Federalism

The States' Failed Experiments

The major provisions of ObamaCare have already been tried. And they don't look good

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Supreme Court Justice Louis Brandeis famously envisioned the states serving as laboratories, trying "novel social and economic experiments without risk to the rest of the country." On health care, that's just what they've done. Like participants in a national science fair, state governments have tested variants on most of the major health care reforms Congress is considering. The results include dramatically higher premiums in the individual market, spiraling public costs, and reduced access to care. In other words, the reforms have failed.

New York is Exhibit A. In 1993 the state prohibited insurers from declining to cover individuals with pre-existing health conditions, a policy called "guaranteed issue." New York also required insurers to charge everyone enrolled in their plans the same premium, regardless of health status, age, or sex, an idea known as "community rating." The goal was to reduce the number of uninsured by making medical coverage more accessible, particularly to those who don't have employer-provided insurance.

New York's reforms haven't worked out very well, according to a 2009 Manhattan Institute study by Stephen T. Parente, a professor of finance at the University of Minnesota, and Tarren Bragdon, CEO of the Maine Heritage Policy Center. In 1994 just under 752,000 individuals were enrolled in individual insurance plans, about 4.7 percent of the nonelderly population. This put New York roughly in line with the rest of the U.S. Today that figure has dropped to just 0.2 percent. By contrast, between 1994 and 2007 the total number of people insured in the individual market across the U.S. rose from 4.5 percent to 5.5 percent.

The decline in the number of people enrolled in individual insurance plans, the authors say, is "attributable largely to a steep increase in premiums" because of the state's regulations. Parente and Bragdon estimate that repealing guaranteed issue and community rating could reduce the price of individual coverage by 42 percent.

New York's experience with guaranteed issue and community rating is not unique. In 1996 similar reforms in Washington state preceded massive premium spikes in the individual market. Some premiums increased as much as 78 percent in the first three years of the reforms—10 times the rate of medical inflation—according to a study presented at the annual meeting of the Association for Health Services Research in 1999. Other results included a 25 percent drop in enrollment in the individual market and a reduction in services offered. Within four years, for example, none of the state's major carriers offered individual insurance plans that included maternity coverage.

A 2008 analysis by Patricia Lynch of Kaiser Permanente, published by Health Affairs, noted that in addition to Washington and New York, the individual insurance markets in Kentucky, Maine, Massachusetts, New Hampshire, New Jersey, and Vermont "deteriorated" after the enactment of guaranteed issue. Individual insurance became significantly more expensive, and there was no significant decrease in the number of uninsured.

Supporters of federal health care reform argue that the problems associated with these regulations can be addressed with the addition of an individual mandate, a requirement that everyone purchase health insurance. Guaranteed issue alone, the argument goes, results in slightly more expensive premiums, which drives healthier individuals out of the risk pool, which in turn further drives up premiums. The end result is that many healthy people opt out, leaving a small pool of sick individuals with very high premiums. An individual mandate, however, would spread those costs across a larger, healthier population, thus keeping premiums down.

The experience of Massachusetts, which imposed an individual mandate in 2007, suggests otherwise. Health insurance premiums in the Bay State have risen significantly faster than the national average, according to the Commonwealth Fund, a nonprofit health foundation. At an average of $13,788, the state's family plans are now the nation's most expensive. The Boston Globe reports that insurance companies are planning additional double-digit hikes, "prompting many employers to reduce benefits and shift additional costs to workers."

Meanwhile, Massachusetts health care costs have continued to grow rapidly. According to a 2009 RAND Corporation study, health care spending is "projected to increase about 8 percent faster than the state's GDP over the next decade." The Globe recently reported that state health insurance commissioners are worried that medical spending could push both employers and patients into bankruptcy and may even threaten the continued existence of the state's universal coverage system.

On top of that, survey data from the Massachusetts Medical Society indicate that the state's primary care providers are being squeezed. Family doctors say they are taking fewer new patients and seeing increases in wait time.

Reform measures in other states have proven to be expensive duds. Maine's 2003 reform plan, Dirigo Health, included a government insurance option resembling the public option supported by many House Democrats. This public plan, DirigoChoice, was supposed to expand care to all 128,000 of Maine's uninsured by 2009. But according to the U.S. Census Bureau, the 2007 uninsured rate was roughly 10 percent—essentially unchanged. DirigoChoice's individual insurance premiums increased by 74 percent during its first four years—to $499 a month from $287 a month—according to an analysis of Dirigo data by the Maine Heritage Policy Center. The cost of DirigoHealth to taxpayers so far has been $155 million.

