Greg Mankiw on Health Care Reform

Harvard economist and former George W. Bush adviser N. Gregory Mankiw wrote an excellent op-ed for the New York Times this weekend about President Obama's public health care plan. Mankiw writes:

Even if one accepts the president's broader goals of wider access to health care and cost containment, his economic logic regarding the public option is hard to follow. Consumer choice and honest competition are indeed the foundation of a successful market system, but they are usually achieved without a public provider. We don't need government-run grocery stores or government-run gas stations to ensure that Americans can buy food and fuel at reasonable prices. […]

This lesson applies directly to the market for health care. If the government has a dominant role in buying the services of doctors and other health care providers, it can force prices down. Once the government is virtually the only game in town, health care providers will have little choice but to take whatever they can get. It is no wonder that the American Medical Association opposes the public option.

To be sure, squeezing suppliers would have unpleasant side effects. Over time, society would end up with fewer doctors and other health care workers. The reduced quantity of services would somehow need to be rationed among competing demands. Such rationing is unlikely to work well.

Mankiw also notes that while politicians may promise today that the public option plan won't require taxpayer funding, the future is another story.

Read the full article here. Also, read Peter Suderman's take on the Public Option here and Ronald Bailey on the reality of the health care debate here. 

Comments

[EoT]

I'm having a hard time making sense of how economists like Paul Krugman can be strongly opposed to rent control, and support government imposed price controls for medicine. Can't they see that price controls for medicine will fail for the same reason?

[EoT]

Also, I don't find Megan Fox to be very attractive.

[Peter]

This is like what has happened to the educational system. The only people who become teachers are those that really love it and can deal with the low pay, and those who couldn't "do" so they decided to "teach", as the saying goes. Either way the whole system goes in the crapper.

[KingShamus]

So basically, if government-run medicine goes through...the only way to avoid it is to become really rich, so you can buy your way into halfway decent care. That isn't too hard, is it?

[PapayaSF]

I believe it was in Reason, years ago, that someone pointed out that the parts of health care not usually covered by insurance (optometry, dentistry, even plastic surgery) tend to be relatively affordable.

Peter: the old saw that teachers are poorly paid is no longer true. Figure in the long vacations and pensions and most do decently well.

[oldtimer]

Peter: Some people may say they love self flagellation, too, about as much as some teachers love teaching. When they say it isn't about the money, believe me, it's about the money.(And they can call themselves professionals).

[Lauren]

Not to be reasonable or anything,
But let's take a long-term, holistic look at the idea of health care for a nation.
With advancement of education, technology, nutrition and all these "prevention" techniques Obama is relying on, are we not to expect the overall amount of sick people in this country to decrease?
What happens to a competitive market when clients decrease? It is in the benefit of competitive hospitals to have more patients, and therefore more profit (so as to have better service, I get it..)
But, if what we want in the end is more healthy people who rely on health care *in general* less of the time, then a competitive system is fundamentally illogical and ill-suited for such a system.
We can think about grocery stores and competition all we want, but health care? Do we really want to see the same growth and expansion of the health industry as we do other industries? I would rather see a highly efficient, gov't run option that is answerable to the people, and which has no goals of profit or expansion in its model at all.

[Marshall Gill]

I would rather see a highly efficient, gov't run option that is answerable to the people, and which has no goals of profit or expansion in its model at all.

I would love to get a BJ from Elizabeth Hurley, and while the chances that my wish will come true are small, yours are less than non-existent.

The only people who are not "motivated by profit" are those who are already financially secure. Why would anyone go through the cost and hard work of medical school if not for profit? You don't need an education, or a brain, to "care" for free. Of course, "caring" with other people's money does get you elected to public office.

Let me guess, you voted for "hope and change"?

[The Angry Optimist]

Lauren, remember back in the early 1900s when everyone died of cancer?

Neither do I. It's possible that, when we break through another age barrier and people are routinely living to 120 and we've licked cancer, something else is going to crop up. Your fundamental premise (that healthcare will eventually whither and die) is nonsense.

[Lauren]

Marshall, something wrong with being idealistic? Always is with some people, but we are looking at a "major overhaul" of the health care system, why would that call for something less than idealistic goals?
And, while I'm sure many Dr.s go to med. school because they have "hope" for "change," I'm equally sure that many health insurance companies, pharmaceutical co.s, corporations and other businesses that now run the system make decisions that fall on one side of the money-health line, and which do you think happens more? Judging by the stats of the last ten years, the US pays more than double for less than a top-30 place on quality of health care - go US.
Unforunately, I *did* vote for this... phony.

Optimist,
My fundamental premise was not that health care would "wither and die," but rather that our goal should be to have a significantly healthier population, which would necessarily mean that less people visited hospitals, conducted (expensive) tests, got prescriptions, etc...
Follow me here? I'm just looking at this long-term, try to open your eyes beyond the next ten (expensive and depressing) years.

[tarran]

TAO,

That's exactly what will happen; I own a book called "Why We Age" written by a biologist who studies aging.

He makes that very case: that as the common sources of death get eradicated, uncommon diseases come to the fore. In fact, he pointed out that with a cure for cancer and a cure for heart disease, human life expectancy would "only" go up by about 8 years.

Very cool book.

[Lauren]

It's funny, Marshall,
because most people tend to argue that doctors would become short in supply if we switched to a public option, but here you are arguing for their sake and their good hearts.
I agree, I think that there will always be people who want to be doctors and don't care about the money - or else teachers would be virtually nonexistent, right? (not that the education system doesn't need an "overhaul" as well...)

[Lauren]

tarran,

while I agree with you and TAO that new forms of disease will continue to happen, I also happen to note that overall, life expectancy *does* go up, and in industrialized nations it increases dramatically with introductions of new technology and education about nutrition, etc.
you two seem to be arguing for a "status quo/nothing ever changes" kind of world, when in fact the average individual has gotten (gradually) smarter, healthier, more productive and most assuredly, more able to cause an incredible impact upon the world.

[tarran]

Lauren,

The government is the mafia. The things the mafia does well, are the things that government does well, killing people, burning stuff down, intimidating people, etc.

Now, if I came to you with a scheme to have the mafia run hospitals, you'd probably laugh me out of the room.

I want the medical industry to become like the food industry. Do you realize how much nutrition has improved? It is the greedy companies like Walmart, A&P, Whole Foods et al who made it happen.

The reason why health care is so expensive has nothing to do with the profit motive. It actually has everything to do with the stranglehold that the government uses to keep prices high by keeping new entrants out of the market and subsidizing the poor.

The fact that we get good care at all testifies as to how inventive people are at routing around government intervention.

We would see a dramatic improvement in the affordability of medical care if
1) The tax break for medical insurance provided by employers was repealed,
2) Medicare and Medicaid were abolished,
3) State medical licensure boards were either abolished, or not permitted to limit the number of doctors medical schools were permitted to graduate and the pretetermine the number of licenses they intended to issue each year.
4) Repeal laws forbidding social organizations from keeping doctors on staff to serve members.

Any one of these on its own will help drive prices down. The more of these enacted, and the more affordable health care becomes.

I don't want to maintain the status quo. I want to government to stop making it harder for poor people to get decent medical care.

[Lauren]

Have you ever lived in a country that had free health care? Or, if not, have you experienced it?
I lived in South America for a while, and got to check out a local public hospital. Here is how I was treated: I saw a doctor, fluent in English and incredibly helpful, within 5 minutes of me sitting in an empty waiting room. I saw him three times within the hour - inbetween my two X-rays (how much in the US? Oh, about $2000), and at the end he gave me two prescriptions, one of which I paid 8 pesos for (about $2.50), the other was free.

