Health Care Is Too Expensive, He Says, While Touting A Requirement That Makes Health Insurance More Expensive
From USA Today's play-by-play summary of President Obama's health care question-and-answer session earlier today:
Obama notes that a provision coming online tomorrow will allow children to stay on their parents' insurance plans until the age of 26. He expresses frustration that he hasn't been able to explain better to Americans the wasteful costs of the heath care system. [bold added]
Which is funny considering that the young adult-coverage provision Obama starts by boasting about won't be used by everyone—but is expected to drive up the average cost of health insurance by about 1 percent.
That's a small hike, for sure, but the point is that it's a step in the wrong direction. Now, it's probably true that there's a lot of waste in the health care system. The going estimate these days is that about 30 percent of medical spending is wasteful. A few years ago, George Mason economics professor Robin Hanson suggested in a provocative Cato Unbound essay that the figure might be as high as 50 percent. But here's the problem: Even if we accept the basic argument, we don't know with any certainty which 30 percent is wasteful. And all that potentially wasteful medical spending is currently going to someone's paycheck—frequently someone with a lobbyist (or a whole bunch of them). That's a recipe for a lot of bitter political squabbling, but not for efficiency and waste-reduction. To further complicate matters, care that may be ineffective for one individual may be quite effective for another, which makes it very, very difficult to make cuts through centralized planning or quality-blind across-the-board rate cuts. And given that new health insurance mandates frequently drive up the cost of insurance premiums—sometimes by not very much, sometimes by as much as 50 percent—adding mandates doesn't exactly seem like the best way to address the issue.
Editor's Note: As of February 29, 2024, commenting privileges on reason.com posts are limited to Reason Plus subscribers. Past commenters are grandfathered in for a temporary period. Subscribe here to preserve your ability to comment. Your Reason Plus subscription also gives you an ad-free version of reason.com, along with full access to the digital edition and archives of Reason magazine. We request that comments be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of reason.com or Reason Foundation. We reserve the right to delete any comment and ban commenters for any reason at any time. Comments may only be edited within 5 minutes of posting. Report abuses.
Please
to post comments
OK this makes a lot of sense dude, I know it is out of control!
http://www.anon-web.tk
Aren't you that guy they called "Wung like a horse"?
So how's that Affirmative Action President working out for ya?
Does it hurt when I do this? How about NOW?!
"So, I told the other guy standing there, 'That's why I never get the egg salad!'"
And Jimmy Kimmel laughed in the background.
"He expresses frustration that he hasn't been able to explain better to Americans the wasteful costs of the heath care system."
Yep, because if we were just smart enough to understand then we'd agree with him wholeheartedly. FAB (I'm starting a new internet acronym for FUCKING ARROGANT BASTARD)!
I suppose, then, you just don't get it.
Wait - the federal government permits insurance companies to drop children from parents' plans at age 26?
Our do-nothing federal government is just sitting there and permitting the insurance companies to engage in this sort of callous behavior?
That's what happens when you let free-market extremists, and well-heeled corporate lobbyists, dictate health-care policy. ? ? ?
Think of us adult children!
Look, you guys joke about this, but as a currently 27 year old man, I have struggled to find anyone my age who does not still act like they're in high school...
Now write 100 times:
I will not chew gum when I type my comments.
All the more reason they need to contract the flu and get off the Earth. More room for the rest of us.
This is bullshit. Children cease to BE children at the age of consent, which is generally eighteen.
The Dems want to change the meaning of the work "kids" just so they can cover shitloads more warm bodies with this expensive, giant-sucking-sound making government boondoggle. No other reason for it.
What about the post-adolescent children???
We don't know with any certainty which 30 percent is wasteful.
Precisely. And most of what people think is probably wasteful is diagnostic work (tests, radiology,etc.). So guess what our genius President has done? Cranked up the incentives for diagnostic testing (under the rubric of "prevention", which is really early detection, which means running a bunch of tests on asymptomatic patients).
Is there one single fucking thing that this guy doesn't get completely ass-backwards?
you MEAN "Is there one single fucking thing that this FAB doesn't get completely ass-backwards?"
Answer- Not that I can think of.
Is there one single fucking thing that this guy doesn't get completely ass-backwards?
He, as a good Christian, probably doesn't get a married fucking thing ass-backwards either.
(Sorry, Michelle, I just couldn't resist.)
Obama seems to be unclear on the concept of "children". Or maybe it's because he thinks everyone is a child. Whatever.
In any case, this is up to the insurance company to decide. I have never understood these laws about who gets to have what coverage. It's up to me and my insurer who gets on my coverage. Whether it's my spouse, my child, my next door neighbor, etc.
It's up to me and my insurer who gets on my coverage for the price I'm paying.
