Clash of The Titans

Pay attention to this initiative from Barney Frank, via an insightful post by Steve Benen:

Many businesses are trying to shed high health care premiums. Frank hopes that workers and businesses can agree on a government-administered plan paid for by workers that would reduce burdens on businesses, which would pass on savings to employees through higher wages.

“I think employer-paid health care is a mistake,” he said. “I think it depresses wages.”

Stephen J. Collins , president of the Automotive Trade Policy Council, which represents Detroit’s Big Three automakers, said business leaders would welcome such a discussion with Frank. “Our companies are very open about the fact that they are facing massive competitive challenges of a global nature that need big answers,” Collins said. “There has to be a partnership between government and industry to solve some of these problems, and health [care] is one of them.”

In many ways our broken healthcare system acts like a lead weight around the ankles of American business. While it’s easy to bitch about American carmakers investing poorly in quality engineering and forward-looking technologies, major employers like Ford, Chrysler and GM have pension and healthcare legacy costs that our Asian and European competitors do not. Among other problems (stratospheric executive pay for one) healthcare costs are driving the country’s airlines into bankruptcy and/or viciously adversarial negotiations with the employee unions. Pick any sector of American industry and the same problem appears.

Whatever the arguments for and against public healthcare there should be no question that it would literally save the life of a significant number of struggling American companies. The linked article shows that a decent proposal modeled after the more successful implementations, and not embarrassing screwups like, say, England or Hillarycare, could easily win the fierce loyalty of a broad swath of American business. Of course, lined up in opposition would be our massive insurance industry and to a lesser degree the hospital business.

The major criticisms of public healthcare never seem to hold much water. The cost argument is a joke when many countries manage to spend half or less as much as we do for roughly the same quality of care. For some metrics like infant mortality the contest isn’t even close; we spend more than twice as much and still lose by a mile. Waiting for elective surgery seems like a problem until you imagine life in America with minimal or no coverage. When your only care provider is the emergency room the idea of waiting a few months for a $25 noncritical operation can sound pretty appealing. Even Americans who think they are covered can wake up one day to a very nasty surprise. As with minimum wage increases, the nightmare scenarios rarely seem to reflect what happens in the real world. By and large business owners are smart enough to know this.

Keep an eye on Barney Frank’s initiative. If healthcare costs push the basic tension between business and the insurance industry past critical the pressure could spark a political realignment to rival the 2006 GOP beatdown. At least that’s how I see it.






532 replies
  1. 1
    Zifnab says:

    But the GOP told me that if we nationalize medical insurance then the communists win. Also, we’ll be more like the French.

  2. 2
    Paul L. says:

    For some metrics like infant mortality the contest isn’t even close; we spend more than twice as much and still lose by a mile

    Infant Mortality: The statistical scam continues
    Of course, Tim and you guys believe Castro’s claims of 100% literacy and universal health care.

    If our healthcare sucks, why do the rich of the world come here for care?
    Of course look at the wonderful treatments, cures, drugs and medical advancements (Stem Cells) that comes from the countries with public healthcare. Canada leads the world in in embryonic stem cell research.

  3. 3
    ThymeZone says:

    Millions of Americans without coverage, and therefore without adequate access to healthcare. These millions include children and families with working parents.

    All of these people are one blood clot, one car accident, one bad X-ray away from financial ruin.

    Millions more are one pink slip, one layoff, one “reduction in work force” announcement away from being in the same boat.

    All Americans are paying much more for healthcare than counterparts in other countries, and not getting comparitively better care for that cost.

    Meanwhile, the actuarial realities paint a picture of the future that bodes ill, a bankrupt country and a social and health crisis of gigantic proportions.

    Meanwhile, our politicians fiddle and equivocate.

  4. 4
    Thomas says:

    Well, we’ve found the corporate handout favored by Tim. I don’t doubt that the K-Street lobbyists for the Ford, GM and Daimler are working hard to get the feds to bail them out of their ruinous union contracts. What I don’t see is a persuasive argument for bailing them out. Honda, Toyota, Hyundai and others are opening plants in the US; health care costs don’t seem to be blocking that. If the so-called foreign automakers are better at the business of making and selling cars, they’re going to win, and they should, and the federal government doesn’t need to do anything to stop that.

    If you want to really cut the cost of healthcare in the US, you should start with the doctors. Of course, if you really want to attack the high-quality of care in the US, you should really cut the pay of our doctors. Just what we need: an incentive for bright people to go into investment banking instead.

  5. 5
    ThymeZone says:

    At least that how I see it.

    I think you see it clearly, and if anything, we are understating the size and impact of the problem here.

    The current model is not sustainable, and when it gets bad enough, Americans will demand that government do something about it.

    That “something” is not going to be a smoke-and-mirrors clusterfuck of the type we’ve come to expect from today’s Republican party and its Wizard of Oz leaders. It’s going to come from progressives and people who are not afraid to call on government to represent the interests of real people, not the interests of the rich and the corporations.

  6. 6
    Zifnab says:

    If our healthcare sucks, why do the rich of the world come here for care?

    I don’t know. Why do we export our sick people to India?

    For Blue Ridge, it costs less to send an employee 7,800 miles to New Delhi than nine miles to the nearest hospital — with the quality being equal in the company’s eyes. The company estimates the employee’s surgeries would cost $100,000 in North Carolina but $20,000 in India.

    “We want better than what we can get here,” said Darrell Douglas, vice president for human resources. Blue Ridge is even kicking in for travel expenses and paying employees a bonus of up to $10,000 for going to India.

  7. 7
    capelza says:

    Thank you Zinfab, you beat me to it. Paul L..it isn’t that we don’t have the technology, it’s that many, many Americans can’t afford the access to it.

  8. 8
    RSA says:

    Nice post, Tim F.

    The major criticisms of public healthcare never seem to hold much water.

    In discussions I’ve had with libertarian-leaning conservatives, the issue isn’t evidence, it’s ideology, as Zifnab suggests above. Publicly funded health care would be wrong, under this view, just as taxation in general is evil, so it doesn’t matter how much good it would result in. I’ve found that it’s impossible to counter these arguments because they’re based more on faith than anything else.

  9. 9
    Tim F. says:

    If our healthcare sucks, why do the rich of the world come here for care?

    A common way to lose a debate is to claim that because the very wealthiest get the best healthcare anywhere, America must have the best healthcare system. See if you can work through the fallacy without me having to tell you.

  10. 10

    If our healthcare sucks, why do the rich of the world come here for care?

    Which rich people come here? As I do live in Minnesota, I’m familiar with the occasional story of some wealthy so and so coming to the Mayo Clinic.

    But generally, they’re wealthy shieks… not European nobles.

    Can you give me an example of a wealthy person from say Japan, England, Germany or Switzerland who comes to the United States?

    The only G8 nation which we are better than is Russia.

  11. 11
    Tim F. says:

    Or, what capelza said.

  12. 12
    Andrew says:

    California is a Terminator away from universal health care.

  13. 13
    ThymeZone says:

    I’ve found that it’s impossible to counter these arguments because they’re based more on faith than anything else.

    You’re right of course, but I find “faith” to be an idea grounded in good intentions and good …. faith. Whereas, the ideology that drives the opposition to healthcare reform seems to me to be entirely self-serving. First of all, it’s grounded in political exploitation of voters who fear and resent a false idea of “big government” sold to them by politicians who are out to have big government. But their big government is the government of Halliburton, Merck, Exxon and Wachovia. These interests will oppose real healthcare reforms because real reforms would require a reexamination of the true relationships between big corporate interests, and government. These monsters want you to believe things that are simply not true, one of which is that medicine is just another business and therefore should be run by business rules.

  14. 14

    For some metrics like infant mortality the contest isn’t even close; we spend more than twice as much and still lose by a mile.

    My understanding is that the counting is different. That is, in the USA a preemie who dies at birth is counted, whereas in many countries that is not the case. Part of this perhaps is that the USA mandates medical care for preemies even if they are surely going to die because they were born way too soon.

    The other statistics are not surprising, but it seems to me that this one seems to be a statistical counting problem.

  15. 15
    srv says:

    In discussions I’ve had with libertarian-leaning conservatives, the issue isn’t evidence, it’s ideology, as Zifnab suggests above. Publicly funded health care would be wrong, under this view, just as taxation in general is evil, so it doesn’t matter how much good it would result in. I’ve found that it’s impossible to counter these arguments because they’re based more on faith than anything else.

    By 2012 or 2014, Republicans will be running on a single-payer platform. Their ‘conservative’ values will adjust to the reality that the baby boomers rule, and without them, they are nothing.

  16. 16
    Paul L. says:

    A common way to lose a debate is to claim that because the very wealthiest get the best healthcare anywhere, America must have the best healthcare system. See if you can work through the fallacy without me having to tell you.

    Since you claim that healthcare is equal between the US and the countries with public healthcare, why don’t the wealthy go to where the counties (w/ public healthcare) where it is cheaper?
    Afterall, the quality of care is the same. Or is it?

    Someone care to defend Tim F’s. infant mortality metric claim?

  17. 17
    ThymeZone says:

    in the USA a preemie who dies at birth is counted, whereas in many countries that is not the case.

    Preemie stats are a rather small … I’d wager, nearly insignificant …. part of the total.

    Of course, the Darrells will soon be here to explain to you that the hapless issue of crack moms and illegal aliens are the real reason that US infant mortality rates are not competitive. In other words, liberals are driving the rates in the wrong direction by coddling these miscreants.

  18. 18
    Pb says:

    nyceve has written about some unbelievable, heart-breaking stories of people who have fallen through the cracks in our healthcare system, sometimes to their deaths:

    But they reasoned, if Delbert needed a liver, he should get on the transplant list. To their shock, they learned the system doesn’t work that way.

    “It was, ‘Show me the money . . . and we’ll get you on the list,’ ” Ann said.

    If you don’t think our system is broken, read it all and then come back and try to tell me that. Clinton knew we needed to start addressing this issue 14 years ago, but the Republicans played games with it while he was President, and then proceeded to do nothing over the past six years, now that the system has really started collapsing. The Republican solution to the health care crisis? Gut Social Security.

  19. 19
    ThymeZone says:

    why don’t the wealthy go to where the counties (w/ public healthcare) where it is cheaper?

    Because the wealthy needn’t “go” anywhere to get superior care. They can afford to get it where they are.

    Also, the fat part of the bell curve in healthcare is not around the leading edge machinery and the most heroic measures. It’s around basic, more mundane care, the kind that makes up the big fat middle of the picture. The boring part. The part that screens for diabetes, for example. Not the part that does leading edge medicine. If a rich person comes to the US for leading edge medicine, it just proves that we’ve skewed our system in favor of the extraordinary and neglected the ordinary.

    Jesus, where do all the stupid people come from?

  20. 20
    Tim F. says:

    Since you claim that healthcare is equal between the US and the countries with public healthcare, why don’t the wealthy go to where the counties (w/ public healthcare) where it is cheaper?

    Tell me honestly that you don’t see the weakness in your argument. I will even give you a hint: what do the very wealthy have that the average citizen does not? Take your time.

  21. 21
    capelza says:

    Paul L, did I miss the link where you show that the wealthy all come to the US for healthcare?

    And you still miss the point. A lot of us Americans aren’t wealthy and can not afford to pay for the privelege that wealthy foreigners can.

  22. 22
    Jay says:

    I say launch Viking-style raids against the health insurance corporations. Or at least, impose stricter regulations to an industry that has become the gatekeeper between patients and providers.

  23. 23
    Zifnab says:

    Since you claim that healthcare is equal between the US and the countries with public healthcare, why don’t the wealthy go to where the counties (w/ public healthcare) where it is cheaper?
    Afterall, the quality of care is the same. Or is it?

    Link plz, Paul L. Where are you getting these statistics?

  24. 24
    Pb says:

    Link plz, Paul L. Where are you getting these statistics?

    A. What statistics? I haven’t seen a statistic out of him yet.

    B. I don’t think you really want him to link to where he gets his statistics from–if that’s even possible.

  25. 25

    […] Tim at Balloon Juice also has some good comments: In many ways our broken healthcare system acts like a lead weight around the ankles of American business. While it’s easy to bitch about American carmakers investing poorly in quality engineering and forward-looking technologies, major employers like Ford, Chrysler and GM have pension and healthcare legacy costs that our Asian and European competitors do not. Among other problems (stratospheric executive pay for one) healthcare costs are driving the country’s airlines into bankruptcy and/or viciously adversarial negotiations with the employee unions. Pick any sector of American industry and the same problem appears. […]

  26. 26
    LLeo says:

    Another interesting question in the Health Care debate is:

    Is Health Care condusive to Free Market solutions? Take for example drugs. If there is a drug that will save your daughter/son from childhood lukemia, how much will you pay for it? I’d think you’d mortgage you home and rob a bank if it were necessary.

  27. 27
    mitch says:

    Can someone explain why healthcare is a “right”? I suggest it’s not. I further suggest that until we abolish group health or any system wherein the healthy subsidize the non-healthy, we will never “solve” a non-existent problem. Those who take care of themselves should not be penalized under single payer or group rates for those who don’t take care of themselves. Furthermore, if one wants to purchase catastrophic insurance to cover then they are free to do so.

    Besides, given that everyone (including illegal aliens) can go to an ER – no one is denied healthcare in the country if they want to avail themselves of it.

  28. 28
    Darrell says:

    The linked article shows that a decent proposal modeled after the more successful implementations, and not embarrassing screwups like, say, England or Hillarycare, could easily win the fierce loyalty of a broad swath of American business.

    Of course many big businesses would “fiercely” be for it, unloading their business costs for health insurance onto taxpayers, just like many businesses are doing with their hiring of illegal aliens, in which they enjoy low labor costs, while Joe Taxpayer ends up footing the bill to educate the children of the illegals, paying that other other of their social costs.

  29. 29
    Decided FenceSitter says:

    From what I remember of the last World Health Organization report, the U.S. does have the absolute best health care. However, it ranks towards the bottom of the pile when you look at the aggregate health care that all U.S. citizen have.

    Basically –

    1) If you compare the best care in U.S. versus the best in the European model, the U.S. comes out on top.

    2) If you compare the worst care in the U.S. versus the worst care in the European model, the European model comes out on top.

    3) If you compare the middle range of care in the U.S. versus the middle range of care in the European model, the European model comes out on top.

    Statistical Annexes can be found here. And please note that the WHO collects and compares figures to make sure that all figures are compared at the same level.

  30. 30
    capelza says:

    mitch…reason.com is that a way ——>

    What is a right anyway? Why should I subsidize police, I have never had to call them, because I chose the neighbourhod I live in carefully. Just because others choose it ain’t my problem. That was sarcastic, but again, what is a right? Why shold a life and death decision about healthcare be determined by market forces and a stockholder’s dividend?

    The healthy subsidizes the unhealthy..while I agree in spirit…the healthy can be struck by an unforseen illness or accident just as easily. But I believe that something has to be done. My family pays through the nose for catastrpohic insurance and we never go to the doctor except for annual check ups. I’ve paid out untold amounts of money because I realise that anything can happen.

    The ER will take care of an immediate situation, it will not treat an ongoing illness like uterine cancer or parkinsons.

  31. 31

    Mitch’s remarks remind me of a core belief I hold about Libertarianism.

    For the vast majority of libertarians, it’s a cover for the politics of selfishness. Most of the arguments can be boiled down to: “Why should I pay one thin dime for the other guy’s benefit?”

    As a rule (not always, but generally) these people disbelieve any evidence or logic which might answer such a question. They tend to dismiss the theory of comparative advantage. Demonstrations of the increase of US economic power occurring subsequent to provisions (economic, educational, and otherwise) that assist the non-wealthy are dismissed as either unique or coincidence.

    Arguments that a healthy and well-educated general populace means that everyone benefits fall on deaf ears. Lower costs overall as ERs are no longer health clinics by default? balderdash. Greater pool of qualified applicants for skilled labor? humbug. More people able to contribute to instead of depend upon the public welfare? preposterous.

    I don’t argue with the position any more. I simply ask them to demonstrate how their position is NOT selfish. How is it anything other than “I’ve got mine, go get your own?”

    And wonder why they believe themselves so self-sufficient when they don’t farm their own food and pump (and distill) their own fuel.

  32. 32
    jcricket says:

    Taiwan recently switched from a health care system similar to ours to a national single-payer system with universal coverage. There were all the same objections & fears that “free market” health care proponents make here. All those objections/fears turned out to be unfounded. The switchover is now almost universally recognized as the right thing to do. It achieved all its goals while nearly everyone now spends less, per person, on their insurance (including the “healthy” who are supposedly “subsidizing” the sick).

    Like so many other countries, the economics of health care make a pooled, single-payer system the most cost-effective model both for achieving universal coverage and for increasing access to preventative and emergency measures. Moreover, the “health care customer satisfaction” rates in all these countries is way higher than ours.

    Oh and Mitch – assuming you’re not a spoof: I hope you get work out a lot, then get cancer and die. Then I will laugh at you. Perhaps learning that a significant portion of diseases are not controllable by being “healthy” would teach you something. That you seriously offer emergency room treatment, catastrophic (not preventative) insurance and “survival of the richest” as the model for health care in America is pathetic and disgusting.

  33. 33
    RSA says:

    Those who take care of themselves should not be penalized under single payer or group rates for those who don’t take care of themselves.

    This seems to be based on an assumption that the set of people who don’t take care of themselves is the same as the set of people who cost the health care system (broadly construed) the most money. In other words, “If you get sick, it’s your own fault.” While this is consistent with a prevalent conservative view that poverty is a moral failing, I don’t buy it. Even if it were true, it would be a simple matter to tailor the rules of public health care not to cover specific types of cases or treatment (e.g., sky-diving injuries would require extra insurance).

  34. 34
    srv says:

    Of course many big businesses would “fiercely” be for it, unloading their business costs for health insurance onto taxpayers just like many businesses are doing with their hiring of illegal aliens, in which they enjoy low labor costs, while Joe Taxpayer ends up footing the bill to educate the children of the illegals, paying that other other of their social costs.

    Darrell sees the future of the Republican party. He just hasn’t figured out yet that the affordable, community college educated nurse wiping his ass in the old folks home isn’t going to be a native.

  35. 35
    mitch says:

    And there is a problem with selfishness? I can voluntary contribute money to “the poor” to “ill”, but to be required to do so and have no say-so in the matter…?

    As far as hospitals covering long-term diseases – again, purchase catastrophic health insurance – no one is stopping you. IF that means a reduction in your “style of living” so be it.

    TANSTAAFL

  36. 36
    capelza says:

    mitch…how old are you? Do you have kids? Are you covered by health insurance at work?

    “style of living”..ha.

  37. 37
    mitch says:

    How about Type 2 diabetes treatment – a totally individual-controllable disease. Why is this different than sky-diving? How about dental care? Obesity?

  38. 38
    capelza says:

    Also, Mitch…you do have a say so..keep voting Libertarian or move to your own island. It this pesky democracy thing. If most people vote for folks that want something done about healthcare..you can “voluntarily” move elsewhere, right?

  39. 39
    mitch says:

    Oh and Mitch – assuming you’re not a spoof: I hope you get work out a lot, then get cancer and die. Then I will laugh at you. Perhaps learning that a significant portion of diseases are not controllable by being “healthy” would teach you something. That you seriously offer emergency room treatment, catastrophic (not preventative) insurance and “survival of the richest” as the model for health care in America is pathetic and disgusting.

    Not before you die of the hatred and bile you’re building up for those who disagree with you.

    Cancer – catastrophic healthcare insurance
    Preventative healcare insurance – good idea
    Subsidize idiocy – I think not

  40. 40
    VidaLoca says:

    mitch, channeling Anatole France:

    “How noble the law, in its majestic equality, that both the rich and poor are equally prohibited from peeing in the streets, sleeping under bridges, and stealing bread!”

  41. 41
    mitch says:

    I can voluntarily move elsewhere. Of course given that Franklin’s admonition about a “republic if we can keep it” is, unfortunately gone.

    You must be one of the wolves who want to disarm the sheep

  42. 42
    mitch says:

    Want to help the poor – do so on your dime. Oh and read Arthur Brooks’s, Who Really Cares: America’s Charity Divide; Who Gives, Who Doesn’t, and Why It Matters.

  43. 43
    jcricket says:

    One interesting note is that at my employer, they already give employees a chart that shows they spend $400-600/month for an employee’s healthcare. Then each employee is responsible for another $50-200/month (depending on plan, dependents, etc). Based on statistics of spending as a percent of GDP, if America had a single-payer government system, we could spend half of what we do now and still insure everyone (i.e. we spend around 14% now, most countries with universal national coverage spend 6% or less). Plus, since it’s “single payer”, you can think of it as pooling money that businesses + individuals currently pay through payroll taxes, plus all the money spent as part of the federal + state programs. Health care spending would be spread across all employers and all individuals, so spending per person would probably drop even more dramatically (to 1/4 or so of current levels).

    Businesses could then use the extra millions to invest in their own initiatives or to give people raises. Even without the raises, individuals would likely have a far smaller individual portion to pay for health care, so they’d have extra money that they don’t have to spend on health care every month – I suspect a mixture of both. Oh, and we’d eliminate the 40-50% of personal bankruptcies that are due to health care related problems. The number of small businesses might even increase because people won’t lose health care if you lose your job, or switch employers, or start your own business.

    Far from dragging the economy down, or resulting in businesses getting richer while people get poorer, everyone would get richer and most people would get healthier. For some people you’d get no healthier, but at least you’d have a little less worry. And the richest? They’d still be able to buy their way into pretty much whatever health care they want.

  44. 44
    canuckistani says:

    Where are the trolls with the stories about some Canadian who had to wait for a knee replacement? I’ve seen the Canadian health care system when my family really needed it, and as far as I’m concerned, it’s worth every tax penny I put into it and more.
    It’s also nice to think that my neighbour won’t be stealing my tv to pay for his son’s open heart surgery.

  45. 45
    capelza says:

    mitch, you didn’t answer my questions…would you please?

    You focus on the poor…I’m more concerned about the working class and the middle class that can not afford the catastrophic insurance you tout so highly. Let alone the preventative care insurance.

    You never did answer my questions. How old are you. are you covered by an employer, do you have kids?

  46. 46
    jcricket says:

    TANSTAAFL

    Did you read the article about Taiwan? In the case of health care, you are absolutely wrong. You can cover everyone, increase preventable treatment and not worsen access to care for anyone while spending less, yourself.

    And btw,

    Not before you die of the hatred and bile you’re building up for those who disagree with you.

    Nope, not “those”, just people like you that think the appropriate health care solution is letting the poor people die. Your complete ignorance of how people get diseases (hint: it’s not just bad choices), how they most effectively be prevented and inability to look into the solutions pretty much every other industrialized nation is using to solve those problems is pathetic.

  47. 47
    mitch says:

    I am 55, and I do have kids who are in college full time, and yes, they are covered by health insurance from both my wife’s and my work. And your point is…? Of course, we pay the premium for thier coverage. Only my wife and I are covered by our employers.

    You’re in the “middle class” or “working class” (whatever they are), don’t buy the color TV, or ATV, or beer, or a home you can’t afford, or the Sony PS3 – you get the point…All of us make choices…

    TANSTAAFL

  48. 48
    jcricket says:

    You focus on the poor…I’m more concerned about the working class and the middle class that can not afford the catastrophic insurance you tout so highly. Let alone the preventative care insurance.

    Mitch also seems painfully ignorant about how it works when the healthy opt out of insurance and only the sick remain. Something known as adverse selection – that would cause rates for insurance to sky-rocket.

  49. 49
    mitch says:

    Don’t want the poor to die – educate them and medicate them – Gather your like-minded friends and family and raise the $$ yourself. You just don’t want to do the work when the gofernment can do it. Sounds to me like you’re amazingly lazy and totally self-absorbed Mr.(?) Bile

  50. 50

    Uh, mitch? We do *not* have catastrophic insurance in this country, dude.

    How do I know? I was lucky — my wife and I chose to spend more than we could afford during a period when I had no benefits, just so that we wouldn’t get nailed if one of the kids got sick. We carefully husbanded our resources to pay for a hospital stay for her before she became pregnant, and made sure that we’d covered all reasonable contingencies.

    Then our baby was born — and spent two weeks in NICU. If it hadn’t been for our foresight and sacrifice, we’d have been ruined. Thanks to our foresight, though, we only accumulated about 20K of hospital bills, and payed those off over the next few years.

    So, how were we lucky? We were lucky that our child was born in 1994. Nowadays, Florida Blue Cross Blue Shield refuses to pay claims for babies under the age of six months.

    That’s right, boys and girls, newborns are not insurable under individual plans in the great state of Florida.

  51. 51
    John S. says:

    Thankfully for the majority of us, those that attain fantastic wealth do NOT usually subscribe to Mitch’s philosophy of FYIGM (Fuck you I got mine).

    Philanthropy is the classic antidote for people like Mitch.

  52. 52
    mitch says:

    The rates should skyrocket – It’s caled the market. As THomas Hobbes stated, Life is “Nasty, brutish and short” Get over it and face reality.

  53. 53
    Jay says:

    How about Type 2 diabetes treatment – a totally individual-controllable disease.

    He must be a spoof. No one could be so blatantly wrong by accident. Could they?

  54. 54
    mitch says:

    The rates should skyrocket – It’s called the market. As Thomas Hobbes stated, “…and the life of man, solitary, poor, nasty, brutish, and short.” Get over it and face reality.

  55. 55
    Pb says:

    Some interesting statistics here:

    The uninsured are 30 to 50 percent more likely to be hospitalized for an avoidable condition, with the average cost of an avoidable hospital stayed estimated to be about $3,300 (11).

    The increasing reliance of the uninsured on the emergency department has serious economic implications, since the cost of treating patients is higher in the emergency department than in other outpatient clinics and medical practices (8).

    …that lead to their conclusion: “Getting Everyone Covered will Save Lives and Money“. I find that convincing, but of course even that wouldn’t be enough to convince the real dyed-in-the-wool, “I’ve got mine” Glibertarians out there.

  56. 56
    capelza says:

    Thanks for answering Mitch.

    My family doesn’t buy the PS3 (or any of that crap), our Tvs are at least ten years old and work fine…our “lifestyle choice” is pretty simple (cable is our big treat, hence my presence here). We are also self employed, I raise food in the garden and we don’t go to the mall, drive older cars, etc, etc…we have never been to the hospital, as I said, rarely go to the doctor and still we have to pay over 800.00 a month for catstrophic insurance, with a 5000.00 deductible. Because we are in our 50’s.

  57. 57
    mitch says:

    I had my Diabetes Quarterly checkup today. You’re ignorant if you don’t know that it is a totally controlable by exercise and diet.

  58. 58
    mitch says:

    My family doesn’t buy the PS3 (or any of that crap), our Tvs are at least ten years old and work fine…our “lifestyle choice” is pretty simple (cable is our big treat, hence my presence here). We are also self employed, I raise food in the garden and we don’t go to the mall, drive older cars, etc, etc…we have never been to the hospital, as I said, rarely go to the doctor and still we have to pay over 800.00 a month for catstrophic insurance, with a 5000.00 deductible. Because we are in our 50’s.

    Sounds like your problem is with a) choices you’ve made in life, and b) actuaries

  59. 59
    ThymeZone says:

    I further suggest that until we abolish group health or any system wherein the healthy subsidize the non-healthy,

    Wow. You’ve just swept away the entire rationale for all insurance models in one sentence.

    Insurance is a risk-sharing scheme, and it works, which is why it is such a successful business.

    The issue here is not whether insurance works. That question is not on the table, either here or anywhere else, so take your trollish bullshit and go away. Without insurance and appropriate risk sharing, life basically becomes a game of Roulette, and not many people are going to settle for that. A few lunatics might, but who cares? Americans will choose otherwise.

    The issue here is who is covered by the insurance, and how it is paid for. That’s the question that will decide the future for most Americans, and unless you are ready to discuss it reasonably, you have no business here.

  60. 60
    capelza says:

    Thanks mitch! I see the light..I am no longer going to pay the portion of my taxes that goes to public security, like police, etc. We have guns, we can take care of ourselves! Why should I pay for the pussied who think that dialing 911 is a god given right?

    After all, life is nasty, brutish and short!

  61. 61
    Tim F. says:

    Jay:

    He must be a spoof.

    Mitch:

    The rates should skyrocket – It’s caled the market. As THomas Hobbes stated, Life is “Nasty, brutish and short” Get over it and face reality.

    I find Jay’s thesis awfully hard to contradict.

  62. 62
    Decided FenceSitter says:

    You know when someone starts quoting Hobbesian philosophy I have to giggle.

    Because Hobbes was actually all about order, we surrendered rights to the nation because to do so otherwise meant that man was in a state of nature, nasty, brutish and short. And it was only in surrender our right to kill another man to get what they had that we arose from that squalor and became something more, and that is why we do not have the right to rebel against a tyrrantical dictator, because the alternative was so much worse. Read Leviathan if you are going to try and quote Hobbes, and while you are at it, read Locke, who is far close to the progenitor of the American rule of law and social contracts, as he gave us the right to rebel.

    That’s it class. Political Theory 101 is done. Class dismissed.

  63. 63
    mitch says:

    The issue here is who is covered by the insurance, and how it is paid for. That’s the question that will decide the future for most Americans, and unless you are ready to discuss it reasonably, you have no business here.

    Tolerant, aren’t you. Didn’t know it was your blog. LIfe is roulette – wake up and smell the reality. You just want to even the odds with the house and force others to pay for your gambling.

  64. 64
    John S. says:

    Sounds like your problem is with a) choices you’ve made in life

    Take that, capelza!

    You chose to not be rich enough to afford exorbitant healthcare costs AND you chose into live to your 50s. Had you dropped dead already, you wouldn’t have to worry about catastrophic insurance.

    Take some personal responsibility, man.

  65. 65
    Pb says:

    Yeah, I’m with Tim F. on this one.

    YHBT. YHL. HAND.

  66. 66
    capelza says:

    John S..oh snap!

    “And if they would rather die, they had better do it, and decrease the surplus population.”

  67. 67
    Tim F. says:

    Of course many big businesses would “fiercely” be for it, unloading their business costs for health insurance onto taxpayers, just like many businesses are doing with their hiring of illegal aliens, in which they enjoy low labor costs, while Joe Taxpayer ends up footing the bill to educate the children of the illegals, paying that other other of their social costs.

    Cut out the rhetorical fluff and what do you know – Darrell agrees with me. Hosannah.

  68. 68
    mitch says:

    Thanks mitch! I see the light..I am no longer going to pay the portion of my taxes that goes to public security, like police, etc. We have guns, we can take care of ourselves! Why should I pay for the pussied who think that dialing 911 is a god given right?

    After all, life is nasty, brutish and short!

