Besides, the rich are many times more likely to purchase additional safety and precautionary devices to protect their valuables.
You mean those security devices, I believe they are called 'alarms'...that call the police?
Boy, you sure disproved my point there.
It's not a monetary point where crimes become 'worse', it's the ease with which crimes can be committed. The FBI are called for bank robberies because it takes a great deal of sophistication and power to successfully rob a bank.
Um, read what you just said. You just said that easy crimes were the worse, and that the FBI is called in for bank robberies, which are incidentally one of the biggest non-violence crimes on the book, because they are very hard.
That doesn't really make a lot of sense.
And, in fact, it is a monetary point where crimes become worse. That's the difference between theft and grand theft, for example. Banks, of course, are the worse type of property crime at all, even if you get away with an amount that would only be 'theft' if it was anywhere else, because only the rich own banks.
I didn't say it couldn't. For all I know it could have, in time.
It didn't, however.
What actually caused the banks to break is their imaginary security market trading worthless crap they managed to get rated as AAA, aka, the 'big shitpile'. It didn't have anything to do with price fixing, or even lending money at all.
The term Libertarian was chosen and adopted by those who considered themselves to be Classically Liberal [wikipedia.org], but who were concerned that the term Liberal, as it had come to be understood in the United States beginning in the 1940s and especially after the 1960s, no longer accurately represented the Classically Liberal positions such as the importance of human rationality, individual property rights, natural rights, the protection of civil liberties, constitutional limitation of government, free markets, and individual freedom from restraint as exemplified in the writings of John Locke, Adam Smith, David Hume, David Ricardo, Voltaire, Montesquieu and others.
Except that everyone one of them would disagree with you, and your party is, in essence, misrepresenting them all. Talking about 'Classic Liberal' like it's some sort of separate entity from 'liberal' is just wrong. Granted, the left today includes a strong streak of progressivism in addition to it's liberalism, and it's a valid point to say 'liberalism doesn't include health care'. It really doesn't, that's the progressive camp.
But that doesn't change the fact that Locke, for example, would have no problem with the government taxing people to provide them with doctors, or Smith regulating industries so they cannot harm people, or any of the other imagined 'super duper classic liberals' you guys are pretending were near anarchists despite all historical evidence to the contrary.
They were pro-freedom, they were not anti-progressive. You can be liberal in the only sense of the word, the John Locke, the Adam Smith, the current Democratic party sense of the word, and be progressive too...or not. It is an entirely different axis, it is not opposed.
You guys have decided that taxes=lack of freedom, which is fine to decide, but you also pretend those guys you listed would agree with you, and this is 'Classic liberalism', which is just dishonest.
Actually, it has been my experience that Libertarians, when we are invited to participate, generally give a good account of themselves in most debates and come off as reasonable and logical people who have interests of the people at heart.
Libertarians do great in debates simple because they are marginalized and no one actually knows what they want.
If you were to actually have an Ron Paul vs. Obama debate, with just them, the very first question would be 'What would you do with Social Security?' and Ron Paul would lose the election right there.
If you ask Americans what they really want, and they are honest with themselves, then I believe that they will say what they want is a fair chance to work hard and succeed without being unduly interfered with by the government or by competitors who benefit from government assistance in unfair competition. They are suspicious of handouts and other socialist promises of the left because those concepts run contrary to the spirit with which this nation was founded, namely hard-work, self-reliance, and perseverance.
No, they don't think that in any way, shape, or form, and the fact libertarians have been asserting it for years doesn't make it magically true.
We're at the point where the slim majority of Republicans think that their own health care costs should help cover people who cannot afford health care.
Your views are not some sort of secret silent majority, or even a secret large minority. They are, in fact, held by almost no one. I mean that literally. We're talking about maybe 3% of the population. Half the votes you get are random protest votes that don't have anything to do with your positions.
The republican party, via years of yammering, has managed to shift the 'center' of the political playing field very far to the right by constantly repainting the lines. But shifting the 50-yard line didn't shift the people standing on the field, and now everyone's found themselves deep deep in liberal territory, and a few o
Well, yeah, of course it happens more often to people who aren't rich. That's the point of the police. Stop crimes against the rich. And incidentally against other people.
Now ask yourself why the FBI spends so much time and resources tracking down and stopping bank robbers when the amount of effort they spend on a single one could trivially take out half the chop-shops in an state.
I mean, there are literal monetary points where crimes become 'worse'.
Ron Paul's beliefs about the Federal Reserve, and his imaginary idea that it caused the current meltdown, are demonstratively false, so, yeah, Obama would crush him.
What caused it, in fact, are exactly what Ron Paul likes...the lack of regulation.
If I'm running around predicting a car's engine will explode because it's full of gasoline, and overheats because of a coolant leak and is forced to pull over, I only look like a prophet to really stupid people.
