I didn't really describe iDine. It sorta defeats the purpose of this if it's the same 'points' at multiple locations. The whole point is to get them at your place. (OTOH, perhaps it's actually divided into rewards per-location. The iDine website does not explain.)
What I was talking about was simply for business to get loyal customers, customers that won't do what the ones described in the article are doing, customers who will buy from X because X will actually reward them in an increasing manner they more they buy.
The iDine card just demonstrates not only is my assumption that people will willing give over correct personal information, instead of the nonsense companies end up with existing 'loyalty' cards...but that data is so fricking popular that third parties will be willing to pay for it.
Instead, businesses do idiotic 'loyalty' cards that do not actually reward you personally in any way, so people get them with bogus information or the cashier just lets you use his. This results in less accurate data than if they'd just collected the last four digits of the credit card and the name, and treated that as 'person'.
Hell, I wasn't even approaching it from the value of that information, but my concept of actual loyalty cards that accrues points in some manner would get them that information essentially for free. Plus give customers an incentive to buy at your place for $105 dollars instead of getting it for $100.
So, to recap: They invent exactly one way discounts could even possible exist...and then attack that way.
The idea of giving someone a discount because they buy a large amount from that place is clearly insane. Why, if they did that, everyone would buy in large amounts from them just to get a discount!
Plastic surgery is a common example--there's a huge spectrum of work that ranges from "affects to quality of life" to "vanity" with a large grey middle ground. It's often an expensive procedure and what one person might say is an acceptable government-paid cost is something the next person might say should be paid out of pocket.
The fact you can easily point to it is pretty clear evidence that it's obvious.
It actually is pretty easy to classify 99.99% of medical procedures as medically necessary or now, and 95% of doctors as one or the other.
The rest is easy enough to require referrals from other doctors, or have some sort of local board.
You'll also get a lot of push back from doctors, who fear their salaries will be decimated,
OTOH, general practitioners should get paid better.
and fear from prospective medical students and society at large that nobody will want to be a doctor if you can't make enough to repay the cost of schooling.
The problem with medical schooling is that medical schools have very deliberately as few educational institutes as possible. That's another entirely different issue that needs addressing.
If I was a sales manager, I would be offering some incentive to my customers to do all their shopping at my store at once. The more they spend, the greater their savings.
See, that's what's gone away: Any reason for customers to have store loyalty.
It used to be that you could actually get discounts. Nowadays, they can offer discounts for exactly one reason: price matching.
Sure, there are those customer loyalty cards, but the free ones are clearly just privacy-invading discounts that should already exist. You're not given a discount for being a 'good customers'.
The ones you have to buy, like bookstore ones, are a manual discount, which is just as idiotic. Those things should be offered free after someone's bought $30 or whatever. Or, even better, offered free, but with no discount, and as you buy stuff using them the discount gets larger and larger.
The only place you get actual discounts for actually buying stuff are those places that punch the goofy cards, which appear to somehow be the lowest rung of discounting. (And airlines have some sort of frequent flying thing too, which I don't know much about. Normally people when talking about 'frequent flyer' inexplicably mean 'stuff out credit card company gave us', but I'm sure there's some actual rewards from flying a lot.)
Other than that, no one offers any sort of discount, which is ironic, because they have more ability to track you than ever, and hence could easily offer customers discounts. They don't even need cards. At checkout: 'I see you've purchased more than $80 this month. If you total more than $100 by the 31st, you get $10 off, so next time you're here, you can get $20 and only pay $10.'
You're doing it backwards, you idiotic resellers. Stop invading privacy against the customer's wishes. Just offer them an actual discount for loyalty, and actual discount based on them being good customers, not a pretend one by marking up prices and then pretending to 'discount' them because someone filled out a stupid card, which people see straight through and, um, doesn't encourage any loyalty. At that point, people will start making sure that you know how much they've bought there. You set something like that up, and forget needing the customer cards...people will deliberately link their credit cards if they're using multiple ones, and tell you their actual name and address. (Not the 80% fake address the 'customer loyalty' cards have.)
And that's just the 'general discount'. It used to be that if you bought a X, you could get X accessories for cheaper at the time, which encouraged people to buy all their stuff at once. Now half the time X is a loss leader and the accessories are marked up 300%. (I'm looking at you, Best Buy.) This is insane.
The only store that gets any sort of store loyalty from me is Barnes and Noble, because I'm afraid if I don't, actual physical bookstores will cease to exist. B&N has it sorta right, in that they keep mailing me coupons (Which I actually do use.), but it seems they're just mailing them because I'm a member, and not because I've bought things per se.
Until companies start actually rewarding actual purchasing and actual loyalty, there is absolutely no reason for customers to be loyal.
Daily consumers of MSNBC and public broadcasting (NPR and PBS) were higher (34 points and 25 points respectively) in [incorrectly] believing that it was proven that the US Chamber of Commerce was spending money raised from foreign sources to support Republican candidates.
I will point out that the misconception there appears to be about what is proven. The US Chamber of Commerce takes in foreign money, and won't explain how it's segregated the money in a way that comply with the law. In other words, that statement could be true.(1) It is a statement of possibility mistakenly elevated to truth.
Whereas the misconceptions with Fox News viewers appear to be about things that not only aren't proven, but pretty definitively proven in the opposite direction. Like Obama's birthplace, or WMDs in Iraq. It's a statement of impossibility elevated to belief.
Or, for an analogy: One group is asserting that a baseball player with persistent rumors of steroid use 'is using steroids', which is actually just a possibility and he denies it. The other group asserts he's ten feet tall, which is rather easily disproven just from the slightest research.(2)
It's not really the same order of magnitude of wrongness at all.
1) I don't think they'd be stupid enough to do that, but, OTOH, I didn't think banks would be stupid enough to not actually transfer loans into the instruments they were making, and, well, they were. I am constantly amazed by the stupidity and blatant lawbreaking of the powerful.
2) We do have to give people some lag time here. For example, if the Chamber of Commerce thing was disproven tomorrow, or, hell, if it was disproven last month and I didn't notice, that is a low level of 'misinformed'. But there really should be some time limit on this. He's been president for two years. And that was never actually plausible at all.
Given the three facts/assumptions above, what is the better option than compulsory health insurance?
Oh, oh, I have one: The government pays medical bills.
Not 'insurance', not any sort of insurance system. No deductibles, no co-pays, no stuff that is authorized and stuff that isn't.
People(1) go to the doctor, the doctor reports he did the Whatever Procedure, the government pays him an amount set by a national board of doctors with regional cost of living adjustments.
Anything else is just needless paperwork and total nonsense that costs more than any 'savings'. The rising cost of 'medical care' is almost entirely due to paperwork and skimming, not actual care. (Along with insurance squeezing general practitioners out because of lopsided pay scales.)
Moving all that overhead to the government would be about the dumbest solution ever. We're spending as much money figuring out if we should pay for something as we do actually paying for things. Just pay for the stupid shit and be done with it.
Medical ethic boards can take care of crazy hypothetical doctors doing needless procedures and tests. If we really really really need some rules we can implement them later. (OTOH, why do we care about 'unneeded' tests? What should happen is that testing becomes cheaper thanks to volume and the fact the medical board pays all testing facilities the same amount, so no more crazy-expensive ones. At some point, who cares? We wasted billions in Iraq, I think we can waste $40 a person in extra test a year.)
1) And, to appease the right, I'll even be willing to say 'only people here legally, except for emergency care'. And people on visas and green cards and stuff would have to pay an 'insurance premium' before getting one.
Libertarians who believe that the Civil Rights Act was unconstitutional, such as Rand Paul, Senator-elect from Kentucky, are essentially saying that private businesses have the right to use state and local law enforcement to exclude black people.
Yup. Rand Paul thinks your tax money should be used to remove black people from the local McDonalds if the owner doesn't like them. (The real question: Can the owner demand that none of the police officers are black?)
