You said earlier: "First, Medicare negotiating lower drug prices causes INCREASED prices for those not on Medicare." Now you say: "I said negotiating prices CAN result in HIGHER prices. "
Make up your mind. Um. Those are not in disagreement. Running causes weight loss. That doesn't mean I will lose weight every time I run.
you've managed to offer no support for any of your claims False.
made blanket statements that are not rooted in logic or reality Also false.
and generally have made an ass of yourself Yes, by bothering to respond to people like you. I hope you didn't make any actual points in the rest of your post, because I never got that far. *plonk*
I don't agree with either assertion. From now and way back even to the Depression, it was government involvement that helped CAUSE all of our problems. Please study economic history before invoking the Great Depression in discussing whether government caused problems. You first.
Lack of regulation was a major factor in causing the great depression. Yes, FDR did a good job convincing people of this. That doesn't make it true.
You mean, encouraging high-risk home loans by deregulating the banking industry and reducing oversight of the consumer lending industry? No, I do not. I mean, government giving out ratings to lenders based on how many high-risk loans they gave out. I mean, explicitly allowing subprime loans, not merely "deregulating" or "reducing oversight."
It is reduced government that has led us to the current mess. False.
I understand the concept of strict Constitutionalism Semantic point: I am not a strict constructionist. No one is, that I've ever heard of. A strict constructionist believes that the intent of the words is most important. But almost no one actually follows that. Textualism is what most conservatives adhere to, and what textualism says is that it is the common understanding -- at the time -- of what the actual words mean, that is most important. Most of the time the distinction is unimportant, because most of the time, the expressed intent IS what the words say. But not always.
I am a textualist, or originalist, not a strict constructionist.
My feeling is that the Constitution is held as sacred by so many people, when it is clear to me that a strict interpretation of the Constitution has failed, because we have failed to change the Constitution with the times That is ENTIRELY beside the point of how to interpret the Constitution. If the Constitution has failed, fine, change it. If we've failed to change it, fine, change it.
The world is remarkably different than it was 220 years ago, and some of the political theories that were new and popular at the time don't fit in with today's world. Due to advances in communication, etc, there are economies of scale unrealizable 30 years ago, let alone 220 years ago. If you want to literally follow the words written 220 years ago, you should think about what they envisioned as an ideal society, and whether that notion of an ideal society really fits in with what is desired now, and if it is even attainable. My interpretation philosophy literally has no serious problems whatsoever, because if there's something you don't like, you can always change it.
Your philosophy -- which sounds much like the one expressed by Justice Breyer in his book "Active Liberty" -- is deeply flawed. It literally destroys the whole concept of self-governance. We decide what the law is, as a people, and then judges come in and flush it down the toilet. And worse, it does not respect ANY rights. The Declaration of Independence says we have certain unalienable rights. Some of these were codified in the Constitution. Your philosophy denies that these rights even exist: the only standard for a law is whether that law promotes your idea of an "ideal society." But there is only one definition of an "ideal society" that matters: the one the people have agreed on (and are fully capable of amending).
And here's the rub: if you want to ignore the Constitution without officially amending it, you are facially subverting your own argument. "What is desired now" is, necessarily, what the people want. But the people have not seen fit to give anyone the power to ignore the Constitution without amending it. The government exists to secure our rights, deriving its just powers from the consent of the governed; your philosophy claims that the government exists not to secure our rights, but to force upon us some society that YOU desire, regardless of what we desire or whether we've given consent.
It can't be, from my perspective. If it is your right, that means I have to provide it. This is not what the Constitution stands for. If there is a cost to provide a standard amount of liberty There isn't. We HAVE liberty. It is not provided, it is only taken away (sometimes justly -- for example, I have the right to swing my fist, but your right to not have me punch your nose supercedes -- and sometimes, unjustly).
How do you interpret the statement that we have a right to life? That no one has a right to take my life. NOT, absoutely not, that anyone has an obligation to keep me alive (except for my parents, during my very early years, when I am not yet a fully responsible adult).
Which is why such a system needs to be a national system.
No. It shows how such a thing doesn't scale.
Then isn't it odd that we spend more per capita than any other industrialized country, cover a far smaller proportion of the population, and get no better results in terms of health care delivered?
Yes, which is why we need to REDUCE regulation and cost controls so we can spend less to provide more.
Making sure that all kids are able to get lunch, regardless of the current state of affairs/budgets in the local town/state does seem to be pretty awful meddling.
I think the fact that anyone thinks so poorly of the state legislatures that they believe those legislatures incapable of handling school lunches on their own is pretty damned awful, myself. It's one of the worst kinds of meddling. It's insidious. It seems so nice and good -- hey, who doesn't agree kids should eat healthy lunches? -- but it inherently assumes what is obviously false: the states need, or want, federal assistance. There has never once been a state incapable of defining standards, or providing the lunches. Ever.
