Barack Obama

Mandating Disaster

Will Americans be forced to buy health insurance?

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ObamaCare has nothing going for it anymore. With unemployment touching double digits, its economic timing is bad; with polls showing tanking support in every group outside of the narrow sliver of die-hard liberal reformers, its political timing is bad; and with the Center for Medicare and Medicaid Services last week saying that it'll add billions to the already out-of-control deficit, its fiscal timing has gone from bad to awful.

So how are Comrades Pelosi, Reid, and Obama able to march ahead with their grand designs undeterred? One reason is that Republicans have done precious little to seize the moral high ground from them. By insisting on the removal of the public option—instead of the individual mandate—as the price of doing business, Republicans have missed a major opportunity to put Democrats on the defensive and change the terms of the debate.

Republicans threw down the gauntlet on the public option—a government-funded, Medicare-style insurance plan that will compete with private insurance—in a June letter to Obama. "Washington-run programs undermine market-based competition through their ability to impose price controls and shift costs to other purchasers," they said. "The end result would be a federal government takeover of our health care system, taking decisions out of the hands of doctors and patients and placing them in the hands of a Washington bureaucracy."

True. But the problem is that Democrats don't need the public option to engineer a "federal takeover of our health care system." All they need is the power to force Americans to purchase insurance.

A mandate will fundamentally alter the relationship between Americans and their government. Instead of the government being accountable to them, they will become accountable to their government. No less than the Congressional Budget Office—a non-partisan government agency—once admitted as much. "A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action," it noted. "The government has never required people to buy any good or service as a condition of lawful residence in the United States."

If the government can force Americans to buy coverage on the threat of fines or even imprisonment—an option that Nancy Pelosi has pointedly refused to rule out—every other government diktat becomes small potatoes by contrast. In fact, it becomes necessary. If uninsured Americans must buy coverage, why shouldn't other Americans be taxed to subsidize them? Why shouldn't the insurance industry be required to sell them coverage? Why shouldn't government set insurance prices to ensure affordability? Why shouldn't doctors and hospitals be asked to charge only "reasonable" rates—or offer only government-sanctioned treatments? Nothing about ObamaCare fundamentally changes so long as the individual mandate remains intact.

Therefore, instead of wonkishly droning about the public option, Republicans should counter Democrats' grand appeals for "universal coverage for all" with equally grand appeals for "medical freedom for all." They should stand together on the Capitol steps and issue the health care equivalent of Reagan's Berlin Wall ultimatum: "Mr. President: Tear up this mandate."

During the campaign, Obama himself successfully stopped poor Hillary dead in her tracks by reminding voters at every turn of her tyrannical plans to force them to purchase coverage. So why aren't Republicans doing the same to Obama?

The main reason is that they themselves are deeply conflicted about the mandate. On the one hand, every Republican on the Senate Finance Committee voted against it—except, of course, for Maine's Sen. Olympia Wavering-Heart Snowe. On the other hand, many Republicans, led by their intellectual lights at the conservative Heritage Foundation, among others, have long accepted—no, championed—the notion that unless people are forced to carry insurance, freeloaders who land in emergency rooms will cripple the health care system. Legislate personal responsibility, in other words. It was a Heritage plan for forced coverage that formed the blueprint for the Massachusetts universal care debacle that the then Republican Gov. Mitt Romney enacted.

Thus Republicans have no leg to stand on now that Obama, pulling one of his many switcheroos, has embraced the individual mandate. Heritage folks are trying to pull their own switcheroo by opposing Obama's mandate, saying what they had originally proposed for Massachusetts was not really a mandate but actually a self-insurance scheme under which an uninsured person would have to post a personal bond before being treated in an emergency room.

But countering mandates with bonds doesn't exactly make for a rousing rallying cry. Indeed, both ideas are based on the mistaken diagnosis that the central cause of our health care woes is the cost of uncompensated care that the uninsured get. The fact of the matter is that this care accounts for no more than $40 billion of the country's $2.26 trillion health care bill—or less than 3 percent of total health care spending. This is less than what department stores lose to shoplifting every year. Several private hospitals that I visited in India last month make a fraction of the profits that American hospitals do but still reported treating up to 10 percent of their patients for free.

The mandate barring American hospitals from denying treatment to anyone who lands in emergency—the root of the supposed freeloader problem—certainly imposes a heavy burden on some hospitals, especially in inner cities. But it is far from clear that it forces American hospitals as a whole to provide more charitable care to the uninsured than what they would have without it. It would certainly be worthwhile at some point to consider policy options to replace this mandate with mechanisms to strengthen voluntary charity by hospitals and others. In the meantime, however, there is zero evidence to suggest that this mandate is imposing a crippling enough burden on hospitals to warrant mandates on everyone else as well.

The Republican strategy for defeating ObamaCare consists of notifying: seniors that they will face rationing and loss of private Medicare options; the uninsured that they will face fines and possibly jail; the young and healthy that they will have to subsidize the old and sick, etc. Alerting Americans to the personal dangers they will confront under ObamaCare is certainly a legitimate part of the political process.

However, the downside of a strategy based entirely on fear is that even if it succeeds now, it won't help to define the proper terms for a genuine solution in the future. For that, Republicans have to offer a principled critique of ObamaCare that delineates the sharp moral choices that Americans face. The current health care battle is the domestic policy equivalent of the Cold War. Democrats are on the side of command-and-control mandates that deprive individuals of choice. Republicans should position themselves on the side of market-based solutions that empower—not enchain—patients.

Shikha Dalmia is a senior analyst at Reason Foundation and a bi-weekly Forbes columnist. This article originally appeared at Forbes.

NEXT: Imperial Eukaryotes

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  1. Umm, we are “forced” to “buy” all sorts of services – retirement savings, police protection, roads, etc – via taxes. The only difference is the accounting. Even the threat of imprisonment is the same!

    The “sharp moral choice” we face is whether we should continue to pay 50% more for a system that provides lackluster care and leaves many uninsured and vunerable to disaster. The “moral” choice is obvious.

    1. Wow. what a winning argument.

      Throw away the compelling indisputable violation (Congress Forcing you to buy something from a 3rd party) and equate it with taxation.

      Wow. that’ll change things!

      1. Eh, Chad’s like that. He thinks we should be forced to do pretty much everything… liberals like him are only pro-choice on abortion and being gay.

        But they’ll damned well be glad to tell you what kind of car to drive, whether you can consume trans-fats, or where you can smoke a cigar.

        1. Actually I am pro life, and yes, “pro-gay” in the sense that any adult should be able to screw any other adult anyhow in any private place they so wish. You got a problem with that?

          1. Wow, surprising you’re pro-life. Although that would prevent you from running for office as a Democrat.

            As for being pro-gay, no, there’s nothing wrong with that. I am, too, in the sense that gov’t should keep its collectivist nose out of their business.

            But what else are you pro-choice on, Chad? Not health care, that’s for damned sure.

            1. You’re definitely not pro-choice when it comes to health care. Fuck the 10th Amendment, force all 50 states to comply, right?

              Hugo Chavez would love someone like you on his staff. And you can afford a one-way ticket. Be sure to send us a postcard.

              1. I disagree. The systems I advocate actually have more choice than what most Americans have now. People do not want a “choice” between a bunch of equally perverted health insurance plans. What they want is a choice of doctor, which is actually more restricted in our system than any national system I know of.

                The choices you are fighting for are worthless, enormously expensive, and result in high risk. They aren’t worth it.

                1. Again, you want the fed to lord it over all 50 states, mandating something it has no business mandating in the first goddamned place.

                  That’s your “solution”, and it’s perverted logic. Using that reasoning, food and shelter and clothing should be paid out of some magical universal/single-payer/socialist utopian horn o’ plenty.

                  Fuck, why have a private sector at all?

                  1. He’s a die hard fascist … I wouldn’t bother responding to him.

      2. Vince, there is little practical difference betweeen this policy and taxation. To libertarians, taxes are some sort of mortal sin. To the rest of the world, they are merely an necessary annoyance.