Now, this is a very poor country, but they manage to keep this level of health care as well as a private option for richer or pickier people who do not trust this (albeit questionable) government.

Do you really think the US would stoop lower than any S. American country with both options?
Aren't you really limiting yourself by restricting it to one instead of allowing for more options?

I find it very difficult to believe that insurance companies would cease automatic denials of claims if your four requirements were followed - in fact, it seems more likely that health care costs would continue to be denied to not just the "poor," but the "have-nots" - but this all depends upon whether or not you think such things like taking care of homeless or feeding the starving is worth it in a public sense...

[Lauren]

*Correction:
"in fact, it seems more likely that health care would continue to be denied..."

[Lauren]

Actually, let me expand on that "public sense" thing. Do you think gov't should control just the basics? What are these basics? Do they include public schools? Public mailing system? Where does our trust in government go?
From my perspective, I find it easier to change legislation or challenge the gov't in court than it would be to challenge an insurance company in court - I'm thinking The Rainmaker here.
I happen to have a severe mistrust for the gov't, which you would probably classify as conspiratorial. However, I am more comfortable with gov't control of health care because I still believe that this US gov't is answerable to the public. "We the people" and all that, remember? You claim this country is run by the "Mafia," and it is - the business mafia. Hasn't watching the news of this economic crash taught you who's really pulling the strings in this world? I am much more wary of power in the hands of a corporation than power in the hands of a checks-and-balances system - in fact, I'm quite proud of our government, sometimes - at least the structure of it anyway.

[TrickyVic]

"""I am more comfortable with gov't control of health care because I still believe that this US gov't is answerable to the public."""

Is it? Because it seems that for all my life government keeps doing the same shit, and getting away with it. The people just complain, then elect another bad leader. I don't believe the public is very good at holding government accountable.

[Lauren]

I agree, they need to get better at it.
That doesn't mean that it's impossible.
How do you think that Bernie Madoff is being held accountable? By a government branch, the judicial one.

Being so critical of the gov't is taking your own power to use it away from you.

[tarran]

Lauren,

Why would anybody purchase a policy from an insurance company that flagrantly refused to honor its contracts?

I have commercial property insurance companies as clients, and I can tell you that keeping their customers happy is a big deal for them. Why? It's one of the most cutthroat businesses in the modern economy, where each salesman lies awake at night fretting about his competitors "stealing" his clients away.

Of course, medical insurance companies are a different animal. Why? Well, guess who tightly controls and regulates the medical insurance industry, making it hard for new competitors to enter the market to snap up dissatisfied customers?

You claim this country is run by the "Mafia," and it is - the business mafia. Hasn't watching the news of this economic crash taught you who's really pulling the strings in this world?

Sigh, so close but misses by a mile.

Again, the government is a mafia, a protection racket that is extremely sophisticated and predatorial.

And the more the mafia controls, the more dangerous and depraved it gets.

The businessmen who ask the mafia for special favors, such as a subsidy, or to have a competitor to develop "trucking" problems are a greedy constant that can be found throughout history and accross numerous cultures. This is, of course, well known to economists, who have coined terms like Rent Seeking and Public Choice Theory to describe them.

The notion that the officers of the state will magically behave differently when it comes to medical care to how they behave while running schools, prisons, orphanages, ports, Indian reservations, fisheries, mines, nuclear reactors etc?

You think the corporate welfare packed into each years' agricultural bill is bad? Just wait as the same political process that gave us high-fructose corn syrup in place of cane sugar now starts to operate on the medical industry.

Actually, let me expand on that "public sense" thing. Do you think gov't should control just the basics? What are these basics? Do they include public schools? Public mailing system? Where does our trust in government go?

I don't think we should have the mafia control anything; schools, courts, roads, charities, scientific research etc. The fact that they can extract money at gunpoint from their "customers" makes them shitty service providers.

I am much more wary of power in the hands of a corporation than power in the hands of a checks-and-balances system - in fact, I'm quite proud of our government, sometimes - at least the structure of it anyway.

Ah yes, and according to the New Testament, the Catholic Church should have been a pretty placid organization that harmed no-one. Maybe the next time you go to South America, you can ask some of the Indians how that worked out...

Incidentally, Madoff's competitors had figured out that he was scamming his customers and alerted regulators. The reglators sat on their asses and did nothing (after all, he was their friend). And why did the competitors not trumpet his fraud from the rooftops and get his clients for themselves? Wouldn't you know it, they are severely limited with respect as to what they can say about their competitors! And who is limiting them? What organization is so powerful that it can tell someone to shut up and get away with it? What organization gave false promises that cost people tens of billions of hard earned savings?

Then again, it's not surprising the regulators didn't think Madoff was committing a crime; after all Madoff's scheme was run the same way that Social Security is run.

Sorry for the bile, but watching people cheer on an organization that is ripping them off so blatantly and thoroughly is really irritating me tonight.

[The Angry Optimist]

My fundamental premise was not that health care would "wither and die," but rather that our goal should be to have a significantly healthier population, which would necessarily mean that less people visited hospitals, conducted (expensive) tests, got prescriptions

I don't understand why you think a healthier population would consume less medical care. How do you think they got that way in the first place?

a vast majority of the pills, and machines and techniques have come about *because* of the profit motive, not in spite of it. Like tarran said, grocery stores provide cheap, nutritious food *because* they have to compete, not in spite of competition.

You should note, too, that you go to what was once a totally private college. The "Wesleyans" (we have one, too, Ohio Wesleyan) were founded entirely privately by the Methodists: no government grants or meddling in the curricula needed. A vast majority, I would bet, of hospitals in this nation were also founded/run by religious groups.

There's no reason to think that private interests are somehow *more* powerful than government. Nothing is more powerful than government, because government is the legal use of force.

[Lauren]

Naming all of the negative parts about government aren't going to get you far - as I said, I'm probably even more conspiratorial against gov't than you are, even considering this "mafia" thing.

However, what you've done is simply outline the wide variety of human greed - from the businessmen seeking the subsidiaries to the congressmen sitting in their pockets as they shift the world in their favor, to the greed and lust for power of religion. These are all aspects of the same characteristics of human behavior, and this is really the core problem of all your examples.
So -
with this basic human nature in mind, you are willing to trust health care to private companies who can only be answerable to a branch of a gov't that you either want to completely or partially dissolve of power?
- Just trying to keep it all straight.

I do not think that gov't is in a good place right now, in fact I'm often disgusted and slightly terrified at the state of the nation. But, I am not beyond the concept that this gov't is still functional, and still has politicians with decent principles - much like the argument that doctors don't go to med school for the huge amount of money they'll receive being doctors, but some of them still have those basic ideals of helping people. That still exists in gov't too, but it is a constant fight between idealism, morality and our more private, selfish instincts. Especially when it seems easy to pinch here in the stock market or take just a little bit of money from some company for your campaign over there... the little things, you know.

Again, your option seems to be that we scrap gov't and rest our fates with the companies you illuminated - let me think, it was Walmart, A&P and WholeFoods. Next you'll be telling me that these are the guys who really have our nutritional health at heart in every decision they make...

Bottom-line, people are trying to rip you off constantly, in both worlds - private and government, religion and pseudoscience. That fact hasn't irritated you before, but my defense of "we the people" does?