Tennessee's plan for universal coverage, dubbed TennCare, fared even worse after it was launched in the 1990s. The goal of the state-run public insurance plan was to expand coverage to the uninsured by reducing waste. But the costs of expanding coverage quickly ballooned. In 2005, with the government bankruptcy, the state was forced to cut 170,000 individuals from its insurance rolls.

Despite these state-level failures, President Barack Obama and congressional Democrats are pushing a slate of similar reforms. Unlike most high school science fair participants, they seem unaware that the point of doing experiments is to identify what actually works. Instead, they've identified what doesn't—and decided to do it again.

Peter Suderman (psuderman@reason.com) is an associate editor at reason. A version of this article appeared in The Wall Street Journal.

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  1. Good morning everybody!

  2. The market has no solution for adverse selection. The government does: Medicare for All.

    Get over it.

    I do love how libertarians can’t seem to understand that rational people would be WILLING to pay more for health insurance that, heaven forbid, ACTUALLY COVERS THEM WHEN THEY ARE SICK.

    1. I do love how libertarians can’t seem to understand that rational people would be WILLING to pay more for health insurance that, heaven forbid, ACTUALLY COVERS THEM WHEN THEY ARE SICK.

      I do love how whatever the fuck you are can’t seem to understand that rational people are not interested in paying for obese, alcoholic smokers when they themselves make choices not to be those things.

      The market has a solution for adverse selection. It is called experience rating. TINSTAAFL fucktard.

    2. I do love how libertarians can’t seem to understand that rational people would be WILLING to pay more for health insurance that, heaven forbid, ACTUALLY COVERS THEM WHEN THEY ARE SICK.

      =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=

      My insurance does that now. Why should I have to pay extra for your ineptitude?

    3. “I do love how libertarians can’t seem to understand that rational people would be WILLING to pay more for health insurance that, heaven forbid, ACTUALLY COVERS OTHER PEOPLE WHEN THEY ARE SICK.”

      Fixed(?!)

    4. Does anyone else remember Chad whining about how sick people couldn’t buy health insurance? Apparently now only sick people buy health insurance, hence the adverse selection.

      Insurance markets seem to work well enough in the auto, life, and homeowners markets; perhaps it is because such policies are priced based on risk with teenage drivers paying higher premiums than soccer moms.

      The main driver of any adverse selection in the market, are government rules like community rating and guaranteed issue which tell companies that no matter what information one has about a person one can’t charge them more or less accordingly. Each state has different laws, but they almost all have random provider mandates for stuff like acupuncture, chiropractic, alcoholism treatment, etc; and rules dictating the ratios between how much healthy people and sick people are charged for insurance. Why the hell would young healthy people want crap like that?

      Young healthy people are also entry level workers, and aren’t rolling around in money; they don’t need plans that pay for everything a lobbyist can attach to a bill in the dead of night, and it’s ironic that progressives so concerned for the poor tax the poorest demographic to give cheap health care to middle aged people who likely have better jobs than them and certainly had more time in life to make good choices leading to better jobs and better health.

      People are risk adverse, and they will pay slightly more than just the risk of getting sick in premiums; that’s why insurance works at all. Markets aren’t perfect and some people will game them, however insurance companies have pretty strong incentives to catch such people provided their tools aren’t taken away. They make more money that way. They’ve figured it out in other insurance markets; but health care is magically more complex than those other markets. No one could every pay out annuities or lump sums to people with chronic illnesses, nor would it ever be possible that such people could if they wanted take that annuity and switch providers and sign a contract that would cover everything else other than that illness. Oh wait, if an illness must be covered under state law then such plans are outlawed; hmmm, maybe that is why many people with random pre existing conditions or riskier lifestyles can’t get covered. If such people weren’t the only ones getting covered, remember gotta keep your contradictory “market failures” straight so you can switch seamlessly to whatever is necessary at the moment.

      Another market solution, a health exam prior to signing an insurance contract on a medically underwritten plan. Lots of young uninsured healthy people will sign up for such plans. While states that deliberately restrict such practices have, omg higher premiums and more adverse selection. No one wants to pay more for health insurance irregardless of their health status so someone else can pay less, and certainly in free markets some people will elect for more comprehensive plans than others; however such people should still be charged lower premiums because they are less of a risk.