Granted, really stupid people do, indeed, vote. So maybe.
Why would you steal from people making such small amounts when you could steal from the rich? I don't get why anyone would do that.
For those with the larger amounts of money, do you believe that they rely on the policing forces of the federal government, which amounts to the military, coast guard, and intelligence agencies, to protect their assets?
Um, yes?
Question: Why do countries invade other countries?
Hey, moron, that's because there are 144,000 troops in Iraq vs. 2,824,434 people in Chicago. Chicago has twenty times the amount of Americans, so having twice the amount of people die is actually quite an accomplishment for one, or an anti-accomplishment for another.
In other words, if you have an American in both those places in 2008, the one in Iraq was ten times as likely to have been killed.
The sad thing is, I assumed at first you were deliberately misleading people, but I actually think you're just a fucking moron who thinks it's reasonable to compare two entirely differently-sized populations with 'total numbers of X'.
Chicago actually has a fairly low murder rate. It's right there with Dallas and Houston and Mobile and Jacksonville and Milwaukee, none of which are particularly known for crime and all of which are smaller and easier to control.
Except that the collapse of the financial industry was exactly because they weren't selling to the Freddie and Fannie, who, if you remember, were actually explicitly guaranteed by the government months ago in what was then called a 'big government bailout', although obviously we had to rescale the word since this latest thing came along.
I'd like to understand the mental gymnastics that are required to blame this continuing mess on entities that, at this point, are full of government-backed demonstratively-good paper. We already fixed any possible GSE problems when they got pulled (back) into the government. Everyone who purchased their securities is fine, by law. How exactly are the GSEs causing problems...telepathy?
What actually caused the problem is that banks were taking loans that Freddie and Fannie wouldn't buy, assigning imaginary value to them and getting them magically rated as AAA and then trading them amongst themselves, a market that the Republicans (and Greenspan) insisted was an amazing example of unfettered-by-government free enterprise. The market went south, and they ended up losing more than just the 'bad mortgages'...because they were complete morons who had stopped rating anything and mixed it all together (easier to sell that way), none of them had any idea of what assets they had at all.
That is, frankly, because your libertarian views are stupid.
No, seriously. "Libertarianism' is a scam invented by the rich, who want the government to only do things that benefit them and no one else. (Like run a police force and court system, to keep people from stealing their shit or living on their land for free.)
They hide this by making claims about the 'original' purpose of government, which is, in fact, exactly that, to protect the rich, although they won't come out and say that.
More to the point, they then make the rather absurd claim that they should get this while paying as little taxes as possible.
While a large percentage of Americans haven't figured out the premise of the party and have a sort of grudging respect for it as the underdog, under no circumstances do they actually want to implement those policies.
Thus libertarians who actually show up and debate on their views for the general election get smashed, and that normally applies to the primaries too, although we saw a fun exception with Ron Paul doing pretty good with some viewers because the GOP has gone so spectacularly off the rails in a different way.
But if Ron Paul had show up against Obama, he would have been crushed. Probably more than McCain, even with the advantage of being able to actually present himself as separate from the Republican Party and without making such a dumb VP choice.
You might wind up with something like happened in the UK recently, where (IIRC) one woman was told that, because she went outside the standard.gov healthplan and got a procedure done out of her own pocket, she was no longer allowed to use the "normal" system at all. I'm worried that the government would either deny some stuff to save costs, or kick someone off the plan if they go outside the system on their own dollar.
Most stuff you hear like that is actually Republican myths, honestly. The NHS accepts anyone who doesn't opt out with private insurance, IIRC. Probably they just wouldn't cover something related to a procedure they had denied but she had anyway, which makes sense to me. I mean, if she had breast implants, and developed problems with that, should the NHS really cover it? Who knows what the actual story is, I'm just pointing out that the NHS might have a legitimate point.
And, frankly, I just have to laugh at stuff like that, considering I was 'kicked out' of the insurance system entirely in the US for being born with a congenital heart defect. All the 'look at how bad socialized medicine is' seems to operate in an imaginary universe where stuff much worse doesn't happen here.
And I'm also worried about the stupid people who go to the ER for every fucking thing and demand antibiotics whenever they don't feel well--even when their illness is caused by a virus. Stuff like that can clog up the system real quick. Now I'm not saying they don't deserve coverage or anything; just pointing out a potential concern.
I'd actually argue that, even under an otherwise completely free national health coverage system, we should still charge people for emergency room use. Not for any actual medical procedures they need, but just 100 bucks for showing up. Maybe refunded if you had an actual emergency or were brought there unconscious.
It's like another poster pointed out--you can get any two of quality, timeliness (availability), and controlled costs with healthcare. But you simply can't get all three.
