Wait, do you seriously look at the US health care system and conclude that the only problem is that markets are less than free? This is theology, not analysis.
The only problem? No.
The most serious problem? Yes.
A lack of free markets means we're paying FAR more than we need to, on the orders of a significant part of the GDP. If we had the ability to squeeze money out of the system then we wouldn't be breaking budgets left and right and there'd be money to spend on other things.
A lack of free markets also has all sorts of nasty side effects other than "money". For example the lack of transparency means I can't research how safe "Hospital "A"" is over "Hospital 'B'", which means there's no reason for whichever is worse to improve.
Where we get into religion is when people look at Cuba's economic system and say "I want that". They're still driving cars built from before the revolution because they have no other alternative.
Market efficiency is merely the matching of wealth and resources. If you have the money and want a toaster, you are matched with a guy who has a toaster and wants money. Why is this a desirable goal in medicine?
How much more efficient is the world's best medical system than ours? Twice? Three times? And they don't use much markets either?
If the cost of medicine were a quarter what it actually is (look at the medical market for pets if you think that's unreasonable), then there'd be a LOT more medicine actually available at a given price and we wouldn't be worrying about breaking budgets.
And to be real clear, so that there's less of a "fantasy world" aspect to this, it means we would be letting sick people die if they didn't have the money to stay alive.
It also means there'd be a lot more money available for things like college, and paying for medicine out of pocket would be a lot less painful than it sounds.
Beyond wishing that would put Peter Pan to shame, the Republican plan is essentially to force individuals to absorb more of the costs of their health care and, if they can’t, to do without. That policy approach will kill people.
Every policy approach in health care kills people. Even if we had unlimited resources (which we don't), the death rate holds steady at 100% and this isn't going to change.
The issue is one of resource utilization and efficiency, which is something that free markets tend to do very well and governments poorly.
We have problems in that the markets are less than free (asymmetry of information among other problems), and various other problems but whatever.
First a quibble: Holding up the US tax system as a model of efficiency and effectiveness is problematic since it's complexity and distortions are so awful.
Scale problem #1: "Who dies"?
Large scale means the federal gov is calling the shots.
How do our politicians grow enough of a spine to say to the elderly, "it's not worth society's resources to fund your last year of life, that money is better spent on [basically anything else]"?
As far as I can tell, the proponents of Universal Care think everyone will get everything, that somehow our medical resources are unlimited.
Scale problem #2: Disruption.
If we're going to do it right, then we need to fire (I assume) millions of people. I'm not opposed, but it's a problem.
Scale problem #3: "Who pays for this"?
I don't see how we do this without breaking the budget. In theory, you cut the cost of healthcare massively by firing (and/or letting die) millions of people so there's money to spread around.
However in practice what I expect we'll try is UC without death panels or disruption, and presumably what we'll see is what the states have seen, i.e. the budget breaks.
Arguably these are all "political" issues and not "scale" issues, but given the later is causing the former we really should have answers for them. And to be really clear, I'm good with "death panels" & "millions of people are fired" as answers, but if Progressives can't admit this is what they're arguing for then there's not a hope it will happen.
Why wouldn’t it scale? And more importantly, if it scales fine for the oldest, most expensive, sickest people in the US — Medicare and Medicaid — why wouldn’t it for the far more healthy rest of the US?
Aren't those two unprofitable in their own right and only work because they get subsidies from the rest of the system?
I like the economics of this, I'm not sure the politics work. Lots of people believe that society has the duty to give everything to everyone. That everyone's life has the same value and all that.
As the jackboots kick her in the kidneys while someone in the room screams “STOP RESISTING”, I suppose I could console myself with the thought that I only care about law and order.
Reading over her wiki, I see *nothing* about her being physically attacked, as opposed to scorned. People think poorly of Jane because she was photographed during the war sitting on a North Korean anti-aircraft gun cheerfully clapping and applauding.
The jackboots are imaginary, something the left tells itself to justify its actions. The anti-aircraft gun was real, and presumably killed US pilots.
I don’t know why we’re assuming it can be accomplished by turning health care into a free market mirage rather than the very many more government-centric systems in other countries that have dramatically lower costs.
Multiple reasons. What other countries have had is "lower rates of cost growth", none of them have had any success at actually lowering costs.
I don't know how we can look at our system and escape the conclusion that large amounts of the cost are from rent seeking. Our system already has large amounts of government intervention and so forth, all of the big players have already taken over whatever part of the gov is supposed to be overseeing them. Bureaucracy isn't good at cutting itself.
Lowering costs will be VERY politically painful because it involves firing large numbers of people and/or lowering their pay. Governments are terrible at that sort of thing, markets are great. Every change the gov makes would be opposed by hoards of insiders and their purchased politicians claiming people will die if a change is made. Some of those claims will be correct.