    Yes, it is. And – the police have no obligation to defend your life when you call 911. That’s reality (and a SCOTUS decision). Their job is to pick up the pieces after the fact.

    Read Leviathan if you are going to try and quote Hobbes, and while you are at it, read Locke, who is far close to the progenitor of the American rule of law and social contracts, as he gave us the right to rebel.

    I have. Whether one agrees with Hobbes or Locke, even those with whom we disagree can be right on occasion. LIfe is what Hobbess stated – Reality for those who walk around life with their eyes open. The rest complain about governmnet’s lack of action on one’s particular cause…

  69. 69
    ThymeZone says:

    LIfe is roulette – wake up and smell the reality

    The reality is that the goofy “you’re on your own” model of America went away about 100 years ago, and it is not coming back. For that matter, your goofy model of any Western, or more recently, even Eastern, model of the middle class never existed in the first place. The whole idea of a middle class requires that people stand on the shoulders of other people. There’s no middle class without shared risk and shared opportunity.

    Your spoof-assed rhetoric isn’t useful here. Go away. That’s reality.

    “My blog?” Of course not, but I’ll bet you ten dollars that you can’t find three people here who think you have anything to contribute to this thread.

    Money, mouth, etc.

  70. 70
    ThymeZone says:

    Hobbes and Locke? Ah, you are a spoof. Every spoof has his tell.

  71. 71
    ThymeZone says:

    Darrell agrees with me. Hosannah.

    Do tell. Can you and Darrell tell us exactly how much the education of illegal aliens is costing you? In USD, please.

    Thanks.

  72. 72
    mitch says:

    The reality is that the goofy “you’re on your own” model of America went away about 100 years ago, and it is not coming back. For that matter, your goofy model of any Western, or more recently, even Eastern, model of the middle class never existed in the first place. The whole idea of a middle class requires that people stand on the shoulders of other people. There’s no middle class without shared risk and shared opportunity.

    Your spoof-assed rhetoric isn’t useful here. Go away. That’s reality.

    “My blog?” Of course not, but I’ll bet you ten dollars that you can’t find three people here who think you have anything to contribute to this thread.

    Money, mouth, etc.

    Damn, the tolerance for disagreement is astounding.

  73. 73
    Ben says:

    The line about people coming to the United States for health care is just BS. They come here by and large for ELLECTIVE surgeries (Yes I’m sure the idiots out there will come up with three or four examples that counter this… that are probably imaginary.) They don’t feel like waiting the extra two to three weeks it’ll take so they come here. That option will still be available for the rich.

    The “philosophical” opposition to universal health care coverage usually boils down to: “Then I have to pay for the brown poor people.” As if we’ll all be asking Darrell and mitch to personally subsidize Detroit.

    Oh and the charity argument is a false one. Do we really need to be setting up charities to provide health care to your average small business owner, or independant contractor? Those are the people most often hurt by their lack of access to affordable insurance.

  74. 74
    ThymeZone says:

    the tolerance for disagreement

    You mean, the tolerance for spoofy theatrics?

    High in my case, but there’s a difference. I’m really good at it when I do it, whereas you suck.

  75. 75
    Cyrus says:

    mitch Says:
    And there is a problem with selfishness? I can voluntary contribute money to “the poor” to “ill”, but to be required to do so and have no say-so in the matter…?

    As far as hospitals covering long-term diseases – again, purchase catastrophic health insurance – no one is stopping you. IF that means a reduction in your “style of living” so be it.

    TANSTAAFL

    Oh, cool, I haven’t read anything by Robert Heinlein in years! Not since I turned 16 or 18, actually. Wow, this brings me back. Remember when we were young and idealistic enough to think that one author’s conception of life on the moon should guide American politics?

  76. 76

    Ah, yes, the Brooks book. Based, at core, on an analysis which makes it impossible for a state with a greater than median income to score better than median on its philanthropy index. It uses flawed statistical reports that have been publicly challenged and usually dismissed ( and frequently even then mis-states the original values).

    All to say, “Liberals are evil.”

    Some of the flaws? Apparently only conservatives go to church, as any church-related support is “conservative.” Apparently EVERYONE in a state is either conservative or liberal. Per capita and absolutes are used with little attempt to sustain apples to apples comparisons – the method of examination chosen is based upon which supports the author’s thesis – conservatives good, liberals evil.

    I’ve read the book, Mitch. I find it as compelling and accurate as Fahrenheit 911 or pretty much anything written by Ann Coulter. That is to say, as long as you ignore context and inconvenient competing information and the occasional contrary fact, it’s an absolutely compelling proof of its thesis.

  77. 77
    srv says:

    Funny, where are all these BJ’ers who tested as ‘libertarian’ last year? What, they were all just compassionate-libertarians?

    People aren’t getting healthier. They’re getting sicker, and will be getting sicker longer (at least until right-to-die or required-to-die passes). And Doctors and drugs won’t bet getting cheaper.

    Y’all seem to think we could adopt a Canada model. Well, you’re smoking crack. We’ll have national healthcare when the pharmohealthcorps can extract maximum wealth from your paycheck and savings. And not a day before.

    But no price is too steep, and you must be selfish to think so. Who will save the children?

  78. 78
    mitch says:

    Hobbes and Locke? Ah, you are a spoof. Every spoof has his tell.

    No spoof – Just a recognition of reality. You want to coerce people into paying for your healthcare. I don’t. You believe healthcare is a “right” I don’t.

  79. 79
    Tim F. says:

    Can you and Darrell tell us exactly how much the education of illegal aliens is costing you?

    That was the rhetorical fluff. The meat was in his first sentence.

  80. 80
    RSA says:

    And there is a problem with selfishness?

    Ayn Rand has done her work well, I see.

    Don’t want the poor to die – educate them and medicate them.

    Talking about “the poor” as if they’re cattle begins as a state of mind.

  81. 81
    Tulkinghorn says:

    Jay Says:

    I say launch Viking-style raids against the health insurance corporations. Or at least, impose stricter regulations to an industry that has become the gatekeeper between patients and providers.

    I’m with you on the Viking-style raids. Aetna just stiffed me more than $800. Where do I sign up for berserker training, and do I really have to wear a bearskin?

  82. 82
    ThymeZone says:

    You want to coerce people into paying for your healthcare. I don’t. You believe healthcare is a “right” I don’t.

    You picked the wrong person to attack by trying to put words i my mouth, amigo. Sorry.

    What I believe is that access to healthcare for the general population is a necessity in a modern liberal society, and you will find that by and large, and more and more as time goes on, people agree with me, which is why I’ll win this contest and you won’t.

    It’s also why most of the Western world has moved in that direction and why the United States will move there. The modern middle class model requires it.

    I have no idea what societal and economic model you envision, but whatever it is, it exists only in fiction.

    Back to you, spoofmonkey.

  83. 83
    mitch says:

    conservatives good, liberals evil

    No, both are more evil than good insofar as using the force of government to pay for one’s follies.

  84. 84
    ThymeZone says:

    That was the rhetorical fluff. The meat was in his first sentence.

    I know, but I figured since you guys are writing Darrell, I’d throw you a curveball.

    :-)

  85. 85
    mitch says:

    You picked the wrong person to attack by trying to put words i my mouth, amigo. Sorry.

    What I believe is that access to healthcare for the general population is a necessity in a modern liberal society, and you will find that by and large, and more and more as time goes on, people agree with me, which is why I’ll win this contest and you won’t.

    It’s also why most of the Western world has moved in that direction and why the United States will move there. The modern middle class model requires it.

    I have no idea what societal and economic model you envision, but whatever it is, it exists only in fiction.

    Back to you, spoofmonkey.

    OK Rosemary Clooney – you may win the argument, but so what? That speaks to our public education system and the infusion of socialism in our culture.

    But hey, enjoy your victory and bankruptcy. I’ll take your advice and get outta here.

  86. 86
    Sherard says:

    Why would I expect anything less from the Balloon Juice comment section.

    Start from the premise that our health care system is “broken”, then link prominently to proof that said health care system is broken in someone’s apparent “right” to a liver transplant.

    I got news for you folks, when you start thinking you have some government underwritten or God give “right” to a liver transplant, you have already explained why we are in the situation we are. What happens when you are 80 years old and need a liver transplant ? What about 90 ? 100 ?

    You all think there is some simple solution to this, but there isn’t. And the questions that really comprise the problem are not who pays and how much, it’s based in where is all the money going and why ?

    And as far as Taiwan goes, I’m sure we could go over all the ways in which the US is similar to Taiwan. I’m just positive whatever they did there will work just peachy in the US.

    For jcricket, sure I suppose it’s possible the cost could go down. Besides the fact that nobody wants to think about how many people end up out of work for all that 6% of the GDP we no longer have to spend, always keep in mind that you get what you pay for.

    Which is why Europeans don’t come here for healthcare, but they DO go to private hospitals in Europe.

    I am all for government action to help reduce health care costs and increase coverage. I am also aware that anything the government touches turns to crap. So I’m pretty much resigned to the fact that we will ultimately have universal health care at some point, but I am also resigned to the fact that my health care will decline as a result.

  87. 87
    ThymeZone says:

    using the force of government to pay for one’s follies

    So if you catch West Nile disease from a mosquito tomorrow, and are in hospital for four months …. that’s your folly?

    How about bipolar disorder? Folly?

    If your child is born with a cleft palate. Your folly?

    Where do you live, man? North Korea?

  88. 88
    Michael says:

    I read an intelligent article during the 2004 election. If I recall the argument was something like “the free market can solve a lot of problems, but there is no free market incentive to insure sick people. The free market pressure is for private insurance companies to find ways to maximize profits by not insuring sick people”. It’s obvious once you hear it, but it explains the many challenges our healthcare systems face. The article went on to propose that private insurance should become portable (not tied to your current employer) and that the government should become the insurer of last resort (like it is with flood insurance). By taking the costly patience requiring chronic care out of the hands of private insurerers, we could make the current private insurance more efficient and portable. It made sense to me.

  89. 89
    ThymeZone says:

    you may win the argument, but so what?

    Heh. Buh-bye.

  90. 90
    Tim F. says:

    I am also aware that anything the government touches turns to crap.

    Normally I would disagree with you. But since Katrina, Iraq, Medicare pt. D and so on I have to admit that you have a point. So yeah, we should probably wait to implement this until we get a president who doesn’t have the reverse Midas touch.

  91. 91
    Ben says:

    I am all for government action to help reduce health care costs and increase coverage. I am also aware that anything the government touches turns to crap. So I’m pretty much resigned to the fact that we will ultimately have universal health care at some point, but I am also resigned to the fact that my health care will decline as a result.

    Take comfort… my wife is Canadian…. and the health care she received was no worse than the patient mill the Aetna forced me to go to at my last employeer. (Here’s a dirty little secret… her families care was actually better) What scares me is I had the “good” coverage that they offered. I often wonder what the care would have been like if I had to take the coverage they offered the peons…

  92. 92
    ThymeZone says:

    I am also aware that anything the government touches turns to crap.

    So, that explains why airplanes are raining from the sky, owing to the failure of FAA and NTSB?

    Why you can’t drive a car from LA to NYC owing to the lack of a federal highway system?

    Why the streets are awash in blood, owing to the failure of government to maintain order and suppress crime?

    Why you have no warning of hurricanes and blizzards, owing to the failure of the government to provide you with weather information?

    Why you can’t get an education, owing to the absence of any public eductation system? Why you can’t go to college, because there are no Land Grant colleges out there?

  93. 93
    Jay says:

    I had my Diabetes Quarterly checkup today. You’re ignorant if you don’t know that it is a totally controlable by exercise and diet.

    Thanks mitch, you don’t need to keep proving you are a spoof but I appreciate your efforts. I wouldn’t dare assume you’re one of those selfish types who thinks that because you’re type II is controlled that way, everyone else’s can be controlled the same way.

    Where was I? Oh yes, ER as primary health care. If you want to talk about something that drives up the hosptial costs and the buggers the economy in general, you’ve found it.

    ER care is some of the most expensive care on offer. People who lack health insurance and resort to the ER for health care are usually very, very ill because they’ve waited until the cut starts to smell funny or they’re hacking up blood. Why? Because they know they’re going to get hit with a huge bill. People who aren’t so ill get patched up and referred to a doctor (and a big bill), they can’t afford to go to a doctor so if they don’t get better, guess where they wind up? Only now they have to be admitted because they’re too sick for a quick patching up. In addition, these people are missing work which means whatever they were hired to do isn’t getting done. If they aren’t working (and aren’t on Medicaid/Medicare) they’re wracking up huge expenses in the hospital that the hospital will have to eat (if it can’t be passed on to other patients/insurance companies).
    But this proves the old saw about an ounce of prevention.
    If there were at least some basic wellness program for all Americans a lot of these costs evaporate or shrink. If a guy with a broken bone or a cough that won’t go away could get help when he breaks his arm or during the second week of the coughing fits; We’d be looking at the price of setting a bone v. orthopaedic surgery, treating bronchitis early on v. a serious case of pneumonia. We might have a more productive work force, we might see lower hospital costs all around, which might result in lower health insurance costs. Though I doubt this last one, those guys know they’re on to a good thing.

  94. 94
    radish says:

    Don’t hold your breath for statistics (unless Paul provides some, in which case, as suggested above, hold your nose instead).

    If there are any real statistics about the “house effect” on US infant mortality measurement, they’re not going to show up in a Glueck/Cihak astroturf article (for some reason this conversation is reminding me of Tim Lambert’s flypaper post).

    Apparently the origin of this claim is some “research” by a rabid scholarly opponent of healthcare reform, noted epidemiologist economist, and wingnut welfare recipient who probably couldn’t run a real business if he inherited one with no debts respected professional pundit named John Goodman. I’ve been poking around for about fifteen minutes now and I have yet to find any indication that his numbers or methodology were ever published. They may be in one of his books, or they may not. Offhand I would guess that the US infant mortality measurement probably is counted high, rather than low, compared to other OECD nations. But if anybody can find any evidence that the effect is statistically significant, I’d love to see it.

    In fairness to Mr. Goodman, he is (I absolutely kid you fucking not!) a winner of the Duncan Black award for scholarly economic writing… Examples of his high quality work can be found here.

  95. 95
    Perry Como says:

    srv Says:

    Funny, where are all these BJ’ers who tested as ‘libertarian’ last year?

    I’m one. I fall on the practical side of things and in the case of healthcare, the system is horribly broken. The market has failed so we need to find some way to fix the system by other means. If we can find a reasonable way to do that with government involvement, then so be it.

  96. 96

    Damn, the tolerance for disagreement is astounding.

    If you assert something, you ought to be willing to back it up. Don’t start whining about how intolerant people are when people demand you backup your assertions.

  97. 97
    Detlef says:

    The Other Steve wrote:

    My understanding is that the counting [for infant mortality] is different. That is, in the USA a preemie who dies at birth is counted, whereas in many countries that is not the case. Part of this perhaps is that the USA mandates medical care for preemies even if they are surely going to die because they were born way too soon.

    I don´t know…
    In Germany a newborn baby counts as living at birth when
    a) the heart was beating or
    b) the umbilical cord was “pulsing” or
    c) natural breathing had started
    If one of these conditions is met, the baby (regardless of the pregnancy week) was living at birth. And if it dies, it will get registered (and counted in the infant mortality rate).
    If none of the conditions above are met but the preemie weights at least 500 grams at birth then it counts as a stillborn baby. Which will still get registered and documented.
    Only if a preemie weights less than 500 grams and hadn´t shown any signs of life at birth (see conditions above), it counts as a miscarriage and won´t get documented.

    Are the USA counting preemies weighting less than 500 grams, heart not beating and not breathing at birth in their infant mortality rate?

  98. 98
    capelza says:

    White Collar Libertarians drive me crazy. The ones that hole up un the boonies and raise and kill their own food, yeah..at least I can repsect them (sppoky as they may be), but the ones that get their insurance from their employers, avail themsleves of everything that the federal governemt has provided and still act like they are hardcore make me sick.

    Ayn Rand, Grover Norquist..sorry these people make me sick.

    A little heads up for the “going it alone” folks…the frontier is gone, our population has doubled in 50 years. The fanatsy doesn’t exist.

  99. 99
    Pb says:

    link prominently to proof that said health care system is broken in someone’s apparent “right” to a liver transplant

    What’s the alternative–to presume that Delbert Davis’s death is proof that the system works? What’s the goal, again?

  100. 100
    srv says:

    So, that explains why airplanes are raining from the sky, owing to the failure of FAA and NTSB?

    You haven’t heard of the faith-based Class W airspace changes?

    Why the streets are awash in blood, owing to the failure of government to maintain order and suppress crime?

    Wow. If it wasn’t for gov’t maintaining order, we’d all be out there butchering each other.

  101. 101
    Zifnab says:

    Why the streets are awash in blood, owing to the failure of government to maintain order and suppress crime?

    US cities are no safer than any given province in Iraq. I know this because an incompetent government spokesman told me so.

    Also, Medicare Plan D was a disaster. The FEMA response to Hurricane Katrina was pathetic. The entire Iraqi War is just one giant pit we keep shoveling dead soldiers and money into. This proves, catagorically, that the All Governments Everywhere should dissolve their medical programs, abandon attempts at disaster relief, and disband the military.

    I’m with Mitch on this one. Every man for himself.

  102. 102
    Zifnab says:

    Are the USA counting preemies weighting less than 500 grams, heart not beating and not breathing at birth in their infant mortality rate?

    I believe we recognize that life begins at conception. That’s why are infant mortality rate is so high.

  103. 103
    srv says:

    Where was I? Oh yes, ER as primary health care. If you want to talk about something that drives up the hosptial costs and the buggers the economy in general, you’ve found it.

    Funny, I live near a community free-clinic, supported by the city. So why can’t other cities have clinics and ERs? Is it really rocket science? We must go to Washington DC to figure out the answer to this problem?

  104. 104
    jcricket says:

    I am also aware that anything the government touches turns to crap.

    Hello Republicans, I’d like to introduce you to my friends, the Self Fulfilling Prophecy and the Pygmalion effect.

    But seriously Sherard – You are aware that within our own country, the structural fixes enacted to the two big government healthcare programs – VA and Medicare – during the 90s (under conservative bogey-man President Clinton) resulted in the opposite of “crap” right? They reduced overhead costs, increased the standard of core, decreased errors and increased patient satisfaction.

    And I don’t need to use Taiwain by itself as a vision for US healthcre. I can combine the experience of Taiwan (a recent convert to nationalized healthcare with a free market economy similar to our own) with all the experiences of Canada, Japan, the UK, Germany & France, to name just a few. The conclusion is simple, universal “single-payer-ish” healthcare largely solves all the problems we have while costing less and covering more.

    No health care system is without flaws, but the flaws in each government system mentioned above are far more easily fixable (i.e. The Japanese overuse prescription drugs because they’re too cheap under their plan – So raise the cost of drugs or lower the limit, or make it harder to get, or whatever. Problem solved), especially when compared to the massive structural defects, patchwork coverage and bankruptcy causation of our current system.

    Let’s not let the perfect be the enemy of the very, very good.

  105. 105
    RSA says:

    So, that explains why airplanes are raining from the sky, owing to the failure of FAA and NTSB?

    Another example: Hardcore libertarians take it as an article of faith that the FDA is a bad organization. One once told me that the FDA kills hundreds of thousands of people every year by preventing some drugs from coming onto the market.

    By the way, if anyone happens to know of a spoof article I read some years ago about libertarianism, could he or she post a link? It’s a straight first-person account of a guy who goes off into farm country, if I remember correctly, builds his own house and lives his life of self-sufficiency. As the article goes on, he encounters more and more trials (road building, doctoring, etc.) that he meets with enormous competence. A great piece.

  106. 106
    jcricket says:

    People who lack health insurance and resort to the ER for health care are usually very, very ill because they’ve waited until the cut starts to smell funny or they’re hacking up blood. Why? Because they know they’re going to get hit with a huge bill

    This is very true (and elsewhere in this thread people have quoted actual $ figures to prove why the ER is just about the worse model for regular care). You want to know what’s worse? The magical “health savings accounts” which have the same issue, only for healthy people. Healthy people would say “bargain”, and opt out of insurance (side effect – raising rates for the unhealthy). They may or may not set aside money in their HSAs, but they will most likely delay getting care for as long as possible to maintain their “health savings” – or because they’re convinced they’re “healthy”. Of course, then they end up so sick that the care they require very expensive emergency/non-preventative interventions. And, unless you’re a subscriber to the “die on the street for all I care, just don’t expect me to clean up your body” philosophy, like Mitch, they’ll end up getting that care, at a greater cost to society than necessary.

    This, along with countless other pieces of systemic evidence, means that at this point in time the government-funded national health care system is the practical solution that meets our society’s stated needs/requirements.

  107. 107
    ThymeZone says:

    If it wasn’t for gov’t maintaining order, we’d all be out there butchering each other.

    Well, we’re bloggers.

    Ha ha.

    Of course, any Libertarians who want to do away with police and fire protection, step up and explain yourselves.

    We’re …. tolerant … here.

  108. 108
    RSA says:

    Of course, any Libertarians who want to do away with police and fire protection, step up and explain yourselves.

    The standard response (devil’s advocate, here) is that you pay for your own private police and fire department (ignoring all the complexities involved). Not to mention your own private court system and prison system (ignoring even greater complexities). But at least you’re not subsidizing anyone else.

  109. 109

    ok, let me throw out a fact in the midst of the noise.

    Why at least a minimal universal (single-payer) healthcare can be good. I submit, as evidence, the following diseases:
    Polio.
    Smallpox.
    Rubella.

    Because of the national universal vaccination for these, there have been no incubation pockets for the diseases to survive and mutate. As an example of what can happen here, I submit tuberculosis, for which the vaccine is only 80% successful AND which began being used worldwide a couple of generations later than the polio/smallpox/rubella vaccines AND which has had been ‘optional’ for a measurable portion of the world (and consequently having to be paid for by recipients and AS A RESULT having new variations on the disease turning up due to isolated development pockets.)

    By ensuring that “they” have at least minimal reliable health care, “You” make it harder for something nasty and contagious to develop and spread.

    There’s your selfish reason. Kill smallpox in “them” and you don’t suffer the loss of “yours”.

  110. 110
    ThymeZone says:

    you’re not subsidizing anyone else.

    Right, but if you are born in a hospital with modern medical practice in use, then you are already, on day One of your solitary existence, standing on the shoulders of others who worked their asses off before you to give you the best possible start.

    So I am a little intolerant of deranged full-Monty Libertarianism. It’s a scam.

  111. 111
    TenguPhule says:

    As far as hospitals covering long-term diseases – again, purchase catastrophic health insurance – no one is stopping you. IF that means a reduction in your “style of living” so be it.

    So when given the choice between food on the table and medical coverage, naturally mitch will pick the latter.

    Honestly, Mitch must be getting paid by an HMO to post here. I can think of no other reason why he’d encourage more expensive costs on taxpayers by forcing them to subsidize bailouts of hospitals already drowning under the ER overload by sending even more people to ERs ‘because they can always go there if they’re not covered’.

    Newsflash: ERs are the MOST EXPENSIVE treatment centers.

  112. 112
    jcricket says:

    Another example: Hardcore libertarians take it as an article of faith that the FDA is a bad organization. One once told me that the FDA kills hundreds of thousands of people every year by preventing some drugs from coming onto the market.

    The only thing the hardcore libertarians hate more than the FDA is the SEC (one of the last remnants of the New Deal/Depression-era market reforms). Despite oh, say, 60 years of evidence around the world that markets perform best (read: people invest more and stock prices go up) when us lowly individual shareholders feel they can trust the market, it’s somehow the SEC and their “nasty” regulations that are the problem. Not sure how libertarians explain why the AMEX is a joke and NASDAQ and NYSE (with better regulations and oversight) are thriving, but no matter…

    Libertarians brush-aside every case of corporate malfeasance uncovered, punished and/or prevented by the SEC actions as something where magical “free market forces would have done better”. Despite 50 years of claiming this, they’ve never offered up a reasonable free-market alternative to things like the SEC, FDA, FAA, EPA, OSHA – to name but a few.

    Which brings me to what I consider the worst thing about libertarians – Their wholly undeserved reputation for “seriousness” or “academic-minded” approach. It’s all voodoo/fantasy economics. Smoke and mirrors to hide that their philosophy falls apart under the simplest of scrutiny. In a sane world they’d be laughed at and ridiculed, not considered as people to be taken seriously regarding governing.

  113. 113
    TenguPhule says:

    You must be one of the wolves who want to disarm the sheep

    Sheep have no arms as they march toward the butcher’s block.

    I’ll have my leg of mitch with a side of mint jelly, please.

  114. 114
    ThymeZone says:

    In a sane world they’d be laughed at and ridiculed

    Exactly, which is why we have blogs ;^)

  115. 115
    TenguPhule says:

    The rates should skyrocket – It’s caled the market. As THomas Hobbes stated, Life is “Nasty, brutish and short” Get over it and face reality.

    And if you believe that, you belong in Iraq, mitch.

    Your life will indeed be nasty, brutal and best of all, short.

  116. 116
    AkaDad says:

    I am also aware that anything the government touches turns to crap.

    Do you honestly believe this?

    Some might say you were bashing our troops. =]

  117. 117
    Perry Como says:

    One other thing that sucks about our current health care system, lack of portability. Coming down with a condition that requires a 9 month cycle of drugs and close monitoring by doctors can really put a damper on moving to a new city, buying a house and starting a new business. Pre-existing condition that a new insurer won’t cover and all that.

  118. 118
    jcricket says:

    Exactly, which is why we have blogs ;^)

    True enough, but I also think libertarians and their viewpoints are far over-represented online and specifically in the blogosphere.

    It’s amazing that an overly-simplistic, fundamentally unworkable economic philosophy has taken over as the “guiding principle” for the “serious thinkers” on the right in the last 30 years.

  119. 119
    TenguPhule says:

    I am also aware that anything the BUSH CONTROLLED REPUBLICAN government touches turns to crap.

    Fixed.

    A simple solution to Healthcare.

    Take all Government Officials off that private plan of theirs and make them use the same HMOs they stuck on regular people.

  120. 120
    ThymeZone says:

    It’s amazing that an overly-simplistic, fundamentally unworkable economic philosophy has taken over as the “guiding principle” for the “serious thinkers” on the right in the last 30 years.

    First, you have to build the theater and attract an audience. Call it Goldwater Conservatism.

    When you wait a while and pretty soon some of the performers will begin to believe their lines.

    I think it explains “Libertarian Conservatism” and also explains “Rapture” thinking. Trickle-down economics. Domino theory. Global War on Terror.

    Really, just plug in the parameters for the bullshit generator, and it runs by itself, unattended.

  121. 121
    Detlef says:

    Zifnab wrote:

    I believe we recognize that life begins at conception. That’s why are infant mortality rate is so high.

    LOL!
    All the fertilized eggs that fail the “uterus test”. They don´t nest in because of contraceptives or because the body rejects the fertilized egg.
    American women should treat menstruation as the death of a child. (snark)

    Considering “your” next HHS appointee for family planning that almost seems to be reality.

    ERIC KEROACK is the medical director of an antiabortion “pregnancy counseling” center that refuses to distribute contraceptives or encourage their use — even by married couples. The organization, called “A Woman’s Concern,” says it is “persuaded that the crass commercialization and distribution of birth control is demeaning to women, degrading of human sexuality, and adverse to human health and happiness.” It believes — despite abundant evidence to the contrary — that making birth control available, “especially among adolescents, actually increases (rather than decreases) out-of-wedlock pregnancy and abortion.”

  122. 122
    Punchy says:

    It’s Barney Frickin’ Frank. I’m sure the healthcare fixes only apply to gay men from the Northeast living with pimps and running a brothel from their basement.

    The rest of us heteros get Advil and a bandaid. Which, actually, helps a large number of ailments.

  123. 123
    Faux News says:

    Even though Mitch is a Troll (give me Darrell and scs ANY day) here is a good link (don’t let the std scare you).

    Critiques Of Libertarianism:

    http://world.std.com/~mhuben/libindex.html

  124. 124
    srv says:

    Of course, any Libertarians who want to do away with police and fire protection, step up and explain yourselves.

    You obviously need to get out of your mega-city paradigm ppG and spend some time outside of Phoenixotropolis. Ever heard of a volunteer fire dept? And when people don’t pay for the county/private service, the fire dept shows up and watches your place burn. Libertarianism In Action, right here in the US of A.

    Now, we could all do with alot fewer cops, but I wouldn’t want to turn it over to Blackwater or some private company.

  125. 125
    srv says:

    It’s Barney Frickin’ Frank. I’m sure the healthcare fixes only apply to gay men from the Northeast living with pimps and running a brothel from their basement.

    libertarians wouldn’t have any problem Barney running all the brothels he wants.

  126. 126
    ThymeZone says:

    Ever heard of a volunteer fire dept?

    Sure, I watched Little House on the Pra$irie.

    Of course, the Blind School burned to the ground before the volunteers got there, and the baby died.

    But anyway ….. great idea. I’ll bet you could run for office on a platform of converting America to volunteer police and fire departments. Here’s $20 to get your campaign fund going ….

  127. 127
    jcricket says:

    From the links above, an article from the American Conservative magazine:

    [L]ibertarianism is basically the Marxism of the Right. If Marxism is the delusion that one can run society purely on altruism and collectivism, then libertarianism is the mirror-image delusion that one can run it purely on selfishness and individualism

    I especially liked this part:

    The most fundamental problem with libertarianism is very simple: freedom, though a good thing, is simply not the only good thing in life.

  128. 128
    jcricket says:

    It’s Barney Frickin’ Frank. I’m sure the healthcare fixes only apply to gay men from the Northeast living with pimps and running a brothel from their basement.

    When private insurance is outlawed only gay pimps from Boston will have private insurance?

  129. 129
    srv says:

    [L]ibertarianism is basically the Marxism of the Right. If Marxism is the delusion that one can run society purely on altruism and collectivism

    I submit y’all are alot closer to Marxism than I or mitch are to libertarianism.

  130. 130
    ThymeZone says:

    closer to Marxism than I or mitch are

    You sure you want to associate yourself with mitch?

    He’s … a fruitcake. You aren’t.

  131. 131
    grumpy realist says:

    It’s also always amusing to watch Libertarians talk about why insider trading is so good.

    Uh, guys? The Italian stock market? Wanna know why not much trading gets done? Because it’s known that insider trading is rampant, so if anyone puts something out to sell, people prefer to wait and see what messiness has been hidden in the woodwork.

    I was posting over at Reason for a while on one of their threads. Never did get them to define what libertarianism was.

  132. 132
    Detlef says:

    Oh, and just as an aside for Mitch and others.