      1. Insurance markets seem to work well enough in the auto, life, and homeowners markets; perhaps it is because such policies are priced based on risk with teenage drivers paying higher premiums than soccer moms.

        Actually it’s because the people using the insurance pay the premiums. Therefore they shop around for less expensive policies and cover only the risk they have to. As opposed to being forced into whatever plan is best for their employer’s bottom line.

    5. The market has no solution for adverse selection. The government does: Medicare for All.

      As noted by the article, several states have tried that as a solution. It hasn’t seemed to work.

    6. Chad, why do you hate science? Why do you deny the results of experiments?

    7. OMG!

      Everyone in Europe, Canada, and Japan are dead!

      Socialist healthcare killed them dead!

      If only the fools had understood about the magic of “preexisting conditions”, insurance company profits, and healthcare by prayer!!!

      1. Socialist healthcare didn’t kill them all, don’t be ridiculous. It only killed the sick ones.

    8. The problem is that government health insurance doesn’t cover you when you’re sick, it covers you eight months later.

    9. I have very good health insurance cause I have a good job with good benifits, and it does not cost that much. It allows me the freedom to choose any doctor in the system with no referals. It is a PPO not an HMO.

      If i get better care some other place for the same cost or less fine so be it. But what I will not do is pay for some one elses “share” of the cost so we can all have a nice warm cup “social justice” together. You want better health care get off your ass and get it for your self.

      Your health care is not MY responsibility.

      Thanks and have a great Christmas.

  3. I live in NJ. NJ has been making reforms since 1992. Specifically, there are two programs, the IHC and SEH. There are 8 companies writing policies that cover the gamut. HMO, PPO, POS and fee-for-service (traditional). Prices, for a 43 year old smoker, range anywhere from 188 to 1,400 per month. Currently I have an HMO with reasonable out-of-pocket expenses, with no out-of-network coverage (after checking I found that most doctors in the area, and all hospitals are in network) for $250. Being self-employed, I also get a tax deduction. That works out to 25-30% off, depending on which tax bracket I fall under for the year.

    I’m not saying what NJ has done is perfect. I don’t know what, if any, subsidies the state provides to the insurance companies, but in my opinion, it has not been a “failure”.

    http://www.state.nj.us/dobi/di…..tures.html

  4. please, Reason, refrain from using terms such as “medical inflation”, “healthcare inflation”, “college cost inflation”, etc. Inflation is price increase due to loss of monetary value. Period.

  5. I do love how libertarians can’t seem to understand that rational people would be WILLING to pay more for health insurance that, heaven forbid, ACTUALLY COVERS THEM WHEN THEY ARE SICK.

    A rational person will only prefer that if there is an appropriate relationship between the dollar cost of the premiums and the actual risk one has of getting sick.

    BY DEFINITION, that will not be the case under these “reforms” for large numbers of people.

    “Community rating” consciously and deliberately overprices insurance for young, single males. It would absolutely be a completely irrational act for any single male under the age of 35 to support any “reform” that includes an insurance mandate or a community rating mandate.

    But Chad’s post neatly illustrates why the state plans aren’t considered failures. Since they were never intended to improve care, but were only intended to act as a smokescreen to make it politically possible to subject individuals and small businesses to insurance mandates, then the plans have in that sense succeeded. Lots of people and small businesses in Massachusetts, for example, are now being forced to buy insurance that they would individually have decided they didn’t want and that is deliberately overpriced. That milch cow money is now available to be steered to other demographics. “Yay!” the plan advocates exclaim. “We succeeded!”

    1. Unlike most high school science fair participants, they seem unaware that the point of doing experiments is to identify what actually works.

      Fluffy, you made the point I was going to: the actual objective function being maximized may not be what many people would choose.

      1. There are 30 OECD nations. 29 have tried variants of universal coverage. They all manage to cover everyone while spending a hell of a lot less than us. How many more experiments do you need?

        1. So that means there are 29 other countries that would be happy to pay for your healthcare. No reason for you to stick around here.

        2. I hate this type of rhetoric, the ‘american needs to get on board’ spiel.

          Ok, I am about to throw out a SHOCKING OPINION.