Zoning laws are the same way. So, this property you 'own', by which we mean the government is willing to defend from invaders for you, can only be used in ways the government says? Well, I'll be damned!
That's why most 'government intrusion' complaints are bullshit. They are inherently nonsensical, and yet the Republicans has managed to rely on them for decades.
The best one is right-wingers who want to keep the government away from the 'free market', so corporations can do whatever. Um, hey...corporations only exist because of the government. You want a 'free market' without the government, sure, we'll dissolve all corporations tomorrow and people can get out there with wheelbarrows selling stuff on the side of the road.
That's not to say the Democrats doesn't make some dumb statements along the same direction, but nowhere to the same level.
And a lot of the stuff the Democrats are trying to 'keep the government out of' (Which aren't that many) actually don't have the government in them, like who you're inviting to your bed. It's not like the government is providing sexual partners but only providing one gender, and the left wants them to keep doing that, but stop checking gender, which would be the analogy with the stuff the right wants the 'the government out of'. (Someone's about to make a gay marriage comment, as the government is indeed in the marriage business, but I've never heard anyone argue that gay marriage is 'less government involvement' so we should do it. Stay on topic, people.)
The only real exception on the left is abortion, because medical procedures are actually regulated...OTOH, the government don't actually punish people for seeing unlicensed doctors, just the doctors themselves. So depending on what exactly the right is trying to do, the left's idea of 'keeping government out of medical decisions' WRT abortion might or might not make sense.
So deflation does not occur if only half of products in the world are sold at lower prices, while the rest stayed the same because their local markets did not catch up yet?
No, as I said, the economy is crippled. Deflation will eventually occur if, magically half the products are sold at some lower price, but this is very painful to the people who are attempting to live during it and now can't afford materials.
And luckily is an utterly absurd premise, because technological progress doesn't work that way.
In that way new goods are always made before they are paid for by buyers at their sell price. That is the whole point of manufacturing something for profit.
And yet deflation occurs after stuff has been produced.
Deflation happens when the same amount of money chases more goods. The 'more goods' part of that happens after the goods are made.
Which means they have to buy materials at the old prices, which is why deflation is so painful and harms manufacturing.
I mean, let's go back to your hypothetical example. First the price of the bread changes, and even if there is inflation and the price of rye changes...it changes after several days, during which the bakers were buying rye for $1 and selling bread of $0.75.
Read what you're actually saying. Goods are made before, inflation happens after those goods are already floating around.
For your information: the amount of labour required to construct a "house" (which is what the average pile of cardboard and sticks is being euphemistically referred to today) has gone down massively over the last 200 years. One has to only take a look at the amount of labour required to produce bricks and lay them down versus screwing a few fasteners through paper and plaster into wobbly "studs" with a power drill.
Just saying things doesn't make them true.
What has really happened is that due to insane inflation, the numerical amounts of fake money paid for crap are now far in excess of what was paid for work that could stand for a century or more instead until the first stronger gust of wind. Which is what has you so confused and believing that no significant changes occurred.
As I said, I was talking about accounting for inflation. See here.
You really have no idea what you're talking about. Things do not magically keep getting easier to make. You have confused mp3 players with the entire world. In non-technological industries, there is maybe a 20% bump as automation shows up, and that's it for another 40 years.
With each new improvement of productivity a whole lot of bakers are forced out of business and have to find new work
Which was not at all the problem I pointed out. The problem I pointed out is that either a) the bakers keep charging the same price, in which deflation doesn't happen, or b) they charge lower prices, which blows up the economy because now they can't actually buy supplies.
But it's moot. Your hypothetical deflation is insane. That is not how deflation happens.
The only way what you are talking about can cause deflation is if there is some massive drop in the cost of making some good that everyone needs. And, yes, that has probably happened once or twice during history...but is not some sort of constant force driving prices down!
Fiat currencies are designed to try to hide this fundamental truth by trying to delay the negative effects onto future generations, but they cannot fix the problem itself.
I've been ignoring the strange rants you go into, but I can ignore no longer.
The reason we've have economic problem has nothing at all to do with fiat currency. It has to do with the banks not being regulated. It has to do with us not actually taxing those 'financiers' you rail against, or stopping them from doing stupid shit. You're right that they pr
So the end result of progress: more goods, same amount of money in circulation: deflation.
That's not really deflation, at least not how you said it. It's only half deflation, and is exactly the problem with deflation in that manner. But you actually stated the problem:
So, after the invention, every day, the farmers sell $1 worth of rye to the baker...and the bakers sell 50 cents back...hey, wait a second. That only works for two days, then the farmer has all the money.
The bakers has to keep selling at $1, simply because he can't make enough to live otherwise. Maybe he can edge out a living at 80 cents if he eats less food, to compete with the other baker and try to sell loafs to both farmers, but it's a race to the bottom. And that other guy is out of work.
The problem with your hypothetical is that unless everything gets cheaper exactly the same, you won't have real deflation, just weird and economy crippling partial deflation in whatever got cheaper. Deflation caused by increasing the availability of goods doesn't work well, at all.(1)
Actually, the real problem with that hypothetical is that progress doesn't work how you think it does. A lot of stuff had, in the 50s or whenever, a huge bump in productivity as production was automated...and that's it. I will point out that houses still cost basically the same to make as they ever did. (That's after removing inflation and the stupid bubble. I'm talking about construction.) Actual hours of human labor are the same, materials are maybe 20% easier to make than 100 years ago. Some things will functionally never get cheaper.
Meanwhile, all economic growth is not 'progress related'. (In fact, very little of it is.) A hell of a lot of it, in fact, comes from population growth.
This would eventually cause deflation, as more goods chase less money, but it's...um...retroactive inflation. The goods have to be made before the money exists to make them.
As I keep pointing out, deflation cripples economies, because it lags pretty far behind the demand for goods. Or, to put it clearer, deflation happens when less money is chasing more goods, and it happens after the goods exist.
Hence people have no actual money to buy the goods in the first place. And thus the goods are never made in the first place, and the deflation never happens.
Inflation also lags behind the goods, but this works basically the other way around. It anti-cripples the economy.
And so you starve sitting on a pile of gold, right? These kinds of "arguments" make you look utterly deranged.
Firstly, people have starved sitting on a pile of gold. You can't eat gold, and if no one will sell you food, you starve. Check what happened to the Spanish Empire, which confused gold with wealth.
Secondly, of course the people with the money don't starve. They're the food producers, no matter how bad the economy is, they presumably would make enough for themselves.
It's the people who would buy the food that starve. That the people with the money were supposed to spend that money on making food, and then sell to the starving people. Instead, they hold on to the money, because it will be worth more later.
That's utter bullshit and you know it. The process (for consumer goods) is self-regulating: if there is not enough sellers, the number of goods available goes down and in a deflationary economy prices stabilize and even go up. That is in fact the whole point of a "free market": that it has this self-regulating ability.
Did you just assert that I was wrong when I said 'no one would build cars' by saying 'the number of goods available goes down'?
I'm pretty certain that's exactly what I said, hyperbole aside.
1) This is accepting the idea that gold value can inflate to whatever you want it to be, which I still do not agree with. As what you actually want is simply an economy where more money is never printed, I've chosen to pretend that's what you're suggesting, which has nothing to do with gold at all.
Oh, I'm with you about cap and trade...and that was basically the Democratic solution in the 1980s.
The thing, at some point people need to realize that often the 'counter' solution to the other party's political solutions is not actually intended as a solution.
And, more importantly, the Democrats should never restart with the Republican solution, which happens constantly. They come with solutions that are 'pre-compromised' to the Republican 'position'...and then the Republicans come out against it. It happens over and other.
With energy, Democrats should have kept harping at a tax until it passed. If the Republicans want to propose cap and trade themselves, whatever. Even Democrats might vote for it, that's fine.
