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Elias Isquith

Elias Isquith is a freelance journalist and blogger. He considers Bob Dylan and Walter Sobchak to be the two great Jewish thinkers of our time; he thinks Kafka was half-right when he said there was hope, "but not for us"; and he can be reached through the twitter via @eliasisquith or via email. The opinions he expresses on the blog and throughout the interwebs are exclusively his own.

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58 Responses

  1. Avatar Mike says:

    Generally, medical reform plans fall into 4 categories.

    – A variant of what we have now: most workers held hostage by employer-provided plans, individual care prohibitively costly to all but the healthiest / richest, and the poor or those suffering from ongoing problems (congenital, sustained/serious injury, genetic maladies) suffering on minimal care provided by the government at taxpayer expense.

    – A reform in which single payer is brought into the equation so that quality of care “evens out” somewhat, and in which higher taxes on those able to pay support the system that most/all rely on. Net effect: this decouples health benefits from employers, hopefully eliminating the “I’d love to quit my job but if I do who will pay for my kid’s/spouse’s chemo” problem.

    – A reform in which everyone is thrown to the wolves, private insurance is the only game in town, and those who “choose not to” (or just can’t afford to) purchase health care either beg/plead for help from religious charities (provided, you know, that they aren’t gay or in some other group that the religions decide should just die) or else, as the TP’ers put it in a recent Republican debate, just “Let ’em die.”

    What I find most interesting in this mess is that it was the TP’ers screaming bloody murder about Obamacare’s reforms claiming it would create “government death panels” who would decide whether grandma got treatment. Apparently the only people responsible for killing grandma should be the TP’ers, their asshole of a god who says the poor aren’t worth saving, and the heartless assholes who currently make people lawyer up in order to get insurance companies to pay out coverage today.Report

  2. Avatar Liberty60 says:

    Because the plan is NOT intended to benefit the old and sick; it is designed purposefully to benefit the sort of persons who contribute to Mr. Wyden and Ryan’s campaigns. It has the practical effect of limiting their tax contribution, while transferring risk to the program recipients.Report

    • Whatever the merits or demerits of this proposal, it depresses the hell out of me that, by virtue of putting his name on legislation with a prominent Republican, the motivation for Ron Wyden’s entire life’s work can so easily get called into question.Report

      • Avatar Jaybird says:

        Which is why ideological purists should never get their hands on the levers of power.Report

      • Avatar Jesse Ewiak says:

        Don’t team up with people don’t want to destroy Medicare and Democrat’s won’t slam you. Not the hardest rule to keep track of, especially when your ‘compromise’ plan with said Republican is 90% the Republican’s plan.Report

      • Avatar Tom Van Dyke says:

        Yes, MarkT, I’m following the Wyden-Ryan thing with interest.  I give them both points for seriousness.Report

        • Avatar Jesse Ewiak says:

          Why is something only considered “serious” when involves taking benefits away from people and privatizing public services?Report

          • Avatar James Hanley says:

            Sincerely, Jesse, because we haven’t yet found another way to control costs.Report

            • Avatar Jesse Ewiak says:

              So, explain why the cost of private insurance is rising faster than Medicare? Or why we spend more than other countries on health care than those with better benefits and less privatization?Report

              • Avatar James Hanley says:

                So, explain why the cost of private insurance is rising faster than Medicare?

                Because we don’t actually have competition between private insurers.  That is, we don’t actually have a competitive market system in health care at this time.

                why we spend more than other countries on health care than those with better benefits and less privatization?

                One, those countries do limit costs.  The reason people wait so long to get elective surgery in so many countries is because that’s where they’re doing the limiting.  (I’m not arguing against doing the limiting there, by the way, just noting that however good and justified, it’s still a method of limiting costs.)

                Second, they negotiate bloc deals with pharmas on drug prices, and that means pharma has to make that diminished revenue up somewhere else–guess where that somewhere else is?  So that simultaneously reduces their spending while increasing ours.

                Third, some of our specific policies may have been poorly designed, and actually ended up creating incentives for costlier treatments.  See here.