It's nanny-statism at its worse, precisely BECAUSE it seems like such an obvious thing, because if it is so obvious, then why does the federal government need to be involved? And the answer is because people WANT the federal government involved, for the sake of CONTROL.
I reiterate: this is pretty damned awful.
Here I have a different philosophy. I have a hard time figuring out how you can make free market solutions work in the health insurance system.
I do not care about the health insurance system. The goal should be fixing the health care system. Health insurance should follow the discussion, not lead it. And the answer is essentially: reduce government regulation, increase competition and choice, reduce costs. When costs lower, people DO NOT NEED to care much about insurance except for expensive or catastrophic care, and if an uninsured person cannot pay for expensive or catastrophic treatment, then we have charities to handle this. If states want to try to cover expensive care for the needy, maybe we can discuss that, but there's no need for a whole universal/comprehensive system just to solve the one problem of relatively rare high-end procedures for poor people, if we reduce other costs across the board.
As a purchaser, you generally have very few options since health care is tied to your employer
Exactly. Which is why we should deregulate to allow more options.
as a layperson, you are not in a very good position to know what different kinds of health care are worth, and therefore important to have as covered options
Exactly. We should focus on providing more options and choices and information to the consumers.
To me, we should be aiming to make health care a universally available thing, unrelated to your employer, current financial standing, or health
To me, this is an utterly terrible thing.
That means that insurance needs to be 1. community rated (insurance companies forced to cover everyone at a similar rate)
Meaning that health care costs will remain high, and we will have fewer insurance options, which means insurance will cost even more.
2. not provided by employers
Well, not essentially FORCED to be provided by employers.
3. universally mandated
Absolutely not. This is evil, with a capital E. Never before in our country have we ever forced anyone to pay any money just for being alive. This would be a first. It is hard to imagine a greater affront to liberty than what amounts to a tax on being alive.
(otherwise healthy people will opt-out until they get sick)
The affront to liberty caused by mandates is much more important than this logistical problem with your health care plan, that I disl
The simple fact of the matter is you do NOT want your food supply subject to the law of supply and demand. False. I absolutely do.
Having beans be $0.10 a can one year, then because no one grew them for $0.10, costing $100 a can the next, if you can find them at all, back to $0.10 because EVERYONE grew them looking for $100 a can, but hey, there's no corn or carrots or potatoes now, cause everyone grew beans, is that a good situation? Absolutely. This creates a market opportunity for a company to come in and provide the produce people want that others are not flexible enough to provide.
I think the idea of having an ample supply of each product, at a reasonable cost, on a regular basis, is good reason enough to justify farm subsidies. I think the idea of having a respectable government, free from false and malicious attacks, is a good enough reason to justify limits on the press.
Oh wait. First Amendment getting in the way? Well, the Tenth Amendment gets in the way of farm subsidies.:-)
I said negotiating prices CAN result in HIGHER prices. Not that not-doing it would result in lower prices. In practice, medicare-negotiated fees define the fees charged all other payers. Not really.
ie: insurance companies will generally refuse to pay more than medicare for equivalent services, so if the provider wants to get paid, they take whatever medicare offers. Yes. But not everyone gets their drugs through insurance companies. I don't have to care because I have a copay for my drugs. I pay the same regardless. But many people do not get their drugs through insurance.
Drug costs, like CD costs, are not in the production of the actual pill but in the nebulous research, development and failed projects that preceded the actual pill, so drug companies do have an enormous amount of flexibility in pricing without going broke Yes, and they also want to recoup those costs, so when you have artificial price controls like this, then you will see them trying to recoup those costs in other ways.
Of course, what is most likely is that a company with exclusive rights to a drug will not lower their cost to Medicare in any significant way if it means they will also see insurance companies mandating the same price.
I don't care. The government has no right to use force on the individual for his own good. By this same logic, government can force us to watch PBS and listen to NPR, because this helps the whole, which helps the individual. Also, get rid of all private schools and homeschooling, because this helps public schools, which helps the whole, which helps the individual. This is not the government's job, ESPECIALLY not the federal government's job. No force involved, we are taking about free access. Well, no. First, I was talking about forcing ME to PAY for it. That absolutely is force. Second, the logic was "if it is good for society, it is good for the individual, so we can force society into it for the individual's own good," which absolutely does extend to the things I mentioned.
Third, the ultimate goal of most universal health care plans -- including Hillary's, I believe, given her previous plan and many statements about it, including her current plan's mandates -- absoultely IS force. It is about forcing everyone into the system, not merely providing access to everyone.
It can be the governments job to provide free access to PBS, NPR, public school and health care because that helps the whole. Not the federal government, no, it can't be, because the Tenth Amendment to the Constitution prohibits it.