People will die with any change we make. The death rate holds steady at 100%. Half of your lifetime use of medicine happens in the last year or so of life. Everyone thinks we should shift resources so they're more cost effective, most people aren't willing to face the ugly details in terms of what that means, the government is poorly equipped to deal with the implications of all that.
...the Death Star... It's not supposed to defend itself very well.
Several problems with this. First the Death Star could have defended itself against larger attack craft, even just waded through enemy fire (with it's force fields and defensive weapons), blown up whatever planet they were defending, and then left.
Second, the Death Star's purpose was strategic, not tactical. Modern day Earth has the ability to kill all life on the planet with nukes. A single Star Destroyer could do the same thing, which raises the issue of why does the Empire need the Death Star at all?
The answer is force fields. Planetary force fields are so good that it was possible for a planet to encase itself in force fields to the point where the rebels thought they could defend themselves from the empire. The Death Star's purpose was to show them that they were mistaken, it's primary weapon's function was to destroy planets by cutting through the force field guarding them.
Go re-watch the destruction of Alderaan. The beam hits the planet for several seconds, even makes the entire thing glow. That would be the forcefield resisting the beam. Then the force fields fail and boom it's over. If memory serves Vader commented at the time that calling Alderann "helpless" wasn't correct.
Because of that, the Death Star (which was a prototype after all) may have actually been a failure. If Alderann's forcefields had been stronger (which might have been possible), then it would have survived the Empire's super weapon and it would have been another day before the Empire could fire it again. The next Death Star was built so it could repeated fire the main beam and overload even the best shields and also blow up capital ships.
Trench-mounted weapons failed at their job.
Even ignoring the DeathStar was fresh off the production line and clearly hadn't had all the bugs worked out yet, it's a hair awkward to claim both that this was easy and on the other that only Vader and Luke could do this and stay alive.
Further without the vent issue it would have been pointless. It was assumed small craft could not be a threat. Without the vent the little guys just die, how long it takes almost doesn't matter.
Speaking broadly, they were less accurate than WWII anti-aircraft guns.
WW2 anti-aircraft guns didn't have to shoot at targets which can move faster than the speed of light and at distances which need to be measured in light seconds. Further those guns were for larger ships.
How many hundred Gs did the "missile" pull when it made that right-angle turn into the thermal port opening?
You're assuming the "missile" was as fast as the ships. More likely it was (by their standards) pretty darn slow. Luke's ship was able to fly multiple "size of the death star" lengths away from the DS in the time that the "missile" took to fly just it's radius.
A slow missile could also presumably be targeted a lot easier than a fast ship.
How long does he have to build the wall before he stars losing his base?
Just make a fence, hire some drones, have Trump make up a new word (air-fence?) and call it a day. Half of illegals enter legally and then overstay their visas so it won't matter.
Weirdly Trump could (more or less) continue what Obama was actually doing with different rhetoric. I think Obama has done FAR more rounding up of illegals than he wanted to take credit for... thus Obama's adventures into publically claiming he was re-writing policy.
Even complete and wholesale deregulation would do what for medical prices?
First, the best example we have of what happens with wholesale deregulation is medical prices for the treatment of pets.
2nd, even if you assume that prices for a human system must be higher just because we care about that more so demand will be higher, there's *still* a lot of problems in the system which *strongly* suggest the system could be made cheaper.
A almost total lack of transparency for prices/safety means right now it's impossible for consumers to price shop. 3rd party pays means there's often to reason to price shop.
Multiple aspects of the system reduce supply, for example the number of doctors is reduced because training spots is limited; and also reduce competition (for example epi-pens).
And then there are aspects of the system which encourage over consumption, pay by piece/test, defensive medicine.
2.) Non-liberals (or folks such as Dark Matter, however he identifies) argue that liberals ought not complain because no one is/will be dying in the streets.
Oh, I'm all over the place.
And my point is Liberals need to pick their battles. If you react every time he's an ass, then he owns you.
He'll have policy proposals out there which matter, and you'll be complaining about some outrageous tweet which is totally off topic. Trump is sucking all the oxygen away from his opposition by deliberately mis-channeling your outrage.
Dark Matter: The very understandable opposition to Trump is being drowned out by the hysterical wailing.
Mike Schilling: He’s spoken with a foreign leader to interfere with American foreign policy while still a private citizen. Not only does that violate all norms of behavior for presidents-elect, it’s against the law.
Great example. So how much time/whitespace have we spent talking about *that* as opposed to him being an ass with the X-mas greeting and proposing having his daughter as first lady?
I’m just going by what I heard the right-wing noise machine say: Hillary was going to be the death of capitalism, democracy, and Christianity.
I was going to say something spiffy about it being pre-game noise, but I don't actually remember any of that. She was another step in the wrong direction, but hardly the last step.
As evidenced by the hoards of roving Democrats laying siege to the land.