But that should never devolve to the Democratic position, which allows the Republicans to reposition themselves even farther away from the sane solution. (In fact, they literally appear to have no solution at all at this point. They have moved so far right they have fallen off the possible 'solution space' to that problem, and have just said 'We do not wish to solve that problem at all.')
Same thing with health care. Democrats should start with single payer, Republicans can then counter with a mandate, and we'd probably even up with some like a public option, which was probably the least objectionable to voters of both sides.
But, no, that would require actual intelligence on the part of the Democratic party. Instead, their plan is to find out whatever the Republicans wanted last time, and put as much of that in as possible so the mean Republicans won't call them names, and maybe even vote for their bill, and then maybe the Republicans will come to their birthday party and they can braid their hair!
I like your circular reasoning here! The amount of gold is too small to cover the amount of currency needed at some fixed exchange rate that belonged to pre-fiat days because of inflation caused by fiat currency which we introduced because there was supposedly not enough gold to cover the inflation that occurred because of the fiat... and so on into the merry infinite loop!
I'm not trying to cover 'inflation'. I am trying to cover economic growth.
You simply missed, again, the fact that none of what I explained causes the amount of the actual original currency to increase, while the amount of goods has increased due to natural progression of scientific and industrial development. Measured in the original dollars, the prices would simply keep falling. Hence deflation.
Oh, my, god.
No, progress does not make deflation. Progress makes things easier, which means they cost less to make, but it also means people get paid to make them.
This alters the standard of living, but does nothing WRT to deflation or inflation at all. (I wondered where the hell you thought deflation was coming from.)
And normal population growth, at minimum, also makes the economy bigger. Which means it needs more actual cash.
True, gold has value as a metal, but by being selected to become the reference metal for a currency it would also acquire a value related to this other role, in this case the secondary gold-as-currency-reference value quite likely far outstripping the gold-as-an-industrial-metal value.
And my question is: Why?
Seriously. You're just asserting deflation would exist. Which is a reasonable assumption as the economy grows and the money supply doesn't, but you don't have a money supply...you have a gold supply. Gold already has a value that the market has assigned it.
I'm sure there's some elasticity in it, but not enough to cover the 100x economic growth we've had over the last century!
If we'd stopped printing money and stop backing it with gold at the same time, back then, yes, we'd have deflation, where cars would cost $2. (Erm, except no one would build cars because by the time they got them to people, the deflation would eat their profits.)
This, incidentally, is not due to 'progress', it's due to our economy being much much bigger and having to stretch the money out. (In actual fact, our economy would be repeatedly crippled through out history by the lack of money, especially as people have every incentive to hoard it.)
But you can't just replace money with an actual gold, you can't replace something that is 'human created with human defined value' with something that has actual value outside that, and exists outside of our system. It is attached, however loosely, to an actual cost.
Err, in a deflationary economy the last thing you want is to hold onto the goods because they will be cheaper tomorrow, not more expensive...
Yes, that was 'backwards', but actually I was trying to say 'Economies where no one is willing to sell because their money will be worth more tomorrow are utterly fucked.'.
I.e, the problem with deflation is that no one will actually make things, because buying raw materials and hiring people to sell the stuff today is stupid when you can do it for 95% of the cost tomorrow. Deflation is incredibly bad for any sort of spending on anything.
Obviously if people do already have things made they'd sell them as quickly as possible.
But as I pointed out, there's no actually any reason for your economy to be deflationary anyway, because it's attached to a fixed thing.
Radiology is a cash cow of hospitals everywhere. Essentially, it's the health care system pushing for the latest and greatest technology, which is extremely expensive.
Yup.
Since you and I are in no position to say we're happy with the resolution that we have, we just get to bit the bullet and pay for it.
Well, 'I' am not in that position, as I have a pacemaker and hence cannot get a MRI.;)
But, yes, almost all the 'advances' in the technology have been quite pointless. Sure, maybe one time out of a thousand the super duper fine-grain scanner is needed, so, sure, build one in each major city so we can scan for that hidden brain clot or whatever.
But 999 out of 1000, the cheap one is fine, and hasn't needed upgraded since it was installed in 1983. (Hardware, that is. Software is another story.)
Won't work. You can't divide electric power that way, so that customers can choose which generator their power comes from. The whole system is a grid, and has to be managed as a system, including the generating plants. You can't have one entity managing the grid, and other people managing the generators, and occasionally fighting over things, because the whole system will fall apart.
Uh, lots of things already work that way. Natural gas does in most place. Electricity does in many places.
The problem is mainly that generators cost a lot of money to build, and have to operate all the way, so the market is a bit weird. Usually the government ends up contracting to buy a set amount of power from specific places, and just resells that.
Won't work. First, if you fine people $1000 for being involved in an accident that wasn't their fault, there'll be an uproar.
...and you would do that why?
Second, if there's only one insurance company (the govt), and you try to fine people for bad driving, there'll be all kinds of lawsuits from people who don't think it's fair, think the accident report was wrong, etc. etc., and the burden to the legal system will be too great.
People are already fined for bad driving. You drive badly, you get given a ticket. I am confused by your premise.
People might be more likely to fight a ticket in court if it was $1000 vs. $100, but whatever. I don't think the solution is extra-judicial punishment from private companies. The solution is to operate more courts. (Which we badly need anyway.)
There won't be any alternative, because there's no competition, so people will see the legal system as the only way to get any justice. With competing insurance companies, if one company charges you bad rates, you have the option of simply going to the competition, which is cheaper and easier than filing a lawsuit, so lawsuits are only used as a last resort. With a monopoly provider, lawsuits are the ONLY resort.
I don't know why you think this would be sold as 'purchase monopoly insurance'. This is a car tax.
I don't see people suing because they think they should be able to pay their car tag with some other company!
So you think the best possible outcome would be your paying full price for healthcare without any ability to negotiate contracts which include rates, billable codes, etc?
You do at least realize that your insurance company is keeping the hospital from gouging you at every possible turn, yes? They at least do that, and that alone is likely a decent reason to keep them around.
HAHAAHAHAHAAHAHAHA
Oh. My. God. You are hilarious.
I do not have insurance. They will not sell me insurance. I have a pre-existing condition.
I know insurance companies negotiate with hospitals, and thus I PAY THREE TIMES AS MUCH AS INSURANCE COMPANIES FOR CARE.
There's not going to be anything that replaces insurance companies when they die.
Ah, yes, the two things the rich need. The justice system to keep the poor from taking their stuff, and the military to keep the other rich from taking their stuff.
Actually, the bulk of the costs were to a mental health facility with whom my insurance company doesn't have an agreement and actually has to pay the full bill. I know this for sure because the facility didn't even bill my insurance directly -- I paid them and the insurance company reimbursed me.
Ah. Your insurance company got unlucky there.
As for the insurance company canceling my policy, it's not going to happen. My employer wouldn't stand for it.
Oh! For some reason I though you were on an individual policy.
Yeah, if you have a good employer, insurance companies can find it hard to drop you.
OTOH, you can Never. Ever. Change. Jobs.
Well, you can, if you can find one with insurance that actually covers you fast enough. But even if you find one with good insurance, that waiting period will kill you.
And, yes, the Democrats are complete and utter cowards who wouldn't understand how to win if they actually did win.
At the very least, any Democrat who threatened to participate in a filibuster of the legislation should have been un-Democrated to whatever extent that is legal. Period. It's one thing not to vote for it, or even filibuster some other bill, but you don't fucking filibuster your own party's election agenda. If you weren't on board with healthcare reform you should not have run as a Democrat.
I don't know if, legally, they could lose the D before their name, but the Democrats could sure as fuck not invite them to any of the policy meetings or second any of their legislation. They can go beg the Republicans for scraps.
It looks like the health care law may be responsible for a small change. Like 3% instead of 2%, or 14% instead of 10%. It's hardly 'skyrocketing'.