          There are 30 OECD Nations. 29 have a variant of universal coverage.

          1 does not.

          This country is the richest, most powerful country on the whole fucking planet.

          This country has the most advanced medical technology in the world, has high rates of medical tourism flowing into the country, creates large amounts of cutting edge drugs, patents and siphons off the worlds medical talent for its own benefit.

          Once again, THIS COUNTRY IS THE RICHEST, MOST POWERFUL COUNTRY IN THE HISTORY OF FUCKING MANKIND.

          So, who should ‘join the club’ again? Oh right, everyone else. Whoops.

        3. Your definition of “cover everyone” is amusing, Chad. Having a card that says you’re insured and can get health care for free isn’t at all the same thing as being able to actually get health care. If you die waiting for treatments, or if your government simply rejects you outright for certain procedures, exactly how is that “universal coverage”?

        4. Thank you, Chad. We would all be beating up a flimsy strawman if it weren’t for you with these softball counterpoints.

          So, is the point of universal health care to “cover” everyone and spend “a hell of a lot less than us” or do you think Americans might be interested in treatments that, though very expensive, might saved the lives of their loved ones?

          None of those 29 other nations has the survival rate for cancer treatment that the U.S. does – most of them not even close. That’s not rare forms of cancer either, but all types. Some U.S. clinics market heavily in Canada for treatments that are rationed under their system.

          Expanding Medicare as you suggest will make matters even worse: It has the highest rate of claims denial by far. People aren’t interested in paying for coverage if that coverage doesn’t involve ever actually getting treated.

        5. Chad,

          If you’re going to have an experiment, you need to have a control. As an example:

          All this medical technology and drugs that are developed in that one country is backed by patents in that one country that are not necessarily backed by the other 29. Which is why they are cheaper in those other countries (That’s a nice drug you got there Pfizer, it’d be a shame if a drug company here were able to manufacture it without having to pay you royalties [I believe that this is also known as The Chicago Way]). So to borrow, the drug company in THE RICHEST, MOST POWERFUL COUNTRY IN THE HISTORY OF FUCKING MANKIND has to overcharge for drugs in that one country to recoup those R&D costs because the 29 others won’t let them.

          So let those other 29 enforce their patent laws with the same ferocity that we enforce ours and lets look at the results.

          Others can feel free to extend the concept to other areas where there is lack of experimental “control”.

  6. Inflation is price increase due to loss of monetary value. Period.

    No, it isn’t.

    If the state passed a law that said that every individual who does not own a ton of zinc by next April 15th will be drawn and quartered and then beheaded, the price of zinc would rise.

    There are ways for state action to cause price increases above and beyond simple abuse of the currency.

    1. Did you think you were rebutting a different statement, i.e. “All price increases are caused by inflation.”?

    2. There is a difference inflationary price rise, and price increases.

      For instance, taxes are a form of cost inflation, without necessarily being tied to monetary expansion, taxes nonetheless cause prices to be higher generally.

      “Inflation”, historically, specifically refers to price increases caused by monetary expansion.

  7. A “right” is a moral principle defining and sanctioning a man’s freedom of action in a social context. There is only one fundamental right: a man’s right to his own life. The concept of a “right” pertains only to action–specifically, to freedom of action. It means freedom from physical compulsion, coercion or interference from other men.
    Ayn Rand, “Man’s Rights” (1964)

    When one polls the populace–people from all sides of the political sphere–and most of them answer in the affirmative when asked, “Is health care a right”?–then you know the battle is lost. A nation without coherent, consistent moral principles is doomed. There’s simply no way to fake it over the long term.

    1. So you’re OK with supporting passive murder because poor people do not have the right to healthcare unless they can afford it?

      1. Well, you have to pick either (very indirect) murder or (very indirect) slavery. You’re evil either way, so why not go for the most passive option?

      2. This is a canard. Health care is extremely affordable despite the onerous regulations in place now. Individual coverage can be purchased for under 100/month which even people on welfare can afford. The truth is that no one is dying from lack of health treatment.

      3. “Poor people” receive “health care” or medical treatment in this country regardless of ability to pay. Please provide just one example of a “poor” person not receiving medical treatment because of ability to pay. Mind you I’m not asking for a story where the person didn’t receive the best treatment available. I’m asking for an example where the person received no medical care because they couldn’t pay for it. Your statement is false and I suspect you know it.

