No, by definition. Leaving out the sick and infirm will make the bottom line look a lot better. See, for example, US health insurance practices until recently.
There are dozens of countries which have put into place UHC. Please show me a graph detailing how their costs actually went down when they did so. Not how their costs are different from someone else, how their costs *actually* *went* *down*.
It's similar to how/why Ben could hide on Vader's home planet for years.
Vader/Anakin was emotionally a mess. Leia was his dead wife reborn, no way he was up for dealing with that.
All of his dealings with her were affected by him needing to avoid that. So he couldn't see clearly into her mind, and his plan *had* to let her escape so he wouldn't be faced with thinking the unthinkable.
He wasn't able to admit she was his daughter until his confrontation with Luke, i.e. after Luke started breaking through his mental blocks.
Ah... no. UHC has never "lowered costs", which is what we need. As part of the gov taking over HC and putting into place UHC they've also put into place things which prevent HC growth.
If we went totally into UHC right now we'd have to pay a lot to get UHC (which is why our politicians have flinched away from doing it) and then long term we'd get lower growth in health care. But we're past the point where reducing the rate of growth can help a whole lot, now we actually need to lower costs. That's going to be really painful, it means jobs will be lost and so forth.
Actual reductions in cost mean doing to our HC system what the market did to the Steel Manufacturers and other industries. The market has a long history of being brutal on entire industries, the government really doesn't.
Anyone who is paying too much for medical services or insurance.
Think about how painful it'd be to take a thousand dollars, or even ten thousand dollars, and just set it on fire. That's basically what we're having almost everyone do.
That's a *lot* of harm. It's lost opportunities and other economic benefits, and these are big numbers so it's a big deal. That people aren't aware of how much harm they're suffering doesn't eliminate its existence.
Which universal system currently is letting sick elderly people die?
All of them (everyone dies).
As I've pointed out, other systems are better at hiding painful realities, but they can't function if they don't have some way to prevent routinely spending millions of dollars on dying elderly to give them a few more weeks of life.
Just because a treatment is available doesn't obligate society to pay for it.
And many of these are people who are elderly and sick and whose spending is easily multiple times your example of 80K.
And these are the same people who, if we actually go to UMC, will receive "no" votes by death panels.
The alternative to an efficient system is NOT that everyone is covered for everything, it's that we do a better job of obfuscating how that choice is made while also making HC expensive for everyone.
So again, I’m not sure who is supposed to find this attractive.
People who want lots more money in their pocket? People who care about growth? People who currently have to choose between paying for HC and paying for HC insurance? People who need epi-pens?
There's a lot of suffering that comes with a system as inefficient as ours. We just lack the obvious signs of people starving in the streets that we'd have if this were food. Not knowing who is suffering let's us pretend there's none, but all that economic damage has real world consequences even if we don't know the details.
millions of people are paying radically lower premiums, or purchasing policies that they could not have afforded prior to Obamacare, or getting Medicaid coverage and not having to pay premiums at all.
He shifted the costs around a little, expanded coverage and raised taxes to cover that. He also decreased the growth of the medical system by somewhere between a little and nothing.
None of these changes that these entitlements have huge funding challenges (is it the CBO who often uses the word "unsustainable"?), and even that wishful reduced growth is on such a huge base that nothing really changed on that level. So what he gave us was medical insurance reform, and what we needed was (and *is*) medical reform.
4x is a *huge* amount of fat, just picture where the Dem party would be if they'd actually reduced HC spending even a little (and a few market reforms would probably be a lot more digestible than what I've suggested).
However it appears reaching for a solution that isn't command and control is either (if I'm being unkind) against their religion and/or (even more cynically) simply unthinkable to the insiders who profit by the system being so darn inefficient and throw some of those profits to the politicians who set the rules.
I don’t have time track down links, but the discussion at the time was always about ‘bending the cost curve.”
Obama said he would cut the annual cost by $2,500. Months before Obama took office, a New York Times reporter dubbed it one of the most audacious pledges of the campaign.
Not only that, but the cost control provisions were the least popular parts of the bill and were ravenously and dishonestly opposed by your own ideological compatriots.
IMHO our gov is poorly equipped to control costs, our experience with death panels is a good example.