FTFY
This keeping your kid on your policy until 26 rule is going to create so many headaches. What about parents who don't like their kids? What about kids who don't like or don't want to be dependent on their parents? Too bad, because insurance companies are going to stop offering college plans and other cheap young people only plans. So either you stay on your parents policy or you go for the ultra-expensive all the bells and whistles policy.
This is so fucking unfair!
"Even if we accept the basic argument, we don't know with any certainty which 30 percent is wasteful."
The percentage of waste - whatever it is - is not going to be alleviated by creating a new entitlement program whereby one group of people are forced to pay for services received by another who won't be paying for it.
Whether the waste is 100% or 0%, it will still result in an increased cost to those on the paying end of the forced transfer.
We are going to bend the spending curve downward by spending more money!
Close. I think they are going to bend the spending curve downward by bending the taxpayesr over and fucking them in the collective asshole until their collective o-ring is blown to bits.
It seems to me that the crux of the health care problem in this country stems from the fact that we have a a free market where anyone can buy into or out of the health care system, but we have a social contract that says that no one will go without health care (in fact, it is illegal to not provide health care based on an inability to pay).
I remember hearing a story on NPR about a town that had a pay-for-service fire department. Meaning that if your house caught fire, they would only come to put it out if you had been paying your monthly dues, or if the fire was affecting the house of another paying member. But if you didn't buy into the service, they would just come by and make sure that your house burned safely to the ground. One of the firemen mentioned how tough it is to watch someone's house burn down as the homeowner pleads for them to put it out, but if they did, then nobody would buy into the program in the first place. Our health care market operates the same way, with the huge fundamental difference being that in the end, everyone gets treatment, regardless if they had been paying or not.
What we end up with is a health care market that allows people to opt out, but a social contract that doesn't. And the difference between those two realities is paid for by the government and those of us in the market.
The Constitution is supposed to be the social contract.
There isn't any other legitimate one.
Ok...but in the real world it doesn't work that way. My step-dad had an aneurysm of the aorta back in 1998 and he was immediately rushed to the hospital where he was kept in ICU for 11 days before passing away. The main point is that he was unconscious throughout the entire ordeal and racked hospital bills amounting to $600,000, despite the fact that he never requested the service, had no insurance, no ability to pay....they didn't even bother running a credit check on him first. I'm sure the hospital made up the money by billing the government and/or jacking up their rates a bit.
The problem is that a true free market system seems incompatible with the demands of a first world society. This is the scenario which would be required under a true free market system: two drivers get into an accident and both are unconscious. Emergency personnel arrive, run a scan on the two drivers and find that only one of them have insurance. The insured victim is taken to the hospital, while the uninsured victim is left in his car, regardless of his condition. The uninsured victim will still receive all the benefits that the police department offers, since he pays into that with his taxes, meaning that they will clean up the oil and glass in the road, tow the cars if necessary and get traffic moving again. But all health care must be denied to the uninsured driver. If he wants he can flag a taxi to the nearest free health clinic. Or he can die in his car. As long as he doesn't run up health care costs he can't pay for.
That is the scenario that will have to play out under a true free market system, and my guess would be that 95% of the public would consider this scenario to be unacceptable.
There is a thing called private charity.
There have beeen private charity hospitals for a long time.
Before the law that mandated emergency room treatment regardless of ability to pay and before WW2 when employer provided health care coverage got started as a result of mandated salary levels.
Now people have less incentive to be responsible for themselves because the government is enabling them to sponge off of others.
Before, they had to take a chance as to whether they would get charity care or not if they were not prudent enough to be responsible for themselves.
Well, then what would you recommend in the scenario above? It happens every day here in Los Angeles. Who will take the unconscious man to a private charity hospital? And do we have enough private charity hospitals to cover the 1/7th of the population that are uninsured?
There are many highways throughout Africa that follow this free market example. But most western tourists are absolutely mortified by the number of dead bodies that litter the roadways. I can't imagine that that scenario would be allowed to unfold in this moderately affluent society.
BODIES!!!! Bodies, people! LITTERING the roadway! Is that how you want America to be, strew with the corpses of the uninsured?! Huh? HUH?!?!!!!!111!1!1!
Then STFU and fork over that sweet, sweet cash.
That's what I've been saying!
"There are many highways throughout Africa that follow this free market example."
Just come out and say "Somalia", Ben. Quit being a pussy.
Your mocking attitude makes no sense here...I don't why you find this so ridiculous. If the idea of bodies in the street is ridiculous, it's only because of our socialist system which makes sure all "bodies," conscious or unconscious will be removed from the streets, treated, and taken to a hospital if needed.
Currently 1 out of every 7 ambulances out there is carrying a patient who has no means to pay for their services. If we did switch to a true free market, each of these cases would have to be handled by a private charity hospital. And, of course, some cases would be left unaddressed. And some of those cases would end up being a body in the street.