                Not arguing goods or bads on any of that mind you, just stating at least some of the factors that caus the difference in costs.Report

              • Avatar Jesse Ewiak says:

                So, we should fix the health care market by giving more power to the health insurance companies who distorted and screwed up the market in the first place instead of doing the opposite and perhaps, getting more people into the single-payer system that is growing slower than private insurance despite being full of old people?

                As I think I’ve said before. Instead of competing plans and all the other political wrangling, the best way to solve our health care crisis is getting a monkey to randomly pick a piece of paper out of a hat that’s filled with the names of all the other countries in the OECD and implement that countries health care system. 🙂Report

              • Avatar Jaybird says:

                So, we should fix the health care market by giving more power to the health insurance companies who distorted and screwed up the market in the first place instead of doing the opposite and perhaps, getting more people into the single-payer system that is growing slower than private insurance despite being full of old people?

                We can call it “Obamacare.”Report

              • Avatar Jesse Ewiak says:

                As I’ve said before, the PPACA’s a crappy bill, but still better than the health care system pre-PPACA. For instance, 2.5 million young people now have health insurance thanks to that.Report

              • Avatar DensityDuck says:

                They have health insurance, and Tanzania has lots of billionaires. Neither is worth much in the real world.Report

              • Avatar James Hanley says:

                Jesse,

                Look, I really don’t want to argue the pros and cons, and so I’m not going to get into a debate about what we ought to do.  If you prefer a single-payer system to any type of market-based system, that’s fine.  But I do want to get the facts straight, and you’re making some fundamental mistakes.

                First, It’s not just the health insurance companies that screwed up the market.  It’s also the labor unions and big corporations who created the pattern of health insurance being tied to employment, and it’s also state governments that have limited health insurance company competition across state lines.

                Second, the general idea (whether it’s good or bad) is not about giving the health insurance companies more power, it’s about creating actual competition.  Competition does not hand power to firms; only protecting them from competition does that.

                My take is that probably either a single-payer system or an actual competitive system would be better than what we have now, which is essentially a half-public/half-private non-market system.Report

              • Avatar Jesse Ewiak says:

                1. I’ll cop to the fact that labor and corporations have had a hand in it.

                2. All that would happen if insurance companies were allowed to sell across state lines without strong federal regulation is the same thing that happened with credit cards. They’d go buy a state legislature, eliminate all regulations, and poof, just like all credit card offers come from South Dakota, all health insurance would be underwritten in Wyoming or something.

                3. Competition is fine for shoes, computers, dog food, and even elective surgeries. Not so much for basic comprehensive health care. You disagree with that fact.

                4. I’m sure an actual free market in health care would be fine. Too bad it’s impossible to actually have a free market in health care as when you’re dying of a heart attack at eighty-five, you can’t exactly Yelp cardiologists.Report

              • Avatar James Hanley says:

                All that would happen if insurance companies were allowed to sell across state lines without strong federal regulation is the same thing that happened with credit cards. They’d go buy a state legislature, eliminate all regulations, and poof, just like all credit card offers come from South Dakota, all health insurance would be underwritten in Wyoming or something.

                Fine, have some federal regulation if necessary.  I’m not saying anything beyond competition lowers costs.  You’re attacking around the edges, but you haven’t rebutted the main point.

                ’m sure an actual free market in health care would be fine. Too bad it’s impossible to actually have a free market in health care as when you’re dying of a heart attack at eighty-five, you can’t exactly Yelp cardiologists.

                This may be the worst argument I’ve ever heard against markets in health care, and believe me I’ve heard it a zillion times.  Whether I get my insurance through my employer, through my government, or through my choice in a competitive market, how does that affect what happens the moment I have a heart attack?  It doesn’t–in each of those cases I’m not in a position to comparison shop.  Single-payer doesn’t do anything to change that!  That doesn’t make single-payer bad; it just demonstrates that this is a pointless argument that has no bearing on the issue.Report

              • Avatar Liberty60 says:

                There is a fundamental disagreement here-

                Medical care is different than toasters or other consumer goods, in that most people in the conservative and liberal worlds believe that there is a moral imperative in society to make medical care universal; conservatives just want it to be delivered via a combination of private enterprise, churches and charities, while liberals want it delivered via government.

