Obamacare

How Much Should the U.S. Spend on Health Care?

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Kevin Drum notes that the United States leads the world in terms of health spending as a percentage of gross domestic product. To some extent, that's explained by the fact that the U.S. is relatively richer than other countries, and richer countries are likely to spend a greater share of GDP on health care. But according to McKinsey's data, the U.S. spends even more of its GDP on health care than you would expect given health spending ratios in other countries.

Does this mean there's a lot of fat in the system? Quite possibly. I'm certainly willing to believe it. There's some evidence to suggest that nearly a third of Medicare spending is wasteful. Robin Hanson, an economist at George Mason University, has suggested that half of all care may not be beneficial. But the key thing to remember about this debate, I think, is that the core problem isn't how much the country spends as a percentage of GDP. If individuals choose to spend more or less of their income on health care, that's not necessarily something to worry about. Instead, from a policymaking perspective, what we ought to be worrying about is how much the government spends on health care—and how much it's committed to spend into the future.

Now, those two things aren't entirely unrelated. But while the current fad in health policy is for expanding coverage while attempting to hold spending in check through better bureaucratic management, there's some evidence that a large percentage of the rapid rise in health spending since 1970 may actually be a product of government-driven programs designed to increase coverage.

In 2007, MIT's Amy Finkelstein found that the introduction of Medicare—and the subsequent increase in health insurance coverage—correlated with a 23 percent rise in hospital spending between 1965 and 1970. As Medicare matured, its influence on spending seems to have grown larger. Finkelstein estimated that Medicare ended up being responsible for about 40 percent in the massive rise of health spending between 1950 and 1990. The actual health benefits, though, were unclear: In a follow-up Wall Street Journal op-ed, Finkelstein noted that although Medicare did help prevent income shocks to the elderly, it "did not have any effect at reducing elderly mortality in its first 10 years of existence." 

The health benefits of other government-run health coverage programs are similarly dubious—as even some of the administrators in charge of the programs will admit. For example, as Cato's Michael Cannon noted a while back, in 2008, one of Indiana's health policy officials wrote a letter to the journal Health Affairs noting that despite holding what he describes as an "almost religious conviction that the State Children's Health Insurance Program (SCHIP) is effective public policy," he admits to having "no empirical evidence to support the assertion that SCHIP is a beneficial and effective way to invest in children's health." That leap of faith—that more coverage is nearly always better—describes a lot of how U.S. health policy ends up being conducted: In 2009, President Obama signed an SCHIP expansion into law.

So the mere fact that the U.S. spends a larger share of its GDP on health care is not necessarily cause for concern—at least not in the abstract. Instead, what's worrying is that the U.S. continues to pursue policies that seem to substantially increase total spending with little evidence that those policies have a significant positive effect on health outcomes.

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240 responses to “How Much Should the U.S. Spend on Health Care?

  1. How Much Should the U.S. Spend on Health Care?

    The economics illiterate say:
    “It should be less than now, and for that: government!”

    Me: Who’s “we” Kimosabe? I spend EXACTLY what I need to spend or I want to spend, so fuck you!

    1. You missed a turn some time ago. Lourockwell was back there by the corner drug.

      1. Re: hoodie,
        Please write in actual sentences: Subject, predicate; noun, verb, adjectives, adverbs.

        Otherwise, fuck off – you didn’t make any sense.

        1. You are ubiquitous, Old Man. We are watching you, and we are armed.

  2. “How Much Should the U.S. Spend on Health Care?”

    AFT:

    “Every red cent you’ve got.”

  3. Kevin Drum notes that the United States leads the world in terms of health spending as a percentage of gross domestic product.

    Which means nothing. If the US was also spending a greater amount of GDP on tricycles, would that be as compelling?

    The fact that the US spends more in GDP on healthcare only means that: People are spending more on healthcare. Meaning: They can.

    1. Unfortunately, about 50 cents of every dollar spent on health care comes from government, so spending more == taxing more OR borrowing more.

    2. Statistically, health care spending in industrialized nations rises with per capita GDP, and this alone explains 50% percent of America’s higher costs.

      http://www.ncbi.nlm.nih.gov/pubmed/15160799

      1. Hmm. GDP per capita (PPP) (IMF values for 2010), pct. GDP health care expenditure (2006) and per capita spending (PPP) for the wealthiest countries:

        Luxembourg: $80,304, 7.3%, $5494
        Singapore: $57,238, 3.3%, $1536
        Norway: $52,238, 8.7%, $4519
        United States: $47,123, 15.3%, $6719
        Switzerland: $41,765, 10.8%, $4179
        Netherlands: $40,777, 9.4%, $3481
        Australia: $39,692, 8.7%, $3119
        Austria: $39,454, 10.2%, $3608
        Canada: $39,033, 10.0%, $3673
        Sweden: $37,775, 9.2%, $3162

        Singapore is certainly an outlier, but then they’re also the only Asian country and probably have even greater income disparity than the U.S. Luxembourg could be consider an outlier because its per capita GDP is so> much higher than everyone else’s. But even eliminating those two, no other country even comes close to U.S. spending levels, including Norway which has a higher per capita GDP (PPP).

        If we were even able to eliminate half the difference between U.S. health care spending and the next highest country (France, at 11% GDP), that would represent a savings of 2.15% GDP, or $314 billion. That seems like something worth working on.

        1. The study makes for no distinction between elective and non-elective procedures and care.

          1. I’m not sure I understand how that’s relevant. The stats I posted also don’t make any distinction between elective and non-elective care. Generally speaking there is probably a correlation between per capita GDP and pct. GDP health care expenditure, but even if so the U.S. is a still a ginormous outlier.

  4. Heh.

    Playadelrey at 1:51 PM February 24, 2011
    I am a graduate school student from China.

    It does not matter about social security, because by 2037, America will be poor, third-world country, as Americans are stupid. As example, writer says today’s 30-year old will be 67 in 2037. Correct? Maybe only Americans think correct. Even Chinese primary school student can do math and know this is not correct. But famous writer for big newspapar in America cannot do simple math. Americans are so stupid! If you have company, will you hire American who cannot solve simple math?

    1. If you have company, will you hire Chinese who will fake result and run off and start new company in own name?

    2. It gets worse (reply):

      fatuous at 4:13 PM February 24, 2011

      You’re kidding right? We’re only 54 days into 2011. That means that 85% of those born in 2010 are currently 30 years old. It also means that only 15% of those who will turn 30 in 2011 are actually 30. 85% of them are only 29.

      But it’s reassuring to know that Chinese Graduate students can’t even do “simple math”. That’s why we invent everything and you make it for us.

      2037 – 2010 + 30 = ????

      1. Note: It’s two thousand and ereven.

        1. Yes, but, 85% of those born in 2010 are currently 30 years old.

          The point is, the author of the article was off by 10 years. A 30 year old will be 57 in 2037, not 67, as the author of the article states.

  5. The actual health benefits, though, were unclear: In a follow-up Wall Street Journal op-ed, Finkelstein noted that although Medicare did help prevent income shocks to the elderly, it “did not have any effect at reducing elderly mortality in its first 10 years of existence.

    But the program would not have been implemented if scores of elderly people were not dying in the streets trying to enter an emergency room! I mean, that is what the marxoid punk told me! Was he lying? Say it ain’t so, Shoeless!

  6. NOTHING! The only people that deserve “free” healthcare are members of the military. Everyone else (including the President) should get it at the private sector. Can’t afford it? Then join a Mutual Aid Society, that’s how LEGAL immigrants used to do it not just for healthcare but housing, jobs, and everything else. Free people working with other free people to achieve their goals without government health.

    Oh, and to the military haters, the Health & Human Services department spends more than the military.

    BLACK TEA PARTIER IS ABUSED BY RACIST UNION THUG.
    http://libertarians4freedom.bl…..acist.html

    1. I like the Cliche’ Bandit’s closing tag-lines better.

    2. Hey, neocon, riddle me this: why the FUCK would you ever think you are a libertarian?

      1. Hey, neocon, riddle me this: why the FUCK would you ever think you are a libertarian?

        Because he listens to Neal Boortz.