    U.S. Census Bureau

    The percentage and the number of children (people under 18 years old) without health insurance increased between 2004 and 2005, from 10.8 percent to 11.2 percent and from 7.9 million to 8.3 million, respectively (Table 8). With an uninsured rate at 19.0 percent in 2005, children in poverty were more likely to be uninsured than all children (Figure 8).

    You might be willing to look at the suffering of children and other sick people, I´m not. But then, on the other hand, I´m not an American citizen. So it is not really “my” discussion.

    I wonder if Mitch got car insurance or any other insurance. After all, if he hadn´t had any accidents, why should he pay for others having car accidents? It seems he fails to grasp the simple idea of “pooling risks”. Which is the basic founding idea of “insurance”.

    Not to mention that he seems not to be afraid enough. Remember the Bush administration? And Islamofascistic terrorism! :)
    Simply put, if anyone ever manages to use a bio weapon in the USA, 40+ million uninsured American citizens will be a perfect breeding ground for it. Because they won´t / can´t go to a doctor in the early stages of being sick. They and millions other Americans under-insured will wait until they´re really sick. Not smart from a disease preventing viewpoint.

  133. 133
    ThymeZone says:

    libertarians wouldn’t have any problem Barney running all the brothels he wants.

    Dinosaur love.

    This is a great blog.

  134. 134
    Jay says:

    Simply put, if anyone ever manages to use a bio weapon in the USA, 40+ million uninsured American citizens will be a perfect breeding ground for it.

    Bush declares uninsured Americans enemy combatants

    President Bush signed a bill today that requires police to use deadly force against anyone who coughs in public. Smelly liberal hippy tree-huggers are outraged but they’re all terrorists too so who cares?

  135. 135
    pie says:

    (give me Darrell and scs ANY day)

    Please watch what you wish for. You might just get it.

  136. 136
    Darrell says:

    The magical “health savings accounts” which have the same issue, only for healthy people. Healthy people would say “bargain”, and opt out of insurance (side effect – raising rates for the unhealthy).

    That’s not true. Health savings accounts would give them the option to buy less expensive insurance with higher deductibles while pocketing the savings, and/or the option to purchase less expensive policies which have higher than $5 or $10 or $20 co-pay for all doctor’s visits and drugs. That way, the choice is given to the customer to cover themselves for the costly illnesses, while saving money in the medical savings accounts. With ridiculously low co-pays in many, many policies, people are more willing to visit the doctor for even the most minor ailment or sniffle.

  137. 137
    srv says:

    The percentage and the number of children (people under 18 years old) without health insurance increased between 2004 and 2005, from 10.8 percent to 11.2 percent and from 7.9 million to 8.3 million, respectively

    I suppose we’d already have universal health care if it weren’t for abortion.

  138. 138
    zzyzx says:

    The irony about Libertarianism is that it would result in significantly less freedom than our current system. Right now I can drive on roads to get me almost anywhere in the country, have large areas where I can demonstrate and freely assemble, and don’t have to spend all of my time reading agreements for poison pills because they’d be illegal.

    Seriously, all it would take to destroy Libertarianism is for someone to draft a standard non-compete clause in a contract that says that the signer can’t work for any other company. Then freeze wages at a penny a year or so and we have reinstituted slavery. Put that clause at random in non-related contracts just for the hell of it and you’ll get a large army of slaves. Sure eventually, you wouldn’t even buy a stick of gum without consulting a lawyer, but does that sound like a free society?

  139. 139
    ThymeZone says:

    With ridiculously low co-pays in many, many policies, people are more willing to visit the doctor for even the most minor ailment or sniffle.

    Leave it to Darrell to discover the most inane and absurd factoid in all the world related to the topic.

    See, the problem with healthcare today is that too many people are going to the doctor too often.

    Probably illegal aliens and gays, but for sure, if we’d make it harder or more expensive to see the doctor, things would get better.

    Why, oh Fucking Why, do they let him post here?

    Oh yeah, I forgot. They write his character.

    Sorry, I forgot.

  140. 140
    Punchy says:

    Screw infant mortality, I want infant morality. Infants not allowed to have abortions, pre-marital sex, drinking, or poker playing. Church on Sunday, bitches.

    And no crying on airplanes. Good morals says no crying when others are trapped in a small metal tube.

  141. 141
    ThymeZone says:

    low co-pays in many, many policies

    Many, many? Is that more than just “many?”

    How many is “many?”

    What is the total cost per year for a family of four, with these riciculously low co-pays, compared to the cost for a family of four with Darrell-approved co-pays?

    Total cost, Darrell. That includes the premiums.

    What are these costs now, compared to five years ago?

  142. 142
    pie says:

    Screw infant mortality, I want infant morality. Infants not allowed to have abortions, pre-marital sex, drinking, or poker playing. Church on Sunday, bitches.

    And no crying on airplanes. Good morals says no crying when others are trapped in a small metal tube

    Can we lock them up for breaking this law? What about their parents, are they charged as accomplices?

  143. 143
    srv says:

    Why, oh Fucking Why, do they let him post here?

    What would you otherwise do with your day?

  144. 144
    pie says:

    Fuck the poor. If you’re stupid enough to try and live without money, you deserve what happens to you. Why not give up and die in the gutter instead? You’d be doing yourself a favor in the long run, and helping the rest of us, too.

    I should know, because Hobbes said so in a quote taken out of context. The idea of anyone using Hobbes as an argument AGAINST government is completely laughable.

    Hereby it is manifest that during the time men live without a common power to keep them all in awe, they are in that condition which is called war; and such a war as is of every man against every man…

    Whatsoever therefore is consequent to a time of war, where every man is enemy to every man, the same consequent to the time wherein men live without other security than what their own strength and their own invention shall furnish them withal. In such condition there is no place for industry, because the fruit thereof is uncertain: and consequently no culture of the earth; no navigation, nor use of the commodities that may be imported by sea; no commodious building; no instruments of moving and removing such things as require much force; no knowledge of the face of the earth; no account of time; no arts; no letters; no society; and which is worst of all, continual fear, and danger of violent death; and the life of man, solitary, poor, nasty, brutish, and short.

  145. 145
    Adam says:

    I’m going to skip the thread and just write this:

    1. As a former small business owner, health care is an absolute killer. Large businesses have muscle in negotiations we don’t, and they get better deals and better coverage at lower costs per person. We had trouble getting programmers unless we paid out the nose for comparable health care plans.

    2. This would be a good opportunity to push something that there’s not nearly enough of in this country: preventative health care. You could make the “universal” health care contingent on getting regular checkups and maintaining certain good health practices. That would reduce the number of catastrophic medical problems drastically (there’s good research on that; think about how much easier it is to cure cancer if it’s caught), to say nothing of improving general public health — and insurance companies would love it.

  146. 146
    mitch says:

    OK – I’m back and once again amazed at posters such as Thyme(I am so clever)Zone, and will once again leave you with an essay to think about without discussing the author or the author’s muse. Given the Democratic takeover of Congress and the possibility of that continuing in ’08 combined with a Democratic president, ClintonCare will be revisited. Hillary has already indicated that she will promote it in the upcoming session. So, without further ado, I present “Healthcare is not a Right”

    ++++++++++

    Americans for Free Choice in Medicine
    http://www.afcm.org
    http://afcm.org/hcinar.html

    Health Care Is Not a Right
    By Leonard Peikoff, Ph.D.

    Delivered at a Town Hall meeting on the Clinton Health Plan, Red Lion Hotel, Costa Mesa, California.

    December 11, 1993

    Good morning, ladies and gentlemen:

    Most people who oppose socialized medicine do so on the grounds that it is moral and well-intentioned, but impractical; i.e., it is a noble idea—which just somehow does not work. I do not agree that socialized medicine is moral and well-intentioned, but impractical. Of course, it is impractical—it does not work—but I hold that it is impractical because it is immoral. This is not a case of noble in theory but a failure in practice; it is a case of vicious in theory and therefore a disaster in practice. So I’m going to leave it to other speakers to concentrate on the practical flaws in the Clinton health plan. I want to focus on the moral issue at stake. So long as people believe that socialized medicine is a noble plan, there is no way to fight it. You cannot stop a noble plan—not if it really is noble. The only way you can defeat it is to unmask it—to show that it is the very opposite of noble. Then at least you have a fighting chance.

    What is morality in this context? The American concept of it is officially stated in the Declaration of Independence. It upholds man’s unalienable, individual rights. The term “rights,” note, is a moral (not just a political) term; it tells us that a certain course of behavior is right, sanctioned, proper, a prerogative to be respected by others, not interfered with—and that anyone who violates a man’s rights is: wrong, morally wrong, unsanctioned, evil.

    Now our only rights, the American viewpoint continues, are the rights to life, liberty, property, and the pursuit of happiness. That’s all. According to the Founding Fathers, we are not born with a right to a trip to Disneyland, or a meal at Mcdonald’s, or a kidney dialysis (nor with the 18th-century equivalent of these things). We have certain specific rights—and only these.

    Why only these? Observe that all legitimate rights have one thing in common: they are rights to action, not to rewards from other people. The American rights impose no obligations on other people, merely the negative obligation to leave you alone. The system guarantees you the chance to work for what you want—not to be given it without effort by somebody else.

    The right to life, e.g., does not mean that your neighbors have to feed and clothe you; it means you have the right to earn your food and clothes yourself, if necessary by a hard struggle, and that no one can forcibly stop your struggle for these things or steal them from you if and when you have achieved them. In other words: you have the right to act, and to keep the results of your actions, the products you make, to keep them or to trade them with others, if you wish. But you have no right to the actions or products of others, except on terms to which they voluntarily agree.

    To take one more example: the right to the pursuit of happiness is precisely that: the right to the pursuit—to a certain type of action on your part and its result—not to any guarantee that other people will make you happy or even try to do so. Otherwise, there would be no liberty in the country: if your mere desire for something, anything, imposes a duty on other people to satisfy you, then they have no choice in their lives, no say in what they do, they have no liberty, they cannot pursue their happiness. Your “right” to happiness at their expense means that they become rightless serfs, i.e., your slaves. Your right to anything at others’ expense means that they become rightless.

    That is why the U.S. system defines rights as it does, strictly as the rights to action. This was the approach that made the U.S. the first truly free country in all world history—and, soon afterwards, as a result, the greatest country in history, the richest and the most powerful. It became the most powerful because its view of rights made it the most moral. It was the country of individualism and personal independence.

    Today, however, we are seeing the rise of principled immorality in this country. We are seeing a total abandonment by the intellectuals and the politicians of the moral principles on which the U.S. was founded. We are seeing the complete destruction of the concept of rights. The original American idea has been virtually wiped out, ignored as if it had never existed. The rule now is for politicians to ignore and violate men’s actual rights, while arguing about a whole list of rights never dreamed of in this country’s founding documents—rights which require no earning, no effort, no action at all on the part of the recipient.

    You are entitled to something, the politicians say, simply because it exists and you want or need it—period. You are entitled to be given it by the government. Where does the government get it from? What does the government have to do to private citizens—to their individual rights—to their real rights—in order to carry out the promise of showering free services on the people?

    The answers are obvious. The newfangled rights wipe out real rights—and turn the people who actually create the goods and services involved into servants of the state. The Russians tried this exact system for many decades. Unfortunately, we have not learned from their experience. Yet the meaning of socialism (this is the right name for Clinton’s medical plan) is clearly evident in any field at all—you don’t need to think of health care as a special case; it is just as apparent if the government were to proclaim a universal right to food, or to a vacation, or to a haircut. I mean: a right in the new sense: not that you are free to earn these things by your own effort and trade, but that you have a moral claim to be given these things free of charge, with no action on your part, simply as handouts from a benevolent government.

    How would these alleged new rights be fulfilled? Take the simplest case: you are born with a moral right to hair care, let us say, provided by a loving government free of charge to all who want or need it. What would happen under such a moral theory?

    Haircuts are free, like the air we breathe, so some people show up every day for an expensive new styling, the government pays out more and more, barbers revel in their huge new incomes, and the profession starts to grow ravenously, bald men start to come in droves for free hair implantations, a school of fancy, specialized eyebrow pluckers develops—it’s all free, the government pays. The dishonest barbers are having a field day, of course—but so are the honest ones; they are working and spending like mad, trying to give every customer his heart’s desire, which is a millionaire’s worth of special hair care and services—the government starts to scream, the budget is out of control. Suddenly directives erupt: we must limit the number of barbers, we must limit the time spent on haircuts, we must limit the permissible type of hair styles; bureaucrats begin to split hairs about how many hairs a barber should be allowed to split. A new computerized office of records filled with inspectors and red tape shoots up; some barbers, it seems, are still getting too rich, they must be getting more than their fair share of the national hair, so barbers have to start applying for Certificates of Need in order to buy razors, while peer review boards are established to assess every stylist’s work, both the dishonest and the overly honest alike, to make sure that no one is too bad or too good or too busy or too unbusy. Etc. In the end, there are lines of wretched customers waiting for their chance to be routinely scalped by bored, hog-tied haircutters some of whom remember dreamily the old days when somehow everything was so much better.

    Do you think the situation would be improved by having hair-care cooperatives organized by the government?—having them engage in managed competition, managed by the government, in order to buy haircut insurance from companies controlled by the government?

    If this is what would happen under government-managed hair care, what else can possibly happen—it is already starting to happen—under the idea of health care as a right? Health care in the modern world is a complex, scientific, technological service. How can anybody be born with a right to such a thing?

    Under the American system you have a right to health care if you can pay for it, i.e., if you can earn it by your own action and effort. But nobody has the right to the services of any professional individual or group simply because he wants them and desperately needs them. The very fact that he needs these services so desperately is the proof that he had better respect the freedom, the integrity, and the rights of the people who provide them.

    You have a right to work, not to rob others of the fruits of their work, not to turn others into sacrificial, rightless animals laboring to fulfill your needs.

    Some of you may ask here: But can people afford health care on their own? Even leaving aside the present government-inflated medical prices, the answer is: Certainly people can afford it. Where do you think the money is coming from right now to pay for it all—where does the government get its fabled unlimited money? Government is not a productive organization; it has no source of wealth other than confiscation of the citizens’ wealth, through taxation, deficit financing or the like.

    But, you may say, isn’t it the “rich” who are really paying the costs of medical care now—the rich, not the broad bulk of the people? As has been proved time and again, there are not enough rich anywhere to make a dent in the government’s costs; it is the vast middle class in the U.S. that is the only source of the kind of money that national programs like government health care require. A simple example of this is the fact that the Clinton Administration’s new program rests squarely on the backs not of Big Business, but of small businessmen who are struggling in today’s economy merely to stay alive and in existence. Under any socialized program, it is the “little people” who do most of the paying for it—under the senseless pretext that “the people” can’t afford such and such, so the government must take over. If the people of a country truly couldn’t afford a certain service—as e.g. in Somalia—neither, for that very reason, could any government in that country afford it, either.

    Some people can’t afford medical care in the U.S. But they are necessarily a small minority in a free or even semi-free country. If they were the majority, the country would be an utter bankrupt and could not even think of a national medical program. As to this small minority, in a free country they have to rely solely on private, voluntary charity. Yes, charity, the kindness of the doctors or of the better off—charity, not right, i.e. not their right to the lives or work of others. And such charity, I may say, was always forthcoming in the past in America. The advocates of Medicaid and Medicare under LBJ did not claim that the poor or old in the ’60’s got bad care; they claimed that it was an affront for anyone to have to depend on charity.

    But the fact is: You don’t abolish charity by calling it something else. If a person is getting health care for nothing, simply because he is breathing, he is still getting charity, whether or not President Clinton calls it a “right.” To call it a Right when the recipient did not earn it is merely to compound the evil. It is charity still—though now extorted by criminal tactics of force, while hiding under a dishonest name.

    As with any good or service that is provided by some specific group of men, if you try to make its possession by all a right, you thereby enslave the providers of the service, wreck the service, and end up depriving the very consumers you are supposed to be helping. To call “medical care” a right will merely enslave the doctors and thus destroy the quality of medical care in this country, as socialized medicine has done around the world, wherever it has been tried, including Canada (I was born in Canada and I know a bit about that system first hand).

    I would like to clarify the point about socialized medicine enslaving the doctors. Let me quote here from an article I wrote a few years ago: “Medicine: The Death of a Profession.” [The Voice of Reason: Essays in Objectivist Thought, NAL Books, © 1988 by the Estate of Ayn Rand and Leonard Peikoff.]

    “In medicine, above all, the mind must be left free. Medical treatment involves countless variables and options that must be taken into account, weighed, and summed up by the doctor’s mind and subconscious. Your life depends on the private, inner essence of the doctor’s function: it depends on the input that enters his brain, and on the processing such input receives from him. What is being thrust now into the equation? It is not only objective medical facts any longer. Today, in one form or another, the following also has to enter that brain: ‘The DRG administrator [in effect, the hospital or HMO man trying to control costs] will raise hell if I operate, but the malpractice attorney will have a field day if I don’t—and my rival down the street, who heads the local PRO [Peer Review Organization], favors a CAT scan in these cases, I can’t afford to antagonize him, but the CON boys disagree and they won’t authorize a CAT scanner for our hospital—and besides the FDA prohibits the drug I should be prescribing, even though it is widely used in Europe, and the IRS might not allow the patient a tax deduction for it, anyhow, and I can’t get a specialist’s advice because the latest Medicare rules prohibit a consultation with this diagnosis, and maybe I shouldn’t even take this patient, he’s so sick—after all, some doctors are manipulating their slate of patients, they accept only the healthiest ones, so their average costs are coming in lower than mine, and it looks bad for my staff privileges.’ Would you like your case to be treated this way—by a doctor who takes into account your objective medical needs and the contradictory, unintelligible demands of some ninety different state and Federal government agencies? If you were a doctor could you comply with all of it? Could you plan or work around or deal with the unknowable? But how could you not? Those agencies are real and they are rapidly gaining total power over you and your mind and your patients. In this kind of nightmare world, if and when it takes hold fully, thought is helpless; no one can decide by rational means what to do. A doctor either obeys the loudest authority—or he tries to sneak by unnoticed, bootlegging some good health care occasionally or, as so many are doing now, he simply gives up and quits the field.”

    The Clinton plan will finish off quality medicine in this country—because it will finish off the medical profession. It will deliver doctors bound hands and feet to the mercies of the bureaucracy.

    The only hope—for the doctors, for their patients, for all of us—is for the doctors to assert a moral principle. I mean: to assert their own personal individual rights—their real rights in this issue—their right to their lives, their liberty, their property, their pursuit of happiness. The Declaration of Independence applies to the medical profession too. We must reject the idea that doctors are slaves destined to serve others at the behest of the state.

    I’d like to conclude with a sentence from Ayn Rand. “Doctors”, she wrote, “are not servants of their patients. They are “traders, like everyone else in a free society, and they should bear that title proudly, considering the crucial importance of the services they offer.”

    The battle against the Clinton plan, in my opinion, depends on the doctors speaking out against the plan—but not only on practical grounds—rather, first of all, on moral grounds. The doctors must defend themselves and their own interests as a matter of solemn justice, upholding a moral principle, the first moral principle: self-preservation. If they can do it, all of us will still have a chance. I hope it is not already too late. Thank you.

    Copyright © 1993 Leonard Peikoff. All rights reserved. Send reprint requests to mail@afcm.org. Reprints must include above copyright statement.

    © 2006 Americans for Free Choice in Medicine. All rights reserved.

  147. 147
    ThymeZone says:

    What would you otherwise do with your day?

    Well … I work 10+ hours a day, and I’m on call 24 x 7.

    What would I do without Darrell? Have more time to bash you, I suppose.

  148. 148
    Jay says:

    With ridiculously low co-pays in many, many policies, people are more willing to visit the doctor for even the most minor ailment or sniffle.

    Some panty-waists might try to get an appointment for their minor ailment, but at least in my neck of the woods by the time they can actually see the doctor the sniffle has cleared up. Or become bronchitis.

    As far as co-pays go I assume you’re talking about the “ideal” situation: Employer pays all HI costs, employee only pays the co-pay. (Lucky bastards.) Then you’re looking at an average of about $25 per basic doctor visit. What I don’t know is what percentage of the work force is still so damn fortunate.

  149. 149
    ThymeZone says:

    Wow, “Socialized Medicine,” Klinton, and Ayn Rand, all neatly wrapped in a 100,000-word pile of shit.

    Thanks, Mitch. Really, we owe you.

  150. 150
    Pb says:

    Leonard Piekoff? Awesome!

  151. 151
    jcricket says:

    That’s not true. Health savings accounts would give them the option to buy less expensive insurance with higher deductibles while pocketing the savings, and/or the option to purchase less expensive policies which have higher than $5 or $10 or $20 co-pay for all doctor’s visits and drugs. That way, the choice is given to the customer to cover themselves for the costly illnesses, while saving money in the medical savings accounts.

    The only things that HSAs accomplish is that healthy, wealthy employees gain an additional tax shelter, while increasing the cost of insurance for everyone else. There’s scant evidence it even saves that much money beyond the tax sheltering effect. Read this report from the Center on Budget & Policy Priorities for a primer on the real data about HSAs.

    With ridiculously low co-pays in many, many policies, people are more willing to visit the doctor for even the most minor ailment or sniffle.

    Evidence please. This is classic “argument from assertion” here, and there are tons of counter-examples, both anecdotal (everyone I know with a $15 co-pay for my good HMO doesn’t visit the doctor more than they have to) and data – none of the countries with national health insurance (super-low-copays) have reported mass increases of unnecessary doctor visits. Healthcare is not consumed like fast food or dessert except when you’re a hypochondriac.

  152. 152
    ThymeZone says:

    Fuck the poor.

    Well, you have staked a claim to one half of Compassionate Conservatism. The other half is “Fuck over the middle class.”

    That’s the hard part. Fucking the poor is easy. They have no power.

    But fucking over the middle class, and getting them to pay for your eternal vacation from responsibility, that’s a lot harder. That’s where the tax money is, unless you want to pay the taxes yourself. So you have to invent a lot of scams to keep those educated, working people distracted.

    Can you say DOMA? You get the idea.

  153. 153
    Darrell says:

    Cut out the rhetorical fluff and what do you know – Darrell agrees with me. Hosannah.

    So we both agree that businesses would love to unload their healthcare costs, just like they would love to unload their retirement, security, and other costs onto taxpayers too. I just didn’t think it was a particularly illuminating observation is all.

    If you’re jumping up and down with glee at the idea of business owners (a small minority of Republican voters) aligning politically with liberals to deliver government health care, it’s not very intelligent of you to ignore the converse political alignment which would oppose such a deal – libertarians and small govt. Republicans aligning themselves with middle class Dems, in which Republicans would rightly point out that such a plan is nothing but a huge a bailout sop to business(the rich!) at the expense of Joe Taxpayers like you. Can’t wait to see how that divide would fall out.

    For you to jump with glee at one observation while ignoring the obvious flip side fallout of such a political alignment, isn’t a well thought out position.

  154. 154
    jcricket says:

    Here’s some more refutation of the supposed benefits of HSAs. Much like every libertarian designed policy initiative, it falls apart under the most modest of scrutiny.

    The shortest answer to libertarians is that we can achieve better healthcare for all with lower taxpayer spending (both as a percent of GDP and per person) by moving to spreading out the “insurance risk” across the entire nation. As the author of the blog above points out, libertarians are supposed to be for lower taxpayer spending, right?

  155. 155
    TenguPhule says:

    Darrell says: That’s not true.

    Darrell’s Irony of the Day.

  156. 156
    ThymeZone says:

    Darrell’s Irony of the Day.

    Snort.

    Thanks, now I have coffee on my rug.

  157. 157
    TenguPhule says:

    Republicans aligning themselves with middle class Dems, in which Republicans would rightly point out that such a plan is nothing but a huge a bailout sop to business(the rich!) at the expense of Joe Taxpayers like you.

    I would pay less for Healthcare, so would everybody else. What was your argument again?

  158. 158
    jcricket says:

    For you to jump with glee at one observation while ignoring the obvious flip side fallout of such a political alignment, isn’t a well thought out position.

    Darrell – It’s because the fallout won’t be what you think. You’re setting up a situation where if businesses don’t pay for and drive the healthcare system, costs for everyone else will go up. We all try to point out, again and again, that with the properly designed national healthcare system, businesses could get out of the healthcare business and we could achieve universal coverage, without increasing business, government or private spending on healthcare. In fact, nationalized healthcare would likely decrease spending (as I mentioned above), possibly by as much as 50%.

    Do you have any evidence, other than your own assertions and occasional anecdotes to refute the mountain of facts on the other side?

    I didn’t think so.

  159. 159
    TenguPhule says:

    Thanks, now I have coffee on my rug.

    You’re welcome. Did I mention I’m invested in rugcleaner companies by the way? :P

  160. 160
    Darrell says:

    The only things that HSAs accomplish is that healthy, wealthy employees gain an additional tax shelter, while increasing the cost of insurance for everyone else

    That is bullshit. HSA give employees the flexibility to spend their healthcare $$’s as they see fit, and pocket the savings. You can spin it as a sop to “the rich”, but your lying your ass off, as HSA flexibility would benefit everyone who participates.

    Problem is now, there is no incentive NOT to see the doctor for those with decent insurance. That drives up costs for others. If you want a plan with low co-pays, fine, pay for it. Let others decide to pocket that savings for themselves, or to purchase other health care products with the savings.

  161. 161
    Darrell says:

    Then you’re looking at an average of about $25 per basic doctor visit. What I don’t know is what percentage of the work force is still so damn fortunate.

    I believe it’s 70%+ of the workforce. You seem to suggest that it’s some tiny minority.

  162. 162
    mitch says:

    Wow, “Socialized Medicine,” Klinton, and Ayn Rand, all neatly wrapped in a 100,000-word pile of shit.

    Thanks, Mitch. Really, we owe you.

    No problem, Parsley, Sage, Rosemary, & ThymeZone)

    So glad you can rationally discuss the article (just over 16,000 words – demonstrating how one can use your word processor to count words)

  163. 163
    Pb says:

    Ah, objectivism

    First, it is very important not to conflate the right to life with a right to health care. The right to life is central to the Objectivist ethics and politics, and health care is certainly essential to maintaining one’s life. However, as Rand puts it: “A right does not include the material implementation of that right by other men; it includes only the freedom to earn that implementation by one’s own effort.” (“Man’s Rights”, The Virtue of Selfishness, pp. 113-114) In this sense, an apt comparison can be drawn to the right of free speech; your right to speak your mind does not create some obligation on the part of others to support that expression, financially or otherwise.

    Got that, folks? The right to live does not include others helping you to continue living–it includes only the freedom to earn that continued life by your own effort…

    We have to draw the same distinctions when we think about altruism. For it is, in the end, the moral code of altruism that makes people think that need is primary, that need gives one a right to the ability and effort of others. In the conventional sense, altruism means kindness, generosity, charity, a willingness to help others. These are certainly virtues, so long as they do not involve the sacrifice of other values, and so long as they are a matter of personal choice, not a duty imposed from without. I might note in this regard that physicians have historically been extremely generous with their time.

    In a deeper, philosophical sense, however, altruism is the principle that one person’s need is an absolute claim on others, a claim that overrides their interests and rights. For example, Dr. Edmund Pellegrino has asserted, in an article for JAMA, “A medical need in itself constitutes a moral claim on those equipped to help.”[7] This principle has often been asserted by thinkers who are opposed to individualism, and it is the basis for the doctrine of welfare rights. It is the reason why advocates of government involvement in health care can take for granted that the needs of patients are primary, and that everyone else can be forced to provide for those needs.

    No rational basis for this principle has ever been offered. The fact is that our needs have to be satisfied by production, not by taking from others. And production comes from those who take responsibility for their lives, who apply their minds to the challenges we face in nature and find new ways of meeting those challenges.

    Yeah, what kind of crazy hippie do-gooder would subscribe to such altruistic, flaky, selfless crap like this:

    I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

    I will prevent disease whenever I can, for prevention is preferable to cure.

    I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

    They obviously don’t have their priorities straight, and therefore need to read all of Ayn Rand’s books a few hundred more times–after they first buy the viewing rights to it, and then transcribe their own copy of it, of course, ahahahahahah!

  164. 164
    TenguPhule says:

    as HSA flexibility would benefit everyone who CAN AFFORD TO participate.

    Fixed. There’s a reason why HSAs are tax sops for the rich and decidingly well off.

    They’ve got the extra money lying around to actually put in those accounts.

    Facts and Darrell. Oil and Water.

  165. 165
    Darrell says:

    You’re setting up a situation where if businesses don’t pay for and drive the healthcare system, costs for everyone else will go up

    Costs ALWAYS go up when government takes control. Look at the Post office versus FedEX and UPS, among a miriad of examples.

    Tell you what, since eating is a “right”, just like universal healthcare, why not similarly demand that govt take over the grocery store business and agriculture industry too? After all, the need for food is as essential or more so than the need for universal healthcare. That’s an entirely valid analogy which exposes the ridiculousness of your arguments.

  166. 166
    TenguPhule says:

    Problem is now, there is no incentive NOT to see the doctor for those with decent insurance.

    Who really likes to go to the doctor? Aside from hypocondriacs? I dunno what fantasy bong you smoked to come up with regular people seeing their doctor for no good reason, but obviously you’ve been sharing with mitch.

  167. 167
    Pooh says:

    Anyone who posits Hobbes’s State of Nature as a Good Thing either doesn’t want to be taken seriously, misread Leviathan quite badly, or is Charles Krauthammer.

    Giving Mitch BOD, we should all thank the esteemed Mr. Krauthammer for joining us…

  168. 168
    ThymeZone says:

    there is no incentive NOT to see the doctor for those with decent insurance.

    Do you know how HMOs and doctors manage these things, Darrell?

    Do you know what a cap plan is, and how it works?

    Can you produce one iota of evidence that any relevant healthcare problem is being caused today by excessively low doctor co-pays? That healthcare is being generally degraded by having too many people who don’t need to see a doctor, seeing a doctor?

    You are doing what you always do here, which is deflect a topic with completely made up bullshit.

  169. 169
    Jay says:

    Leonard Peikoff — the world’s foremost authority on Ayn Rand’s philosophy

    More than enough said. It is important to note that supporting one’s rambling thoughts with another person’s rambling thoughts doesn’t really work.

    I actually went to the AFCM’s website and not only do they get some things dead wrong, but it is a curiously one-dimensional organization. There is no “About” section, the only business report I could find on the org. lists two employees and the articles I’m finding are either by a Scott Holleran (who has zero understanding of how Medicare works) or refer to Mr. “I’m cool because I know Ayn Rand” Piekoff.”

  170. 170
    mitch says:

    Got that, folks? The right to live does not include others helping you to continue living—it includes only the freedom to earn that continued life by your own effort…

    Wrong – not forcing other men to live for you. Voluntary help, or trade for help is just fine.