As for ideology, I seriously doubt the GOP will go to a market based HC system, nor will they embrace the death panels a gov system needs to work.
I’m just not getting the concept here.
Who would benefit from this?
Why should they?
The European system comes with European GDP growth rates. The countries which do the best job at running their social system do so by having few people and lots of oil.
Let's use some US numbers to put this plan into perspective. Median household income is roughly $50k, Medical insurance for that median family is what... $15k? Average medical costs $5k? So call Medical Insurance + Costs of $20k (note the gov taxing it from you and giving it to you or someone else counts, as does your company withholding it from your paycheck).
I've been assuming a handwave 4x in inefficiency, so the system in our alternative universe gives you basically the same medicine at a cost of $4k, so the other $16k goes in your pocket. That has serious effects on inequality, the general good, and so forth.
Now lets assume you (in this universe) are persistently sick to the tune of $80k a year. In our alternative universe that's $20k a year so in theory you're no worse off (although yes, it's going to suck if you don't have access to that).
Further, it's strongly implied that taxes will be seriously less in this alternative universe, this should have good effects on growth rate and other good things so that median $50k is probably an understatement.
There’s also a pretty decent circumstantial case to be made that it has caused a significant slowdown in cost growth already,
Ignoring that the economy hasn't been doing all that well and some of that reduction in growth might have been from that, victory conditions were *reducing* costs, that's what's needed and that's what was promised.
Those people still die if they’re poor and the voucher only makes a trivial difference.
Yes.
It's also true that many of them will be able to purchase treatment because the treatment itself won't be so crazy expensive, but I've already pointed out that people will die.
One of the huge disadvantages with this system is people will die, and they'll know who they are. The vast numbers of people helped by the system (basically everyone but the first group) will mostly have the benefits taken for granted. Worse even people supposedly harmed by this system might be better off with this system than the command/control model because there will be more treatments available/created here.
If someone is hungry they know it, if someone is not starving to death because the system works then they don't know it.
You’ll have to require insurers to cover them, I suppose.
No.
You don't get to buy insurance after your house is on fire. There are things we should do to make sure people can keep their insurance, but that's probably a different issue.
In terms of insurance reform what we probably want to do is outlaw everything but major medical. Insurance is supposed to cover big things, not the equiv of changing light bulbs.
...If the old choice was “die” and the new choice is, “die or spend a buttload of money,” then increased spending is a win... Yes, there’s a lot of overhead and mismanagement, but the increase in overall expenditure isn’t 100% attributable to those things.
Absolutely right, we're asking for a lot more from the HC system, and that's a big part of the growth of the system if we compare to the beginning of time.
However overhead and mismanagement are clearly serious problems, probably to the tune of 4x if these comparisons to other countries can be believed (who themselves also must have issues given how many are using command & control).
Why would the government wish to make a profit on Medicare and Medicaid? Did you have some other meaning of “unprofitable” like “underfunded” or “not having enough money using their dedicated tax stream” or something like that?
What I'm pointing out is if those two only function because of support from the rest of the system, then you're suggesting that everyone subsidize everyone.
Due to who uses them, those are the highest possible per capita costs the US government can possibly see providing healthcare. Expanding Medicare to, well, everyone who actually drop per-capita costs drastically.
Putting the military's airplane developers in charge of building civilian aircraft isn't going to lower costs for the entire system. Nor is giving every civilian a "free" airplane.
UHC (i.e. expanding coverage) is going to add costs to the system, probably dramatically. Paying for these programs is already problematic.
Part of that was me realizing how effective and market friendly Food Stamps are, part of it is we really do have 6 digit cures which only the rich (and/or insured) would have access to and we'd have to drop the idea that everyone can have everything.
In any system, people are going to die because of a lack of resources. A market approach is a LOT more honest about that and skips the obfuscation that other systems try to use to hide it.
Give everyone X dollars a year for HC. Someone is going to die because they need 2X, and the typical middle class guy with a middle class job will be able to pay it.
Command and control tries to pretend that whatever treatment that someone needs can be reserved for him by preventing someone else who needs it less from taking it. That it also requires 0.75X be wasted through inefficiencies and unintended consequences isn't mentioned.
Saying those important judgments are best made by markets is a one giant whopping hell of a value judgment. And it also avoids looking at who gets helped and who is hurt by that giant value judgment.