        1. On the 60’s Batman, besides having enemies like The Joker, The Penguin, The Riddler, Catwoman (don’t ever go look at the picture of Julie Newmar on her Wikipedia page…oh my god), Egghead, King Tut, etc., there should have also been an enemy called The Neocon. Milton Berle could have played the character for laughs.

          1. don’t ever go look at the picture of Julie Newmar on her Wikipedia page…oh my god

            Just did, jeezus what the fuck happened there? It’d be more flattering to prop up a corpse and put a ‘Julie Newmar’ sign around its neck.

            1. Just did, jeezus what the fuck happened there? It’d be more flattering to prop up a corpse and put a ‘Julie Newmar’ sign around its neck.

              Gravity, like death, is still in effect.

              1. I’m not going to look. It would ruin too many good memories of watching Batman after school

              2. It ain’t gravity or getting old, what has happened to Julie Newmar is much more sinister. I suspect that what we are seeing is a zombie disguised as an elderly teevee star.

                Holy BRAIIIINSSS Batman, indeed.

            2. Damn, she looks more like a cat woman instead of Catwoman now 🙁

              1. I did 2 blogs on catwoman and batgirl. I think they are cool women
                http://rctlfy.wordpress.com/20…..s-hawtter/

                http://rctlfy.wordpress.com/20…..dquarters/

          2. As I recall, Milton Berle already had a Batman villain. Wasn’t he “Louie the Lilac”?

      2. I don’t give a crap what you think of me. I know what I am and what I believe. Besides, I think you’re actually a LIBERAL looking for a tax break and an Obama lover. So do me a favor, turn on MSNBC, lube up that vibrator with Obama’s picture, and do to yourself what Obama is doing to the country.

  7. The older and more educated I get, the less I believe in seeing doctors. I’ve taught too many premeds to put my life in their hands.

    1. All my friends who went through med school are alcoholics. I’m doing my own surgeries from now on.

      1. Huh, that’s just like pilots. Wonder what the correlation is?

        1. Huh, that’s just like pilots. Wonder what the correlation is?

          Groupies, alimony, and stress.

          1. Men are pussies now and can’t handle the stress

            1. Men are pussies now and can’t handle the stress

              How is this observation objectively derived?

              1. Just ignore the stupid whore.

                1. Warty, do I have to teach you how to ignore women? Taking your dick out and jerking-off every time you see my handle won’t work.

              2. Men use to work, provide, fuck their wives only, and now they can’t ‘handle the stress’, leave their kids financially & emotionally screwed-up, and fuck any pussie willing because it is all about their delicate manhood

                1. Men use to work, provide, fuck their wives only, and now they can’t ‘handle the stress’, leave their kids financially & emotionally screwed-up, and fuck any pussie willing because it is all about their delicate manhood

                  I see. So, it’s not about the children or caring about others. You have an unresolved, emotional, ideological ax to grind, with very little objectivity. You are indeed very selfish and resentful, typical of an Adherent of the Church of Utilitarianism (Orthodox). I dare say, a devoted disciple who has not progressed beyond the “Veruca Salt” stage of mental development.

                  1. I’ve never been inside that church

                    -So you failed psych rotation again.

                    1. So you failed psych rotation again.

                      I am not the one in need of psychiatric treatment. You are vindictive and blame strawmen and spectres for whatever issues you have. Whatever motivates your need to indict the world for perceived injustice is probably unhealthy.

  8. We all know how this game is played…if we spend less than other countries, then we are barbarically allowing people to die, and need to increase our spending. If we spend more than other countries, then our greedy insurance companies are profiting off the system.

  9. You can get all goddamn coverage you want, but if your doctor is crap, well then shit you. Who prescribes Acyclovir and antibiotics for candida? WHO>?!!!

    1. A doctor that cannot properly diagnose, much less treat, thrush. It requires an anti-fungal.

    2. Just eat some Vagisil.

      1. Ugh, meant handle to say “Cartman”.

        1. Don’t forget to trademark Cartisil.

  10. This seems a little like avoiding the argument because it doesn’t play into a vulgar libertarian perspective on health care. Remember the Frankenstein system we currently have?

    Clearly, the rate of which health care costs are rising are a concern, from a private and public perspective. And we spend a great deal more than any other country on a system that by many respects is equal or inferior. Blaming it on Medicare spending and closing the case doesn’t even begin to address the argument.

    Can you imagine the cost of a “free market” insurance plan for an elderly person absent medicare or some other form of government subsidy? I haven’t really the heard the humane libertarian case for that and I’ve read plenty of Michael Cannon’s work.

    Maybe, just maybe, the health care market is incredibly distorted for a number of reasons.

    1. And we spend a great deal more than any other country on a system that by many respects is equal or inferior

      You have zero fucking idea what you’re talking about. If you can’t even get this basic shit right, why should anyone listen to you?

    2. Can you imagine the cost of a “free market” insurance plan for an elderly person absent medicare or some other form of government subsidy?

      Why, yes. Yes, I can.

      If you’ve paid a premium throughout your younger years that insures your health in your old age, then your premiums as an elderly person won’t be high at all. You could even arrange to pay no premiums when you are old. It’s all down to annuity tables.

      I haven’t really the heard the humane libertarian case for that and I’ve read plenty of Michael Cannon’s work.

      Try reading more.

    3. Ohhsweetconcord, yes!

      1. Stop masturbating, rectal. Everything’s getting sticky.

        1. hmm, check my next post after 6pm. I’m dedicated it to your suggestion

    4. Maybe, just maybe, the health care market is incredibly distorted for a number of reasons.

      No, only one: Health care is not a right. Until that mindset is corrected, any health care scheme, be it totally private, single payer, or ObamaCare, is destined to crumble and implode.

      1. Sure. It’s not a right. Neither is “having food to eat”. Many folks still feel some obligation to ensure that their fellow citizens don’t starve to death.

        1. Many folks still feel some obligation to ensure that their fellow citizens don’t starve to death.

          Pony up.

          1. Believe me, I do. And I’m keenly aware of the inefficient and counterproductive ways in which it is often spent.

        2. Many folks still feel some obligation to ensure that their fellow citizens don’t starve to death.

          And many slimeballs feel they have some obligation to steal from their neighbor, and pay several bureaucrats and social workers to redistribute the stolen money to people who are not starving. All the while congratulating themselves for how much they “care” and are preventing starvation that wasn’t occurring in the first place.

          1. I mentioned starvation only as an example. You’re correct that few people are in danger of starvation in this country. There are, however, plenty of folks who couldn’t afford vital health care without assistance and who would die without it.

            If “we”, as a country, decide we want to spend tax revenue on X and you’re in disagreement, the subsequent collection of that tax revenue is not “stealing”. By choosing to remain a citizen (yes, it’s a choice) and enjoy all the benefits thereof, you agree to abide by the decisions made by your elected representatives. You can, of course, endeavor to see representatives elected who will enact policies you more closely agree with. If that doesn’t happen, and you can’t handle the fact that your taxes are being spent in ways you don’t support, you’re free to find somewhere else to live.

            1. The constitution does not give any elected representative the power to steal money from productive people and spend it on health care. Pass an amendment.

              1. The Supreme Court, i.e. the body specified by the document itself as being responsible for resolving disputes over its meaning, disagrees with you. Sorry.

                Though, I’m not necessarily opposed to the call for a constitutional amendment, so long as that amendment’s failure to pass would have the effect of ending all federal health spending. I think it would pass, though, because I don’t see many red states voting to obliterate Medicare, Medicaid and SCHIP. Congressional Republicans can’t even bring themselves to make cuts to these programs. So the amendment would pass and thereby silence all criticism of these programs on constitutional grounds.

    5. Re: Ohhsweetconcord,

      Can you imagine the cost of a “free market” insurance plan for an elderly person absent medicare or some other form of government subsidy?

      I can – Mexico’s. We have some of the lowest cost medical services in North America, almost totally free-market. We have charity or university hospitals, high-end hospitals and clinics, and low cost clinics for people with sore throats and colds. Medicines and prescription drugs are sold over the counter (except pseudoephedrine – thanks, America!) making them DIRT CHEAP – none of those stupid amber bottles! Unless you happen to live in a very isolated place, most folks receive care which is either paid by charity, or with one’s own money, or through the almost bankrupt Social Security system. And people are certainly not dying in the streets because of lack of care – they die because of your war on drugs.