[Lauren]

TAO, you want to know something about private colleges?
A kid was kicked out of one for having a website that promoted a picture of his school's president making an obscene gesture - the picture wasn't doctored, it was just awkward. The kid was kicked out of school. He protested in a court, and a judge ruled that private institutions can do what they want.
So much for free speech - what was that you were saying about "force" again?

[Lauren]

And, TAO, for your sake, I'll explain what "less" medical care means:

In a nation with a growing population and an economy that grows at an exponential rate, income, GDP and creation of new money all increase as well. And many people who love money love it when this happens.
Let's imagine a place where population starts to even off, as constraints of space and resources tighten up - let's say, 2100? Okay, on the conservative side, 2200.
And let's say that technology, education and knowledge about health are so good that virtually all "preventable" deaths have ceased, and easily treatable conditions are addressed, etc..
In this hypothetical and yet likely future world, medical care will not vanish. Most likely, it will be more or less average, as constant as the birth and death rate - and for that sake, it will be reliable.
What ever happened to the notion of a steady-state business, or economy, by the way? That's another post...
Or do you think the future of health care will consist of more and more pills and tests and hospitals and doctors and profits and people and.. everything?

[The Angry Optimist]

I was saying that private institutions don't have the power of force that the government does, and your example illuminated that point. It does seem rather arbitrary and capricious on the part of the school to remove the student, but do you somehow disagree with the notion that "private is private"? If I shopped around a photo of my boss doing something embarrassing, I also expect that there will be consequences.

Regardless, there was no force involved, was there?

[The Angry Optimist]

Lauren, I need to be more systematic with your point. You originally contended this:

What happens to a competitive market when clients decrease? It is in the benefit of competitive hospitals to have more patients, and therefore more profit (so as to have better service, I get it..)
But, if what we want in the end is more healthy people who rely on health care *in general* less of the time, then a competitive system is fundamentally illogical and ill-suited for such a system.

Basically, that a competitive model for health care did not make sense because the optimal "end state" is to have "less" people using certain amounts of health care, not more. In your hypothetical world, it would be not only true that health care usage would "even out" as a percentage of total expenditures, but that everything would because growth has effectively stopped. Also, I would argue that your original implicit premise is that competitive health care is going to somehow make sure people remain...sick? Is that what you're saying?

It may be the case that at some point, competitive health care will not look as we know it today. Neither does the buggy-whip industry or the candle industry of yore.

[The Angry Optimist]

anyway, I would say that people are consuming much more health care than they did 50 years ago. I would bet that the average number of "daily" pills taken by 20-year-olds in 2009 dwarfs what 20-year-olds took in 1939. That's an "increased consumption" of health care, and a commensurate increase in life expectancy.

[The Angry Optimist]

and Lauren? I'm sorry, but this made me laugh:

Let me be clear: the real problem is not that we are running out of drinking water, but that the planet cannot sustain the amount of water we use and the way we use it

[The Angry Optimist]

oops, link fail:

And Lauren? I'm sorry, but this made me laugh:

Let me be clear: the real problem is not that we are running out of drinking water, but that the planet cannot sustain the amount of water we use and the way we use it. It is absolutely imperative that we start changing the way we live to become not just sustainable, but efficient in all that we do.

Have you never heard of the Water Cycle, Lauren? It is a fourth-grade scientific fact that the level of water on the planet remains constant (with random molecules drifting to and from space). I hope that a geology professor corrected you post-haste.

[Lauren]

Actually,
Many professors of science and poli-sci professions congratulated me on talking about an issue that has yet to really surface in relation to its importance.
You'll find out eventually, I suppose, but for some early signs take a look at the state of Western Australia, the Himalayan glaciers, the amount of people living on the water from those glaciers, and the way we use water in the industrial process which, with the rapid development of many nations (china, india being the staples), the amount of water we use for our standards of living is... unsustainable.
That's a great word, "sustainability." A lot of what I say comes from the ideas behind that word.
But.. nice try, what with the "Water Cycle" jibe and looking me up on Google to arm your quiver with more arrows - but you could've stuck with the health-care debate, you know.
But speaking of cycles, the predictions of the collapse of the Amazon rainforest and the Greenland ice sheet are.. a coin-toss, more or less. If you follow environmental news you probably knew that already, it breached mainstream news - somewhat.

[Lauren]

Speaking of articles, here's a great one in the National Journal about Public Insurance - citing some good polls, if you trust that kind of thing. Enjoi:

http://www.nationaljournal.com/njonline/mp_20090629_2600.php

[The Angry Optimist]

I know, sustainability and the water "shortage" that I've been hearing about for 15 years are the topics that have just been "shunted aside", except for intrepid journalists such as yourself.

In case you didn't notice, I continued the healthcare debate in three separate posts.

[The Angry Optimist]

regardless, the "planet" can sustain the level of water use just fine. Care to countercite the Hydrologic Cycle?

[SugarFree]

The government should distribute all food. No one needs more than 1800 calories a day, anything more than that is just greedy.

[MJ]

"With advancement of education, technology, nutrition and all these "prevention" techniques Obama is relying on, are we not to expect the overall amount of sick people in this country to decrease?"

No, in the long term there will be no decrease in patients. No matter what preventative care there is everybody is likely to suffer some chronic degenerative geriatric ailment that will cost a lot of money to treat before death comes. If anything, preventative care will increase that, as it will likely decrease how many people are taken by the quicker ailments (like heart attacks).

[Gilbert Martin]

"the amount of water we use for our standards of living is... unsustainable."

Well lets see, build some breeder reactor nuclear power plants along the coasts to power a bunch of desalination plants to take the salt out of seawater.

Presto - we've got plenty of freshwater to use.

[Gilbert Martin]

And as far as the healthcare debate goes, healthcare is not a right. It is merely another consumer commodity available for those who can afford it.

Government has not Constitutional authority to mandate charity.

So the "goal" should be to get government out of all the meddling and distorting ways it has inserted itself into the process so far and let the free market work.

The main reason costs have gone up for teh privately insured is because of cost shifting from Medicare and Medicaid.

[Adderall Apocalypse]

Lauren | June 29, 2009, 10:15pm | #

Not to be reasonable or anything[...]

Does this mean we can drink? I think we need an official opinion... somebody get TWC on the case...

Anyway, is it entirely accurate to say that the AMA is categorically opposed to the public option? I might not have been here for a while, but I thought we were all pro-science and empirical evidence here... can't we look at case-studies of the "health-care" reform programs of other countries? Of course, I don't currently have an ideological position on whether or not health-care is a "right." On the most fundamental level, there really aren't any "rights," just privileges we all gave ourselves so society wouldn't completely collapse...

[Lauren]

Adderall,
Unfortunately, I do happen to "believe" that there are fundamental rights that humans have. But, if you have a problem with that, you can start by taking it up with that bit in the constitution about "inalienable rights." Perhaps you'd like that we changed it to "privelages"?

The reason health is a basic right for every individual that comes into this country, not necessarily a citizen, is along the same reasoning as the kind of thinking that put public schools or the police force in place - there are certain public interests which should be guarded by the public, answerable to the public, and free to the public - these describe every service with public schools and police, am I right?