How many unaddressed cases would be acceptable? I can already picture the field day the local news would have with just one such case. In fact, your mocking hysterics belies just how unacceptable this outcome is in today's society. My mere mentioning of it had you mocking me as a hysterical loon.
Ben|9.22.10 @ 6:59PM|#
"If we did switch to a true free market, each of these cases would have to be handled by a private charity hospital. And, of course, some cases would be left unaddressed. And some of those cases would end up being a body in the street.
Conclusion does not follow from premise.
I would say it's the other way around. The conclusion that private charities will pick up the slack is not a conclusion at all. It's just a hope and does not follow from the original premise. And unless you're proposing some force of the market that will ensure that no case goes unaddressed, then it's all but assured that some cases will go unaddressed. But what market force can guarantee that? Private charity? Either you can conclude that private charities will pick up ALL the slack. Or that some cases will fall through the cracks. Since the former can't be guaranteed in a free market, the latter must be true.
Ben|9.22.10 @ 7:24PM|#
"I would say it's the other way around. The conclusion that private charities will pick up the slack is not a conclusion at all."
I would say you have the strawman in a head lock, but you're going to be in trouble when the issue gets hold of you.
You presume that "private charities" are specific entities that must be other than the institutions that currently provide healthcare. You're further presuming that a market-based healthcare system would do nothing other than maximize profit.
Neither presumption holds water.
Sure, Ben. Because there were just bodies, bodies everywhere before the health care system got "socialized" to the level it's at today.
The hospital makes a conscious decision to treat cases they know will not be paid for. They negotiate their rates with insurance companies with this in mind. Do you not understand the concept of pro bono work? Or the concept of assumed risk of loss when they take a patient without insurance? Fortunately they do.
Of course we are mocking you as a(n) hysterical loon. Your arguments are either unsubstantiated fear-mongering statism or they are unintelligent, unresearched and undeniably undeserving of our undivided attention.
Alliteration aside, hospitals typically choose their patients on the health benefits the patient will receive as well as the financial health of the hospital. In a true free market, they can choose to provide care for 80% of their patients free of charge and jack up the rates for the other 20%. Of course, no insurance company in the world will accept these terms, so the hospital must adjust their rates. What hamstrings the process more than anything is the federal government turning insurance into a subsidized care program rather than insuring against catastrophic illnesses or injuries, which is what most people want to insure against. And second on the list is bloodsucking, ambulance-chasing attorneys constantly at the ready to force malpractice rates through the roof every time a homecoming queen gets a scar after emergency surgery or some such case where the doctor acts in the patient's best interest, but that's just not good enough.
Hospitals do not make decisions about who they treat. That would be called "patient dumping" and was made illegal in after the passage of Emergency Medical Treatment and Active Labor Act of 1986.
As for malpractice suits, perhaps you're suggesting lowering the cap of all claims to $250,000 like Bush suggested back in 2004. However both the CBO and GAO found "no evidence that restrictions on tort liability reduce medical spending."
The real problem is twofold. We want all the health care options that are available to us, regardless of the cost. And 1/7th of the public doesn't pay for health care but use emergency rooms anyway.
Ben|9.22.10 @ 7:55PM|#
"Hospitals do not make decisions about who they treat. That would be called "patient dumping" and was made illegal in after the passage of Emergency Medical Treatment and Active Labor Act of 1986."
Which sort of blows your earlier claims.
I think you misread my earlier claims....
I think most of you are underestimating what a drastic change this country has gone through in the past couple of centuries. "Bodies everywhere" is not exactly how I'd describe it, but throughout the 19th century he mortality rate in the U.S. was anywhere between 20-40 per thousand depending on which estimates you use. To give you some perspective, Afghanistan is currently at 20 per thousand, Somalia is at 15. Bodies might not have been everywhere, but they certainly were common. But the point is that in today's society, just one is considered unacceptable, and our government policy reflects that. Unfortunately, we never changed our market to reflect that fundamental change in society.
Uh, I'm well aware of current and historical like expectancies, but WIH does this mean?
"...Unfortunately, we never changed our market to reflect that fundamental change in society."
It's very simple...in the 80's, patient dumping was becoming rampant in many urban areas. In response to the huge public outcry, EMTALA was passed which made it illegal to deny treatment based on ability to pay. This would be the "fundamental change in society" that I was referring to. However, no market was ever set up to pay for this outpouring of civic goodwill, and ever since we have paid for it with higher and higher premiums.
Ben|9.22.10 @ 9:01PM|#
"It's very simple...in the 80's, patient dumping was becoming rampant in many urban areas."
Cite, please, and I'm sure you'll include the economics of that 'dumping', like any government requirements that might have an effect.
Can't you just use your libertarian powers of economic projection to "imagine" the scenario?
Prior to the passage of EMTALA: economics would dictate that hospitals admit the patients most likely to be able to pay.
After the passage of EMTALA: hospitals have to accept everyone.