I'll argue that what you can't actually get is both timeliness (availability) and controlled costs. Quality is pretty irrelevant.
But that's always true when there are shortages. Shortages are handled by the universe in one of two ways: Letting everyone go in order, which results in delays for everyone, or letting prices bid up, which results in people who have money getting it, and no one else.
The actual solution is to not have a shortage of medical care. The reason we have slowly developed a shortage of medical care in the last few decades, which is an absurdity in a free market for a service industry, is that the health insurance industry has been slowly bleeding them dry.
Often if you are financially strapped the hospital will reduce the bill if they think you wouldn't pay the old bill but could pay the new one.
But that's covered by charitable hospital donations. Yes, a business is having to resort to donations to operate.
But, yes, all this actually does vary largely from state to state, so talking about this is sorta weird. The Medicare thing is national, though, you start billing them more than people off the street and they'll attempt to charge you with Medicare fraud. But other stuff is per-state.
For example, I tell people I cannot get insurance, and they don't believe me, simply because many states have high-risk pools people can get in as a last ditch measure. But not mine.
Indeed. In fact, I've actually toyed with the idea that, under universal health care, we should 'bribe' people to get regular checkups simply to change their behavior. Like a 100 dollar tax deduction for the first checkup a year, and 50 for the second, or something.
As time went on, and people got used to the idea, we could stop doing that, but I think we should certainly do it the first year or so so that people who've gone years without a checkup will go at least once.
The actual question isn't if they used 'more' healthcare or not, it's whether or not they cost more or not. (Actually, it's if they used more resources, but we tend to measure that using cost.)
Health care is not fungible. All doctors visits and all hospitalizations do not cost the same amount.
Someone who goes to the doctor complaining about back pain, gets a followup appointment, and then gets a minor back surgery costs a good deal less than someone who waits two months and shows up at the emergency room and has to do an entirely different and more costly procedure.
But the first guy has two doctor visits and one hospitalization, and the second guy just had one hospitalization.
You just need to recognize it at the location of the scarce resource.
If someone is using up a lot of lab time, or getting a lot of MRIs, at some point those labs or MRIs should start questioning the referring doctor, asking 'Hey, do you know this guy appears to be abusing the system? Cause he's been here half a dozen times this year, all from different doctors, all negative tests. You sure he needs this test?'.
Of course, in an ideal world, everyone's medical records would be stored in a single reference point that require patient consent to get at, but contained everything. (Possibly even some sort of card people carried around.)
You show up at a doctor, don't give them access to your medical records, they will immediately suspect something is up. Not that they shouldn't treat you for obvious problems like broken arms, but they shouldn't schedule tests and whatnot.
Oh, and incidentally, it is actually illegal in many cases to bill non-insurance customers less than insurance companies. Or, if not illegal, it's still considered fraudulent by the insurance company and they will stop sending people that way.
Medicare, for example, has that rule. You bill them for more than other people, it's considered fraud.
No one's ever bothered to make it illegal to bill non-insured people more than insured people, though.
Prices are set high for the insurance company and often times much lower for cash payments.
I don't know where you're getting that, but it's almost entirely wrong. Yes, some very small doctors with low operating costs in might accept less payment in cash, especially if it's a field that insurance rarely deals with at all, such as sports injuries.
Especially if it's one of the few places that, unlike almost every other medical establishment in the country, does not have a full time staff member attempting to make insurance companies pay. If it cost them more than $50 worth of time, it's worth giving a discount for.
However, it's entirely the opposite way around for hospitals and surgeries. You know, the medical things that actually cost a lot of money.
Things that cost insurance companies $100 might cost people $50, but that's more than made up by things that cost insurance companies $20,000 costing people $35,000.
But don't take my word for it. Go and ask people who ended up in emergency surgery how much they were billed, and then ask them how much it cost insurance.
While there are a lot of doctors in various areas, there are usually limited MRI machines.
Thus, this problem is solvable simply by the people running the MRI machine notifying the doctor that the patent they scheduled for the MRI has had 4 already this year.
Or, you know, we could just build more MRI machines. The reason we don't is, like I've been saying, the health insurance company has been harming the health care industry for several decades, resulting, at this point, in crippling shortages.
I refuse to accept a problem that the health insurance industry made as a reason to keep the health insurance industry around. In an actual free market(1), we'd have damn MRI machines everywhere there's demand for them, not trying to cope with shortages.
1) And bear in mind that the form of universal health insurance I favor, there would be a free market in health care, because the government would pay set amounts for each service and thus some companies would attempt to get the costs lower so they pocket more, whereas others would attempt to lure customers in other ways, such as providing free food during hospital stays and whatnot. And if the town could support another MRI machine by God someone would come along and build one.