Incidentally, AC, are you with Regence Blue Shield? They are known to have sent out a lying letter blaming the rate increases on the new health care and were forced to send out a correction by regulations.
And a lot of companies are shifting more costs of premiums to the workers due to the recession, which has nothing to do with the health care law.
Even with non-group care, the area that should raise the most (Because it's those people with children that can now get insurance) has roughly one third of the premium change from the law, and two thirds just from normal cost increases.
It was 'all you people on the right suddenly worried about the constitution'. You know, the people bitching about the mandate?
The Democrats had two plans without a mandate to buy insurance from private corporations. If the mandate was such a bad idea, you (Same you here.) shouldn't have 'bargained' the left down to the one that did. (Or, hell, suggested it in the first place.)
Please note when I say 'the left' and 'the right', that 'the right' includes some Democrats.
Yeah, there were a lot of things supported by the Republicans back then, in opposite to the Democrat's plan, that mysteriously became the antithesis of Republican ideas this time when the Democrats decided those ideas were better than nothing.
Same with, for example, cap and trade. Democrats want minimum restrictions that apply to everyone, Republicans want the free market cap and trade. Nothing gets done. Later, Democrats decide cap and trade is better than nothing, so Republicans decide it's a bad thing.
Happens over and over. The left attempts to solve something, the right says 'That's stupid, we should do this other, less useful thing instead', we fight, nothing happens, years later, Democrats say 'Fine, whatever, we'll do your idea instead.' and Republicans say 'That idea we were for a decade ago is stupid!'
The Republicans: Keeping solutions just out of reach.
Completely agree here. But keep in mind that "value" does not always mean cheaper. If a doctor costs you twice as much but fixes the problem in 1/4 the time and more reliably, generally it's worth the upfront cost. Patients need to educate themselves. With information flowing so freely, there's no reason to rely entirely on what your doctor says. For anyone with a moderate education, those days should be over.
Ah, you have greater faith in humanity than I do.
You certainly could have some sort of system where people ended up paying more for medical inefficiencies, and yet everyone got care. Like people pay 5% of their medical care up to $100 every month or something, which is low enough that everyone should be able to get care (Or have a charity pick up the tab.), but enough that they'd pick the $500 MRI instead of the $1500 MRI, because it costs them $10 instead of $30.
I'm just not sure there would be a net benefit.
Sure, 20% of patients, if incentivized right, might pick a better value...but then another 20% might be swayed by some TV ad, and another 20% will attempt to save money by not getting that prescription for anti-biotics so they develop full pneumonia, or not get that MRI the doctor said they needed because their cancer might be back, utterly and totally undoing all our gains.
I know that there's a longing that people would make better medical decisions, but I don't think there's any evidence that more decision making==more affordable care in general.
Plus, now you've added a level of bookkeeping. The entire point of what I suggested is that there is literally no reason to keep 'per-patient' financial bookkeeping. Doctor's payments are entirely per-procedure. Did a procedure, get paid X for it, that's it. No checking anything, no figuring anything.(1) You don't even need a billing system.
If you just get some sort of appointed medical board to set prices for medical procedures, and say 'This procedure pays with $150 + location cost of living adjustment', then doctors automatically have incentives to do it cheaper.
1) Strictly speaking, some areas would get checked. Doctors would probably need permission before plastic surgery that they intend to bill the government for, for example. Presumably, some sort of local board could be set up. But 95% of the doctors wouldn't have to deal with any permissions, and of the 5% doctors left, 90% of their procedures wouldn't involve the government at all. It's only the rare medically needed breast implant or plastic surgery that would get filtered past a board.
There is a lot of expense that the family practitioner does not make nor invest money on (such as diagnostic testing, imaging, prescriptions, etc).
Someone is going to have to explain to me, someday, how MRIs are anywhere near as expensive as they are. Them, and labs, are a huge example of absurd amount of wasted money in the system. And it's because patients don't really understand what's going on.
But, strangely, they're the easiest to fix under my system, because they are the most objective. It's possible for a doctor to argue that he should get paid more than another doctor, because he does a better job, and a flat fee totally removes incentive for him to do a better job.
While I don't really agree with that, because which doctors people go to is random and if they've choosing a more expensive one it's probably because of his bedside manner rather than any 'medical' ability...
...that argument can't even be made for testing lab and MRI. It's absurd that their prices vary in the least. They should be as close as gasoline prices, they are commodities and indistinguishable from each other!
The fact some of them cost five times as much as others demonstrates there's something seriously wrong with the system.
Plus all of the consequential cost increases due to the existence of the system.
Like deliberate lying on the part of patients who do have pre-exist
I hate to break it to you, but this isn't an exclusively American idea, it's shared by basically all developed countries, including the "socialist" western European countries.
Yeah, but they have much tighter regulations, and often require those corporations to be non-profits. They almost always regulate every aspect of the payout, so the only difference is that they compete on overhead.
There's other services that just about everyone needs in today's society, which aren't provided by the government: electricity, communications, and water and sewer in some places.
This works saner if you divide it into two things: The service of moving electricity into your house, which is a service and, as everyone needs it (and it requires a monopoly), the government should probably do it. And the actual production of electricity, which is a 'good' (although perhaps only metaphorically) that people use in different amount, just like food, and private companies should produce it. Where and how private companies get paid is up for debate...perhaps the government should bid, and charge people, perhaps private citizens should choose 'which company' they are using.
Strangely, while I'd always thought we should do utilities that way, I hadn't actually phrased it that way until just now.
For instance, with auto insurance, you can get a liability-only policy to save money, or you can get comprehensive and collision coverage for more money.
Everyone doesn't need collision, so people who wanted that would go out and buy that from third parties.
In fact, the government insurance should probably just provide for the other person, period. (This would work a lot saner if the government was covering medical expenses anyway.)
Interesting trick: Instead of trying to tax people different for how bad a driver they are, or tax everyone the same, we can just increase fines for accidents and tickets. You don't get a rate increase for an accident, but you get hit with a $1000 fine.
Our society needs to sit down and decide if we want one of two situations: A) everyone has a minimum level of health care that they don't need to pay for, or B) health care is completely private, and not a right at all, but a luxury.
But deciding things as a nation would require politicians to actually attempt to lead us, instead of just emotionally manipulate us.
Oh, don't make the mistake of thinking I like the bill, or even that I think it's constitutional.
I'm just glad that insurance companies can no longer go to my hospital, drive rates lower for themselves and higher for everyone else, and then I, who cannot get insurance from them, have to go pay the higher rates.
It is blatant violation of anti-trust laws, it really should already be illegal, and the entire system is so stupid to start with it's incomprehensible. (But you just read my other post about how insurance seems to have become an anti-reseller of health care. Which is, um, utterly insane as a premise.)
There's plenty of good in the bill, though. Even if the mandate is struck down, and it takes away the 'no previous conditions' rule...well, there are still the stop-gag 'Pre Existing Condition Insurance Plans' which were supposed to last until then.
And, of course, it's already in effect for children. Taking that away is going to piss people off.
I think giving people a taste of a (slightly) saner system and then snatching it away has to be better than doing nothing, politically.
Actually, it would be the elusive 'fourth' category. I'm in the third.
You'll find yourself in the third, too, unable to get any insurance at all, if your insurance ever lapses or if they kick you out.
But, obviously, there actually are people that the insurance industry doesn't kick out when they get sick (At least, they haven't kicked you out yet), and who have enough insurance to cover it.
And there are just as many people who ended up in a situation like yours and, somehow, the insurance company canceled their insurance for some reason.
$100,000 isn't really that much, BTW. You really only cost the insurance company about $25,000 (Because the hospital over charges for uninsured people because they are forced to undercharge for insured, so all the 'costs' you see are bogus.), and that seems like it's below the point where they start looking for reasons to dump you.
Slashdot Mirror
I didn't really describe iDine. It sorta defeats the purpose of this if it's the same 'points' at multiple locations. The whole point is to get them at your place. (OTOH, perhaps it's actually divided into rewards per-location. The iDine website does not explain.)
