Medicareless

Brian Doherty | March 17, 2005

In case you've forgotten amid all this "reform Social Security" hubbub, Medicare is in even more trouble, and sooner. USA Today does a quick survey of the grim landscape:

The National Health program for Americans 65 and older faces all the demographic difficulties that have made Social Security the president's No. 1 domestic priority: aging baby boomers, fewer workers paying taxes in the future, and a system that will soon be unable to deliver on its promises. Social Security's fiscal problems escalate in about 2018, when it is projected to begin paying out more in benefits than it receives in taxes; Medicare reached that milestone last year.
......
The daunting job of fixing the seniors' health care program was underscored last month by Federal Reserve Chairman Alan Greenspan, who told a Senate panel that Medicare is "several multiples more difficult than is Social Security."
......
"Social Security is solvable," says Sen. Lindsey Graham, R-S.C., who's trying to bring together Republicans and Democrats for a plan that includes new private investment accounts. "I just don't know how to do Medicare."

More than 41 million Americans depend on Medicare to pay for doctors' visits and hospital bills. Beginning next year, it will cover part of their prescription-drug bills as well. The program's $325 billion cost is dwarfed by the $517 billion spent on Social Security. But Medicare is projected to grow by 9% a year through 2015, while Social Security's annual growth rate is estimated at 5.6%.

The article, worth reading in its entirety, goes on to briefly discuss some possible cost-cutting measures, and explain why they are all more or less politically impossible right now. Oh well, like all things that can't go on forever, this system will inevitably stop. How, when, and what will replace it, as the cliched news anchors say, remains to be seen--though a shift away from so much third party payment, and its concomitant cost explosion, is doubtless inevitable, somehow, someway.

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|3.17.05 @ 3:06PM|#

Medicare reform will be tackled as part of a comprehensive health care reform that will happen soon as costs continue to skyrocket and more and more people lose coverage. It will be changed as a universal health care model is proposed and implemented at some point in the next 10 years. Probably after the 2008 election when the Democrats will come to power partially on this issue due to the increasing health care crisis.

|3.17.05 @ 3:09PM|#

I don't know, truth, the line "do you want your health care decisions made by bureaucrats" is a pretty powerful argument for somebody enjoying the free market glories of an HMO.

|3.17.05 @ 3:16PM|#

truth:I shutter at the thoughts of what kind of medical system Hilliary Clinton will put us under.Medicare is in trouble no doubt! But rather than a new system maye the answer is to figure out why it is in trouble. One thing is the scams by med professionals. Another is current tort laws. For example I am being scheduled for some high priced heart tests. The doc admitted that although he believed the tests were needed he wanted to be sure that they were done so if I croaked my wife wouldn't have a law suit against him. Now, I understand that logic and appreciate his candor. But, how many tests are run and billed to medicare that are only becuase of this reason. ( I am not under medicare, I have a HMO that is pretty damn particular in what they will pay for.)

It will be changed as a universal health care model is proposed and implemented at some point in the next 10 years.

And the gov't's track record on this issue is so good, isn't it?

Oh, wait, I just noticed you didn't actually say they'd solve anything, they'll just pass another law.

MP|3.17.05 @ 3:19PM|#

While people may whine about HMOs, believing that government management will be superior to HMO management is a hallucination worthy of Timothy Leary.

|3.17.05 @ 3:21PM|#

As much as libertine-arians may hate to admit it, people need to get healthier. This may have to be done by increasing no smoking laws and taxing juck food. It seems so anti-liberty, but the fact is, many people are too stupid to take good care of themselves and they really do need to be forced to live healthfully. I agree, a person with means should be able to do whatever he likes, assuming he can pay for his medical bills. The reality is that the poorest people live the least healthy lifestyles, as a rule, and we're all going to be paying for their bad decisions unless we force them to make better ones (via taxes and laws).

|3.17.05 @ 3:25PM|#

That's an odd thing to say, MP, since people in Medicare report higher rates of satisfaction than people with private insurance, and people in VA hospitals - government-owned and opperated hospitals staffed by government employees - report higher satisfaction than people in private hospitals.