      1. I predict a huge upsurge in free-market clinics along the Mexican border should Obamacare manage to slip through the constitutional shit filter. I know I’ll be making a run for the border if I need anything.

        1. Why? You’d still have to pay for coverage here (unless you’re talking about actually moving down there.)

      2. We have some of the lowest cost medical services in North America, almost totally free-market.

        Isn’t there only 3 countries in North America?

        1. *Aren’t.

          And if you include Central America and the Caribbean, no.

    6. Frankenstein system? I don’t think you’re in the right system. When I had to have surgery, I found the best doctors available. Interestingly, some similarly discerning patients from around the world also chose my doctors. Also, have you ever noticed how the US attracts some of the best doctors from overseas?

      If you want to lower costs, pursue tort reform and encourage more competition among insurers and medical providers.

  11. US per capita spending on health care is $7700 vs $3800 in Western Europe.

    Of course what this really means are that medical taxes are 2x higher on US citizens than in Western Europe but idiot conservatives who support unfettered Medicare can’t see this.

    Medicare is the problem here – it needs to be slashed every year – but the GOP base runs very old – like 55-80 – so we are all fucked.

    1. Re: shrike,

      US per capita spending on health care is $7700 vs $3800 in Western Europe.

      Those poor, poor Western Europeans, they don’t have higher aggregate spending… The Krugman should be appalled! How can they live like this?

      Of course what this really means are that medical taxes are 2x higher on US citizens

      Or maybe that Western Europeans don’t bother to go to the doctor anymore.

      1. Old Mexican,
        Or maybe that Western Europeans don’t bother to go to the doctor anymore

        try harder

        1. I would rather eat a prickly pear than trying harder just because you asked, rather.

        2. Why? That is a perfectly legitimate argument. Europeans have a much longer wait time when they go to the doctor, so they have a disincentive to go at all.

          Many Americans, on the other hand, go every time they get a cold, “just in case…”

          1. Many Americans, on the other hand, go every time they get a cold, “just in case…”

            Yes, and on some one else’s dime. If they were paying themselves, they may not be as quick to “run to the doctor.”

  12. Can you imagine the cost of a “free market” insurance plan for an elderly person

    First, determine the level of coverage. If you expect the person to be kept alive forever, it will be expensive.

  13. “The U.S.” can spend as much as “it” wants. Just don’t look to me to pay for it.

  14. How Much Should the U.S. Spend on Health Care?

    This is the wrong question, Mr. Suderman. The question should be, “How much should individual consumers spend on health care.”

    The answer is: However much they can afford.

      1. STFU jackass

        Do you find random people and take them to the doctor, paying out of your own pocket? Do you volunteer your own time and sweat equity, or are you paying lip service while sitting on a moral high horse?

        If not, then STFU.

          1. Then you need to STFU and get back to work instead of wasting time on a chat board. You are very lazy and selfish.

            1. I’ve been doing volunteer work since I was six

              1. Liar – and a fool, to boot.

                1. I could prove it but fuck you

  15. Maybe the reason we spend more on healthcare is because our healthcare isn’t rationed as heavily as other nations with socialized medicine?

    Maybe we spend more on healthcare–because we can!

    1. If you have money anyway. If not, you are pretty much SOL

    2. Ken Shultz,
      Medical care costs are inflates here. In socialized countries, medical care cost is tied to the procedure and not to their patients insurance deal, postal code, or the Doctor’s car payment.

      1. In socialized countries, medical care cost is tied to the procedure and not to their patients insurance deal, postal code, or the Doctor’s car payment.

        Then go where the system is more to your liking. Otherwise, it is not your business how people choose to spend their money or earn a living.

        1. Yeah, it’s a fact.

          In Canada, if the bureaucracy decides it won’t pay for whatever procedure you want?

          Then you’re free to go south of the border and pay for it.

          Given the choice between a system where you have to leave the country and pay for it yourself–or just pay for it yourself?

          I’d rather just pay for it myself.

        2. Rationing.

          It puts a cap on the amount of money spent on healthcare.

          And why wouldn’t it?

        3. it is not your business how people choose to spend their money or earn a living.
          I agree
          …and it isn’t your business why that patient cant afford to spend their money or earn a living too. Treat them, and pretend you don’t have contempt as you do so.

          1. …and it isn’t your business why that patient cant afford to spend their money or earn a living too. Treat them, and pretend you don’t have contempt as you do so.

            If it is my dime, then it is my business and I have moral authority to pass judgment.

            1. Is your moral authority selective? Do you check that the businessman that is paying with his insurance is not doing so with funds that were procured by war crimes? Did you check if that stockbroker who paid cash didn’t use the funds from a client? Or is it so easy to single out that person in poverty, and blame your disillusionment on them?

              1. Is your moral authority selective? Do you check that the businessman that is paying with his insurance is not doing so with funds that were procured by war crimes? Did you check if that stockbroker who paid cash didn’t use the funds from a client? Or is it so easy to single out that person in poverty, and blame your disillusionment on them?

                1) No.
                2) The businessperson’s affairs are not my concern.
                3) How a stockbroker spends his or her money is not my concern.
                4) The poor are also not my concern.

                1. If it is my dime, then it is my business…
                  The business man’s actions left damaged people who could never recover, as well as the stockbroker’s absconding-society is already picking up the tab, and it was with our dime but you were paid and your moral authority dissipates at the sight of cash. Congrats you are a typical libertarian

                  1. I have to admit I get confused about this one…

                    When it’s about ObamaCare, then Wall Street got away clean with the taxpayer’s money, but when subject’s our politicians who gave our money away–then the money’s already been paid back and we’re all fools to complain about it?!

                    I was gonna say something about how stupid it is to saddle our nation’s employers with mountains of debt–if you’re trying to help the working class–but first things first…

                    Who gave Wall Street our money, and why aren’t they to blame?

                    Then as a follow up, maybe somebody can explain why squandering taxpayer money on Wall Street’s bad investments somehow justifies destroying almost all competition in the healthcare market.

                    Those things seem completely unrelated to me!

                    1. they are to blame

                      But we are too. The public let it happen, and the echo of that decision will not end. Business knows that they can count on their political friends. Did you know we paid for the defense of those thieves?

                      Wall street, the banks and GM should have been left to die but we should have done something for the industries that support car manufacturing. Ford would have been punished for GM’s incompetence otherwise

                  2. The business man’s actions left damaged people who could never recover, as well as the stockbroker’s absconding-society is already picking up the tab, and it was with our dime but you were paid and your moral authority dissipates at the sight of cash. Congrats you are a typical libertarian

                    This does not follow from your original premises. You assume the conclusion and equivocating to fit a pre-conceived notion of what you want the world to be. I fail to see the where “our” dime entered into the equation. Therefore, a Non sequitur has occured.

                    Congratulations on your Communion and Confirmation with the Sacrament of The Church of Utilitarianism (Orthodox). Please stay out of my pocket, find a poor person, and personally pay for their care.

                    Cash makes the world around. Magical thinking does not. Use your your own money to save the world and tithe accordingly. Pony up.

                    1. a ‘pre-conceived’ notion that you can determine as fact. Do you check the provenance of all the monies paid to you, or not?
                      Put-up or shut-up

                    2. a ‘pre-conceived’ notion that you can determine as fact. Do you check the provenance of all the monies paid to you, or not?

                      Put-up or shut-up

                      I have no concern where money comes from: that onus is on the parties paying. My concern is mine stolen from me. Sister Theresa had no qualms accepting donations from what might be considered questionable sources, yet spent that money for the poor, lived an austere life, and was an inspiration to others. All done without coercion.

                      This red herring of yours has nothing to do with you paying for medical care for the poor with your own funds.

                      There is a person sitting, right now, in whatever town or city that you live, in an ER that may not be able to pay for their care. Go and pay their bill for them. Then you will have moral authority as to how they live their life and you can project your fantasies of male/female dominance and control.

                      It’s the Utilitarian thing to do and would be consistent with your religion.

                    3. I don’t have a religion Dr. Catholic. I don’t know of any religion that advocates the ‘that’s mine and fuck-off and die’ approach.

                    4. I don’t have a religion Dr. Catholic. I don’t know of any religion that advocates the ‘that’s mine and fuck-off and die’ approach.