What I was talking about was simply for business to get loyal customers, customers that won't do what the ones described in the article are doing, customers who will buy from X because X will actually reward them in an increasing manner they more they buy.
The iDine card just demonstrates not only is my assumption that people will willing give over correct personal information, instead of the nonsense companies end up with existing 'loyalty' cards...but that data is so fricking popular that third parties will be willing to pay for it.
Instead, businesses do idiotic 'loyalty' cards that do not actually reward you personally in any way, so people get them with bogus information or the cashier just lets you use his. This results in less accurate data than if they'd just collected the last four digits of the credit card and the name, and treated that as 'person'.
Hell, I wasn't even approaching it from the value of that information, but my concept of actual loyalty cards that accrues points in some manner would get them that information essentially for free. Plus give customers an incentive to buy at your place for $105 dollars instead of getting it for $100.
Yes, they're known to be doing this.
So, to recap: They invent exactly one way discounts could even possible exist...and then attack that way.
The idea of giving someone a discount because they buy a large amount from that place is clearly insane. Why, if they did that, everyone would buy in large amounts from them just to get a discount!
Plastic surgery is a common example--there's a huge spectrum of work that ranges from "affects to quality of life" to "vanity" with a large grey middle ground. It's often an expensive procedure and what one person might say is an acceptable government-paid cost is something the next person might say should be paid out of pocket.
The fact you can easily point to it is pretty clear evidence that it's obvious.
It actually is pretty easy to classify 99.99% of medical procedures as medically necessary or now, and 95% of doctors as one or the other.
The rest is easy enough to require referrals from other doctors, or have some sort of local board.
You'll also get a lot of push back from doctors, who fear their salaries will be decimated,
OTOH, general practitioners should get paid better.
and fear from prospective medical students and society at large that nobody will want to be a doctor if you can't make enough to repay the cost of schooling.
The problem with medical schooling is that medical schools have very deliberately as few educational institutes as possible. That's another entirely different issue that needs addressing.
If I was a sales manager, I would be offering some incentive to my customers to do all their shopping at my store at once. The more they spend, the greater their savings.
See, that's what's gone away: Any reason for customers to have store loyalty.
It used to be that you could actually get discounts. Nowadays, they can offer discounts for exactly one reason: price matching.
Sure, there are those customer loyalty cards, but the free ones are clearly just privacy-invading discounts that should already exist. You're not given a discount for being a 'good customers'.
The ones you have to buy, like bookstore ones, are a manual discount, which is just as idiotic. Those things should be offered free after someone's bought $30 or whatever. Or, even better, offered free, but with no discount, and as you buy stuff using them the discount gets larger and larger.
The only place you get actual discounts for actually buying stuff are those places that punch the goofy cards, which appear to somehow be the lowest rung of discounting. (And airlines have some sort of frequent flying thing too, which I don't know much about. Normally people when talking about 'frequent flyer' inexplicably mean 'stuff out credit card company gave us', but I'm sure there's some actual rewards from flying a lot.)
Other than that, no one offers any sort of discount, which is ironic, because they have more ability to track you than ever, and hence could easily offer customers discounts. They don't even need cards. At checkout: 'I see you've purchased more than $80 this month. If you total more than $100 by the 31st, you get $10 off, so next time you're here, you can get $20 and only pay $10.'
You're doing it backwards, you idiotic resellers. Stop invading privacy against the customer's wishes. Just offer them an actual discount for loyalty, and actual discount based on them being good customers, not a pretend one by marking up prices and then pretending to 'discount' them because someone filled out a stupid card, which people see straight through and, um, doesn't encourage any loyalty. At that point, people will start making sure that you know how much they've bought there. You set something like that up, and forget needing the customer cards...people will deliberately link their credit cards if they're using multiple ones, and tell you their actual name and address. (Not the 80% fake address the 'customer loyalty' cards have.)
And that's just the 'general discount'. It used to be that if you bought a X, you could get X accessories for cheaper at the time, which encouraged people to buy all their stuff at once. Now half the time X is a loss leader and the accessories are marked up 300%. (I'm looking at you, Best Buy.) This is insane.
The only store that gets any sort of store loyalty from me is Barnes and Noble, because I'm afraid if I don't, actual physical bookstores will cease to exist. B&N has it sorta right, in that they keep mailing me coupons (Which I actually do use.), but it seems they're just mailing them because I'm a member, and not because I've bought things per se.
Until companies start actually rewarding actual purchasing and actual loyalty, there is absolutely no reason for customers to be loyal.
Daily consumers of MSNBC and public broadcasting (NPR and PBS) were higher (34 points and 25 points respectively) in [incorrectly] believing that it was proven that the US Chamber of Commerce was spending money raised from foreign sources to support Republican candidates.
I will point out that the misconception there appears to be about what is proven. The US Chamber of Commerce takes in foreign money, and won't explain how it's segregated the money in a way that comply with the law. In other words, that statement could be true.(1) It is a statement of possibility mistakenly elevated to truth.
Whereas the misconceptions with Fox News viewers appear to be about things that not only aren't proven, but pretty definitively proven in the opposite direction. Like Obama's birthplace, or WMDs in Iraq. It's a statement of impossibility elevated to belief.
Or, for an analogy: One group is asserting that a baseball player with persistent rumors of steroid use 'is using steroids', which is actually just a possibility and he denies it. The other group asserts he's ten feet tall, which is rather easily disproven just from the slightest research.(2)
It's not really the same order of magnitude of wrongness at all.
1) I don't think they'd be stupid enough to do that, but, OTOH, I didn't think banks would be stupid enough to not actually transfer loans into the instruments they were making, and, well, they were. I am constantly amazed by the stupidity and blatant lawbreaking of the powerful.
2) We do have to give people some lag time here. For example, if the Chamber of Commerce thing was disproven tomorrow, or, hell, if it was disproven last month and I didn't notice, that is a low level of 'misinformed'. But there really should be some time limit on this. He's been president for two years. And that was never actually plausible at all.
This.
Given the three facts/assumptions above, what is the better option than compulsory health insurance?
Oh, oh, I have one: The government pays medical bills.
Not 'insurance', not any sort of insurance system. No deductibles, no co-pays, no stuff that is authorized and stuff that isn't.
People(1) go to the doctor, the doctor reports he did the Whatever Procedure, the government pays him an amount set by a national board of doctors with regional cost of living adjustments.
Anything else is just needless paperwork and total nonsense that costs more than any 'savings'. The rising cost of 'medical care' is almost entirely due to paperwork and skimming, not actual care. (Along with insurance squeezing general practitioners out because of lopsided pay scales.)
Moving all that overhead to the government would be about the dumbest solution ever. We're spending as much money figuring out if we should pay for something as we do actually paying for things. Just pay for the stupid shit and be done with it.
Medical ethic boards can take care of crazy hypothetical doctors doing needless procedures and tests. If we really really really need some rules we can implement them later. (OTOH, why do we care about 'unneeded' tests? What should happen is that testing becomes cheaper thanks to volume and the fact the medical board pays all testing facilities the same amount, so no more crazy-expensive ones. At some point, who cares? We wasted billions in Iraq, I think we can waste $40 a person in extra test a year.)
1) And, to appease the right, I'll even be willing to say 'only people here legally, except for emergency care'. And people on visas and green cards and stuff would have to pay an 'insurance premium' before getting one.
Libertarians who believe that the Civil Rights Act was unconstitutional, such as Rand Paul, Senator-elect from Kentucky, are essentially saying that private businesses have the right to use state and local law enforcement to exclude black people.
Yup. Rand Paul thinks your tax money should be used to remove black people from the local McDonalds if the owner doesn't like them. (The real question: Can the owner demand that none of the police officers are black?)
