Reforming Medicare for the Real World
The status quo cannot last.
After House Budget Committee Chairman Paul Ryan unveiled a plan to overhaul Medicare, Democrats announced that despite some imperfections, it was a brave and thoughtful attempt to grapple with a problem that has been ignored for too long.
Just kidding. They said it was the worst thing they've seen since Sex and the City 2.
House Democratic leader Nancy Pelosi accused Ryan of offering "a path to poverty for America's seniors." Rep. Chris Van Hollen of Maryland said his proposal would not reform Medicare, but "deform it." The White House faulted Ryan for "placing a greater burden on seniors."
The chief outrage, in their minds, is his proposal to restructure Medicare for Americans currently younger than 55 while keeping the old version for older folks. Instead of guaranteeing a certain set of benefits regardless of cost, the government would pay a fixed premium so recipients could choose their own packages.
The amount provided for premiums would not shrink as time goes on. It would grow at the rate of inflation. Seniors wouldn't get less help than they do now; they just wouldn't get more.
This approach to health insurance is not really a radical concept. In fact, it's modeled on the same system used for federal employees, including members of Congress. You get a certain amount of money to cover your health insurance, and you can either choose any policy available for that amount or kick in a little extra to get better coverage.
Critics have a point when they say it's not as sweet a deal as the status quo. But the status quo is too good to last. Mark Pauly, a health care economist at the University of Pennsylvania's Wharton School, says of Ryan's plan, "It's not better than what we have now, but what we have now is not something we can have 20 years from now."
Why not? Because it will cost too much for the nation to afford. Medicare spending has been rising rapidly in recent years, and under realistic assumptions, it will more than double as a share of the economy by 2050.
The reason for Medicare's cost spiral is that the number of beneficiaries is growing—I'm looking at you, baby boomers—at the same time the cost of treating each one is going up. Absent substantial changes, Pauly has calculated, payroll taxes would have to triple to pay all the promised benefits.
I have news for people old enough to be thinking about retirement: Your children may love you, but not enough to be taxed into poverty. Ryan's detractors pretend we can go on enjoying the status quo indefinitely. But it's only a matter of time before we hit a fiscal wall, hard.
There are three basic choices. We can keep on just as we have in the past until the program collapses of its own weight. Or we can restrain costs by letting the federal government ration medical care. Some patients would have to wait months or years for procedures now taken for granted—and some wouldn't get them at all. Death panels, anyone?
Or we can switch from a guaranteed-benefit program to a "premium support" model. Everyone enrolled in Medicare would be allotted a certain amount of money to buy a health insurance policy, with higher amounts for sickly patients and extra help for poor ones. Insurers would compete to get their business. A retiree who wants a policy costing more than the government payment would have to fork over the difference.
As the Congressional Budget Office notes, "most elderly people would pay more for their health care." That's not a terribly enticing prospect. But we might as well stop pretending there's any alternative.
Eventually, someone has to pay for all the health care the elderly get. In the past, the cost has been passed on to younger workers. As the senior population expands and the labor force fails to keep pace, that trick will no longer be feasible. When a Ponzi scheme runs out of victims, it ends in tears.
Critics can offer different solutions, but there is no escaping the constraints at work here. The reason people will dislike what Ryan offers is not that he's needlessly cruel. It's that his plan confronts reality, and reality bites.
COPYRIGHT 2011 CREATORS.COM
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
Good morning reason!
The Democrat response is worse than Ryan's pitch.
Doomed. We're all doomed.....
The problem here is that most people want to find a way to make sure all people over 65 get some basic coverage regardless of their ability to pay and many libertarians don't care about that. So of course all reforms, seeking to still in the end have some way to ensure everyone of that age gets covered, are going to fall short for those libertarians.
Also, some reforms may be more "liberty-friendly" than others, but it is hard to imagine a purely market solution that enables all folks over 65 to have medical insurance coverage.
hard to imagine....no it isn'r
The new/old fuck-off and die policy
Without my government handout I wouldn't be able to buy all the delicious cat food I need.