Free access to a minimum standard of living that allows people to focus on a meaningful participation in the society (instead of a focus on obtaining food, safety, shelter, education or health) should be the goal of democratic government that espouses liberty for all. No, it should not. Those things have nothing to do with promoting either liberty or democracy. And to the extent it represents the democratic will of the people, it does so at the COST of the liberty of the minority that disagrees, which is why -- as per Federalist 10 -- we have a republic, and not a democracy.
Yes, because of the obvious problems in PAYING for it. I see the problem as paying the salaries and dividends of the people who work for and own stock in MY INSURANCE COMPANY. Take themout of the loop and my health care will be a lot less expensive. Yes. I am not arguing in favor of the current system. The insurance companies of today are a HUGE part of the problem. But acknowledging this does not imply "the government should do it."
Medicare negotiating lower drug prices causes INCREASED prices for those not on Medicare What if Medicare covered everyone, young and old, rich and poor? That was not the point of what I said. Novick said he wanted MEDICARE, as it stands now, to negotiate lower drug prices. And I was just pointing out the fact that this very well could increase costs for everyone else.
We can't just dump everyone into Medicare, as the system can't handle it. It is not designed as a comprehensive, universal, system of care. So let's not talk about a hypothetical that won't happen.
patent terms should be tailored to provide the MINIMUM rights necessary to accomplish that goal. Twenty years isn't that long a time. I only wish copyrights were as short. Well, I disagree. Twenty years is a very long time, especially where those drugs' development was subsidized by our tax dollars. But even where not, the whole point of patent terms is to encourage development, and therefore, they should be narrowly tailored for that goal alone. And twenty years is just too long, most of the time.
Further, however, the government often EXTENDS those patent terms arbitrarily. Including when tax dollars paid for it!
I couldn't agree more with you on subsidies (as well as about everything else in your post I didn't argue with). If the government subsidizes a drug, that drug should not have a patent. And we shouldn't subsidise farmers. I say that as a citizen of a farming state, too! You'll never get elected, then.:-)
That's the thing about health care - there's no way the free market can work. That's self-evidently false, since the free market DID work in health care for many, many years. It's only in the last couple of decades that it has been failing, and that is largely because it has become LESS of a free market.
It's not about forcing "you" to serve "me" dinner. It's about society as a whole taking care of it's less fortunate members. It is not their RIGHT to be taken care of.
By doing so we provide a benefit for society as a whole. Fine. Say it is a good thing. Say you want to do it. But don't call it a right. It isn't.
Daycare assistance enables more people to be productive members of the workforce. That in turn helps us to remain competitive in the global economy. Ditto for student financial aid -- an educated workforce is the only way that we will remain competitive (Wal-Mart and McDonalds aren't gonna do it). And those are not rights, either.
A right is something that must be provided to you, or cannot be taken from you, unless you give up that right somehow, or there is some sort of compelling state interest (such as suspending habeas corpus during times of invasion or rebellion). The right to free speech, the right to keep and bear arms, the right to due process, the right against unwarranted search and seizure, the right to vote, and so on. All of these things either the government must provide to you (due process), or cannot be taken from you (free speech, arms), or both (depending on how you look at it).
Health care... that obviously, in this context, is not something we are talking about people providing for themselves (although that too is, separately, an issue: choosing which drugs to administer, legal suicide, and so on). Here we are discussing something the government must provide TO you, if it is to be a right. And if the government provides it to you, that means I, and every other member of society, are therefore obligated to provide it, since we are the government.
So if you're going to invent a new right, that obligates us to provide something to every citizen, dammit, you better get us -- the whole of society -- to generally AGREE that it actually is a right. Because one thing you have no right to do is to obligate society to recognize a new right without the just consent of that society.
I think our economy will be MUCH better off without government involvement The historical record and recent events suggest otherwise. I don't agree with either assertion. From now and way back even to the Depression, it was government involvement that helped CAUSE all of our problems. Whether it is government literally encouraging high-risk home loans in the last decade or so, or Hoover's progressive economic policies that rejected Coolidge's laissez-faire conservatism, we've never had serious economic problems where government involvement was NOT a part of the problem.
I am the type of conservative who puts principles of small government and liberty ahead of principles of actively helping the economy Liberty != watching your child/sibling/spouse/parent/self die from a treatable disease because of your unfavorable socio-economic standing. Correct, that is not liberty. It is an unrelated thing, so I am not sure why you bring it up at all.
And why is health care any less of a right then living without fear of violence Um. Because the former you control, the latter you rely on others for. If you mean without THREAT of violence, and not FEAR, well, no, that is not a right at all. However, the federal government is obligated to help protect us, because that is what we agreed to in the Constitution. We further agreed that the federal government would NOT be allowed to do things like health care.
Is dying from a treatable disease because you can't afford treatment somehow better then being murdered during an armed robbery? Both should outrage us and serve as motivation to do better. It is illogical to say "here is a problem" and conclude "therefore the government is the solution." Yes, I am motivated to fix our health care problems. But not through increased government control or regulation.
that means I have to provide it No, that means society has to provide it. That is a distinction without a difference.