      4. “mass murder”

        Hyperbole much?

  8. Chad probably believes in equality of outcome, something else not guaranteed by the Constitution.

    1. I do love how Chad can’t seem to understand that only irrational people would believe that removing ALL price signals from a market will somehow make prices go down instead of UP! And that there will be a magic pot of money to cure every ailment that ACTUALLY COVERS THEM WHEN THEY ARE SICK.

      1. As long as you are fully insured in any form, you are almost entirely insulated from price signals.

        The countries with the best systems actually have HIGHER out-of-pocket expenses than we do. But they cover everyone from cradle to grave, and limit out of pocket expenses so that no one gets screwed by them.

        I can’t quite figure out why libertarians can’t grasp that universal systems cannot utilize market based mechanisms to similar or greater degrees than our current system does.

        1. Maybe it is because all the advocates of universal systems in America want people to pay less out of pocket, and criticize libertarian plans that do so as providing substandard coverage to people. That is what you whined about when I brought up the universal plan with catastrophic insurance combined with a health savings account.

          You really need to get your story straight. So the best universal systems have higher out of pocket costs than us, I agree, but at the same time you seem to think any insurance plan covering less won’t work. It’s a contradiction, just like the contradiction you never answered about your posts whining about how sick people can’t get coverage before you turned around to whine about adverse selection.

          If you were concerned about equity, you could transfer wealth directly to the people who would allegedly be broke by out of pocket costs; rather than smack price controls on the system. I don’t see where libertarians are claiming that universal systems will utilize price signals much better than we do now; as most libertarians aren’t advocating universal systems and most universal systems won’t. However, it is quite conceivable to have a single government insurance plan that covered all expenses over $50k and everything else was paid for out of pocket from health savings accounts that the government could subsidize for poor people. It would meet the definition of universal access and take advantage of market signals quite well. So would a system of health care vouchers or something like a negative income tax that would let people go out and buy plans on the private market.

          By seemingly defining “fully insured” as covering everything from chiropractic to hair cuts you arrive at your pre ordained solution that markets can never work for health care thus we have to do everything you enlightened progressives tell us to. So yes if you want to use insurance regulations to stealthily redistribute wealth to far more than just poor people because people won’t vote for you to do it explicitly then markets won’t work because the products you want them to sell are things rational people would never buy.

          1. You must be stinking rich. How else could you not know that only a small fraction of Americans could afford a $50,000 hit? Hell, the majority couldn’t take a $5000 hit, let alone $50,000. The few thousand they may have piled up in an HSA wouldn’t buy them a day in the hospital. I am not a fan of HSAs, though. They are overly-complicated.

            Health insurance needs to be universal, to avoid all the problems with adverse selection and general unfairness. It can (and indeed) should have significant out of pocket costs, which then can be subsidized for the poor and subject to a cap for everyone. Japan does it right. Their 30% out of pocket cost on most things causes people to pay attention to prices but isn’t enough to hurt most people, especially with the additional protections. Their system is stupidly simple, stupidly cheap, workers as well as ours, and is guaranteed.

            What is our advantage? Hmm…our doctors can afford bigger McMansions, I suppose.

            1. A lot of Americans seemed to find more $50,000 to buy houses. They routinely seem to find $25,000+ to buy cars. I mean if a house and a car are more important to you than a new liver, so be it. But that decision shouldn’t become everyone else’s problem.

              Also, doctors should be able to afford the biggest McMansions they can buy. When you grow up and put in nearly 2 decades of education and 80 hour weeks, you too can buy all the crap you want. That’s fair. Using a government to threaten other people with gang rape in prison if they don’t turn over their money to buy you shit is not fair. Seems like that should be pretty obvious.

            2. Wait… Chad finds a savings account to be overly complicated? Man, that explains a lot.

            3. Why no means-testing, Chad? That way, the “filthy rich” – as you put it, in your usual wealth-envy tripish manner – would be exempt from the Glorious Workers’ Right to Health Care Which Isn’t Really a Right.

              Because there IS no right to health care. But I digress.

              So… how about that stiffing what you call “filthy rich”? Why not turn ’em away from the shitty health-care dispensaries you and your kind envision – kind of like waiting in line at the DMV, except people don’t bleed to death at the DMV very often – and force those evil rich bastards to do without?