Re: rather,
"There's no more money"
"You want me to just die!"
"No, but what the fuck do you want me to do? There's no more money!"
"Well, steal it! But you have to feed me, Seymur! FEED ME!"
If the decision to insure the elderly is left to the market, they won't.
Other than repeating the free market mantra, Libertarians can't come up with a sincere plan.
There isn't a business that will pursue a profitless margin.
You mean there's no way to prevent people from getting old and dying?
It's called life and scarcity.
No, I mean that insurance companies left to their own asses will insure based on their potential profit, and not always on age.
Aggressive breast cancer occurs in younger women, not old. So lobster girl will be more at risk that grandma of losing her boobs
It's just unpossible!!!!!1
If not enough people care about a problem to use their wallets to fix it, then it can't be much of a problem can it? I can't imagine it would be that hard to fix considering most people in this country claim to believe that seniors should have guaranteed health care. If all those people actually believed that then there is no reason to suppose they couldn't use their own money to fix the problem. Either that, or most people don't actually believe that poor seniors should have healthcare! Instead they really believe that other people should have to pay for seniors' healthcare. Put your money where your mouth is or shut up.
Actually, I think the "problem" is many people like MNG don't want to be bothered having to take out their checkbook, write a check and mail it in to help people. They would much rather just have the money taken out of their paycheck every week and sent to the government, and let them handle it. Oh, and BTW, you get a nice little refund for the amount you overpaid, without interest, of course.
Well yes, MNG probably believes the government can do a better job at charity work then he can, which means that the government can do a better job than everyone else, obviously.
Don't be silly, if we use our own money to help the sick and the poor, then how will WE be able afford things like Starbucks and Subway?
It's much easier to use other people's money.
So, you're down wit' O.P.P.?
Yeah, you know me.
Heller
We had a system of private charity for those folks before Medicare and the public found it did not meet the needs they saw.
To "leave it to charity" is to leave seniors to the mercy of their fellow citizens. You think that mercy is enough to take good care of them, most people don't buy that.
Re: MNG,
You must think you're writing to idiots, MNG. Medicare did not come to being because the olf folk were not getting medicine; it was put in place as a vote-obtaining scheme, nothing more.
And "Medicare" is not?
Look, MNG! A unicorn!!
"it was put in place as a vote-obtaining scheme, nothing more."
Citation needed.
"And "Medicare" is not?"
No, it is not. It creates a legal entitlement which the courts recognize as a legally enforceable property interest. That's a far cry from charity which is relying on "the kindness of strangers". Libertarians want a Blanche Dubois policy for seniors.
Relying on the kindness of strangers or the ruthlessness of politicians? You're right, the ruthlessness of politicians is more reliable! Too bad that doesn't make it the right thing to do.
"or the ruthlessness of politicians"
Which is why it is a legally enforceable.
Interesting that you count on the kindness of strangers to take care of our seniors who cannot but don't count on them to vote into office people who would keep laws in effect to do the same.
I don't count on the kindness of strangers. I never made a prediction that said people would act kindly. All I count on is that people will do what they want to do if they are free to do it.
And of course I do count on people to vote for politicians to do such things, since they I know that they do. But this has nothing to do with our argument, pretty much irrelevant to everything.
"All I count on is that people will do what they want to do if they are free to do it."
And if that leaves many seniors in a terrible state then you are willing to make that trade. Abstract property rights > the welfare of human beings.
Terrible only to those who would do something to make it not terrible. Utilitarianism doesn't work MNG. Moral rules should and do trump consequences. You just don't like the rule of property rights, but you aren't willing to give up every right for utility, so just shut the fuck up already.
You blatantly admit that if you were faced with a situation where violating property rights would aid an actual human being you would not. How monstrous is that? Please don't lecture anyone else about morals Mr. Pharisee.
It's not monstrous at all. You can't tell me that I have a moral imperative to steal in order to aid someone else. That would mean I also have a moral imperative to kill to aid others, as long as the aid saves more people than I kill. I refuse to engage in idiotic hypotheticals involving an arithmetic of souls. There is no justification to murder someone who is not threatening your life, there is no justification to enslave someone else. That's it. The opposite view is what is monstrous.