  171. 171
    Darrell says:

    as HSA flexibility would benefit everyone who CAN AFFORD TO participate.

    Fixed. There’s a reason why HSAs are tax sops for the rich and decidingly well off.

    Stupid is as stupid does. HSA’s would help EVERYONE with health insurance. Since the overwhelming majority of Americans have employers pay their health insurance, HSA’s would give these same workers the flexibility to spend that health care benefit more wisely as they see fit.. as an alternative to the (pretty much) one-size-fits-all options available to them now.

  172. 172
    docg says:

    Mitch, what a lovely screed you posted. Do you use health insurance? If you do, you are participating in socialized medicine. Which part of an insurance pool, to spread the costs more evenly, do you not understand? If everyone paid for all health care out of pocket, with no sharing of risk and expense, what do you think the medical result would be? Do you really think the innovations in medical care over the last 50-100 years would be available without pooling resources? The average life span in the United States, pre-health insurance, was 47 years (1900). In 2000, the average life span here was 78 years. Chalk that 31 year increase to socialism, whether in fits your John Wayne fantasy or not.

    Your screed said that doctors should not be slaves to serve at the behest of the state. Ask any doctor how they feel about being a slave to insurance companies. Where medical decisions are being made by ninnies with no medical education, following a decision tree on eligibility for services based on cost concerns, not medical concerns.

    We have long ago decided that the public good in the United States requires public expeditures. That train left the station and is not coming back. I would be interested in which countries do NOT publically subsidize anything? Can you name one? Your imaginary friends at Fox News and the Golden EIB microphone can bloviate all they want, but your version of independent living, without a social network, doesn’t exist.

    As with any good or service that is provided by some specific group of men, if you try to make its possession by all a right, you thereby enslave the providers of the service, wreck the service, and end up depriving the very consumers you are supposed to be helping.

    Ever drive or ride on a street or highway, genius?

  173. 173
    TenguPhule says:

    Costs ALWAYS go up when government takes control.

    Another proud believer in Bush’s SS Privitization is revealed.

  174. 174
    Darrell says:

    Do you know how HMOs and doctors manage these things, Darrell?

    WTF are you talking about? Do you have a point to make asshole? If so, make it.

  175. 175
    Darrell says:

    Do you really think the innovations in medical care over the last 50-100 years would be available without pooling resources?

    Do you really think the innovations in medical care over the past 50 – 100 years would be available with government controlled healthcare? One needs only to look at the number of medical technology and pharmaceutical “innovations” coming from Canada to see the answer to that question.

  176. 176
    Pb says:

    Problem is now, there is no incentive NOT to see the doctor for those with decent insurance. That drives up costs for others.

    Ah, the secret life of Darrell. I bet it goes something like this:

    I don’t know about you guys, but there’s just nothing I love more than an unnecessary visit to the doctor! Why, if I had free health care, I’d always be going over there, going, “Hey, doc, what’s new this week?”, or “Hey doc, got anything for the sniffles?”, or “Hey, doc, got any magic pills that’ll turn me into Superman?” But if I have to pay $20 per visit, well then I have to choose–I could spend some time waiting in the doctor’s office, or I could go see a new movie and get some popcorn. It’s a tough choice, though–half the time I go to the doctor anyhow!

  177. 177
    jcricket says:

    . HSA give employees the flexibility to spend their healthcare $$’s as they see fit, and pocket the savings. You can spin it as a sop to “the rich”, but your lying your ass off, as HSA flexibility would benefit everyone who participates.

    Hmm, so I point you to a long article with all sorts of facts, figures, cites and analysis that concludes exactly the opposite and you just repeat your assertion. I win.

    Costs ALWAYS go up when government takes control. Look at the Post office versus FedEX and UPS, among a miriad of examples.

    Seriously? It’s more expensive to send a package via the post office, because I see exactly the opposite any time I ship something I sell on eBay. Please send me those rate tables you’re using, otherwise I win.

    As ThymeZone so eloquently points out:

    [Darrel is] doing what [he] always do[es] here, which is deflect a topic with completely made up bullshit.

    Yep, which is why I usually just let his special brand of dishonesty pass on by without comment. Unless he’s a particularly vicious troll (like Al and American Hawk on Political Animal), Darrel has proven himself as one of the most misguided and intellectually uncurious people I’ve ever encountered.

  178. 178
    TenguPhule says:

    HSA’s would help EVERYONE WEALTHY with health insurance. Since the overwhelming majority of Americans have employers pay their health insurance, HSA’s would give these same workers the flexibility to spend health care benefits as they see fit

    Fixed.

    That Employers pay health insurance does not automatically mean employees have extra money lying around to be put into HSAs. Fallacy, thy name is Darrell.

  179. 179
    ThymeZone says:

    WTF are you talking about? Do you have a point to make asshole? If so, make it.

    I’ve already made it, you lying ignorant fuck.

    You are sitting here spouting bullshit about a system you know nothing about.

    Where did you get the idea that low copays and excessive doctor visits were a problem? Do you know how copays are determined, and how doctors and HMOs manage their populations of covered persons and resources?

    I don’t think you do. You can’t answer a single question on the subject. SO SHUT THE FUCK UP.

    Doctors and HMOs have enormous control over access to healthcare, Darrell … THEY EXIST PRIMARILY FOR THAT PURPOSE. Without that control, they cannot control their costs and have no prayer of making a profit. Without that control, care providers cannot manage their practices.

    Do you really think that a few copay dollars are the determining factor in who gets care, and when, and how often? You’re a fucking idiot.

  180. 180
    Pooh says:

    I would be interested in which countries do NOT publically subsidize anything?

    I don’t think it’s possible for such a place to exist. At the very least, the state needs to finance the implements which give it it’s monopoly on ‘legitimate’ coercive force, which is the kinda the defining feature of The State. Of course, you probably also need laws, and courts to enforce those laws, and people to write those laws, and means to determine who writes the laws, etc…

    I suppose you could privatize all that, I just don’t know of anyone who would seriously suggest that that is a desirable outcome. But then, I’m something of a half-assed libertarian myself. Pesky facts and Ayn’s rather turgid prose helped ensure that.

  181. 181
    TenguPhule says:

    HSA’s would give these same workers the flexibility to spend ON FOOD ORhealth care benefits as they see fit

  182. 182
    jcricket says:

    Tengu – It’s not even the entire “group” of wealthy people. Just those without chronic, re-occurring or otherwise serious medical conditions. Those people would still be far better off with the coverage provided for by pooled insurance.

    HSAs help wealthy, healthy individuals at the expense of everyone else, and are the least best solution to our current healthcare crisis.

    No amount of repeated assertions from Darrell or hand-waving from the CATO institute will ever disprove this.

  183. 183
    Darrell says:

    Pb,

    I have allergies. I am able to get by fine for the most part with generic Clariten. My Blue Cross Blue Shield policy has a deductible which, if I meet it, will incentivize the hell out of me to go in for a whole host of other medical treatment options which I could get by without just fine.

    Before we switched to Blue Cross, we had another policy with a straight $20 co-pay from dollar one. As a runner and basketball player, I went to several podiatrist treatments for orthotics to help me run better. Now, I get along fine with $20 Spenco arch supports.

    Multiply my example X 220 million Americans, the average of whom has health problems more costly than my allergies and podiatrist… and soon, you’re looking at real money.

    Denying the obvious human reaction to incentives in order to make a political point is dishonest as hell, but typical of the leftists posting here at BJ.

  184. 184
    Perry Como says:

    That healthcare is being generally degraded by having too many people who don’t need to see a doctor, seeing a doctor?

    Darrell visits a cranial proctologist a few times a week, so he is extrapolating his experience across the population.

  185. 185
    jcricket says:

    HSA’s would give these same workers the flexibility to spend ON FOOD OR health care benefits as they see fit

    One could simply transfer money from the healthcare insecurity account to cover any food insecurity, right?

  186. 186
    Darrell says:

    It’s more expensive to send a package via the post office, because I see exactly the opposite any time I ship something I sell on eBay. Please send me those rate tables you’re using, otherwise I win.

    The Post office rates are subsidized by taxpayers and not reflective of their true costs. Even with massive subsidies it’s still often cheaper to send by FedEx than USPS. You lose.

  187. 187
    Perry Como says:

    Multiply my example X 220 million Americans, the average of whom has health problems more costly than my allergies and podiatrist… and soon, you’re looking at real money.

    Wow. I was pretty freakin’ close. Darrell thinks everyone takes advantage of the system just like him.

  188. 188
    jcricket says:

    Denying the obvious human reaction mountains of research data that contradicts every assertion I make to incentives in order to make a political point is dishonest as hell, but typical of the leftists Darrells posting here at BJ.

    FIXED

  189. 189
    Teak111 says:

    Two points: First, we have to move away from quality of care arguements. rRecently had a kidney stone that took two ER visits @6K per and eventual surgery @20K to remove that nasty sucker. Luckily, I work in corp Amer and pay $98 a paycheck (bi-weekely) for family coverage and aside from $50 copay/ER, $20 copay/Urologiest, and $250/surgery, there were few other costs and the service even in the crowded ER, the office, and in surgery was good if not very good. So for my 2400 a year, 30k+ in medical was taken care of. For me (and I suspect millions of other white color, corp office workers, the system worked well.

    So wehn folks say the system is broken they mean it is broken for certain people of lesser social economic/eductional backgrounds. But that won’t be for long.

    What’s going to change HC is business. When biz puts its foot down and says no mas to high HC, politians will start listening. Because while your single vote is NICE, 500K from big auto is NICER. And change will happen because the cost to corps, not the quality of care, becomes unsustainable.

    Remember when everyone had a pension? And now corps are going BK to dump pesky pensions (United) because they are unsustainable in the current business climate. My copr just dropped its pension program. Soon, we will see this with HC.

  190. 190
    Pooh says:

    People, people, people, Darrell doesn’t know what he thinks about a subject until “an unhinged leftie” takes a position. At that time, he points and says “whatever that is, I’m against it.” Why are we expecting consistency, rationality or fidelity to evidence from him?

    [/soft bigotry of subterranean expectations]

  191. 191
    Jay says:

    Darrell says:
    I believe it’s 70%+ of the workforce. You seem to suggest that it’s some tiny minority.

    Nope, that was bitter snarkiness. Where did you get your stat? I can’t find anything that breaks it down by total employer insurance/partial employer insurance.

  192. 192
    ThymeZone says:

    Denying the obvious human reaction to incentives in order to make a political point is dishonest as hell,

    No, what’s dishonest as hell is you inventing a theoretical possibility and then extrapolating it into an actual problem which in fact does not exist.

    Doctors are not being swamped by people “incentivized” to go see the doctor and ask for frivolous medical serivices.

    Doctors are swamped in many cases, mainly because of the way HMO cap plans work and the number of patients they have to carry on their rolls in order to satisfy the demands of the HMO. When the HMO controls access to care, neither patients nor doctors really have any choice but to play by their rules.

    Do you know what a cap plan is? I don’t think you do. I don’t think you ever heard of one. It’s the basic model for all HMO PPO (preferred provider) systems. It is at the foundation of the HMO plan where the provider works for the HMO. Without the cap plan and the actuarial realities it provides, you can’t do large scale healthcare insurance.

    The cap plan depends upon management of the number of visits to the doctor (or clinic) in order to function. It doesn’t throw arbitrary copays out there and then wait to see how many people show up at the doctor’s office for frivolous consultations, you moron.

  193. 193
    DougJ says:

    Uh, oh, the tax and spenders are at it again. Tax and spend, tax and spend. The last thing American needs is Hillary-care.

    I’ve just given you the rhetoric that will destroy any efforts at national health care for the next 20 years.

  194. 194
    Punchy says:

    Ayn Rand

    Is she the first half of that damn road map-making monopoly? Does partner McNally KNOW the garbage this chick is shoveling?

  195. 195

    Problem is now, there is no incentive NOT to see the doctor for those with decent insurance. That drives up costs for others. If you want a plan with low co-pays, fine, pay for it. Let others decide to pocket that savings for themselves, or to purchase other health care products with the savings.

    This is amazing. I have wonderful insurance with a $20 copay(which is chump change), and I have absolutely NO DESIRE to go to the doctor.

    Hell, when I had Pneumonia, it was 5 days before I went to the doctor.

    My problem with the current healthcare system, and I’m not sure if HSAs would solve this or not, but there is NO INCENTIVE to cure problems, but every incentive to drug you to death.

    I have allergies. Personally, I’d prefer not taking drugs. But the healthcare system is incented to make me take drugs. Why? Because the medical community needs to increase revenues, and you don’t increase revenues by curing people. Same with the insurance companies. Sure they talk about trying to cut costs, but at the end of the day they need to show their stockholders they are increasing revenues.

    So our health system doesn’t operate as a proper free market. I’m not convinced that HSA’s are going to change that. I think HSA’s are all about pushing costs off of the employers onto the employees.

  196. 196
    Darrell says:

    Doctors are not being swamped by people “incentivized” to go see the doctor and ask for frivolous medical serivices.

    Well, depending on the definition of frivolous, every single one of us who has ever worked at a company with low co-pay, has seen many, many examples of people going to the doctor when they could have easily gotten by on their own.. including their own/my own behavior under such the system.

    Why the hell not see the doctor? After all, it’s only $20 or $25… in some cases needed visits, others mildly frivolous doctor visits, and in other cases very frivolous visits. But with low co-pays “I’m not paying, the insurance company is”.

    Incredible the dishonesty of so many of the lefties here denying basic human reactions to incentives.

  197. 197
    ThymeZone says:

    Hell, when I had Pneumonia, it was 5 days before I went to the doctor.

    Wow. Exactly the same story here. I waited until I could barely craw to the phone to call and make an appointment.

    Once in front of the doctor, as I recall, he listened to me for about one minute and said, I think you have pneumonia. Let’s get a chest xray. Why didn’t you come in sooner?

    My answer was something like “Burble.”

    Anyway, I think that reluctance to go the to doctor is pretty common, especially amongst us males.

  198. 198

    The Post office rates are subsidized by taxpayers and not reflective of their true costs. Even with massive subsidies it’s still often cheaper to send by FedEx than USPS. You lose.

    USPS rates are not subsidized by taxpayers.

    The USPS could be described as a GSE – Government Secured Entity. That is, if they ran into trouble the Govt would be there to bail them out. But for all purposes, they operate as a private company.

    As anybody who knows Ebay will tell you, the USPS is the cheapest way to ship small lightweight packages, up to say 5 pounds or so in either a cheap(Parcel Post) or timely(Priority) manner. UPS handles larger packages better. Fedex handles express delivery better, and has better customer service all around. Plenty of competition in this market, and each has their own nice niche they are good at.

  199. 199
    ThymeZone says:

    Incredible the dishonesty of so many of the lefties here

    Oh, just shut up, Darrell. You have no idea in the world what you are talking about. As usual.

  200. 200
    Darrell says:

    My copr just dropped its pension program. Soon, we will see this with HC.

    Did they offer anything else in it’s place? Employer matched contributions to 10k or something like that?

    If they simply dropped the pension benefit with no other benefits added to compensate, in this competitive job climate, they’re going to get their clocks cleaned.

  201. 201
    ThymeZone says:

    I ask you again, Darrell. Do you know what a cap plan is?

    What determines the desired rate of doctor visits, and how does the plan manage it?

    If you don’t know, then what the fuck are you doing taking up space here flapping your gums?

  202. 202

    Wow. Exactly the same story here. I waited until I could barely craw to the phone to call and make an appointment.

    I find it interesting. Here we are talking about abusing the system, or rather going more often then you need to versus no motivation to go.

    The Liberals point out they have to be deathly sick to go, and say there’s no reason to change.

    The Republicans point out they abuse the system all the time, and say we need to make it harder to visit.

    What’s that say about the groups as individuals?

    It seems Liberals are better with self-control, personal responsibility.

    This is a fascinating statement on our society. This debate mirrors similar debates with regards to tort reform, sexual relationships, drug use, etc.

  203. 203
    Perry Como says:

    Well, depending on the definition of frivolous, every single one of us who has ever worked at a company with low co-pay, has seen many, many examples of people going to the doctor when they could have easily gotten by on their own.. including their own/my own behavior under such the system.

    I’ve been working for companies with low copay for a decade now. I can’t recall a single time I’ve seen someone go to the doctor “because they feel like it.” I’ve been to the doctor twice in the last decade. Once to get a medical cert for a marriage license, the second was an ER visit. And I have *really* good health insurance.

    Maybe I should start going to the dentist for recreational visits. Everyone else seems to be doing it!

  204. 204
    rreay says:

    With ridiculously low co-pays in many, many policies, people are more willing to visit the doctor for even the most minor ailment or sniffle.

    That’s basically the reason given when my company changed policies on us this year.

    Basically it was “People have a low deductible so they don’t worry about going to the doc for minor things. With the high deductible and itemized bills so you can understand the actual costs involved…”

    -rr

  205. 205
    Darrell says:

    I ask you again, Darrell. Do you know what a cap plan is?

    Dear shit for brains, there are several types of “cap” plans. You are obviously to ignorant to know this fact, as evidenced by your foot stamping petulance on this issue.

    There are : 1) enrollment cap plans 2) total payout caps and 3) cap payouts by illness 3) cap by treatment type (hospital stay, for example).

    Despite being asked to explain, being the true dreg you are, you instead continue to use BJ threads as a sounding board for your mental illness

  206. 206
    TenguPhule says:

    Well, depending on the definition of frivolous, every single one of us who has ever worked at a company with low co-pay, has seen many, many examples of people going to the doctor when they could have easily gotten by on their own.. including their own/my own behavior under such the system.

    This may come as a shock to your system, Darrell.

    Not everyone is a whiny hypocondriac panty who must see a doctor without need like you. In fact, it’s safe to say that most people are definitely not like you.

  207. 207
    ThymeZone says:

    All HMO-PPO systems are based on actuarial models and on capitation plans that both predict, and manage, the behavior of the population in the plan.

    Without this, which is pretty much the basic idea behind insurance in general, there wouldn’t be health insurance.

    It’s the reason why it works. It’s the reason why the Frist family sold its HMO interests this year for $21b …. that’s BILLION … dollars, and where the energy comes from to pay Congress to keep making Americans the unwilling participants in a scheme designed to make corporations rich and fuck over middle class Americans.

  208. 208
    TenguPhule says:

    Why the hell not see the doctor? After all, it’s only $20 or $25… in some cases needed visits, others mildly frivolous doctor visits, and in other cases very frivolous visits. But with low co-pays “I’m not paying, the insurance company is”.

    And of course we all have nothing better to do with that money…right? We wouldn’t want or need it for something more pressing like say….the bills?

    Darrell, you may be an idiot when it comes to medical needs but the rest of us are not.

  209. 209
    ThymeZone says:

    The question here, Darrell, is whether your bullshit tirade about low copays and unnecessary doctor visits is real, or made up.

    Every cap plan is an expression of the actuarial realities on which it is based. Describe one actual such plan, Darrell, which has been unfavorably impacted by the “problem” you made up here. One.

  210. 210
    Darrell says:

    I’ve been working for companies with low copay for a decade now. I can’t recall a single time I’ve seen someone go to the doctor “because they feel like it.”

    I love the dishonestly in trying to place all ‘frivolous’ doctor visits under the category of “because they feel like it”.

    The question is, could they have reasonably and easily gotten by without the doctor visit or treatment. In my case, I didn’t “have” to go see the podiatrist, but at $20 co-pay, why not see what they can do to improve knee pains when I play ball on concrete? That custom made orthotic cost plenty, but for me, performed no better than Spenco arch inserts.

    At $20 – $30 co-pay, go get a $900 battery of allergy tests instead of getting by on Clariten.. and on and on. There are gazillions of similar examples.

    If you lower the cost of something, in this case medical treatment through low co-pays, you’ll be selling much more of it. That’s just human nature. Incredible how so many lefties on BJ try to deny this.

  211. 211
    ThymeZone says:

    there are several types of “cap” plans. Y

    Describe how one of them works, and don’t take time to look it up and copy and paste the answer.

    In three or four short sentences, describe how a cap plan works, and how your imaginary “problem” can derail it.

  212. 212
    TenguPhule says:

    Multiply my example X 220 million Americans, the average of whom has health problems more costly than my allergies and podiatrist… and soon, you’re looking at real money.

    But there are not 220 million more Darrells in America (A fact we’re all grateful for since one is too many).

    There is no incentive to see the doctor needlessly, Darrell. This may come as a shock to you, but it’s true.

  213. 213
    TenguPhule says:

    In my case, I didn’t “have” to go see the podiatrist, but at $20 co-pay, why not see what they can do to improve knee pains when I play ball on concrete?

    So we’re supposed to object to lower healthcare costs because you’re afraid we’ll turn into you?

    Irony rises from the dead, again.

  214. 214
    Darrell says:

    Describe how one of them works, and don’t take time to look it up and copy and paste the answer.

    Jackass, thy name is ThymeZone

  215. 215
    ThymeZone says:

    Most cap plans have provisions for increasing, not decreasing, frequency of doctor visits. That’s because the success of the plan depends, among other things, on improving the health of the capitated population. Without improvements in health, costs go out of control, and the plan will fail.

    Doctors on cap plans, which are almost all non-HMO doctors seeing patients in their own offices these days, are out to get people in to see them on a regular basis in order to screen for diseases and factors which are threats to health, and therefore, to the plan.

    The entire paradigm is based on a planned and managed timeline of visits, tests and screenings aimed at early detection and prevention of disease.

    Nothing about a successful cap plan is left to chance, especially the frequency and nature of doctor visits.

    Darrell didn’t know this, which is why he just wasted an hour of your time talking about a “problem” which doesn’t even exist.

  216. 216
    ThymeZone says:

    I ask again, why is Darrell allowed to post here?

    Anyone?

  217. 217
    Perry Como says:

    In my case, I didn’t “have” to go see the podiatrist, but at $20 co-pay, why not see what they can do to improve knee pains when I play ball on concrete?

    So why did you go? Couldn’t help but take advantage of the system? Amazing that I can’t think of a single example of people that I know that take advantage of low copays like you. How “honest” of you to visit a doctor when you didn’t really need to.

    I think this is typical of the modern conservative movement. They take a look at their worst habits and nature and assume everyone else will act just like them.

  218. 218
    ThymeZone says:

    BTW, if anyone doubts my view of the cap plan and how it works, and its significance to the HMO model, ask your doctor, your HMO and your employer’s benefits coordinator to explain it to you. You don’t have to take my word for it.

    Better yet, talk to a health insurance actuary. Get his/her perspective, and decide for yourself.

  219. 219
    TenguPhule says:

    I ask again, why is Darrell allowed to post here?

    A slave chained next the Roman General reminds him he’s human and not a god.

  220. 220
    srv says:

    I just got back from the doctor, and he says I have Darrellitis.

  221. 221
    Darrell says:

    So why did you go? Couldn’t help but take advantage of the system?

    Not “taking advantage” of the system, as good insurance was part of the package they had to offer to lure me to the company. I went because at $20, why not check if the podiatrist could help? It is, after all, part the package provided by my employer.

    Just like millions of others who could reasonably self medicate colds and flus, or twisted ankles at home, but with cheap co-pays, why would they do that? It’s so cheap and easy to see a doctor when you have, like most Americans, good health insurance.

    You call it taking advantage of the system. I call it dishonesty on your part in not acknowledging it as reasonable human reaction to incentives put in front of them.

  222. 222
    ThymeZone says:

    I just got back from the doctor, and he says I have Darrellitis.

    You should ask for a second opinion. You display none of the outward signs ….

  223. 223
    Perry Como says:

    Just like millions of others who could reasonably self medicate colds and flus, or twisted ankles at home, but with cheap co-pays, why would they do that?

    Because going to the doctor is not a recreational activity? Because my work ethic dictates that the time spent at the doctor for something that can be taken care of OTC is wasting my employer’s time and money as well as the doctor’s time? I can think of plenty of reasons.

    How “honest” of you to get medical services for things you know you can deal with yourself. You’re part of the problem and you expect that everyone else will follow your example.

  224. 224
    RSA says:

    It’s so cheap and easy to see a doctor when you have, like most Americans, good health insurance.

    Maybe it’s just me, but I have better things to do with my time than wait on hold for a receptionist to schedule an appointment, rearrange meetings if necessary, drive to a doctor’s office, sit in the waiting room for up to an hour or so, and then have cold metal objects thrust against and possibly into my body by a stranger—and pay for the privilege. On the other hand, as Darrell points out, if I could get all that for only $20. . .

  225. 225
    Darrell says:

    The entire paradigm is based on a planned and managed timeline of visits, tests and screenings aimed at early detection and prevention of disease.

    People who die at 60 from a heart attack or cancer, incur on average, much lower lifetime health costs than those who live to 80 or 85.

    You insinuate that your “cap” plan is designed to lower health care costs. But regular checkups and screening, although important and good for the patient, do not lower health care costs.

  226. 226
    Darrell says:

    Because going to the doctor is not a recreational activity? Because my work ethic dictates that the time spent at the doctor for something that can be taken care of OTC is wasting my employer’s time and money as well as the doctor’s time?

    Yeah jackass, just like all the “employer’s time” you spend posting on BJ. So ethical of you

  227. 227
    Perry Como says:

    Yeah jackass, just like all the “employer’s time” you spend posting on BJ. So ethical of you

    I’m self-employed now, jackass.

  228. 228
    ThymeZone says:

    You insinuate that your “cap” plan is designed to lower health care costs. But regular checkups and screening, although important and good for the patient, do not lower health care costs.

    Darrell, go and get educated. Nobody here has time for you and your bullshit.

    Nobody can be as stupid as you are. What do you think a cap plan is for, Darrell? The entertainment of HMO employees?

    What do you think they pay their actuaries stacks of money for, Darrell? Tip sheets on horse races?

    Prediction and management of capitation populations are what HMOs do. It’s the basis of their business. It is their business.

    Like I said, you have no fucking idea on earth what you are talking about. None. Zero. Shut up and go away.

  229. 229
    chopper says:

    Dear sht for brains, there are several types of “cap” plans. You are obviously to ignorant to know this fact, as evidenced by your foot stamping petulance on this issue.

    someone finally found google. took you long enough.

  230. 230
    Mary says:

    Malcolm Gladwell

    … when you have to pay for your own health care, does your consumption really become more efficient? In the late nineteen-seventies, the RAND Corporation did an extensive study on the question, randomly assigning families to health plans with co-payment levels at zero per cent, twenty-five per cent, fifty per cent, or ninety-five per cent, up to six thousand dollars. As you might expect, the more that people were asked to chip in for their health care the less care they used. The problem was that they cut back equally on both frivolous care and useful care. Poor people in the high-deductible group with hypertension, for instance, didn’t do nearly as good a job of controlling their blood pressure as those in other groups, resulting in a ten-per-cent increase in the likelihood of death. As a recent Commonwealth Fund study concluded, cost sharing is “a blunt instrument.” Of course it is: how should the average consumer be expected to know beforehand what care is frivolous and what care is useful? I just went to the dermatologist to get moles checked for skin cancer. If I had had to pay a hundred per cent, or even fifty per cent, of the cost of the visit, I might not have gone. Would that have been a wise decision? I have no idea. But if one of those moles really is cancerous, that simple, inexpensive visit could save the health-care system tens of thousands of dollars (not to mention saving me a great deal of heartbreak). The focus on moral hazard suggests that the changes we make in our behavior when we have insurance are nearly always wasteful. Yet, when it comes to health care, many of the things we do only because we have insurance—like getting our moles checked, or getting our teeth cleaned regularly, or getting a mammogram or engaging in other routine preventive care—are anything but wasteful and inefficient. In fact, they are behaviors that could end up saving the health-care system a good deal of money.

  231. 231
    Darrell says:

    This thread makes clear the leftist reaction to inevitable disaster of government health care – You idiots will predictably scream, like you’re doing right now: “Too many people took advantage of the free govt. healthcare. That’s why it’s not working”, etc.

    As if that would some ‘unforseen’ result of ‘free’ government healthcare.

  232. 232
    Perry Como says:

    Nobody here has time for you and your bullshit.

    I do. The insight into the modern conservative mindset is priceless. Darrell’s attitude towards healthcare mirrors the moralizing asses like Haggard, Foley and Bennet so well. They stand on the corner screaming about the evils of something, because they are secretly doing those evil things themselves.

  233. 233
    Perry Como says:

    “Too many people took advantage of the free govt. healthcare. That’s why it’s not working”

    If everyone is a Darrell, then it will be a massive problem. But thankfully not everyone thinks going to the doctor is a recreational activity.

  234. 234
    ThymeZone says:

    Darrell’s attitude towards healthcare

    I agree with your post, but I can’t figure out what Darrell’s attitude actually is.

    As near as I can tell, it’s All Lefties Are Poopyheads.

  235. 235
    Darrell says:

    They stand on the corner screaming about the evils of something, because they are secretly doing those evil things themselves.

    What evils have I ever screamed about which I am “secretly” doing myself? I know it must make you feel empowered and all to write something like that, but you’re simply a dishonest person at your core.

    Unless, of course, you can demonstrate where I am secretly doing something I scream about when others do it..

  236. 236
    Darrell says:

    If everyone is a Darrell, then it will be a massive problem. But thankfully not everyone thinks going to the doctor is a recreational activity.

    The less someone has to pay for a given product or service, the more it will purchased. If gasoline drops to .15/gallon, people will {gasp} use more gasoline.

    In liberal nomenclature, such reasonable behavior always equates to ‘selfishness’ and ‘lack of ethics’. Liberals know what’s best for you. And tsk, tsk Perry, with your lies that you are a libertarian given the hard left positions you routinely stake out.

  237. 237
    Perry Como says:

    It’s called projection, Darrell. You went to the doctor when you didn’t need to. And since you do it, that means everyone else does it. Since the government can’t pay for everyone engaging in that type of behavior, any sort of government health care will fail because everyone will act just like you.

    Simple, really.

  238. 238
    Jay says:

    Just like millions of others who could reasonably self medicate colds and flus, or twisted ankles at home, but with cheap co-pays, why would they do that? It’s so cheap and easy to see a doctor when you have, like most Americans, good health insurance.

    Now we know why it’s so damn hard to get an appointment. But let’s look at this oft repeated assertion closely.

    Say I have a cold (and assume I can get an appointment before the cold clears up). According to the “Why not? It’s cheap,” model of health care, instead of paying six bucks for an OTC medication I pay $20 dollars because it is cheaper than the OTC route.

    Correct me if I’m wrong, but $20 is a lot more than $2 (I’m assuming the six dollar OTC will cover bouts of flu/cold). Not to mention the additional costs associated with driving to the doctor and then to the drug store to pick up a prescription.