No no, joe, that can't possibly be true. Everything the government does is inferior to the private sector. In the name of Reagan, Rand, and the Invisible Hand Amen.

Well, sorry. http://www.slate.com/id/2114554

Vache Folle|3.17.05 @ 3:30PM|#

Andy wrote:

"As much as libertine-arians may hate to admit it, people need to get healthier. This may have to be done by increasing no smoking laws and taxing juck food. It seems so anti-liberty, but the fact is, many people are too stupid to take good care of themselves and they really do need to be forced to live healthfully."

Wouldn't that just exacerbate the problem with Medicare and SS? If we discourage smoking, alcohol abuse, gluttony and sloth, people might live longer and drain the system. More alcohol, tobacco, firearms, etc. will help people live happier albeit shorter lives and reduce the burden on Medicare and SS.

|3.17.05 @ 3:31PM|#

reagan, rand and the invisible hand is hilarious.

beyond that, we're fucked.

|3.17.05 @ 3:35PM|#

"....enjoying the free market glories of an HMO."

"Free Market" HMO's? Was that supposed to be joke, joe?

|3.17.05 @ 3:36PM|#

don't forget medicaid either...

http://www.wachovia.com/ws/econ/view/0,,2349,00.pdf

AP: The Senate voted 52-48 to strip all proposed Medicaid cuts from next year's budget, killing the heart of the plan's deficit reduction and dealing a setback to Bush.

http://www.bloomberg.com/apps/news?pid=10000103&sid=av0O6QCEOyLM

|3.17.05 @ 3:37PM|#

I think corporations would love to unload the costs of providing health insurance onto the federal gubmit. I wonder what's taking so long?

Morat|3.17.05 @ 3:37PM|#

You know, the "Universal Health Care will make you wait a year for your CAT Scan like in Canada" line just doesn't really scare you after noting that, sure enough, HMO's make you wait that long -- or longer -- already.

You might as well make your peace with it. Universal health care is coming. Save up and buy the nice private add-ons the free market is bound to throw up if you don't like it.

There's no stopping, especially once business gets behind it. Healthcare is a major outlay for businesses, and they're stuck competeing with foreign firms that -- you guessed it -- don't have to pay for healthcare.

It can't be any frickin' worse than Aetna, that's for sure.

|3.17.05 @ 3:38PM|#

Has any persons or organizations actually done a study on the projected cost of nationalized catastrophic health insurance mixed with directly paid fee-for-services versus the cost of the current system of partially socialized, partially privatized, employer partly-provided HMO, PPO clusterfuck of a system?

Also, regarding Joe's link, I wonder what the cost per patient at the VA is versus at a private hospital. I'll admit to being surprised at the story - most vets I've talked to loathed the VA.

|3.17.05 @ 3:40PM|#

Vache folle, the problem with your theory is that the reduction in lifespan from unhealthy lifestyle doesn't work out to having the same working life, followed by a shorter retirement. The 20 years taken of an obese, alcoholic smoker's life could just as well mean he's forced into retirement by 45, and is a patient for 10 years. His health care costs are going to be higher than the average for each year of his working life, and his working life is likely to be shorter.

|3.17.05 @ 3:45PM|#

"Wouldn't that just exacerbate the problem with Medicare and SS? If we discourage smoking, alcohol abuse, gluttony and sloth, people might live longer and drain the system. More alcohol, tobacco, firearms, etc. will help people live happier albeit shorter lives and reduce the burden on Medicare and SS."

Hard to say. I think that, all things considered, the longer people are alive and healthy the more productivity a society has. I'm not sure the per capita spending on health care would be reduced in your scenario, but productivity certainly would. People would just die at 66 in bad shape after having been sick for years, whereas in my situation they die at 96 after being sick a few years, but having produced a lot more.