Re: MNG,
YOU first: "We had a system of private charity for those folks before Medicare and the public found it did not meet the needs they saw."
That extraordinary claim requires extraordinary evidence.
Here's mine:
http://www.emaxhealth.com/72/1272.html
Everything said above contradicts your assertion in to-to, especially in light of the survey mentioned above, which indicated that "only" 56% of seniors had medical insurance, that CHARITY would not cover all seniors for care. The above survey made it clear that a) only 44% of seniors did not have coverage, and b) population distribution of 1960 indicates that only represented 4% of the population. Are you seriously telling me that 4% of the population could not ever receive assistance from charitable contributions or their family members?
http://www.infoplease.com/ipa/A0110384.html
Now, the fact that almost all 65+ were covered (rich or poor) which coincidentaly and very conveniently comform the biggest voting block, indicates clearly that the Medicare bill was a vote-getting bill. That's my conclusion.
Let me see your link that states CHARITY was not enough to cover that 4% of the population in 1960.... AAaaaannnd - GO!
I don't have an extraordinary claim to support. The people who ran on and passed Medicare told the voters exactly why they were doing it, to address the needy seniors who needed care. The voters responded and continue to respond to that with their support. It's you that have to show that things were and are not what they seem to be on the surface.
Interesting that though the area was left to the free market alone barely half of seniors had coverage.
As to proving that charity could not cover the other 44%: a. the question is not "could" but "was", was it covering them and b. since I don't want that 44% to be left to the mercy of others or the kindness of strangers whether charity covers them is largely irrelevant
Re: MNG,
Yes, you do - this: "We had a system of private charity for those folks before Medicare and the public found it did not meet the needs they saw."
This is as extraordinary a claim as they can get. So, please - go ahead, link to the evidence for such an assertion. Aaaaaannnnd - GO!
Re: MNG,
It wasn't free market them, MNG - you still had licensing laws and the distortion created by tax credits on "benefits".
Besides this, more childre took care of their parents than today. You are judging events based on current attitudes.
What you want or wish for is irrelevant. It is clear that you're making a value judgment by dismissing people's charity - that does not mean charity was not providing coverage for the poor an elderly.
MNG|4.7.11 @ 10:06AM|#
"We had a system of private charity for those folks before Medicare and the public found it did not meet the needs they saw."
Citation needed.
No, not the public, politicians. Remember, if the public actually cared they would do something about it by themselves.
No, but I do think you aren't fucking listening to what I'm saying. If private charity is not enough that shows that
A. people don't actually care about the problem.
and
B. people don't want to be forced to fix the problem.
So if the majority of people in this country support being forced to fix this problem, they should necessarily support voluntarily paying to fix the problem.
"Remember, if the public actually cared they would do something about it by themselves."
You foolishly assume the public shares your goofy assumptions and axioms. Most people think they can address problems by voting just as they can by giving money.
"If private charity is not enough that shows that
A. people don't actually care about the problem."
Again, only if we assume your axioms. And we don't.
Huh? A total non-sequitur. Remember that I am arguing against voting to take people's money away, not that doing so would not solve the problem. Again, if people actually cared, and not given the option to vote to take people's money away, they would voluntarily fix the problem. Get it?
Not everyone thinks the way you do. If I care about something I can give money and/or vote for government programs to address it. See, I don't buy into the "government=teh slavery" meme, and even if I did I don't share your goofy property based deontology so there are some programs where the "horror" of taxation is outweighed by the alternative to leaving people to the kindness of strangers.
BTW-I pay (sadly) bunches of taxes, and so do most people who support those programs. They know when they vote for them that they will be paying for them. But they would like to create legally enforceable rights to the benefits not "the kindness of strangers."
Yes but your agreement and acceptance of it doesn't make it right. You're justification for making other people agree with the use of force is that you agree with the use of force. It's a tautology with no moral value outside itself.