It's a huge fucking change to the economic foundations of the health care system. You don't need numbers the numbers to acknowledge that. Just an understanding of basic economic theory.
Ben,
Your understanding of EMTALA is not entirely correct. Hospitals are only required to provide *emergency* care to everyone. Hospitals are still free to deny *nonemergency* care, to anyone, especially those who are not likely to be able to pay.
True. I'll be more specific. But the spirit of the law is the same. When it boils down to it, you will get healthcare, whether you can pay for it or not.
"Bodies everywhere" is not exactly how I'd describe it
Except for the part where you described just that...
No my point has been that just one body would create a public shitfit and media shitstorm. And so a system that allows that to happen will not last.
Except that precisely this scenario did *NOT* happen prior to government manipulations of the health care market... In fact, what happened was that doctors & hospitals ran free clinics and operated with sliding fee structures to work with people who couldn't afford care.
This has since become increasingly difficult, if not impossible for most health care providers simply because of the inflated costs of operation. However - those costs have been created by market distortions foisted upon us all by meddlesome politicians.
The presumption you make is that health care MUST be ridiculously expensive and that simply is not the case. Imagine that 11 days of intensive care only cost... let's say... $50,000... or even less than that... Insurance becomes cheaper and more affordable, and those without insurance aren't going to be a huge burden on everyone else.
Ironically, if we actually have no choice but to watch government manipulate the health care system, then at least what they should have done was find a way to balloon supply of resources... They did the opposite - they punish producers and subsidized demand.
Fail.
The Constitution is supposed to be the social contract.
Ok...but in the real world it doesn't work that way.
So, in the-way-we-imagine-things-should-be, "the contract" is an actual document (the Constitution), but in the real-world "the contract" is some imaginary construct that contains whatever people want at the moment. Ok, now that I understand that, is there any chance of getting a copy to sign (or not)?
That's actually the most hilarious thing I hear people tell me about living in the US anymore... That I have a social contract with the government. If that's true, then the "contract" is the Constitution, and if so, I live up to my end of it but the government has not lived up to theirs. So where's my legal/mediation service and compensation for their continual breaches of contract?
You don't have a social contract with the government. You have a social contract with society. You can break free of this contract by moving away from all people. But the act of living among each other creates the social contract. Things like, police and fire protection, road maintenance, trash collection, pollution restrictions...none of these are outlined in our constitutional contract, but they are a part of the social contract, and you can easily escape them by moving out to Ruby Ridge or the like.
escape by moving to ruby ridge?
really bad example
I thought Ruby Ridge was a nice quiet countryside where you could live out your life free of government interference?
Jeez, lighten up a little...obviously it was tongue-in-cheek...
The problem with this line of thinking is that if I have a contract with "society" that presumably means people i actually interact with and effect on a daily basis. I personally think there are a lot of flaws with the "social contract" idea to begin with (namely, if I have a contract, why do I not remember agreeing to and/or signing anything?) but there are tremendous flaws that in thinking that such a contract would extend to people thousands of miles away from me.
It's one thing to say "if you don't like the services being provided for what you're paying" referring to fire & police, etc. and then suggesting I move to a difference town - and saying that concept extends to my interaction with 310,000,000 people covering almost 2 billion acres of land in the world.
How do I have a social contract with someone I don't know in Tallahassee? I don't/shouldn't be paying for their police, fire protection, road maintenance, trash collection, or even pollution restrictions... Should I?
If so... Why?
What reasonable argument could you possibly make in favor of such a thing?
Even if I agreed that there is some kind of mystical social contract that I "agree" to merely by being born within some arbitrary political demarcation, it's a ridiculous stretch to say that "contract" applies between me and every other person on the planet regardless of my influence on them or their environment.
You already are part of this social contract whether you like it or not, and whether you acknowledge it or not. You can't opt out of police protection or fire protection. You can't not pay for roads and other shared infrastructure. And you can't opt out of emergency medical services. These, and many others, are all freedoms we give up in order that we may live in close proximity with one another. And there very well may be better methods for addressing these societal needs. Whether you agree with these issues is another matter, but you can't argue that they don't exist.
First, Benny, calling it "protection" is hyperbole. Many have been victims of police brutality and firemen incompetence. Why choose protection instead of the latter?
People opt out of paying police and fire all the time, Ben.
In many municipalities, only property taxes go to pay for police and fire. Many choose to rent and not own a house. They don't pay.
There are plenty of complaints to be lodged against our police and fire services, but c'mon, we're not living under the Taliban. You can still go to the police and have a 99% chance of being treated fairly and equally under the law.
And if you think you are "escaping" from property taxes by renting instead of owning, you don't have a full understanding of market economics. Every landlord out there is paying property taxes, and market theory dictates that any increase incurred on them, will be passed down to the renter. Furthermore, a huge chunk of municipal expenses are funding through sales taxes, which are incurred by everyone. So in short, nobody escapes the costs of the social contract, though the further you remove yourself from municipalities, the more you can opt of these costs.