Yes and no. In theory, everything you just said is right.
But keep in mind our "food as a right" example. Almost NO ONE is better off with the command-and-control-starvation model, the only insiders who benefit from money/power can reasonable think they're better off.
Efficiency means there's a lot more resources to throw around, even to the poor, and the system is far more responsive (also even to the poor).
The problem with a market HC system is similar to "broken windows" economic fallacy and/or the "free trade" political problem. People die, politicians point to them as reasons they should have more power, don't explain the side effects of the system they're offering, and the much larger group of people who benefit from a working system don't understand how they benefited.
...dozens of countries that have universal access and radically lower per-unit costs. People who say we need less government are appealing to…nothing. To a fantasy, a matter of theological belief that markets are the way...
What we're talking about is "how do we fix the current system".
The big options on the table are "more command and control" and "more market". Basic economic theory has predictions for what will happen in each case, we should pay attention.
It's inappropriate to point to other countries' systems and claim we can import every detail of them here. For example many of our HC issues go away if Americans become less fat, but changing that is unlikely without serious culture changes.
Similarly, referring to "economic theory" as a "religion" is like trying to refer to the "Theory of Gravity" as a "religion".
I will outright say that I don’t have any real problem replacing our privately run death panels with government death panels.
I go back and forth on this one. I think we need death panels to make anything like UHC work, and it's more likely than not that we'll attempt something like UHC.
However I don't expect good things from the gov on this, and the advantage of a privately run company is it's incompetence has feedback loops to make it respond (maybe not respond to you, but in general).
With the gov... basically incompetence needs to rise to the attention of the media or something in order to attract attempts to fix it.
Ideally everyone sits on their own death panel, perhaps is even the only person on it, and takes ownership of what happens.
If you think that being poor and diabetic should be a death sentence, then I suppose we’re not going to able to argue very productively.
People are currently dying because your "command and control" solution results in only one, seriously expensive, epi-pen on the market. That's what "resource inefficiencies" mean here and the epi-pen is only going to be one example of many.
Countries which claim "food is a right" and insist on using command/control for it typically see starvation because command/control is *that* inefficient.
The number of people who starved to death in the US last year was effectively zero, because we use the market and market friendly policies like food stamps.
So give the poor guy in your example a voucher for medical care and let the market work (you can attach it to his food stamp card).
The thermal exhaust port doesn't need a real purpose or function.
Say you're an Imperial Engineer working on the project. If you try to research what that port is doing and why, you'll find complicated technological speak and requirements which require a LOT more time to understand than you have.
The port doesn't impact any of the subsystems you do understand. A high level system architect thought it was a good idea and apparently put a lot of thought into it. He knows a lot more about this than you do, any confusion on the issue is probably your fault (note the word "fault" is important here).
You're a busy man, there are unrealistic deadlines, and Lord Vader shows up occasionally looking for inefficient people to serve as example(s). It's a really bad idea to actively try to do things which waste time and draw attention to what can be viewed as your own incompetence.
I accept the reality. I just reject the demagogic framing of it. Anyway, it’s not “We’re going to kill you”, it’s “You’re going to have to pay for that part yourself, either out of pocket or with more expensive insurance”, which has always been true.
Demagogic? It's a Panel of experts which decides who gets life saving treatments and who dies. "Death Panel" is literal, descriptive, and has entered popular culture.
Embracing the concept is a big part of what makes UHC possible in other countries. Which raises the issue of "why can they do it and we can't"?
Unified culture? Is a bunch of rich white doctors deciding that some poor guy's life isn't worthwhile more scary here?
Umm are some peoples lives worth more than others?
The moment we start allocating scarce resources? Yes. This isn't a new concept in the real world, witness the 911 compensation payouts.
The moment public funds gets involved we end up making value judgements; For example, which is the most cost effective way to spend a million dollars, keeping a dying 90 year old man alive for another year or giving vaccinations to 50,000 babies?
However these sorts of value judgements are very complex, subjective, and that's a description of something normally best resolved by markets.
True, but this is Star Wars and it's scale is absurd.