    So if many, many people are in fact taking their runny noses to the doctor because they think it is cheaper, then many, many people are utter fuckwits and I have a very nice bridge I’d like to sell them.

  239. 239
    Perry Como says:

    The less someone has to pay for a given product or service, the more it will purchased.

    Which is why I go see the doctor everytime I get a sniffle. Oh wait. I don’t. None of my friends do. My wife doesn’t. You may, but not everyone is you.

    And tsk, tsk Perry, with your lies that you are a libertarian given the hard left positions you routinely stake out.

    There’s a massive problem and the market forces are not going to fix it. I don’t know what the answer is, but I’m open to a discussion of ideas. That means dropping ideology in the face of reality. Something “conservatives” can’t seem to understand.

  240. 240
    Steve says:

    I guess it all depends on your point of view.

    To some people, if a person goes to the doctor to get a cold treated because the co-pay is only $20, that’s a problem.

    To other people, if a parent doesn’t take their child to the emergency room because they don’t want to pay a $500 deductible, and that tummy ache turns out to be acute appendicitis and the child dies, that’s a problem.

    It just depends on how you look at it.

  241. 241
    ThymeZone says:

    Which is why I go see the doctor everytime I get a sniffle.

    Darell’s point is, if your copay went down, you’d go to the doctor more times with the same sniffle.

    For example, if your copay was $1000, you’d never go.

    If it were $50, you’d go on Monday with your sniffle.

    If it were $25, you’d go on Monday and Tuesday with the same sniffle.

    If it were $5, you’d go several times in the same day with the same sniffle.

    By that time, the doctor’s office would be jammed with hundreds of sniffling patients, and the guy with cancer? He’d be dying because the doctor wouldn’t have time to see him.

    That’s exactly what happens in Canada, and France.

    Right, Darrell?

  242. 242
    Darrell says:

    Perry Como Says:

    It’s called projection, Darrell. You went to the doctor when you didn’t need to

    Who says I didn’t “need” to? My knees were sore after playing basketball. Had I not had such a low co-pay (paid for by my employer as part of a package used to lure me to to work there), I probably wouldn’t have bothered, but I did. It was part of my employment benefits which I took advantage of. Nothing wrong or ‘unethical’ in the least with what I did.

    Part of your nanny-state mentality Perry, telling others when health care treatment is necessary and when it’s not.

  243. 243
    TenguPhule says:

    This thread makes clear the leftist reaction to inevitable disaster of government health care

    To Paraphrase Darrell: Just because Social Security worked, Medicare worked, and the government’s own Medical Coverage works, that doesn’t mean Government can do anything.

    Darrell, trusts the government to wage war but not to provide essential healthcare. Go figure.

  244. 244
    DoubtingThomas says:

    I ask again, why is Darrell allowed to post here?

    Because he never gets sick of arguing with you. Why not have your opposite post? It makes for some lively threads and I suspect you both secretly enjoy it!

  245. 245
    Darrell says:

    To Paraphrase Darrell: Just because Social Security worked, Medicare worked, and the government’s own Medical Coverage works, that doesn’t mean Government can do anything.

    Each of those programs have experienced costs which spiraled exponentially beyond what was projected. I think since eating is such a fundamental basic right, that the govt. needs to take over all grocery stores and agriculture.

  246. 246
    TenguPhule says:

    Part of your nanny-state mentality Perry, telling others when health care treatment is necessary and when it’s not.

    Irony is having a good time today.

    Darrell insists that people will make unnecessary medical decisions and then tries to pretend Perry is the one saying what is needed and what is not.

    So with Universal Health Care, we all pay less. What was your argument again, Darrell?

  247. 247
    TenguPhule says:

    Each of those programs have experienced costs which spiraled exponentially beyond what was projected.

    I’m sorry, we’re not discussing the Bush Regime’s Agenda of Failure here. But thank you for finally noticing that.

  248. 248
    Darrell says:

    Darrell insists that people will make unnecessary medical decisions

    Sigh. Thick as concrete your head.

  249. 249
    Perry Como says:

    Who says I didn’t “need” to?

    You did:

    As a runner and basketball player, I went to several podiatrist treatments for orthotics to help me run better. Now, I get along fine with $20 Spenco arch supports.

    So instead of trying a $20 pair of arch supports, you went to a doctor. And since you do it, everyone else must do it too.

    Part of your nanny-state mentality Perry, telling others when health care treatment is necessary and when it’s not.

    Yes, such a nanny-statist am I. Saying that there’s a problem with the healthcare system in the US and we should discuss ways to fix it. Help, you’re being oppressed!

  250. 250
    Darrell says:

    As a runner and basketball player, I went to several podiatrist treatments for orthotics to help me run better. Now, I get along fine with $20 Spenco arch supports.

    So instead of trying a $20 pair of arch supports, you went to a doctor

    But how could I have known that the podiatrist wouldn’t have done any better, without first trying him out, to see if he could help improve my problem? Can you answer that jackass?

    Again, this was an insurance benefit provided by my employer which I took advantage of. Nothing wrong or unethical in the least with what I did, and I think it’s clearly dishonest as hell for Perry to portray it otherwise.

  251. 251
    TenguPhule says:

    Shorter Darrell: Stinky Poo!

  252. 252
    capelza says:

    But how could I have known that the podiatrist wouldn’t have done any better, without first trying him out, to see if he could help improve my problem? Can you answer that jackass?

    Because, if you were smart, you’d try the arch supports first.
    Just as when i have the sniffles I slam down the OTC or herbals out of my garden, rather than charging off to the doctor to see if he could charge me more.

    I think you got it backwards.

  253. 253
    Perry Como says:

    But how could I have known that the podiatrist wouldn’t have done any better, without first trying him out, to see if he could help improve my problem?

    The same way that I don’t run to the allergist whenever the seasons change and pop a Benadryl instead. I’d rather not waste my time, the doctor’s time, and the insurance company’s money when an OTC remedy will do just fine.

    Again, this was an insurance benefit provided by my employer which I took advantage of. Nothing wrong or unethical in the least with what I did, and I think it’s clearly dishonest as hell for Perry to portray it otherwise.

    Knock yourself out with your benefits, it’s only the rest of us that pay for the higher premiums. What’s dishonest is the assumption that your behavior is what everyone else does.

  254. 254
    Darrell says:

    Because, if you were smart, you’d try the arch supports first

    Who says I didn’t? How intelligent of you to assume otherwise.

  255. 255
    Perry Como says:

    I just checked my benefits list and it covers something called “nuclear medicine.” I’m not sure what that is, but it sounds cool, so I’m going to take the Darrell approach and make an appointment to see if I can get some of that nuclear medicine. Maybe it will turn me into the Incredible Hulk or something.

    Rawr.

  256. 256
    Perry Como says:

    (*Now* I’m being a jackass)

  257. 257
    Darrell says:

    What’s dishonest is the assumption that your behavior is what everyone else does.

    The assumption that employees will take advantage of health care benefits? How dishonest of me to assume that!

  258. 258
    ThymeZone says:

    since eating is such a fundamental basic right, that the govt. needs to take over all grocery stores and agriculture.

    You mean, in Iraq, right?

  259. 259
    ThymeZone says:

    Maybe it will turn me into the Incredible Hulk or something.

    I hear the yellowcake is tasty this time of year.

  260. 260

    Perry, did I just see someone call *you* a nanny-statist? Bwahahaha.

    That’s pretty rich.

  261. 261
    ThymeZone says:

    The assumption that employees will take advantage of health care benefits

    Benefits, and people taking advantage of them, is pretty much the whole point.

    And what happens then? Health improves.

    And then?

    Costs go down.

    The present system is optimized for high costs and poor delivery. Absolutely bass-ackward, the opposite of what is needed.

    Fewer and fewer people get regular care, health degrades, costs go up. More and more employers are damaged by the burden of doing the government’s work of carrying the load. Fewer and fewer workers get benefits. The spiral deepens.

    This model is absolutely not sustainable, and will collapse.

    Another great Republican accomplishment.

  262. 262
    Steve says:

    By the way, is there some kind of overarching rule that says single-payer health care can’t involve any kind of user fees at all? Like, we can’t have anything resembling a co-pay?

  263. 263
    Darrell says:

    And what happens then? Health improves.

    And then?

    Costs go down

    Actually, that’s false. People who don’t take care of themselves, are more likely to die suddenly at a younger age, making their lifetime healthcare costs significantly less than someone living to 85 who received regular healthcare.

    There are other arguments to make, but cost savings isn’t one of them.

  264. 264
    Darrell says:

    Steve Says:

    By the way, is there some kind of overarching rule that says single-payer health care can’t involve any kind of user fees at all? Like, we can’t have anything resembling a co-pay?

    Well Steve, that idea would indicate a desire for rational discourse, something rarely found here.

  265. 265
    ThymeZone says:

    is there some kind of overarching rule that says single-payer health care can’t involve any kind of user fees at all?

    No such rule. In fact fees are almost certain to be part of the solution.

  266. 266
    Adam says:

    Hey Darrell:

    DID YOU EVER WONDER WHY YOUR AUTO WARRANTY REQUIRES YOU TO CHANGE YOUR OIL?

    If you can unlock that puzzle, you’ll understand why your argument is retarded.

  267. 267
    Pb says:

    Perry Como,

    Go for it. They’ve got X-Ray machines, so why not a Gamma Ray machine–or a Cosmic Ray machine? Fantastic Four, baby!

  268. 268
    ThymeZone says:

    In the Darrell Model of Healthcare,the more expensive it is, the better it is.

    When access to care gets cheaper, too many people get healthcare, and the quality of care goes down.

    In order to keep the quality high, and the care available to the people who can afford high-cost care, you have to keep the fees up as high as possible.

    Did I miss anything, Darrell?

  269. 269
    Perry Como says:

    or a Cosmic Ray machine? Fantastic Four, baby!

    As long as it’s not The Venture Brothers version…

  270. 270
    somehoser says:

    Do you really think the innovations in medical care over the past 50 – 100 years would be available with government controlled healthcare? One needs only to look at the number of medical technology and pharmaceutical “innovations” coming from Canada to see the answer to that question.

    Quite a few if you bothered to look.

  271. 271
    Steve says:

    When access to care gets cheaper, too many people get healthcare, and the quality of care goes down.

    In order to keep the quality high, and the care available to the people who can afford high-cost care, you have to keep the fees up as high as possible.

    Did I miss anything, Darrell?

    I think you missed the part where it’s cheaper if we can get people to leave their illnesses untreated and just drop dead all of a sudden.

  272. 272
    jcricket says:

    The level of vitriol with which people like Darrell oppose a goverment program is usually a sign it will work. Take this wonderful comment:

    This thread makes clear the leftist reaction to inevitable disaster of government health care

    So, according to Darrell, every other implementation of nationalized healthcare has been a “disaster”? Oh wait, that’s not the case? Other countries have better care as measured by pretty many statistics that matter (including life expectancy and infant mortality), and everyone is far more satisfied with their health care? And it costs everyone less?

    That’s just crazy talk. It’ll never work here. Nothing to see, move along.

    People like Darrell oppose government programs because the more successful the government is at providing necessary services for people, the less appealing he and his fellow “government is for sissies” party sound.

  273. 273
    jcricket says:

    I think you missed the part where it’s cheaper if we can get people to leave their illnesses untreated and just drop dead all of a sudden.

    No, Darrell didn’t miss that at all. See a bit further up thread.

    People who die at 60 from a heart attack or cancer, incur on average, much lower lifetime health costs than those who live to 80 or 85.

    For the outcome of the Darrell health plan see Logan’s Run.

  274. 274
    TenguPhule says:

    People who don’t take care of themselves, are more likely to die suddenly at a younger age, making their lifetime healthcare costs significantly less than someone living to 85 who received regular healthcare.

    Darrell’s true agenda finally becomes clear.

    Translation of Darrell Speak: I want people to die young to keep healthcare costs down. Screw the old people!

  275. 275
    Adam says:

    Darrell, this is an interesting suggestion:

    I think since eating is such a fundamental basic right, that the govt. needs to take over all grocery stores and agriculture.

    However, I just got off the phone with ADM and the farm lobby and they said that the agriculture subsidies are working out just fine, so no government involvement is necessary.

    Then they laughed and hung up.

  276. 276

    Darrell wrote:

    If you lower the cost of something, in this case medical treatment through low co-pays, you’ll be selling much more of it. That’s just human nature. Incredible how so many lefties on BJ try to deny this.

    The only thing you’ve demonstrated here is that you are a bad example for others. Everybody else has basically stated they don’t enjoy going to see the doctor unless they really have to.

    Yet you keep insisting the rest of the world is like yourself, prone to abusing the system, and so we need laws to stop you from yourself.

    An interesting study on human nature, I think.

  277. 277

    DID YOU EVER WONDER WHY YOUR AUTO WARRANTY REQUIRES YOU TO CHANGE YOUR OIL?

    Is this why so many car companies are now offering free maintenance during the warranty period?

  278. 278
    ThymeZone says:

    I’d call it the Darrell-Stormy Healthcare Model:

    Hey, I ain’t paying the way for friggin sick people!

    Simple, elegant, cost-efficient.

    And, it increases the supply of Soylent Green.

  279. 279
    CaseyL says:

    Once upon a time, kidney dialysis was such a new treatment that only a few places in the country had it. Since there were plenty more people who needed dialysis than there were dialysis machines, someone had to make the decision of who got the treatment: a decision of who would live and who would die.

    Seattle had one of the very few dialysis centers back then, and had created a volunteer committee to decide who got treated. I used to work with a woman who had been on that committee. She said they worked hard to come up with parameters that were both ethical and pragmatic. (The only guideline I clearly remember was that family breadwinners had priority over single people. There were others, but that’s the one I’m most certain of. This was also during a time long before “medical bioethics” existed as a recognized field.)

    She said it was the most difficult, nightmarish, gut-wrenching work she’d ever done. She said everyone on the committee was grateful beyond words when dialysis became widely available, was covered by insurance, and the committee could disband.

    Whenever I hear fools talk about limiting medical treatment to “the most deserving,” because said fools value their own ideology more than they do the people who’d have to live under it, I think about that committee. I think about how horrible it must have been, not only to be on it, but also to be the patients – already sick, already dying, already desperate – who had to go before that committee to plead for their lives.

    At least then the scarcity was a matter of objective fact: there simply weren’t very many dialysis machines around. No one was withholding treatment for reasons extrinsic to the issue itself, such as profit margins or ideology.

    The idea of making sick people plead for their health, for their lives, when the scarcity is artificial – a matter of economic inequity and ideological purity – is immoral, unethical, and downright obscene.

    Yet that is precisely the situation we’re in.

  280. 280
    grumpy realist says:

    I really wonder whether a gov’t health care system could possibly be as inefficient as the system we have now. How much are going for administration costs?

    And even after you’ve done everything “correctly” and gotten your treatment, the insurance company suddenly says oh, by the way, no, we’re not going to pay at all because we’re going to claim that this was an “existing condition”.

    I’ve dealt with three different health care systems so far. Two nationalized, and the one here in the US.

    I’d rather pay taxes and know I can go to a clinic and pay 7-15$ rather than the bloody high payments here in the US for standard stuff. Even with the discount from Blue Cross/Blue Shield. I still had to pay over $100 for a simple dental check-up with x-rays. This is ridiculous.

  281. 281
    b-psycho says:

    I just have one question for anyone who supports nationalized healthcare in the US for any reason: Considering how badly the gov’t fucks up EVERYTHING else they do, why do you trust them with this?

    A case can be made for pooling of resources being more efficient in certain situations, all other things being equal. Interpreting that as “we can trust politicians to design a healthcare system that doesn’t screw 99% of the population for their own benefit” is just nuts. Eventually we need to rediscover the fact that group/community responsibility does not inherently assume a role for the State & act accordingly.

  282. 282
    b-psycho says:

    Honestly, it should say enough against the idea that big business is latching onto it. They could give half a fuck if it’s designed in a reasonable way, the entire point is to socialize their costs while keeping the profit private.

    None of this would’ve happened if healthcare didn’t get attached to employement in the first place.

  283. 283
    Steve says:

    Interpreting that as “we can trust politicians to design a healthcare system that doesn’t screw 99% of the population for their own benefit” is just nuts.

    Because Medicare screws things up for 99% of participants, right? Why, there’s not a soul who thinks Medicare is a good thing. It certainly demonstrates why the government has no business getting anywhere near health insurance, because Medicare is universally regarded as an abject failure that needs to be abolished forthwith.

  284. 284
    ThymeZone says:

    Considering how badly the gov’t fucks up EVERYTHING else they do, why do you trust them with this?

    Because it’s access, not medicine, that the government will provide.

    The govt builds the highway, the people drive the cars.

    The govt builds the airports, and maintain safety. The people plan the trips and pack the bags.

    The govt builds a payment structure, the doctors and patients use it. I’m not going to ask Bill Frist to diagnose me. I’m just going to expect his successors to provide me access to the diagnosis I’ll need.

    As long as everyone can get routine care routinely, extraordinary care when needed and without bankrupting my family, and I don’t have to hang onto an undesirable job to get healthcare, or abandon plans to move to another state for fear of losing insurance, or live in fear of a medical crisis that would bankrupt my family …. then it’s working.

  285. 285
    Adam says:

    Shhhh! Part of Grover Norquist’s “drown the government” plan is to kill off all the politicians with that crappy Medicare coverage. Stop giving it away, you fools.

  286. 286
    b-psycho says:

    Steve: …and that’s going to eat up a lot of the budget in the coming years, prompting huge cuts & strict rationing of services, so I wouldn’t use that as an example.

  287. 287
    jake says:

    People who die at 60 from a heart attack or cancer, incur on average, much lower lifetime health costs than those who live to 80 or 85.

    For a heart attack victim? Sure if they kindly drop dead right away and don’t linger in the ICU for days. As for cancer patients, you’re kidding, right? Unless we assume the cancer is only ever detected at the point where all the doctor can do is give the patient a big drip bag of morphine you can easily cram many, many years of health care costs into the time between detection and death.

  288. 288

    Grumpy…in fact, the VA and Medicaid are the most efficient delivery systems in the US, with management burdens below 5%. (Social Security, by the way, is similarly efficient.) That’s about an order of magnitude lower than the management burden of the lowest margin private plans — and, in the case of the VA, it’s coupled with excellent outcomes with a difficult patient population.

  289. 289
    b-psycho says:

    As long as everyone can get routine care routinely, extraordinary care when needed and without bankrupting my family, and I don’t have to hang onto an undesirable job to get healthcare

    Like I said, none of this would’ve been an issue if not for the tying of healthcare to employment. That association needs to be broken, but nationalizing it is a bailout they don’t deserve.

    Here’s some ideas: You know how some businesses get discounted group rates? Open that to everyone. Also, tell the drug companies that the subsidies to their research will only continue if in exchange they forfeit the patents ASAP, they don’t like it they can use their own damn money. And in the particular case of the auto industry, the unions should be legally allowed to take over responsibility for existing benefits, as part of reconfiguring the purpose of organized labor away from depending on employers.

  290. 290
    Perry Como says:

    and, in the case of the VA, it’s coupled with excellent outcomes with a difficult patient population.

    Why do you hate the troops?

  291. 291
    ThymeZone says:

    nationalizing it is a bailout they don’t deserve.

    I’m not out to save businesses. I’m out to save people and families from being one bad lab test away from ruin.

  292. 292
    Perry Como says:

    I’m out to save people and families from being one bad lab test away from ruin.

    Communist.

  293. 293

    I just have one question for anyone who supports nationalized healthcare in the US for any reason: Considering how badly the gov’t fucks up EVERYTHING else they do, why do you trust them with this?

    Only if you elect Republicans to office.

  294. 294
    Jimmm says:

    But Frank is gay and Michael Moore is fat. It’ll never work.

  295. 295

    […] Posted by TFG on November 20th, 2006 The major criticisms of public healthcare never seem to hold much water. […]

  296. 296
    Zifnab says:

    Here’s the deal. I kinda work in the medical business as a software engineer, so I get to see all the grit behind some of the business practices.

    When a hospital decides to charge a patient, there is a simple formula. Take the standard Medicare Coverage for the treatment, add X%, bill.

    I regularly get to parse through the aggregate billing in a year, and any given doctor will averge in the tens of millions. To say the medical community in my area make money hand over fist does a disservice to both hands and fists. The cash influx is absolutely huge. And yet, the primary complaint in my state is the over-regulation. You see, doctors need to have insurance. This is for much the same reason that drivers are required to have insurance. When your daily routinee can potentially maim or kill somebody, it seems only fair that you be required to have the collateral to pay for the damage.

    So because there are so many doctors in my state, there are also a great number of bad doctors. This brings on a great number of lawsuits. And lawsuits give insurance companies a great excuse to raise premiums. When a doctor is making millions of dollars a year, a six figure premium on insurance doesn’t sound quite as exhorbatant. But it sure sounds like a great excuse to raise hospital rates. My state legislature wants to solve this problem through “tort reform” which would limit the punative damages assigned to, say, paralyzing someone for life or causing serious organ damage, below a quarter million dollars. My state legislators don’t think crippling someone for life is really worth much more than a quarter million dollars. And to a man who makes millions a year, a quarter million in damages really is punishment enough.

    So yes. Rambling, somewhat off-topic, and a little incoherent. But my point is simple. Our system is fucked up. Horribly fucked up. I don’t know who told you that the American Health Institution is the greatest Institution in the World, but they were either dumb or lying. I’ve seen the inside of the beast, and she is one ugly mother fucker.

    Just something to keep in mind.

  297. 297
    TenguPhule says:

    A case can be made for pooling of resources being more efficient in certain situations, all other things being equal. Interpreting that as “we can trust politicians to design a healthcare system that doesn’t screw 99% of the population for their own benefit” is just nuts.

    There is a very simple solution to that problem.

    Take away Government Officials Health Care Plans and put them on whatever plan they design for the public.

  298. 298
    TenguPhule says:

    Darrell says: Well Steve, that idea would indicate a desire for rational discourse, something rarely found here.

    Okay, I was wrong. *This* is the Darrell Irony of the Day.

  299. 299
    scarshapedstar says:

    Since you claim that healthcare is equal between the US and the countries with public healthcare, why don’t the wealthy go to where the counties (w/ public healthcare) where it is cheaper?

    This may be the greatest nonsense argument of all time.

    Riddle me this, Paul! Why do rich people drive Bentleys and limousines when a Toyota is cheaper? Huh? Gotcha!

  300. 300
    ImJohnGalt says:

    Just read the entire thread so far. I can’t scrub my eyes enough to wash away the idiocy therein.

    Let’s me recap:

    Darrell says the problem with national health care is that people will abuse a government provided health care system if they aren’t financially incented to not go. If it’s cheap, they’ll go too much, and that’s wrong.

    However, his employer provided insurance is cheap, and he went to his doctor for a frivolous sports “injury” that could’ve been solved by an OTC treatment. Is this bad?

    Again, this was an insurance benefit provided by my employer which I took advantage of. Nothing wrong or unethical in the least with what I did.

    Um…okay.

    His original quote:

    As a runner and basketball player, I went to several podiatrist treatments for orthotics to help me run better. Now, I get along fine with $20 Spenco arch supports.

    Now, I’m no grammarian, but the structure of those sentences implies that you went several times to a podiatrist, and then settled on OTC arch supports. I defy anyone to read those sentences in any other way.

    In fact, you said:

    But how could I have known that the podiatrist wouldn’t have done any better, without first trying him out, to see if he could help improve my problem? Can you answer that jackass?

    When someone then said:

    Because, if you were smart, you’d try the arch supports first

    You, in a stunning plot twist, said:

    Who says I didn’t?

    A rhetorical tactic which answer should be clear from the above quoted text. You did.

    Dickhead.

  301. 301
    ThymeZone says:

    I’ve seen the inside of the beast, and she is one ugly mother fucker.

    Oh … whew. For a minute there, I thought this had become a Cindy Sheehan thread ….

  302. 302
    ImJohnGalt says:

    Secondly, in a stunning misreading of Adam Smith’s Wealth of Nations, Darrell states the obvious, that:

    The less someone has to pay for a given product or service, the more it will purchased. If gasoline drops to .15/gallon, people will {gasp} use more gasoline.

    Applying the invisible hand to the practice of medicine, Darrell implies that if only Barium enemas were cheaper, people would be lining up with some uranium and a douche on their Friday evenings rather than go to a movie. (Darrell, of course could just use himself, although he’d still need some Barium).

    What Darrell fails to recognize is that gasoline is a commodity that is in demand by most everyone. Barium enemas, or other unpleasant diagnostic tools, are in demand by people who generally need them after having been diagnosed by a doctor.

    People who cannot afford these diagnostic tools, or the treatments that are indicated as a result of their use, may develop complications, or wait too long to see a medical professional so that by the time it is diagnosed, less expensive treatments are no longer effective. What’s that old saw about prevention v. cure? [hint: It’s not about activist judges]

    Darrell, what if government co-pays were exactly the same as the co-pays you enjoy with your employer plan? Not less, not more, but exactly the same. Would you expect doctor visits to go up? If so, why? Also, if they did, why would you begrudge people the right to do exactly as you did, which, as you said above, is perfectly above-board and ethical.

  303. 303
    jake says:

    When a doctor is making millions of dollars a year, a six figure premium on insurance doesn’t sound quite as exhorbatant.

    Add to this the fact that many doctors don’t make six figures and many times a law suit will include everyone involved in the patient’s care (I’ve worked in credentialling so I’ve seen a lot of doctors who have been named in law suits because they were observing a surgery). And of course the malpractice insurers don’t bother to distinguish between the doctor who is only named as a defendant in a case and the doctor who is named as a defendant but the case is dropped and the doctor who removed the tonsilectomy patient’s feet by mistake. It doesn’t have to think of such trifling details, the doctor must have insurance to practice, so the m.i.cs could require doctors to wear tu-tus every Wednesday if they were so inclined. So far they seem content to ask for more money.
    And of course, the costs of frivolous fee hikes eventually lands in the patient’s lap.

  304. 304
    ImJohnGalt says:

    And finally, why is nobody talking about doctor incentives to drive up costs?

    What’s the incentive for a doctor to not see patients, or to not order a profitable diagnostic if his hospital makes more money by him doing so?

    To be fair, doctors also overdiagnose because they are afraid of being sued if they miss something. While some slight form of tort reform might be indicated here, it should be nothing along the line of capping compensation at 250K. Some opiate-addicted doctor leaves his scissors in someone because he’s been on a bender, he better be punished in a way that hurts him, and ensures he doesn’t practice again.

  305. 305
    grumpy realist says:

    Well, I would think that the present efficiency of the VA (particularly in holding down administrative costs) shows that yes, indeed, the gov’t can carry out this efficiently.

    What I was trying to point out is that the present system is so dysfunctional that the bar the gov’t has to hop over is pretty low. We could have a pretty bad gov’t system that would still be oceans better than what we have now.

  306. 306
    jcricket says:

    if only Barium enemas were cheaper, people would be lining up with some uranium and a douche on their Friday evenings rather than go to a movie.

    This may be true, depending on the movie

    Understanding that health care doesn’t work like other “commodity markets” (come to think of it, no market is exactly the same) is obviously beyond the grasp of someone as simple-minded as Darrell. Unfortunately, people like Darrell have “ruled” our national political debate for the last 12 years. Glad to see it’s coming to an end. I only hope we can undo the damage.

  307. 307
    jcricket says:

    And finally, why is nobody talking about doctor incentives to drive up costs?

    Everyone talks about the weather, but why is no one doing anything about it?

    Working directly with doctors, I can say that while this might happen a little, most are too busy trying to give patients good care at ever-shrinking reimbursement rates to start fooling around with added diagnoses. I know that ERs (and all the tests they routinely order) are the exception, but general practitioners have been struggling under the increasing weight of lowered reimbursement rates for so long that most are seeing twice as many patients, for half as long (or less), just to make what they made 10 years ago.

    The only people “making out big” in our current system are the specialists (and they deserve it, largely) and the insurance companies. I wouldn’t begrudge the insurance companies their profits if we had universal coverage without all the BS of the current system – but given as there’s a snowball’s chance in hell of them spontaneously building a good healthcare system, I say fuck the insurance companies. I won’t be sad when they go.

  308. 308
    jake says:

    What’s the incentive for a doctor to not see patients, or to not order a profitable diagnostic if his hospital makes more money by him doing so?

    I think it would be better to focus on the doctor’s practice (solo/group) because that’s where most of the work gets done, meaning he’s ordering tests from his office and perhaps sending the patient to hospital based on those results. However, with any procedure (regardless of where it is performed) the patient’s health insurance company acts as the gate keeper to health care.

    A doctor can order a test or perform a surgery, but what if the hic decides it wasn’t necessary, or just gets it wrong and denies payment? The doc’s choices are: Spend time (and money) dickering, or eating the costs. To avoid this, particularly for more expensive, less common procedures, the doctor’s staff will ask before (and spend time and money dickering). If after all of the calls and appeals and so on the hic still says no the patient will have to come up with the money or the procedure doesn’t occur. So, if you imagine going through this song and dance several times a week you can see why there is no incentive to order tests willy nilly. That profitable diagnostic (or any other procedure) might not be so profitable after all.

    Some opiate-addicted doctor leaves his scissors in someone because he’s been on a bender, he better be punished in a way that hurts him, and ensures he doesn’t practice again.

    Yes, the 250K cap is insane and if anyone thinks the m.i.cs will stop raising premiums with such caps in place they’ve been gobbling Percodan and chasing it with vodka. There is no correlation between the number of malpractice lawsuits, damages awarded or settlement amounts (the only time the mic has to cough up) and malpractice insurance rates. Once again this administration’s concern with the “little guy” this desire to allow Ob/Gyns to “practice their love of women” was a big fat farce for the benefit of a few large corporations.

  309. 309
    JimSaco says:

    Health care “problem” solved:

    1. Everyone must have health insurance.

    2. You can obtain this by:

    a) getting it through your employer; or
    b) buying your own individual insurance; or
    c) paying a special tax of 14% of income (first $10k exempted) and buying into Medicare.

    But you are mandated to do one of those 3 things.

    Everybody’s covered!

    Then we go to work on the structural issues.

  310. 310
    Bombadil says:

    Sadly, the standard browser here is Internet Explorer, and the troll busting macros don’t work well with it. Threads like this are much easier to read with Firefox, although I do get an insane craving for pie.

  311. 311
    Zifnab says:

    if only Barium enemas were cheaper, people would be lining up with some uranium and a douche on their Friday evenings rather than go to a movie.

    After they raised the price of tickets to $9 a showing, those Barium enemas started looking better and better.

    Seriously, though, is this the best arguement that can be presented against Health Care? We need high prices so that less people will see doctors?