Okay, let me approach this another way - an example of a public service now becoming private. In my region, we can't afford trash collection anymore. The state funding has completely disappeared, and we literally cannot support the infrastructure of free trash collection. Now, this became a huge issue, but then the region decided (we're quite conservative on most days) that we would contract out to private companies that could compete and keep our prices low. Well, did that work? Hell no - they knew the trouble we were in, and prices are ridiculously high, but it's our only option (sound familiar?). They compete, but that just keeps the prices and quality about the same - and every household has to hop on the bandwagon with some private company, and usually they pick one of two, and the same neighborhood will all pick the same one. This is an example of how the things we expect from a free market don't always happen like that - low prices, high quality. Sometimes, if demand is high or if profits would increase because of a decision away from quality, well... you know how it goes. Or you should.

And TAO,
yea, I saw your earlier posts on our original debate, but that still doesn't explain your incessant curiosity to know who this long-winded person is - hence your retreat to the Google search engine, and your feeble attempts to poke at my articles, which I am not embarrassed by at all.
But, back to the debate, since you're arguing that health consumption will constantly increase, that must mean you think population will continue to increase - because we're certainly not getting sicker. And while I agree that many people take pills now, I don't think that's a good argument for an increase in our quality of health - if you want to talk about that, explain to me why our oh-so-wonderful private system of health care leaves so many uninsured, and leaves our country with the worst quality of health in the industrialized world. Can you explain that?

[Lauren]

Oh, and the water cycle? Acid rain is a part of that, and so is salt water. I am speaking from the perspective of a human, but maybe you didn't get that the first time - for one sixth of the human population, there is no access to clean drinking water. Irrigation systems that supported whole cities have dried up and left entire communities at a loss - again, please see Western Australia for a great example of this. They've considered plants that convert salt water to fresh water, but the nasty residue left over from the process, the energy needed and the potential harm to local environments (like their coral reefs) are too risky for that to be the end-all-be-all answer.
Maybe you have been hearing about these kinds of water fears for 15 years - how long ago would that be now, 1994? Well, remember when the cost of grain and wheat skyrocketed? One of the reasons was Australia's sudden disappearance from the grain market - prices shot up, because supply went way down, and the world had a sudden panic about food availability. Another reason for this was the sudden increase in corn-based ethanol, which shifted a lot of corn production in non-mouth directions. All those food strikes, remember?

The Earth has a finite amount of space and resources, and that includes the production of fresh water in the water cycle. If we begin to disrupt this balance, we see the effects - like acid rain over Europe, decade long droughts over numerous continents, etc etc...
If you want to argue that fact, you'll have to say something like that technology will feed us all cheaply one day, or we will have the technology to produce as much water as we want, etc., or that tech. will get us off this world and we can increase in population (and markets) - forever!
Now, if that is your argument, who is the idealist here?

[Lauren]

An example of how serious the US has taken the coming water shortages is it's under-the-table deal about 2 years ago with Canada through NAFTA to secure water sources there - now, more than half of all our water in the US comes from Canada, and we knew we had to do this because there is a great basic of water under the midwest that has been drying up or become polluted with chemicals from various industrial processes of resource and water extraction, such as "fracking" - go use Google for something useful, instead of my email address.

[mark]

All those food strikes, remember?

All those food strikes were caused by George Bush's war and the Fed. And Iowa.

Fed. Iraq. Iowa. Short words explain it all.

[Lauren]

I love it when complex problems are reduced to three-word answers, it reminds me of mainstream media, blogs and tweets. Welcome to the new world.

[Abner MacGillicuddy]

Guys, give up, already.

Lauren's gonna win every argument. Coz she really cares, I mean, she really, really cares.

Caring is all that matters, man, your logic and facts are nothing.

[Adderall Apocalypse]

Lauren: I did say "the most fundamental level." Sure, we can say that we have unalienable rights (which is what the writers of the Constitution did), but at some point, it becomes a semantics issue and a question of the existence of silly things like "absolute truth." We don't need to get into that! or do we...

Believe me, I'm completely open to the idea of public health-care, I'm just a skeptic... which means that all I need to be convinced is evidence. And believe me, Pascal's Wager-type arguments and words like "socialism" don't really scare me at all.

By the way, since you put forward your example of the private takeover of garbage disposal, I'd be interested in knowing if there was any "government intervention" in that market. I suspect it's entirely possible that some of that may have seeped in, stifling competition... whatever most contributors and commenters on this blog are always talking about... blah!

[Gilbert Martin]

"Unfortunately, I do happen to "believe" that there are fundamental rights that humans have. But, if you have a problem with that, you can start by taking it up with that bit in the constitution about "inalienable rights."

All of those inalienable rights are negative rights - not affirmative ones.

A "right" to health care paid for by somebody else would be an affirmative right.

There is no such thing as affirmative rights.

[Kreel Sarloo]

"All those food strikes, remember?"

Actually, no, I don't. Remind me.

I'm intrigued by the "free garbage collection" you referred to. How exactly does that work? This was possibly in another dimension you travelled to.

[Lauren]

Hahaha, I'm so glad you linked to George Carlin, that really made my morning. That's one of my favorite of his shows. "God skipped a couple of things, like SLAVERY! It just slipped his mind..."
Brilliant.

Anyway, I'm not gonna pull the God card on you, don't worry. And, I will admit that my stance is much more like yours, in that I go back and forth on each side of many issues - it's good for your brain to hold two opposing ideas at one time - like yoga. Haha.

Carlin is right. These aren't God-given rights, they are created by man, as is language, his own identity, and if you wanna go subjective, all of the reality around him. But, just because we created the idea of the stock market, does that make it any less real? I know the little electrons firing between computers are "real," but you're more or less boiling this argument down to complete subjectivity in which humans cannot even agree on which color the sky is - MY blue may not look exactly like YOUR blue.

But, we are not that individualistic. We, as a species, are much more group-oriented, herd-like. Not that going with the tide is always a good thing (trust me, I often swim against it,) but working with others, cooperation is what is necessary for any kind of human effort beyond that which the individual can accomplish - that's a bit repetitive, I know. But, think of some examples. Everything around you right now took a long series of people to think of these "things" as ideas, then more people to create them, people to distribute them and people like you to buy them or collect them. We got to the moon through a very complex network of people working together and communicating efficiently. We will only have a successful system in any respect when we begin to do those things. We need more cooperation, not more individuality. Don't get me wrong, I love individuality. But, systems like schools, health care, trash collection, NASA and agriculture and every other of our structures of co-living that we've built in our evolution as a species - these require us to agree on principles, on direction as communities, states, nations and as a species and a world. We all keep getting hung up on agreeing on any principles, but your alternatives are representative of a fractioning point of view - you'd rather dog-eat-dog, to each his own, i take care of me and mine, buy my own health care with my own money, buy my children's education with my own money, and on...
I mean, it'd be certainly more free if we all lived like Thoreau in Emerson's back yard, building our own shacks and teaching our children our selves and clutching our principles of non-gov't and no-one-tells-me-what-to-do as we go to sleep every night...

But the reality of the world is that we do things best when we work together the closest, and can agree on things - like agreeing on the fact that everyone in this nation deserves to see a doctor if they need one, free of charge. And I, as poor and jobless as I am, I am willing to give up some of my pay (when I'm working) to pay for some homeless guy in california to get medicine, or.. whatever the case may be.

[Lauren]

And Abner, I'm not lookin to "win", and it sucks you think of the world that way, but actually I study logic and philosophy, and the truest stance I can take is an undecided, or agnostic one on any issue. But my idealism and my natural empathy make me want to help others, and so my arguments are often on the side of peace rather than war, high quality education and health care that is paid for in a participatory and collective way (yea, that's right... taxes.)