It's you who lacks understanding, Benny.
Only when landlords have PRICING POWER, can they foist taxes paid into the rent price.
RIGHT NOW, landlords lack pricing power.
Get with the times, clueless one.
Pricing power only determines where the market equilibrium is at. But implicit in that equilibrium is the cost of property taxes, as well as any other costs that go into maintaining a rental property. This is very, very basic economics that you're attempting to refute.
And then of course, that's to say nothing of the sales tax. Even if you rent, you can't avoid that, unless you choose to conduct all business outside of your municipal jurisdiction.
"You don't have a social contract with the government. You have a social contract with society."
No we don't.
"Society" is nothing more than a word used to describe a specific collection of individuals.
It is not an entity that is accoutable for anything or that anyone is accountable to.
You're not acknowledging what is clearly in front of your face. Do you have a Police department where you live? A fire department? Maintained roads? Guess what? You're helping to pay for that. You've acquiesced to the social contract all your life and never even realized it. And guess what else? No matter where you move, if you're going to live among other people, you're going to have to deal with these factors among many others. You have the freedom to live among society or not, but when you do, you have to live with the curtailed liberties.
Ben, you need to use another word besides contract.
For a contract to exist, there must be agreement between TWO PARTIES one who makes an OFFER, the other who makes ACCEPTANCE, and who gives PAYMENT of something of WORTH, all done within a defined, FINITE time
If you lack these key components -- offer, acceptance, payment, finite time -- you lack having a contract.
Again, the phrase "social contract" is hyperbole, rhetoric, mere bullshit used by Socialists to push their agenda for how to collectivize individuals in order to extract wealth from them.
No social contract, social compact or any other bogus Socialist concept exists, regardless of what label in which you use.
Merely, there are laws and those who gain power to justify their acts by decreeing laws and referring to those laws.
You refuted the term "contract." But you did nothing to refute the concept behind it. When you live among society, you choose to obey the societal laws, federal, state, and local. If you move into a dry county, you are agreeing to the social contract of that society. If you like to drink though, and you want to opt out, you can simply move away. But the mere act of choosing to live among others implies your consent in this whole affair.
No, Ben, what we will wind up with is a system where one is NOT allowed to opt out. And that's where the ass-fucking starts.
Newsflash....we have this already....
You can't opt out of police service, fire service (in most places), or military protection. And you can't sign a waiver opting out of the health care system. If and/or when you need emergency medical attention you will get it in this country, regardless if you are an unconscious, uninsured, broke illegal immigrant. You can't opt out of that system and ask for your money back.
So, Ben, where would you say "okay, stop here, and from this line in the sand one CAN opt out"?
Jesus, just root for Universal Food, Clothing, and Shelter while you're at it. You know you want to.
Speaking as one liberal douchebag to another, that is. Of course, I want all of the above, and anyone who doesn't is a fool.
It depends on what we as a society find acceptable. If the worst does happen and I die in a car accident, does the government have a duty to haul my carcass away? That would literally be the bare minimum they could provide....but bear in mind, that would still be a government backed system. My personal opinion is that the government should provide health care in the same way they provide police and fire protection. Of course this also means that if you chose to live outside of police, fire and health services areas, you shouldn't be taxed for it. But if you are going to live in a municipality, with all of its coordination, planning and logistics, there are certain thing you can't opt out of. It's just part of the social contract.
But more importantly than that, I want our system to be coherent. If it's gonna be a free market, you can't also guarantee health care to all the freeloaders as well. But if our policy, indeed, the law of the land, is that no one will be denied health care, then the market needs to reflect that.
"But more importantly than that, I want our system to be coherent. If it's gonna be a free market, you can't also guarantee health care to all the freeloaders as well. But if our policy, indeed, the law of the land, is that no one will be denied health care, then the market needs to reflect that."
You act like it can't be both ways. Tell me, when in a free market syatem have you seen a hospital wheel a patient out and dump them in the street because they didn't have insurance? You say "law of the land" and "markets need to reflect" in the same sentence like they are the same thing. Well, before there was a "law of the land" regarding health care, the "market" reflected the prevailing attitudes of market providers: they operated free clinincs, provided services on sliding scales and generally cared for their patients regardless of their ability to pay....yeah, that's called charity in my book. No coercion, no threats of fines, just good old-fashioned charity.
Funny how the charity ended the same time the Dept of HHS started in the 50's. This is another prime example of a progressive arguing against the free market just to argue. Face it, the system worked because the free-marketeers made it work. Once it ceased to be a free-market system, that's when it got all fucked up.
This happens all the time. Every few months here in L.A. we hear about uninsured patients being dumped out of the back of ambulances on skid row. This happens all the time despite the fact that it's illegal (see the EMTALA of 1986, also known as the Patient Anti-Dumping Act).