        1. The difference is we don’t buy the your fallacious argument that health insurance is some special good that only the government can properly provide such as police protection and national security are.

          Therefore taxes/mandates to pay for such things are an unjustified intrusion upon people’s individual rights. Non anarchist libertarians accept taxation, just not taxation and government provision of things markets can provide just fine. Don’t say markets don’t work for the current system because we don’t really have them in individual health insurance due to the ban in interstate commerce on individual plans.

          There is the additional practical concern of even if the mandate were restricted to catastrophic care so people couldn’t “freeload” off the E.R. , the mandate will go well beyond this requiring people to buy all sorts of coverage for non essential health needs like alcoholism treatment and in vitro fertilization such as many states currently mandate.

          You are building up a straw man here, Chad; rather than defend your own position.

        2. They’re a mortal sin when they add up to half or more of one’s income.

          But hey, soak the rich, right? That’s what they’re HERE for, right? Half isn’t enough, take 90 percent, right?

        3. Taxes may be a necessary annoyance to the rest of the world, who after all think that businessmen too are a necessary annoyance. They also seem to think, as proved repeatedly by history, that when necessary annoyances are no longer necessary it is perfectly fine to kill those who are necessarily annoying. Taxes at a local level are usually far better than taxes at a state level, which have to be better than taxes at a federal level. But to keep your own money is the most moral position of all, however annoying that is to people who don’t think that that is necessary. Yet, to have the feds take $20 out of every citizen to give it back to them as a stimulus and a community development block grant is indeed theft. For not only do we not get the true $20 back — but only $17, what with that $3 federal overhead charge, but then the feds will tell the payer of the $20 how to spend his $17. And to tell someone else how to spend the money you take from them is indeed immoral. Just as bank robbers are a necessary annoyance to having banks does not mean you eliminate banks to get rid of bank robbers. Sorry, Chad, your logic of “necessary annoyance” would have us appoint a king merely because he is a “necessary annoyance” which the rest of the world tolerates — and since the point of the country was NOT to be like the rest of the world, well, let them keep their necessary annoyances, and go join them. Oh, yeah, we got a passel full of czars — all necessary annoyances who are working diligently to decide if you yourself are a necessary or unnecessary annoyance to the Republic. Good luck when you become an unnecessary annoyance.

    2. Are you of the illusion that this will improve care and treatment rates?

    3. Re: Chad,

      Umm, we are “forced” to “buy” all sorts of services[…]

      That is not a valid argument.

      The “sharp moral choice” we face is whether we should continue to pay 50% more for a system that provides lackluster care and leaves many uninsured and vunerable to disaster. The “moral” choice is obvious.

      50% more compared to what? You’re begging the question.

      1. We pay around 50% more (in terms of GDP, even MORE in real dollars) than other industrialized nations. We are spending 16% of GDP. The next highest I have heard of is France at 12%. Most are around 10%.

        Our results are not impressive. We do well in some measures and awful in others….certainly nothing to crow about, nor pay a 50% premium for.

        1. Is your argument then that in the aggregate we spend too much on healthcare with too paltry results? That seems to be a valid position but I would say there is nothing in the current legislation that will aid that situation.

          As you suggest vulnerable people may indeed be saved from “catastrophe” but again, in the aggregate, health will not improve greatly. By what conceivable mechanism could this occur? And to believe that somehow healthcare costs will decline–however you choose to measure them–is to entertain fantasies, or to simply be dishonest.

          1. Take Japan, for example. They spend only 9-10% of GDP on health care, despite having far more seniors as a portion of the population. They also have more fancy gadgets (MRIs, cat scanners, etc) per capita, and go to the doctor far more often. How on earth do they hold costs down?

            First, their insurance system is actually a lot like the house and senate bills, but done right. They have a Medicare equivalent and a “public option” that covers the unemployed, self-employed, and students. Everyone else is covered via their employer, but the insurers are non-profit, regulated like utilities, and essentially identical.

            People pay basically an 8% tax for this. Co-pays are actually quite high (often 30%), but there is a generous out-of-pocket limit, so no one goes broke. This is actually not far different than the plans Republicans and Libertarians seem to like…essentially a “high deductible plan for all”. Of course, poor people are further subsidized.

            The high co-pay plan helps hold costs down, as does the centrally-negotiated pay tables. Prices for drugs and equipment are held low, and salaries are fair and not as excessive as they often are here.

            1. Just a quick question: is that “9-10% of GDP” including the “8% tax” that’s levied on the populace?

              1. Yes. The tax is like our social security tax…4% for you, 4% by your employer, which ultimately means you anyway.

    4. Equating a tax levied so that the government can provide Constitutionally required services such as national defense and infrastructure to a mandate on how people spend the money the government doesn’t take is about par for the course as far as idiotic comparisons go.

      Chad, if we assume that the healthcare systems of other countries are as vastly superior as you claim, should Americans be allowed the opportunity to pay into those superior systems and reap the benefits of doing so? If you want to equate health insurance to other products, the government doesn’t forbid Americans from buying foreign made cars.

      1. Oh, so you only object to taxes on Constitutional grounds. So if the Constitution was modified such that the health care bill was clearly constitutional, you would be ok with it?

        It is not feasible for foreign nations to sell their plans here, as their doctors are not here, and the systems function precisely because they are NOT optional for their citizens.

        1. “Oh, so you only object to taxes on Constitutional grounds.”

          Where did I say that?

          “So if the Constitution was modified such that the health care bill was clearly constitutional, you would be ok with it?”

          No, I’d still object on moral grounds, but if the government were to do this, I at least could not say that what they were doing is unconstitutional. But the Democrats know they wouldn’t be able to get an Amendment passed that gave the federal government the authority to tell Americans how to spend their untaxed money, so they’ll just try to ram the bill through on their own (or nearly so, in the House bill’s case), and stuff the Supreme Court with judges who will legislate from the bench.

          “It is not feasible for foreign nations to sell their plans here, as their doctors are not here, and the systems function precisely because they are NOT optional for their citizens.”

          That makes no sense whatsoever. Are you now saying that doctors in these countries are better than those in America? Health insurance =/= healthcare. An American buying into their system would simply be subject to that country’s laws regarding what is and what is not covered. They submit their claims through the doctor’s offices, who file them electronically (no Pony Express anymore). It would be logistically easier to purchase health insurance from another country than to purchase a car, as there’s no material goods to ship. You don’t have to send over a health insurance policy by boat the way you do a Toyota.

          And if these foreign plans are not optional for their citizens, that should make it all the more desirable for non-citizens to join, as the plans already have a source of healthy individuals being forced pay in to pay for the care of whatever pre-existing conditions the sicker individuals might have. Let those who want to keep the ‘broken’ system we have do so, and those who want something better have access to it.

          1. Their doctors are not better. They are CHEAPER. We significantly overpay ours, especially specialists.

            It is their entire system that works, not some little element, which you seem to be trying to extract. No, they would not be any more efficient than our insurance companies at doing what our insurance companies do. The whole problem is that our insurance companies are doing the wrong thing in the first place.

            And if you think you are going to keep your insurance much longer, you either are on the Medicaid dole, or believe in some fantasy world where your employer is going to pay $25000/year for your insurance in 2020. The industry, by its own admission, expects to jack rates 79% in the next decade. Do the math.

            1. Maximum wage, Chad?

              1. Naah, just much higher taxes on huge incomes. In particular, we need to raise the capital gains tax and make it progressive. Wall Street tycoons can afford to pay as much as their secretaries. On the other hand, we should lower our corporate tax to 25% to bring it more in line with other nations’.

                1. But you hate rich people. Why would you want lower taxes for eeeevul corporations?

            2. “Their doctors are not better. They are CHEAPER. We significantly overpay ours, especially specialists.”

              I see, so now it’s the doctors who are greedy? Well we’ll just FORCE them to accept less, tax them on what the government allows them to make, and require them to continue providing medical care! That’ll teach ’em!

              Medicare already pays out less than what doctors charge, which is part of the reason why many doctors refuse to accept it. I’m sure the freedom to choose which health insurance providers doctors can accept will be quietly revoked somewhere in the 2,000+ pages of the bill, mixed in with the pork needed to get senators on board with it.