Unless you think that you've gained no benefit from society (are you good at chasing wildebeests on the plains of the Serengeti?) then I honestly can't understand the aversion to giving something back. It's not about not wanting to give back. This is another illogical argument. It is about what the proper role of government is.
This is not what the Constitution stands for. The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; Yes, and? Every student of the Constitution knows that "common defence and general welfare" is not a blanket grant of authority to do anything that falls within those two things. If that were the case, then the government could do anything it wanted to do for the common defense. We have a Tenth Amendment that clearly states that unless the Constitution grants a power to the federal government -- explicitly, or implicitly e.g. via the "necessary and proper" clause -- then the federal government MAY NOT DO IT. Universal health care is unconstitutional.
Providing insurance to everyone is not the answer. Reducing the cost of health care is the answer. So that a procedure that once cost 10x what a poor family could afford is now only 5x what they can afford? Maybe. Or maybe it is exactly what a poor family can afford.
Unless you can really drop the cost That is the goal, yes.
it doesn't make any difference to the lowest income brackets. Why should we have universal health care just to make sure the people in the lowest income brackets can afford the most expensive treatments? Why not treat that as a unique problem, for the people who need help?
The real big problem is the lack of competition and choice that allows all kinds of health care providers -- from drugs to machines to hospitals -- to jack up the cost of health care. While that may work in theory, the problem with that idea is that it will very likely result in low and high quality care determined by wealth. Of course. How is this a problem? We have low and high quality food, housing, clothing, schooling, and everything else determined by wealth. I do not believe this is something for the government to "fix." I believe in liberty and private property, and I do not believe the government has any right whatsoever to try to make everyone have equal access to these things.
Anyway, an economy is most productive when its labor force is taken care of. What helps the individual helps the whole, which in turn helps the individual. I don't care. The government has no right to use force on the individual for his own good. By this same logic, government can force us to watch PBS and listen to NPR, because this helps the whole, which helps the individual. Also, get rid of all private schools and homeschooling, because this helps public schools, which helps the whole, which helps the individual.
This is not the government's job, ESPECIALLY not the federal government's job.
That the legislature blocked it is a good thing: universal health care does no one any good if everyone is broke. And what good is money if you're dead? Everyone dies without universal health care?
Wow, so, so wrong. False.
Now doing it on a national level would be better because it would be cheaper drugs for all. Um. Uh. No. Only for people who ARE IN THE MEDICARE PROGRAM. If you are not in Medicare, then you do not benefit from the lower prices that Medicare gets. If you are, you do.
See you at OSCON, asshole. Shrug. If you say so, dillweed.
You don't seem to understand this finance, don't seem to ahve any experience reviewing other countries mass drug purchase, and you certianly do not understand drug patents. Shrug. False on all counts.
There are countries with that philosophy, and exactly zero of them have ever produced anything new. False.
ideologically believe we SHOULD have government-provided universal health care, and try to shoehorn reality into that ideology, instead of addressing the actual problems of cost. Actually, the government is the only entity that can do it, regardless off the reform. False.
but our taxes will be significantly less What the fuck have you been smoking? significantly? really? Um. Yes. Food subidies are about 2.5% of the federal budget. On an income of $75K, that is about $250. Feel free to call that insignficant, but I don't.
your just fucking stupid and spouting off things based on ideology and not any actual knowledge. Your moran!
But not negotiating prices isn't going to lower prices for anybody. I never said that it would. I said negotiating prices CAN result in HIGHER prices. Not that not-doing it would result in lower prices.
Further, I agree that taxpayers should not be subsidizing drug companies' ads. I still find it fascinating that drug prices started skyrocketing when we allowed drug companies to advertise. You seem to think there is a link. What link is that?
Providing insurance to everyone is not the answer. Reducing the cost of health care is the answer. There doesn't seem to be any incentive to reduce cost. Exactly, because government regulation essentially protects medical businesses. For example, here in WA, health insurance is so tightly regulated that most insurance companies end up being the same. So there's a distinct lack of competition, and therefore no incentive to lower costs.
If we had less regulation and more competition, and gave consumers more control and choice, we would see cost cutting. Necessarily.
Increasing revenues when you have a fixed market means increasing costs. Exactly: and why do we have a fixed market? Primarily, it is because of government regulation.
At least if our healthcare system were funding by the taxpayers, there would be a political motivation to reduce costs. That is entirely backward. When it is funded by the taxpayers there is LESS incentive to reduce costs, because you never pay for ANYTHING out of your pocket.
I also absolutely disagree with federal school lunch standards. The federal government has no business of any kind in the local public schools. Period, end of story. For the poorest Americans, school lunches are the only real meal they get. So they get five squares a week. We should make sure they don't count. Your response has nothing to do with what I said.