The law amounts to a huge unfunded liability for everyone paying into the health care system. However, the law represents the popular will of the people.
Ben|9.22.10 @ 7:13PM|#
"It depends on what we as a society find acceptable. If the worst does happen and I die in a car accident, does the government have a duty to haul my carcass away? That would literally be the bare minimum they could provide....but bear in mind, that would still be a government backed system."
You seem confused. Libertarianism /= anarchy.
You seem confused. This should be very easy to comprehend for a libertarian...what market force is going to guarantee to clean my damn body from the street. It has nothing to do with anarchy. It only has to do with money.
You all seem to be implying that something or some force of the market will come in and fulfill society's demands. I'm pointing out that society demands that all bodies be treated, 100% of them, every emergency in every city. And that the only way to ensure that is by government backing.
Ben|9.22.10 @ 8:41PM|#
"...It only has to do with money."
And, thank you for proving your ignorance.
Also I gotta say - you're conflating "society" and "government" anyway...
We "as a society" don't decide ANYTHING. Society is just the label we ascribe to the aggregate result of the independent actions of a culturally or geographically unified population of human beings.
It is the same way that the "market" isn't an entity that exists in any literal sense, but rather is the word we use to describe the aggregate result of all the trades individuals are busy making with each other every day.
So you can't say that "we as a society" find this or that acceptable. Society has no brain - individuals can decide if something is acceptable to them or not, and we can get some general concept of social norms by observing what things *most* people find acceptable... But "society" is just a label to describe an abstract idea.
So you must conflate it with government - but then we're back to where we started in the comments above... Government is the only entity with which I can have a contract, and that would presume that the contract is defined by the Constitution - and in that case, the government doesn't live up to their end at all.
And by the way - that means that *as an individual*, you can decide for yourself whether or not it's acceptable to have dead bodies laying in your street...
Let me guess... It's not?
Me neither.
I wonder if you or I could possibly find any way of making sure that doesn't happen without resorting to force? Like... Oh, I dunno... Contributing to a charitable hospital that does nothing but take on the task of providing medical care and emergency services to those who can't afford it?
And if you're a doctor, perhaps you too wouldn't like the thought of people dying in the street just cause they didn't have a lot of money... What might you think to do about it? Nothing? Not very smart, are you...
Sean W. Malone|9.22.10 @ 9:14PM|#
"I wonder if you or I could possibly find any way of making sure that doesn't happen without resorting to force? Like... Oh, I dunno... Contributing to a charitable hospital that does nothing but take on the task of providing medical care and emergency services to those who can't afford it?"
Which might be a whole lot more attractive if your wallet hadn't been hoovered for all the brain-dead schemes your taxes currently support.
Society has thousands of brains...maybe even millions of them. And those brains are constantly evolving and demanding changes. One year, society might want Jim Crow laws, the next they might want civil rights, or they might demand that drugs be legalized, or that alcohol be prohibited, or a social safety net for all seniors, or that all all people have a right to health treatment, regardless of their ability to pay. When I'm conflating society and government, it's because the two are related. Society shapes goverment, government shapes society. But regardless, I am talking about a specific law that was passed as a result of societal pressure (i.e. it was all over the news and was reflected in public opinion polls), as it took years of public opposition to patient dumping before government reacted.
Ben|9.22.10 @ 9:34PM|#
"...When I'm conflating society and government, it's because the two are related. Society shapes goverment, government shapes society."
Uh, yes, but....
"Society" carries no guns; it operates by persuasion.
"Government" carries guns; it operates by coercion.
So, equating "Jim Crow" laws with "legalizing" drugs is a false equivalence; in one case the guns are used to deny rights; in the other the guns are *not* used to enforce a prohibition.
There is a qualitative difference.
This is not a fucking meaningful argument. This law is clearly a result of public persuasion, not government coercion. Want proof? The next 10 people you meet, ask them if they believe hospitals should have the right deny treatment to a homeless person based on their inability to pay. I guarantee you no less then 8 out of 10 would say that should be illegal. An in fact, I wouldn't be surprised if 10 of 10 said so.
Ben|9.22.10 @ 9:50PM|#
"This is not a fucking meaningful argument. This law is clearly a result of public persuasion, not government coercion."
Right. That hag Pelosi forces it through and you claim it to be a result of public persuasion?
I see you're a fucking idiot who has no idea of what you post or what the Constitution means.
Go away, asshole.
Are you fucking dense? This whole time I've been talking about EMTALA. The law passed in 1986 that requires hospitals to treat everyone, is supported by virtually everyone in the nation and is the main reason for our current health care debacle where health care premium rise 10-15% per year. It has nothing to do with Pelosi.
Go fuck yourself.
Ben|9.22.10 @ 11:06PM|#
"Are you fucking dense?"
Uh, could be, but not nearly as dense as you seem to be.