[KingShamus]

Lauren | June 30, 2009, 1:24am | #
"Actually,
Many professors of science and poli-sci professions congratulated me on talking about an issue that has yet to really surface in relation to its importance."

Wow.

You got a pat on the head from your ideological kin. Huzzah and bully for you.

[Lauren]

TAO,
it occured to me, that you seem to want less government interference in your life. I assumed this to be a reflection of your principle of individuality, but then I wondered why you argued that we would become more dependent upon the health care system as time goes on. It seems like you perhaps of all people would want to be dependent on any one industry or system of power, especially one concerning something so precious as our health. I happen to not take any vitamins or supplements, and when I'm sick I never go to a doctor or the hospital unless it is an absolute emergency - besides the fact that I have no health insurance, I also want, as Carlin said, to give my immune system some practice. Those white cells need that practice if they're gonna fend off next years man-bear-pig flu!

[Lauren]

Correction:
"It seems like you of all people would NOT want to be dependent on any one industry..."

[Gilbert Martin]

All this "collective" talk is bunch of hogwash.

Liberals like Lauren want to unilaterally decide what the "collective" objectives should be and then we are all just supposed to "collectively" fall in line and agree to it.

[Abner MacGillicuddy]

Lauren

Keep up studying that logic and philosophy, and get back to us when you figure how to do that whole "participatory and collective" thing without jailing and killing people. OK?

[Twisted Nerve]

Lauren, I would ask you to consider the difference in results of a society operating in a collective fashion but under a voluntary/non coercive framework as opposed to a society operating under a non voluntary/coercive framework. Which produces greater wealth, peace and humanity for its citizens?

[Adderall Apocalypse]

Lauren: I see other people have touched upon what I was planning on talking about (i.e., your mischaracterization of my position). I lost my connection for a few minutes :'(
...
Look. I fully support voluntary associations of just about any sort. I'm not an "every-man-for-himself anarchist." I know it's better when we cooperate with each other. I just think that there are many cases in which it's possible that "we the people" might be able to do a better job of cooperating with each other without the government dictating to us exactly how to do it. (I have heard that the way the insurance companies are set up now, they could completely crush any type of "co-op" deal that any of the states try to start up, so I guess that would be a counter-example, even though I heard that from Howard Dean...) Anyway, I think that more freedom (including the freedom to cooperate and form various types of legal contracts with others) is generally a good thing. And like the others said, taxes=armed robbery, and blah...

[Lauren]

Adderall,
You have a point about a possible difference between the people and the government. Ideally, it isn't set up to be that way, but (as Carlin and others reiterate), it seems sometime that this country has sold out to the power and influence of multinational corps, big business interests, and that decisions made at even the local level are, at best, minimally influenced by the public.
This is, after all, just a representative democracy, not a direct one. This means that if and when we vote, we place our trust in politicians to make decisions that match our principles. Accountability means that when they don't follow them, or if they get caught up in Argentine scandals, we can choose to not re-elect them, or even impeach them.

Even I can't go further, it's very idealistic to think that gov't really still works this way. But every response to my posts has seemed to suggest that government has fallen out of the hands of the will of the people, and if that is true then you would need to explain why that is true, besides referring to the government as a mafia and nothing less. Besides raising taxes, what proof is there that the people have lost their power in gov't *completely*? I'll stress that last word, because right now I'm balanced between a sense that there is encroaching corruption, but that we still have the power to address that corruption using the same system...

[An asshole]

Is Lauren the new Chad, or is she just retarded?

[ChicagoTom]

The talking points are making there way around I see.

Consumer choice and honest competition are indeed the foundation of a successful market system, but they are usually achieved without a public provider

Richard Shelby (R-AL) also said something similar:
Sen. Richard Shelby (R-AL), speaking earlier this month on Fox News, called President Obama's plan the "first step in destroying the best health care system the world has ever known." A public option, Shelby added, would "destroy the marketplace for health care."

From the TPMMuckraker blog :

But the notion that most American consumers enjoy anything like a competitive marketplace for health care is flatly false. And a study issued last month by a pro-reform group makes that strikingly clear.

The report, released by Health Care for America Now (HCAN), uses data compiled by the American Medical Association to show that 94 percent of the country's insurance markets are defined as "highly concentrated," according to Justice Department guidelines. Predictably, that's led to skyrocketing costs for patients, and monster profits for the big health insurers. Premiums have gone up over the past six years by more than 87 percent, on average, while profits at ten of the largest publicly traded health insurance companies rose 428 percent from 2000 to 2007.

Far from healthy market competition, HCAN describes the situation as "a market failure where a small number of large companies use their concentrated power to control premium levels, benefit packages, and provider payments in the markets they dominate."

So extreme is the level of consolidation, in fact, that one former top Federal Trade Commission official working with HCAN has sent a letter to the Justice Department's Antitrust Division, asking for an investigation into the health insurance marketplace.

The problem is most acute in small rural states, according to the report. In Shelby's own state of Alabama, the biggest insurer, Blue Cross Blue Shield, controls 83 percent of the statewide market. There, and in nine other states -- Hawaii, Rhode Island, Alaska, Vermont, Maine, Montana, Wyoming, Arkansas and Iowa -- the two largest health insurers control at least 80 percent of the market. So much for Shelby's "marketplace for health care."

The study itself can be found here

I must say I do enjoy the irony of the "Free market" crowd calling Lauren the idealistic one here.

The free market approach tends to lead to consolidation and less consumer choices. Without a public option (or some type of government intervention/regulation) how do you deal with the consolidation and the handful of companies that control the insurance market?

Why are the insurance companies pulling out all the stops to oppose the public option? It isn't because they are afraid it's going to be a crappy option that people won't want.

[The Angry Optimist]

Lauren -

First of all, appealing to the "herd mentality" that you think is somehow inherent in humans is pure silliness. I very much doubt you want to go down the road of "we should do what we're naturally inclined to do", because that doesn't fare very well for your gender.

And I, as poor and jobless as I am, I am willing to give up some of my pay (when I'm working) to pay for some homeless guy in california to get medicine, or.. whatever the case may be.

Then please do so. One has to wonder why if *you* think it's a good idea, you want to force the rest of us to go along with it.

It seems like you perhaps of all people would [not] want to be dependent on any one industry or system of power, especially one concerning something so precious as our health.

And government is going to somehow break down the rules and laws of biology? Look, like people have told you repeatedly, I am 'dependent' on the grocery stores for my food; I am 'dependent' on contractors for my shelter; I am 'dependent' on department stores for my clothes.

I am entirely 'dependent' on others for the three most vital things: food, clothing and shelter. It's not "dependency", it's liberation. Before all this, I would have been in the fields, sowing grain and bashing it with a rock to make flower. I would have been bartering for cloth so my 40-year-old (ancient at the time) mother could sew me some clothes with her barely-working eyes.

Just don't give me this 'dependency' garbage. The market is what has liberated you from where you naturally belong. Do you think that if we went back to your Hobbesian state of nature/herd mentality, that women would fare very well? That we would somehow be wealthier?

[The Angry Optimist]

ChicagoTom - what planet do you reside on where a free-market = government-mandated cartel?

you know, I expected much better out of you, but you're back to your same prickish ways: you know goddamned well that this isn't a free-market system, and you know why.