Not only that, but you aren't willing to accept the full consequences of that argument. You also hold that you have certain liberties that cannot be impinged, even for the benefit of others, like freedom of speech etc. So not only is your argument meaningless, you don't even believe it.
I think freedom of speech does lead to benefit of society at large, see On Liberty for that argument.
As to your tax issue I want care for the elderly to be a legally enforceable entitlement, those are provided by government, so yes I want government to provide that and the way they do that is through taxation. I support it because I find the alternative to be worse than the "horrors" of making you pay along with it to help someone who needs it.
And speech that does more harm than good? I suppose you agree with Lindsey on that one.
You mean the alternative of putting your own money (and not someone else's) where your mouth is? I don't see how that's horrible.
"....rights to the benefits..."
Fail.
The system of government anything is loud about its accomplishments and very good about hiding its problems until the whole thing crashes down around our heads in a huge train wreck. Well the train wreck is about to be here and the left is plugging its ears and screaming "la la la, I can't hear you".
When medicare crashes it's going to be very ugly and a lot of people are going to die prematurely as our entire medical system comes apart. If we reform along the lines that Rep Ryan talks about it's going to be merely painful and unpleasant with a lot less excess mortality involved.
The progress curve of government programs is the same time and again. The government takes something over, achieves a large chunk of progress almost immediately, and then progress slows down a lot, almost to the point of stagnation. After a couple of decades we actually start to backslide to the point that we're worse off than if we had just stuck to the same slow and steady private system progress that we had before.
"they really believe that other people should have to pay for seniors' healthcare."
You are right on the money heller. What Pelosi and Van Hollen and others believe is that there is still a huge untapped pile of money out there and they want to build enough political pressure to force those holding it to cough up more money. Unfortunately for me and you, it's our money they're after.
Re: MNG,
Your lack of imagination is not everybody else's problem, MNG - it's entirely yours.
By the way, there are 100% market-driven systems that over most 65+ year olds - in Mexico. A combination of private clinics (big and small), catastrophic insurance, charity-driven hospitals and hospices, and private doctors who are actually paid in (get this) cash.
So don't say "it's hard to imagine" because people already imagined it and have been making money out of it for years.
And everyone there over 65 is covered? I doubt that.
Re: MNG,
There must be someone in Mexico who is not covered, yes. Just like there must be someone in Mexico with no access to clean water.
There's always someone, MNG, always.
I bet there are more someones under that system than ours, and that is kind of the point.
Re: MNG,
Maybe, but has nothing to do with who pays for it. it has to do with the fact that we had 90 years of socialism and that the totally free-market system has been free-market for just a few years.
MNG - its easy to criticize our ideas, yet you've been unable to produce one of your own that works. To simply say give health care for free and raise taxes is what we've been doing and clearly the system is failing. Medicare will crash and its been running on your current tax and spend ideology. Economic reality is catching up to it and all you do is criticize our solutions.
It's hard to imagine a free market in medicine. We haven't had one in my lifetime. We routinely spend big bucks doing things that have orders of magnitude cheaper solutions available, all because we don't use the price mechanism to drive out high cost, inefficient solutions.
We pop people into hospitals for dehydration at a cost of thousands a day when rehydration salts and an in home care giver could solve the problem for well under a hundred. We develop cheap medical solutions for the third world and then don't implement them at home. That's nuts and it will keep happening so long as we don't have market based medicine.
Actually, deregulating the medical industry would fix the entire problem. Hence, the government would not be in the business of licensing (granting oligopoly status) and effectively setting price minimums on medical labor.
The problem here is that most people want to find a way to make sure all people over 65 get some basic coverage regardless of their ability to pay and many libertarians don't care about that.
Are all people over 65 so poor that they can't afford basic health insurance?
The way we define "basic health insurance."
The problem here is that most people want to find a way to make sure all people over 65 get some basic coverage regardless of their ability to pay and many libertarians don't care about that.
That's bullshit. I too would like to find a way of paying for poor old peoples' healthcare. I just don't believe that it's right to force other people to agree with me!