Zoning laws are the same way. So, this property you 'own', by which we mean the government is willing to defend from invaders for you, can only be used in ways the government says? Well, I'll be damned!
That's why most 'government intrusion' complaints are bullshit. They are inherently nonsensical, and yet the Republicans has managed to rely on them for decades.
The best one is right-wingers who want to keep the government away from the 'free market', so corporations can do whatever. Um, hey...corporations only exist because of the government. You want a 'free market' without the government, sure, we'll dissolve all corporations tomorrow and people can get out there with wheelbarrows selling stuff on the side of the road.
That's not to say the Democrats doesn't make some dumb statements along the same direction, but nowhere to the same level.
And a lot of the stuff the Democrats are trying to 'keep the government out of' (Which aren't that many) actually don't have the government in them, like who you're inviting to your bed. It's not like the government is providing sexual partners but only providing one gender, and the left wants them to keep doing that, but stop checking gender, which would be the analogy with the stuff the right wants the 'the government out of'. (Someone's about to make a gay marriage comment, as the government is indeed in the marriage business, but I've never heard anyone argue that gay marriage is 'less government involvement' so we should do it. Stay on topic, people.)
The only real exception on the left is abortion, because medical procedures are actually regulated...OTOH, the government don't actually punish people for seeing unlicensed doctors, just the doctors themselves. So depending on what exactly the right is trying to do, the left's idea of 'keeping government out of medical decisions' WRT abortion might or might not make sense.
So deflation does not occur if only half of products in the world are sold at lower prices, while the rest stayed the same because their local markets did not catch up yet?
No, as I said, the economy is crippled. Deflation will eventually occur if, magically half the products are sold at some lower price, but this is very painful to the people who are attempting to live during it and now can't afford materials.
And luckily is an utterly absurd premise, because technological progress doesn't work that way.
In that way new goods are always made before they are paid for by buyers at their sell price. That is the whole point of manufacturing something for profit.
And yet deflation occurs after stuff has been produced.
Deflation happens when the same amount of money chases more goods. The 'more goods' part of that happens after the goods are made.
Which means they have to buy materials at the old prices, which is why deflation is so painful and harms manufacturing.
I mean, let's go back to your hypothetical example. First the price of the bread changes, and even if there is inflation and the price of rye changes...it changes after several days, during which the bakers were buying rye for $1 and selling bread of $0.75.
Read what you're actually saying. Goods are made before, inflation happens after those goods are already floating around.
For your information: the amount of labour required to construct a "house" (which is what the average pile of cardboard and sticks is being euphemistically referred to today) has gone down massively over the last 200 years. One has to only take a look at the amount of labour required to produce bricks and lay them down versus screwing a few fasteners through paper and plaster into wobbly "studs" with a power drill.
Just saying things doesn't make them true.
What has really happened is that due to insane inflation, the numerical amounts of fake money paid for crap are now far in excess of what was paid for work that could stand for a century or more instead until the first stronger gust of wind. Which is what has you so confused and believing that no significant changes occurred.
As I said, I was talking about accounting for inflation. See here.
You really have no idea what you're talking about. Things do not magically keep getting easier to make. You have confused mp3 players with the entire world. In non-technological industries, there is maybe a 20% bump as automation shows up, and that's it for another 40 years.
With each new improvement of productivity a whole lot of bakers are forced out of business and have to find new work
Which was not at all the problem I pointed out. The problem I pointed out is that either a) the bakers keep charging the same price, in which deflation doesn't happen, or b) they charge lower prices, which blows up the economy because now they can't actually buy supplies.
But it's moot. Your hypothetical deflation is insane. That is not how deflation happens.
The only way what you are talking about can cause deflation is if there is some massive drop in the cost of making some good that everyone needs. And, yes, that has probably happened once or twice during history...but is not some sort of constant force driving prices down!
Fiat currencies are designed to try to hide this fundamental truth by trying to delay the negative effects onto future generations, but they cannot fix the problem itself.
I've been ignoring the strange rants you go into, but I can ignore no longer.
The reason we've have economic problem has nothing at all to do with fiat currency. It has to do with the banks not being regulated. It has to do with us not actually taxing those 'financiers' you rail against, or stopping them from doing stupid shit. You're right that they pr
So the end result of progress: more goods, same amount of money in circulation: deflation.
That's not really deflation, at least not how you said it. It's only half deflation, and is exactly the problem with deflation in that manner. But you actually stated the problem:
So, after the invention, every day, the farmers sell $1 worth of rye to the baker...and the bakers sell 50 cents back...hey, wait a second. That only works for two days, then the farmer has all the money.
The bakers has to keep selling at $1, simply because he can't make enough to live otherwise. Maybe he can edge out a living at 80 cents if he eats less food, to compete with the other baker and try to sell loafs to both farmers, but it's a race to the bottom. And that other guy is out of work.
The problem with your hypothetical is that unless everything gets cheaper exactly the same, you won't have real deflation, just weird and economy crippling partial deflation in whatever got cheaper. Deflation caused by increasing the availability of goods doesn't work well, at all.(1)
Actually, the real problem with that hypothetical is that progress doesn't work how you think it does. A lot of stuff had, in the 50s or whenever, a huge bump in productivity as production was automated...and that's it. I will point out that houses still cost basically the same to make as they ever did. (That's after removing inflation and the stupid bubble. I'm talking about construction.) Actual hours of human labor are the same, materials are maybe 20% easier to make than 100 years ago. Some things will functionally never get cheaper.
Meanwhile, all economic growth is not 'progress related'. (In fact, very little of it is.) A hell of a lot of it, in fact, comes from population growth.
This would eventually cause deflation, as more goods chase less money, but it's...um...retroactive inflation. The goods have to be made before the money exists to make them.
As I keep pointing out, deflation cripples economies, because it lags pretty far behind the demand for goods. Or, to put it clearer, deflation happens when less money is chasing more goods, and it happens after the goods exist.
Hence people have no actual money to buy the goods in the first place. And thus the goods are never made in the first place, and the deflation never happens.
Inflation also lags behind the goods, but this works basically the other way around. It anti-cripples the economy.
And so you starve sitting on a pile of gold, right? These kinds of "arguments" make you look utterly deranged.
Firstly, people have starved sitting on a pile of gold. You can't eat gold, and if no one will sell you food, you starve. Check what happened to the Spanish Empire, which confused gold with wealth.
Secondly, of course the people with the money don't starve. They're the food producers, no matter how bad the economy is, they presumably would make enough for themselves.
It's the people who would buy the food that starve. That the people with the money were supposed to spend that money on making food, and then sell to the starving people. Instead, they hold on to the money, because it will be worth more later.
That's utter bullshit and you know it. The process (for consumer goods) is self-regulating: if there is not enough sellers, the number of goods available goes down and in a deflationary economy prices stabilize and even go up. That is in fact the whole point of a "free market": that it has this self-regulating ability.
Did you just assert that I was wrong when I said 'no one would build cars' by saying 'the number of goods available goes down'?
I'm pretty certain that's exactly what I said, hyperbole aside.
1) This is accepting the idea that gold value can inflate to whatever you want it to be, which I still do not agree with. As what you actually want is simply an economy where more money is never printed, I've chosen to pretend that's what you're suggesting, which has nothing to do with gold at all.
Oh, I'm with you about cap and trade...and that was basically the Democratic solution in the 1980s.
The thing, at some point people need to realize that often the 'counter' solution to the other party's political solutions is not actually intended as a solution.
And, more importantly, the Democrats should never restart with the Republican solution, which happens constantly. They come with solutions that are 'pre-compromised' to the Republican 'position'...and then the Republicans come out against it. It happens over and other.
With energy, Democrats should have kept harping at a tax until it passed. If the Republicans want to propose cap and trade themselves, whatever. Even Democrats might vote for it, that's fine.