                      Utilitarian philosophy does, as your fellow parish member MNG, who was wildly arguing with Old Mexican, demonstrates. You assume a collective and therefore it is yours to plunder as you see fit: that is theft disguised as a moral ethos and does not allow for free will.

                      Islam advocates the “That is mine, fuck-off and die”. Though, unlike Utilitarianism, they at least offer the option of conversion, then resort to more coercive means if the environs permit. Utilitarianism is nothing short of coercion and force guided by warped moral turpitude.

                      Your religion, and it is a religion, worships both yourself and government as deity, and is polytheistic. I have more than demonstrated that this crusade of yours is not based in any sense of duty or obligation, but a reflection of hubris. In short, you worship yourself.

                    5. OK, you have me laughing
                      MNG, who was wildly arguing
                      Was is storming outside as he wrote his passionate argument?
                      I allow for free will. I believe man should choose his own destiny; I abhor liars, cheats, and above all the ‘do as I say, not as I do’ crowd renders me non compos mentis.

                      Islam has very strict rules of charity, and your ignorance reflects your provincially terminal American education. I can’t speak of duty because I am anonymous here but I know I have always held it to be important in my life

                    6. Was is storming outside as he wrote his passionate argument?
                      I allow for free will. I believe man should choose his own destiny; I abhor liars, cheats, and above all the ‘do as I say, not as I do’ crowd renders me non compos mentis.

                      Islam has very strict rules of charity, and your ignorance reflects your provincially terminal American education. I can’t speak of duty because I am anonymous here but I know I have always held it to be important in my life

                      1) You do not allow for free will. That is patently false.

                      2) You wish people to conform to your skewed vision of what is ideal, and is far from others choosing their own destinies. This is called coercion.

                      3) Non compos mentis and projection are mutually exclusive.

                      4) Islam is only charitable to other practitioners of Islam and charging interest on loans is forbidden. There are guidelines for hospitality, but any infidel is subject to dhimmi status at any time. Dhimmis are subject to whatever taxes, theft, and violation at the hands (and other members) at the will of an Islamic under Sharia.

                      5) Your goading, taunting, and effete condescension doesn’t work and magnifies my points elsewhere stated. It confirms you worship you, and all else is inconsequential unless you are able to successfully reconcile this with your ability to rationalize.

                    7. 1. …That is patently false
                      because you say so? Hallowed?
                      2. Allowing people to suffer is called cruelty
                      3.Libertarianism and reality is a dichotomy
                      4.Ever travelled/lived in an Arab country? -Psychic feeling you have not!
                      5.Your goading, taunting, and effete condescension doesn’t work and magnifies my points elsewhere stated. It confirms you worship you, and all else is inconsequential unless you are able to successfully reconcile this with your ability to rationalize. usually, at this point, I am just called a whore 😉

                    8. 1) Res ipsa loquitur
                      2) Pay for Mr. Shulz’s health care.
                      3) Utilitarianism is monstrous.
                      4) Yes to both.
                      5) Your predilections are not my concern.

                    9. “He has a right to criticize, who has a heart to help”

                      Name the country

                    10. I’m a self-employed person with a preexisting condition, and just for the record, I don’t want anything to do with ObamaCare.

                      It’s absurd that someone in my position should have to pay for my own preexisting condition and everybody else’s healthcare too?!

                      I agree. If you want to help people in need, help them with your own damn money–don’t use everybody else’s. That isn’t charity–that’s a con.

                    11. Ken, you would change your mind when you resolve would evaporate with pain. I have never heard of anyone choosing to suffer. Not even the beloved Ayn Rand

                    12. I’ve been in extreme pain.

                      You don’t seem to get the idea that dealing with my condition would be much easier without Medicare, Medicaid and ObamaCare blowing up the costs of my illness.

                      It’s bad enough that I have to pay for my own healthcare–why would you assume that making me pay for everyone else’s in addition to that would make life easier for me?

                    13. There is no healthcare system where you get more care out of it than the resources put into it–you understand that, don’t you?

                      The world would be a better place if average people only had to pay for their own healthcare. Anything more than that comes at a price in terms of accessibility and/or quality.

                      If I could keep all the money the government has taken from me and keeps taking to pay for other people’s healthcare, I could afforded my healthcare easily…

                      And healthcare providers would have been competing for my business on price.

                    14. Ken, without knowledge of your chronic condition/tax bracket, I can’t research the cost of treatment but it is unlikely the medical portion of your taxable income would cover the expense of a lifelong disease.

                      Further, insurance is not the solution but direct payments to physicians, and hospitals. Without insurance determining your physician, hospital and treatment, the medical industry would compete for all our business through pricing.

                    15. Just because you’re weak and immoral doesn’t mean everyone else is, you stupid prick.

                    16. That’s to rather.

                    17. MIR, If I had a prick, I have no doubt it would be intelligent

  16. David Brooks’ column, which I saw earlier and am not going to provide a link to, is all about “spreading the pain”.

    He doesn’t want those poor downtrodden teachers to suffer alone; everybody should suffer equally. Typical dipshit big government economics, applicable to the question at hand. Distribution of effort and expenditure based on qualitative judgements is evil.

    Bottom line, according to Brooks and the “Empathic Left” it would be immoral to allocate finite resources to treat one hundred broken arms instead of one cancerous pancreas.

    Discrimination is bad, mmmmkay?

  17. I think the reason we spend so much is because it’s over regulated.

    Can you go to the store and buy antibiotics off the shelf?, No. You have to visit a doctor, who proscribes them, so you then go to a pharmacy and get them from a trained and licensed pharmacist.

    Blah blah blah, doctors say you shouldn’t self diagnose. But isn’t that better than the option that poor people have, which is basically not seeing a doctor at all?

    Sure, they could go to a emergency room, which is what a lot do, but then the hospital ends up paying the bill. So they have to charge the other patients more.

    Not to mention the whole medical malpractice industry. Do other countries have lawyers running ads on TV constantly trolling for patients? I suspect not…(I’m not complaining about the ads, but that it is an industry)

    1. Oh, yeah – prescription drugs sold over-the-counter – that will happen.

      It would cull out the Southern meth/Oxy population though (I like to look at the bright side).

      1. Re: shrike,

        Oh, yeah – prescription drugs sold over-the-counter – that will happen.

        It’s already happening – you just have to go down to Tijuana and buy as many as you want – over the counter.

      2. I recently lived in southern Mexico for a year.

        You have to get a prescription for pain killers, anything like Valium or high grade Tylenol…

        All the other prescriptions, you can buy over the counter. The prescriptions I need to get from a doctor here in the US, I could just buy over the counter in Mexico.

        It’s not a big problem.

        The fiction that people with chronic conditions need to go pay a doctor once every three months for a prescription is hilarious.

        If you’ve been taking the same medications for years, and you’ll be takin’ them ’til the cows come home, then why do you need to go see a doctor every three months?

        Doctors aren’t even responsible for things like bad drug interactions anyway–that’s the responsibility of the pharmacist!

        1. I agree with you – I just said it won’t happen. I take just one med (called Synthroid) and hate re-upping it.

          Big Doctor rules here. I hate the bastards because they won’t let me experiment.

          1. Big Doctor rules here. I hate the bastards because they won’t let me experiment.

            With?

          2. It’s gotta be even worse for the elderly.

            “No, my heart condition still hasn’t gone away.”

    2. Jeremy, yes we are overregulated but Texas and California have medical limited liability and the insurance in those states is among the highest.

      1. Re: Rather,

        Texas and California have medical limited liability and the insurance in those states is among the highest.

        Bullshit.

        What makes the cost of health insurance is the limitation of supply by licensing laws or by coverage requirements (which California has galore) which limit competition, but not the caps on tort liability.

        1. tort liability is the Chewbacca defense of Heath Care reform. I have heard Obama, the republicans and even libertarians use it. Ignorance knows no party affiliation

          1. Re: Rather,
            Why are you giving me that stupid rant for? I already told you, tort reform has NOTHING to do with insurance costs, and I don’t believe you when you say Texas has the highest cost among the states – that’s BULLSHIT.

          2. Are you a doctor, pharmacist, RN/CRNA/ARNP/DPN? Or even a chiropractor for that matter?

            1. Re: DNS,
              No, rather is a performer. He can perform an act few can achieve: Talking out of his ass. A sight to behold.