I said the FEDERAL government has no business in the local public schools. Why do you think that I am therefore against school lunches? Since when is that a federal responsibility? Do you think state and local governments are incapable of doing this without federal involvement?
Providing insurance to everyone is not the answer. Reducing the cost of health care is the answer. And while you have some good ideas, it is only barely a start. Frankly, I think many people -- not sure if this includes you -- ideologically believe we SHOULD have government-provided universal health care, and try to shoehorn reality into that ideology, instead of addressing the actual problems of cost. Then again, the most expensive healthcare in the world is also the country where the government doesn't pay for it. Yes, mostly because of government regulation of the health care, and health insurance, industries that decrease competition and therefore drive up costs.
We do not have a true private, free market, system now. We should.
Stop the war against the middle east and we will have enough money to pay for healthcare for every american and triple the budget for NASA and all science foundations. First, I reiterate the fact that federal spending on health care for Americans in general is unconstitutional.
Second, your estimate of costs is not true. Edwards estimated his plan was $120b for the first year. And that is a LOW estimate. Truly universal coverage will cost more per year than the war, and, of course, will surely last much longer.
I've never understood why Conservatives are opposed to funding research. How many for-profit drug companies do you think would be willing to pour hundreds of millions of dollars into things like a vaccine for AIDS with no prospects of recouping that money for decades (if ever)? BILLIONS of dollars have been donated to AIDS research. Government clearly is not needed.
Furthermore, isn't funding scientific research (in any field, not just pharmaceuticals) usually a good thing for the economy in the long run? I am the type of conservative who puts principles of small government and liberty ahead of principles of actively helping the economy. Not that I am conceding the point: on the contrary, I think our economy will be MUCH better off without government involvement. But even if it weren't: the ends don't justify the means. Obviously, you do not believe the means is bad; but I do.
Frankly, I think many people -- not sure if this includes you -- ideologically believe we SHOULD have government-provided universal health care For me, I ideologically believe that health care is a right of everyone It can't be, from my perspective. If it is your right, that means I have to provide it. This is not what the Constitution stands for.
instead of addressing the actual problems of cost. I don't see why one (addressing the problems of cost) precludes the other (making sure everyone has access to health care). Cost is THE most important factor, bar none, in making sure people do have access to health care. You cannot address the latter without addressing the former; instead, you'll just be shifting the burden to people you choose to deem "more able" to pay for it.
Novick had some decent ideas for addressing cost, but I don't think it goes NEARLY far enough to make a serious dent.
you never got around to explaining why it would cost more money other than to assert that it would cost more money False.
Now you've hijacked this discussion, again. Yes, to an extremist, someone who disagrees WOULD be viewed as "hijacking the discussion." However, to rational people, it is merely giving an opinion.
And please, stay out of OSCON. We here in Portland don't want you here. Go work for Microsoft or Google, instead, where they would agree with your market-based and Enron-like non-solutions for everything. Yawn. I was at the very first OSCON. Including before it was OSCON. I've spoken there many times. I was on the papers committee one year. I was given an award by O'Reilly at OSCON. I've been writing open source software and contributing to many open source projects for more than a decade. If you really want to attempt to impugn my "open source" credibility, be my guest. It will only make you look that much more foolish.
I would suggest that Oregon's attempt at universal health care never got off the ground because major portions of it were blocked by the Republican-controlled legislature.
Yes, because of the obvious problems in PAYING for it. That the legislature blocked it is a good thing: universal health care does no one any good if everyone is broke. The proposed system was literally incapable of sustaining itself.
I think that experience underscores the need for us to address health care reform at a national level. The path our health care system is on is clearly unsustainable, with exploding costs and declining coverage. I think there are several comprehensive plans out there to ensure everyone has affordable health care, while tackling the cost of care.
None I've seen. All of them only discussed more regulation, and direct cost controls, to control costs, which either wouldn't work, or would only work in the short term, increasing costs and decreasing care in the long term (which always happens when you remove competition).
I see several problems. First, Medicare negotiating lower drug prices causes INCREASED prices for those not on Medicare. This will be a big hit to middle class and poor families. I agree with this in principle, but see no way around it harming others. The middle class especially is already subsidizing drugs to Canada and other countries; now they would be subsidizing drugs to Medicare recipients.
This does not actually reduce national costs, it just shifts them, from the taxpayer to the drug consumer, which seems to me to be the wrong direction that most Democrats who favor universal health care want to go.
I also absolutely disagree with federal school lunch standards. The federal government has no business of any kind in the local public schools. Period, end of story.
As to hospitals, similar story: the federal government should not be paying for this equipment, or restricting its purchase.
However, I ABSOLUTELY agree that we need to reform the drug patent system. Thanks for highlighting that. I don't believe government should be in the business of handing out monopolies JUST FOR THE SAKE of handing out monopolies. The Constitution is clear: the point of a patent is to encourage innovation. It is only worthwhile to the extent it does that, and patent terms should be tailored to provide the MINIMUM rights necessary to accomplish that goal.