                Libertarians don’t think it is important to be universally delivered at all.Report

              • Avatar Jaybird says:

                If eighty-five year olds die of a heart attack, is that supposed to be a signal of societal failure?

                I’m beginning to suspect that there are a great many hard truths that have been kept hidden from many of us and I don’t know that I want to be the person to break them, necessarily…Report

              • Avatar Jesse Ewiak says:

                If the eighty-five year old could have lived and the decision not to save him was based on next quarter’s stock price, then yup, it’s societal failure.Report

              • Avatar James Hanley says:

                Liberty60,

                I’m pretty much in agreement with that.  But I’m not making an argument about that.  A) I know it wouldn’t accomplish much and B) I’m conflicted on it myself, so C) I’m just trying to clarify facts rather than take a stand on issue.Report

              • Avatar James K says:

                Liberty60; what about doing what we do with another of life necessities: food. Does the government deal with food affordability by buying everyone in the country a basket of groceries each week? Of course not, that would be absurd. Let the market do what it does best (fit services to paying consumers) and use welfare to deal with problems the market can’t fix (like poverty).

                This is about using the right tool for the right job.Report

      • Avatar Dan Miller says:

        I think if he’d put his name on legislation with a different prominent Republican–e.g. Olympia Snowe–he might be getting less flack.  I’m reserving judgement on the plan itself until I have more time to read about it, but greeting Paul Ryan’s involvement with skepticism is, for liberals, both understandable and justified.Report

        • My point is that this is a guy with a reliably liberal track record as a principled advocate of health care reform.  He was certainly one of the most important players in keeping health care reform alive in the post-Clinton era, and it’s safe to say that without him, PPACA probably (1) does not pass at all; and (2) if it does, is even more watered-down than it turned out to be.

          He co-sponsored a health care reform bill with Republican Bob Bennett that most liberals agreed would have been a far better bill than PPACA.  In the process – and this was just months before Ryan assumed his current role – he and Bennett worked fairly closely with Ryan (though Ryan never officially signed on), for which Ezra Klein (and a few other liberal pundits, IIRC) heaped praise on Wyden, Bennett, and Ryan.  For working with Wyden, conservatives successfully primaried Bennett, who was a pretty solid conservative.

          This is one of the very few politicians in Washington who, 24 hours ago, would have universally been characterized by liberals as being serious and passionate about health care.

          But now that he’s co-sponsoring a bill with Paul Ryan, that all suddenly goes out the window, and it can be safely assumed that he’s working with Ryan only because of the campaign money it will allegedly raise?

          I’m sorry, but that’s ridiculous.Report

          • Avatar James Hanley says:

            +1.   Wyden was my senator when I lived in Oregon.  Frankly he’s too liberal for my taste, but I like the guy.  I voted for him back then, and I’d probably vote for him again if I still lived there.  If you’re looking for an honest pol inside the beltway, Wyden’s your guy.Report

          • Avatar Jesse Ewiak says:

            No, I don’t care about the money angle.

            But, here’s what you don’t do. Give people who want to destroy the welfare state cover by cosponsoring bills with them. For instance, Marco Rubio would never co-sponsor a bill to “reform” Social Security that removed the cap on the FICA tax, increased benefits, and for his big ‘get’, increase the retirement age by six months. Two seconds later, there’d be a primaryrubio site and rightly so.

            If this was a truly bi-partisan bill, like Wyden-Bennett, I may disagree with it, but hey, at least it’s a plan. In a lot of ways, this is worse than the Ryan plan because hey, the Ryan plan was horrible, but at least it did save money.

            On the other hand, from everything I’ve read about this plan, once you get past the opening that’s about extolling what brave and serious people Wyden & Ryan are, there’s the fact that in the actual rhetorical/political collaboration, it’s 80% free market conservatism and 20% vague assurances we won’t kill Grandma. If you’re going to make a bipartisan deal with somebody your side rightly sees as an ideologue, get actual concessions in both policy and rhetoric.