              1. No, we won’t “force” them to accept less. They are free to quit and find a different job that pays as much, if they can.

                You are living in some fantasy world if you think that either the number of doctors or their pay is set by anything approximating a free market.

                1. “No, we won’t “force” them to accept less. They are free to quit and find a different job that pays as much, if they can.”

                  Why take on the debt of the student loans they’d need to repay to become doctors if they can make the same in another field with less expensive educational requirements? Is Pelosi going to have to make altruism mandatory?

                  “You are living in some fantasy world if you think that either the number of doctors or their pay is set by anything approximating a free market.”

                  On this we agree. However, you have to provide an adequate incentive if you want people to become highly trained individuals with tons of responsibility (that being the continued health of their patients) on their shoulders. You have to pay them more than people who don’t need as much training, or don’t have as much responsibility, or else you will have a huge shortage of doctors, which will serve to increase the price of healthcare instead of reduce it.

                  You are living in some fantasy world if you think highly capable doctors won’t become more scarce if you just start paying them less, and that simple supply and demand will have no subsequent effect on the cost of healthcare.

          2. Brian, the Chads of the world assume that people have a “right” to health care.

            They don’t.

            1. A-fucking-men.

              This is the root of the argument that nobody wants to discuss. There are so many imbeciles out there that believe that they have a right to healthcare, education, housing and food. No you fucking don’t. Go out into the world and earn it. As for the less than 1% that cannot do so, well, we have charity for them. However, when you setup a system that “gives” these things away unconditionally, then you will have 3-10x as many lazy fucks who will abuse the system. Likewise, the persons who administer this system will ask to expand it for more money and goodies to give to their cronies, too. Moral hazard is a pretty basic concept, but the folks with good intentions are just blind to it.

              1. But… but… what about poor people who can’t work at McDonald’s because of their french-fry allergies?

                You don’t care about The Children, either, you selfish bastard. I’ll bet you want to keep most, if not all, of your income. How fucking DARE you. That money belongs to The People, not your tightwad ass.

    5. This Chad guy is pretty awesome. Libertarians need to drop the bad GOP arguments on this stuff. Which isn’t to say there aren’t arguments to be made about the current plan, but I’m sick of people waxing holier than thou about protecting the current corporatist system.

      There is nothing resembling a free market in almost any aspect of American Healthcare, so you bozos aren’t exactly defending Adam Smith from Marx here. The question is how efficient the system will be.

    6. If by lackluster you mean “best survival outcomes on the planet” then yes, the US is lackluster.

      And oh yeah. Just because you enslave some people for some things doesn’t excuse enslaving more people.

      Just sayin.

      We’re forced to pay for a corrupt government that ignores the voice of the people. That doesn’t make it moral.

      Your argument boils down to nihilism.

      And yet you are shocked that every time any nation falls to collectivism that nihilism becomes the rule of the land.

  2. This article is WRONG!!!

    Republicans have done their darness to derail the President’s plan.

    Hopefully, they will be unsuccessful.

    I’d rather pay for other peoples healing than other peoples amputations, decapitation, paralization that the “MORAL PEOPLE” that don’t want healthcare and want WAR do.

    Go to hell u stingy people. U r already paying for war, israel, .latin america, africa, the roads, the salaries and healthcare of senators, the cops, the drug war…so what something else is going on your tab.

    None of u said anything when bozo paid $11billion per month for iraq. Now, all of the sudden, everyone is concerned about the budget. Fuck all of u.

    I hope he does nationalize healthcare.

    1. I hope you get really sick and need it.

      1. i can tell u had a really nice friday

      2. That’s the problem KY Jelly…No one realizes how important the healthcare is until u get really sick. That ‘s why 80% of people are happy with their plan…b/cause they don’t realize what will happen once they become sick.

        1. Why do you believe this legislation is going to make things better. The Bill has been, and is still being, crafted to get enough votes to pass, not necessarily to “fix” anything.

          1. Why? Because we have the most right-wing system in the industrialized world, and it sucks. We vastly overpay for mediocre care, while living under the constant threat of getting screwed that no other citizen of any advanced nation faces.

            Despite all your screams of “left-wing socialism”, if any variant of these bills pass, WE WILL STILL HAVE THE MOST RIGHT WING SYSTEM OF ANY RICH NATION. And yes, it will still suck, but a little less so.

            1. As much as libertarians note that socialism and fascism are simply two sides of the same coin, there is one crucial difference: In the latter the government directs nominally private interests to government ends rather than simply running the interests outright.

              So in that sense, yes, after this bill passes — perish the thought — with all of its mandates on insurers and mandates on consumers, we will have the most right wing system of any rich nation.

              1. It’s not right-wing.

                Socialism and Fascism are just Collectivist cousins.

                Musillini (who formed Fascism) was a Marxist who rejected the anti-nationalist ideas of class struggle but who nonetheless believed in Anti-Liberal Collectivism mixed in with Proto-fascist American progressivism.

            2. Re: Chad,

              Why? Because we have the most right-wing system in the industrialized world, and it sucks.

              What’s a “right-wing” system? I have been in this country 6 years and all I can say is that you either have Socialism light or Socialism Heavy Duty. Right or Left are meaningless terms.

              1. If everyone else’s is even more socialistic than ours (which they are), then we are the right wing, by definition.

                1. So?

            3. As opposed to vastly overpaying for crappy care?

              At any rate. The fact that the government would have a financial stake in my personal health choices is COMPLETELY unacceptable. This leaves the option for gubmint to tell me how I should eat (which btw they are trying to do already). I choose NOT to give government a say in my day to day liberties. That is why I WILL seek out any representative of mine that voted for this monstrosity and vote against them regardless of the parenthetical letter that follows their name on CSPAN.

              1. The problem is your childish, self-serving and petty concept of liberty, where a Wall Street tycoon has less “freedom” than a lone man starving on a desert island.

                How does a system that is complex, dangerous, and expensive make you more “free” than a system which is safe, automatic, and cheap? Simply because the former offers you a few almost identical complex, dangerous and expensive options?

                1. I love this stinky old argument.

                  Social orders don’t apply to lone men on desert islands, do they Chad? Should he vote for himself to pass a law forcing himself to get health insurance? The true “single payer”.

                  If, however, there were two other people starving on the island, then Yes, he would be less free if the they formed a majority rule over him and tasked him with providing their survival in exchange for allowing his.

                  I’m not saying Wall Streeters are my heroes, I’m just saying that your thoughts smell like farty dorm-rooms.

                2. Hmmm …

                  System where people need to take responsibility for their own lives and earn what they keep – childish

                  System where government makes things “safe, automatic and cheap” through control – is “free” (in the liberty sense)

                  Makes sense to me.

            4. And if we had the most LEFT-wing system in the industrialized world… we’d all be farting health care. Right?

              Jesus, if you hate it so much… fucking move, Chad. Cuba would love to have another true believer.

              1. Actually, it would be better if you left the country for once. You’d quickly learn that we ain’t number one in everything anymore.

                Try it, you may like it.

                1. I can’t afford to leave, Chad. You make more money than I do, although your dumbshit logic compels you to pay more in taxes than you should.

                  1. There isn’t any place in America where it would cost you more than a few tanks of gas to get the heck out.

                    1. Um… living expenses? Visas? I’m on a goddamned no-fly list, too, because I sported Ron Paul stickers on my car.

                      Why should I have to leave my country when it’s you that wants to turn it into a socialist hellhole? YOU should get the fuck out, and go somewhere more in line with your belief system.

                      I hear Kim Jong Il could use a hand…

                    2. Get a job. Miraculously, your “living expenses” get taken care of.

                      And are you seriously so crackpot that you believe Ron Paul stickers get you on a no-fly list?

                    3. No crackpot about it:

                      http://www.constitution.org/ab…..report.pdf

                      Scroll down to page 7 of the report. It tried to tie support of Ron Paul, Bob Barr, or other non-liberal parties into the white-supremacist movement. In clear violation of Homeland Security guidelines, it used political profiling against people who did nothing more than show support for presidential candidates… instead of focusing on the actual, dangerous groups.