I think you misread what I said, or maybe I just wasn't clear. That was actually my point.
If the government wishes to force us to put money in escrow, in case we injure someone, in return for the privilege to drive, I understand.
And I'm in favor of not doing that literally, if one out of ten drivers get in accidents that cost $10,000, maybe I should only need $1000 in escrow a year, with the understanding that what I put in might go to cover other's accidents instead. Many dangerous activities require something of the sort.
What I seriously disagree with is having private companies operate these accounts as 'car insurance'. I see absolutely no benefit to that at all vs. simply having a driver's license renewal cost $5000. (Presumably with payments spread out.)
They can even use actuary tables if they want, and charge different rates, although honestly what I'd rather see is large fines attached to accidents, which instead of paying off at once you pay off along with your license renewal over a few years. (Aka, your 'rates are raised'.)
Possibly these should be a combination of driver license and car tax rates, instead. As people who have licenses but don't have cars should legitimately be paying somewhat less, as they presumably drive less.
The reason there's a scarcity is that the health insurance industry has been crippling the health care industry for 30+ years.
It's sorta self-evidence in how we'd developed a scarcity, in fact. In an actual free market, scarcities for services do not develop like that. Scarcities should only happen when we are physically running out of materials or when there is a surge in demand.
If we switched over to national health insurance, we'd still have scarcity for a while until the system corrected, which could take years to send people back through medical school. Which I'm sure would be seized upon as proof the system doesn't work, but, in reality, if we don't have enough doctors, we don't have enough doctors and won't magically get them when switching systems.
What we might get, however, is a system where health care is not a race to the bottom which has pushed half the good doctors out.
Essentially, I'm imagine health care being divided into two, possibly three, levels.
One should include 95% of all medical procedures.
The second is everything that is both fairly expensive and might be unneeded medically. Stuff like plastic surgery(1), very expensive tests for rare diseases, expensive procedures that have cheap alternates that can be done in 95% of the cases, etc.
Things that are clearly needed, like expensive cancer drugs or whatever, we don't worry about, just things that might possibly not be. And cheap things...frankly, it would be more expensive to determine if someone needs a $35 dollar prescription than to get it to them.
What's left over, what we need to do with those is make sure an independent doctor says it's needed, or some independent board like the already-existing medical review boards. Not a doctor or hospital who's going to benefit from it. Rather like how health insurance works now, except with doctors instead of bureaucrats, and we should work to make this category as small as possible.
Hopefully this decision-making board would be located fairly local, so they would have a good sense of the local doctors and personal appeals could be made. Respected retired doctors or something, that can flip through and say 'Um, no', or 'Yeah, they need that, normal procedure X won't work because, as they say, the patient is Y-positive.'
The third is just experimental procedures that need volunteers and should be handled however, I dunno much about that.
1) Plastic surgery, and even breast implants, are both things that people associate with vanity surgery, but both can honestly be needed if injured and deformed people, or people who had mastectomies, want to live normal lives.
Yes, and obviously we'd have to have rules about prescribing controlled substanc...hey, wait a minute. We do.
If you're implying that they will constantly shuffle through your office if they don't have to pay to see a doctor, I'm sure there is some logical way to prevent that. Like simply not letting abusers schedule visits.
The fact the government would pay for someone to talk to a doctor for 20 minutes a day, every day, is not a good reason for the doctor to see that person for 20 minutes a day, every day. After the first couple of days, the doctor should simply refuse to see them.
They could, of course, still go to an ER, but I'd be okay with some sort of charge for people who abused ERs. Honestly, I'm not sure we'd even need to require them to accept all patients anymore. But if we kept that up, some sort of fee for people who don't have serious immediate problems but go there anyway is a good idea.
Basically, what you're talking about is like homeless people who squat in public parks. A tiny bit of vigilance would keep them under control, and isn't really a good objection to public parks.
The real question is why anyone thinks government health care would ever 'deny' anything.
See, that's the problem, right there. The government should pay doctors and hospitals for their costs plus profits. Period.
It doesn't need to do anything past that point, we don't need a list of 'approved procedures', although we might need some 'disapproved unless there's a medical reason' like plastic surgery.
People aren't going to wander in and get triple bypasses for fun. There are already medical ethic boards that punish doctors for unnecessary procedures, and you could solve any abuse simply by making sure that doctors that recommend procedures do not profit from them because someone else has to do them.
The idea that we should replicate the costly bureaucracy in a government system is stupid. Do we have bureaucrats deciding when we can use public parks?
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Besides, the rich are many times more likely to purchase additional safety and precautionary devices to protect their valuables.
You mean those security devices, I believe they are called 'alarms'...that call the police?
Boy, you sure disproved my point there.