              1. It must be the Act of the Blessed Sacrament of the Church of Utilitarianism (Orthodox). You are arguing with another member of the parish downthread. Apparently, the tithe requires the act of theft from another.

              2. You have no clue what I do, or that I’m female.

                IIRC, California has the highest insurance rates to compliment the idiocy of reform, and Texas is top five

                1. You have no clue what I do, or that I’m female.

                  You write decidedly male.

                  It is also no coincidence those states also have the highest populations.

                  1. Yes the highest illegal immigration population-oh snap!

                    You write decidedly male
                    I use to have a back profile picture that clearly shows I have excellent taste in jeans, and I’m female but I had a stalker on my ‘real’ site and it was a concern. My argument is based on my philosophy, and not my sex. The little boys here like to spoof me, call me a parental incest victim, and a whore-all of which tells me who they are.

                    1. Yes the highest illegal immigration population-oh snap!

                      You write decidedly male
                      I use to have a back profile picture that clearly shows I have excellent taste in jeans, and I’m female but I had a stalker on my ‘real’ site and it was a concern. My argument is based on my philosophy, and not my sex. The little boys here like to spoof me, call me a parental incest victim, and a whore-all of which tells me who they are.

                      Inconsequential. I could care less if the population of each respective state was from Mars.

                      Your gender is irrelevant as well. Your arguments are easily reduced to “But ..but…Greed!” and an unhealthy obsession with retribution, vindication, an unresolved emotional, ideological ax to grind, with very little objectivity. You appear to rely on identity politics and, quite frankly, your constant attention seeking and penchant for victimization lends you to be remarkably self-unaware. It is an extension of narcissism and an entitlement mentality.

                      Your Utilitarian (Orthodox) religion is why you fail to see the forest for the trees, to invoke a trite expression.

                    2. Inconsequential. I could care less if the population of each respective state was from Mars. You are more annoying than Old Mexican playing semantics with every word! The demographics are important because they account for uncompensated care. Insurance industries base their ratings on the cost of care in the state.

                      Your gender is irrelevant as well. Your arguments are easily reduced to “But ..but…Greed!” and an unhealthy obsession with retribution, vindication, an unresolved emotional, ideological ax to grind, with very little objectivity. You appear to rely on identity politics and, quite frankly, your constant attention seeking and penchant for victimization lends you to be remarkably self-unaware. It is an extension of narcissism and an entitlement mentality. Lol, you just called me a hysterical female

                      One cliche deserves another: Your lemonade-stand psychiatry is as useful as sand in the dessert
                      .

                    3. The demographics are important because they account for uncompensated care. Insurance industries base their ratings on the cost of care in the state.

                      Which comes back to:

                      DNS|2.24.11 @ 6:08PM|#

                      How Much Should the U.S. Spend on Health Care?

                      This is the wrong question, Mr. Suderman. The question should be, “How much should individual consumers spend on health care.”

                      The answer is: However much they can afford.

                      If you choose to refer to yourself that way, its none of my concern.

                      The observations are sound. You have an over-developed sense of import and you lash out when you are not recognized for a distorted sense of brilliance and consumed with envy.

                      Again, if you can do better than a doctor, pharmacist, RN/ARNP/CRNA/DNP or chiropractor, then show the medical world how it’s done.

                      Pony up.

                    4. holy crap OCD and insomnia

                    5. The observations are sound. You have an over-developed sense of import and you lash out when you are not recognized for a distorted sense of brilliance and consumed with envy.

                      Lucy, is it still 5cents?

      2. As a Texas resident who has paid for three different insurance plans, that sounds ridiculous. The first insurance plan I had was private, medical only, and I paid $150 a month for it. The second, from my employer, was ~$50 for medical, a few dollars for prescription, several dollars for dental and vision each, per paycheck. The third, from another employer, was a little more than the second one and also per paycheck.

        The first plan I had a $35 co-pay. I paid $60 for tests conducted with wellness exam specimens (Pap smear, blood test, etc.). Two different anti-biotics I had to pay for were $15 and $30 each. I didn’t even have prescriptions covered by the insurance! Obviously the other two plans were even cheaper.

        I am a healthy, young, non-smoking female so that is probably why my premiums are so low, but I don’t treat my body like shit so I deserve not to pay as much. Texas is probably more expensive as a whole though because of all the damn fatty smokers bumping up their own premiums.

  18. they could go to a emergency room, which is what a lot do, but then the hospital ends up paying the bill.

    The actual cost to the hospital is a small fraction of what they bill. Even the “opportunity cost” is small, since (assuming the patient is not actually bleeding profusely or otherwise at Death’s door) they can keep shuffling the indigents to the back of the line. Presumably, if they can’t pass that invoice (or some portion thereof) along to a government agency, they write it off against revenue on their tax return. They have every incentive to maximize that number; politicians then come along and seize upon this “crisis” and rush to the teevee cameras.

    The real loss and the accounting loss are completely unrelated.

    I happily invite R C Dean to expand upon or debunk my hypothesis.

  19. Jesus, save everyone’s time: this question doesn’t matter because it is wrong, wrong, wrong to coerce people to pay a few bucks a person to save lives or for that matter for any reason. See, coercion* is the ultimate and only wrong in the universe, no matter what the consequences of the coercion are.

    *coercion is defined as “any violence libertarians think is wrong,” throwing someone off your land, that is not coercion.

    1. because it is wrong, wrong, wrong to coerce people to pay a few bucks a person to save lives

      Pony up.

      1. sounds like your having trouble paying the clubhouse bill doc

        1. sounds like your having trouble paying the clubhouse bill doc

          .

          The truth value stands, it is wrong to force people to pay for something they do not wish to pay for.

          1. Yes, and all those incapable of helping themselves will be rescued by the Charity Fairy?

            The only truth is that their is a right to health care

            1. The only truth is that their is a right to health care

              In your Church of Utilitarianism (Orthodox), which need not be brick or mortar, that may be your belief. If you wish to be that Charity Fairy, then do so, as you assert.

              There is no “right” to health care, however much you wish this to be true. All your swearing and projecting blame on others does not make it so. Magical thinking is indicative of stunted emotional growth and childish fantasies.

              1. But there is a right, in the fabric of nature, to own the dirt beneath your feet and have men with guns defend it from trespassers.

            2. If there were are right to healthcare, then spending anything less than 100% of GDP on healthcare would be a violation of that right.

            3. “The only truth is that their is a right to health care”

              If there actaully were a “right” to healthcare (or any other affirmative right), then the exact same universality of it would apply as does to the negative rights actually ennumerated in the Constitution. Everyone has exactly the same right to freedom of speech.

              Translated to an affirmative right such as healthcare, then everyone would be entitled to completely free healthcare and no one would have to pay anything for it. This of course is an economic impossibilty and is one of the main reason why there can be no such thing as affirmative rights.

              1. I don’t base it on the Constitution. Why do all our rights have to be derived from it? Did man not have rights before the supreme law 1787??

                1. “I don’t base it on the Constitution”

                  Indeed you don’t.

                  You base it on nothing more than your personal preference.

                  “Why do all our rights have to be derived from it? Did man not have rights before the supreme law 1787??”

                  Our rights aren’t derived from it. It merely ennumerates certain specific rights.

                  There are plenty of other rights – other negative rights that is.

                  There are no affirmative rights. To give to one is to take from another. And taking from another violates their negative rights.

                  1. My personal preference or the history of man?

                    1. There isn’t any “history” that proves healthcare is a right.

                    2. affirmative rights-the natural law of man or what distinguishes us from animals

    2. Re: MNG,

      this question doesn’t matter because it is wrong, wrong, wrong to coerce people to pay a few bucks a person to save lives or for that matter for any reason.

      Yes, it is wrong to steal. Even thiefs know it’s wrong, otherwise they would not run afterwards.

      Next question?

      1. Stealing is the ultimate wrong.

        In our world the necessity or “choice of evils” defense cannot be used for the crime of murder. In Libertopia it would not be allowed for stealing, or trespass, or vandalism…

        1. Re: MNG,

          Stealing is the ultimate wrong.

          No, just wrong.