Weather or not the private sector will produce more efficient coverage on average is irrelevant. Health coverage is and should be a right and therefore must be universally available. Surely you wouldn't accept an argument such as "private security companies provide more efficient and better protection" as reason to dissolve the police. Libertarians spend so much time pointing out when the state steps beyond its bounds that we forget there are areas the government legitimately (even from a libertarian perspective) should be involved in.

joe, I don't doubt that Medicare satisfies a lot of its customers. Spending without regard to economic realities usually does satisfy the recipients.

The problem is that it can't continue forever.

|3.17.05 @ 3:46PM|#

Thank you Joe for saying that much more concisely than I.

MP|3.17.05 @ 3:52PM|#

Yeah, people love the quality of service at the town run nursing home where I live. They say it is superior to all of the other facilities in the area. Too bad the labor costs are 25% more than the other facilities and that there has been hardly any investment in capital improvements over the last 20 years...to the extent that now the solution is tear down and build a new facility.

Management is not simply about making people feel as though you are doing a good job. Cost control is a key factor when evaluating management competence.

|3.17.05 @ 3:54PM|#

You might as well make your peace with it. Universal health care is coming.

There's no stopping, especially once business gets behind it.

You're probably right. GM is on the verge of Chapter 11, and its major expense is healthcare. Something like 2 retirees receiving benefits for every current employee.

That sounds like an incentive for a govt takeover. The Repuglikans will vote to help the shareholders and the Dimmycraps will vote to help the workers (and the shareholders too, they just won't admit it).

Ah, the smell of bipartisanSHIT.

|3.17.05 @ 3:59PM|#

The problem is that it can't continue forever.

Of course it can, thoreau. We'll grow into it. joe said so. It'll work for Social Security too.

And all the kiddies will have ponies.

|3.17.05 @ 4:07PM|#

DAVID LEVY: '--health care should be a right--'
Says who and where and why? Any right to health care includes the right for you to pay for it--not society. It is bad enough that we pay out the nose for health insurance which actually subsidizes those who have made poor health choices over a lifetime, ie, smokers, over-endulgers of alcohol and drugs, and otherwisedangerous lifestyles. But, that is what insurance is all about, sharing the risks. But a right to medical care? Show it to me in the constitution. This sounds like some of John Kerry's propaganda. I suppose if a lie is told often enough it will become a fact?

|3.17.05 @ 4:16PM|#

Guyk, how would that be? Most people die from their bad choices after they've already reached the reproductive age and had a chance to bear children.

|3.17.05 @ 4:20PM|#

Another way of saying "health care should be a right" is "the field of medicine is best thought of, and achieves its greatest success as, a public service (like the military, police, or trash pickup), rather than as a for-profit service (like car washes or housepainting).

The basic moral idea here is that people's lives, health, well being, their bodily integrity, trump financial considerations. If you have a choice of Mary dying and John being a little wealthier, or Mary being saved and John being a little poorer, the ethically superior choice is obvious. Yeah, John can't get the leather seats. OTOH, Mary's kids will still have a mother. Not really that difficult.

The basic systemic argument is that the imbalance of power between the providers and consumers of medical services, the low level of knowledge patients have about the field of medicine, and the pshchological distress and gun-to-your-kids-head compulsion under which medical decisions are often made, prevent the provision of health services from being subject to the dynamics that keep making the price of VCRs go down.

Last week's issue of (Even) The New Republic contains a lengthy piece that makes this case far better than I ever could. It would be interesting to see Reason respond to that.

MP|3.17.05 @ 4:33PM|#

the ethically superior choice is obvious
I submit to you that it is not obvious, but that's a debate I don't really want to get into at this time.

Regardless, the systemic issues are a challenge, although I don't see universal coverage as being the panacea that solves this challenge.

Thanks for the tip on the TNR article.

Vache Folle|3.17.05 @ 4:35PM|#

Andy and Joe,

Thanks for considering my theory about encouraging life shortening choices as a solution to the Medicare/SS crisis. Your points about overall costs increasing are well taken; however, in the scenario with the fat smoker who becomes disabled at 45, wouldn't he and his employer bear the costs of his care and lower productivity? Also, even if per capita health care costs go up, these would not be socialized but would be borne by individuals and their employers and families. Finally, if someone retires at 65 and lives to be 95, but does no work, how can he be said to be "productive". I am not slamming old people (I'm just curious) other than, as Homer S. would say, "those mooching war widows".

|3.17.05 @ 4:47PM|#

Mike|3.17.05 @ 4:56PM|#

The problem is that it can't continue forever.