It's not a monetary point where crimes become 'worse', it's the ease with which crimes can be committed. The FBI are called for bank robberies because it takes a great deal of sophistication and power to successfully rob a bank.
Um, read what you just said. You just said that easy crimes were the worse, and that the FBI is called in for bank robberies, which are incidentally one of the biggest non-violence crimes on the book, because they are very hard.
That doesn't really make a lot of sense.
And, in fact, it is a monetary point where crimes become worse. That's the difference between theft and grand theft, for example. Banks, of course, are the worse type of property crime at all, even if you get away with an amount that would only be 'theft' if it was anywhere else, because only the rich own banks.
I didn't say it couldn't. For all I know it could have, in time.
It didn't, however.
What actually caused the banks to break is their imaginary security market trading worthless crap they managed to get rated as AAA, aka, the 'big shitpile'. It didn't have anything to do with price fixing, or even lending money at all.
The term Libertarian was chosen and adopted by those who considered themselves to be Classically Liberal [wikipedia.org], but who were concerned that the term Liberal, as it had come to be understood in the United States beginning in the 1940s and especially after the 1960s, no longer accurately represented the Classically Liberal positions such as the importance of human rationality, individual property rights, natural rights, the protection of civil liberties, constitutional limitation of government, free markets, and individual freedom from restraint as exemplified in the writings of John Locke, Adam Smith, David Hume, David Ricardo, Voltaire, Montesquieu and others.
Except that everyone one of them would disagree with you, and your party is, in essence, misrepresenting them all. Talking about 'Classic Liberal' like it's some sort of separate entity from 'liberal' is just wrong. Granted, the left today includes a strong streak of progressivism in addition to it's liberalism, and it's a valid point to say 'liberalism doesn't include health care'. It really doesn't, that's the progressive camp.
But that doesn't change the fact that Locke, for example, would have no problem with the government taxing people to provide them with doctors, or Smith regulating industries so they cannot harm people, or any of the other imagined 'super duper classic liberals' you guys are pretending were near anarchists despite all historical evidence to the contrary.
They were pro-freedom, they were not anti-progressive. You can be liberal in the only sense of the word, the John Locke, the Adam Smith, the current Democratic party sense of the word, and be progressive too...or not. It is an entirely different axis, it is not opposed.
You guys have decided that taxes=lack of freedom, which is fine to decide, but you also pretend those guys you listed would agree with you, and this is 'Classic liberalism', which is just dishonest.
Actually, it has been my experience that Libertarians, when we are invited to participate, generally give a good account of themselves in most debates and come off as reasonable and logical people who have interests of the people at heart.
Libertarians do great in debates simple because they are marginalized and no one actually knows what they want.
If you were to actually have an Ron Paul vs. Obama debate, with just them, the very first question would be 'What would you do with Social Security?' and Ron Paul would lose the election right there.
If you ask Americans what they really want, and they are honest with themselves, then I believe that they will say what they want is a fair chance to work hard and succeed without being unduly interfered with by the government or by competitors who benefit from government assistance in unfair competition. They are suspicious of handouts and other socialist promises of the left because those concepts run contrary to the spirit with which this nation was founded, namely hard-work, self-reliance, and perseverance.
No, they don't think that in any way, shape, or form, and the fact libertarians have been asserting it for years doesn't make it magically true.
We're at the point where the slim majority of Republicans think that their own health care costs should help cover people who cannot afford health care.
Your views are not some sort of secret silent majority, or even a secret large minority. They are, in fact, held by almost no one. I mean that literally. We're talking about maybe 3% of the population. Half the votes you get are random protest votes that don't have anything to do with your positions.
The republican party, via years of yammering, has managed to shift the 'center' of the political playing field very far to the right by constantly repainting the lines. But shifting the 50-yard line didn't shift the people standing on the field, and now everyone's found themselves deep deep in liberal territory, and a few o
Well, yeah, of course it happens more often to people who aren't rich. That's the point of the police. Stop crimes against the rich. And incidentally against other people.
Now ask yourself why the FBI spends so much time and resources tracking down and stopping bank robbers when the amount of effort they spend on a single one could trivially take out half the chop-shops in an state.
I mean, there are literal monetary points where crimes become 'worse'.
Ron Paul's beliefs about the Federal Reserve, and his imaginary idea that it caused the current meltdown, are demonstratively false, so, yeah, Obama would crush him.
What caused it, in fact, are exactly what Ron Paul likes...the lack of regulation.
If I'm running around predicting a car's engine will explode because it's full of gasoline, and overheats because of a coolant leak and is forced to pull over, I only look like a prophet to really stupid people.
Granted, really stupid people do, indeed, vote. So maybe.
Why would you steal from people making such small amounts when you could steal from the rich? I don't get why anyone would do that.