"This whole time I've been talking about EMTALA. The law passed in 1986 that requires hospitals to treat everyone, is supported by virtually everyone in the nation"
So?
"and is the main reason for our current health care debacle where health care premium rise 10-15% per year. It has nothing to do with Pelosi."
Oh, and here I thought is was because of the meeting between Nixon and Hitler in Paraguay in '56!
Want to try to offer some evidence for your ignorant claims? Didn't think so; there isn't any, but that won't stop brain-deads....
"Go fuck yourself."
Stupid, stupid stupid.
Stuff it in your ear, ignoramus. Pretty much unlikely that facts will affect your stupidity.
Now I remember why I stopped arguing with people on the net...
Me: EMTALA was passed because of huge public support
You: Right. That hag Pelosi forces it through and you claim it to be a result of public persuasion?
Me: I'm talking about EMTALA, passed in 1986.
You: Want to try to offer some evidence for your ignorant claims?
Ben, there's no question that most people *want* all kinds of things... That isn't a particularly meaningful argument because reality is independent of your wants.
Why don't you ask people a different question.
How about you ask 10 people on the street this question. There are two grandmothers with cancer who need cancer treatment, but there is only enough of the medicine for one. The first grandmother has paid $250 a month to her insurance company her whole life and is expecting to have her treatment covered - the second grandmother did not purchase any insurance and cannot pay for the one available dose of medicine. Who should be given preference?
Why?
Show your work.
Fact: Supply of health care is limited by physical reality.
It's all well and good to pass a law that demands that X or Y people be given a good or service no matter what, but in a world of limited resources, what you're really doing is saying that some other people - who have ostensibly actually contributed to the system - are left with poorer quality or no goods & services at all. Why is that moral? You've just stripped a deserving person (equally likely to be a sympathetic character such as a little girl or a grandparent) of something they've worked hard to plan for and given it to someone who - for whatever reason - did not do that.
You're writing laws based on a magical conception of the universe where supply isn't limited by production, but rather limited because some people are just greedy & mean.
And... Uh... Fail.
Addendum: Health Care supply IS artificially limited by retarded politicians who think that punishing producers, restricting market entry, giving protectionist favors to selected companies and creating perverse incentives skewing demand for health care goods drastically up is a good idea.
We could, in fact, have health care supplied at a massively higher rate without the vast majority of mandates on the books - and thus there would be medicine for both grandmothers and it would become a moot question - while also pushing prices way down (thus making health care more affordable and insurance cheaper for everyone)
I don't disagree with any of this. In every post here, I have been pointing out the incoherence of our current system. That our laws are based on a magical conception of the universe where supply isn't limited by demand. Where on one hand, it is illegal to withhold expensive medical treatments to people who can't afford it, and on the other, the government has to spend whatever it takes to keep me alive (no death panels!).
Yeah, but what you keep ignoring, or pretending to ignore is that it's not a binary issue - just because the law doesn't require hospitals to treat the poor or insurance-less doesn't mean that those people won't still find medical care.
For godsake man, the Hippocratic Oath is almost enough to make sure that doesn't happen all by itself.
People are a LOT better than you give them credit for.
I'm willing to give them a lot of credit. The problem is the guarantee to health care in emergency situations, which is required by law, and supported by an overwhleming majority of the public. Even if people are a lot better than you give them credit for, there could still be that 1% that slips through. The public will demand nothing less than 100% coverage, as is evidenced by the collective shitfit that gets thrown any time a homeless person gets dumped from a hospital. We no amount of confidence in charity can possibly match that public commitment.
Are you talking about the health care bill that polls as consistently unpopular, which actually most of America *did not* want?
Just checking... Cause if so, I think you may want to re-evaluate how much of an effect "society" has on government.
Additionally... What Ron L said above is also key. When you have half your earnings stripped away in the form of taxes, it's harder and harder for you to set up the charitable endeavors that would otherwise exist to replace the coercive versions of fake-compassion that you find in government-"provided" options.
Additionally - you've touched on the whole problem with pretending that the issue is about whatever the majority wants.
The majority frequently wants asinine things - like as you said, Jim Crow Laws and prohibitions on all kinds of perfectly peaceful & consensual behaviors. In my view, they have no right to do that because my view rejects the idea of a social contract and instead adopts the concept of individual liberties stemming from the idea that I (and not you, government, "society", or even an extra terrestrial) "own" my own body and mind and get to decide for myself what I do with those things. Since I must also recognize your right to do the same - the line is simple. I don't use force to prevent you from doing what you want and you don't do that to me, and we each respect each other's property and bodies.
It's actually pretty simple and is essentially how you operate with everyone you ever meet every day unless you're a complete psychopath.
It doesn't require a the mental gymnastics of the social contract idea, and it actually prevents me from initiating force to get what I think I want... Anyway. Point is... Any time you ask the question, "But in a free market system who would take care of ____???" The answer is simple: YOU!