             

             Report

            • I’ve got no problem with claiming that Wyden made a bad deal here, or even made a dumb deal, whatever my personal thoughts on it.  Not many liberals would count me as one of their own and I haven’t evaluated the bill closely enough to even form my own opinion, so I sure as hell have no authority to tell liberals whether this is a good bill or a bad bill.

              My point is just that the rapidity with which Wyden’s history has been disposed is disgusting to me.  It seems that liberals are suddenly treating him the way that Bob Bennett was treated by conservatives, except that Wyden’s history would seem to make him even less deserving of that vitriol than Bennett was deserving of the conservative vitriol (and eventually primary defeat).Report

              • Avatar Tom Van Dyke says:

                Aye, MarkT.  I’m just happy both sides are talking, and not just a RINO and a DINO.  Props.Report

              • Avatar Liberty60 says:

                Wyden is a grownup. This is serious stuff we are talking about, not some college dorm room debate.

                His actions will likely result in real people suffering real anguish and misery, even death if their health care is reduced or cut off.

                That sort of unfairness I can get worked up about; writing caustic words about a politician on a blog? Not so much.Report

              • For the most part, I don’t give a crap about being unfair to a politician, though if Wyden were to get primaried because of this or were forced to become the type of politician that just panders to his base, I will give a crap – honest politicians are an extraordinarily rare bird that are the only way that good things can get done in Washington.

                But I’ve found that doing so should be a warning bell to the person being unfair, because:

                1.  Especially where the person to whom one is being unfair is someone one thought highly of 24 hours ago, it suggests that one’s reaction is an emotional knee-jerk reaction, not a considered evaluation of the proposal; and

                2. It really, really undermines one’s credibility with others and one’s ability to persuade others.  Which, if one doesn’t care about those two things, then why the heck is one here?Report

              • Avatar Jesse Ewiak says:

                I don’t think you understand where many people are coming from, including Liberty and I. Nobody at least on this site thinks Ron Wyden is a horrible person. We just think he’s being rolled. And as liberals who have seen Democrat’s rolled way too many times, we try to let said Democrat’s know they’re being rolled.Report

              • Avatar James Hanley says:

                Jesse,

                Re-read Liberty’s original comment.  He did not say Wyden got rolled; he said the plan was designed to benefit Wyden contributors.  That was pretty clear.Report

              • Avatar Liberty60 says:

                I thought very highly of that quarterback right up until he handed the ball to the defensive tackle.

                Then blocked for him as he ran it downfield.

                And slapped his butt and called him a “courageous man”.

                But yeah, he was really something last week, wasn’t he?Report

          • Avatar Liberty60 says:

            Granted that Wyden is all that and a candy bar, liberalwise.

            And I will allow that maybe this is some sort of eleventy dimensional chess rope-a-dope strategy to beat the Republicans at their own game. Maybe.

            But in my experience, plans to “save” entitlement programs that include all kinds of complex voucher/ privatized/ free market usually amount to what I stated at the outset- shifting risk onto the recipients, while guaranteeing no added tax burden for the affluent class.

            And no matter how liberal politicians are- from Obama on down- there IS the pernicious tendency of the governing class to draw plans solely for their own benefit, or the benfit of those who fund them.

            I can pretty much guarantee you that not one single person who had a hand in creating this will feel even the slightest bit of discomfort from its effects.

            Oh, and speaking as a loyal member of the Democratic Central Committee, I would advise Wyden that his eleventy dimensional chess game notwithstanding, down here in the trenches what the battle plan looks like is that he has ceded the battlefield to the market fundamentalists- “even the liberal Ron Wyden admits the market is is best and that benefits need to be cut”.

            Please- I would love to be proven wrong, that this will result in better care and benefits for the sick and elderly. But I just don’t see it.Report

            • The problem is that you are mistaking your predicted effect for Wyden’s intent.  Your predicted effect is nothing more than your prediction.  Wyden’s history as one of the few unflinchingly honest and, yes, liberal politicians provides no basis upon which to conclude that his predictions as to this proposed legislation’s effects are anything more or less than his own predicted effects. Indeed, that history provides no basis to conclude that he’s just got some sort of ulterior, hidden strategy here.