It's reasonable to walk into a random bar in a hick backwards town, on a hick backwards system, and find someone with a spaceship with transwarp drive. Transwarp drive means everything is within reach of everything. We've seen the equiv of taxis move halfway across the galaxy, we've seen ships lift off the surface of a planet and be in orbit a few seconds later.
There's no exploration in SW because the entire galaxy was fully mapped a long time ago. Similarly "new" technology is also something of a non-starter, technology is *old*.
Private companies can have enough "security" droids to think they can take over planets. Criminal gangs actually do. These things are considered small enough that it's not worth the attention of the authorities.
The Empire tried to hide the building of the 2nd Death Star in the imperial budget by farming it out to some virtual organization. Construction of the Death Star has to involve stripping multiple systems of resources, absurd numbers of people and droids, and it's such a small part of the Imperial budget that they think it's possible to hide the money.
Some fans pointed out that the destruction of the 2nd DS would bury the Ewoks home in many meters of steel and exterminate them all. Lucas pointed out that the rebels could (and did) bring in enough ships to tractor the debris elsewhere.
Moving back to the missile; It has to function in space and have a range greater than the diameter of the moon, maybe much greater. I also suspect our missiles have "drives" better than our taxis.
The fighter very clearly has a drive (multiple drives probably since it's probably able to do translight), a missile probably also has a drive.
Nothing on the screen is going to be using chemical propellants, whether or not anything experiences "acceleration" is also seriously questionable from a 21st century viewpoint, and I very much don't trust that "conservation of momentum" applies.
More importantly, Luke can only fire that thing when he's right on top of the port, it's possible he's got a tail gun so its "launch" is only relative to himself and it comes out slower than he is.
For a whole slew of goods and services markets are a better mechanism to allocate resources than central planning, but health care provision isn’t one of em.
Why is central planning "a better mechanism to allocate resources" for health care?
Judging by the rest of the first world? The next most expensive system would cost half as much per person than we spend now, with better results, and full coverage of the population.
You totally missed the point. All of these other systems were imposed when costs were low, and they reduced the *growth* of the system.
For example there are hospitals in other countries which use the "ward" model and have lots of patients in one large room. However we're not going to be burning down hospitals and building new ones and expect to save money.
None of these other systems actually reduced costs after they were imposed. It's very difficult to cut salaries of and/or fire anyone, much less gov employees.
If we want to reduce medical spending by say 5% of GDP, that's a lot of jobs and pain inflicted on people. What's more realistic, that the gov has the political will to stand up to doctors and other health care workers, or that the markets can squeeze things?
Seriously, what is with the weird insistence that universal health care is some area the US is breaking new ground on?
UC in the States is a history of Progressives trying to enact it and the people flinching away from the cost.
Or to put it differently, you're claiming you're NOT going to ration by Price (markets) or by Queue, and instead will ration by "triage".
I'm asking you if you know what that means.
I think you're talking about death panels (which btw I favor), but if you can't even bring yourself to pronounce the words then how can you realistically argue in favor of it?
Triage means you don't give more than minimal care to people who will die anyway. If that's what you're suggesting, then you aren't doing yourself any favors by being evasive.
https://en.wikipedia.org/wiki/Triage
*Comment archive for non-registered commenters assembled by email address as provided.
On “Liberals are Smug”
There are dozens of countries which have put into place UHC. Please show me a graph detailing how their costs actually went down when they did so. Not how their costs are different from someone else, how their costs *actually* *went* *down*.
On “Regarding the Thermal Exhaust Port “Design Flaw””
It's similar to how/why Ben could hide on Vader's home planet for years.
Vader/Anakin was emotionally a mess. Leia was his dead wife reborn, no way he was up for dealing with that.
All of his dealings with her were affected by him needing to avoid that. So he couldn't see clearly into her mind, and his plan *had* to let her escape so he wouldn't be faced with thinking the unthinkable.
He wasn't able to admit she was his daughter until his confrontation with Luke, i.e. after Luke started breaking through his mental blocks.
On “Liberals are Smug”
Ah... no. UHC has never "lowered costs", which is what we need. As part of the gov taking over HC and putting into place UHC they've also put into place things which prevent HC growth.
If we went totally into UHC right now we'd have to pay a lot to get UHC (which is why our politicians have flinched away from doing it) and then long term we'd get lower growth in health care. But we're past the point where reducing the rate of growth can help a whole lot, now we actually need to lower costs. That's going to be really painful, it means jobs will be lost and so forth.