You do it. You convince other people to help you. You get a rich benefactor...
You will find that if it is a worthy goal, like clearing the roads and protecting the poor and the sick, you'll find a LOT of people who want to help. Which is, as you have to admit, precisely why there are movements to get these things covered by government in a number of cases. That is a mistake made by lazy thinkers, but the intention is often in the right place.
I'm fine with moving the majority of the burden from the existing system to the public charity sector. It would require a huge change to our existing system, but it would shift the costs to those who can better afford it. Furthermore, I think it would have a positive effect on society as a whole, as it would force us to more dirently confront the economic costs of our societal demands.
But the fundamental point is that as long as society demands that you treat homeless people and others who are unable to pay, a charity-based system is simply not going to be enough. Even if the public-charity system manages to cover 99% of the uninsured people out there, what happens to that inevitable 1%? Maybe in light of this new system, we will see a shift public opinion and that 1% will just be considered the small downside in an otherwise perfect system. But more likely, those 1% will be all over the news and the people will clamour for the government to step in and help those people.
You want an indicator of this? Here in L.A., every few months you'll see a story on the news of how a local hospital dumped a homeless patient back on skid row. It's only one case out of probably tens or hundreds of thousands, but it's enough to make the news and create a huge public outcry.
Ben|9.22.10 @ 10:46PM|#
"You want an indicator of this? Here in L.A., every few months you'll see a story on the news of how a local hospital dumped a homeless patient back on skid row. It's only one case out of probably tens or hundreds of thousands, but it's enough to make the news and create a huge public outcry."
I'm still waiting for the cite that "in the 80's, patient dumping was becoming rampant in many urban areas." as you claimed. And now you admit that what you claim to have 'solved' the problem by government coercion did nothing of the sort. Amazingly (not really) as a brain-dead, you presume *more* government intrusion will solve a problem which you haven't yet shown to be a problem, and which hasn't been solved by government the current intrusion.
Exactly how ignorant are you? There must be some level of evidence which would convince a brain-dead that brain-dead 'solutions' are the problem, but seemingly the concept of evidence is beyond your ken.
My god, you argue every point, no matter how insignificant or self-evident....
In 1986 congress passed EMTALA, also known as the anti-dumping act. Look it up on wiki real quick.
The law requires hospitals to treat patients for free in some cases. The pre-1986 statistics are irrelevent. What is relevent, is that starting in 1986 hospitals were required to treat people who couldn't pay, and that cost is being paid by the rest of us. Welcome to socialized healthcare. It's here already and it's been here for 25 years. Now let's find a fairer way to pay for it.
There is no "fairer" way to pay for it. There's just an issue of delaying the inevitable destruction of all health care in the US by one amount of time or another. No amount of wishful thinking is going to make socialism a system that generates wealth & prosperity.
Well it's hard to argue in the face of that cyncism. But there is plenty of room in the existing system to improve market efficiency, while retaining it's socialist nature. I mean, really, I imagine most of us participate in the health care market, but how many of us actually get a chance to flex our buying power? Maybe we can shop provider against another, but if consumer choice was maximized throughout the entire system, we could really see some major price drops. If we acknowledge that we already have a socialist health care system, let's at least restructure it to maximize choice and consumer flexibility.
Look... I basically see your point there, but that's not exactly the direction these things go.
No disagreement here...but here we are with a socialist approach, paid for through an inefficient capitalist market. Something's gotta give...either we can restructure the system to reflect the current fact that everyone is entitled to emergency health care as a right, or we need to change people's minds about who should and shouldn't recieve health care in a world of limited resources.
But what if many of us here don't really care about society's demands. That's when government steps in with the guns, right?
"Social Contract" is a false belief, a phrase of rhetoric and a bogus concept.
In short, there is no such thing as a social contract.
The phrase is socialist hyperbole.
"Several health insurers say they will stop selling new child-only individual insurance policies as they face a health care reform provision that will prevent them from excluding children with potentially costly pre-existing conditions."
And that hag Pelosi will just pitch a hissy; she didn't expect this, did she?
http://www.sfgate.com/cgi-bin/.....753D03.DTL
You're giving her too much credit. I have no doubt she expected this. Now she can call for more publicly-funded options because the insurance companies are dropping coverages. It's simply the next step in the playbook.
I was being sarcastic; she'll not only pitch a hissy, she'll immediately blame the 'free market'.
She's stacked the deck and now will feign outrage when everyone sits out.
The idea of getting more healthy young people on insurance plans sounded great to the insurers. They are looking for ways to fund the growing costs of the senior population. But this whole question will be moot when the insurers are out of business in five years.
"...and to think, we were only months away from that extra market share. Pass the grilled shoe leather would ya?"
Peter, you have no source for the claim that the young-adult provision will increase health care costs one percent.
Do a better job.