Further, I agree that taxpayers should not be subsidizing drug companies' ads. Indeed, we should not be subsidizing drug companies at all, including money for research. This ties into the patent issue because we pay them to do research and then give them a patent, too! Any research we DO subsidize should be public domain.
Which brings me to farm subsidies: no, we should cut all of them. We do not need them. Yes, the cost of food may rise, but our taxes will be significantly less (assuming the government doesn't spend that money on something else... ha!), and individual states can increase food aid to needy families if necessary.
But all this put together will only begin to address the cost problems. The real big problem (other than tort reform, which is not a big issue for some, but a huge issue for others) is the lack of competition and choice that allows all kinds of health care providers -- from drugs to machines to hospitals -- to jack up the cost of health care. It's very similar to the patent issue. That is what government should be working on: finding ways to introduce more competition.
Providing insurance to everyone is not the answer. Reducing the cost of health care is the answer. And while you have some good ideas, it is only barely a start. Frankly, I think many people -- not sure if this inclu
That was the whole point of the discussion I started. You need it to establish that we need to follow your government intervention philosophy. No, in fact, I do not have to do any such thing. In fact, I could have had a totally arbitrary basis for what government should do, as you do. 1) If you don't like arbitrariness, then you should defend your philosophy as not arbitrary if it's to undermine mine. See, that's the thing: someone can complain about arbitrariness, but YOU are not that someone, since YOUR philosophy is totally arbitrary.
2) If you think my philosophy is arbitrary and you don't like arbitrariness, then you should continue down that argument. There's nothing to argue. It's self-evident (if we take as given that you exist, and that you have the philosophy you've been espousing). Your philosophy has no basis other than, at root, "I think it should be this way, therefore it should be this way."
I would say to most rational people, "you can't disagree with this obviously true statement," but as you have a history of disagreeing with obviously true statements, I won't bother.
That was the whole point of the discussion I started. You need it to establish that we need to follow your government intervention philosophy. No, in fact, I do not have to do any such thing. In fact, I could have had a totally arbitrary basis for what government should do, as you do.
Slashdot Mirror
"First, Medicare negotiating lower drug prices causes INCREASED prices for those not on Medicare."
Now you say:
"I said negotiating prices CAN result in HIGHER prices. "
Make up your mind. Um. Those are not in disagreement. Running causes weight loss. That doesn't mean I will lose weight every time I run. you've managed to offer no support for any of your claims False. made blanket statements that are not rooted in logic or reality Also false. and generally have made an ass of yourself Yes, by bothering to respond to people like you. I hope you didn't make any actual points in the rest of your post, because I never got that far. *plonk*
I am a textualist, or originalist, not a strict constructionist. My feeling is that the Constitution is held as sacred by so many people, when it is clear to me that a strict interpretation of the Constitution has failed, because we have failed to change the Constitution with the times That is ENTIRELY beside the point of how to interpret the Constitution. If the Constitution has failed, fine, change it. If we've failed to change it, fine, change it. The world is remarkably different than it was 220 years ago, and some of the political theories that were new and popular at the time don't fit in with today's world. Due to advances in communication, etc, there are economies of scale unrealizable 30 years ago, let alone 220 years ago. If you want to literally follow the words written 220 years ago, you should think about what they envisioned as an ideal society, and whether that notion of an ideal society really fits in with what is desired now, and if it is even attainable. My interpretation philosophy literally has no serious problems whatsoever, because if there's something you don't like, you can always change it.
Your philosophy -- which sounds much like the one expressed by Justice Breyer in his book "Active Liberty" -- is deeply flawed. It literally destroys the whole concept of self-governance. We decide what the law is, as a people, and then judges come in and flush it down the toilet. And worse, it does not respect ANY rights. The Declaration of Independence says we have certain unalienable rights. Some of these were codified in the Constitution. Your philosophy denies that these rights even exist: the only standard for a law is whether that law promotes your idea of an "ideal society." But there is only one definition of an "ideal society" that matters: the one the people have agreed on (and are fully capable of amending).
And here's the rub: if you want to ignore the Constitution without officially amending it, you are facially subverting your own argument. "What is desired now" is, necessarily, what the people want. But the people have not seen fit to give anyone the power to ignore the Constitution without amending it. The government exists to secure our rights, deriving its just powers from the consent of the governed; your philosophy claims that the government exists not to secure our rights, but to force upon us some society that YOU desire, regardless of what we desire or whether we've given consent.
I LOVED that episode. :-)
Which is why such a system needs to be a national system.
No. It shows how such a thing doesn't scale.
Then isn't it odd that we spend more per capita than any other industrialized country, cover a far smaller proportion of the population, and get no better results in terms of health care delivered?
Yes, which is why we need to REDUCE regulation and cost controls so we can spend less to provide more.