Actual reductions in cost mean doing to our HC system what the market did to the Steel Manufacturers and other industries. The market has a long history of being brutal on entire industries, the government really doesn't.
"
Anyone who is paying too much for medical services or insurance.
Think about how painful it'd be to take a thousand dollars, or even ten thousand dollars, and just set it on fire. That's basically what we're having almost everyone do.
That's a *lot* of harm. It's lost opportunities and other economic benefits, and these are big numbers so it's a big deal. That people aren't aware of how much harm they're suffering doesn't eliminate its existence.
All of them (everyone dies).
As I've pointed out, other systems are better at hiding painful realities, but they can't function if they don't have some way to prevent routinely spending millions of dollars on dying elderly to give them a few more weeks of life.
Just because a treatment is available doesn't obligate society to pay for it.
"
And these are the same people who, if we actually go to UMC, will receive "no" votes by death panels.
The alternative to an efficient system is NOT that everyone is covered for everything, it's that we do a better job of obfuscating how that choice is made while also making HC expensive for everyone.
People who want lots more money in their pocket? People who care about growth? People who currently have to choose between paying for HC and paying for HC insurance? People who need epi-pens?
There's a lot of suffering that comes with a system as inefficient as ours. We just lack the obvious signs of people starving in the streets that we'd have if this were food. Not knowing who is suffering let's us pretend there's none, but all that economic damage has real world consequences even if we don't know the details.
"
He shifted the costs around a little, expanded coverage and raised taxes to cover that. He also decreased the growth of the medical system by somewhere between a little and nothing.
None of these changes that these entitlements have huge funding challenges (is it the CBO who often uses the word "unsustainable"?), and even that wishful reduced growth is on such a huge base that nothing really changed on that level. So what he gave us was medical insurance reform, and what we needed was (and *is*) medical reform.
4x is a *huge* amount of fat, just picture where the Dem party would be if they'd actually reduced HC spending even a little (and a few market reforms would probably be a lot more digestible than what I've suggested).
However it appears reaching for a solution that isn't command and control is either (if I'm being unkind) against their religion and/or (even more cynically) simply unthinkable to the insiders who profit by the system being so darn inefficient and throw some of those profits to the politicians who set the rules.
"
Obama said he would cut the annual cost by $2,500. Months before Obama took office, a New York Times reporter dubbed it one of the most audacious pledges of the campaign.
http://www.politifact.com/truth-o-meter/promises/obameter/promise/521/cut-cost-typical-familys-health-insurance-premium-/
http://www.heritage.org/research/factsheets/2014/01/top-10-broken-obamacare-promises
IMHO our gov is poorly equipped to control costs, our experience with death panels is a good example.
As for ideology, I seriously doubt the GOP will go to a market based HC system, nor will they embrace the death panels a gov system needs to work.
"
The European system comes with European GDP growth rates. The countries which do the best job at running their social system do so by having few people and lots of oil.
Let's use some US numbers to put this plan into perspective. Median household income is roughly $50k, Medical insurance for that median family is what... $15k? Average medical costs $5k? So call Medical Insurance + Costs of $20k (note the gov taxing it from you and giving it to you or someone else counts, as does your company withholding it from your paycheck).
I've been assuming a handwave 4x in inefficiency, so the system in our alternative universe gives you basically the same medicine at a cost of $4k, so the other $16k goes in your pocket. That has serious effects on inequality, the general good, and so forth.
Now lets assume you (in this universe) are persistently sick to the tune of $80k a year. In our alternative universe that's $20k a year so in theory you're no worse off (although yes, it's going to suck if you don't have access to that).
Further, it's strongly implied that taxes will be seriously less in this alternative universe, this should have good effects on growth rate and other good things so that median $50k is probably an understatement.
"
Ignoring that the economy hasn't been doing all that well and some of that reduction in growth might have been from that, victory conditions were *reducing* costs, that's what's needed and that's what was promised.
"
Yes.
It's also true that many of them will be able to purchase treatment because the treatment itself won't be so crazy expensive, but I've already pointed out that people will die.