But of course MNG is right. Libertarians just hate poor people and want to see them die, that's the true reason why we're against these programs. It has nothing to do with taxes or force, we just hate poor people. You're a fucking genius MNG.
Sure. The answer, according to MNG, is to enslave all people over 65 to the government. That way, government has control over people. All people over 65 are exactly the same, and they should all be forced into a healthcare scheme that is a "one-size-fits-all" program, whether they like it or not. Not to mention that all government programs are bureaucratic nightmares that are prone to fraud, abuse, cronyism, and manipulation and create all sorts of unintended consequences.
"All people over 65 are exactly the same, and they should all be forced into a healthcare scheme that is a "one-size-fits-all" program,"
Just like black people! Well then, I really shouldn't be so concerned. Government programs designed to target a specific group always work out smashingly.
Thanks MNG, if you didn't trot out that old meme every once in a while we might actually have to take you seriously.
Re: MNG,
"Libertarians are evil! Eeeeevil!!!"
I am evil for not wanting to hand over my wallet to the nice robber who just wants to give his 65 year old grandmother more Bingo money.
I didn't say you were evil, but it's interesting how many of you jump to that. Methinks thou dost protest too much?
So the part about not caring about poor seniors is a virtue? Oh I see you wer complimenting us...
You don't care about seniors having a legally enforceable benefit to cover their insurance costs, you've said so. In fact you not only don't care you actively oppose it. I don't think it is because you are evil, it's because of your warped deontological views fetishizing property.
Re: MNG,
Ahhh, the spin.
It's not a question of caring, MNG. Seniors don't have a RIGHT to take money from others to pay for their medical expenses; it does not matter if someone else does the thieving for them or they do it.
Which is not the same thing as making "sure all people over 65 get some basic coverage regardless of their ability to pay." Nice try at changing your own words though.
Fixed that for you. Either you support property rights or you don't, MNG. Either I have the right to take your stuff for my needs, or I don't. You can't have both dude.
That's silly. Think of the "choice of evils" or necessity defense long recognized by the common law. When rights conflict with human welfare the former should at times give way. The Sabbath was made for man, not man for the Sabbath. You're thinking like the Pharisees who scolded Jesus for healing the sick on the Sabbath because prohibitions on such things on that day was the abstract rule. As Jesus noted, rules (or rights) are good if they serve the welfare of actual human beings, when they work to the detriment of that they are terrible things.
Rejecting the Sabbath doesn't affect others, only you. Yes, you should be free to reject your own rights for your own welfare, but not reject the rights of others for your welfare.
Dude, you do realize that was like a metaphorical analogy? The point is that the Sabbath rules and your property rules are rules that are only good if they benefit actual human beings, when they are used to the detriment of actual human beings they are monstrous things.
Yes, that's why I pointed out how it was not analogous to what we are talking about! The Sabbath rules, and property rights, are not justified by the good they cause (even though they do cause good). The Sabbath rules were solely justified as personal law decreed by God. Property rights are part of the freedom that should be inherent to humanity.
Re: MNG,
There's no choice of evils, MNG. I can make the case that burning a few witches is the lesser evil compared to having whole harvests rotting in the fields due to their hexes. You can use utilitarian ethics to justify any sort of crime.
Consequentialism does require you to be correct in your actions, but so does deontology (for example you may be mistaken as to what is your or another's property).
There is certainly a choice of evils, it's actually happened many times as found in actual legal cases. For example take the fellow who broke into a basement because he was fleeing a tornado. Courts rightly hold him blameless for the b+e property intrusion because human well being is more important than some property rule.
Re: MNG,
And here I thought you were talking about consequences, as in "to be correct in the consequences."
Now you changed it to actions. I don't know if it is because you are equivocating or because you want to slidder your way out of the conundrum.
One has nothing to do with the other.
"When in doubt, throw red herrings"
Old Statist proverb.
No, you subjectively judge them to be evils.
You should place that in your epitaph, MNG: "I left it to the opinion of 12"
The fact that a jury found the person not to be responsible does not make him not responsible. Let's say that the person barges into the homeowner's basement, knocks down a gas line and burns the house down. Would you still say that he is still not responsible because he was fleeing a tornado?