  9. Gosh, I’m sure it will work really swell if we only have smarter people running it with heart.

  10. “Unlike most high school science fair participants, they seem unaware that the point of doing experiments is to identify what actually works. Instead, they’ve identified what doesn’t?and decided to do it again.” Well, if that isn’t the best argument for eradicating the use of private health insurance then I don’t know what is.

    1. “Well, if that isn’t the best argument for eradicating the use of private health insurance then I don’t know what is.”

      You seriously think it’s the role of government to prevent people from buying and selling services from each other OF THEIR OWN FREE CHOICE? WTF

      1. Nmg, part of the role of the government is to protect the consumer and the fact is private insurers have too much influence in government. No plan will work with private healthcare because it is not a free choice to say you can jump over the cliff here or move two feet.

        1. common denominator|12.22.09 @ 3:36PM|#
          “Nmg, part of the role of the government is to protect the consumer and the fact is private insurers have too much influence in government.”
          Well, you should read that again.
          *If* the private insurers have too much influence in government, how is that ‘influenced’ government to protect anyone?

        2. Government actually doesn’t have any role.

  11. It does not and that is why it does not make a difference if it is the Dems or the Repubs in power.

    1. The common denominator is that you seem incapable of coherent thought. What makes you salivate is the loss of freedom.

      1. Geezer80, I assume you are up pass your bedtime because you find me incoherent. Goodnight.

    2. So what you claim is a role of government isn’t possible, correct?
      Or do you fantasize that if some whacko further lefties got elected, *they’d* accomplish it?

      1. Ron La,it is possible to have a government we need and deserve but the public needs to demand change with respect to who influences leadership. In your perfect world would Libertarians kick out the lobbyist or would it be the same old, same old?

        1. No you tard, it has nothing to do with “kicking out the lobbyists”, it’s removing the power structure which provides lobbyists something to manipulate!

          As long as politicians have control over X part of our lives, the people who are effected by X will use whatever resources they have available to influence those politicians in control of it. It’s very simple, it’s been a feature of governments the world over for 1000s of years and it should be a lesson easily learned.

          Imagine that I’m a king, and I control whether or not you can enter my kingdom and trade with my people. Do you stand a better chance by ignoring me and hoping I’m generous… Or by sending me lavish gifts and trying to win my favor?

          (I hope you’re not so dumb as to not answer that right…)

          So it’s quite simple. You want to remove the lobbyists? Remove the power that they are manipulating. Problem solved. *NO ONE* has the power to stop you from trading with other people voluntarily – no one has a special advantage, and there is no one in power to influence – thus lobbyists disappear completely, having lost any purpose.

          1. Sean W. Malone, “No you tard…Imagine that I’m a king” then your majesty,I would call you King of the Tardians.

            1. Amazing retort. Your skills at ignoring the point in favor of triviality are excellent, sir. +42

              1. excellent,mam. FIFY. It bores me when a poster writes “tard” or “dumb”. It lacks any creativity and I gloss over everything that could have been worthy to read.

                1. common denominator,
                  your ability to evade arguments that crush your deeply held personal views are not all that great.

                  You got nothing substantially to rebut Sean’s argument. In fact you KNOW that you cant argue against such common sense arguments. Instead you complain about being called a “tard”.

                  no wonder this country is bitterly divided. there is no honest debate possible when liberal dogma stubbornly refuses to face facts

                  1. NaSa, you are under the mistaken impression I care to debate Sean. He is a toy and I will play with it however I like. Now face this fact: fuck off and let me play.

  12. Every once and a while I visit this site to checkout the sort of real folks that subscribe to this whole “libertarian” thing. Quite frankly, most of them sound like tea baggers. Now the authors seem to be calm and have some good points, but I can’t see any rational person wanting to advance these ideas with these kinds of supporters who seem ready, willing and able to degenerate into the worst sort of discourse. These are supposed to be the kind of people to turn to when revitalizing your country? Not a chance…

    1. steve|12.22.09 @ 8:04PM|#
      “[…]but I can’t see any rational person wanting to advance these ideas with these kinds of supporters who seem ready, willing and able to degenerate into the worst sort of discourse.”

      And this would be as opposed to the lefty viewpoint where there’s ‘higher form’ of discourse followed by a gun if you don’t agree?
      I’ll consider that.