How many riots did we have after the election? How many people, apparently seriously, thought that Trump's election meant they personally were now in danger?
The Imperial Presidency has not, yet, grown to the point where it's a life or death matter.
*Comment archive for non-registered commenters assembled by email address as provided.
On “Liberals are Smug”
The only problem? No.
The most serious problem? Yes.
A lack of free markets means we're paying FAR more than we need to, on the orders of a significant part of the GDP. If we had the ability to squeeze money out of the system then we wouldn't be breaking budgets left and right and there'd be money to spend on other things.
A lack of free markets also has all sorts of nasty side effects other than "money". For example the lack of transparency means I can't research how safe "Hospital "A"" is over "Hospital 'B'", which means there's no reason for whichever is worse to improve.
Where we get into religion is when people look at Cuba's economic system and say "I want that". They're still driving cars built from before the revolution because they have no other alternative.
"
How much more efficient is the world's best medical system than ours? Twice? Three times? And they don't use much markets either?
If the cost of medicine were a quarter what it actually is (look at the medical market for pets if you think that's unreasonable), then there'd be a LOT more medicine actually available at a given price and we wouldn't be worrying about breaking budgets.
And to be real clear, so that there's less of a "fantasy world" aspect to this, it means we would be letting sick people die if they didn't have the money to stay alive.
It also means there'd be a lot more money available for things like college, and paying for medicine out of pocket would be a lot less painful than it sounds.
"
Every policy approach in health care kills people. Even if we had unlimited resources (which we don't), the death rate holds steady at 100% and this isn't going to change.
The issue is one of resource utilization and efficiency, which is something that free markets tend to do very well and governments poorly.
We have problems in that the markets are less than free (asymmetry of information among other problems), and various other problems but whatever.
"
First a quibble: Holding up the US tax system as a model of efficiency and effectiveness is problematic since it's complexity and distortions are so awful.
Scale problem #1: "Who dies"?
Large scale means the federal gov is calling the shots.
How do our politicians grow enough of a spine to say to the elderly, "it's not worth society's resources to fund your last year of life, that money is better spent on [basically anything else]"?
As far as I can tell, the proponents of Universal Care think everyone will get everything, that somehow our medical resources are unlimited.
Scale problem #2: Disruption.
If we're going to do it right, then we need to fire (I assume) millions of people. I'm not opposed, but it's a problem.
Scale problem #3: "Who pays for this"?
I don't see how we do this without breaking the budget. In theory, you cut the cost of healthcare massively by firing (and/or letting die) millions of people so there's money to spread around.
However in practice what I expect we'll try is UC without death panels or disruption, and presumably what we'll see is what the states have seen, i.e. the budget breaks.
Arguably these are all "political" issues and not "scale" issues, but given the later is causing the former we really should have answers for them. And to be really clear, I'm good with "death panels" & "millions of people are fired" as answers, but if Progressives can't admit this is what they're arguing for then there's not a hope it will happen.
"
Interesting.
Define "by need". Who decides that and how?
"
Yes, exactly, and if we're going to make something like this work, then we need to face this reality and accept it.
"
I've got no clue what you're referring to. And "Jane Fonda Beaten" doesn't show anything useful in google.
Link?
"
Aren't those two unprofitable in their own right and only work because they get subsidies from the rest of the system?
"
I have problems with the idea that we can put roughly 25 cents of tax on a transaction that earns 2 cents of profit.
I have larger problems with the calm assurance that no one will change their actions and we'll raise as much money as predicted.
"
I like the economics of this, I'm not sure the politics work. Lots of people believe that society has the duty to give everything to everyone. That everyone's life has the same value and all that.
"
No, they're just suggesting that he won the election because of Russian hacking.
"
Reading over her wiki, I see *nothing* about her being physically attacked, as opposed to scorned. People think poorly of Jane because she was photographed during the war sitting on a North Korean anti-aircraft gun cheerfully clapping and applauding.
The jackboots are imaginary, something the left tells itself to justify its actions. The anti-aircraft gun was real, and presumably killed US pilots.
"
Multiple reasons. What other countries have had is "lower rates of cost growth", none of them have had any success at actually lowering costs.
I don't know how we can look at our system and escape the conclusion that large amounts of the cost are from rent seeking. Our system already has large amounts of government intervention and so forth, all of the big players have already taken over whatever part of the gov is supposed to be overseeing them. Bureaucracy isn't good at cutting itself.
Lowering costs will be VERY politically painful because it involves firing large numbers of people and/or lowering their pay. Governments are terrible at that sort of thing, markets are great. Every change the gov makes would be opposed by hoards of insiders and their purchased politicians claiming people will die if a change is made. Some of those claims will be correct.
People will die with any change we make. The death rate holds steady at 100%. Half of your lifetime use of medicine happens in the last year or so of life. Everyone thinks we should shift resources so they're more cost effective, most people aren't willing to face the ugly details in terms of what that means, the government is poorly equipped to deal with the implications of all that.
