They will oppose this even if it causes themselves great harm and huge expense.

That's right. They would rather pay 2x for their own healthcare than paying 1x and letting some poor person get part of the savings.

By the way, here is an interesting article about the costs of end-of-life care.

This is clearly a difficult and sensitive subject in and by itself, but the article contains also interesting information about negotiated prices versus list prices, and the variability of both across different providers.

End-of-Life Warning at $618,616: Was It Worth It?

http://www.bloomberg.com/apps/news?pid=20601087&sid=avRFGNF6Qw_w

The cost to benefit ratio of cancer drugs approaches infinity.

Nomograph says

Kevin says

Enough people know how medicare works to speak honestly about it without having to distort the arguments.

The distorted arguments always distill down to a single point: some people may get health care who the opponents feel do not deserve it or are otherwise unworthy. They will oppose this even if it causes themselves great harm and huge expense. It’s a classic example of cutting of one’s nose to spite the face.

Actually, there is more than one point so you are WAY oversimplifying things. I would rather have maximum control over my health care rather than little to none. If we have a public health care system (funded by me a taxpayer) my taxes will confiscate a great portion of the money I could use to seek the care of MY choosing. It is not just about fairness (eg who gets what kind of care) it is about freedom. Freedom to use my income as I see fit and seek the medical and/or alternative of my OWN choosing.

theoakman says

The cost to benefit ratio of cancer drugs approaches infinity.

Yes and the number needed to treat (NNT) even on blockbuster drugs like lipitor is also rather huge. The cost benefit on MANY medications is hard to justify. That is why taxpayers should not be forced to pay for these medications. Antibiotics you can make a case for but so many others are just plain wasteful. I wonder the what the number needed to treat on "Swine flu" is. 100000? is it even that good?

AdHominem says

That is why taxpayers should not be forced to pay for these medications.

My niece is on a therapy for Crohn's Disease that is quite expensive. Without enzyme treatments she would have died long ago, with it she's an otherwise healthy college Senior. So all the members of her health-care group are paying for most of it. Where is the fairness in that? She will NEVER in her life pay a fraction of the price the drug companies assign to it, unless of course she ever has a gap in coverage. Then she will have a "pre-existing condition" and nobody will want to let her join!

Don't get me started on the various HMO doctors who misdiagnosed for years. She'd go in with repeated unexplained vomiting being a primary notable symptom, and they kept thinking "oh just another crazy anorexic teenage girl". She was in hospital more than once near death, and then she'd get better and the doctors would seemingly shrug and it remained a mystery. Finally she was seen by a GI specialist from Atlanta Children Hospital who looked briefly at her fingernails and said "you have Crohn's!" and not long after removing a chunk of already too-damaged intestine and putting her on enzyme she's like any other lively college girl.

If there's one good thing that comes out of this it's an answer for people with pre-existing conditions who will be dead otherwise. There are of course many ways to approach this, but either someone's having to compromise and pay a price, or we "put down" the unfit.

The thing I fail to get with most people is they don't realize they already have very little meaningful choice. There are variances in how they group their price tiers versus deductible, beyond that I don't see much but their choice of logo & corporate colors. You're probably not going to find Dr. House working at your local HMO group. Picking my HMO was largely about which one had closest offices. Choice for most of us amounts to do you want McDonalds or Burger King and are you picking from the dollar menu or getting a combo.

Vicente says

The thing I fail to get with most people is they don’t realize they already have very little meaningful choice.

Actually I think most people do realize this. However most people are not excited about giving the federal government any MORE control over our health than they already have.

It is too bad insurance companies have any say in the matter, and we should work to end this (make all health care expenditures tax deductible, not just for employers but for everyone). But if my choice is between Blue Cross and the VA system. I will go with Blue Cross 11 times out of ten.

AdHominem says

However most people are not excited about giving the federal government any MORE control over our health than they already have.

Does it ever bother you that you are objectively wrong about everything?

http://www.washingtonpost.com/wp-dyn/content/article/2009/10/19/AR2009101902451.html

Troy,

You misrepresent the facts. First of all one poll with a leading question does not public opinion of most Americans represent. Second, the leading question took the demonized insurance companies and played on peoples love of the free market by using the word "competition" in it.

I stand behind my earlier statement.

Pick 1000 random names out of a national phone directory and ask them if they want government to have MORE or LESS control over their health. I think we all know what the most popular answer will be and it rhymes with mess, which is what nearly every federal program is. A mess.

How are those private highways working out? Having trouble thinking of any? Imagine that. I love anti-government types. When I see all of them with signs picketing to close all military installations and shut down the VA hospitals and end MediCare/MedicAid, then I'll think they are serious about their allegedly total belief that all government functions should be strangled in the tub.