    Let’s spend a moment talking about preventative care. Seeing a dietitian for your son or daughter’s health can often head off Type 2 diabetes in its infancy. A $100 doctor’s visit today can potentially save you and your loved one tens of thousands in diabetes meds over the course of the rest of his life.

    Under Darrell logic, going to see that dietitian is frivilous, something that should only be available to those who can shell out the full C-note on his own dime. After all, its not like certain people have a predisposition to diabetes, right? Just eat lots of cucumbers and never have any chocolate cake and you should be perfectly fine. Personal responsibility.

    Of course, when these irresponsible kids end up in the emergency room… repeatedly… as they go into insulin shock ten years down the line, the HMO can catch it and pay some paltry fraction of the cost. Sure, the cost of a single emergency room visit could potentially cover the cost of a dozen visits to a dietitian. But if people were just allowed to get diabetes diagnosed at an early age, everyone would be doing it constantly and you’d have to get on two-week waiting lists to see these people. Which is a total pain if you just want to slap a C-note on the table and see a doctor.

    Basically, poor people clog our medical system enough as it is. Universal Medical Assistance would just compound the problem. Nothing in the Bill of Rights says you have the freedom to be not sick. So suck it and die.

  312. 312
    Bombadil says:

    Per Charlie Pierce at Tapped:

    Alzheimer’s Disease, which struck down my father and every one of his four siblings…is a disease that takes a horrible toll on almost everyone in a patient’s family. The estimated cost of caring for an AD patient is $174,000, and average course of the disease is seven years. The Alzheimer’s Association estimates that 16 million Americans might have the disease by 2050. Even if a therapy can be found, a lot of the cost of caring for an AD patient is still going to come from things like home nursing and respite-care, which enable the fulltime caregiver, usually an aging spouse, the opportunity to sleep three or four consecutive hours.

    This was in response to another post from Exra Klein about a Kaiser study (link in the post — I’ve maxed out on links) on cancer care issues.

    According to Kaiser’s survey, a full quarter of households used up all their savings treating the patient. One in ten had to forego major expenses like food, heat, or housing in order to bear the burden. 13% ended up going into debt and being hounded by collection agencies, 3% declared bankruptcy. 8% of respondents said they delayed or went without treatment due to the expense. 11% were unable to health insurance because of their cancer and 6% lost insurance they already had.

    HSA’s won’t begin to cover all of the costs associated with these kinds of medical problems, no matter what Pieboy thinks. And if mitch wants to opt out of the insurance pool and save his money, well, he can go right ahead and run the risk of having to do it all on his own.

    Medical (indeed, all) insurance is a form of risk management. It’s a bizarre form of gambling, where you bet you’re going to get sick and the insurance provider bets you’re going to stay well. If you “win” the bet, it’s because something pretty nasty has occured.

    Health coverage, as I see it, is somewhat different. It’s a way for society as a whole to acknowledge the desirability of a healthy population, and to recognize that it benefits everyone, not just the sick.

    Whatever happened to the concept of “enlightened self-interest”?

  313. 313
    Bombadil says:

    Full disclosure, and why I have a dog in this hunt, too. My grandfather and three of his siblings had Alzheimer’s, and their father likely did, as well (it wasn’t called Alzheimer’s then). My aunt is in the beginning stages of it now, and my wife’s grandmother had it. My mother, her brother and their father all died of cancer.

    Beyond smoking, there are any number of causes of cancer that are not “personal responsibility” issues (be they environmental causes, genetic proclivities, whatever), and the causes of AD are still being searched for, and they can strike anyone, any time. Pick your own catastrophic medical issue (muscular dystrophy, multiple sclerosis, mental illness, on and on and on), figure out the long-term costs and decide what you’re going to do when your HSA runs out. Then see if you think shared risk is such a bad idea.

  314. 314
    Darrell says:

    But how could I have known that the podiatrist wouldn’t have done any better, without first trying him out, to see if he could help improve my problem? Can you answer that jackass?

    IMJohnGalt, welcome back you insufferable fucking asshole. ANYONE who has ever in their life been fitted for orthotics knows it takes a MINIMUM of 3 visits. One for consultation, possibly the cast is made that first visit, sometimes not. After making the cast and taking measruements, another visit for fitting modification of the orthotic mold before it’s finished. And another visit to received the final product. In addition, most podiatrists want another followup visit to check how things are working. Again, this is standard procedure for EVERYONE who gets fitted for orthotics.

    A rhetorical tactic which answer should be clear from the above quoted text. You did.

    Dickhead.

    IJG, you stalk me on threads like this ranting over nonsense because you are an obsessed freak. This is but one of many examples.

  315. 315
    ThymeZone says:

    The reason why Single Payer looms like a spectre over this issue is because you need Single Underwriter to make the actuarial realities work.

    If you allow various demographics to opt out or seek other solutions, you deprive the scheme of funding.

    You need the whole population contributing, so that as you work to improve the health of that population, you increase the ratio of funds to costs to the greatest possible extent. When the rich or healthy people can take their action somewhere else, your system can’t work. That’s a large part of what is wrong with the current system. By treating coverage and participation as optional, and treating medicine as a business, the system skews toward expensive infrastructure and high costs, while at the same time leaving more and more people uncovered. A time bomb.

    Why do you think the anti-tax nuts, and their heroes like George Bush, want to siphon off money from Social Security to do things like “private accounts?” Because they love you and love capitalism? No, it’s because they (actually, CATO Institute) figured out a long time ago that if they could break up the Social Security demographic, they could starve the core system and make it appear to be nothing more than welfare for poor people. Whereupon, voters would abandon it.

    Well, they haven’t succeeded so far in making that happen, although Bush gave it his best try. But they have succeeded grandly in turning the healthcare system into a system skewed toward wealth and privilege, as more and more people are left behind, and the everyone’s costs go up and up.

    If you want to see what old-age security would look like under a CATO government, just look at the present healthcare situation, basically tilted toward Haves and the expense of Have Nots, and tilted toward very big money interests and corporations. The GOP’s dream.

  316. 316
    ThymeZone says:

    welcome back you insufferable fucking asshole.

    Darrell’s Comity of the Day.

    Sorry, T-Phule, your idea is so good, I had to steal it.

  317. 317
    Darrell says:

    The estimated cost of caring for an AD patient is $174,000, and average course of the disease is seven years.

    My grandfathers on both sides had alzheimers. Their medical treatments in the 1990’s was nothing remotely approaching the $174,000/year. I call bullshit on that number as in any way representative or “typical”.

  318. 318
    Darrell says:

    JimSaco Says:

    Health care “problem” solved:

    1. Everyone must have health insurance.

    2. You can obtain this by:

    a) getting it through your employer; or
    b) buying your own individual insurance; or
    c) paying a special tax of 14% of income (first $10k exempted) and buying into Medicare.

    But you are mandated to do one of those 3 things.

    Everybody’s covered!

    Best post/idea on the entire thread. Treat it like car insurance. Mandatory. If you don’t have it through your employer, either buy it yourself or pay an additional tax for it.

    ThymeZone, you’ve indicated in the past that you had an expensive heart attack or stroke (I can’t remember which).. but you’ve also indicated that you own rental homes and have a high income. Why didn’t you have adequate insurance when you got hit with the attack?

    Was that a case, like with so many other Americans (some high percentage of uninsured Americans earn over $50,000/yr), that you could have afforded it, but chose not to buy it?

  319. 319
    John D. says:

    Was that a case, like with so many other Americans (some high percentage of uninsured Americans earn over $50,000/yr), that you could have afforded it, but chose not to buy it?

    It’s hard to understand what your point is, since $50K/year is barely over the poverty line if you have a family of 9, for example. HHS has a nice breakdown of insured levels based on income relative to the FPL.

    27% total of the uninsured made 3 times the poverty level or more in 2004. Which, of course, means that 73% were less than that, and fully 53% were less that twice the FPL.

    See figure 2

    Lack of health insurance disproportionately affects the poor.

    Also, endnote 4 at that link shows

    4. In 2004, 300% of poverty was $27,930 for a single individual and $56,550 for a family of four, and 500% of poverty was $46,550 for a single individual and $94,250 for a family of four.

    So, a family of four making $50K/year would fall into the 73% above.

  320. 320
    spoosmith says:

    As a Canadian with health issues who lives under a universal health care system, let me enlighten some of you:

    Our health care system comes under fire for wait times. While it’s true that the universal system invites abuses (I know a lot of people who will run to the doctor when they feel a cold coming on to get antibiotics, mistakingly thinking that they help) and we are concerned that the aging baby boomers will bust the system, the fact is that if a Canadian is sick they can get help. Our government negotiates bulk pricing from drug manufacturers – something that your governement for some reason refuses to do. I have MS and my medication is just over $1600 per month. My husband has a health plan with no prescription caps, so I pay a dispensing fee of $6. I see a neurologist every 6-8 months, get an MRI every 2 years and blood work done every 6 months because the medication does a number on my liver. I pay for this through taxes. Do we find wait times frustrating? Yes, but the alternative would be harder to live with.

  321. 321
    Pb says:

    Darrell,

    I believe that figure isn’t per year, it’s total, as seen here:

    The average direct cost of caring for an Alzheimer’s patient from diagnosis to death is $174,000.

  322. 322
    ThymeZone says:

    Why didn’t you have adequate insurance when you got hit with the attack?

    I did have it, you forgot that part of the story. My little episode was billed out at about $175k, of which I paid about $200 in copays.

    The point of my story was, and is today, that every person without the great insurance that I am very very very lucky to have is one bad day away from financial ruin.

    Nowadays, frankly, $175k worth of medical bills is not that big a deal. It’s routine.

    Also, something else for you to ponder: My insurance carrier, CIGNA, paid about 60 cents on the dollar for these invoices. This is pretty standard.

    What it means is that the provider routinely bills the walk-in rate, the retail rate, considerably higher than the group coverage rate for the same services.

    Think about that. If you were uninsured, and had my bad day at the office, you’d be sitting on $175k worth of bills for services that my carrier bought for about $100k.

    Now you tell me how the American system works, when millions of families out there, most of them working people, not bums or illegal aliens, are just one bad day, one accident, one x-ray, one lab test away from being hit by a financial train wreck, without warning, and without recourse?

    That’s your system, Darrell. You own it, you are responsible for it. So explain to me how it is defensible.

  323. 323
    RSA says:

    Beyond smoking, there are any number of causes of cancer that are not “personal responsibility” issues (be they environmental causes, genetic proclivities, whatever), and the causes of AD are still being searched for, and they can strike anyone, any time.

    I have a dog in this hunt, too: a close relative survived childhood leukemia and has been in remission for 30 years. You would not believe the premiums that health insurance companies demand, given that history. Even for someone who’s currently in perfect health.

  324. 324
    pie says:

    Basically, poor people clog our medical system enough as it is. Universal Medical Assistance would just compound the problem. Nothing in the Bill of Rights says you have the freedom to be not sick. So suck it and die

    Exactly. Fuck the poor!

    1. Everyone must have health insurance.

    2. You can obtain this by:

    a) getting it through your employer; or
    b) buying your own individual insurance; or
    c) paying a special tax of 14% of income (first $10k exempted) and buying into Medicare.

    But you are mandated to do one of those 3 things.

    Fuck the poor! Are you poor? If so, then fuck you!

    I propose a special voluntary death avoidance tax. Gangs of defense contractors roam the streets at night, searching for the homes of poor people who haven’t paid their death avoidance tax. Those caught “uninsured” by this tax are liquidated immediately. Those who pay into the tax are permitted to live. The tax money is invested into the stock market, and the profits are used to finance health insurance for those paying into the tax. Overpopulation, welfare, and emergency room waits are all solved in one fell swoop. Best of all, poor people get fucked!

    Yeah, yeah, yeah, the ACLU and the other do-gooders will piss and moan about due process and basic human rights and that whole rigamarole. Pay them no heed. When we start the “freedom tax,” those who speak out of turn without chipping in will soon find themselves incarcerated.

  325. 325
    ThymeZone says:

    Fuck the poor! Are you poor? If so, then fuck you!

    Hey, preachin to the choir here, amigo!

    But the real problem here is, you don’t have to be poor to be completely fucked over by the American system now.

    Well, another way to state this is, you might not be poor in America except for the fact that the American healthcare system made you poor.

    Franklin Roosevelt took over a country in depression and in shambles and left behind a safety net legacy and a public works legacy unmatched in American history.

    Ronald Reagan, George Bush I, Newt Gingrich, and George Bush II will leave behind a legacy of Fuck You Very Much to most Americans, along with the undying gratitude of a tiny sliver of very rich people and CEOs who owe their bounty to these assholes.

  326. 326
    ThymeZone says:

    Oh, sorry, those assholes also gave you a ban on partial birth abortions, and Terri Schiavo law. So, never mind.

  327. 327
    pie says:

    That’s your system, Darrell. You own it, you are responsible for it. So explain to me how it is defensible.

    If the middle class bleeds enough, they too will become poor. Then, we can fuck them!

  328. 328
    pie says:

    Ronald Reagan, George Bush I, Newt Gingrich, and George Bush II will leave behind a legacy of Fuck You Very Much to most Americans, along with the undying gratitude of a tiny sliver of very rich people and CEOs who owe their bounty to these assholes

    At least they saved marriage and Christmas.

  329. 329
    ThymeZone says:

    At least they saved marriage and Christmas.

    Amen. Amen.

    { pours from KoolAid pitcher }

  330. 330
    pie says:

    Oh, sorry, those assholes also gave you a ban on partial birth abortions, and Terri Schiavo law. So, never mind.

    If Terri Schiavo had had no insurance, she, too, would’ve been fucked.

    It isn’t about what DeLay calls “a culture life.” When he was governor of Texas, George Bush signed into effect a law that grants hospitals the right to cut off life support in cases that are even more controversial than Schiavo’s. Under Texas law, hospitals can cease to feed a patient whose prognosis is so poor that further care would be futile if that patient has no way to pay his or her medical expenses. A baby was pulled of life support under that legislation this past week, against his mother’s wishes. It was ok with the National Right to Life committee in 1999 and it was ok with Governor George W. Bush. What changed? Only political expediency.

  331. 331
    pie says:

    Amen. Amen.

    { pours from KoolAid pitcher }

    You don’t hear much about TWOC this season. What happened, did Zombie Santa win that one?

  332. 332
    Jay says:

    It was ok with the National Right to Life committee in 1999…

    The NRL, like many pro-life groups, is only concerned with life from conception until parturtion. After that life can get stuffed.

  333. 333
    Bombadil says:

    My grandfathers on both sides had alzheimers. Their medical treatments in the 1990’s was nothing remotely approaching the $174,000/year. I call bullshit on that number as in any way representative or “typical”.

    Read it again, Pieboy.

    The estimated cost of caring for an AD patient is $174,000, and average course of the disease is seven years.

    It didn’t say $174,000 per year. It says $174,000 over seven years. That’s $25,000 per year for primary care, medications, medical visits, personal care as needed and so on. Add inflation over the last 10-20 years and $25K per year averaged for advancing medical requirements and the $174K is not out of line.

  334. 334
    John S. says:

    Oh, Darrell…

    To coin a phrase, you are an authoritarian on every subject and yet an authority on none. I guess that explains your undying fealty to the current government.

  335. 335
    ImJohnGalt says:

    IMJohnGalt, welcome back you insufferable fucking asshole.

    You make me laugh, Darrell. I point out the inconsistencies in your posts, something I’ve taken the time to do maybe only twice before in the two years I’ve been lurking here, and I’m stalking you.

    On the other hand, rather than address the substance of my posts, which is that you were using rhetorical tricks to avoid having to address the questions or arguments posed by others here, you went off on a rant.

    I’m sorry that you ran out of cheetohs, or that you weren’t able to get your new PS3 because you were number 47 in line when Best Buy had only 46 of them, but hey, if you need to take out your rage on the unfairness of the universe on someone, fine. I’ll volunteer.

    IJG, you stalk me on threads like this ranting over nonsense because you are an obsessed freak. This is but one of many examples.

    I’d ask you to enumerate them, since there are “many examples”, but it’d be a fool’s errand: a) because there are not “many examples”, and b) I’ve yet to see you post links backing up any assertion you’ve ever made on this board that didn’t point to WorldNetDaily.

    You’re one of the few people I’ve seen who when confronted with their own lies, rather than say “mea culpa” call the fact-checker a loon and a stalker. Forgive me for trying to reconcile your irreconcilable posts.

    I guess you are a Republican!

    Have a nice day.

  336. 336
    John S. says:

    It didn’t say $174,000 per year. It says $174,000 over seven years.

    Your seven year figure is sort of bullshit, though considering that:

    The study of 521 people with newly diagnosed Alzheimer disease found that the median survival period was 4.2 years for men and 5.7 years for women, about half what a person of the same age who did not have the disease would be expected to live.

    Granted, the costs of caring for someone with Alzheimers are fairly high, but the likelihood of the average person living that long with it is extremely unlikely.

  337. 337
    Bombadil says:

    Median is not the same as mean (average). The median age is the half-way point between high and low; given a perfect bell curve, it might line up with the mean, but it doesn’t have to. My grandmother-in-law was in full-time nursing care for over nine years.

  338. 338
    Tim F. says:

    The median age is the half-way point between high and low; given a perfect bell curve

    Not precisely correct. If you have 100 different numbers the median is the value of #50 when you rank them from highest to lowest, while the mean is the sum of the numbers divided by 100.

    Here is the best illustration of why demographers use median values – Picture an ordinary bar, then add Bill Gates. Even though the regulars haven’t gotten any richer the average income will skyrocket. The median, on the other hand, should barely change.

  339. 339
    Pb says:

    Actually, in Schiavo’s case or cases like it, tort reform, Medicaid, and Medicare could come into play as well–because they had been paying her medical bills out of money from a malpractice settlement, and she also was enrolled in Medicaid at the state level, the hospice took care of her living expenses (although they apparently could have billed Medicare for that as well), and they also allegedly set up a Medicaid disability trust fund with the last of the money from the settlement.

  340. 340
    John S. says:

    Median is not the same as mean (average).

    I am well aware of that, so spare me the condescending math tutorial. An intelligent person can look at that numbers cited for both men and women pretty easily interpolate that the majority of Alzheimers patients do NOT live for an additional 7 years. And although my own grandmother has had it for 7 years, by no means is her or your grandmother’s life expectancy the norm.

    In fact, median life expectancy of that high only seems to occur in those diagnosed at a relatively early age:

    The statistical analysis found that the median survival times ranged from 8.3 years for people diagnosed at age 65 to 3.4 years for people diagnosed at age 90. Persons diagnosed with Alzheimer’s disease at age 65 could anticipate a 67 percent reduction in life span compared to those without Alzheimer’s disease, while persons diagnosed at age 90 could anticipate a 39 percent reduction in life span.

    And considering that:

    One in 10 individuals over 65 and nearly half of those over 85 are affected.

    I think you will find a larger number of people living with the disease and the older end of the spectrum, thereby significantly reducing the median life expectancy of the majority of people coping with the disease.

    Therefore, your peddling of this seven-year dollar figure as the average scenario comes up short as far as I am concerned.

  341. 341
    Pb says:

    The median age is the half-way point between high and low

    Not precisely correct. If you have 100 different numbers the median is the value of #50 when you rank them from highest to lowest

    AKA, “the half-way point between high and low” (in the series, not on the number line). But yes, Tim F., that is a more precise way of expressing it. And then there’s always the Wikipedia page

  342. 342
    ThymeZone says:

    One in 10 individuals over 65 and nearly half of those over 85 are affected.

    That is absolutely breathtaking, and terrifying.

    I sort of already knew these things, but seeing it here is just a reality slap in the face. Thanks for bringing it up, seriously.

  343. 343
    Pb says:

    John S.,

    On the other hand, you’ll probably find less people over 85, period. In 1998, the FDA published an article in their magazine that said this:

    People with Alzheimer’s live an average of eight years, although some live up to 20 years or more after the first onset of symptoms.

    …so I don’t think that seven year figure is entirely unreasonable.

  344. 344
    Tim F. says:

    AKA, “the half-way point between high and low” (in the series, not on the number line). But yes, Tim F., that is a more precise way of expressing it.

    I could also say that Harvard Medical School is where kids end up, given a perfect daughter. It is technically correct but prone to misunderstanding.

  345. 345
    John S. says:

    Bombadil-

    Upon further examination, I stand corrected – but apparently the situation is even worse than you estimated:

    While some patients may live up to 20 years after being diagnosed with AD, the average life expectancy after diagnosis is eight years.

    The Alzheimer’s Association estimates that the cost of care in a nursing home for one AD patient with severe cognitive impairments, not including losses in productivity or wages, represents an average of $42,000 per year but may exceed $70,000 in some parts of the country. For a disease that can span from two to 20 years, the overall cost of AD to families and society in the U.S. is estimated at $80-100 billion annually. (Estimates as of June 2002.)

    Based on the the most current (four year old) figures, an Alzheimer’s patient that lives for seven years will cost nearly $300,000 to care for.

    Jesus.

  346. 346
    John S. says:

    Almost forgot the link.

  347. 347
    pie says:

    IMJohnGalt, welcome back you insufferable fucking asshole.

    You gotta admit, though, this is one of the most colorful salutations any of us have received in quite a while.

  348. 348
    ThymeZone says:

    It is technically correct but prone to misunderstanding.

    It’s just the Panglossian view, with a coat of wax on it, isn’t it?

  349. 349
    Zifnab says:

    And then there’s always the Wikipedia page…

    God bless you Wikipedia.

  350. 350
    JimSaco says:

    My what an interesting place!

    I said, if you make less than $10k/yr, which last I looked was the poverty line, and had no insurance, your insurance would be Free. This was interpreted by an individual as meaning that I said “Fuck you” to the poor.

    Would people rather I said, if you’re poor, go to the doctor and we’ll Give You Money?

    The problems in health care cost/delivery center, largely, around 1. the elderly, 2. the poor, 3. those with chronic illnesses.

    The elderly are already covered, today. The poor would be covered for free under my plan. Those with chronic illnesses who get discriminated against currently would have a guaranteed availability of coverage at society’s cost of insurance, as a percent of income as opposed to a flat fee.

    As far as I am concerned, anybody who doesn’t consider something like that at minimum a place to start a discussion, simply has some other agenda. Like hating business/not trusting people/trusting the government more than people/etc.

  351. 351
    ThymeZone says:

    this is one of the most colorful salutations any of us have received in quite a while.

    True. He’s never that nice to me.

  352. 352
    Pb says:

    …and since at least one of the 8 year figures I saw was citing a study from 1987, here’s something more recent, from the UK:

    The median life-expectancy for people with Alzheimer’s disease, from onset of disease, is thought to be around eight years (Van der Steen, 2002).

    And, of course, note that they are citing the median this time, not the mean… :)

  353. 353
    Pb says:

    JimSaco,

    You didn’t have to say “Fuck you” to the poor, though, Darrell effectively did it enough already upthread. But yeah, this is an interesting place, stick around, have some pie!

  354. 354
    ImJohnGalt says:

    You gotta admit, though, this is one of the most colorful salutations any of us have received in quite a while.

    Yeah. I know that the Welcome Wagon folks used it as their motto for a while, but for some reason it never took.

    That said, I had no idea that I’d been gone. Perhaps Darrell added me to his anti-troll script. Somehow, the idea that Darrell might use that script amuses me.

  355. 355
    John S. says:

    I sort of already knew these things, but seeing it here is just a reality slap in the face.

    It’s a horrible thing to have to deal with – from any angle.

    My mother (age 62) has basically destroyed her own retirement while caring for her mother who has Alzheimer’s (age 90). Obviously, my grandmother never planned to live so long (few who were born in 1916 would have), and exhausted her financial resources years ago.

    I guess I was hoping that more people didn’t have to deal with the same situation – that somehow mercifully, their families would be spared nearly a decade of heartache and financial ruin.

    Unfortunately, the numbers don’t seem to bear my wishful thinking out.

  356. 356
    Bombadil says:

    I am well aware of that, so spare me the condescending math tutorial.

    Untwist your shorts, John S. I was just pointing out that, while your numbers are likely just as “accurate” as mine, we were talking about two different units (median vs mean).

  357. 357
    John S. says:

    The elderly are already covered, today.

    That is a gross exaggeration.

    Check with anybody caring for an elderly person with a fairly common illness – like say Alzheimer’s – and you will find that Medicare covers just about jack shit.

  358. 358
    ThymeZone says:

    The problems in health care cost/delivery center, largely, around 1. the elderly, 2. the poor, 3. those with chronic illnesses

    Sorry, my group insurance cost has doubled in about seven years, to an organization that has upwards of 15k employees. That’s because the original carrier, Blue Cross, refused to sell coverage to the group any longer and the contract had to be renegotiated.

    Your post is absurd to the point where if this were my blog, I’d take it down as a nuisance and as destructive to the conversation. Of course, I’m not as tolerant as John and Tim are, so there you are.

    The problems actually center around a system designed by and for large corporations, in cahoots with a government that has found it convenient to make that deal with the devil and thereby fuck over citizens and businesses, because they could get cheap votes using fearmongering and deception, and so far, they’ve gotten away with it.

    The time window is closing, and the time bomb these assholes have built is going to go off in the not too distant future. And when it does, it will the final, absolute end of the so-called “conservative” movement in this country. When people see how completely they have been fucked, they will react, as they have done with other issues just recently.

  359. 359
    Bombadil says:

    John S.:

    Based on the the most current (four year old) figures, an Alzheimer’s patient that lives for seven years will cost nearly $300,000 to care for.

    Yeah, I’m not sure if Pierce was talking about what the cost was for his father (in the 90’s) or now, so your numbers don’t surprise me either. And that cost will only go up as we boomers get to that point in our lives. Scary, isn’t it? I hope Pieboy is piling as much into his vaunted HSA as he can. He’s going to need it.

  360. 360
    Zifnab says:

    The problems actually center around a system designed by and for large corporations, in cahoots with a government that has found it convenient to make that deal with the devil and thereby fuck over citizens and businesses, because they could get cheap votes using fearmongering and deception, and so far, they’ve gotten away with it.

    Only in America can a politician give a stump speech with the words “Beware Universal Health Coverage!” and get more votes.

  361. 361
    ImJohnGalt says:

    While I in no way wish to make light of any of the heartbreaking stories of Alzheimer’s (my family too has a 90-year-old great aunt who doesn’t recognize any of us), I find it interesting that so many of these policy issues only get seriously debated when the conservative baby-boomer generation comes of age and realize that all those shitty policies that they supported are actually going to affect them soon, regardless of how well they did with their tax cuts.

    I only worry that whatever solutions they come up with will screw over the generations that follow them. I’ve yet to see a whole lot of largesse and altruism among the baby-boomers.

    Also, I caveat this post with the recognition that there is no completely homogenous “baby-boomer” profile. But as long as you can call us Gen-X slackers, I feel less guilt about broad-brushing anyone who may be of that age.

  362. 362
    Pb says:

    Only in America can a politician give a stump speech with the words “Beware Universal Health Coverage!” and get more votes.

    Don’t let the government waste your tax dollars to put a chicken in your pot against your will!

  363. 363
    John S. says:

    But as long as you can call us Gen-X slackers

    LOL

    I always got a real chuckle out of that moniker they slapped on us. Any person I know around my age is anything but a slacker. In fact, I’d say if anything we’re a rather cynical lot (as supported by an advertising industry analysis that found we are the least marketable generation). Now, if you want to see a real group of salckers, get a load of that Generation Y…

    They fancy themselves athletes and rap stars.

  364. 364
    Jay says:

    When people see how completely they have been fucked, they will react, as they have done with other issues just recently.

    The hics are hoping we’ll all be too old and sick to do anything but gurgle.

    We’re heading towards a pretty major social crisis and while some people would like to think it is a matter of holding a steady job and avoiding cigs and booze, look not just at Alzheimer’s but at the aging population in general. Someone has to take care of the boomers and the US is already going to other countries for nurses because there just aren’t enough of them here.

    How many of those nurses have been or will be trained to work with the elderly, I don’t know. Nursing homes? Well, there are different levels. Most of them don’t offer the type of care an AD or SD patient needs, not all of them offer the type of care an immobilized person needs and all of them are expensive. Then, even if the elderly person (or family) can afford it, I’ve yet to see a nursing home I’d want to live in (nursing shortage strikes again). And you can apply the same problems to home health services.

    So people can take care of the relative themselves. And miss work caring for them, and that affects productivity, which will affect the economy. Fire the people with sick relatives and hire people who don’t? Fine, but what do the former employees do to put food on the table and pay for health care? Turn to social services. Hooray. The gov’mint can raise taxes to pay for all of these suddenly impoverished people or say tough shit, but they’ll still be there. Maybe this is where Pie’s death avoidance tax would come in.

    I’m sure the hic industry is aware of the looming disaster. If they’re smart they’ll take some steps now to decrease the burden on society, rather than wait until they’re forced. I’m banking on forced.

  365. 365

    JimSaco — don’t let the facts stop you, but the current poverty level for a family of four is $57K (rounded to the nearest thousand). The figure is cited and sourced further up the thread.

    But, like I said, you shouldn’t let facts get in your way. Pesky things, those facts. Facty assertions are much more useful than factual ones, aren’t they.

  366. 366
    Darrell says:

    You make me laugh, Darrell. I point out the inconsistencies in your posts, something I’ve taken the time to do maybe only twice before in the two years I’ve been lurking here, and I’m stalking you.

    But the alleged ‘inconsistencies’ you claim you pointed out, for which you called me a “dickhead”, were nothing of the sort. EVERYONE who goes to a podiatrist for orthotic inserts has to go 3 or 4 visits to complete the work. But you jumped all over this like the crazed jackass that you are, screaming that I’m a “dickhead” who was caught being inconsistent, when in fact, I was being entirely consistent.

    And after having it spelled out for you, instead of having a shred of honesty and saying “yeah Darrell, you got me. What you said probably is true, that it takes several visits to get 1 orthotics and I overreacted”. But no, you didn’t say that, because you’re dishonest as hell. So you continue to post lies that my orthotic fitting was some kind of “rhetorical trick”, when it absolutely was nothing of the sort.

    Dishonest as hell of you.. but typical

  367. 367
    Pb says:

    get a load of that Generation Y

    You know, I always thought ‘Generation X’ was a real cop-out of a name, but at least we (I myself as a nominal ‘fringe’ member of that generation and a charter member of the ‘MTV generation’) were named for something, unlike “Generation Y”, which is currently just stuck with a total bullshit, meaningless term.

  368. 368
    Darrell says:

    JimSaco—don’t let the facts stop you, but the current poverty level for a family of four is $57K (rounded to the nearest thousand). The figure is cited and sourced further up the thread.


    Busted
    again you lying sack of shit. Poverty level for family of 4 is $19,350.