Making sure that all kids are able to get lunch, regardless of the current state of affairs/budgets in the local town/state does seem to be pretty awful meddling.
I think the fact that anyone thinks so poorly of the state legislatures that they believe those legislatures incapable of handling school lunches on their own is pretty damned awful, myself. It's one of the worst kinds of meddling. It's insidious. It seems so nice and good -- hey, who doesn't agree kids should eat healthy lunches? -- but it inherently assumes what is obviously false: the states need, or want, federal assistance. There has never once been a state incapable of defining standards, or providing the lunches. Ever.
It's nanny-statism at its worse, precisely BECAUSE it seems like such an obvious thing, because if it is so obvious, then why does the federal government need to be involved? And the answer is because people WANT the federal government involved, for the sake of CONTROL.
I reiterate: this is pretty damned awful.
Here I have a different philosophy. I have a hard time figuring out how you can make free market solutions work in the health insurance system.
I do not care about the health insurance system. The goal should be fixing the health care system. Health insurance should follow the discussion, not lead it. And the answer is essentially: reduce government regulation, increase competition and choice, reduce costs. When costs lower, people DO NOT NEED to care much about insurance except for expensive or catastrophic care, and if an uninsured person cannot pay for expensive or catastrophic treatment, then we have charities to handle this. If states want to try to cover expensive care for the needy, maybe we can discuss that, but there's no need for a whole universal/comprehensive system just to solve the one problem of relatively rare high-end procedures for poor people, if we reduce other costs across the board.
As a purchaser, you generally have very few options since health care is tied to your employer
Exactly. Which is why we should deregulate to allow more options.
as a layperson, you are not in a very good position to know what different kinds of health care are worth, and therefore important to have as covered options
Exactly. We should focus on providing more options and choices and information to the consumers.
To me, we should be aiming to make health care a universally available thing, unrelated to your employer, current financial standing, or health
To me, this is an utterly terrible thing.
That means that insurance needs to be 1. community rated (insurance companies forced to cover everyone at a similar rate)
Meaning that health care costs will remain high, and we will have fewer insurance options, which means insurance will cost even more.
2. not provided by employers
Well, not essentially FORCED to be provided by employers.
3. universally mandated
Absolutely not. This is evil, with a capital E. Never before in our country have we ever forced anyone to pay any money just for being alive. This would be a first. It is hard to imagine a greater affront to liberty than what amounts to a tax on being alive.
(otherwise healthy people will opt-out until they get sick)
The affront to liberty caused by mandates is much more important than this logistical problem with your health care plan, that I disl
Oh wait. First Amendment getting in the way? Well, the Tenth Amendment gets in the way of farm subsidies.
Of course, what is most likely is that a company with exclusive rights to a drug will not lower their cost to Medicare in any significant way if it means they will also see insurance companies mandating the same price.
Third, the ultimate goal of most universal health care plans -- including Hillary's, I believe, given her previous plan and many statements about it, including her current plan's mandates -- absoultely IS force. It is about forcing everyone into the system, not merely providing access to everyone. It can be the governments job to provide free access to PBS, NPR, public school and health care because that helps the whole. Not the federal government, no, it can't be, because the Tenth Amendment to the Constitution prohibits it. Free access to a minimum standard of living that allows people to focus on a meaningful participation in the society (instead of a focus on obtaining food, safety, shelter, education or health) should be the goal of democratic government that espouses liberty for all. No, it should not. Those things have nothing to do with promoting either liberty or democracy. And to the extent it represents the democratic will of the people, it does so at the COST of the liberty of the minority that disagrees, which is why -- as per Federalist 10 -- we have a republic, and not a democracy.
We can't just dump everyone into Medicare, as the system can't handle it. It is not designed as a comprehensive, universal, system of care. So let's not talk about a hypothetical that won't happen. patent terms should be tailored to provide the MINIMUM rights necessary to accomplish that goal. Twenty years isn't that long a time. I only wish copyrights were as short. Well, I disagree. Twenty years is a very long time, especially where those drugs' development was subsidized by our tax dollars. But even where not, the whole point of patent terms is to encourage development, and therefore, they should be narrowly tailored for that goal alone. And twenty years is just too long, most of the time.
Further, however, the government often EXTENDS those patent terms arbitrarily. Including when tax dollars paid for it! I couldn't agree more with you on subsidies (as well as about everything else in your post I didn't argue with). If the government subsidizes a drug, that drug should not have a patent. And we shouldn't subsidise farmers. I say that as a citizen of a farming state, too! You'll never get elected, then.
A right is something that must be provided to you, or cannot be taken from you, unless you give up that right somehow, or there is some sort of compelling state interest (such as suspending habeas corpus during times of invasion or rebellion). The right to free speech, the right to keep and bear arms, the right to due process, the right against unwarranted search and seizure, the right to vote, and so on. All of these things either the government must provide to you (due process), or cannot be taken from you (free speech, arms), or both (depending on how you look at it).