AdHominen, did you see the poll that stated how many folks don't know that Medicare IS government run! So for folks to say that they want LESS government makes me wonder how much these folks know about current government involvement.

http://www.publicpolicypolling.com/pdf/surveys/2009_Archives/PPP_Release_National_819513.pdf

"One poll question indicative of how difficult it is to gain public understanding on a complicated issue asked if respondents thought the government should ‘stay out of Medicare,’ something inherently impossible. 39% said yes."

I still get a chuckle when I think about one of the news report about the protests at the health care town halls held by local politicians. One showed a elderly man holding a sign "Stay out of my health care". And I doubt that he passed up Tricare or Medicare just so he could participate in the 'free market". Could you imagine his premiums...hahahah.

Vicente, good insights in the "Crohn" post, about mis/missed diagnoses and choice being mostly an illusion.

The point I was trying to make is people label "government medicine" as SOCIALIST because it's government run. You have a certain form of "socialism" built right into the fabric of having a group insurance plan. You can dress it up all you want with actuarial tables and talk about profits etc. But the core idea is that healthy people pay in constantly, in order to heal total strangers in the plan who are sick. One of the crises we are facing right now with rising HMO costs is that young healthy people without jobs are dropping out, so naturally per-participant costs have to go up. People that talk about "it's not fair that I pay for some welfare momma to get a new liver" and similar really shouldn't be on ANY kind of insurance, because I suspect if they met some of the people being healed on their HMO plans right now, they would disapprove for one reason or another. Why are we healing this person or that one? If you hate the idea of anything smells SOCIALIST I got news for you, you really shouldn't be in any insurance plans either. Pay cash!

Labelling is everything. Again I see most people as opposed to SOCIALIST HEALTHCARE are directly or indirectly invoking old Soviet imagery of people waiting in line for toilet paper. The jibber-jabber about "death panels" alone is pure emotional propaganda. Do you think your insurance company doesn't assign a DOLLAR VALUE to your life and every medical procedure, and decide what does and doesn't get done on the basis of what minimizes costs? Inherent in the insurance-dominated health-care industry is what I can only consider as distributed death panels. Bureaucrats all through the chain make decisions about what are the most cost-effective treatments offered for an illness, and that is the menu they let their doctors offer.

"Labelling is everything. Again I see most people as opposed to SOCIALIST HEALTHCARE are directly or indirectly invoking old Soviet imagery of people waiting in line for toilet paper."

... And yet Obama directly and clearly admitted that certain amendments were inserted into the bill that "violated" (his words) some of the basic tenets of his stated approach... So, were some of the objections over the bill valid, or was Obama lying?

"The jibber-jabber about “death panels” alone is pure emotional propaganda. Do you think your insurance company doesn’t assign a DOLLAR VALUE to your life and every medical procedure, and decide what does and doesn’t get done on the basis of what minimizes costs? Inherent in the insurance-dominated health-care industry is what I can only consider as distributed death panels. Bureaucrats all through the chain make decisions about what are the most cost-effective treatments offered for an illness, and that is the menu they let their doctors offer."

And yet you are convinced that the government can increase people covered, increase service, and decrease cost - even though it cannot do that now in its own government-run programs - all while not putting a dollar value on everything? They can decrease costs while in theory there will be no price limit because bureaucrats and actuaries will not be involved in policy decisions?

I love anti-government types. When I see all of them with signs picketing to close all military installations and shut down the VA hospitals and end MediCare/MedicAid, then I’ll think they are serious about their allegedly total belief that all government functions should be strangled in the tub.

You live in a bubble. You cannot refute the positions of your opponents when you argue against something that is not their position. Who has this alleged "total belief" that "ALL" government functions should be ended? Other than perhaps individualist anarchists, how about... NO ONE???? If you are attempting to argue against conservatives in this fashion, you are arguing from a completely false premise.

Are you a communist? Do you believe that the central government should run ALL functions of society? YES or NO?

No, libertarians just want to keep those gov services that benefit them directly.

"YES or NO"... its all so black and white, isn't it? its all that simple...

Paralithodes says

And yet you are convinced that the government can increase people covered, increase service, and decrease cost - even though it cannot do that now in its own government-run programs

Actually, it does. Medicare admin costs amount to about 7 percent of its budget while the private insurance companies spend about 25 percent. So that would mean that the gov run system is about 3 times as efficient as private insurers.

- all while not putting a dollar value on everything? They can decrease costs while in theory there will be no price limit because bureaucrats and actuaries will not be involved in policy decisions?

This garble needs more of an explanation, please.

kentm says

No, libertarians just want to keep those gov services that benefit them directly.
“YES or NO”… its all so black and white, isn’t it? its all that simple…

I don't know, maybe... Vincente seems to have defined conservativism, albeit incorrectly, in quite black and white terms. Don't you agree? YES or NO?