They should hold him blameless because the owner did not seek charges after the fact, not because he did it save himself. There are many crimes I could commit to for my own welfare, the courts would not hold me blameless for most of them.
If Seniors had a legally enforceable benefit like they have a legal right to free speech, we would be in the same boat as Canada where you have multiple provincial supreme courts ruling that governments are violating their constitution because the length of the wait lines functionally denies them medical care.
Yeah, that's the system I want!
More accurate, less spin.
Yes, most people think the "horror" of coercing people to provide a public benefit for seniors is outweighed by the horrors of leaving seniors to fend for themselves.
Once again MNG fails to understand the concept of "putting your money where your mouth is," to his own detriment.
Once again heller fails to understand the idea of voting, public goods, consequentialism and a host of other concepts that don't fit into his narrow worldview.
Re: MNG,
You see, for a statist fuck, the principle of not violating someone's right to his or her property is a "narrow view."
Thiefs also think their victims are narrowminded when they hold on to their wallets...
I understand them, and I can say why they're wrong. That's more than you can say about my points.
If that makes you feel better, then by all means believe it.
You're wrong because you hold property rights to trump any consequences to human welfare. I think that's inhumane and monstrous, that's why you are wrong.
Re: MNG,
Violating property rights LEADS to a negative consequence for human welfare. You are merely being dishonest by unduly separating private property rights from human welfare.
"Violating property rights LEADS to a negative consequence for human welfare."
When and to the extent we are in agreement. It's when it appears not to that you go off the cliff.
Re: MNG,
Oh, right - YOU pull the exceptions out of your ass yet I am the one falling off a cliff!
"When in doubt, shift the focus."
Old Statist proverb.
Monstrous is people being hurt by your actions, not people being hurt while you don't act. People die everyday, and you sacrificed nothing to save them. Is that monstrous?
Most people indeed do find it to be monstrous to not act when acting would bring significant betterment to actual human beings. Read some Dickens.
If we are all monsters, then isn't monstrosity meaningless?
I believe in property rights because doing so creates the pool of wealth necessary to actually solve problems sustainably instead of the unsustainable government programs that have crashed economies all over the US and Europe. It is positively unchristian to create a system which solves your problem by creating an unsustainable burden on future generations, piling on debt after debt until the whole nation comes down and suffers. Intergenerational musical chairs is no real solution and it's never so evident as when the music is stopping and the panicked scramble is starting.
You're way off, MNG. You only see the visible consequences of statist actions. So by robbing everyone to pay for the poor and elderly, you think you are doing good. But you do not understand that your actions can create even more poor that will need help.
If I had a business in a tax free world, I have thousands of employees and make a good profit. Suddenly, tax man comes and starts stealing my money. I have to, not only lose profit, but I have to cut back on employment. I was going to hire more people to expand my business, so those people will not get employment. They become part of the poor that I have my money robbed to support. I also can't spend money to suppliers and other service providers, making it harder for them to employ people.
Nope, all you see are the poor and elderly folks who demand more and more and point at the wealthy business owners as "greedy bastards who should give up more to give to us." Never mind that they did not earn it. They have a RIGHT to my money. They are entitled, and do not have to work for it themselves.
MNG, you have a right to believe what you want. But you go beyond that to DEMANDING that we put our money into something YOU believe in. Nevermind that you don't want to put it up yourself. All you know how to do is force people to do what you want. You're an enabler of tyrants.
Re: MNG,
"Up is down"
"Stealing is good as long as the intention behind it is good."
By the way, why would you assume that seniors are left to "fend for themselves" as if all of them suddenly lost touch of their children and family? Only a population disaster would cause such scenario, which makes this sob story you bring up a clear red herring.
""Stealing is good as long as the intention behind it is good."
Not at all Captian Reading Comprehension. The intention is not the issue, it's the consequences. The horrors of taxation can be justified if it leads to better consequences for human beings than the alternative.
It can be justified by a consequentialist. It can't be justified by someone who supports property rights. You seem to be trying to do both.