          In our world the necessity or “choice of evils” defense cannot be used for the crime of murder. In Libertopia it would not be allowed for stealing, or trespass, or vandalism…

          Tell me just how prevalent murder would become if a “choice of evils” defense prevailed, and then we can talk.

          1. Stealing is the ultimate wrong.

            No, just wrong.

            But you’ve said that ‘stealing’ even to save human lives is wrong. It must be a pretty big wrong when you can’t even do it to save a human life…Essentially this is what seems to define libertarianism, a deonotological, abnormally exagerrated idea of the wrongness of coercion.

            1. Re: MNG,

              But you’ve said that ‘stealing’ even to save human lives is wrong. It must be a pretty big wrong when you can’t even do it to save a human life…

              How would you know? Why would I take your word for it?

              Would you take MY word for it when I am ripping a kidney out of your body by force? “Hey, MNG, listen, I am saving a life here, so don’t mind the pain and the feeling of being raped, a human life is more valuable than… uh… YOUR personna.”

              Now, if you find COMFORT in that, weeeeell… pony up! I have the scalpel right here!!!

              Essentially this is what seems to define libertarianism, a deonotological, abnormally exagerrated idea of the wrongness of coercion.

              How quaint – a strawman with pretty words.

              1. Your being coy. Let’s say we can know that person x is dying, man y has medecine that will save him. If the latter refuses to give the medecine because he wants to wet his hair with it for a date would a third person be justified in coercing the medecine from him to give to the man? Let’s not answer “but you don’t know absolutely it will save the man.” You can say that about initiations of force too (a hit man deciding to pull the trigger doesn’t “know absolutely” it will harm him)

                1. OOH! An absurd hypothetical situation-off, I love these.

                  I don’t know if OM can top the hair-tonic medicine man that minge pulled off here. He better think of something wacky, and quick!

                2. I think the third man is a terrorist and we should torture him until he gives us the location of the bomb.

                  Give it up, Rudy Giuliani.

    3. Re: MNG,

      coercion is defined as “any violence libertarians think is wrong,” throwing someone off your land, that is not coercion.

      You’re being infused with the stupid, by Tony. Be careful, there’s no known cure.

      COERCION is compelling by threat of violence, harm or death. I don’t now about YOU, MNG (maybe you’re a masochist) but I don’t like that.

      http://oldmexican.blogspot.com…..-help.html

      1. That’s right, that’s how most people think of coercion. But you don’t understand the libertarian definition. Throwing someone off your land would seem to involve “compelling by threat of violence, harm or death” (namely, compelling them off the property) but to libertarians it magically becomes something else.

        1. Re: MNG,

          Throwing someone off your land would seem to involve “compelling by threat of violence, harm or death” (namely, compelling them off the property) but to libertarians it magically becomes something else.

          Aaaand, let me guess – you think that coercion should be good all the time, like for instance when government takes your money and runs, instead of only in cases of self-defense. Am I right?

          And for your information, what libertarians espouse is the preinciple of non-initiation of force, or non-aggression. Trespassing IS initiation of force; self-defense is not the initiation of force, as it logically implies someone else’s initiation. Thus, coercion for self-defense is moral or ethical, as it is in response of a previous and current act of coercion, aggression, violence, whatever you want to call it – something that’s not groovy, to put it more succinctly.

          1. let me guess – you think that coercion should be good all the time

            No, it is bad, but there are worse things.

            Trespassing IS initiation of force

            That’s absurd. Me walking across a plot of ground you call yours is an intiation of force? Do libertarians have some kind of Bizzaro dictionary?

            1. Re: MNG,

              No, it is bad, but there are worse things.

              Well, yeah – there are supernovae, universal floods. I can think of a myriad of things worse than coercion – SO WHAT?

              That’s absurd. Me walking across a plot of ground you call yours is an intiation of force?

              Yes. Me walking to the house you claim is yours is not? Me entering the car you claim is yours and driving it is not?

              I mean, we can dance all night with this, MNG.

              1. Supernova and floods are bad because they kill people. Would you be ok with coercing someone (who was doing nothing to initiate the flood) to stop a flood which would certainly kill other people?

                1. Re: MNG,

                  Supernova and floods are bad because they kill people.

                  Fuck, no shit. So the moral test is whatever kills people. If stealing doesn’t kill me, that’s ok. If the rape of my daughter does not kill her, well, no problem.

                  Would you be ok with coercing someone (who was doing nothing to initiate the flood) to stop a flood which would certainly kill other people?

                  You mean you want me to coerce Superman? I guess that would be foolish.

                  1. I can give you an easy, actual historical case. A fire sweeps through a town, going from house to house. If one of the houses were removed the fire would stop. The police go to a house in line of the fire with many more houses after that one. They plan to blow up the house and by doing so it will not be able to spread to further houses. But the owner says “heck no, you can’t blow up my house!”

                    Can they force the man out of the way and blow up his house?

                    1. Re: MNG,

                      Can they force the man out of the way and blow up his house?

                      What if it’s your house they want to blow up? What if suddenly it starts raining?

                      If the owner doesn’t want to have his house blown up, the firefighters can always go to the next one and try to convince THAT owner.

                    2. OM, this is crazy. Sometimes we can know that not blowing up a house which is in the line of a spreading fire will allow the fire to continue down that line of houses as surely as a hitman can now that his pulling of the trigger will harm his target. In such a case what principle would stand in the way of blowing up that house? Is coercion so terrible that it is to be avoided even when a greater amount of property and lives are at stake?

                    3. Re: MNG,

                      OM, this is crazy.

                      What’s crazy is YOU trying to set up an ethic based on very simplistic scenarios: simple conditions and simple outcomes. The model works pretty darn BAD when the outcomes are not that clear cut, which is pretty much every single time.

                      There’s a reason some utilitarians don’t make moral judgments based on utilitarianism, MNG and that is: when the victims are THEM. Many a utilitarian cowers in fear when placed against the wall, like el Che, for instance: “How can this be happening to me? My presumed, neat outcomes were not like this! Boo Hoo Hoo!”

                    4. You’re a fundamentalist dude. It’s not about being a simple scenario, it’s about your extremism being exagerrated to such a bizarre degree that you must be against an act of coercion in ANY situation, real or hypothetical. Your fetishism of anti-coercion has actually spun out of control into an ‘ethic’ that puts human well being secondary to an abstract committment to non-aggression.

                    5. Re: MNG,

                      You’re a fundamentalist dude.

                      Thank you. Coming from a relativist, that’s a very nice compliment.

                      BY the way, I am a fundamentalist even when it comes to YOUR property and YOUR life, MNG. When it comes to MINE, I am prepared to shoot your head off your relativist body, if you dared come to my turf to prove your brand.

            2. That’s absurd. Me walking across a plot of ground you call yours is an intiation of force?

              Wrong. If you fall and hurt yourself on my land, I am liable.

    4. MNG, I would reply to these criticisms, but we already have refuted each of them in the past multiple times.

      1. I’ve never heard a reply that wasn’t essentially “we mean the bad type of coercion”.

        1. But look heller, perhaps you could clear this up. Does not libertarianism hold that coercion is wrong despite the consequences? And doesn’t libertarianism find it ok to “compel with violence of threat of violence” someone off another’s property?

          1. Re: MNG,

            Does not libertarianism hold that coercion is wrong despite the consequences?

            “Fallacy of loaded question”

            Despite what consequences? If you do not coerce (like for instance, if you don’t place a knife in a woman’s throat to rape her), what possible “consequences” would you have to worry about?

            And doesn’t libertarianism find it ok to “compel with violence of threat of violence” someone off another’s property?

            Of course, responding to an act of aggreession – which is the trespassing.

            1. “Despite what consequences?”

              Consequences to other human beings.

              1. Re: MNG,

                Consequences to other human beings.

                WHAT consequences? Like what?

                And don’t try this utilitarian bullshit, because unless you presme to know the future, you cannot KNOW the supposed “consequences” of not taking an action.

                1. “you cannot KNOW the supposed “consequences” of not taking an action”

                  That is retarded. If a mother doesn’t feed a child they can know it will die. If a man is mortally ill but would be cured if given medecine x then you can know he will die if you don’t give it to him.

                  You know many things will happen if you don’t do something as sure as you know what would happen if you do. This is one of your nuttier memes.

                  1. Re: MNG,

                    If a mother doesn’t feed a child they can know it will die.