"Actually, it does. Medicare admin costs amount to about 7 percent of its budget while the private insurance companies spend about 25 percent. So that would mean that the gov run system is about 3 times as efficient as private insurers."

And taxes collected to pay Medicare cover medicare expenditures?

Paralithodes says

I see most people as opposed to SOCIALIST HEALTHCARE are directly or indirectly invoking old Soviet imagery of people waiting in line for toilet paper.”

As an aside, in response to this, if I have to wait in line for toilet paper I'd rather it be because of a real shortage instead of because some private company decided it was more profitable to keep it from me. just a thought.

"This garble needs more of an explanation, please."
The unstated premise, in Vicente's rant about insurance companies putting things in dollar terms, is that the government would not - otherwise why would he mention dollar terms at all? To think that the goverment would not - all while talking about how this could decrease costs - is ridiculous. "Death panels" is of course hysterical hyperbole, but to think that there will be some open-ended spigot to pay for every medical cost - while reducing costs, is funny. Of course the government will put people in dollar terms! And certainly it must! It does now, why would anything with that change?

Paralithodes says

And taxes collected to pay Medicare cover medicare expenditures?

What does that have to do with anything?

Immediate shutdown of VA hospitals, MedicAid, MediCare, any form of medical aid by Federal government to citizens or foreigners.

Yes or no?

I see most people as opposed to SOCIALIST HEALTHCARE are directly or indirectly invoking old Soviet imagery of people waiting in line for toilet paper.”

As an aside, in response to this, if I have to wait in line for toilet paper I’d rather it be because of a real shortage instead of because some private company decided it was more profitable to keep it from me. just a thought.

The statement was incorrectly attributed to me - I think because I copied/pasted incorrectly somewhere.

In any case, if some private company decided it was more profitable to keep it from you, why wouldn't some other company just come in and undercut the price and take all the business?

"Democratic Government is a locus of power derived from the people"

It must be nice living in that fantasy land.

Two thirds of the money buying our "democratic government" comes from the bankers that own this country and just looted it for everything that wasn't nailed down, in case you didn't notice.

The government works only for the corporations that lobby it and bribe it with campaign contributions. Democrat/Republican Left/Right is just window dressing for the masses. Kind of like professional wrestling.

Your leftist belief that our government is "democarctic" and is a "locus of power derived from the people" is charming, quaint and totally unfounded.

Vicente says

Immediate shutdown of VA hospitals, MedicAid, MediCare, any form of medical aid by Federal government to citizens or foreigners.
Yes or no?

Of course not...

Government control over every aspect of the economy? Yes or no?

kentm says

Paralithodes says

And taxes collected to pay Medicare cover medicare expenditures?

What does that have to do with anything?

Asking that question is a joke, right?

Paralithodes says

Of course not…

SOCIALIST!

Vicente says

Paralithodes says

Of course not…

SOCIALIST!

So then it is perfectly accurate and valid to label President Obama a Socialist as well? And all Democrats?

And why are you not answering the question? Third time: Total government control over all aspects of the economy? Yes or no?

Paralithodes says

he unstated premise, in Vicente’s rant about insu...

The idea is that a private health care system puts dollar value ABOVE humanity - as a private company they're designed with profit as the reason they exist, and so its actually in their interest to deny care because thats how they make money. More in, less out, and so the more they can deny service while raising fees, the better. Its simply how their entire structure is designed.

The idea of a gov run health care system is that its NOT run for profit, so they can better respond to and provide actual care to people because the bottom line is not the entire reason they exist.

Thats about as simple as it can be put, and this is the entire problem.

For all the libertarian screaming about individual rights and personal freedoms, you people don't actually seem all that interested in actual people and what honestly helps them, you just seem to be interested in your own little selfish needs, like children screaming "ME" all the time. When I see someone who calls themselves a 'libertarian' I see those seaguls from "Finding Nemo"... saying "mine", "mine", "mine", "mine", "mine" over and over.

I wish you'd just be honest about that instead of hiding your real aims all the time.

Paralithodes says

And why are you not answering the question? Third time: Total government control over all aspects of the economy? Yes or no?

Are you writing in response to me? If you are then:

Because its a stupid question.

I shouldn't have to say this, but do you want a police force, or an army, or a fire dept?...

Nearly every American citizen is a socialist. And yet we hurl this around as a negative label? If we have a person that is entirely self-centered and does only what pleases and advances them and nobody else, we give them labels like..... SOCIOPATH.

YOU are a SOCIALIST! Oh ick!

And yet, to drag this back to Ayn Rand and hardcore Libertarians, SOCIOPATHY IS PRECISELY WHAT THEY WORSHIP!

Of The Fountainhead's hero, Howard Roark: He "has learned long ago, with his first consciousness, two things which dominate his entire attitude toward life: his own superiority and the utter worthlessness of the world." (Journals of Ayn Rand, p. 93.)