              He is one of the extraordinarily rare politicians who has earned the presumption of good faith.  That doesn’t mean you should assume his predictions are correct.  It just means that you should allow for the possibility that there are good faith, and indeed liberal, justifications for this bill (and for market-based solutions generally), just as there may be good faith, and indeed, conservative/libertarian, justifications for Medicare/PPACA, etc. (and for government-based solutions generally).Report

              • Avatar Jesse Ewiak says:

                If you team up with a butcher and tell a cow you’re on his side, the cow shouldn’t be faulted for not giving you any good faith in the matter.Report

              • Avatar Liberty60 says:

                “you should allow for the possibility that there are good faith, and indeed liberal, justifications for this bill (and for market-based solutions generally), ”

                Got any to share?Report

              • Let’s start with Wyden’s.

                And how about a good chunk of everything that’s ever been written on this site?  Presumably you don’t think we’re all just writing in bad faith, otherwise why are you here?Report

              • While we’re here, aren’t you the one who insists that libertarians are closed minded ideologues?Report

              • Avatar Patrick Cahalan says:

                chuckleReport

              • Avatar Liberty60 says:

                I’m fairly new here so I don’t have acces to these terrific ideas you speak of.

                My beef with Wyden is in two parts, as I mentioned- one is the plan sounds awful, based on my previous decades of hearing about plans like this. But I do admit there is the possibility of this one being beneficial in some bizarre way that no one has yet managed to figure out, so I will leave the door open.

                The second is tactical; as a party activist, I have spent the past 6 months or so staging protest rallies and townhall confrontations, pounding home  a simple message that the Ryan Plan is crap and will privatize Medicare.

                Now, what, I am supposed to say “oh, but now Ryan is a good guy- THIS privatized voucher plan is so totally different and more sweller than that OTHER privatized voucher plan we talked about last time.” That sounds like a satire worthy of Animal Farm.

                 

                As for being closed minded- seriously, has anyone here actually seen a privatized voucher style plan over the past 30 years that actually led to GREATER benefits and security for the sick and poor?* In every case I have seen, the overriding outcome is greater risk to the recipients and less to the taxpayers.

                *(Military contractors and Wall Street beneficiaries don’t count.)Report

              • What “privatized voucher style plans over the last 30 years” have actually been implemented, much less specifically – and demonstrably and indisputably- led to less benefits and security for the sick and poor? How many examples do you have? Moreover, for those who might think that vouchers, at least in some circumstances, would have more benefits and security for the sick and poor compared to the status quo, why do you think they are wrong? By what mechanism will the opposite occur?

                As for you not being around here long, I don’t see that as very relevant. You obviously disagree with a sizable amount of what is written around these parts, and have certainly commented plenty, but AFAIK, you haven’t made any accusations of outright dishonesty, and have presumably been trying to persuade those with whom you disagree. That implies that you acknowledge those disagreements to be in good faith, otherwise, why argue with people you believe to dishonest?Report

              • Avatar Liberty60 says:

                Off the cuff, I was referencing the general trend of eliminating single payer- government programs with privatized ones. Examples:

                1. Cutting government funded colleges, while encouraging private loans;

                2. Outsourcing government work to private entities;

                3. Private entities moving away from defined benefit pensions to 401K plans.

                Different programs of course, but they share a common trend of shifting financial risk onto the shoulders of the recipients yet protecting the taxpayers from higher contributions.

                Im not interested in debating the fine points of these- I am sure that these changes have their advocates and I know an argument can be made that it is all for the good.

                My point is that I can’t think of a new proposal or program that has or would result in a greater amount of benefits and security for the recipients- have you?Report

              • On 1, I’m not sure I get where you’re going, especially given that we have more people going to college than ever before.

                On 2, I question whether that actually protects taxpayers from higher contributions. I think you will also find that many/most libertarians, especially those on this site, find that trend to be anything but market-based (actually quite the opposite), and are just as disturbed by it as liberals, for many of the same reasons, in fact.