One of the huge disadvantages with this system is people will die, and they'll know who they are. The vast numbers of people helped by the system (basically everyone but the first group) will mostly have the benefits taken for granted. Worse even people supposedly harmed by this system might be better off with this system than the command/control model because there will be more treatments available/created here.
If someone is hungry they know it, if someone is not starving to death because the system works then they don't know it.
No.
You don't get to buy insurance after your house is on fire. There are things we should do to make sure people can keep their insurance, but that's probably a different issue.
In terms of insurance reform what we probably want to do is outlaw everything but major medical. Insurance is supposed to cover big things, not the equiv of changing light bulbs.
"
Absolutely right, we're asking for a lot more from the HC system, and that's a big part of the growth of the system if we compare to the beginning of time.
However overhead and mismanagement are clearly serious problems, probably to the tune of 4x if these comparisons to other countries can be believed (who themselves also must have issues given how many are using command & control).
"
What I'm pointing out is if those two only function because of support from the rest of the system, then you're suggesting that everyone subsidize everyone.
Putting the military's airplane developers in charge of building civilian aircraft isn't going to lower costs for the entire system. Nor is giving every civilian a "free" airplane.
UHC (i.e. expanding coverage) is going to add costs to the system, probably dramatically. Paying for these programs is already problematic.
"
Part of that was me realizing how effective and market friendly Food Stamps are, part of it is we really do have 6 digit cures which only the rich (and/or insured) would have access to and we'd have to drop the idea that everyone can have everything.
In any system, people are going to die because of a lack of resources. A market approach is a LOT more honest about that and skips the obfuscation that other systems try to use to hide it.
Give everyone X dollars a year for HC. Someone is going to die because they need 2X, and the typical middle class guy with a middle class job will be able to pay it.
Command and control tries to pretend that whatever treatment that someone needs can be reserved for him by preventing someone else who needs it less from taking it. That it also requires 0.75X be wasted through inefficiencies and unintended consequences isn't mentioned.
"
Yes and no. In theory, everything you just said is right.
But keep in mind our "food as a right" example. Almost NO ONE is better off with the command-and-control-starvation model, the only insiders who benefit from money/power can reasonable think they're better off.
Efficiency means there's a lot more resources to throw around, even to the poor, and the system is far more responsive (also even to the poor).
The problem with a market HC system is similar to "broken windows" economic fallacy and/or the "free trade" political problem. People die, politicians point to them as reasons they should have more power, don't explain the side effects of the system they're offering, and the much larger group of people who benefit from a working system don't understand how they benefited.
"
What we're talking about is "how do we fix the current system".
The big options on the table are "more command and control" and "more market". Basic economic theory has predictions for what will happen in each case, we should pay attention.
It's inappropriate to point to other countries' systems and claim we can import every detail of them here. For example many of our HC issues go away if Americans become less fat, but changing that is unlikely without serious culture changes.
Similarly, referring to "economic theory" as a "religion" is like trying to refer to the "Theory of Gravity" as a "religion".
"
I go back and forth on this one. I think we need death panels to make anything like UHC work, and it's more likely than not that we'll attempt something like UHC.
However I don't expect good things from the gov on this, and the advantage of a privately run company is it's incompetence has feedback loops to make it respond (maybe not respond to you, but in general).
With the gov... basically incompetence needs to rise to the attention of the media or something in order to attract attempts to fix it.
Ideally everyone sits on their own death panel, perhaps is even the only person on it, and takes ownership of what happens.
"
People are currently dying because your "command and control" solution results in only one, seriously expensive, epi-pen on the market. That's what "resource inefficiencies" mean here and the epi-pen is only going to be one example of many.
Countries which claim "food is a right" and insist on using command/control for it typically see starvation because command/control is *that* inefficient.
The number of people who starved to death in the US last year was effectively zero, because we use the market and market friendly policies like food stamps.
So give the poor guy in your example a voucher for medical care and let the market work (you can attach it to his food stamp card).
On “Regarding the Thermal Exhaust Port “Design Flaw””
The thermal exhaust port doesn't need a real purpose or function.
Say you're an Imperial Engineer working on the project. If you try to research what that port is doing and why, you'll find complicated technological speak and requirements which require a LOT more time to understand than you have.