Of course it can, thoreau. We'll grow into it. joe said so. It'll work for Social Security too.

I thought the inexorable march of progress argument was the Libertarian side. "Don't worry about global warming, we'll invent some new tech that'll fix it!" "Don't worry about social security, invest in the never-a-down-decade stock market!"

|3.17.05 @ 4:57PM|#

"And both are pretty much nothing but unfounded assertions."

Uh, no, the former is a statement of values.

Only my statement is an assertion, and it's not unfounded.

|3.17.05 @ 4:58PM|#

There is only so much money to be spent on health care. It doesn't matter who the payor is. Sooner or later, you run into the situation where 100% of the economy is spent on health care, and then not a single additional cent can be spent. It doesn't matter that a new headache can be cured by a simple aspirin, because there are no more resources to spend on aspirin.

Currently, medical care is extending the lives of people who would have died years earlier. Unfortunately, extending the lives of the unhealthy is an exponential cost. Each additional increase in longevity is much more expensive than the previous increase. Adding 1 month to a sick person might cost just $10, and is easily afforded. But adding a second month is another $20, not $10. And the third month is $40. Pretty soon, we reach a point where the cost to extend life is impossibly expensive. At some point, we have to tell people they can't live forever. This will happen regardless of how health care is financed.

We need to make people aware that there is a limit to the amount of money that can be spent on health care. Once the limit is reached, you gonna die. It's cold, but it is reality.

|3.17.05 @ 5:09PM|#

joe

Repetition may emphasize, it does not prove.

Since when do your "values" bind me?

MP|3.17.05 @ 5:17PM|#

don't take the bait, joe

|3.17.05 @ 5:36PM|#

Another way of saying "getting plenty of good food should be a right" is "the field of agriculture is best thought of, and achieves its greatest success as, a public service (like the military, police, or trash pickup), rather than as a for-profit service (like car washes or housepainting).

Joseph Stalin

|3.17.05 @ 5:45PM|#

NOTHING is more important to our collective health and well-being than the food we eat, and yet we leave a great deal of this critical industry in the hands of CORPORATIONS exploiting the hungy for profit. And look where it's gotten us!!

It is time for the government to take over, and streamline, the oh-so important food delivery system in this country.

|3.17.05 @ 6:08PM|#

Not to spoil your fun Trey, but those are huge, politically-connected corportations that would likely not exist in a free market.

To an extent, government has taken over and "streamlined" the food market through billions in farm subsidies given to these corporations at the expense of smaller, non-politically connected farmers.

|3.17.05 @ 6:09PM|#

Joe-

Calling access to health care a "right" does nothing to resolve the cost or problems associated with health care. It may or may not be true, but its a moot point. The delivery of medical services is inherently a limited commodity. Simply calling it a "right" and saying everyone should be allocated health care equally does not make it so. Nor can health care be seperated from economic concerns - as long as health care cannot be provided for free and reasources are limited, there will always be an opportunity cost associated with the provision of health care, whether the payer is an employer, the government, or the individual. We could conceivably live in a world where everyone at any given time is provided the maximum level of health care conceivably poissible - but what would we have to give up to acheive that world? Probably a lot more than luxury goods and SUV's...

The question, then, is how best to allocate the limited resources to maximize both need and, presumably, equality. More important - how best to acheive the most efficient allocation of a scarce resource. One can endlessly debate if that should be government or the private sector, but saying health care should be liberated from economic factors basically means nothing.

|3.17.05 @ 6:23PM|#

andy: "The reality is that the poorest people live the least healthy lifestyles, as a rule, and we're all going to be paying for their bad decisions unless we force them to make better ones (via taxes and laws)."