                      Displaying a Gadsen flag = terrorist, according to that mindset. But you’d be okay with that, wouldn’t you?

                    4. And there you go Chad: telling necessary annoyances — those who want to keep their money — to get out of the country. Which is exactly what our grandfathers/mothers did — they were necessary annoyances for liberty in Europe, who became unnecessary for the local king, so they were told to leave and came to America, and now, you, arbiter of what anyone should spend on health care, and who and who is not a necessary annoyance, will not be asked to leave, as if banished from a Medieval kingdom. Got to hand it to our modernism, Chad — right their with Edward III of England lo those many enlightened years ago.

                  2. And btw, I *worked* overseas and made decent money doing it. There is no need for significant upfront cash.

                    1. I don’t want to leave my country, Chad. I want you and your ilk to not turn it into a proto-communist hellhole.

                      It’s you and your fellow travelers who should leave… or give up trying to impose your colletivist hogwash on the whole of the populace.

    2. None of u said anything when bozo paid $11billion per month for iraq. Now, all of the sudden, everyone is concerned about the budget. Fuck all of u.

      You don’t read this site very often, do you?

      1. I’m glad someone finally said it. My God, when GWB was president, all the bloggers on this site were almost as anti-war as moveon.org. I think Alice Bowie and Ray Butlers may be the same person. They both assume that we’re all GWB lovers.

    3. Re: Alice Bowie,

      Republicans have done their darness to derail the President’s plan.

      No, they have not. Republirats are pussies.

      I’d rather pay for other peoples healing than other peoples amputations, decapitation, paralization that the “MORAL PEOPLE” that don’t want healthcare and want WAR do.

      I’d rather think I do not face such a false dilemma. I’d rather want to pay for NEITHER.

      None of [you] said anything when bozo paid $11billion per month for [I]raq.

      You probably have not been around here much.

    4. Alice, it’s this simple:

      I don’t want YOU to pay for MY health care.

      Why do want ME to pay for YOURS?

      1. U say that 2-day … bcause u r fine

        if u were terminally ill, and can’t work, I’d be more than happy 2 pay ur healthcare along with the rest of the american taxpayer.

        1. if i were 2rminally L, then i would be happy 2 tell u to mind your own business rather than commit other people’s money in a vain attempt to assuage the guilt u seem 2 feel at your own good health.

        2. You didn’t answer my question, Alice.

        3. You’re also assuming I’m “fine”, Alice. For all you know, I may not BE fine.

          My body, my choice. Not yours.

        4. Post your address and I’ll be sure to contact you if that ever happens. In the meantime, until that happens, keep you fucking hands out of my pockets so I can save enough money myself to take care of myself …

    5. Yes, come on the libertarian website and whine about us “stingy people” happily paying for foreign wars, bloated government salaries, and the war on drugs. No libertarian has ever criticized those…

      1. It only counts if one complains from the progressive POV.

    6. “u” just made me sick.

      1. No need to be such a stingy tight wad, Alice. Splurge, y and o are only two more keystrokes.

        Not like you would, you people are all the same.

        There should be a law forcing you to give up enough of those keystrokes you’ve been looting from the public and hiding off shore to cover all the poor people too lazy to do their own keystrokes.

        Fascist pig!

    7. None of u said anything when bozo paid $11billion per month for iraq. Now, all of the sudden, everyone is concerned about the budget. Fuck all of u.

      Careful. You’re on a libertarian website saying this. You need to be on TownHall or MichellMalkin. There are plenty of anti-IRaq invasion libertarians around, me included.

    8. Alice you’re a moron. If nationalizing anything made for abundance we wouldn’t be having the argument.

      Your ‘solution’ will kill more people. That’s why we’re against it. Because you’re too stupid to avail yourself of the data from every nation where it’s been tried doesn’t help your case.

      None of u said anything when bozo paid $11billion per month for iraq.

      Ok I stand corrected, you’re Queen moron. The vast majority of libertarians were against the war and the spending for the war.

  3. There should be a nation-wide strike. No one go to work.. flood your downtowns and demand the restoration of the Constitution.

    1. I think I speak for many when I say, “What the fuck?”

      1. You dont need to remind me that fucking people like you are Constitutionally illiterate. Of course you dont fucking know what I’m talking about you fucking statist.

  4. Shikha, you do better when you use less rhetoric. As demonstrated by the above comments, you’ve largely engaged your readers on an emotional level, and you’ve gotten mostly emotional responses.

    My impression of the Republican response was that they are really a corporatist party at heart. The mandate supports this agenda. The public option was the only part that undermined it.

    As a party, they only seem to get any inertia for free markets when they have a corporate client in mind. This is the only way that I have been able to make sense of the last eight years. They are only interested in libertarians if we can get them to the dance, but once there they really want to dance with the corporatists.

    1. Amen.

    2. At least they do dance with us before the bend us over.

      The dems never take time from dancing with the corporatists.

  5. @Rimfax I’m inclined to agree with you.

  6. The Republicans know as well as the Democrats that without the insurance mandate, the private insurance industry would be broke in few years, given the requirement to take people with pre-existing conditions. The Republicans would rather have a private insurance industry than not, and are too cowardly to argue the perverse consequences of the pre-existing conditions stuff.

    However, the mandate really is horrifying. It’s no small potatoes to buy health insurance at current prices, and the bill explicitly requires such coverage to be comprehensive (and hence expensive).

    Here’s what’s going on: This elaborately contrived scheme is all a mechanism to try to allow Americans to have their cake and eat it too, by promising free unlimited healthcare, forcing third parties to pay for it, and then cost shifting repeatedly, all the way back to the federal budget.

    You force health insurers to cover already-sick patients. You force individuals to buy insurance – thereby subsidizing the sick patients. Then you subsidize individuals so they can buy the insurance. The money is ultimately coming from the federal budget.

    But who is allowed to control costs? Nobody! The insurance companies can’t turn anyone down or deny treatment. Individuals can’t opt out of the system by not buying insurance. The government subsidies become a new entitlement, so they can’t refuse to pay the premiums either. Ultimately this system is deliberately contrived to avoid cost control. It’s a deliberate mechanism for making sure that sick people get unlimited treatment, other people are forced to pay for it, and those people can’t restrict what they pay for.

    1. OMG U JUST SAY THAT NOW B-CUZ U R FINE!

    2. I’ve never seen it put so well.

    3. You’re so right.

      But there will be cost controls imposed. Later. When the rats can’t get off the ship anymore, because every other ship already sank.

  7. …and then cost shifting repeatedly, all the way back to the federal budget.
    This is the new American Way. It’s our new core competency. How can you deny us that which we are so obviously good at? 😉

  8. As Hazel Meade describes the scam, it sounds like a variation on the game of “Bailout,” which G. Edward Griffin described so clearly in his “Creature From Jekyll Island” book. Griffin’s explanation and anecdotes illustrating the rules of the game should be taught in schools by the eighth grade, so that soon-grown kids will be equipped to call shenanigans on government scams like this one and the recent financial bailouts.

  9. Hazel Meade|11.20.09 @ 8:23PM|#
    The Republicans know as well as the Democrats that without the insurance mandate, the private insurance industry would be broke in few years, given the requirement to take people with pre-existing conditions.

    Hazel gets right to the heart of it, here. Thanks for making our point!

    The insurance industry only profits by AVOIDING PAYING FOR SICK PEOPLE. Whoda thunk?

    1. Sick people? They were not unresponsive

    2. Because you can’t insure people against events that have already happened…

      Do you even understand insurance?

      You can insure sick people against diseases they don’t have yet, however I would bet that this is quite hard to do under the current system, since if you have an illness that is mandated to be covered an insurer can’t write a policy that would exclude the pre existing condition while covering everything else.

      1. I agree, Tim. That is why optional health insurance does not work well, REGARDLESS OF WHO PAYS FOR IT. The adverse selection issue is inherent in any optional form of health insurance. This creates a massive market failure which can only be fixed by insuring everyone all the time.