[ChicagoTom]

ChicagoTom - what planet do you reside on where a free-market = government-mandated cartel?

you know, I expected much better out of you, but you're back to your same prickish ways: you know goddamned well that this isn't a free-market system, and you know why.

TAO -- I don't think I was being a prick at all. The pricks are the disingenuous people (like Mankiw and Amanda Carey who cites this OP/ED approvingly).

I know it isn't a free market, but the people opposing the public option and trying to maintain the status quo keep crouching their opposition in terms of the markets and the libertarians site them approvingly (like this post.)

Greg Mankiw knows damn well it isn't a free market, but he writes as if there is one, and that a public option will destroy it. If this is the free market he is talking about then let it be destroyed.

If my options are A) sticking with the status quo or B) adding a government competitor, I'll take B each and every time. (And right now those are the only two options that are being presented/discussed)

What about you? of the options being presented, what would you prefer and why?

If you want to go all idealistic and talk about creating a "real free market", Id be happy to have that discussion. But NO ONE is advocating that idealistic approach.

So do you want to have a discussion about how it should be and unicorns -- or do you want to have a practical discussion?

How do you deal with the market concentration? How do you deal with the currently oligarchies in the insurance market? How do deal with the big players running the show?

I don't think it's a dick move to cite data that proves that the whole premise of this post is a big bunch of nonsense and that the people most adamantly opposed to the public option are full of shit.

The current situation is that a handful of companies are running the show in a pretty crappy manner. How do we break that stranglehold while at the same time keeping some stability in people's lives/coverage? I think the public option is a good step.

[The Angry Optimist]

Option "A", please. The status quo is vastly preferable to yet another expensive and efficiency-killing boondoggle government bureaucracy.

ChicagoTom, you absolutely must stop calling it the public "option". It's not really an "option" when we already have saber-rattling from the administration about how everyone is going to get taxed for it, how the government is going to force down prices and how insurance benefits are going to be taxed. That doesn't really make it an option, does it, Sonny Jim?

If you want to go all idealistic and talk about creating a "real free market", Id be happy to have that discussion. But NO ONE is advocating that idealistic approach.

Are you friggin' retarded? Look, we all here talk about the idealistic approach (and it's not idealistic: idealistic is that you think with enough Hope, Change and Force, you can repeal the laws of supply and demand. That's idealism bordering on nutjobbery) and want it to happen, but it's not going to the second you get this lousy, horrendous "public" "option".

I'm sorry, but you've been snowed by the government. There are problems with the system, yes, but they are entirely overexaggerated and your Senators and Reps are crying crocodile tears over those problems. Most of them are invented, puffed-up bullshit.

[Twisten Nerve]

Chicago Tom, are you saying that there is nope of a free market solution so we should give up advocating for such and just submit quietly to the will of our masters? Even if we believe the results will be disastrous?

[Medical insurance]

healthcare reform proposed by the Federal Government may actually eliminate affordable medical insurance from the private sector entirely.

While publicly funded healthcare may seem to create affordable medical insurance for more Americans, it may actually create a bigger problem.

[Affordable medical insurance]

Private medical insurance is not the enemy of affordable healthcare in the US. In fact, if the federal government creates another public healthcare program, it will ultimately raise the costs of private medical insurance to exorbitant levels. While the idea of expanded public healthcare may seem to be the answer to affordable medical insurance, it could be the end of private insurance altogether.

Medicare and Medicaid, the two public health programs currently in effect, cost private insurance companies - and by extension, Americans paying premiums for private insurance- $88 billion in 2007, according to the consulting group Milliman, Inc. In fact, the average family of four with private medical insurance saw their premiums increase $1500 because of public programs.

In California alone, that represents nearly 10% of every premium dollar paid.
The problem comes because Medicare and Medicaid pay as much as 15% to 30% less than private insurance companies on every doctor and hospital bill. Because the doctors and hospitals aren't willing or able to accept this much loss, they push those losses onto private insurance companies, who, in turn, shift the loss to the consumer through higher premiums.

[Affordable medical insurance]

Private insurance companies must not only cover their costs and earn a profit; they also need to maintain a reserve of cash to pay out claims. If a new public health care program is developed and then pays medical costs at a reduced rate like the current systems do, it means there will be an increase in expense shifted onto private insurance to make up the difference.

This increased cost will need to be offset through higher premiums for the people covered under private medical insurance plans. As those who have private insurance become forced to pay increasingly higher premiums, the number of Americans who no longer find private insurance an affordable health coverage option will increase. Those people will then need to turn to the newly formed public healthcare program and will then become part of the increased costs passed on to private insurance by underpaid doctors and hospitals.

As more unpaid costs from private health insurance continue to be pushed into premium prices and more people become unable to pay those premiums, eventually private health insurance will be completely unable to compete with public programs and will face the inability to stay in business. Affordable healthcare in the private sector will become impossible to find.

[Family medical insurance]

Market-based policies are more cost effective for the government - and therefore the taxpayers- than publicly funded healthcare. According to the Kaiser Commission on Medicaid and the Uninsured, January 2005, if every uninsured individual was covered by a government program such as Medicaid, the cost to the federal and state governments is approximately $2000 each.

If, however, low-income and modest-income Americans could purchase their own health insurance by utilizing a $1000 tax credit, the federal government would save 50% of that money. With over 45 million uninsured Americans, that savings would be substantial indeed.

[medical insurance plans]

Market-based insurance would not only be more affordable health coverage, it would also provide consumers with more choice. Because savings come from a tax credit, the option to choose insurance companies, policies and doctors is left to the person who purchases the insurance, not a group of politicians. Health insurance needs vary widely from one individual to the next and having the ability to choose the options that work best for an individual's circumstances is fundamental to quality health care.

Several different market-based solutions could help low and modest-income individuals and families find affordable health coverage. Tax credits, tax deductions, health savings accounts and high-risk pools are all market-based options to make affordable medical insurance a reality for uninsured people who are working, but cannot afford medical insurance.

[Isaac Bartram]

Well, the public option on homeowners insurance has been an outstanding success in Florida.

NOT!!!!

[medical insurance companies]

Tax credits allow people to keep more of their income on a monthly basis in their pay so the can purchase coverage. Because tax credits enable people to make their own choices of providers, plans and doctors, they are considered to be a preferred market-based solution for affordable health coverage. Tax credits enable working people to pay for their own health insurance without having to fall back on Medicare or other government health programs. Because a tax credit would cost only half the amount of Medicare per individual, the burden on all taxpayers is also reduced, saving everyone money.

Private health insurance can be affordable health coverage for every working American. By working with market-based solutions, health care reform can be a workable solution to the millions of Americans living in fear of a medical crisis because they have no medical insurance.

[Adderall Apocalypse]

nice going with this bot here... *round of applause*...

[Lauren]

I'm going to go back to my experience, which is where we all come from, in the end.
Having had direct experience with public health, I know that the hype from the opposition that a public hospital would be of low quality is just not true. And, if the claims that private insurance would disappear were also true, would we not have seen that trend in the decades past that every other industrialized country has had both options?
Personally, I find statistics to be quite enlightening, though sometimes misleading. The only statistics available in the last ten years on quality of health care worldwide rank the US very low, especially compared to the rest of the first world. I think were in the high twenties for infant mortality and life expectancy, and somewhere in the 30s for overall quality of care. Access to health care probably brings us so far down, despite the presence of numerous excellent hospitals in the US - no use to me if I can't afford them.
There is no evidence from any country that has implemented both plans that shows that the public option dissolves the private one.