For those with the larger amounts of money, do you believe that they rely on the policing forces of the federal government, which amounts to the military, coast guard, and intelligence agencies, to protect their assets?
Um, yes?
Question: Why do countries invade other countries?
Answer: To take their resources.
Question: Who control the resources?
Answer: People with money.
Hey, moron, that's because there are 144,000 troops in Iraq vs. 2,824,434 people in Chicago. Chicago has twenty times the amount of Americans, so having twice the amount of people die is actually quite an accomplishment for one, or an anti-accomplishment for another.
In other words, if you have an American in both those places in 2008, the one in Iraq was ten times as likely to have been killed.
The sad thing is, I assumed at first you were deliberately misleading people, but I actually think you're just a fucking moron who thinks it's reasonable to compare two entirely differently-sized populations with 'total numbers of X'.
Chicago actually has a fairly low murder rate. It's right there with Dallas and Houston and Mobile and Jacksonville and Milwaukee, none of which are particularly known for crime and all of which are smaller and easier to control.
Except that the collapse of the financial industry was exactly because they weren't selling to the Freddie and Fannie, who, if you remember, were actually explicitly guaranteed by the government months ago in what was then called a 'big government bailout', although obviously we had to rescale the word since this latest thing came along.
I'd like to understand the mental gymnastics that are required to blame this continuing mess on entities that, at this point, are full of government-backed demonstratively-good paper. We already fixed any possible GSE problems when they got pulled (back) into the government. Everyone who purchased their securities is fine, by law. How exactly are the GSEs causing problems...telepathy?
What actually caused the problem is that banks were taking loans that Freddie and Fannie wouldn't buy, assigning imaginary value to them and getting them magically rated as AAA and then trading them amongst themselves, a market that the Republicans (and Greenspan) insisted was an amazing example of unfettered-by-government free enterprise. The market went south, and they ended up losing more than just the 'bad mortgages'...because they were complete morons who had stopped rating anything and mixed it all together (easier to sell that way), none of them had any idea of what assets they had at all.
That is, frankly, because your libertarian views are stupid.
No, seriously. "Libertarianism' is a scam invented by the rich, who want the government to only do things that benefit them and no one else. (Like run a police force and court system, to keep people from stealing their shit or living on their land for free.)
They hide this by making claims about the 'original' purpose of government, which is, in fact, exactly that, to protect the rich, although they won't come out and say that.
More to the point, they then make the rather absurd claim that they should get this while paying as little taxes as possible.
While a large percentage of Americans haven't figured out the premise of the party and have a sort of grudging respect for it as the underdog, under no circumstances do they actually want to implement those policies.
Thus libertarians who actually show up and debate on their views for the general election get smashed, and that normally applies to the primaries too, although we saw a fun exception with Ron Paul doing pretty good with some viewers because the GOP has gone so spectacularly off the rails in a different way.
But if Ron Paul had show up against Obama, he would have been crushed. Probably more than McCain, even with the advantage of being able to actually present himself as separate from the Republican Party and without making such a dumb VP choice.
You might wind up with something like happened in the UK recently, where (IIRC) one woman was told that, because she went outside the standard .gov healthplan and got a procedure done out of her own pocket, she was no longer allowed to use the "normal" system at all. I'm worried that the government would either deny some stuff to save costs, or kick someone off the plan if they go outside the system on their own dollar.
Most stuff you hear like that is actually Republican myths, honestly. The NHS accepts anyone who doesn't opt out with private insurance, IIRC. Probably they just wouldn't cover something related to a procedure they had denied but she had anyway, which makes sense to me. I mean, if she had breast implants, and developed problems with that, should the NHS really cover it? Who knows what the actual story is, I'm just pointing out that the NHS might have a legitimate point.
And, frankly, I just have to laugh at stuff like that, considering I was 'kicked out' of the insurance system entirely in the US for being born with a congenital heart defect. All the 'look at how bad socialized medicine is' seems to operate in an imaginary universe where stuff much worse doesn't happen here.
And I'm also worried about the stupid people who go to the ER for every fucking thing and demand antibiotics whenever they don't feel well--even when their illness is caused by a virus. Stuff like that can clog up the system real quick. Now I'm not saying they don't deserve coverage or anything; just pointing out a potential concern.
I'd actually argue that, even under an otherwise completely free national health coverage system, we should still charge people for emergency room use. Not for any actual medical procedures they need, but just 100 bucks for showing up. Maybe refunded if you had an actual emergency or were brought there unconscious.
It's like another poster pointed out--you can get any two of quality, timeliness (availability), and controlled costs with healthcare. But you simply can't get all three.
I'll argue that what you can't actually get is both timeliness (availability) and controlled costs. Quality is pretty irrelevant.