On “Regarding the Thermal Exhaust Port “Design Flaw””
Several problems with this. First the Death Star could have defended itself against larger attack craft, even just waded through enemy fire (with it's force fields and defensive weapons), blown up whatever planet they were defending, and then left.
Second, the Death Star's purpose was strategic, not tactical. Modern day Earth has the ability to kill all life on the planet with nukes. A single Star Destroyer could do the same thing, which raises the issue of why does the Empire need the Death Star at all?
The answer is force fields. Planetary force fields are so good that it was possible for a planet to encase itself in force fields to the point where the rebels thought they could defend themselves from the empire. The Death Star's purpose was to show them that they were mistaken, it's primary weapon's function was to destroy planets by cutting through the force field guarding them.
Go re-watch the destruction of Alderaan. The beam hits the planet for several seconds, even makes the entire thing glow. That would be the forcefield resisting the beam. Then the force fields fail and boom it's over. If memory serves Vader commented at the time that calling Alderann "helpless" wasn't correct.
Because of that, the Death Star (which was a prototype after all) may have actually been a failure. If Alderann's forcefields had been stronger (which might have been possible), then it would have survived the Empire's super weapon and it would have been another day before the Empire could fire it again. The next Death Star was built so it could repeated fire the main beam and overload even the best shields and also blow up capital ships.
Even ignoring the DeathStar was fresh off the production line and clearly hadn't had all the bugs worked out yet, it's a hair awkward to claim both that this was easy and on the other that only Vader and Luke could do this and stay alive.
Further without the vent issue it would have been pointless. It was assumed small craft could not be a threat. Without the vent the little guys just die, how long it takes almost doesn't matter.
WW2 anti-aircraft guns didn't have to shoot at targets which can move faster than the speed of light and at distances which need to be measured in light seconds. Further those guns were for larger ships.
You're assuming the "missile" was as fast as the ships. More likely it was (by their standards) pretty darn slow. Luke's ship was able to fly multiple "size of the death star" lengths away from the DS in the time that the "missile" took to fly just it's radius.
A slow missile could also presumably be targeted a lot easier than a fast ship.
On “Liberals are Smug”
Controlling the growth? Yes. Reducing cost? No.
And the missing question in there is how much would UC cost in addition to what we already do?
The story of Universal HC in the USA is one of states attempting to implement it and stopping either before or after it blows up the budget.
"
Just make a fence, hire some drones, have Trump make up a new word (air-fence?) and call it a day. Half of illegals enter legally and then overstay their visas so it won't matter.
Weirdly Trump could (more or less) continue what Obama was actually doing with different rhetoric. I think Obama has done FAR more rounding up of illegals than he wanted to take credit for... thus Obama's adventures into publically claiming he was re-writing policy.
"
You left out "expand government".
That quibble aside, yep. Fiscal conservatives typically get screwed by the GOP the moment they get the ability to spend other people's money.
"
First, the best example we have of what happens with wholesale deregulation is medical prices for the treatment of pets.
2nd, even if you assume that prices for a human system must be higher just because we care about that more so demand will be higher, there's *still* a lot of problems in the system which *strongly* suggest the system could be made cheaper.
A almost total lack of transparency for prices/safety means right now it's impossible for consumers to price shop. 3rd party pays means there's often to reason to price shop.
Multiple aspects of the system reduce supply, for example the number of doctors is reduced because training spots is limited; and also reduce competition (for example epi-pens).
And then there are aspects of the system which encourage over consumption, pay by piece/test, defensive medicine.
"
Sounds like a good prescription for defeat in detail.
https://en.wikipedia.org/wiki/Defeat_in_detail
"
Oh, I'm all over the place.
And my point is Liberals need to pick their battles. If you react every time he's an ass, then he owns you.
He'll have policy proposals out there which matter, and you'll be complaining about some outrageous tweet which is totally off topic. Trump is sucking all the oxygen away from his opposition by deliberately mis-channeling your outrage.
"
Great example. So how much time/whitespace have we spent talking about *that* as opposed to him being an ass with the X-mas greeting and proposing having his daughter as first lady?
"
The very understandable opposition to Trump is being drowned out by the hysterical wailing.
"
Monster? Because of a tweet which didn't kill or injure anyone?
At the moment he's lacking social skills and/or deliberately manipulating people by pushing their buttons.
"
I was going to say something spiffy about it being pre-game noise, but I don't actually remember any of that. She was another step in the wrong direction, but hardly the last step.
"
How many riots did we have after the election? How many people, apparently seriously, thought that Trump's election meant they personally were now in danger?
The Imperial Presidency has not, yet, grown to the point where it's a life or death matter.
*Comment archive for non-registered commenters assembled by email address as provided.