[Lauren]

There are some really fascinating animated stats that Hans Rosling put together on TED.com, I highly recommend checking them out:

He shows how countries in the world must improve upon health before they can begin to gain in wealth and GDP, and that when they aim for increase in wealth first, their health and GDP increase at a slower rate than countries which focus on health first.

In other words, if you're going to argue that it would cost too much, and we would be taxed too much, just compare the fact that the US spends twice as much as the rest of the world for the lowest (in the industrialized world) quality of health care.
And, Aderroll, you think this is, how did you put it, "vastly preferable"?

[Lauren]

Oops, a link to Hans:

http://www.ted.com/talks/lang/eng/hans_rosling_shows_the_best_stats_you_ve_ever_seen.html

I recommend watching all of his presentations.

[ChicagoTom]

I'm sorry, but you've been snowed by the government. There are problems with the system, yes, but they are entirely overexaggerated and your Senators and Reps are crying crocodile tears over those problems. Most of them are invented, puffed-up bullshit.

And yet when the actual consumers are polled, people are less satisfied by their private insurance than people who are on Medicare.

And anecdotally speaking, my great private insurance was a fucking nightmare. And they had ZERO incentive to get better.

Chicago Tom, are you saying that there is nope of a free market solution so we should give up advocating for such and just submit quietly to the will of our masters? Even if we believe the results will be disastrous?

Not at all.

I am saying that right now, what the powers that be are advocating are the status quo or more government involvement.

The status quo is not a maket, but an oligarchy where a handul of large insurers control over 80 percent of the market and dictate rates and coverage and whatnot.

That stranglehold needs to be broken, and since these oligarchs have decided they don't want to compete with each other, then the competition has to come from somewhere.

So based on the choices I am being given, I am choosing one of them, rather than sticking to some idealogical belief that will not come to fruition

[Lauren]

Personally speaking, my "great" private insurance was a fucking nightmare as well. And I have heard countless stories that detail the same, whereas the only stories that defend the status quo are in defense of free markets, not from personal experience of a "great" system in place.

[ChicagoTom]

Option "A", please. The status quo is vastly preferable to yet another expensive and efficiency-killing boondoggle government bureaucracy.

Thankfully 75% of the population doesn't want option A. Not only that, but we already spend a shit ton of money on health care and it's getting worse with the status quo. SO yeah, let's give government a shot. Maybe it will fail miserably and validate everything you guys say. Or maybe it will be better.

But we've tried it the way it is for quite some time, and most people hate it.

ChicagoTom, you absolutely must stop calling it the public "option". It's not really an "option" when we already have saber-rattling from the administration about how everyone is going to get taxed for it, how the government is going to force down prices and how insurance benefits are going to be taxed. That doesn't really make it an option, does it, Sonny Jim?

Right now there are lots of things being talked about but nothing concrete. So your scare tactics don't really phase me.

I doubt that insurance benefits are going to be taxed (politically I dont think that's feasible) -- and as for everyone being taxed for it -- well it happens with schools, and libraries and so many other things. That's life. And it's a small price to pay to make insurance companies change their ways and to try to make our health care system better.

[Lauren]

"-- and as for everyone being taxed for it -- well it happens with schools, and libraries and so many other things. That's life. And it's a small price to pay to make insurance companies change their ways and to try to make our health care system better."

Tom, I agree. I'm often baffled as to the priorities people set - it seems, with many of these responses, that money has come to take such a valuable position in our lives that we would rather do anything except raise our taxes, as if money were to be equated with happiness. In fact, countries with the highest amount of income tax (about 50%) are also the happiness countries in the world, and have the most efficient social programs. Their population may be smaller, but they are also more stable, have less increase in economic growth, and clearly, different priorities from us.
Perhaps, Adderall, you will react by saying there is nothing to learn from the rest of the world? America does it best?

[Kreel Sarloo]

Lauren

Life expectancy in America is affected by factors which have absolutely nothing to do with healthcare and infant mortality rates are different because what is a live birth is counted differently.

On things like cancer survival outcomes the US is as good as or better than anywhere in the world.

[Kreel Sarloo]

Oh, and health insurance sucks because it's not insurance. It's a transfer payment.

What people really seem to be complaining about is that they can't get someone else to pay their medical bills.

I don't really understand why people expect this.

I mean, how many people expect someone else to pay their grocery bills?

[Lauren]

It's funny how we never equated grocery bills with school bills - I don't want to pay for any children I have in the future to go to school, especially if I can't afford it. But, for some reason, instead of equating health care with education, you're equating it with grocery stores. Fascinating.

[Twisted Nerve]

Chicago Tom, it sound to me that you are simply restating the submit quietly option
"So based on the choices I am being given, I am choosing one of them, rather than sticking to some ideological belief that will not come to fruition"
just with a little more elaboration. I chafe under collar and chain, so I think I will continue trying to break free.

Lauren, my experience with private insurance is exactly the opposite, simple efficient and reasonable. Neither of our anecdotal experiences should be the basis for picking the pockets of others. Also, money is a enormous factor in my happiness. See, I only have so many hours of existence, and only a portion of those that I can trade with others for the things that I need or desire. Money is the conduit for that exchange, and it allows me to provide myself and my family with food, shelter, and leisure time so that I may enjoy my family and things that give me pleasure, in a word, happiness. When I have to apportion a larger and larger portion of those precious hours of my life to provide free stuff for others the wont do so for them, the I am sorry, Yes that strikes me a fundamentally unjust.

[Lauren]

It would indeed strike you as unjust, unless it was one of your family members who you were giving your time and/or money to. If you didn't know the person, or didn't care about them if you did, then yea, I get it, you don't want to take care of strangers.
Well big deal. You're already doing that with the concept of taxes in the first place. And if you can't see how benefiting someone you don't know indirectly betters your life, by making society better, by reducing the amount of sick or poor, by moving in the direction of a better future for yours and everyone elses children, then... you aren't looking at a big enough picture, but rather a small one which includes only your money, your family, and the "so many hours of existence" you have left, and beyond these things you could give a rat's ass about the world and people.

Am I getting it right? I'm just trying to understand you, but it's so difficult because I have this innate sense of empathy, and it really blocks all those self-interested perspectives from being properly understood. But I try.

[Kreel Sarloo]

It's funny how we never equated grocery bills with school bills -

You're even more of a newcomer than I thought. That very thing is discussed herer all the time. And, I don't quite know how to say this to a sensitive soul like you, we even talk about closing all the government schools.

I don't want to pay for any children I have in the future to go to school, especially if I can't afford it.

Well, geez, Lauren, I don't want to pay for my booze and hookers, especially if I can't afford them.

Why in the world do you believe you're entitled to to consume something that has to be produced by someone else.

[Kreel Sarloo]

Why in the world do you believe you're entitled to to consume something that has to be produced by someone else without paying for it?

that is.

A lot of people I know call that stealing.

And the world would certainly be a better place with less stealing.