                    Only if it dies, she will know. She can guess it, of course. The interesting thing is the scenario you chose – a mother and her baby.

                    What about this: You steal someone’s car because your wife has been stabbed and you need to take her to the hospital. Now, you *think* you know the consequence of NOT taking the car is a dead wife. That’s the SEEN. What about the UNSEEN?

                    What if the owner received a call from HIS wife that SHE was stabbed? The poor devil is now without a car because MNG already decided he could do without it. What about THAT consequence?

                    Here’s another: Let’s say you take the car and it has NO brakes and you crash and kill your wife. Did you *know* that consequence when stealing the car? No?

                    Before you try this utilitarian shit, you should *think* about the myriads of possible CONSEQUENCES of acts, and how it is IMPOSSIBLE to know them all. You would be doing nothing better than GUESSING on the outcome, to then justify your action. That’s not how acts are judged, because we cannot *know* the outcomes until it is too late.

                    If a man is mortally ill but would be cured if given medecine x then you can know he will die if you don’t give it to him.

                    I don’t know that. I can only guess. However, if I have a contractual agreement with him to give him medicine X, I am bound to that agreement. That has NOTHING to do with utilitarianism.

                    We guess the outcomes based on our past experiences and our imagination, but we cannot rely on those to morally justify acts. We can justify them economically, but not morally.

                  2. Yes, we all know of examples in which the consequences are clear, where utilitarianism fails is when consequences are not clear. Every day, the government coerces great amounts of people on the premise that doing so will cause a “greater” good. This is all theoretical, not clear.

                    1. I grant you that in many situations the consequences are not clear. Any sensible utilitarianism takes probability of consequences as well as utility into account. Less certain outcomes should be discounted appropriately.

                      And I concede that much of what government does is coercion based on questionable certainty. But what I am talking about are situations where we can be fairly certain. And I can concede those situations may be very rare. What amazes me is that many people, actually most, seem to me to be saying that even if we could know, even if such situations are rare, we can and should not violate a property or liberty principle.

                    2. Re: MNG,

                      What amazes me is that many people, actually most, seem to me to be saying that even if we could know, even if such situations are rare, we can and should not violate a property or liberty principle.

                      That’s because claiming to know is not the same thing as being convincing. I am not convinced you know, so what are you going to do about it? Shoot me? Hit me in the head with a rock?

          2. Does not libertarianism hold that coercion is wrong despite the consequences?

            Some libertarians are utilitarians. They believe that eliminating coercion will cause the greatest good.

            Some libertarians are moral absolutists. These libertarians don’t believe that consequences have anything to do with the moral character of an action, and that coercion is wrong no matter what.

            And doesn’t libertarianism find it ok to “compel with violence of threat of violence” someone off another’s property?

            No. Libertarians believe that force is only justified in self defense, when the victim is being coerced. Only when a party is trespassing can violence or the threat of violence be used in order to counter the trespasser’s coercion. To clarify, if I invite you onto my property, I can’t just violently throw you off. You being on my property after I invited you is not coercion. Only if I ask you to leave and you refuse are you coercing me.

            Again, nothing I haven’t explained to you before MNG. I seriously doubt you didn’t know how I would answer.

            1. I appreciate the first answer. I used to think of myself as kind of a utilitarian libertarian. I felt that liberty is good because it usually promotes well being. I felt that property was good for the same reason. There may be some rare occasions where liberty and property are not conducive to human well being, and in those cases we would have to be flexible, but honestly I thought those would be few and far between. I was a Reason subscriber.

              Then I came to H&R and found a very different libertarianism, a libertarianism that seems to hold “let liberty be done though the heavens fall!” Many times I’ve proposed hypotheticals to see just how far people would take this, and it is pretty far indeed. It seems insane to me, a fetishism of liberty and property.

              As to your second point, I just don’t see how many forms of trespassing are “initiations of force.”

              1. Re: MNG,

                It seems insane to me, a fetishism of liberty and property.

                Slavers and thiefs would agree with you, MNG…

                FYI, you’re creepy.

                1. Yes OM, people placing property and liberty above human well being strikes me as a bizarre fetishism. FYI I find it creepy.

                  1. Re: MNG,

                    Yes OM, people placing property and liberty above human well being strikes me as a bizarre fetishism.

                    The interesting thing (and what I find creepy about YOU) is that you place “human well being” and “liberty” as if one was precluded by the other.

                    Use your head, for once. I cannot fathom a way a person is well in his or her being, while being a slave. can you?

                  2. “people placing property and liberty above human well…”

                    The gold has just been awarded in the “False Dichotomy” event.

                    1. Tell us where you live, MNG, and we’ll all come over and hang out until you throw us off your property.

                      Oops, wait! We wouldn’t show up uninvited.

                      See the subtle hint?

                      What’s so maddening is, you have occasional glimpses of insight… then you veer back into the ditch.

              2. Drink?

          3. Why the fuck do you want to come on my property? Are you casing my house? Are you hiding in my bushes watching my teenage daughter get undressed? Are you planting a bomb? I don’t know, and I don’t care. If you are on my property, you are in my HOME! If you are in my home without my permission, I will fill you with 00 buckshot, motherfucker.

    5. ARFARFARFARFARFARF

      THROW THE FUCKING STIIIIIIIIIIIIICK!!!!!!!

      1. School is out even on Pacific time I guess.

  20. I will also add: if this “tsunami” of uninsured supplicants were truly a major problem affecting the day-to-day operations of hospitals, they would devise a means to shunt the indigents away from the emergency room via some sorting method.

  21. “did not have any effect at reducing elderly mortality in its first 10 years of existence.”

    Still 100%, presumably.

    1. Still 100%, presumably.

      Yes, and gravity is still in effect.

  22. lot’s of reasons why our system is broken but the third party payer system is the biggest issue.

    you have to bill the people who get services & they need to have some skin in the game for things to be priced properly. when patients aren’t involved in transactions, services are performed that aren’t needed (especially if the whole diet & exercise part of the equation is involved) and at prices they would never pay.

    i would prefer giving money directly to people and let them spend it on health care, with some protection with major issues.

    1. Mike, I agree with you but the problem is that those who have insurance hold on to it like a a 12yr old boy to his dick. The price of medical care will stabilize when we we all pay cash.

      1. The price of medical care will stabilize when we we all pay cash.

        Like buying any other product. I fail to see how this makes it a universal right by your pronouncement and fiat.

        1. Competition bringing prices down is “Pronouncement and fiat” in your world?!

          1. Competition bringing prices down is “Pronouncement and fiat” in your world?!

            I fully support competition in the marketplace. What I don’t support is someone has a right to a product or service by pronouncement and fiat based on wishful thinking.

            But in a true marketplace with more diversified labor without the sense of entitlement of the population.

            1. that sense of entitlement of the population is a causatum of the medical community’s greed.

              Insurance companies offered to be your collection agency, and now they are making you pay for the privilege.

              1. that sense of entitlement of the population is a causatum of the medical community’s greed.

                Fallacy of ambiguity. Become a physician, pharmacist, RN/CRNA/ARNP/DNP, or DPM, or even a chiropractor and provide care yourself at subsistence wages. Pony up.

                Insurance companies offered to be your collection agency, and now they are making you pay for the privilege.

                I pay for all my medical care out of pocket.

                The greed here is of people thinking that they have rights to other people’s property. I am assuming that you, as member of the Church of the Utilitarians (Orthodox) that you live a meager and ascetic existance. I strongly suspect, based on your performances thus far, that this is not the case. Resentment and guilt go hand in hand, along with magical thinking and a penchant for coercion.

                1. Fallacy of ambiguity? Or your ignorance of the origin of modern health care insurance?
                  The argument does not consider how you pay but the insurance companies engendering doctors to be their bitches

                  1. Fallacy of ambiguity? Or your ignorance of the origin of modern health care insurance?
                    The argument does not consider how you pay but the insurance companies engendering doctors to be their bitches

                    I am well aware of the history of insurance companies. And they do have their faults, specifically being tied to employment and insurance not being taxed as income, as benefits are a form of income.

                    Doctors have made a deal with your deity stemming from before 1933. Today’s medical professionals are essentially slaves to a system where most would like to break out if they could, but your Utilitarian cronies have hijacked it with the, and always it comes back to this, magical thinking that health care is a right. It is no more moral to demand the services of another’s labor than it is their property at the point of a gun, even if they entered into a loaded game willingly.