        Everyone else has figured this out but us. Actually, we do understand this, as evidenced by our employer-based system, which has the practical effect of making insurance not really an option for 2/3 of people. This is enough to mitigate the adverse selection problem, but unfortunately leaves the self employed and unemployed in a real bind.

        1. Yes. We must FORCE people to have insurance.

          At gunpoint, if necessary.

        2. Then don’t call it insurance. That’s not what you want. You want either free or very heavily subsidized care.

          Economics 101 – making anything free or heavily subsidized doesn’t do much for quantity or quality of that which is being subsidized or given away.

        3. BTW – agree with you that the employer provided health care scheme is the source of the problem.

          What was that caused by … because government had imposed wage controls and companies, wanting to lure good people, starting offering health care as a way of increasing pay without violating the controls.

          But, hey, only free markets and evil corporations looking for profit ever cause any problems.

        4. The adverse selection issue is inherent in any optional form of health insurance.

          Oh really? How does this work exactly? It doesn’t seem to be a problem with any other insurance.

          You can’t answer that because you know the causes of adverse selection are all needless and directly laid at the foot of government.

          Everyone else has figured this out but us.

          Oh yes, and people have their care rationed and waiting in line to die is a viable triage method.

          unfortunately leaves the self employed and unemployed in a real bind.

          Yet the last thing you want to do is move the tax break to the individual. Or remove the barriers to insurance competition. Or fix the tort system. Or break up the prover cartels.

          All of which are easy to do and I will note, not that it seems important anymore, but are actually Constitutional measures we could take.

          Hmm.. I wonder why you’re afraid to try the simple things that will work?

    3. The insurance industry only profits by AVOIDING PAYING FOR SICK PEOPLE.

      Good God! What utter bullshit! If you don’t know that insurance companies make most of their “profits” by investing the premiums they take in, then you are too damned ignorant of the subject to even be expressing an opinion. However, what I suspect you really are is just plain dishonest.

      1. They can’t invest any money if they have to pay it out, silly goose.

        1. Hence the whole actuarial profession.

          Simplistically, premiums are meant to cover the cost of the risk associated with the policy and nothing more. Profits are made from investments. That is the model.

    4. The insurance industry, like every other industry, only profits by charging its customers nominally more than its customers cost.

      If they charge a person with a pre-existing conditions less than the expected value of that person’s expense, that is not insurance: that is charity.

      If the government forces them to do so, that is not insurance either. That is government welfare executed through nominally private interests with high-end mandates designed to guarantee profits.

      That is a service the insurance companies are only too willing to provide as it essentially makes them into profit-protected utilities.

      However, it completely messes up the market for the majority of people who could, in fact, afford health insurance on their own. A messed up health insurance market means a messed up health care market.

      And messed up markets don’t result in lower costs: they result in higher costs.

  10. Did I miss the meeting where health insurance became an inalienable right?

    1. When you equate health insurance with health care it is.

      And when you believe that human rights extend beyond self ownership but also magically entitle you to the labor of others.

    2. It isn’t a right, inalienable or otherwise.

      But Chad thinks it is. And there are millions of Chads in this country.

      1. Actually, have you ever heard me say it was a right? Because I haven’t.

        I base my policy choices on what works. Our system doesn’t, and everyone else’s, while not perfect, is better. Hence, we should behave like those crazy socialists in Taiwan, and look around the world to choose what is parts of which health care systems are working best everywhere else, and then implement those here.

        Libertarians, on the other hand, just blame all our problems on the government, as they always do, and keep bleating their same anti-tax anti-government mantras.

        1. Okay, YOU haven’t, but OTHER liberals insist health care is a “right”.

          Hell, Michael Moore thinks food is a right. But that’s understandable, as he must be fed often.

          If you weren’t so busy whoring for more government, and took your blinders off, you’d realize government IS the problem. But you won’t, because you have its dick in your mouth.

          1. And if you would take your blinders off, you would realize that the government is not the source of all problems, and can actually solve some.
            You would also realize that your free market religion does not always work well in the real world, where its assumptions are invalid.

            1. That’s funny, you calling me a religious zealot, when it’s YOUR kind who worship government and see the private sector as The Great Satan.

              I’m still amazed you call yourself an American citizen.

              1. I neither worship the government nor view the private sector as a pure evil. Both are tools, which can be useful if pointed in the right direction and deadly if pointed in the wrong direction.

                The problem is that you assume that the private sector is, by definition, always pointing in the right direction.

                1. I trust the private sector more than I trust 535 self-appointed experts/graft artists/criminal-minded powermongers.

                2. Free people are not “tools” (well, at least those not named Chad) to be used in your and others “direction pointing” – who appointed you (or BHO) God (or the great spaghetti monster in the sky, or whatever). Why do you believe that you have the knowledge to somehow pull the right levers and push the right buttons to get it all right.

                  I don’t believe that the market or private sector or whatever gets it right all of the time. But life isn’t perfect or perfectible – but at least we can live free and stand or fall on our own decisions.

            2. Have you ever questioned your assumptions about government? Your magical world of “sound government policy” never quite works out that way.

              Have you ever heard of “government failures” as analogous to “market failures”? Where things like rational ignorance and concentrated benefits and diffuse costs make it highly unlikely that when government gets control over something as broad as an individual mandate that the government will merely restrain itself to mandating the appropriate level of insurance coverage rather than mandating coverage for everything from Christian science faith healing to alcoholism treatment? How does the government even discover what the appropriate level of coverage is for each of its diverse citizens? How does the government know what the right price for treatments is? Markets figure those things out, something we don’t have now due to various state and federal interventions. When government controls rather than even simply redistributes 50% of all health spending, enforces state health insurance oligopolies, allows the AMA to rent seek, and gives a vast tax advantage to certain products over others you can’t really blame our health care problems on free markets; and you bear the burden of showing us how you can set up some magical government system that avoids these woes. For example the government system advocated here wouldn’t be the end of the world if run properly, a pretty big if. http://www.theatlantic.com/doc/200909/health-care

              You are in every way as “state worshiping” as you accuse us of being “market worshiping”; overstating the alleged threats of market failures just as you accuse us of overstating the problems with government. Virtually no markets ever meet the assumptions of perfect competition, but most goods are provided better by them than by government. Government programs aren’t created and administered by the perfectly informed, rational, and morally incorruptible Chad; they are written in back rooms by people like Nanci Pelosi and Harry Reid and administered by the same people that run the post office and the DMV.

              Ultimately government just replaces one set of poor incentives or collective action problem for another; for example good public policy itself is a public good. Only rarely in extreme cases like national defense and law and order does the case for government come out ahead, often by the narrowest margins.

              It’s not a choice between left or right utopias, but between second bests. That’s why I’m not an anarchist nor a purist, and you could convince me of something like tax funded education vouchers; but not to put you in control of all the schools.

              1. Chad believes government never does bad, as long as it’s progressives doing the pickpocketing.

              2. How many times are you going to keep dipping into the straw-man well? Where did I ever claim government was perfect?

                Neither the market nor the government is perfect. Sometimes one works better than the other, sometimes they work better on concert. I am glad you admit that there are at least a few circumstances where the government beats markets. Now that you have sacrificed your principles, you can start looking at facts. It’s gonna be a whole new world for you.

                Btw, I support vouchers and I always have. I hate the teacher’s unions and how they have a lock on our education policy. The biggest travesty is that without any pay for performance, we have wound up with a vastly disproportionate share of poor teachers. Not surprisingly, our students have followed suit.

                I note that you said “most goods” are best provided by the private market, and not “most goods and services”. That is a quite telling slip.

                Also, about the post office. I have always found it as pleasant to deal with as UPS and FedEx, if not more so. What is your particular beef with it?

                The DMV, on the other hand, is a bit different. I think the reason people hate it so much is that you never deal with it of your own violition. You are there to both give them money and provide THEM with a service. You do not walk out the door with anything other that the right to be left alone. They are more like the local mafia than a shopkeeper, albiet with a social purpose. I think the INS and Homeland Security fall into the same basket. However, something like Medicare, the post office, or national parks, where you directly GET SOMETHING for your effort and money, are much less of an annoyance.