[Twisted Nerve]

Lauren, sorry I am not as wonderfully empathetic as you; I'm just a low down greedy bastard, perhaps it is a birth defect. Except that I don't mind contributing to provide health care for the infirmed and infants. It's called Medicaid. What I don't want to do is pay for your health care; you are neither infirmed nor an infant, so hitch up your britches and see after yourself, I will do the same. Or perhaps we can work out an exchange, you come mow my yard for a month, and I will pay for your next annual physical, or better yet perhaps I could pay you money, and you can use that to pay for your physical, which seems fair to me. Apparently that is cruel and unjust to you, and as luck would have it you have the government that you can get to twist my arm, throw me in jail, or put a bullet in my head to get me to do your bidding. And you don't even have to break a sweat; much less get grass clippings all over your shoes. Sounds like a good deal for you, I can see why you like it so. As for me who cares, remember I'm the greedy bastard, I just got what I deserved.

[Lauren]

"The world would be a better place if..."

This is really what's on our mind. What our ideal future world looks like - yours and mine clearly differ.
But, human society in general decided long ago, as has been witnessed in nearly every country and culture we observe, that it is beneficial to our society to have a healthy, educated, protected citizenry and that, because we collectively want and appreciate this, we're all willing to pay for it as citizens of said culture or country, in exchange for these services. The reason we did this is because our society becomes stronger, smarter, more productive, healthier, and on and on...
But I guess you just want to cut out and try your luck on your own? Find a good school and pay for it on your own, find your own insurance provider, and such?

[Lauren]

Twisted,
You're already paying for me because I'm uninsured, and if/when I ever step inside an emergency room and rack up ridiculous costs, you'll pay for them, not me. Because I can't (poor, and such.) But, let's say I was impaired, infirmed, or otherwise incapable of walking over and mowing your lawn. Would you consider me worth paying for then? What if I was a genius, like Steven Hawking, would you pay for my computer chair?
The idea behind having a public service is to help those who are uninsured for a variety of reasons. It's beneficial as a whole to care for these people rather than let them spiral ever downward in debt and sickness and drag the economy and country down with them -
We're all connected, and you really don't see it, do you?

[Kreel Sarloo]

You're already paying for me because I'm uninsured, and if/when I ever step inside an emergency room and rack up ridiculous costs, you'll pay for them, not me. Because I can't (poor, and such.)

Ahah. you have revealed what I suspected from the first. You're not high minded, idealistic and compassionate, you're just a sponger. Most people who talk the way you do try to play the part of the former but they always in the end show themselves as the latter.

Believe me, I'm not paying for you at the emergency room because I want to, I'd have no trouble at all with them throwing you out on your ass.

I rarely get this personal, but I really can't stand selfrighteous selfentitled assholes.

[Lauren]

Look man, I'm not tryin' to be self-righteous in my lack of money. I really just can't afford the insurance, and try not to get sick. I'm good at that, don't worry. But, I want and need a job, and if I had one I would gladly give some of my money to support a public system that I could use, instead of having to wonder if hospital bills will suck me into that black hole of debt that I see all around me - sorry if I don't want that. I understand it's the norm for most people.

[Twisted Nerve]

Lauren, yes if you were acutally unable to come over and mow my lawn because you were truly incapacitated, the I would want to help you. I thought I made that clear. You wouldnt be WOTRH paying for, but I would feel compassion for your situation and be moved to help. I would not however got to my neightbor and demand that they do the same. Sorry, but you just arent that important, neither am I.
And not to change the subject, but you are already in a black hole a debt, your portion of the PUBLIC debt is staggering. We got in large part via the same reasoning and methods now being conteplated for national heath care. I wonder how that going to turn out for us.

[Kreel Sarloo]

Lauren, that's fine, as long as you just admit that you're a sponger. Frankly, I'd have no problem begging if I had to (and actually havein the far distant past) but I'd never pretend I was getting something i was really entitled to.

But you see, you started out with this whole like, high minded, idealistic and compassionate pose and now we know that's all bullshit.

So I hope you'll understand when I tell you that you're not someone that I'm going to take seriously in a discussion on public policy.

You see, your poverty, your potential sickness or any children you should happen to bear do not constitute any kind of claim whatsoever on the property or resources of others.

Now it's a wonderful thing if someone decides to help you out out of the goodness of his or her heart (or even to get you to quit your pitiful whinging) but it isn'rt a debtr they owe you, it's a gift and charity.

And yes the world would be a better place with more charitable and compassionate people in it, but you're not going to get that if you go around putting people in jail or killing them because they don't meet you standards of compassion and charity.

And, believe me, when you advocate for a law what you're saying is, "this issue is so important that it's ok to kill people if they fail to comply."

[Lauren]

Funny how I don't remember ever advocated for the death of anyone - in fact, my main principles behind what I say directly oppose anything like that, so your assumptions are strange and pitiful at best, Kreel...
However, to claim that I cannot be idealistic and poor at the same time?

"The property or resources of others,"
I hear the "Mine" game again.
I took a hike through Alaska with some friends once, and we played a game called "Mine." Every time someone said that, you had to do 10 push-ups, or 20 sit-ups. And we kept track of who was winning. By the end of the 3 weeks, none of us were saying "Mine," or even playing anymore. It was pretty fun, I think you should try it some time.

[Kreel Sarloo]

Lauren, what happens to prisoners who resist?

In case you aren't aware, they either get severely beaten or they get killed.

Pass a law and you have turned over the fates of hundreds if not thousands of people to the tender mercies of psycopathic, violent thugs called policemen and prison guards. And yes when you turn to force to get your way you and aren't prepared to do it yourself your contracting it out to the kind of violent sadistic psychos who like doing that kind of thing. It's one thing when people who have actually caused harm to others fall into their clutches but condemning people to this treatment because you don't like the way they live is just plain evil.

"However, to claim that I cannot be idealistic and poor at the same time?"

No, you can't be a mocher and expect anyone to take your idealistism seriously.

"It was pretty fun, I think you should try it some time."

No, I shouldn't. It's sounds vapid and selfabsorbed and pointless. Exactly the way your life sounds.

But I'll give you credit, you might be an airheaded vacuous bimbo, but you sure can take a lot of punishment. You've worn me out. Doesn't matter how many insults you come back for more. What a fine verbal punching bag you are. But I'm tired.

[Twisted Nerve]

Lauren,
Yo may not be acvocating for the death of someone for not funding the lifestyle to which you have become accusotmed, but think it thru....
If Kreel were to say no, I am not paying, a process begins which ends up with him, if he remains uncooperative,being escorted to prison, with people carrying guns. If he resists that guess what those guns are for?

RE: the "mine" (mind?) game; sorry that sounds like a creepy cultish mind conditioning routine to me. Were your friends Moonies by any chance?

[Kreel Sarloo]

"RE: the "mine" (mind?) game; sorry that sounds like a creepy cultish mind conditioning routine to me. Were your friends Moonies by any chance?"

That's it. I knew something like that was what I was looking for.

But seriously, Lauren. What is wrong with "mine"?

Why shouldn't I enjoy what I create?

"Because you might offend some loser who can't do what you do" is not an acceptable answer.

[um]

Isn't Lauren just a spoof troll?

[Adderall Apocalypse]

Hey, Lauren. I'm pretty sure you confused me with "the Angry Optimist" a couple of times... Thanks... Thanks a lot!

[wizard of oz books]

With many new announcement about the wizard of oz movies in the news, you might want to consider starting to obtain Wizard of Oz book series either as collectible or investment at RareOzBooks.com.

[CaptiousNut]

I believe it a mistake to praise/elevate Mankiw for this article. Rightfully, he should be de-certified for his larger portfolio of folly and rank hypocrisy.

Consider my blog post on this same article:

http://marginalizingmorons.blo.....atism.html

[????? ??????]

Thanks