  369. 369
    Pb says:

    the current poverty level for a family of four is $57K

    No it isn’t–check yourself.

    4. In 2004, 300% of poverty was $27,930 for a single individual and $56,550 for a family of four

    Note: 300% of poverty, aka 3x the poverty level.

  370. 370

    Sorry, D-boy — 300% of poverty is still poverty, according to HHS. FPL is not “enough to live on” it is, in fact, 60% of the minimum to supply essentials such as food and shelter.

    But, again, don’t let the facts get in the way of the evidence. Factiness will out in the end.

  371. 371
    Darrell says:

    As far as I am concerned, anybody who doesn’t consider something like that at minimum a place to start a discussion, simply has some other agenda

    Of course that’s true. But the leftists posting here are so fanatical and crazed, that any ideas or facts that conflict with their extremist dogma must be smeared, as they’re doing right now on this thread, as “fuck the poor” or “you hate the poor”. It’s the type of people they are.

  372. 372
    Bombadil says:

    Of course that’s true. But the leftists posting here are so fanatical and crazed, that any ideas or facts that conflict with their extremist dogma must be smeared, as they’re doing right now on this thread, as “fuck the poor” or “you hate the poor”. It’s the type of people they are.

    Who do you have to “fuck you” to get banned around here?

  373. 373
    Darrell says:

    demimondian Says:

    Sorry, D-boy—300% of poverty is still poverty, according to HHS

    After getting busted, you still insist on lying your ass off. Again, poverty level for family of four, is not $57,000 as claimed, but instead $19,350.

    That some families can receive benefits at 125%, 185%, or 300% of the poverty line, in no way changes what that poverty line actually is. You lied about it, and worse, when called on your lie, you continue to defend it.

  374. 374
    Bombadil says:

    You lied about it, and worse, when called on your lie, you continue to defend it.

    There’s a shorthand for that sort of thing. It’s called “Darrelling”.

  375. 375
    John S. says:

    Good ol’ Darrell…

    Authoritarian on every subject – authority on none.

    Except pie. He’s an expert on that.

  376. 376
    John S. says:

    Good ol’ Darrell…

    Authoritarian on every subject – authority on none.

    Except pie. He’s an expert on that.

  377. 377
    ImJohnGalt says:

    Darrel, nice of you to focus on a tangential point I made, which was that you went several times for orthotics. How about addressing the main point: a) That you yourself said you went to him first, even though you asked a rhetorical question implying you hadn’t, and b) you would deny people under a government program the courtesy of doing the same thing you do under your employer-paid program, arguing, in fact, that in one case (yours) it is perfectly fine, but in the other that it’s abusive.

    Hell, if we’re each confessing to our intellectual dishonesty, you may even want to acknowledge that, contra the point you tried to make, the market for medicine has only one thing in common with the petroleum markets, to wit: they both occasionally have something to do with gas.

    Tell you what, I’ll grant that I didn’t understand that multiple trips for orthotics are the norm if you a) admit that you were wrong about comparing the gas market to the medical markets and b) that you were abusing the system by seeing a medical professional for something that could’ve been solved with a pair of $20.00 OTC orthotics.

    In fact, I’ll go first. I didn’t know that orthotics required multiple trips. My bad.

  378. 378
  379. 379
    ImJohnGalt says:

    Hey, look at the positive. At least Darrell posted a link to HHS. That is some serious progress right there.

  380. 380
    Bombadil says:

    Except pie. He’s an expert on that.

    Well, maybe not an expert, but he knows what he likes.

  381. 381
    ThymeZone says:

    There’s a shorthand for that sort of thing. It’s called “Darrelling”.

    Snort!

  382. 382
    Bombadil says:

    Hey, look at the positive. At least Darrell posted a link to HHS. That is some serious progress right there.

    Even a blind squirrel finds an acorn once in a while. Pieboy plays with his nuts enough that he should be able to come up with one, every so often.

  383. 383

    Hmm. Uh, D-boy pie-friend? Your body appears to have become suffused with the by-products of pie consumption which the rest of us egest. You might…wish to evacuate those by-products.

    FPL is not enough to live on, snookums. That’s not what it’s meant to mean; it’s mean to be a level at which there is no way to provide even the scant minimum of a living. A household earning the FPL is not able to maintain a home without massive assistance. The people who are the problem cases for medical insurance are the “working poor” — and, yes, 300% of FPL is working poor.

  384. 384
    Darrell says:

    How about addressing the main point: a) That you yourself said you went to him first, even though you asked a rhetorical question implying you hadn’t,

    Nothing tangential about it. I address the crux of your “point”, which was nothing but a lie. Where in the hell did I say/write that I went to the podiatrist first? In point of fact, I had other inserts which weren’t working so well. Where did I “imply” different? Truth is, you and the other leftist dregs posting here dishonestly attribute statements to me which I never wrote or implied.

  385. 385
    ImJohnGalt says:

    I swear to Cthulu that Darrell only reads one of every three words people write. I’ve just re-read his riposte to me up above and apparently, he believes that I said that his orthotic fitting was a “rhetorical trick”.

    Now, I’m no etymologist, but even I wouldn’t make that mistake.

  386. 386
    ThymeZone says:

    you and the other leftist dregs posting here dishonestly attribute statements to me which I never wrote or implied.

    It’s called “Responding in kind,” Darrell.

  387. 387
    Bombadil says:

    On the topic of Pieboy’s feet, I think I speak for most of us here when I say, “Eww. Just — eww”.

  388. 388
    ImJohnGalt says:

    Oh, for goodness’ sake.

    As a runner and basketball player, I went to several podiatrist treatments for orthotics to help me run better. Now, I get along fine with $20 Spenco arch supports.

    Please explain to me how the second sentence could in any way be implied to pre-date the actions of the first.

    Show your work for extra credit.

  389. 389
    ImJohnGalt says:

    And thus was shown the futility of an appeasement strategy by ImJohn Galt.

  390. 390
    Darrell says:

    and b) that you were abusing the system by seeing a medical professional for something that could’ve been solved with a pair of $20.00 OTC orthotics.

    More dishonesty. At the time of my visit, I had no idea whatsoever, that the orthotics designed by the podiatrist would be no better than a pair of $20 otc orthotics. None whatsoever. Of course, that doesn’t stop you from lying your ass off about it, as it’s in your nature to do so. You’ve done it repeatedly on this very thread.

  391. 391
    Bombadil says:

    Of course, that doesn’t stop you from lying your ass off about it, as it’s in your nature to do so. You’ve done it repeatedly on this very thread.

    Pie! It’s Darrellicious!

  392. 392
    ImJohnGalt says:

    At the time of my visit, I had no idea whatsoever, that the orthotics designed by the podiatrist would be no better than a pair of $20 otc orthotics.

    Right. Because, contrary to your earlier implication, you hadn’t tried them before going to see the podiatrist.

  393. 393
    Darrell says:

    Please explain to me how the second sentence could in any way be implied to pre-date the actions of the first.

    Since you made the accusation scumbag, you explain how the second sentence in any way indicates that I a) didn’t discover the Spenco orthotics until years after the podiatrist designed orthotics (true) or b) that I had different, less effective OTC orthotics prior to the podiatrist-designed ones (also true)

    So instead of saying “yeah Darrell, I overreacted and even lied about what you actually wrote”, you march on, continuing to dishonestly attribute statements and actions to me which I never wrote or implied when you launched into your obsessive ranting that I’m a “dickhead”, based on a lie you made up out of whole cloth. It’s who you are deep down…the kind of person you are.

  394. 394
    ImJohnGalt says:

    Or are you arguing that even though the OTC ones worked fine, you wanted to see if perhaps the podiatrist could prescribe something that would help you dunk, or at least stop throwing up enough bricks to build a house.

  395. 395
  396. 396
    ImJohnGalt says:

    Keep churning out the posts, Darrell. Eventually people will stop holding you accountable for things you’ve written. Maybe they’ll even learn to read things into your text that you haven’t written, which is what you want.

    Further, if you keep focusing on the most unimportant pieces of each blogpost, and keep faking outrage [OUTRAGE, I tell you!] you’ll continue to be able to avoid addressing the substantive points in the civil, intellectual manner that you say you crave.

  397. 397
    ImJohnGalt says:

    Man, this is so much more fun than a Barium enema, if even the enemas were half-off!

  398. 398
    Darrell says:

    Textbook definition of dishonest leftist moving goalposts

    the current poverty level for a family of four is $57K

    When busted on that lie, and it is a lie, you move the goalposts to the description “working poor”, which conveniently is undefined by the poverty level.. No mention of that standard. It’s one of those vague terms which means what you want it to mean, and another way to evade responsibility for the lie you got caught making. Not a matter of disputed opinion, but lie.

  399. 399
    Pb says:

    Well if we’re going to talk about actual poverty as opposed to what the federal poverty guidelines may be, then check out the Living Income Standard — it uses actual cost data from my state to approximate a reasonable budget, and in my county (for 2005), it estimates that a family of four (2 adults, an infant and a pre-schooler, to be exact) would need to make $56,952 a year to get by–that’s ~2.6x the Federal Povery Threshold. Similarly, each parent would have to be making over 2.5x the federal minimum wage…

  400. 400
    Bombadil says:

    What class uses a textbook that defines “dishonest leftist moving goalposts”?

    Is this some kind of “Coaching Team Sports” elective?

  401. 401
    Darrell says:

    Sorry, D-boy—300% of poverty is still poverty, according to HHS

    Can you please show us where the HHS says that making 3 times the poverty level income still = poverty level? Please cite, or admit you lied again.

  402. 402
    Jay says:

    What class uses a textbook that defines “dishonest leftist moving goalposts”?

    Such subjects are covered extensively in podiatry school.

  403. 403
    Pb says:

    Well, HHS does acknowledge that there are “low income workers” who earn at least up to 300% of the federal poverty level:

    Low-income workers who receive help buying employer-sponsored group health plans will see income eligibility rise from the current 200 percent of the federal poverty level ($40,000 for a family of four) to 300 percent of poverty ($60,000 for a family of four). This will allow more workers to participate in job-based insurance rather than relying on the taxpayer funded safety net care pool that operates in the state with a mix of federal and state dollars.

  404. 404
    ImJohnGalt says:

    Wouldn’t it be more appropriate (given the discussion thus far) to say that we’re “dishonest leftists moving the baskets”?

  405. 405
    Pb says:

    Do the Boy Scouts have a “dishonest leftist moving goalposts” spotter merit badge yet, or has this been suppressed by the recent epidemic of gay scout leaders–their own Velvet Scout Mafia, if you will…

  406. 406
    Darrell says:

    ImJohnGalt Says:

    Wouldn’t it be more appropriate (given the discussion thus far) to say that we’re “dishonest leftists moving the baskets”?

    Pb Says:

    Do the Boy Scouts have a “dishonest leftist moving goalposts” spotter merit badge yet, or has this been suppressed by the recent epidemic of gay scout leaders—their own Velvet Scout Mafia, if you will…

    I love it. Leftists get caught in bald faced lies, and then hide behind snark.. of course never admitting that they ever lied.

  407. 407
    Zifnab says:

    My god, when did this thread get so fruity and delicious?

    On a complete tangent to all of this (as facinating as it may appear) I do question the authenticity and reliability of that entire Generation X Wiki article based sololy off the bar on the left-hand side.

    How in the holy hell does American Society progress First Great Awakening, Second Great Awakening, Third Great Awakening, Jazz Age(?), Consciousness Revolution, Culture Wars. Jazz Age? Seriously? I mean, its good and all, but does it actually qualify as a consensus building movement on par with the Great Awakenings and the Consciousness Revolution. Culture Wars loses points just because O’Reily jacks off to the phrase every night before he goes to bed, but I’ll allow it because “Age of the Dumbshits” probably wouldn’t get picked up in the common vernacular.

    I also mildly object to not being included in the Internet Generation, in part because its way cooler than Generation Y and in part because my lifestyle, my livelyhood, ney my very existance seems to hinge on the internet emergence and continued presense. And the Space Age isn’t given any love at all on there, which is equally depressing.

  408. 408
    Pb says:

    Darrell,

    Actually, I pointed it out when you did. However, demi has a point in that the Federal Poverty Guidelines don’t accurately reflect poverty, and aren’t used as a hard cut-off for aid–in fact, 200% or 300% of the FPG is often used, which shows just how shoddy those guidelines are. Now go get back to your pie.

  409. 409
    ImJohnGalt says:

    What’s the matter with a bald face? It’s rich (but not rich enough to afford health-care) of you to accuse people who merely show your irreconcilable posts and your own contradictions “liars”, Darrell. But that’s okay. Your fundamental dishonesty, your purposeful misinterpretations, and your focus on trivialities to avoid actual debate or having to support your arguments is all you have. It’s who you are at your core.

    If only the politicians you admire would campaign on the same irrationality and bile that you (and they) possess, America could finally see the right for who they are.

  410. 410
    ThymeZone says:

    Do the Boy Scouts have a “dishonest leftist moving goalposts” spotter merit badge yet

    I think it’s part of their new Trolls for Jesus program.

  411. 411

    Gee, D-boy…looks like your factiness isn’t winning here. I know, it’s hard to be an authoritarian who can’t seem to manage authority…but Ill give give your credit for trying. You get a D- (for “D-“boy), rather than the E (for “effort”) you earned.

  412. 412
    Bombadil says:

    What’s the matter with a bald face?

    Couldn’t have come from me.

    I’ve had a beard for 23 years now.

  413. 413
    John D. says:

    Hey, look at the positive. At least Darrell posted a link to HHS. That is some serious progress right there.

    Actually, he just copied my link, but it’s a start.

  414. 414
    Bombadil says:

    Do the Boy Scouts have a “dishonest leftist moving goalposts” spotter merit badge yet

    They should be issued helmets, whistles and “DLMG Spotter” armbands. They can roam the streets like the Civil Defense guys did during WWI, making the world safe.

    As an optional accessory, they can also have a little “DLMG Spotter” shoulder bag to carry either a bag of Cheetos or a slice of pie. It’s hungry work, spotting enemy goalpost movement.

  415. 415
    ThymeZone says:

    they can also have a little “DLMG Spotter” shoulder bag to carry either a bag of Cheetos or a slice of pie

    A true warrior like Darrell would carry some PREs.

    Pie Ready to Eat.

  416. 416

    A true warrior like Darrell would carry some PREs.

    Pie Ready to Eat.

    Or, in the case the One Real Darrell, it would be “Pie Ready to Egest”.

  417. 417
    Darrell says:

    Darrell,

    Actually, I pointed it out when you did. However, demi has a point in that the Federal Poverty Guidelines don’t accurately reflect poverty

    According to the subjective opinion of a leftist editorial writer? Of course some of it is regional too. A family of four can live reasonably comfortably for $57k/year in many areas of the US, yet demi told us that such $57k income for a family of four would be officially “poverty level”, an abject lie on his part, as has already been demonstrated.

  418. 418
    Bombadil says:

    A true warrior like Darrell would carry some PREs.

    Pie Ready to Eat.

    In the real world, they’re called “Pop Tarts”.

  419. 419
    Darrell says:

    If only the politicians you admire would campaign on the same irrationality and bile that you (and they) possess, America could finally see the right for who they are.

    Hey, no fair projecting on others. You’re the one who dropped in to launch a 100% personal attack full of bile, launching into one of your trademark psychotic episodes screaming what “dickhead” I am over something you lied about. Prior to that, did you make even one substantive post on the subject of this thread? Of course you didn’t.. with you, it’s ALL personal.

  420. 420
    ThymeZone says:

    Hey, no fair projecting on others

    Uh, well this new rule will require the deletion of every post Darrell ever made here.

    That will take a little while, so please be patient …..

  421. 421
    Pb says:

    According to the subjective opinion of a leftist editorial writer? Of course some of it is regional too. A family of four can live reasonably comfortably for $57k/year in many areas of the US

    They can barely scrape by on that where I am (and I’m in no major metropolis, not even close…), as I already mentioned in detail upthread.

  422. 422

    A family of four can live reasonably comfortably for $57k/year in many areas of the US

    …provided that they’ve got a well insulated bridge abutent to sleep under.

  423. 423
    ThymeZone says:

    A family of four can live reasonably comfortably for $57k/year in many areas of the US

    They can get by, not live comfortably. Assuming two adults and two children in school, I would say, get by barely, and without luxuries … and only if the family is covered by good health insurance within that $57k envelope. Because with any health problems and no insurance, that family is screwed.

    Also, all of the above only applies to the middle of the cost bellcurve. Families of four living in places like the Bay Area are going to be living in their car, or pretty close to it, at that rate of income.

  424. 424
    Darrell says:

    They can barely scrape by on that where I am (and I’m in no major metropolis, not even close…), as I already mentioned in detail upthread.

    They could in many, many part of the US. Here in Houston, no problem buying a 2,500+ sq ft house in the suburbs, decent neighborhood at $150,000 – $175,000, althought the average $57k/year family income earner purchased their house some years earlier at an even lower price and has equity and lower house payments than the following. That puts the house payment (principal/interest/taxes/insurance) at around $900/month, of which he gets to deduct a good chunk of that off taxes. Family of four can comfortably eat for $700/month here, leaving $2,200 – $2,500/month additional after tax income for transportation, fuel, clothing, savings, extras, etc. More than $2,500/month extra to spend if they bought the house 5+ years ago, as they would pay even less for housing.

    $57k/year would be poorboy in the Boston area, but not at all in many suburbs of Atlanta, San Antonio, Houston, Dallas, Tulsa, Topeka, Albuquerque and many, many other cities thoughout the US.

  425. 425

    Darrell — Houston is not a good choice of comparison. It’s a very low cost-of-living city. (In fact, I’d bet that the FIL for Houston is more like $40K.)

    Let’s look at the second ring suburb where I live, Redmond. The demi-bunker is a 2800 sq. ft. house, 5br, frpl…standard kind of junk, OK? Its assessed value is on the order of 700K, and, according to real estate agents, it’s really worth more than a million bucks. (No, I’m not joking. FDDD and I bought it quite a while ago, and although we’ve put quite a bit of money in, we haven’t put anywhere near that much in.) $57K wouldn’t even cover the monthly interest on a loan on it, and it isn’t a particularly large house.

    Even a 1900 square foot house, by the way, would cost $500K+ here — I know, because the largest chunk of money we’ve put in the place was a thousand square foot extension last year.

  426. 426
    Darrell says:

    Darrell—Houston is not a good choice of comparison. It’s a very low cost-of-living city. (In fact, I’d bet that the FIL for Houston is more like $40K.)

    Let’s look at the second ring suburb where I live, Redmond

    Houston is the fourth largest city in the entire country, and is more costly than San Antonio and other major cities. I think Redmond is poor choice for comparison as housing prices there are so far above the national average. Microsoft is headquartered there for chrissakes. And it’s not just Houston being the exception. There are many, many, many other cities in the US where $57k/year for a family of 4 can live comfortably.

    You lied earlier and got caught. Now you’re not willing to concede an entirely valid point. You are textbook example of a closed minded fanatic.

  427. 427
    ImJohnGalt says:

    Hey, no fair projecting on others. You’re the one who dropped in to launch a 100% personal attack full of bile,launching into one of your trademark psychotic episodes screaming what “dickhead”

    I asked you to reconcile a couple of your posts re:your podiatrist, which I quoted so that you could see them side by side (well, top to bottom), and pointed out the inconsistency vis a vis what someone else asked about going to your podiatrist before settling on the OTC solution. That you saw that entire post as a personal attack says more about your understanding of what debate consists of than it says about me.

    I then pointed out that you seemed to be arguing that under a single-payer government-run insurance program someone who did what you did would be abusing the system, but that you also seemed to be arguing that you were completely in-bounds to do it under your employer-paid program. I thought it was pretty clear that I was asking how you reconciled those two opinions, as well.

    Now, to be fair, I did call you a Dickhead.

    Says Darrell elsewhere in the thread:

    WTF are you talking about? Do you have a point to make asshole?

    Dear shit for brains, there are several types of “cap” plans.

    I think perhaps you need to get off your fainting couch if you feel justified in throwing out the insults above and yet a single word insult ending in a period (not an exclamation point) is seen by you as a psychotic screaming episode. In fact, I do not believe I used an exclamation mark or caps anywhere in that post.

    I thought I made it clear in my initial post that I was late to the thread. Apparently, you now expect us to post when we’re not here, and our first post in any thread has to meet your approval for substance. While I’ll grant that (given your own insubstantive ravings) this is probably a pretty low bar, I think I’ll pass on that particular suggestion, thanks.

    Why are you so angry, Darrell? Was it the election?

  428. 428
    John D. says:

    That puts the house payment (principal/interest/taxes/insurance) at around $900/month

    Garbage.

    $150K at 5.75% on a 30-year note is $875 by itself. Once you add taxes and insurance, expect that to jump to $1100, more if you have valuable contents, like computers, TV, jewelry, etc. You have no maintenance costs there. You have no utility costs there.

    You can’t use lowball, let alone off-the-chart-low, estimates and expect anyone to take you seriously. My house note is currently about $600/month, yet I’m shelling out over twice that due to associated expenditures.

  429. 429
    Pb says:

    The cost of living in Houston is 9.1% lower than that of my city–and my city is only the 94th largest city in the nation. So $57,000 here would be like $51,818 there.

  430. 430
    Darrell says:

    I asked you to reconcile a couple of your posts re:your podiatrist, which I quoted so that you could see them side by side (well, top to bottom), and pointed out the inconsistency vis a vis what someone else asked about going to your podiatrist before settling on the OTC solution. That you saw that entire post as a personal attack says more about your understanding of what debate consists of than it says about me.

    Let’s quote verbatim from your post, which you say I “misunderstood” as a personal attack:

    Dickhead.

    Is there really anything else that needs to be said?

  431. 431
    ImJohnGalt says:

    Heh, that’s a whole lot of ignoring of a post, even for you, Darrell. Congratulations.

  432. 432
    ThymeZone says:

    Why are you so angry, Darrell? Was it the election?

    According to this pill bottle I have here, I should contact my doctor if I have an election that lasts more than 4 hours.

  433. 433
    Darrell says:

    Garbage.

    $150K at 5.75% on a 30-year note is $875 by itself. Once you add taxes and insurance, expect that to jump to $1100,

    Not garbage, as that drops their after housing/food/taxes spending money to $2,000/month rather than $2,500. But your point regarding the mortgage payment is valid. In other words, just because I misstated the mortgage payment by $200 – $300, that in no way, shape or form changes the fact that a family of four in that same neighborhood could live comfortably.

  434. 434
    ThymeZone says:

    Oh sorry, I misread that ….

  435. 435
    RSA says:

    Darrell’s got a reasonable point, vitriol aside. $57K is higher than the median household income of every state except NH, based on data a few years old. The median household income in the entire U.S., from these numbers, was less than $45K. I don’t know the variance of the distribution of income, and these numbers ignore how big each household is, but still. . .

  436. 436
    Darrell says:

    Pb Says:

    The cost of living in Houston is 9.1% lower than that of my city—and my city is only the 94th largest city in the nation. So $57,000 here would be like $51,818 there.

    I call bullshit. In order for that to be true, everything else in your city (groceries, clothing, gas, etc) would ALSO have to be 9.1% lower in order for your statement to be true. Housing is obviously but one component in the cost of living.

  437. 437
    Pb says:

    Darrell,

    You insufferable moron. I didn’t say housing, did I? I said cost of living. Now go sit in the corner–no pie for you!

  438. 438
    ImJohnGalt says:

    There are several online resources for doing salary comparisons. One of them is available here.

    I’m always stunned at the regional differences. Look at Houston to Boston, for example. No reason I picked that other than Darrell mention Boston above.

  439. 439
    Darrell says:

    RSA Says:

    Darrell’s got a reasonable point, vitriol aside. $57K is higher than the median household income of every state except NH, based on data a few years old. The median household income in the entire U.S., from these numbers, was less than $45K. I don’t know the variance of the distribution of income, and these numbers ignore how big each household is, but still. . .

    I indisputably had a point. Calling $57k/year “poverty level” was utter bullshit dishonesty. Funny though, how only until a fellow leftist acknowledges the obviousness of a point, that somehow only then it becomes valid.

  440. 440
    ImJohnGalt says:

    The result, in case you don’t want to be bothered:

    The cost of living in Boston, Massachusetts is 93.3% higher than that of Houston, Texas. A salary of $50,000 in Houston, Texas has the same buying power that a salary of $96,667 has in Boston, Massachusetts.

  441. 441

    Calling $57K poverty FOR A FAMILY OF FOUR is entirely reasonable.

    The median income across all households is not the appropriate measure here; it merely shows that a family of one or two can live on less than a family of four.

  442. 442
    RSA says:

    Funny though, how only until a fellow leftist acknowledges the obviousness of a point, that somehow only then it becomes valid.

    Don’t call me a fellow leftist.

  443. 443
    Pb says:

    Incidentally, here’s a site that has a full breakdown of all the cost of living factors involved, including housing. Conclusion?

    Housing: 23% cheaper in Houston.
    Food: 7.5% cheaper in Houston.
    Utilities: 2% more expensive in Houston.
    Transportation: 5% more expensive in Houston.
    Health: 1.7% more expensive in Houston.
    Misc: 9.3% cheaper in Houston.
    Overall: 10.3% cheaper to live in Houston ($57,000 -> $51,124)
    Darrell: 100% full of crap.

  444. 444
    John S. says:

    Houston is the fourth largest city in the entire country, and is more costly than San Antonio and other major cities.

    It certainly is the 4th largest, and the 76th most expensive city in the world (8th in the US), but Miami is the 39th most expensive in the world (5th in the US) and there is no way in HELL that a family of 4 can live comfortably on $57k/year.

    Sorry.

  445. 445
    TenguPhule says:

    Darrell says: You lied earlier and got caught. Now you’re not willing to concede an entirely valid point. You are textbook example of a closed minded fanatic.

    Darrell’s Irony of the Day, Folks.

  446. 446
    Darrell says:

    It certainly is the 4th largest, and the 76th most expensive city in the world (8th in the US), but Miami is the 39th most expensive in the world (5th in the US) and there is no way in HELL that a family of 4 can live comfortably on $57k/year.

    Sorry.

    Dickweed, show us where anyone suggested otherwise. Oh yeah, nobody brought up Miami before you. What a wonderful you’ve made John S. Thank you for such an ‘insightful’ contribution.

  447. 447
    Darrell says:

    Don’t call me a fellow leftist.

    Remark withdrawn.

  448. 448
    Pb says:

    John S.,

    8th most expensive out of 20 US cities surveyed for expatriate employees–and note that Houston ranked higher than Boston in that survey–I’d love to know how!

  449. 449
    ImJohnGalt says:

    Dickweed

    OH MY GOD!!!One!11! Darrell is off on one of his unbelievably personal psychotic screaming fests!1!1!1!!! QUICK!! GET THE RITALIN!!!!!!1!!!!!!110N3!!

  450. 450
    ImJohnGalt says:

    Man, Balloon-Juice’s editor screens out l33t exclamations. How sad.

  451. 451
    Pb says:

    ImJohnGalt,

    It just seems to have severe problems with multiple exclamation points, turning them into some kind of super exclamation (!) that there isn’t an image for…

  452. 452
    Jay says:

    Calling $57K poverty FOR A FAMILY OF FOUR is entirely reasonable.

    According to federal guidelines it isn’t. The Census Bureau provides a lot of data on poverty and how it is “officially” measured. There’s also this extensive report on poverty and health insurance in the US.

    That’s the official line on poverty. When one uses an “unofficial” range of variables, for example where you’re living as you spend your $57K, then things get interesting. In Washington, DC you’ve dropped below impoverished and hit fighting over the best steam grates. In Warsaw, IN, you’re doing fine. (Unless you’re hit by a train, always a possiblity in flat land.)

    If one person defines poor as “meeting the federal guidelines,” and another defines it as “taking the local CoL and other factors into account,” then you get a big fat fucking row because you’re talking about two entirely different things.

  453. 453
    ImJohnGalt says:

    The most recent ACS report (published August 2006 on 2005 numbers) on household incomes can be found here. [Warning, it’s a PDF]

  454. 454
    Pb says:

    Jay,

    Yeah, we know what the federal guidelines say, now we’re talking about poverty… you know…

    Poverty \Pov”er*ty\ (p[o^]v”[~e]r*t[y^]), n. [OE. poverte, OF.
    povert[‘e], F. pauvret[‘e], fr. L. paupertas, fr. pauper
    poor. See {Poor}.]
    1. The quality or state of being poor or indigent; want or
    scarcity of means of subsistence; indigence; need.

    And yes, see above for how idiotic the federal poverty guidelines are for my area, an area that is actually *below* the average cost of living of the nation. In fact, 300% of the federal poverty guidelines is probably roughly about enough for a family of four to live on, given that the cost of living in their area *is* the average cost of living for the nation. How messed up is that?

  455. 455
    ImJohnGalt says:

    And man, is there some shocking shit in there. Regional differences, gender and racial differences in median income. I mean, it’s not shocking that there are some diffences but the scale of some of them is a bit jarring.

  456. 456
    Pb says:

    ImJohnGalt,

    Great, now adjust the data for cost of living… :)

  457. 457
    Darrell says:

    If one person defines poor as “meeting the federal guidelines,” and another defines it as “taking the local CoL and other factors into account,” then you get a big fat fucking row because you’re talking about two entirely different things.

    I think those outside of the ‘reality based’ community fully acknowledge the geographical cost-of-living differences and argued against those on this thread who were making the blanket unsupported statement that a family of 4 making $57k/year was ‘poverty level’. Furthermore, even if they work in a high-cost city, people commute to less expensive outlying areas. Also, regarding the comparison to Boston, it’s worth noting that Boston surpassed New York city and San Francisco to become the #1 most expensive city in the US. Even then, a worker in Boston would have the option to commute to a less expensive outlying area with fairly low cost public transportation options.

  458. 458
    ImJohnGalt says:

    There’s an interesting take on poverty in the left-wing rag, the San Francisco Gate. It hits all the typical notes when discussing the poverty issue – a decent primer on the “controversy”. The upshot, however, is that nobody currently in power wants to re-examine how the poverty line is calculated, because if it were to reflect the realities of today (vs. 40 years ago, when it was developed) it would almost certainly significantly increase the poverty rolls.

    Now, I’m not sure why, on its face, that’s a bad thing. I’ve certainly never seen a politician die of shame, which they should certainly feel over the lack of political will to raise minimum wage. At least it would provide a realistic measure to ensure that those that most need help receive it.

  459. 459
    Perry Como says:

    Calling $57K poverty FOR A FAMILY OF FOUR is entirely reasonable.

    Not in Puerto Rico you dishonest Leftist. Typical. It’s who you are. It’s what you do. Smart. Strong.