                1. You don’t address the failures of government, particularly those of regulatory capture and how to accurately set prices and the appropriate level of insurance coverage; while whining about asymmetric information when in a competitive health insurance market where plans can cross state lines and individual plans treated the same way as employer plans most people would buy insurance and keep it all their life never developing pre existing conditions rather than being forced to switch every time they switch jobs.

                  Your facts and cost benefit analysis conveniently compare the U.S. system to those countries with different demographics and cultures whose health systems are designed to hide costs in the costs of taxation and the dead-weight loss, wait times, and available care. Where are the studies that control for factors like lifestyle choices such as obesity? For violent crime rates and traffic accidents?

                  Your entire claim for the government failures you claim to acknowledge being less bad than the market failures you overstate rests on vague comparisons to vastly dissimilar countries. You haven’t isolated government caused problems in the health markets from those caused by private markets and from those caused by things unrelated to the government/markets debate, and then you compare such total costs to systems that hide many of their costs while not controlling for advantages they would have regardless of the health system.

                  You’ve built up the straw man all yourself with the simplistic and shoddy analysis of government provision of health care from which one can only conclude that you feel that government can do no wrong.

                  1. Pray tell, what is so different about the culture of, say, South Korea or New Zealand that they can get a national system to work and we can’t? Before you blather about a “homogenous” population, please explain wtf difference skin color makes that would drive up costs by 50%.

                    I am actually very much opposed to the part of the bill which allows insurance companies to sell out of state. This will result in a pure race to the bottom, as they will all relocate to places with low regulations, low taxes, big subsidies, or all three. Prices will come down because we will now be buying crap products, as well as tax revenues as the Delawares and Texases of the country will scramble to provide the biggest tax subsidies. It is odd that you guys whine about these kinds of subsidies, yet encourage policies that will directly result in them.

                    I also suggest you look up data on wait times. Like most other elements of our health care system, we are pretty good but not great and certainly not number one.

                    Also, if liberal policies were adopted, there would be a lot less violent crime, traffic accidents, and bulging waistlines. I am advocating a much wider systematic change than simply the health care system.

                    1. This discussion is going nowhere, first you race bait; then you equate advocacy of free markets with support for the status quo by citing current wait times in our heavily regulated and government controlling 50% of all spending system as something indicative of what will happen under free markets. Then you try and refute my arguments by attributing the entire visible cost differential to one of many causes I suggested, while giving only passing reference to hidden costs in government systems and still not separating the U.S. costs caused by government and non market factors from those allegedly inherent in the free market system we do not have in health insurance.

                      You then make a ficticious argument about how we whine about subsides yet promote polices that will result in them. How exactly? Certainly not in states run by libertarians. By that line of reasoning I can say you by supporting state insurance restrictions support the concentration of wealth and power into the hands of a few small private companies since the easiest way to get into another state’s insurance market is to just gobble up an existing company, and this has been going on for years. Or I could argue you support “butchered women” for being pro life since some women will have back room abortions, or that people who support legal drinking and pot smoking support kids drinking and smoking pot as Bill O’Reilly uses to argue against legalization of medical marijuana. The logic is false.

                      You never address how your policies will be able to avoid regulatory capture, nor gather the knowledge necessary to grasp the optimal level of health insurance coverage or the optimal price for health services; preferring to rattle off logical fallacies and misdirections.

                      You are nothing more than an arrogant nanny statist unwilling to recognize the limits of your own knowledge and thinking that it entitles you to micromanage people’s lives and control vast swaths of the U.S. economy. You might find a few more converts if you actually answered questions, represented the facts and opposing arguments honestly, and made your arguments with a little less snark and a little more humility. You come on here and call our conception of freedom “childish” while behaving like a kid right out of college who has yet to figure out he doesn’t know quite so much as he claims to.

                    2. Brilliant reply, Tim. Elegant, mature, and true.

                    3. Tim, there are no, and never will be, any states run by libertarians. So that portion of the house bill will, with a high level of certainty, result in the standard race-to-the-bottom, beggar-thy-neighbor practices the states of been waging against each other for years. Anyone who supports this part of the bill is supporting its inevitable results, whether they like them or not, especially when you offer no plan to mitigate or prevent them…or even acknowledge the problem.

                      What “hidden costs” are you talking about? Frankly, I see more “hidden benefits” of single-payer systems than “hidden costs”. For example, the extra feeling of security is not captured in either health or cost statistics, nor is the fact that you don’t need to waste any time worrying about insurance, like you do here. Simple, secure, and cheap. What is not to love?

                      I was a libertarian when I was in college. Then I grew up, and realized that the libertarian world-view was simply inconsistent with facts. People are not homo economicus, the assumptions of market theory almost never hold, and life is far too unfair to leave it uncorrected.

                      In the context of this debate, there are only three relevant facts:

                      1: We pay much more than everyone else, around 50%.

                      2: We endure far more risk of financial devastation

                      3: The care that we get is good but not great

                      The implications of this is that we are doing something wrong, and we should become MORE like the people who are doing better. Libertarians believe we should head the opposite direction, because their invalid theory tells them to. Why anyone would listen to them baffles me.

                      How can we avoid “regulatory capture”? By whom? If we adopt the types of system I am advocating, there will either be no insurance companies, or they will be non-profit. The nations that I am calling for us to mimic also face the risk of regulatory capture, and clearly they are able to mitigate it enough such that it is not a major issue. We can use the same methods they use to set prices and coverage as well. They won’t be perfect, but they are good enough to give us a better result than what we currently have. The proof is in the results. I don’t know why you think it would be hard for the government to set prices for health services, because they already do.

                    4. Tim, there are no, and never will be, any states run by libertarians. So that portion of the house bill will, with a high level of certainty, result in the standard race-to-the-bottom, beggar-thy-neighbor practices the states of been waging against each other for years. Anyone who supports this part of the bill is supporting its inevitable results, whether they like them or not, especially when you offer no plan to mitigate or prevent them…or even acknowledge the problem.

                      What “hidden costs” are you talking about? Frankly, I see more “hidden benefits” of single-payer systems than “hidden costs”. For example, the extra feeling of security is not captured in either health or cost statistics, nor is the fact that you don’t need to waste any time worrying about insurance, like you do here. Simple, secure, and cheap. What is not to love?

                      I was a libertarian when I was in college. Then I grew up, and realized that the libertarian world-view was simply inconsistent with facts. People are not homo economicus, the assumptions of market theory almost never hold, and life is far too unfair to leave it uncorrected.

                      In the context of this debate, there are only three relevant facts:

                      1: We pay much more than everyone else, around 50%.

                      2: We endure far more risk of financial devastation

                      3: The care that we get is good but not great

                      The implications of this is that we are doing something wrong, and we should become MORE like the people who are doing better. Libertarians believe we should head the opposite direction, because their invalid theory tells them to. Why anyone would listen to them baffles me.

                      How can we avoid “regulatory capture”? By whom? If we adopt the types of system I am advocating, there will either be no insurance companies, or they will be non-profit. The nations that I am calling for us to mimic also face the risk of regulatory capture, and clearly they are able to mitigate it enough such that it is not a major issue. We can use the same methods they use to set prices and coverage as well. They won’t be perfect, but they are good enough to give us a better result than what we currently have. The proof is in the results. I don’t know why you think it would be hard for the government to set prices for health services, because they already do.

                    5. The three points relevant to the debate are

                      1. The status quo is not free markets, and using it in comparison to other systems has little bearing on how those other systems would compare to a free market system. Almost your entire argument is based around this flawed comparison, because it is what you use to measure the alleged costs of your “market failures.”

                      2. You are building up straw-men in libertarian alleged support for the status quo based upon dogmatic support for free markets and belief in homo economicus while contradicting yourself to any rational observer by holding similar positions about state power and government bureaucrats.

                      3. Which you proceed to knock down with your own assumptions disguised with vague allusions to “data sets” which don’t control for outside factors nor measure all costs and benefits.