But that's always true when there are shortages. Shortages are handled by the universe in one of two ways: Letting everyone go in order, which results in delays for everyone, or letting prices bid up, which results in people who have money getting it, and no one else.
The actual solution is to not have a shortage of medical care. The reason we have slowly developed a shortage of medical care in the last few decades, which is an absurdity in a free market for a service industry, is that the health insurance industry has been slowly bleeding them dry.
Often if you are financially strapped the hospital will reduce the bill if they think you wouldn't pay the old bill but could pay the new one.
But that's covered by charitable hospital donations. Yes, a business is having to resort to donations to operate.
But, yes, all this actually does vary largely from state to state, so talking about this is sorta weird. The Medicare thing is national, though, you start billing them more than people off the street and they'll attempt to charge you with Medicare fraud. But other stuff is per-state.
For example, I tell people I cannot get insurance, and they don't believe me, simply because many states have high-risk pools people can get in as a last ditch measure. But not mine.
Indeed. In fact, I've actually toyed with the idea that, under universal health care, we should 'bribe' people to get regular checkups simply to change their behavior. Like a 100 dollar tax deduction for the first checkup a year, and 50 for the second, or something.
As time went on, and people got used to the idea, we could stop doing that, but I think we should certainly do it the first year or so so that people who've gone years without a checkup will go at least once.
The actual question isn't if they used 'more' healthcare or not, it's whether or not they cost more or not. (Actually, it's if they used more resources, but we tend to measure that using cost.)
Health care is not fungible. All doctors visits and all hospitalizations do not cost the same amount.
Someone who goes to the doctor complaining about back pain, gets a followup appointment, and then gets a minor back surgery costs a good deal less than someone who waits two months and shows up at the emergency room and has to do an entirely different and more costly procedure.
But the first guy has two doctor visits and one hospitalization, and the second guy just had one hospitalization.
Cows are not very well equipped to beat things to pulps.
You just need to recognize it at the location of the scarce resource.
If someone is using up a lot of lab time, or getting a lot of MRIs, at some point those labs or MRIs should start questioning the referring doctor, asking 'Hey, do you know this guy appears to be abusing the system? Cause he's been here half a dozen times this year, all from different doctors, all negative tests. You sure he needs this test?'.
Of course, in an ideal world, everyone's medical records would be stored in a single reference point that require patient consent to get at, but contained everything. (Possibly even some sort of card people carried around.)
You show up at a doctor, don't give them access to your medical records, they will immediately suspect something is up. Not that they shouldn't treat you for obvious problems like broken arms, but they shouldn't schedule tests and whatnot.
Oh, and incidentally, it is actually illegal in many cases to bill non-insurance customers less than insurance companies. Or, if not illegal, it's still considered fraudulent by the insurance company and they will stop sending people that way.
Medicare, for example, has that rule. You bill them for more than other people, it's considered fraud.
No one's ever bothered to make it illegal to bill non-insured people more than insured people, though.
Prices are set high for the insurance company and often times much lower for cash payments.
I don't know where you're getting that, but it's almost entirely wrong. Yes, some very small doctors with low operating costs in might accept less payment in cash, especially if it's a field that insurance rarely deals with at all, such as sports injuries.
Especially if it's one of the few places that, unlike almost every other medical establishment in the country, does not have a full time staff member attempting to make insurance companies pay. If it cost them more than $50 worth of time, it's worth giving a discount for.
However, it's entirely the opposite way around for hospitals and surgeries. You know, the medical things that actually cost a lot of money.
Things that cost insurance companies $100 might cost people $50, but that's more than made up by things that cost insurance companies $20,000 costing people $35,000.
But don't take my word for it. Go and ask people who ended up in emergency surgery how much they were billed, and then ask them how much it cost insurance.
While there are a lot of doctors in various areas, there are usually limited MRI machines.
Thus, this problem is solvable simply by the people running the MRI machine notifying the doctor that the patent they scheduled for the MRI has had 4 already this year.
Or, you know, we could just build more MRI machines. The reason we don't is, like I've been saying, the health insurance company has been harming the health care industry for several decades, resulting, at this point, in crippling shortages.
I refuse to accept a problem that the health insurance industry made as a reason to keep the health insurance industry around. In an actual free market(1), we'd have damn MRI machines everywhere there's demand for them, not trying to cope with shortages.
1) And bear in mind that the form of universal health insurance I favor, there would be a free market in health care, because the government would pay set amounts for each service and thus some companies would attempt to get the costs lower so they pocket more, whereas others would attempt to lure customers in other ways, such as providing free food during hospital stays and whatnot. And if the town could support another MRI machine by God someone would come along and build one.
I think you misread what I said, or maybe I just wasn't clear. That was actually my point.