      1. Back in the 60s you might have been able to make that claim, but all the guns show up at the conservative/tea bagger rallies. Remember the guy with the Ak 47 at the health care rallies/

        1. You’re kidding, I hope.
          Yep, one guy carrying a gun. Just like government coercion, isn’t it?

          1. But that one guy defines the movement and becomes the spokesman for it. If the “mainstream” members of the movement support and encourage extreamism in thier followers, then what does that say about them and thier goals and what they will do to achieve them? It seems to me to be a policy of win by any means, and that can only lead to extreamism if they gain power. Sure, you like them now, but you will not be able to control them…

            1. “But that one guy defines the movement and becomes the spokesman for it. If the “mainstream” members of the movement support and encourage extreamism in thier followers, then what does that say about them and thier goals…”
              That won’t fly.
              First, you make the claim that one (one!) person defines a movement you haven’t bothered to define.
              And then, based on that specious claim, you impute (“if”) all sorts of nonsense.
              I’m gonna presume history isn’t one of your interests; try reading a bit. Yes, I know about Mcviegh, and I further know he had no connection to libertarianism at all.
              Ignoring outliers like that, or the French Commune (hardly a force for individual freedom) organized killing is the role of governments.

            2. And there’s never been a Code Pink member threatening violence, right?

              Right?

          2. Hey awesome… a perfect opportunity to pimp my recent video release 😛

            The Fear of Violence: Governments vs. Liberty

            Thing is Steve, it’s time you learned that every law that statists write are not enforced by *one* guy holding a gun, but by millions of guys actively using them. Exactly what do you think law enforcement officers are carrying? Bunny rabbits?

        2. None of those people with guns throw you in jail if you don’t pay your taxes. The Feds do. So who’s threatening who at gunpoint again?

          1. I am. Or will be… soon. Oh, so very soon.

    2. You want to lecture people here on discourse when you start your post with a witty, original reference to teabaggers?

      So far, the only serious violent acts at any TEA Party events have been by opposition, such as SEIU members. The gist of their protests should appeal to “any rational person”: Don’t punish work and investment by taxing the hell out of people for doing it. They are night-and-day more civil than the tempermental socialists who vandalize G-8 and WTO host cities. Your “worst discourse” reference is completely unsubstantiated. What are these “worst discourse” incidents you speak of?

      Like it or not, you will have to turn to people who want to encourage work and investment if you want to revitalize the country. Someone has to pay the loan-debt on all these left-wing boondoggles.

  13. To late to wake up America. I think is obvious that the Insurance Companys will all ban toghether and raise premiums to the point of Forcing people to go with the Government Owned health care. Just another con to Make the people conform to a Totaly Political run Country. The “United States”? The Military is the only thing United about it. I just cal it America now – Dominated by Greed, and eventually WAR.

    1. Umm, yeah, because the insurance companies are just dying to put themselves out of business? Why would they do that when just one of the companies can defect, charge lower rates, and then steal all the customers from the others? Unless they’re going to just move into HHS and siphon tax dollars directly, I don’t see a reason for insurance companies to intentionally funnel business away from themselves, especially since this insane bill will give them millions of new customers.

  14. For those covered under an employer (most people), I’d bet less than 5% know the amount a company paid for their health coverage. And I would say even fewer know how much money is spent for health expenses (for a major surgery you will receive bills and notices for YEARS afterwards and no one can tell you what it will cost *up front* – how’s that for a bad pricing mechanism!). .

    We do not have anything even close to a efficient market for medical services. It is very very broken the way it is.

    I have no idea if Congress will make it better or worse. I am pretty sure no one can say that because we do not have a transparent enough market to know how bad things are!

  15. Peter: while I agree that many state experiments have failed, do you consider Hawaii’s to be among them? 95% of residents have insurance, at much lower cost than NY and Ma.

  16. How much of New York’s problem do you think is attributable to not being able to base premiums on age? The Senate bill allows insurance companies to charge older folks three times as much as younger folks.

  17. 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…the Bible’s books were written by people with very different mindsets…in order to really get the Books of the Bible, you have to cultivate such a mindset, it’s literally a labyrinth, that’s no joke

  18. How much of New York’s problem do you think is attributable to not being able to base premiums on age? The Senate bill allows insurance companies to charge older folks three times as much as younger folks.
    reply to this

  19. That was a very interesting read, thanks for taking the time to post it.

  20. That was a very interesting read, thanks for taking the time to post it.

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