Health care
So if you're going to invent a new right, that obligates us to provide something to every citizen, dammit, you better get us -- the whole of society -- to generally AGREE that it actually is a right. Because one thing you have no right to do is to obligate society to recognize a new right without the just consent of that society.
This is not the government's job, ESPECIALLY not the federal government's job.
Huh. I didn't know that!
If we had less regulation and more competition, and gave consumers more control and choice, we would see cost cutting. Necessarily. Increasing revenues when you have a fixed market means increasing costs. Exactly: and why do we have a fixed market? Primarily, it is because of government regulation. At least if our healthcare system were funding by the taxpayers, there would be a political motivation to reduce costs. That is entirely backward. When it is funded by the taxpayers there is LESS incentive to reduce costs, because you never pay for ANYTHING out of your pocket.
I said the FEDERAL government has no business in the local public schools. Why do you think that I am therefore against school lunches? Since when is that a federal responsibility? Do you think state and local governments are incapable of doing this without federal involvement? Providing insurance to everyone is not the answer. Reducing the cost of health care is the answer. And while you have some good ideas, it is only barely a start. Frankly, I think many people -- not sure if this includes you -- ideologically believe we SHOULD have government-provided universal health care, and try to shoehorn reality into that ideology, instead of addressing the actual problems of cost. Then again, the most expensive healthcare in the world is also the country where the government doesn't pay for it. Yes, mostly because of government regulation of the health care, and health insurance, industries that decrease competition and therefore drive up costs.
We do not have a true private, free market, system now. We should.
Second, your estimate of costs is not true. Edwards estimated his plan was $120b for the first year. And that is a LOW estimate. Truly universal coverage will cost more per year than the war, and, of course, will surely last much longer.
Novick had some decent ideas for addressing cost, but I don't think it goes NEARLY far enough to make a serious dent.
I would suggest that Oregon's attempt at universal health care never got off the ground because major portions of it were blocked by the Republican-controlled legislature.
Yes, because of the obvious problems in PAYING for it. That the legislature blocked it is a good thing: universal health care does no one any good if everyone is broke. The proposed system was literally incapable of sustaining itself.
I think that experience underscores the need for us to address health care reform at a national level. The path our health care system is on is clearly unsustainable, with exploding costs and declining coverage. I think there are several comprehensive plans out there to ensure everyone has affordable health care, while tackling the cost of care.
None I've seen. All of them only discussed more regulation, and direct cost controls, to control costs, which either wouldn't work, or would only work in the short term, increasing costs and decreasing care in the long term (which always happens when you remove competition).
Here's a fuller explanation of what I think that will take and several measures we need to take to control costs.
I see several problems. First, Medicare negotiating lower drug prices causes INCREASED prices for those not on Medicare. This will be a big hit to middle class and poor families. I agree with this in principle, but see no way around it harming others. The middle class especially is already subsidizing drugs to Canada and other countries; now they would be subsidizing drugs to Medicare recipients.
... ha!), and individual states can increase food aid to needy families if necessary.
This does not actually reduce national costs, it just shifts them, from the taxpayer to the drug consumer, which seems to me to be the wrong direction that most Democrats who favor universal health care want to go.
I also absolutely disagree with federal school lunch standards. The federal government has no business of any kind in the local public schools. Period, end of story.
As to hospitals, similar story: the federal government should not be paying for this equipment, or restricting its purchase.
However, I ABSOLUTELY agree that we need to reform the drug patent system. Thanks for highlighting that. I don't believe government should be in the business of handing out monopolies JUST FOR THE SAKE of handing out monopolies. The Constitution is clear: the point of a patent is to encourage innovation. It is only worthwhile to the extent it does that, and patent terms should be tailored to provide the MINIMUM rights necessary to accomplish that goal.
Further, I agree that taxpayers should not be subsidizing drug companies' ads. Indeed, we should not be subsidizing drug companies at all, including money for research. This ties into the patent issue because we pay them to do research and then give them a patent, too! Any research we DO subsidize should be public domain.
Which brings me to farm subsidies: no, we should cut all of them. We do not need them. Yes, the cost of food may rise, but our taxes will be significantly less (assuming the government doesn't spend that money on something else
But all this put together will only begin to address the cost problems. The real big problem (other than tort reform, which is not a big issue for some, but a huge issue for others) is the lack of competition and choice that allows all kinds of health care providers -- from drugs to machines to hospitals -- to jack up the cost of health care. It's very similar to the patent issue. That is what government should be working on: finding ways to introduce more competition.
Providing insurance to everyone is not the answer. Reducing the cost of health care is the answer. And while you have some good ideas, it is only barely a start. Frankly, I think many people -- not sure if this inclu
I would say to most rational people, "you can't disagree with this obviously true statement," but as you have a history of disagreeing with obviously true statements, I won't bother.