If the government wishes to force us to put money in escrow, in case we injure someone, in return for the privilege to drive, I understand.
And I'm in favor of not doing that literally, if one out of ten drivers get in accidents that cost $10,000, maybe I should only need $1000 in escrow a year, with the understanding that what I put in might go to cover other's accidents instead. Many dangerous activities require something of the sort.
What I seriously disagree with is having private companies operate these accounts as 'car insurance'. I see absolutely no benefit to that at all vs. simply having a driver's license renewal cost $5000. (Presumably with payments spread out.)
They can even use actuary tables if they want, and charge different rates, although honestly what I'd rather see is large fines attached to accidents, which instead of paying off at once you pay off along with your license renewal over a few years. (Aka, your 'rates are raised'.)
Possibly these should be a combination of driver license and car tax rates, instead. As people who have licenses but don't have cars should legitimately be paying somewhat less, as they presumably drive less.
The reason there's a scarcity is that the health insurance industry has been crippling the health care industry for 30+ years.
It's sorta self-evidence in how we'd developed a scarcity, in fact. In an actual free market, scarcities for services do not develop like that. Scarcities should only happen when we are physically running out of materials or when there is a surge in demand.
If we switched over to national health insurance, we'd still have scarcity for a while until the system corrected, which could take years to send people back through medical school. Which I'm sure would be seized upon as proof the system doesn't work, but, in reality, if we don't have enough doctors, we don't have enough doctors and won't magically get them when switching systems.
What we might get, however, is a system where health care is not a race to the bottom which has pushed half the good doctors out.
Essentially, I'm imagine health care being divided into two, possibly three, levels.
One should include 95% of all medical procedures.
The second is everything that is both fairly expensive and might be unneeded medically. Stuff like plastic surgery(1), very expensive tests for rare diseases, expensive procedures that have cheap alternates that can be done in 95% of the cases, etc.
Things that are clearly needed, like expensive cancer drugs or whatever, we don't worry about, just things that might possibly not be. And cheap things...frankly, it would be more expensive to determine if someone needs a $35 dollar prescription than to get it to them.
What's left over, what we need to do with those is make sure an independent doctor says it's needed, or some independent board like the already-existing medical review boards. Not a doctor or hospital who's going to benefit from it. Rather like how health insurance works now, except with doctors instead of bureaucrats, and we should work to make this category as small as possible.
Hopefully this decision-making board would be located fairly local, so they would have a good sense of the local doctors and personal appeals could be made. Respected retired doctors or something, that can flip through and say 'Um, no', or 'Yeah, they need that, normal procedure X won't work because, as they say, the patient is Y-positive.'
The third is just experimental procedures that need volunteers and should be handled however, I dunno much about that.
1) Plastic surgery, and even breast implants, are both things that people associate with vanity surgery, but both can honestly be needed if injured and deformed people, or people who had mastectomies, want to live normal lives.
Yes, and obviously we'd have to have rules about prescribing controlled substanc...hey, wait a minute. We do.
If you're implying that they will constantly shuffle through your office if they don't have to pay to see a doctor, I'm sure there is some logical way to prevent that. Like simply not letting abusers schedule visits.
The fact the government would pay for someone to talk to a doctor for 20 minutes a day, every day, is not a good reason for the doctor to see that person for 20 minutes a day, every day. After the first couple of days, the doctor should simply refuse to see them.
They could, of course, still go to an ER, but I'd be okay with some sort of charge for people who abused ERs. Honestly, I'm not sure we'd even need to require them to accept all patients anymore. But if we kept that up, some sort of fee for people who don't have serious immediate problems but go there anyway is a good idea.
Basically, what you're talking about is like homeless people who squat in public parks. A tiny bit of vigilance would keep them under control, and isn't really a good objection to public parks.
And by 'actually pay', don't include the people with insurance in that, as the insurance companies have negotiated their prices downward.
Of course, it's rather unlikely that the insurance companies passes any noticed amount of the savings on to their customers.
The real question is why anyone thinks government health care would ever 'deny' anything.
See, that's the problem, right there. The government should pay doctors and hospitals for their costs plus profits. Period.
It doesn't need to do anything past that point, we don't need a list of 'approved procedures', although we might need some 'disapproved unless there's a medical reason' like plastic surgery.
People aren't going to wander in and get triple bypasses for fun. There are already medical ethic boards that punish doctors for unnecessary procedures, and you could solve any abuse simply by making sure that doctors that recommend procedures do not profit from them because someone else has to do them.
The idea that we should replicate the costly bureaucracy in a government system is stupid. Do we have bureaucrats deciding when we can use public parks?
As opposed to McCain's plan, where...um...it's the health insurance companies that won't give people insurance. Like me.
At least if it's the government doing it was can vote them out of office if they do.