                      The hidden costs reflected, all other things being equal, are higher rates of taxation and deterred economic growth, along with waiting lists and technology rationing. This is only in the aggregate, and doesn’t take into account the net costs to individuals; and public goods type arguments are generally supported by the idea that they benefit everyone even if some benefit unequally. Just getting it past the greater good yard line doesn’t get it past the common good one.

                      Then you would compare these costs to the alleged benefits of your “simpler more secure system”, finding some way to measure such costs other than just inferring them from assumptions about the free market informed by our heavily regulated system, if facts were your concern.

                      You also seem to assume that the further left one goes the better the health system gets, not acknowledging the fact that our mixed system could be both worse than free markets and better run government systems.

                      I’ll also point out that other countries still have special interest groups such doctors and hospital workers and people with certain diseases that will find it easier to organize and lobby for what they want even if it is at the expense of other patients and providers. I don’t see you posting any examples, and your reliance on “things other countries do” still depends upon your false equation of the status quo with free markets.

                      You are supposedly Mr. Facts as opposed to using theoretical assumptions and guesswork to try and compare systems. However you are making just as many assumptions about the world and how it works as we. The market assumptions are rarely perfect, but markets don’t require perfect to work; just close enough.

                      Just as much as man doesn’t exactly always behave as described in Intro Micro, government doesn’t behave as described in high school civics. I find that the knowledge and incentives available to the individual through imperfect markets most often tends to produce better actors than the knowledge and incentives available to government bureaucrats.

                      What you do is build up the straw-man that I believe all men are homo economicus. Heck if people aren’t somewhat rational, how are they going to respond better to government incentives or even pick the few supposedly rational progressives to create those incentives? How does that fit into your worldview?

                      You betray yourself here, it’s about your conception of fairness; with real market failures really having little to do with it, you just define the market as failing when it produces an outcome you don’t like. Then you assume charity can’t address such concerns, and finally conflate the possible public goods argument for government supplementing charity with a mixed system for something like healthcare and are well on your way to advocating a much more intrusive measure of government control than merely redistributing income. And because we’ve hardly ever had free markets, you have little proof civil society wouldn’t work while lacking the ability to even accurately determine working; so you conflate evidence from the mixed system with evidence against free markets.

                      What exactly is your conception of the role of government anyways? The “facts” of your “pragmatism” are woefully lacking and seem heavily influenced by your own progressive ideology; while your single most coherent, supported, and consistent point against libertarianism is that it is unlikely to get enacted, despite it having nothing to do with the actual merits of the policy. How is that facts-based, and why don’t you apply that argument to other issues? Is it because you are a progressive ideologue?

                      There’s nothing wrong with that; until you try and disguise your ideology as some kind of post partisan above the fray fact based pragmatism as a means to appear somehow smarter and a better person than your opponents. Which perception progressivism essentially relies upon since it has no reply to the knowledge and incentives problems associated with government; because such a perception of elite intelligence and superior morality is what gives them the claim to the special knowledge they need to credibly claim they can micromanage our lives.

                    6. For all the arguments about “childishness” you are the one running to mommy government saying “not fair” and thinking you can run the house better than she can cause you got good grades in school.

                      Just sayin.

                    7. You are right, Tim. The status quo is not a free market. There will never BE a free market. Get over it and move on. It is absolutely irrelevant if your fantasy would work, because it will never be attempted. I have never claimed that you like the status quo. You don’t. You simply want to move in the opposite direction that the data implies and the current bills are moving us, and therefore you defend the status quo as the lesser evil.

                      Your real choices are some variant of the hybrid public-private monstrosity we have now, or something like what every other nation has and is working much better.

                      Actually, Tim, once the market assumptions are violated (which they usually are), there is no guarantee that they will come even close to the right answer. Indeed, if the choice is fairly binary, it can push us 180 degrees in the wrong direction. Sometimes, markets work fairly well despite the imperfections. Sometimes, they catastrophically fail.

                      And yes, “charity” cannot solve the problems I am talking about. They are much larger in scope than people donate freely, which is around 2% of our incomes.

                    8. Then don’t pretend that you are all about facts and what works. You are trying to strengthen your argument by calling it “pragmatic”.

                      You also assume a static world, that everyone who is poor under our mixed system would also be poor under a more free market system; and that the greater economic prosperity and people keeping more of their own money won’t have a significant effect on charitable contributions. While I guess who you consider poor likely is quite different from who I consider poor, as evidenced by the many progressive programs that pay for all kinds of things the middle class who could afford them if they lived responsibly, which they don’t have to do when government is giving them things for free.

                      There is no guarantee government works either, and it often performs less well than markets. And as for this case health insurance markets aren’t failing because people with pre exisiting conditions don’t get covered, markets here are operating efficiently, you just don’t think they are fair. Obviously insurance companies aren’t exactly having trouble making a fair estimate about the health risks of individuals, and it isn’t that hard to offer discounts to people who get routine preventative care.

                      So exactly what market failure are you really talking about then? Adverse selection would imply that only sick people get health insurance, which is what will happen when government dictates private companies can’t do anything with the information it gathers.

                      Again, trying to mask your argument about equity as a fact based economic efficiency one.

            3. I may have missed something here but in my observations our government engages in perpetual legislation to “solve” problems usually created by previous perpetual legislation. Can you give us some examples of problems the government has actually solved?

              1. Has anyone invaded your home town lately?

                Driven your car anywhere lately?

                Noticed many street urchins begging for crumbs lately?

                Noticed any rivers catching on fire lately?

                Naah, they never get nuttin’ right.

              2. Don’t play right into his hands…

                1. Further if people like Chad had been around in the abolitionist or civil rights days we might never have beaten slavery or Jim Crow; I’m sure tons of people at the time thought “it will never happen” regardless of how their “fantasy” of a racial equality would work.

                  I guess MLK never should have talked about his dream, and tried to go for some second best solution.

                  Who would have thought even a few decades ago America would have an African American President? No one should talk about it cause it won’t happen though, and it might piss the racists off and keep them from making some lesser concessions. Right?

                  I feel I am in good company in standing up for what I feel is right regardless of some people’s perception of the short term tactical successes it might have. I’m sure you feel the same way holding the pro life position, I don’t see Roe coming down any time soon; does that mean you can’t speak out on issues of life because they might tactically make it harder to pursue other short term strategies to reduce abortions?

                  The implications of this incredibly fallacious argument are wildly inconsistent with history and other positions you likely hold.

        2. Our system doesn’t, and everyone else’s while not perfect, is better

          Except that’s a lie.

          Our outcomes are best in the world.

          It is however expensive, and we need to fix that problem. But we know how to fix that problem because we can look at every other market that doesn’t suffer pervasive government intervention.

          And if you really think that wouldn’t work why are you so against it? What are you afraid of?

  11. You can get instant quality full coverage medical insurance for entire family at the best price from http://bit.ly/39pFJx

  12. At the end of the following page is one of the Ayn Rand quotes that I do agree with and should pretty much end this debate

    http://aynrandlexicon.com/lexicon/consumerism.html

  13. Flood the market with doctors-costs will go down.

    1. Brilliant! Maybe the government can mandate that everyone get a medical degree.

      1. Good idea. I’ll write my Congressman, we’ll have mandatory medical school attendance.

        At gunpoint, if necessary.

        1. Naah, we just need to let in, say, 45% of the applicants rather than 40%.

          1. At gunpoint, if necessary.

            And make the evil rich people pay all the tuition. Fuck personal responsibility, this is about turning America into East Germany, Part II.

          2. We just need to let in anyone who can score well enough on an MCAT to satisfy the school and afford tuition. And in turn we should let anyone who wants to open a med school do so, and the LCME can accredit them or not. Patients can decide if they want a ‘board certified’ provider or not for any particular ailment. Potential providers can in turn decide if they want a degree from a LCME certified school or not.

            You’re tossing out a percent that ‘should’ be allowed is exactly the philosophy that causes the problem.

    2. Far easier steps:

      1. Unlimited visas for immigrant doctors.

      2. Make medical licensing advisory only.

      No mandates needed. Quite the opposite, in fact, as it simply requires the lifting of prohibitions.