But that should never devolve to the Democratic position, which allows the Republicans to reposition themselves even farther away from the sane solution. (In fact, they literally appear to have no solution at all at this point. They have moved so far right they have fallen off the possible 'solution space' to that problem, and have just said 'We do not wish to solve that problem at all.')
Same thing with health care. Democrats should start with single payer, Republicans can then counter with a mandate, and we'd probably even up with some like a public option, which was probably the least objectionable to voters of both sides.
But, no, that would require actual intelligence on the part of the Democratic party. Instead, their plan is to find out whatever the Republicans wanted last time, and put as much of that in as possible so the mean Republicans won't call them names, and maybe even vote for their bill, and then maybe the Republicans will come to their birthday party and they can braid their hair!
I like your circular reasoning here! The amount of gold is too small to cover the amount of currency needed at some fixed exchange rate that belonged to pre-fiat days because of inflation caused by fiat currency which we introduced because there was supposedly not enough gold to cover the inflation that occurred because of the fiat ... and so on into the merry infinite loop!
I'm not trying to cover 'inflation'. I am trying to cover economic growth.
You simply missed, again, the fact that none of what I explained causes the amount of the actual original currency to increase, while the amount of goods has increased due to natural progression of scientific and industrial development. Measured in the original dollars, the prices would simply keep falling. Hence deflation.
Oh, my, god.
No, progress does not make deflation. Progress makes things easier, which means they cost less to make, but it also means people get paid to make them.
This alters the standard of living, but does nothing WRT to deflation or inflation at all. (I wondered where the hell you thought deflation was coming from.)
And normal population growth, at minimum, also makes the economy bigger. Which means it needs more actual cash.
True, gold has value as a metal, but by being selected to become the reference metal for a currency it would also acquire a value related to this other role, in this case the secondary gold-as-currency-reference value quite likely far outstripping the gold-as-an-industrial-metal value.
And my question is: Why?
Seriously. You're just asserting deflation would exist. Which is a reasonable assumption as the economy grows and the money supply doesn't, but you don't have a money supply...you have a gold supply. Gold already has a value that the market has assigned it.
I'm sure there's some elasticity in it, but not enough to cover the 100x economic growth we've had over the last century!
If we'd stopped printing money and stop backing it with gold at the same time, back then, yes, we'd have deflation, where cars would cost $2. (Erm, except no one would build cars because by the time they got them to people, the deflation would eat their profits.)
This, incidentally, is not due to 'progress', it's due to our economy being much much bigger and having to stretch the money out. (In actual fact, our economy would be repeatedly crippled through out history by the lack of money, especially as people have every incentive to hoard it.)
But you can't just replace money with an actual gold, you can't replace something that is 'human created with human defined value' with something that has actual value outside that, and exists outside of our system. It is attached, however loosely, to an actual cost.
Err, in a deflationary economy the last thing you want is to hold onto the goods because they will be cheaper tomorrow, not more expensive ...
Yes, that was 'backwards', but actually I was trying to say 'Economies where no one is willing to sell because their money will be worth more tomorrow are utterly fucked.'.
I.e, the problem with deflation is that no one will actually make things, because buying raw materials and hiring people to sell the stuff today is stupid when you can do it for 95% of the cost tomorrow. Deflation is incredibly bad for any sort of spending on anything.
Obviously if people do already have things made they'd sell them as quickly as possible.
But as I pointed out, there's no actually any reason for your economy to be deflationary anyway, because it's attached to a fixed thing.
Radiology is a cash cow of hospitals everywhere. Essentially, it's the health care system pushing for the latest and greatest technology, which is extremely expensive.
Yup.
Since you and I are in no position to say we're happy with the resolution that we have, we just get to bit the bullet and pay for it.
Well, 'I' am not in that position, as I have a pacemaker and hence cannot get a MRI. ;)
But, yes, almost all the 'advances' in the technology have been quite pointless. Sure, maybe one time out of a thousand the super duper fine-grain scanner is needed, so, sure, build one in each major city so we can scan for that hidden brain clot or whatever.
But 999 out of 1000, the cheap one is fine, and hasn't needed upgraded since it was installed in 1983. (Hardware, that is. Software is another story.)
Won't work. You can't divide electric power that way, so that customers can choose which generator their power comes from. The whole system is a grid, and has to be managed as a system, including the generating plants. You can't have one entity managing the grid, and other people managing the generators, and occasionally fighting over things, because the whole system will fall apart.
Uh, lots of things already work that way. Natural gas does in most place. Electricity does in many places.
The problem is mainly that generators cost a lot of money to build, and have to operate all the way, so the market is a bit weird. Usually the government ends up contracting to buy a set amount of power from specific places, and just resells that.
Won't work. First, if you fine people $1000 for being involved in an accident that wasn't their fault, there'll be an uproar.
Second, if there's only one insurance company (the govt), and you try to fine people for bad driving, there'll be all kinds of lawsuits from people who don't think it's fair, think the accident report was wrong, etc. etc., and the burden to the legal system will be too great.
People are already fined for bad driving. You drive badly, you get given a ticket. I am confused by your premise.
People might be more likely to fight a ticket in court if it was $1000 vs. $100, but whatever. I don't think the solution is extra-judicial punishment from private companies. The solution is to operate more courts. (Which we badly need anyway.)
There won't be any alternative, because there's no competition, so people will see the legal system as the only way to get any justice. With competing insurance companies, if one company charges you bad rates, you have the option of simply going to the competition, which is cheaper and easier than filing a lawsuit, so lawsuits are only used as a last resort. With a monopoly provider, lawsuits are the ONLY resort.
I don't know why you think this would be sold as 'purchase monopoly insurance'. This is a car tax.
I don't see people suing because they think they should be able to pay their car tag with some other company!
So you think the best possible outcome would be your paying full price for healthcare without any ability to negotiate contracts which include rates, billable codes, etc?
You do at least realize that your insurance company is keeping the hospital from gouging you at every possible turn, yes? They at least do that, and that alone is likely a decent reason to keep them around.
HAHAAHAHAHAAHAHAHA
Oh. My. God. You are hilarious.
I do not have insurance. They will not sell me insurance. I have a pre-existing condition.
I know insurance companies negotiate with hospitals, and thus I PAY THREE TIMES AS MUCH AS INSURANCE COMPANIES FOR CARE.
There's not going to be anything that replaces insurance companies when they die.
I felt the same way about Ted Bundy.
Ah, yes, the two things the rich need. The justice system to keep the poor from taking their stuff, and the military to keep the other rich from taking their stuff.
Actually, the bulk of the costs were to a mental health facility with whom my insurance company doesn't have an agreement and actually has to pay the full bill. I know this for sure because the facility didn't even bill my insurance directly -- I paid them and the insurance company reimbursed me.
Ah. Your insurance company got unlucky there.
As for the insurance company canceling my policy, it's not going to happen. My employer wouldn't stand for it.
Oh! For some reason I though you were on an individual policy.
Yeah, if you have a good employer, insurance companies can find it hard to drop you.
OTOH, you can Never. Ever. Change. Jobs.
Well, you can, if you can find one with insurance that actually covers you fast enough. But even if you find one with good insurance, that waiting period will kill you.
Sorry, I will amend:
The right killed it.
Including some Democrats.
And, yes, the Democrats are complete and utter cowards who wouldn't understand how to win if they actually did win.
At the very least, any Democrat who threatened to participate in a filibuster of the legislation should have been un-Democrated to whatever extent that is legal. Period. It's one thing not to vote for it, or even filibuster some other bill, but you don't fucking filibuster your own party's election agenda. If you weren't on board with healthcare reform you should not have run as a Democrat.
I don't know if, legally, they could lose the D before their name, but the Democrats could sure as fuck not invite them to any of the policy meetings or second any of their legislation. They can go beg the Republicans for scraps.
Yeah, but that doesn't change the fact they're lying about reasons for the premium increase.
See here.
It looks like the health care law may be responsible for a small change. Like 3% instead of 2%, or 14% instead of 10%. It's hardly 'skyrocketing'.