                    1. You want to tax more? Obviously you will never qualify for a libertarian decoder ring.

                      I agree insurance should not be tied to employment but I prefer to eliminate the insurance system. I use a catastrophe insurance and pay cash but the truth is that HSAs/catastrophe insurance is for the educated, and financially stable.

                      Doctors surrendered the public’s choice and the fault lies with their greed. They made a deal for steady clients, and direct payments but failed to understand they were abdicating practicing medicine.

                    2. You want to tax more? Obviously you will never qualify for a libertarian decoder ring.

                      I agree insurance should not be tied to employment but I prefer to eliminate the insurance system. I use a catastrophe insurance and pay cash but the truth is that HSAs/catastrophe insurance is for the educated, and financially stable.

                      Doctors surrendered the public’s choice and the fault lies with their greed. They made a deal for steady clients, and direct payments but failed to understand they were abdicating practicing medicine.

                      I don’t care about any decoder ring. I would eliminate the income tax, and the tax on insurance benefits would be a sales tax/excise tax.

                      Not true, as HSAs/CI is no more complicated than savings accounts and life and auto insurance. You just assume the average person is a moron and more of your paternalistic hand holding.

                      Define “greed.” The ever popular “No True Scotsman” as defined by you is more of your hubris. Find a poor person and pay for their care and you can dictate terms. Pony up.

                      This crusade of yours is nothing more than hubris and projection. If you can do better, become a doctor, ARNP/DNP, or DPM and show the industry how it’s done.

                    3. It is no more moral to demand the services of another’s labor than it is their property at the point of a gun, even if they entered into a loaded game willingly.

                      Except the services of soldiers, police, firefighter, perhaps teachers? Think of the police as single-payer law & order, and you’ll understand why liberals have a hard time figuring out what’s so different about healthcare.

                    4. you’ll understand why liberals have a hard time figuring out what’s so different about healthcare.

                      I already do. It is called E-N-T-I-T-L-E-M-E-N-T. I’m not yelling, but merely spelling it out for you.

                      The other examples are expressly public servants and your reading comprehension of Mr. Suderman’s article is less than optimal. I have already read your arguments today and I have no desire to engage another worshiper at The Altar of The Utilitarian Church (Orthodox).

                    5. Tony, most of them would prefer not to have any police. They will simply all get along because of their natural rights philosophy

                    6. Think of the police as single-payer law & order, and you’ll understand why liberals have a hard time figuring out what’s so different about healthcare.

                      You are aware, of course, that there are more private security guards than State police in this country, yes?

                      You are also aware, perhaps, that there is a fundamental difference between the business of policing, involving as it does the enforcement of laws via coercion and threats of coercion, and health care?

                    7. Why is the difference fundamental? Why do we need enforcement of laws? Because it contributes to collective human well-being. Same with single-payer armed forces, single-payer diplomacy, single-payer firefighting, single-payer courts, you name it. Healthcare does not differ from these things on the grounds of human well-being, but it does differ from other market commodities, because it’s necessary for human well-being.

                    8. Why do we need enforcement of laws? Because it contributes to collective human well-being.

                      Wrong! Because there are people who will ultimately try to violate the rights of others. Police are expected to prevent that from happening, though that is not always the outcome. Also, the fact that you’re comparing the police, known for their own hideous violations of people’s rights, to healthcare destroys your case.

                    9. What on earth is ‘collective human well-being’?

  23. i would prefer giving money directly to people and let them spend it on health care, with some protection with major issues.

    I would prefer to steer people to HSA with catastrophic coverage as well, independent of employers. Which major issues?

  24. …Amy Finkelstein…

    Is she related to the Finkelstein Shit Kid?

    http://www.youtube.com/watch?v…..re=related

  25. Freedom costs a buck ‘o five

    FUCK YEAH

  26. Then I came to H&R and found a very different libertarianism

    And yet, despite your horror and revulsion, you stayed.

    Fuck.

  27. 42

  28. The level of spending isn’t a problem in itself.

    At Reason, at least, the problem we should focus on is the lack of health care freedom. We aren’t free to have access to any medical care without going through a government deputized medical care gatekeeper. We’re not free to buy the medication we want without permission, and having permission, we can’t buy from the lowest cost provider.

    Providers aren’t free to give non fda approved information to us. The government is hugely distorting the market for health care with tax breaks and regulations.

    The Life Extension Foundation has a good article in the March edition (already online) about how we don’t have a medical cost problem, we have a medical regulation problem.

    http://viewer.zmags.com/public…..205510e7/8

  29. How much should the “US” spend on healthcare? To ask the question is to assume collectivism, assuming this is a collective responsibility that demands a collective (read: State) solution.

    Try “How much should US residents spend on healthcare?” and you are already pointing at a different result, having something to do with “As much as they want, and can afford.”

  30. How can you measure the price of health care when you don’t know what it is? Forget mental health, and focusing on the physical, what do you cover? Orthodontia? Massage? Dermatology? Hair treatments? Personal trainers?

  31. The problem with American health care is the fact that the US is spending money on it.

    Individual Americans should control 100% of the money they spend on their health care. What logic says that you should pay for my health care or mine for yours and any type of efficiency should arise from that relationship.

    End the farce of Medicare now for every American under 50. Let’s realize the tragic failure of this well intentioned social experiment, but always remembering that the path to hell is paved with good intentions.

    Fee for service paid for by individual Americans who are allowed tax free health savings accounts that carry-over annually will reduce expenditures on health care in a way no other solution will.

  32. The government should spend NOTHING on health care – it should get the hell out of our lives. Health care costs are high BECAUSE the government is the middleman taking a huge cut itself/supporting Unions/limiting insurance companies from competition/over-regulating business/ and fostering corruption of taxpayer $$$. GET THE FEDERAL GOVERNMENT THE HELL OUT OF OUR LIVES and STOP electing Marxist Democrats and Rhinos. Throw Obysmal/Soros/unions out in ’12.

  33. I have an idea – spend nothing except for our military personnel. Everyone else buys their own in the private sector – and is able to do so regardless of state lines. Imagine what the competition would do to prices.

  34. What is needed is 1)Tort reform, 2)First person payment (use vouchers).

  35. Literally nothing really prevented the Democrats from 2009 to 2011 from determining what France spent on health care for a given demographic, and setting exactly those rates for Medicare/Medicaid beneficiaries in those demographics. Now, can anyone make a rational argument for why they didn’t approach the problem that way. Let us suppose they had done so- the rest of the country could have observed whether or not people like Hanson and the single payer proponents were right and that the US was overspending. Certainly that fact alone, should it be observed, should be incentive enough for the private sector to realign it’s priorities towards lower spending on healthcare.

  36. My MD at Madison WI, June 1953was preceede by 24 hours by a lecture presented by Edwin Witte PhD who was the author of the FDR Bill that initiated the SSA. Accompaning was a Universal Healthcare Bill, not presented to the Congress. When Witte spoke to us at the Dean’s request to tell us the future of the Government role in our future practice Professor Witte said clearly, before you finish your residency, “We will own you.” A call to slavery to the gtovernment,by the Progressive Political Movement of a segment of the US citizenry. In 1990 Congressman Waxman, same political bent, was interviewed and quoted in a California Business Publication with the statement, ” It is our intent to cause healthcare to cost so much that the public will demand government intervention.” These two irrational political statements negates any rational attempt to explain valid fiscal numerics and budgeting.. Delfin J Beltran, MD

  37. It is hard to imagine how to answer the question of how much should we spend on health care. The idea that we can compare it to past years is ridiculous. I will use a comparison since we are using them right now. What percentage should we spend on personal computers? How come it is so much higher a percentage now than it was 40 years ago? Shouldn’t we control the spending on personal computers to the same level it was 40 years ago? Of course not. The amount, quality and types of services now available dwarf those of 40 years ago. Guess what? Same with medical care. In 1970 if you had testicular cancer, your days were numbered. Look at the survival rate. Today? If you die from it you didn’t find it early enough or were an anomaly to the treatment. We have allowed the question to be asked without requiring the asker to accommodate for an expanding market of goods and services.

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