      1. 2. Make medical licensing advisory only.

        Wouldn’t that open the door for Witch Doctors?

        http://nancysullivan.typepad.c…..970c-800wi

        1. Why not? As I recall a large number of people go to the doctor for self limiting problems anyway. At least a doctor’s visit would be entertaining.

        2. Maybe I want a witch doctor. So what? It’s my money and my life.

          You might find however when it’s people lives on the line they care a little more about the credibility of the provider.

      2. We don’t really need large numbers of immigrant doctors – we just need the AMA to increase the supply of doctors.

        Currently, only about 40% of people who apply to med school ever get in. We could increase the supply of doctors by 25% simply by letting in half the applicants.

        1. And mandating that 1) they all graduate, and 2) they work for minimum wage.

        2. we just need the AMA to increase the supply of doctors.

          Yeah well the AMA controls government that you want stronger because then you think the AMA won’t control it.

          How about lets just undo the legislation that allows the AMA cartel?

          The commerce clause can easily be invoked to allow providers to practice across state borders just like it can be done for insurance.

  14. Loosen educational standards like some other countries and more people will become doctors. More doctors equal more competition equals lower costs.

  15. “Republicans have done precious little to seize the moral high ground from them.”

    Dalmia is a stand-up comic, right?

    1. Agreed!

  16. Odd that the liberals aren’t insisting on means-testing, and forbidding those evil rich people (which, to some liberals, would be those making $100K) from participating in this glorious people’s paradise of government-ladled health care…

    1. $100K? To a liberal that’s filthy rich. Rich, to a liberal, starts somewhere around “scraping by”.

      1. No, to Congressional liberals, rich is “anyone who earns even a dollar more than my Congressional pay”

        1. No, to liberals, rich is anyone who still has a dollar.

      2. True dat.

  17. Likely HR3962 will pass. McCain took it from the left and right on Campaign Finance Reform and Obama nearly tripled him on spending. McCain took it from the left and right on Immigration Reform with lie after lie and now we have defacto amnesty. McCain took it from the left and right in the 2008 Election and you got Obama Nation. Welcome to the real world, voters. Actions have consequences.

  18. I’m going to have to take your word on the OACT report, Shikha, I tried to read through it, but gave up. Women have a higher threshold of pain it seems.

    Your concern about the Republican and the Heritage Foundation is understandable, on the other hand we could use some artillery, we have a BB gun, looks like we better hope the BB gun isn’t too broken, because it’s all we have.

    This may sound twisted, but given our pathetic state of readiness, in a way I hope they do get their public option, and that Pelosi has her way, good stiff sentences and steep fines.

    The reception for the possibility of such an event down here amongst little people is, well, I’ve never seen anything cause so much of a reaction with otherwise non-political and political people alike.

    There’s little doubt such a move would be complete political suicide for these Trotskyites, few would ague that’s not a good thing. While agreeing, I see even a much greater benefit, it’s waking Americans up to their responsibility to oversee their government.

    If they push this through they will trigger a serious backlash from the citizenry with the stroke of Obama’s pen.

    It’s not the way I’d hope for, but it may well be for the best.

    These idiots in power have been lying and controlling the flow of information for so long they’ve come to believe their own lies and have no idea what’s really going on.

    The state I’m presently in has vast resources, and no say in accessing them, there’s been talk about leaving the union here for sometime. Why wouldn’t they feel that way? Why should populous states or Washington, DC tell them they can’t prosper, or even make a living doing honest work. Make all their choices for them.

    Such a move I would have never supported, not in the over half century I’ve been here. Today I’m open to anything.

    Perhaps the states would be better off fending for themselves. All the states except those who have been calling all the shots, that is. They’d be in some serious hurt.

    Thomas Paine warned of the dangers of too small of a body of representatives, but stated a much graver danger lay in unequal representation. We can’t be any more unequal than having a handful high population centers making all the decisions for the rest and using the federal government as their weapon to enforce their will.

    This is in no way what the founders envisioned. They revolted over taxes and tyranny, it couldn’t possibly have been their intentions we would return to the same.

    People need to understand that if this thing passes we are little more than property of our government. Given the choice between extreme poverty or hardship and liberty it’s not a hard choice, I’ll take freedom.

  19. Taking the moral high ground is something Republicans are particularly qualified to do.

    1. Hmm, left out a negation somewhere in that sentence.

  20. To Chad,

    In the gov’t vs. free market argument, can we at least acknowledge that a the free market cannot force me to buy a product or service. They must satisfy my needs or risk losing me as a customer. We never have that option with government, which means we should minimize the number of things we are mandated to do by government.

  21. Chad’s argument is ridiculous

    We libertarians keep saying that we want a completely free market in health care and medical care – NOT the current system we have now

    Chad is basically saying that we are extremely unlikely to get that – and then uses some twisted leap of logic and concludes that this means we are effectively FOR the policies that SEEM more free-market or are CLOSER to the Status Quo, since we aren’t for the healthcare overhaul bill.

    That’s a RETARDED argument.

    The Libertarians are arguing for a FREE MARKET. THAT’S IT. I don’t even care if what he’s saying is true and we are effectively keeping the nation closer to the status quo. THAT IS NOT WHAT WE ARE ARGUING FOR.

    That’s like saying that because radical communists will never get their policies enacted nor even get lots of people to listen to them, that they are effectively for the status quo, too.

    THAT’S NOT AN ARGUMENT.

    Now, if Chad thinks a totally free market in health care would work badly, then he should quite simply say so. But he has to admit that we have few, if any examples of that.

    We libertarians do, however, have overwhelming evidence in pretty much every other part of the economy and throughout history.

    Also, we’ve got the absolutely RETARDED laws that we have in place that MASSIVELY jack up costs in our healthcare system. Chad’s can keep arguing quite simply because he ignores these things. If farmers could only get into the farming business by getting approved by a government-set board run by farmers who have an incentive to lower competition, and could only sell their products in their own state, and had to spend many years and hundreds of millions of dollars getting new farming techniques or fertilizer mixes approved, and the government took their food and payed them less than its worth very often, etc. ETC ETC AD INFINITUM WITH THESE RETARDED POLICIES, THEN FOOD WOULD BE FUCKING EXPENSIVE TOO.

    But Chad just IGNORES all this. People are looking for an explanation why healthcare is so expensive; WELL THAT’S FUCKING WHY.

    Chad and people like him DELIBERATELY IGNORE all this, to AVOID the much SIMPLER libertarian solution. That’s the ONLY way they can keep babbling on and on.

    It’s fuckers like HIM who are for our corporatist status quo.

  22. I also laugh at the idea that, if people were allowed to purchase policies from other states, the only policies that would be available will be ones that meet the lowest requirements of all states, and that people who wanted to purchase policies with additional or specialized coverages would be unable to find providers to meet their demands.

    1. The best indication that free market solutions will work is that the progressives are in dire fear of trying any of them.

  23. Only thing that will work is to throw all these criminals out of our house. Nothing more nothing less.

  24. Only thing that will work is to throw all these criminals out of our house. Nothing more nothing less.

  25. So I guess the whole “freedom of association” claptrap is the next item on the “let’s shred the constitution” hit list. I guess we are free to associate with whomever we’re damn well told to associate.

    Me, I’ll wait until it passes and then file a lawsuit the next day, for all the good it will do. Hey, maybe I’ll become famous and be able to charge enough for speaking engagements to cover the cost of “the new” health care.

  26. FAT BEN MADE POOP

  27. My only point is that if you take the Bible straight, as I’m sure many of Reasons readers do, you will see a lot of the Old Testament stuff as absolutely insane. Even some cursory knowledge of Hebrew and doing some mathematics and logic will tell you that you really won’t get the full deal by just doing regular skill english reading for those books. In other words, there’s more to the books of the Bible than most will ever grasp. I’m not concerned that Mr. Crumb will go to hell or anything crazy like that! It’s just that he, like many types of religionists, seems to take it literally, take it straight…the Bible’s books were not written by straight laced divinity students in 3 piece suits who white wash religious beliefs as if God made them with clothes on.

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