  460. 460
    John S. says:

    Dickweed

    So typical of a rightist…you launch into your obsessive ranting that I’m a “dickweed”, based on your failure to comprehend an entirely relevant analogy. It’s who you are deep down..it’s the kind of person you are.

    Is there really anything else that needs to be said?

  461. 461
    ThymeZone says:

    I’ll tell you what poverty is. It’s not having an original thought in your head.

    Do I smell pie?

  462. 462
    Pb says:

    Oddly enough, a lot of people in my area commute from more expensive areas to less expensive areas as well–it just depends on where the jobs are, or which jobs are where.

  463. 463
    ImJohnGalt says:

    From the article that Darrell linked to:

    ”To get anything affordable, we’re talking about being an hour to two hours away,” Walder said. ”At that point, I might as well move back to Connecticut and be near my family.”

    Jennifer Norris, a 34-year-old Medford resident, said the struggle to buy a house is a wrenching topic of conversation.

    Norris, who works for an environmental group, and her husband, employed at Harvard Law School, make a combined salary that exceeds $100,000. But that isn’t enough to buy a house near their jobs, they say, and for five years they have rented a two-bedroom apartment.

    I recognize, Darrell, that you have on occasion claimed a libertarian outlook, and so may be entirely unsympathetic, but

    Even then, a worker in Boston would have the option to commute to a less expensive outlying area with fairly low cost public transportation options.

    seems a bit of a Faustian bargain, no?

  464. 464
    Darrell says:

    Norris, who works for an environmental group, and her husband, employed at Harvard Law School, make a combined salary that exceeds $100,000. But that isn’t enough to buy a house near their jobs, they say, and for five years they have rented a two-bedroom apartment.

    I recognize, Darrell, that you have on occasion claimed a libertarian outlook, and so may be entirely unsympathetic, but

    I call bullshit. I could find MANY 2 bedroom options within a 30 – 40 minute commute from Boston at under $300,000 (which they could easily qualify for at their income), maybe some 3 bdrms too if I looked hard enough.

  465. 465
    ImJohnGalt says:

    My assumption is that what constitutes “near” [one’s job] varies widely among consumers.

  466. 466

    Gosh, P.C., you’re right. And in Zambia, $57K will get you a mansion with hot and cold running water — and running hot and cold gang raids, too. But, it’s better than Washington, D.C.

  467. 467
    TenguPhule says:

    I call bullshit. I could find MANY 2 bedroom options within a 30 – 40 minute commute from Boston at under $300,000 (which they could easily qualify for at their income), maybe some 3 bdrms too if I looked hard enough.

    So Darrell disputes the article he linked to.

    Irony will never die.

  468. 468
    Jay says:

    Yeah, we know what the federal guidelines say, now we’re talking about poverty… you know…

    I do know, my point was if you’re trying to engage in a debate about poverty with someone who says “These and ONLY these numbers are the ones that I will accept as relevant when discussing poverty…” You can’t have that discussion any more than you can discuss world travel with someone who thinks the Earth is flat.

  469. 469
    Darrell says:

    ImJohnGalt Says:

    My assumption is that what constitutes “near” [one’s job] varies widely among consumers.

    Average commute nationwide 26 minutes, so my statement still stands regarding commuting.

  470. 470
    Zifnab says:

    OMG! COULD YOU PLEASE FIND SOMETHING SLIGHTLY LESS BORING TO ARGUE ABOUT!

    Why can’t we bicker over pot and hookers like other cooler blogs? But the standard cost of living for a family of four in a suburban environment over the past five years aggregated for inflation and the rampant pop-tart shortage is driving me to tears.

    Please, will someone just start a new thread or something?

  471. 471
    Zifnab says:

    Here. Look. UCLA Police Officer with a history of violence.

    In May 1990, he was accused of using his nightstick to choke someone who was hanging out on a Saturday in front of a UCLA fraternity. Kente S. Scott alleged that Duren confronted him while he was walking on the street outside the Theta Xi fraternity house.

    Scott sued the university, and according to court records, UCLA officials moved to have Duren dismissed from the police force. But after an independent administrative hearing, officials overturned the dismissal, suspending him for 90 days.

    In October 2003, Duren shot and wounded a homeless man he encountered in Kerckhoff Hall. Duren chased the man into a bathroom, where they struggled and he fired two shots.

    ~link

  472. 472
    Darrell says:

    So Darrell disputes the article he linked to.

    The article quoted the subjective opinion of one woman in the article. She suggested there were “no” homes in their price range unless they commuted 1+ hours. However, there are a number of nice homes that are available in their price range in 1/2 that commute time, but for whatever reason, she doesn’t like them. Maybe they are too small for what she wants or doesn’t like the neighborhood, or whatever. But is is a fact that there are a number of condos, houses and townhomes under $300,000 in and around Boston.

  473. 473
    ImJohnGalt says:

    Zifnab, there is an open thread, if we’re boring you.

    Dickweed.

    [Sorry, I’m off my meds]

  474. 474
    ImJohnGalt says:

    Why can’t we bicker over pot and hookers like other cooler blogs?

    Waitaminute. There’s some disagreement over either pot or hookers?

    I need to get out more.

  475. 475
    John S. says:

    I could find MANY 2 bedroom options within a 30 – 40 minute commute from Boston at under $300,000

    I call bullshit.

    According to an actual person working in Boston who lives in an affordable area:

    Kelly Schoonover, who lives in Fall River, is reluctant to leave her family in Massachusetts, but she is one worker whose commute makes her consider moving somewhere else. Fall River is only about 50 miles south of Boston, where Schoonover works at a downtown financial firm, but she has to hop into her Volvo by around 7 a.m., because traffic on Route 24 turns the trip into a two-hour odyssey. She gets home so late at night, the 31-year-old analyst said, that getting to the gym is a ”pipe dream,” eating healthy is ”a joke,” and weeknight dates are out of the question.

    Sounds just like your fantasy, doesn’t it?

  476. 476
    John S. says:

    But is is a fact that there are a number of condos, houses and townhomes under $300,000 in and around Boston.

    With a commute time of only 20-30 minutes, too?

    I’m sure I’m not the only one that would LOVE to see some proof of that.

  477. 477
    Darrell says:

    I call bullshit.

    According to an actual person working in Boston who lives in an affordable area

    Oh John, you mean to tell us you quoted an “actual person” working in Boston? Well that settles everything doesn’t it? Look moron, Fall River is on the other side of the state. There is much other affordable housing closer in.

  478. 478
    Darrell says:

    John S, just because you’re a fucking moron who doesn’t have the first clue what he’s talking about, doesn’t mean that everyone else is a free research service to educate you on the most basics of which you so painfully ignorant. Had I searched the surrounding towns, no question I could have come up with far, far more affordable housing options in the Boston area, much less than a 1 hour commute.

    If you had a shred integrity you would come back and post, “you know Darrell, you got me.. you were right and I was wrong”

  479. 479
    John S. says:

    Oh John, you mean to tell us you quoted an “actual person” working in Boston?

    As opposed to a spoof living in Houston? Yeah.

    Fall River is on the other side of the state.

    Geography was never a strong subject for you, was it? Then again neither is linking to information. As the article mentioned – and the map I linked to shows – it is a mere 50 miles to the south of Boston, not on THE OTHER SIDE OF THE STATE.

    There is much other affordable housing closer in.

    Still waiting to see proof of that. I won’t hold my breath, though.

  480. 480
    Zifnab says:

    Dickweed.

    *tears* My ego and my heart hath been ripped assunder. Verily, this forum hath not honor, nor regard for the scruples and dignity of a humble working man. I go now. Do not wait for me upon the dawn.

    *departs*

  481. 481
    Darrell says:

    As the article mentioned – and the map I linked to shows – it is a mere 50 miles to the south of Boston, not on THE OTHER SIDE OF THE STATE.

    You’ve dug yourself a deep hole halfwit. A “mere” 50 miles. LOL!

  482. 482
    John S. says:

    John S, just because you’re a fucking moron who doesn’t have the first clue what he’s talking about

    LOL

    This from the guy who can’t read a map. Regardless, anyone who knows anything about Boston or real estate care to comment on the “quality” of the homes shown at Darrell’s link? Apparently in Darrell’s haste to mouth off, he neglected to look further into his results.

    Look Darrell, if you had a shred integrity you would come back and post, “You know John, you got me…I don’t know what the fuck I’m talking about even though I pretend that I do.”

    Again, I won’t hold my breath.

  483. 483
    John S. says:

    You’ve dug yourself a deep hole halfwit. A “mere” 50 miles. LOL!

    Lots of people who work in large cities live that far away from the jobs you genius. In fact, here in Ft. Lauderdale we are roughly 50 miles from Miami, and guess what? Loads of people commute back and forth. Shit, there are people that commute from Ft. Lauderdale to Jupiter – even St. Lucie.

    But again, in your haste to muth off you make yourself look like a complete moron. And one who not only cannot read a map, but who doesn’t seem to understand the logistics of people that work in urban areas.

  484. 484
    Darrell says:

    LOL

    This from the guy who can’t read a map

    John, I’ve been through Massachusetts plenty of times, and I can read a map. Mass is a small state, and Falls River is on the other side of the state, as any map will show. As for the “quality” of those real estate choices, a lot of them were damn nice. There would me many more choices if I had decided to check out the outlying Boston suburbs, the results of which would have humiliated you even further. You tried to make a point and you got called on it because you didn’t have a clue.

  485. 485

    Um, Darrell? A town 50 miles south of Boston is, effectively, inaccessible to Boston — and it is also almost in the next state.

    For some years, I lived in Natick, and commuted into Boston, a total distance of somewhat less than 16 miles. Even then, it was an hour and a half commute during rush hour *on a good day*. It’s gotten steadily worse.

  486. 486
    Darrell says:

    anyone who knows anything about Boston or real estate care to comment on the “quality” of the homes shown at Darrell’s link?

    Let’s take you up on your dare jackass

    Here
    Here
    and Here
    Many more where those came from. And I spared you the embarrasment of checking the nearer outlying areas which would have shown many more listings of decent affordable properties in and immediately around Boston.

    Shit, there are people that commute from Ft. Lauderdale to Jupiter – even St. Lucie.

    Too funny and too stupid for words. Completely ignorant to the fact that NE states like Massachusetts are tiny compared to Florida and Texas. You really seem like you ‘know’ what you’re talking about John.

  487. 487
    Jay says:

    At the risk of infuriating Zifnab.

    No mention of hookers or pot but it also doesn’t mention the spiraling cost of Froot Loops.

  488. 488
    Bombadil says:

    Even then, a worker in Boston would have the option to commute to a less expensive outlying area with fairly low cost public transportation options.

    The commuting options in Boston are by no means “fairly low cost”. If I take the train into town (which I did last week, twice) it cost’s me $10.50 round trip. Or I could drive to the T (the subway) and pay to park for the day and the cost of the trip in ($1.25 each way). The bus is anywhere from $.90 to $3.45, depending on the zones traveled.

    A good amount of the commuting in the Greater Boston area is not inbound/outbound, though, but “around bound”. In years past, the preponderance of jobs were inside the Route 128 area, but that’s expanded out to Route 495 now. Commuting options for folks in those regions are “drive” or “forget it”.

  489. 489
    Darrell says:

    A good amount of the commuting in the Greater Boston area is not inbound/outbound, though, but “around bound”. In years past, the preponderance of jobs were inside the Route 128 area, but that’s expanded out to Route 495 now. Commuting options for folks in those regions are “drive” or “forget it”.

    Yeah, but 495 is outlying and easier to get to for many living outside of Boston

  490. 490
    Bombadil says:

    Average commute nationwide 26 minutes, so my statement still stands regarding commuting.

    In the Greater Boston area, it’s closer to one hour. Given the demographics, relatively few people live near where they work. My morning commute is at least an hour (and I leave for work at 6:00 AM), and my evening drive is generally an hour and a half, with spikes to three hours if the weather is bad. From conversations with co-workers, this is on the high side, but I’m not alone there. And because my job is not downtown, public transporation is not a real options (I’d need to take a train into Boston, subway (with one change) to South Station, and another train to my work area, followed by a ten minute walk to the building. Total time, assuming connections are not missed, would be two hours each way.

  491. 491
    b-psycho says:

    Since I didn’t see anyone reply to this point…

    Why do you think the anti-tax nuts, and their heroes like George Bush, want to siphon off money from Social Security to do things like “private accounts?”

    Those accounts were never private in the true sense of the word, it was more corporatist in structure. The government still dictated what you could & couldn’t do with them.

    Besides, technically we already have private accounts, they’re just called “IRAs”.

    …they (actually, CATO Institute) figured out a long time ago that if they could break up the Social Security demographic, they could starve the core system and make it appear to be nothing more than welfare for poor people.

    Why shouldn’t it be for poor people? Next to the blatant robbery of the “trust fund” ever since it was created, the providing of benefits to people regardless of need is one of the biggest reasons it’s headed into the red.

    Now, obviously I’m biased against political solutions to anything, but what really gets me is the concept of a middle-class entitlement. At least the poor have a case for some kind of aid.

  492. 492
    Perry Como says:

    My wife’s office is 16.2 miles from our front door. It takes 1-1.5 hours by car during the morning or evening rush hours and roughly 45-60 minutes using public transportation. Some people *really* don’t understand living in urban areas.

  493. 493
    Bombadil says:

    Yeah, but 495 is outlying and easier to get to for many living outside of Boston

    Key word is “outside”. And then you need a car, as there is virtually no public transportation going to the Route 495 area. So add to your cost of living the car, insurance, gas and maintenance.

    Even then, a worker in Boston would have the option to commute to a less expensive outlying area with fairly low cost public transportation options.

    You’re either living in the “outlying area”, where 495 is accessible, or your a “worker in Boston”. Can’t be both. If you live near 495 and work in Boston, you need a car, even if only to drive to a train station. If you live near 495 and work near 495, you need a car and can’t take public transportation. If you live in Boston and work near 495, again you need a car as public transportation won’t get you there.

  494. 494
    Darrell says:

    In the Greater Boston area, it’s closer to one hour. Given the demographics, relatively few people live near where they work

    That’s assuming you’re not living by any of the subway routes, right? The subways go out pretty far too, like to Riverside past Boston College and similar far reaching areas don’t they? How long is the typical commute using subways/bus connections for those living by subways?

  495. 495
    Bombadil says:

    You’re either living in the “outlying area”, where 495 is accessible, or your a “worker in Boston”.

    Change the wording on that, I was unclear as to what I was referring to.

    “You’re either living in the “outlying area”, where 495 is accessible, or your a “worker living in Boston”.

    If you’re a worker living and working in Boston, you’re a fairly rare breed and either on the top end or the bottom end of the pay scales.

  496. 496

    Riverside is in Newton — barely 7 miles west of Kenmore Square.

    To give a sense of scale, I used to work at BU, so FDDD could drop me at Riverside on the way to Brandeis (where she taught). That was a 30 min drive. I would then have had a 30-45 min ride on the subway, including the wait, then a 15 minute walk to my office.

    And, trust me, Newton makes Redmond look cheap, cheap, cheap.

  497. 497
    Darrell says:

    Some people really don’t understand living in urban areas.

    Are you really so ignorant to belived that most people haven’t visited extensively to urban areas and/or lived in urban areas?

  498. 498
    Bombadil says:

    That’s assuming you’re not living by any of the subway routes, right? The subways go out pretty far too, like to Riverside past Boston College and similar far reaching areas don’t they? How long is the typical commute using subways/bus connections for those living by subways?

    The subways don’t go out nearly as far as the people do. On the North Shore, for example, they go only as far as Revere. The nearby towns/cities of Lynn, Swampscott, Salem, Beverly, Danvers, Peabody — no subway service, and these are a lot of commuters there. If you superimpose the subway map on a road map, you’d see how limited the subways are. The Green line goes out nearly to Route 128 (or one branch of it does), and the Red Line extends to Braintree, but otherwise none of the subway lines comes close. The percentage of commuters who live within walking distance of the T is quite low. If you’re “lucky” enough to live near the subway, yes, your commute time can be relatively low. I put “lucky” in quotes, though, as that most areas that near the subway are overcrowded and lower-end socioeconomically. Not to be snobbish, but they’re the kind of areas you work hard to get out of, and once you do, you’re not within walking distance any more.

  499. 499
    jcricket says:

    500th post

  500. 500
    jcricket says:

    Sorry, couldn’t resist doing that.

    I just love Darrell waxing idiotically about how easy it is to find quality

  501. 501
    jcricket says:

    sorry, sentence got eatan: “how easy it is to find quality sub-$300k housing in the Boston area. Despite the 11 relatives and 5 family friends I have who’ve lived in the Boston area their entire lives telling me differently. Despite all the reports that indicate the Boston area is one of the most expensive housing markets in the nation. Despite all the news reports to the contrary, Darrell’s who we should trust. A couple of links to some houses Darrell thinks are close-by is a good enough refutation for me.

    Sorry, something’s coming over me… must…stop…uncontrollable…laughter…

  502. 502
    Perry Como says:

    Are you really so ignorant to belived that most people haven’t visited extensively to urban areas and/or lived in urban areas?

    Please Darrell, school me on the ways of urban living and urban commuting. I’ll be right back. I have to run downstairs to the bodega and get some beer.

  503. 503
    ThymeZone says:

    All over America, pies are in the oven.

    Mmmm.

  504. 504
    Perry Como says:

    Actually, nevermind. They deliver.

  505. 505
    Bombadil says:

    There’s a map here showing the average commute time for the different areas of Boston. Right below it is another map showing rapid transit and commuter rail stops with a 1/4 mile buffer zone around them, to show rough coverage. [From the article: “One-quarter mile is generally taken as the distance most people are willing to walk to a public transit stop. The number of households, jobs, and schools within a quarter mile, or about a 10-minute walk, from a transit stop is an indicator of the transit system’s coverage.”]

    While the city average is 28 minutes, there are a number of areas where it exceeds 45 minutes. And this is just Boston itself; the surrounding communities are higher.

  506. 506
    ImJohnGalt says:

    PC, that made me laugh.

  507. 507

    By the way, Darrell: Bambadil was careful to say that most of the areas near the T are places you work hard to get out of. Braintree, etc. are. Newton and Brookline are the two exceptional areas.

    But, like I say, you aren’t going to be finding people with incomes of 100K/yr living in either of those. They can’t afford it.

  508. 508
  509. 509
    TenguPhule says:

    500+ Posts and Darrell still hasn’t explained how everyone paying less for universal health coverage is a bad thing.

    On the other hand, we do know he has plenty of room for pie!

  510. 510
    Perry Como says:

    500+ Posts and Darrell still hasn’t explained how everyone paying less for universal health coverage is a bad thing.

    Oh, that was covered 300 posts ago. Poor people would use their coverage to see an orthopedist instead of using $20 inserts. Ergo, universal healthcare will fail.

  511. 511
    RSA says:

    Ergo, universal healthcare will fail.

    Also, according to the Objectivists, universal healthcare has been immoral and a failure wherever it has been tried: “it is a case of vicious in theory and therefore a disaster in practice.” Now that’s reality-based thinking in a nutshell. (That is, if you lived in a nutshell, or if your brain were small enough to fit in a nutshell. . .)

  512. 512
    jake says:

    All over America, many, many pies are in the many, many ovens.

    Fixed.

  513. 513

    I think the solution to both the health-care crisis and the pie shortage crisis is simple. These problems are a Gordian knot, which a wise warrior can easily cleave in twain.

    Those who wish to remain healthy will continue to supply the warriors of this nation with pies, sweetmeats, ale, and other victuals. In exchange, they will be permitted to live, and their temples will retain the idols of their gods. Their priests will not be slaughtered, so if the peasantry become ill they can beseech their gods in their temples through the medium of priests offering burnt offerings and blood sacrifices.

    Those who do not turn over their pies and other victuals shall perish on my blade. This will alleviate the pie shortage, as well as solve any health woes the serfs may have experienced.

    Let us pray. Wodan, harden my heart and steel my resolve. I prithee, endow me with the strength to carry out my many murders of the pieless and insubordinate!

  514. 514
    jcricket says:

    Poor people Dishonest Republicans would abuse their coverage to see an orthopedist illegally obtain massive quantities of oxycontin instead of using $20 inserts Tylenol.

    Fixed. It’s all projection, I tell you.

    (That is, if you lived in a nutshell, or if your brain were small enough to fit in a nutshell. . .)

    Help, help, I’m in a nutshell. Let me out. It’s hard to breathe in here :-)

    That people named “objectivists” can claim with a straight face that universal nationalized healthcare has been tried and “failed” is among the most laughable things they’ve ever said. And they’ve had some doozies. The good thing is that this recent election shows Americans can realize when they’re being led off a cliff by doomsday cultists with peanuts for brains and hop off the runaway train.

  515. 515
    pie says:

    I’d just like to say how please I am that both I, and those who love me, are so well-represented on this thread.

    Mission accomplished. Also, fuck the poor. Let them eat cake- keep them away from me!

  516. 516
    Zifnab says:

    Mission accomplished. Also, fuck the poor. Let them eat cake- keep them away from me!

    Poor people have cooties. Also, they may cry on you and give you AIDS. Bill Frist told me so.

  517. 517
    pie says:

    Poor people have cooties. Also, they may cry on you and give you AIDS. Bill Frist told me so.

    I’ll second that. There you have two witnesses. That makes it Gospel truth- poor people will cry on your grave to give your soul AIDS in the afterlife.

  518. 518
    jcricket says:

    Bill Frist told me so.

    In his defense, there was a videotape.

  519. 519
    Darrell says:

    Also, according to the Objectivists, universal healthcare has been immoral and a failure wherever it has been tried

    I’ve yet to see anyone calling universal healthcare “immoral”. And can you point us to an example of universal healthcare which you consider a “success”?

  520. 520
    RSA says:

    I’ve yet to see anyone calling universal healthcare “immoral”.

    Search on “immoral” upward in this thread. Of course, no one takes Objectivists seriously except for other Objectivists.

  521. 521
    jcricket says:

    I’ve yet to see anyone calling universal healthcare “immoral”. And can you point us to an example of universal healthcare which you consider a “success”?

    Taking you seriously for a second, let’s first remember that
    in most countries “universal national healthcare” simply means the government is the insurer, not the provider.

    I would argue that Canada, the UK, Taiwan, Germany, France, Sweden & Switzerland are successes, in every measure. Read this survey for some of the basic facts. Every one of those systems has achieved universal coverage with similar or better quality outcomes than the US, while also achieving significantly higher customer satisfaction rates and spending significantly less on their healthcare percent of GDP. Taiwan in particular offers a very recent example of massive success in switching from a private insurance based system to a single-payer national system. Switzerland’s low overhead is a model for other countries to follow. Or if you prefer, just read this Fox News article

    Before you start in, everyone (including me) will admit that all of these systems have their own unique problems, but those problems pale in comparison to those our system has. In the surveys of the populations in those countries, even the most “dissatisfied” would not get rid of their system in favor of private insurance a la the US.

    Moreover, every healthcare systems will have to deal with the new challenges an aging population brings, but again ours system is the least able to to effectively deal with those spiraling costs.

    So why not just start with the proven model that industrialized nations use to effectively administer healthcare. Then, all we need to do is use some American know-how, add some incentives for R&D and some better structural funding and we’ll probably beat everyone.

    Since we’ve now provided a massive amount of links, surveys and statistics (not just personal arguments) showing that it’s better, do you have any evidence (I don’t mean your assertions or suppositions) that nationalized healthcare would be worse? Or would not be better? Please show me the data.

  522. 522
    ImJohnGalt says:

    I know this comment is going to get pretty lost down here, but the Angry Bear has some great posts on universal healthcare comparisons. The link is to the first in a series – look at the sidebar on the left for later posts in the series.

  523. 523
    pie says:

    IMJohnGalt, welcome back you insufferable fucking asshole! Happy Thanksgiving, BTW.

    (Seriously, we should start greeting Darrell that way all the time. It’s not as if he doesn’t have it coming. Also, one of us needs to start a Darrellwatch blog, so we can catch him in all his many inconsistencies without wasting time on tedious Balloon Juice research.)

    Let us all praise the miracle of Pie.

  524. 524
    scs says:

    Let’s face it, the way to deal with healthcare today in this country is to lie, lie, lie. Switch insurance companies often when you’ve had any payment lapses. When you sign up for new insurance, you do NOT say you’ve ever had any health problems, or ever visited a doctor for any reason- even a flu. You switch to a new doctor and a new hospital when you sign up, so that they can’t check your old doctor records. If you are new to a policy, you go through the steps of any ailment you have had anew, pretending you never had those kinds of symptoms before. If worse comes to worst, you get health insurance in another state, so they can’t trace you.

    This may sound ethically wrong and may be fraudulent, but your health and your life is at stake, and you are only cheating people who are cheating you. If you follow that prescription, you’ll be fine within our helathcare system.

  525. 525
    TenguPhule says:

    SCS says: This may sound ethically wrong and may be fraudulent, but your health and your life is at stake, and you are only cheating people who are cheating you.

    Shorter SCS: I’m a lying bitch, which means everyone else is a lying bastard, so you should be one too!

  526. 526
    jake says:

    This may sound is ethically wrong[,] and may be fraudulent [and illegal]

    Fixed.

    And as an added bonus, once your cheating arse in prison for multiple counts of fraud, your healthcare won’t cost you a dime! Yipee!

    Make sure you cheat good and hard because the civil penalties that stem from providing false information on a contract, “switching insurance companies often when you’ve had any payment lapses” (that’s welching out on bills for the rest of us) and supplying false SSNs so they can’t track your information will mean the insurance companies get your fucking house.

    Is there some sort of contest to be the biggest spoof? If so, I declare scs the winner. If not, STFU.

  527. 527
    Darrell says:

    IMJohnGalt, welcome back you insufferable fucking asshole! Happy Thanksgiving, BTW.

    (Seriously, we should start greeting Darrell that way all the time. It’s not as if he doesn’t have it coming. Also, one of us needs to start a Darrellwatch blog, so we can catch him in all his many inconsistencies without wasting time on tedious Balloon Juice research.)

    Weirdly obsessive of you to dredge up the same no-context quote from days back on multiple threads, even when I’m not posting. Apparently you’re obsessing to the point that I’m in your head and you can’t get me out.. all those voices in your head, and you can’t make them stop.

  528. 528
    scs says:

    Make sure you cheat good and hard because the civil penalties that stem from providing false information on a contract, “switching insurance companies often when you’ve had any payment lapses” (that’s welching out on bills for the rest of us) and supplying false SSNs so they can’t track your information will mean the insurance companies get your fucking house.

    The penalty on fraud on a contract are civil penalties, not criminal. Especially fraud for a reason like this, health, would probably considered less serious. The health insurance company would have to pursue it in court, and it would cost them more to do that than the money they receive back, in addition to the bad publicity they would receive. And even if they did win, and you had to pay, it would probably not be a large amount, just the amount of the money received – unlikely damages, and you could work out a payment arrangement. Even still it might be hard for the insurance company to collect the money, civil suits always are. Remember OJ and how he has not paid a dime yet for his judgement. Probably, it’s most likely the insurance company would just drop you rather than bother to pursue it legally.

    In other words, your health is worth the gamble. The health insurance with their “pre-existing condition” clauses, and “not being able to be sued” clauses, are frauds, and everyone knows it, so you have to do what you have to do. That’s why when I watched that Grisham movie about the kid who had leukemia and couldn’t get coverage and died – I was thinking the whole time “what a fool!”. He should have just lied and signed up with another insurance company- he would have lived.

  529. 529
    TenguPhule says:

    In other words, your health is worth the gamble. The health insurance with their “pre-existing condition” clauses, and “not being able to be sued” clauses, are frauds, and everyone knows it, so you have to do what you have to do. That’s why when I watched that Grisham movie about the kid who had leukemia and couldn’t get coverage and died – I was thinking the whole time “what a fool!”. He should have just lied and signed up with another insurance company- he would have lived.

    Shorter SCS: I get my ideas from the movies! And they tell me it’s okay to be a lying bitch. So everyone should join me.

  530. 530

    […] This is stupendously good news for a couple of reasons. Obviously having another influential Dem politician behind the idea brings it that much closer to happening, and it would be nice to see the Obama campaign settle on a signature issue or two. But to me this is particularly good news because as I have pointed out before the American health care system is in a fundamentally unstable place right now. Relative to our competitors with more sensible healthcare plans (that is, virtually every other developed nation) American industry is suffocating under the financial burdens of our employer-provided healthcare system. […]

  531. 531

    […] In my view the only way to make progress involves choosing an ally that can counterbalance the predictable hew and cry from insurers and their titanic lobbying arm. That’s a tall order, but as I laid out in two recent posts it’s clearly within our reach. […]

  532. 532

    […] It is about time somebody figure out that the Democrats need powerful allies to move healthcare reform forward and it won’t be the insurance biz. I have only pointed this out now in three separate posts. You can go read those to get the gist of my point so I’ll be brief. It is very, very exciting to see Stern working together with Wal-Mart on this because for one, Wal-Mart is the single largest employer in America and a heavy contributor to party politics. That’s a lot of pull. […]

Trackbacks & Pingbacks

  1. […] It is about time somebody figure out that the Democrats need powerful allies to move healthcare reform forward and it won’t be the insurance biz. I have only pointed this out now in three separate posts. You can go read those to get the gist of my point so I’ll be brief. It is very, very exciting to see Stern working together with Wal-Mart on this because for one, Wal-Mart is the single largest employer in America and a heavy contributor to party politics. That’s a lot of pull. […]

  2. […] In my view the only way to make progress involves choosing an ally that can counterbalance the predictable hew and cry from insurers and their titanic lobbying arm. That’s a tall order, but as I laid out in two recent posts it’s clearly within our reach. […]

  3. […] This is stupendously good news for a couple of reasons. Obviously having another influential Dem politician behind the idea brings it that much closer to happening, and it would be nice to see the Obama campaign settle on a signature issue or two. But to me this is particularly good news because as I have pointed out before the American health care system is in a fundamentally unstable place right now. Relative to our competitors with more sensible healthcare plans (that is, virtually every other developed nation) American industry is suffocating under the financial burdens of our employer-provided healthcare system. […]

  4. […] Posted by TFG on November 20th, 2006 The major criticisms of public healthcare never seem to hold much water. […]

  5. […] Tim at Balloon Juice also has some good comments: In many ways our broken healthcare system acts like a lead weight around the ankles of American business. While it’s easy to bitch about American carmakers investing poorly in quality engineering and forward-looking technologies, major employers like Ford, Chrysler and GM have pension and healthcare legacy costs that our Asian and European competitors do not. Among other problems (stratospheric executive pay for one) healthcare costs are driving the country’s airlines into bankruptcy and/or viciously adversarial negotiations with the employee unions. Pick any sector of American industry and the same problem appears. […]

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