A rather totalitarian sentiment. The problem is not that they make bad decisions; the problem is trying to force other people to pay for those "bad" decisions. And who decides what a "bad" decision is anyway? Are you so sure that all your decisions will stand up to my scrutiny? Maybe I should be able to force you to make better decisions in some aspect of your life.

|3.17.05 @ 6:32PM|#

Matt, it's not perfect, but the whole system is pretty private. Not private enough, of course, all those subsidies, etc. are bullshit!

Also, I was thinking more of the downstream end of the channel - restaurants and grocery stores.

I meant streamlining as in how our government tries to keep healthcare costs down by limiting our choices.

In the end, consumers rule when it comes to food; that's why we have more food than we know what to do with. If only we treated healthcare the same way.

|3.17.05 @ 6:33PM|#

dlc-

No the primary question is weather or not people have a right to health care. I don't think anyone thinks we have a right to DVD players therefore it would not be necessary for the government to create equality of DVD ownership even if only the richest could afford them. If there is no inherent right to health care then there is no need for equal access.

If on the other hand we do believe that everyone deserves health care then we need to deal with the issues of distribution. Even assuming such a right does not automatically mean socializing the system is the best solution but it does mean the state has a duty to affect some kind of solution. There would be no duty if the right didn't exist and therefore the issue of distribution (privatization or socialization or some mixture) presupposes the issue of rights.

Trey-

Actually food is a perfect example. I do believe that people have a right not to starve to death and yet this does not mean a government controlled system. In fact we leave food production and distribution to a largely free market (the subsidies are unfortunate) but the government still steps in with food stamps and other programs to insure that no one starves. If the number of people starving to death in this country was anywhere near the number of people dying for lack of adequate health care then I'm sure we'd have different opinions of the role of government in food production.

The point remains that deciding weather or not people have a right to health care precedes the issue of distribution and yet claiming that there is a right does not mean the answer to solving distribution is complete socialization.

|3.17.05 @ 7:11PM|#

"If you have a choice of Mary dying and John being a little wealthier, or Mary being saved and John being a little poorer, the ethically superior choice is obvious."

Yes, if you are John, the choice seems pretty obvious. If I can save Mary by giving up my leather seats, then of course I'll do it. Deciding to save someone by giving up something of yours is indeed noble and to be encouraged. Saving someone by taking from someone else is not so ethically clear to me (for the sake of proper attribution, I think it was Walter Williams that made the point: reaching into your own pocket to help someone is noble, reaching into someone else's is theft).

Comparing health care to defense or police or trash (which is privatized in my neighborhood) assumes the reason those are public goods is some inherent value in the service. That is not the case. The justification for making those public is some problem such as the difficulty in properly assessing costs to each individual and/or free-rider problems. Do I consume more defense or police protection than my neighbor? Perhaps, and to the extent we can make those distinctions in an efficient manner we should try to achieve a better fit between consumer and cost bearer. Such is the case with gas taxes as a proxy for road user fees. In these large scale activities no system is likely to be perfect, and in defense or police, it may be impossible to do at all (though if you support a progressive income tax you could make the case the more income you have the more you benefit from its defense but that's another issue). In the case of healthcare, however, there is no problem assessing the cost to the user. It is certainly unfair that perhaps Mary got cancer, but that is not an argument for forcing John to pay for it at gunpoint if he prefers not to.

The point is that something's value is not an argument for making it public. That argument needs to come from some failure of the market (and saying "I don't get as much health care as I'd like" doesn't count as a market failure - we'd all like more and better everything, but that is why markets exist, to allocate scarce resources in an efficient manner)

|3.17.05 @ 7:13PM|#

Trey:

I gotcha. I didn't mean to imply you supported subsidies.

David Levy:

Do I have a right to be left alone? Or does satisfaction of your needs (whether it be health care, food, education, et.) trumph my right to decide how to allocate my resources as I see fit?

|3.17.05 @ 7:22PM|#

Matt-

Unless you're an anarchist then no you don't have an absolute right to be left alone. The state has a right to force you to pay for certian services like military and police protection. The argument here is not weather or not such a category of services exist (at least I don't think anyone is arguing such a thing) but simply weather or not health care falls under that heading.

|3.17.05 @ 7:26PM|#

Some of the responses here remind me of why my Dad says, on occasion, that some Republican, and libertarians, are just plain selfish.