The port doesn't impact any of the subsystems you do understand. A high level system architect thought it was a good idea and apparently put a lot of thought into it. He knows a lot more about this than you do, any confusion on the issue is probably your fault (note the word "fault" is important here).
You're a busy man, there are unrealistic deadlines, and Lord Vader shows up occasionally looking for inefficient people to serve as example(s). It's a really bad idea to actively try to do things which waste time and draw attention to what can be viewed as your own incompetence.
On “Liberals are Smug”
Demagogic? It's a Panel of experts which decides who gets life saving treatments and who dies. "Death Panel" is literal, descriptive, and has entered popular culture.
Embracing the concept is a big part of what makes UHC possible in other countries. Which raises the issue of "why can they do it and we can't"?
Unified culture? Is a bunch of rich white doctors deciding that some poor guy's life isn't worthwhile more scary here?
"
The moment we start allocating scarce resources? Yes. This isn't a new concept in the real world, witness the 911 compensation payouts.
The moment public funds gets involved we end up making value judgements; For example, which is the most cost effective way to spend a million dollars, keeping a dying 90 year old man alive for another year or giving vaccinations to 50,000 babies?
However these sorts of value judgements are very complex, subjective, and that's a description of something normally best resolved by markets.
On “Regarding the Thermal Exhaust Port “Design Flaw””
True, but this is Star Wars and it's scale is absurd.
It's reasonable to walk into a random bar in a hick backwards town, on a hick backwards system, and find someone with a spaceship with transwarp drive. Transwarp drive means everything is within reach of everything. We've seen the equiv of taxis move halfway across the galaxy, we've seen ships lift off the surface of a planet and be in orbit a few seconds later.
There's no exploration in SW because the entire galaxy was fully mapped a long time ago. Similarly "new" technology is also something of a non-starter, technology is *old*.
Private companies can have enough "security" droids to think they can take over planets. Criminal gangs actually do. These things are considered small enough that it's not worth the attention of the authorities.
The Empire tried to hide the building of the 2nd Death Star in the imperial budget by farming it out to some virtual organization. Construction of the Death Star has to involve stripping multiple systems of resources, absurd numbers of people and droids, and it's such a small part of the Imperial budget that they think it's possible to hide the money.
Some fans pointed out that the destruction of the 2nd DS would bury the Ewoks home in many meters of steel and exterminate them all. Lucas pointed out that the rebels could (and did) bring in enough ships to tractor the debris elsewhere.
Moving back to the missile; It has to function in space and have a range greater than the diameter of the moon, maybe much greater. I also suspect our missiles have "drives" better than our taxis.
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The fighter very clearly has a drive (multiple drives probably since it's probably able to do translight), a missile probably also has a drive.
Nothing on the screen is going to be using chemical propellants, whether or not anything experiences "acceleration" is also seriously questionable from a 21st century viewpoint, and I very much don't trust that "conservation of momentum" applies.
More importantly, Luke can only fire that thing when he's right on top of the port, it's possible he's got a tail gun so its "launch" is only relative to himself and it comes out slower than he is.
On “Liberals are Smug”
Why is central planning "a better mechanism to allocate resources" for health care?
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You totally missed the point. All of these other systems were imposed when costs were low, and they reduced the *growth* of the system.
For example there are hospitals in other countries which use the "ward" model and have lots of patients in one large room. However we're not going to be burning down hospitals and building new ones and expect to save money.
None of these other systems actually reduced costs after they were imposed. It's very difficult to cut salaries of and/or fire anyone, much less gov employees.
If we want to reduce medical spending by say 5% of GDP, that's a lot of jobs and pain inflicted on people. What's more realistic, that the gov has the political will to stand up to doctors and other health care workers, or that the markets can squeeze things?
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UC in the States is a history of Progressives trying to enact it and the people flinching away from the cost.
Or to put it differently, you're claiming you're NOT going to ration by Price (markets) or by Queue, and instead will ration by "triage".
I'm asking you if you know what that means.
I think you're talking about death panels (which btw I favor), but if you can't even bring yourself to pronounce the words then how can you realistically argue in favor of it?
Triage means you don't give more than minimal care to people who will die anyway. If that's what you're suggesting, then you aren't doing yourself any favors by being evasive.
https://en.wikipedia.org/wiki/Triage
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