                On 3, I don’t see how that is motivated by a desire to protect taxpayers from higher contributions. I assume you’re referring to the PBGC, but on the whole, that’s small potatoes, and in any event isn’t funded by general tax revenue. There’s an element of long run vs short run benefits that I think you’re also overlooking with this, not to mention the benefit being able to more easily change jobs without risking one’s retirement benefits.

                But all that said, let me put forward a clear example where privatization increases benefits to the poor: school voucher programs. You may well quibble with these programs for other reasons, but these programs are just about always limited to the poor. On a per capita basis, and all other things being equal, the voucher programs that actually get implemented actually increase per student funding in the relevant schools (for political reasons, this may not always happen, I will concede) for those students that do not use them; meanwhile, they provide those who receive them with an opportunity they otherwise would not have.Report

              • Avatar Koz says:

                “The second is tactical; as a party activist, I have spent the past 6 months or so staging protest rallies and townhall confrontations, pounding home a simple message that the Ryan Plan is crap and will privatize Medicare.”

                Gotta consider all the alternatives. The important one is this: “I’m a lib so I’ve no hope at all of actually contributing something useful to the body politic. So, I’m going to chill out on this activist thing and see what the American people come up with. And then I’ll vote Republican on the way out.”Report

        • Also, it seems worth mentioning that Bob Bennett would still probably be in the Senate if his bill was called Bennett-Nelson but was otherwise identical to Wyden-Bennett.

          Thing is that Bennett-Nelson would have been a substantively worse bill for both conservatives and liberals in reality.Report

  3. Avatar Kyle Cupp says:

    Have to quibble with your characterization of a medieval monk, who would not have neatly divided the world into saints and sinners, but rather seen all people as sinners who, by the grace of God, can become saints.Report

  4. Avatar Underwriterguy says:

    I’ll admit to not having read all the comments, but the first dozen or so drift into discussions of non-Medicare delivery systems. The bill specifically deals with Medicare.

    As i understand the proposed bill, current Medicare will remain a choice among other plans developed by non-government sources (insurance cos., ACO’s, etc). This will have the effect of offering a single payer plan plan alongside the private ones, something many advocated for Obamacare.

    Further what is proposed is very similar to a demonstration project proposed in AZ and, I think, CO for what was then called Medicare+Choice. A plan design was to be determined and then private carriers were to bid on the plan. I don’t remember the exact details but the winner would have been something like the current proposal’s “second lowest.” Incidentally, politics killed the project.

    I don’t know how we can preserve Medicare without going to some sort of defined contribution approach. Allowing the market to innovate and find ways of delivering benefits that please customers while bending the cost curve seems like a pretty sound idea. There are some good signs in the privately offered Part D and Medicare Advantage successes that we can build on.Report

    • Avatar NoPublic says:

      There are some good signs in the privately offered Part D and Medicare Advantage successes that we can build on.

      The what now?  One giant unfunded mandate and a program which does nothing to improve healthcare costs or coverage but only increases the monies paid out solely to give profit to private firms.  These are the two things you want to call “good” and build on?Report

      • Avatar Morat20 says:

        Yeah, I don’t get the love of Medicare Advantage. It costs more than regular Medicare, it doesn’t offer better services, and from what I’ve read people who try it tend to zip back to traditional Medicare quickly.

        So I don’t get how “let’s pay more for, at best, the same basic service” is a PLUS.

        It’s like the student loan thing — why was the government both guarunteeing loans AND subsidizing private banks offering them? The banks are taking absolutely no risks — defaults get covered by the government — so the loan subsidies were entirely for bookkeeping.

        If you’re going to pay for that, why not a simple fee for service model? It’s cheaper. Or heck, since the government is actually providing the money and collecting from defaulters, why not handle it yourself and cut out a middleman?Report

      • Avatar Underwriterguy says:

        The good signs that I had in mind are that something like 24% of Medicare eligibles sign up for Medicare Advantage. So the consumers get to make a choice, always a good thing.  Part D has high satisfaction (not the donut hole, but that ispart of the federal design) and costs less than theFeds thought, maybe because of competition.

        The challenge for any private provider in the proposed bill will be to provide attractive benefits at the “second lowest” bid price. Worth seeing if it can be done.