Make all the logical, Ayn Rand, "its my stuff I bought it" arguments you like. But humans have compassion, and we help each other. Spend a few years with no health insurance and get a serious illness, and you'll be wishing someone could help you.

This does not mean, neccesarily, that a huge, inefficient, poorly run system of socialized medicine is the answer to keeping people well. But leaving health care to the "free market" is not an effective way of providing coverage for all. Exhibit A: the vaccine shortage.

|3.17.05 @ 7:36PM|#

green: "...some Republican, and libertarians, are just plain selfish.

Make all the logical, Ayn Rand, "its my stuff I bought it" arguments you like. But humans have compassion, and we help each other."

I think selfishness knows no political bounds - plenty of selfish democrats around. As for compassion, yes, we do need it, but being compassionate is a personal decision. It isn't compassion when you take from someone who you deem is being insufficiently compassionate. We should encourage people to help others, but forcing them to at gunpoint is not the same thing, and is hardly compassionate.

|3.17.05 @ 7:52PM|#

Green: being selfish is not the point. Humans are compassionate and have a tendacy to give until it hurts. But, the same ones of us who will give until it hurts also get angry at forced income redistribution for any purpose. Taxes for security and infa-structure are neccessary. Taxes for income redistribution are legalized extortion.
Ask me to help someone and there is a good chance that I will comply. Put a gun to my head and try to force me to help someone and I will fight back.

MP|3.17.05 @ 8:30PM|#

The state has a right to force you to pay for certian services like military and police protection.
The state has no right (natural or otherwise) to do this. The state was granted the authority to do this by the citizenry.

You do not have a "right not to starve to death". What you do have is a natural right not to be forcefully deprived from the ability to be self-sufficient. Because food is in abudance in our society, we normally find it very discomforting when someone is reduced to such a level that they can't even feed themselves. Thus, there is a very high level of agreement across political boundaries that providing at least a minimal amount of welfare to keep someone from starving is a good thing. But this in no way implies a right. If someone were to come up to me and say "I don't want to work, but you must feed me anyhow", I wouldn't hesitate in telling them to f*ck off and feeling morally just in doing so.

It annoys me to no end to see the word "right" tossed around like so much verbal fodder.

|3.17.05 @ 8:40PM|#

David Levy-

I don't neccesarily disagree with you, but its still not the point. Even if every last person in the county agreed that a) health care was a "right" and b)government had a duty to find a solution, we'd still be arguing over the best methods to acheive the best outcomes (which you acknowledge in your response). Since this is basically what we are doing know, why have a spurrious argument over rights, which is a tricky enough issue in its own right? I think even a libertarian could acknowledge a 'right' to health care, and then say the best way for people to have this right protected is to [have the government] find market-based ways to improve the system.

Green-

The "vaccine shortage" is most certainly not Exhibit A. For one, there did not end up actually being a shortage and, even if there was to be one, it was largely a result of regulation.

http://www.boston.com/news/globe/health_science/articles/2005/02/09/us_flu_vaccines_shortage_ends_in_an_oversupply/

I particular like the quote about "what one would like to do is match supply and demand, and that's not possible under the current system." Well sure, the solution is called the MARKET. It works well for those tricky supply-demand problems.

|3.17.05 @ 8:45PM|#

MP-

Excuse me but I am in no way "tossing" the word around. You're the one confusing the notion of rights with popular consent. Your account of where a state derives its legitimacy is a half truth at best. Yes the citizenry grants a government the right to govern but the very act of governing is to trample on the wishes of others. If you only had government make laws upon which there is unanimous consent what would be the point. Therefore in addition to popular consent we require a notion of rights that determine when the coercive power of the government is legitimate. Democracy creates particular laws but rights determine the scope of possible laws.