Incidentally, AC, are you with Regence Blue Shield? They are known to have sent out a lying letter blaming the rate increases on the new health care and were forced to send out a correction by regulations.
And a lot of companies are shifting more costs of premiums to the workers due to the recession, which has nothing to do with the health care law.
Even with non-group care, the area that should raise the most (Because it's those people with children that can now get insurance) has roughly one third of the premium change from the law, and two thirds just from normal cost increases.
Um, I pretty clearly identified the 'you' there.
It was 'all you people on the right suddenly worried about the constitution'. You know, the people bitching about the mandate?
The Democrats had two plans without a mandate to buy insurance from private corporations. If the mandate was such a bad idea, you (Same you here.) shouldn't have 'bargained' the left down to the one that did. (Or, hell, suggested it in the first place.)
Please note when I say 'the left' and 'the right', that 'the right' includes some Democrats.
Yeah, there were a lot of things supported by the Republicans back then, in opposite to the Democrat's plan, that mysteriously became the antithesis of Republican ideas this time when the Democrats decided those ideas were better than nothing.
Same with, for example, cap and trade. Democrats want minimum restrictions that apply to everyone, Republicans want the free market cap and trade. Nothing gets done. Later, Democrats decide cap and trade is better than nothing, so Republicans decide it's a bad thing.
Happens over and over. The left attempts to solve something, the right says 'That's stupid, we should do this other, less useful thing instead', we fight, nothing happens, years later, Democrats say 'Fine, whatever, we'll do your idea instead.' and Republicans say 'That idea we were for a decade ago is stupid!'
The Republicans: Keeping solutions just out of reach.
Completely agree here. But keep in mind that "value" does not always mean cheaper. If a doctor costs you twice as much but fixes the problem in 1/4 the time and more reliably, generally it's worth the upfront cost. Patients need to educate themselves. With information flowing so freely, there's no reason to rely entirely on what your doctor says. For anyone with a moderate education, those days should be over.
Ah, you have greater faith in humanity than I do.
You certainly could have some sort of system where people ended up paying more for medical inefficiencies, and yet everyone got care. Like people pay 5% of their medical care up to $100 every month or something, which is low enough that everyone should be able to get care (Or have a charity pick up the tab.), but enough that they'd pick the $500 MRI instead of the $1500 MRI, because it costs them $10 instead of $30.
I'm just not sure there would be a net benefit.
Sure, 20% of patients, if incentivized right, might pick a better value...but then another 20% might be swayed by some TV ad, and another 20% will attempt to save money by not getting that prescription for anti-biotics so they develop full pneumonia, or not get that MRI the doctor said they needed because their cancer might be back, utterly and totally undoing all our gains.
I know that there's a longing that people would make better medical decisions, but I don't think there's any evidence that more decision making==more affordable care in general.
Plus, now you've added a level of bookkeeping. The entire point of what I suggested is that there is literally no reason to keep 'per-patient' financial bookkeeping. Doctor's payments are entirely per-procedure. Did a procedure, get paid X for it, that's it. No checking anything, no figuring anything.(1) You don't even need a billing system.
If you just get some sort of appointed medical board to set prices for medical procedures, and say 'This procedure pays with $150 + location cost of living adjustment', then doctors automatically have incentives to do it cheaper.
1) Strictly speaking, some areas would get checked. Doctors would probably need permission before plastic surgery that they intend to bill the government for, for example. Presumably, some sort of local board could be set up. But 95% of the doctors wouldn't have to deal with any permissions, and of the 5% doctors left, 90% of their procedures wouldn't involve the government at all. It's only the rare medically needed breast implant or plastic surgery that would get filtered past a board.
There is a lot of expense that the family practitioner does not make nor invest money on (such as diagnostic testing, imaging, prescriptions, etc).
Someone is going to have to explain to me, someday, how MRIs are anywhere near as expensive as they are. Them, and labs, are a huge example of absurd amount of wasted money in the system. And it's because patients don't really understand what's going on.
But, strangely, they're the easiest to fix under my system, because they are the most objective. It's possible for a doctor to argue that he should get paid more than another doctor, because he does a better job, and a flat fee totally removes incentive for him to do a better job.
While I don't really agree with that, because which doctors people go to is random and if they've choosing a more expensive one it's probably because of his bedside manner rather than any 'medical' ability...
The fact some of them cost five times as much as others demonstrates there's something seriously wrong with the system.
Plus all of the consequential cost increases due to the existence of the system.
Like deliberate lying on the part of patients who do have pre-exist
I hate to break it to you, but this isn't an exclusively American idea, it's shared by basically all developed countries, including the "socialist" western European countries.
Yeah, but they have much tighter regulations, and often require those corporations to be non-profits. They almost always regulate every aspect of the payout, so the only difference is that they compete on overhead.
There's other services that just about everyone needs in today's society, which aren't provided by the government: electricity, communications, and water and sewer in some places.
This works saner if you divide it into two things: The service of moving electricity into your house, which is a service and, as everyone needs it (and it requires a monopoly), the government should probably do it. And the actual production of electricity, which is a 'good' (although perhaps only metaphorically) that people use in different amount, just like food, and private companies should produce it. Where and how private companies get paid is up for debate...perhaps the government should bid, and charge people, perhaps private citizens should choose 'which company' they are using.
Strangely, while I'd always thought we should do utilities that way, I hadn't actually phrased it that way until just now.
For instance, with auto insurance, you can get a liability-only policy to save money, or you can get comprehensive and collision coverage for more money.
Everyone doesn't need collision, so people who wanted that would go out and buy that from third parties.
In fact, the government insurance should probably just provide for the other person, period. (This would work a lot saner if the government was covering medical expenses anyway.)
Interesting trick: Instead of trying to tax people different for how bad a driver they are, or tax everyone the same, we can just increase fines for accidents and tickets. You don't get a rate increase for an accident, but you get hit with a $1000 fine.
Our society needs to sit down and decide if we want one of two situations: A) everyone has a minimum level of health care that they don't need to pay for, or B) health care is completely private, and not a right at all, but a luxury.
But deciding things as a nation would require politicians to actually attempt to lead us, instead of just emotionally manipulate us.
Oh, don't make the mistake of thinking I like the bill, or even that I think it's constitutional.
I'm just glad that insurance companies can no longer go to my hospital, drive rates lower for themselves and higher for everyone else, and then I, who cannot get insurance from them, have to go pay the higher rates.
It is blatant violation of anti-trust laws, it really should already be illegal, and the entire system is so stupid to start with it's incomprehensible. (But you just read my other post about how insurance seems to have become an anti-reseller of health care. Which is, um, utterly insane as a premise.)
There's plenty of good in the bill, though. Even if the mandate is struck down, and it takes away the 'no previous conditions' rule...well, there are still the stop-gag 'Pre Existing Condition Insurance Plans' which were supposed to last until then.
And, of course, it's already in effect for children. Taking that away is going to piss people off.
I think giving people a taste of a (slightly) saner system and then snatching it away has to be better than doing nothing, politically.
Actually, it would be the elusive 'fourth' category. I'm in the third.
You'll find yourself in the third, too, unable to get any insurance at all, if your insurance ever lapses or if they kick you out.
But, obviously, there actually are people that the insurance industry doesn't kick out when they get sick (At least, they haven't kicked you out yet), and who have enough insurance to cover it.
And there are just as many people who ended up in a situation like yours and, somehow, the insurance company canceled their insurance for some reason.
$100,000 isn't really that much, BTW. You really only cost the insurance company about $25,000 (Because the hospital over charges for uninsured people because they are forced to undercharge for insured, so all the 'costs' you see are bogus.), and that seems like it's below the point where they start looking for reasons to dump you.
Government bailouts?
Oh, please. You're acting like they're moderately ethical people.
I suspect they will start hiring assassins to kill people with cancer.
Ha ha only serious.