        Having been responsible for about 100,000 Medicare+Choice (pre- Medicare Advantage) in an earlier life, I can tell you that a managed care approach to chronically ill seniors has advantages in pharmaceutical compliance and cutting down or hospital readmissions among other things.Report

        • Avatar Morat20 says:

          24% of medicare eligibles signing up for Medicare Advantage is a meaningless statistic. Literally. It has absolutely zero bearing on ANYTHING useful, unless you think the mere existance of a choice is somehow a magic plus. “You can choose between death by hanging or death by gunshot — the mere fact that 24% of people chose to hang shows how wonderful hanging is!”.

          You want actual information on Medicare Advantage? Look at %s who stayed and left after a year — that tells you about satisifaction compared to traditional Medicare.

          Look at costs — does it cost more or less? At coverage — does it cover more or less? Actual useful information.

          There mere existance of Medicare Advantage is not a plus or a minus — it’s merely a fact.Report

  5. Avatar Liberty60 says:

    @ Mark Thompson up above-

    #1, More people going to college isn’t my point; a generation ago, public colleges were funded well enough to be cheap enough to where very few graduates carried any debt upon graduation; today nearly all do, in staggering amounts owed to private banks. Less taxpayer cost, higher risk and lower benefits to the beneficiaries.

    #2 Outsourcing is usually done for the purpose of evading public unions, with the goal of paying lower wages and benefits;

    #3, a generation ago large corporations assumed the risk of pensions, with the workers getting a defined benefit; today nearly all have replaced this with a 401K which transfers the risk of loss onto the worker.

    Again- the trend is both lower reward AND higher risk of bad outcomes onto the less powerful members of society while the more powerful are able to negotiate both higher rewards AND lower risk.

    So reaching waaaay back to the original post, when I read that Ron Wyden is collaborating with Paul Ryan on a privatized voucherized scheme for Medicare, it isn’t just knee jerking to suspect it won’t be of a benefit to the program recipients.Report

    • Avatar Patrick Cahalan says:

      #1: Many public colleges are still well funded enough that you can graduate carrying little debt.  People who are carrying large amounts of debt are usually attending either private school or public universities with large operational costs.  It is still eminently possible to get a B.S. or B.A. without carrying a pile of debt.  This isn’t to dispute that there are problems in this domain space, but there are a number of confounding factors here.

      #2: Outsourcing is done to cut costs.  As long as private sector unions demand an order of magnitude greater wages than workers elsewhere, that’s where the jobs are going to go.  One can make two arguments in favor of this: (a) who’s to say that people in China ought not to have these jobs over anybody else and (b) corporations are already seeing their ROI for outsourcing drop for a large number of reasons so the labor market may equalize to some degree.  Much as I dislike the American consumer’s motivations, they buy what they buy.

      #3: The pension system bankrupted an entire swath of American corporations, which did the pension holders no damn good.  The risk has always been on the worker.  While I’m no fan of the way 401k/403bs work (and certainly don’t think they are a good vehicle for privatizing Social Security, for example), I will say that they are better than the pension system.

      Again- the trend is both lower reward AND higher risk of bad outcomes onto the less powerful members of society while the more powerful are able to negotiate both higher rewards AND lower risk.

      I don’t think these are particularly good examples to buttress your point.  Capital gains taxes, inheritance taxes, bailouts, the upper marginal tax rate… those all are structured to keep wealth flowing upwards.  Risk transference is largely a red herring; pensions actually less secure than independent retirement accounts because they were subject to a class-break, where a pension system failed everybody all at once.  A lot of the risk of the 401k system isn’t in fact necessary: simple default behaviors could probably go a long way to ensuring that people’s money move to lower risk investments as they approach retirement age by default (it’s the people who have 90% of their 401k in Stocks who can get screwed by a short-term market fluctuation).

      Outsourcing certainly doesn’t transfer risk away from the American worker, if anything it puts more risk on the company (as many companies are finding out, to their chagrin).

      Now, there are a number of other problems with outsourcing that involve risk management, but this is more a case of companies being stupid than companies being coldly calculating and evil.Report