|3.17.05 @ 8:53PM|#

dlc-

Based on some of the other posts I don't think there is much agreement as to the "right" hood of healt care. The argument is not spurious beceause it changes the nature of the means debate in a subtle but profound way. If you beleive that healt care is a right then you'll necesarily be willing to sacrifice efficiency for universality. If not, well then you won't be.

|3.18.05 @ 1:15AM|#

David Levy has a right to medical services. I may not block David's entrance to a clinic. Once inside the clinic, David must make arrangements with the staff to pay for medical services. If he is upset with the costs, he may not pull a gun and rob me to pay his medical bills. If he and a majority of voters choose to have the government take money from me at gunpoint to pay David's medical bills, then democracy has been committed.

David, you are not arguing for a right to medical services, your argument is for forcing someone else to pay your medical bills. You are selfish.

|3.18.05 @ 2:21AM|#

David-

What you don't get about this argument is the idea that efficiency is a quicker path to fairness than supposed "universality." Not all people need health care equally; and things that are free tend to be taken for granted. If health care is universal, it will become devalued and debased, leading to a wholly unequal and often unfair sitation. See Britian, Great for an example of a health care system that is universal and equal, but not fair.

|3.18.05 @ 3:35AM|#

"Excuse me but I am in no way "tossing" the word around. You're the one confusing the notion of rights with popular consent. Your account of where a state derives its legitimacy is a half truth at best. Yes the citizenry grants a government the right to govern but the very act of governing is to trample on the wishes of others. If you only had government make laws upon which there is unanimous consent what would be the point. Therefore in addition to popular consent we require a notion of rights that determine when the coercive power of the government is legitimate. Democracy creates particular laws but rights determine the scope of possible laws." -David Levy

Eeeeeeeeeeek! Mental overload! Must...Resist...Urge...To...Ague...Over...Definition...Of..."Rights"...

This is why after years of being a strong proponent of the Lockean/natural rights/libertarian school of thought, I now find myself drifting further and further into the David Friedman/utilitarian/anarcho-capitalist school of thought. You can talk for hours and hours about "rights", "democracy", "consent", "laws", etc., etc., etc.

Now I just tend to advocate limiting the scope of the state (and therefore increasing the scope of civil society) simply because history has shown that doing so tends to make the greatest percentage of people freer, healthier, happier, wealthier, etc., etc., etc.

|3.18.05 @ 4:14AM|#

"But leaving health care to the "free market" is not an effective way of providing coverage for all." -green

Green:

Sheeeesh...What you are asking for is not possible. Dlc [comment dated "March 17, 2005 06:09 PM"] already did far better job of explaining this than I could [tipping my hat to dlc]. Yes we would all love to have a health care system that is:

-100% fair
-Cheaper than dirt
-The highest quality
-etc...

But you can't make the sky purple by passing a law stating: "henceforth the sky shall be purple". Economics are bound by certain laws and forces (supply, demand, inflation, etc.) that are as immutable, unpredictable and uncontrollable as the laws and forces of nature (wind, gravity, the tides, etc.).

In order to make the laws of economics fit your wishes you would first need to control those central dynamic forces which drive and shape economies: Individual free will and human nature. I believe the word for this is "SLAVERY"...

Anonymous Proxy# 2260406737|3.18.05 @ 6:07AM|#

There can be only ONE valid long-term answer to Chairman Alan Greenspan Conundrum: The Activating Message for X-it & Security.

|3.18.05 @ 11:34AM|#

Yes, that's right, Spain, where they spend a lot less money per person, give it to a government-run medical system, and still kick our ass in measured outcomes.

|3.18.05 @ 12:31PM|#

Sounds great. I would jump on a plane headed to Spain today, but my tickets to the Reckless Kelly show are nonrefundable. As for kicking ass in measured outcomes, there are lies, damned lies and statistics. Did you hear about the statistician who drowned in a lake with a mean depth of thirty inches?

|3.18.05 @ 12:56PM|#

MP

30% Tax Rate just for Social Security

It's only 5% paid by the employee. 25% is paid by the employer. Like, that's the same as free, isn't it? :)

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