A consequentialist can support property rights as they tend to bring about better overall human welfare than not having them. But a consequentalist cannot fetishize them the way you do, holding them more dear than actual human welfare. That is true.
Then it's not a fucking right at all is it? If I can violate it at any time just to gain some welfare, it's isn't a right, it's just something you have for now but won't later. It's meaningless.
Also, there is no choice between welfare and rules. You can have rules and still manage welfare, but you can't have rules that are slaves to welfare.
"It's meaningless."
Not so, it only means that rights or rules divorced from human consequences are meaningless, or better put pernisciously silly things. And you can't violate a rule that usually acts to better human kind "at any time" but only when the consequences would lead to better conditions for actual human beings than the alternative.
No the silly thing is to say that you have a right except when someone else benefits more from you not having the right, which is just about always. The end result of utilitarianism is that the value of the freedom of the individual approaches zero when compared to the welfare of the masses. The entire point of rights is to secure individual freedom against sacrifice demanded by the masses. What you're describing therefore aren't really rights at all, since they are completely emasculated. Not only that, but what you are describing isn't what you're trying to protect in real life. You don't realize how little your rights compares to the welfare of the masses, rendering them meaningless. Would you get to keep any property that you didn't absolutely need in a utilitarian system? No. Would you even be able to keep that property that you do need? Probably not, since that property might benefit others more. Utilitarianism doesn't care about the consequences to you as an individual.
Re: MNG,
You can't know the consequences beforehand, you can only assume them; thus, you can only rely on the intention behind the act.
But you can't know those consequences until they happen MNG. That's the main pitfall of untilitarianism: You can't know the future. This is why argumentation ethics does not assume the consequence will be good, because it may turn out to be bad.
If you say "Well, look at A which lead to B," you're already talking with the benefit of hindsight, Tuesday-morning quarterbacking. If "B" has not happened yet, then you only have the intention to justify your act. You can't escape this, no matter how much you want to believe in unicorns.
Acts cannot be judged by a future outcome, they are only judged by their own. This is why people shoot thiefs, rapits and burglars, MNG - victims don't wait to see if the consequences of the thievery, rape or burglary lead to a better world.
The world is such that we act every day in ways that are prudent but without total knowledge of the future. When you buy your wife a birthday present she might freak out and stab you, but you guess she will likely be happy with you and so you do it. you don't fail to buy it because you can't be sure of the consequences. That's a ridiculous if oft invoked by you trope.
"This is why people shoot thiefs"
Actually if you shoot a thief who is not physically threatening you in most jurisdictions you are to blame. This is because the long held common understanding is that human life trumps property law.
Which is totally irrelevant to moral philosophy. I can tell that buying a cake is not immoral, because it doesn't violate anyone's freedom. You can't tell me whether buying a cake is moral or not because you don't know the full consequences of doing so.
If we wish to act according to a moral system, I can easily live by mine. By yours I can't. Whether or not I make choices based on consequences that I don't know of in my normal life doesn't make your moral system make sense.
No, it's because if a thief is not threatening you there is no justification for killing him. It has nothing to do with life trumping property.
OM and heller you are just as much consequentialists as anyone else, you just have a different (extremely flawed) calculation of human well-being. Actually the problem is you place sacrosanct property rights above all other measures of human well-being. You are claiming that a person having a right not to be taxed leads to better outcomes than alternatives where he is taxed. How else can it be? Otherwise you're just worshiping on the false idol of property rights, and you shouldn't expect others to go along with it since others won't share your arbitrary concern.
So we're utilitarians that don't care about human well-being. Bravo Tony, you've outdone yourself in stupidity.
No, we aren't. You're just an idiot.
Either you care about the outcomes for humans or you've chosen an arbitrary thing to worship as sacred. If there's something else I'm missing, tell me.
Either you care about the outcomes for humans or you've chosen an arbitrary thing to worship as sacred.
Yeah I care about outcomes, but outcomes have nothing to do with morality.
Unfortunately, all that taxation does is hide its horrific inefficiencies in the future. Well, we're in the future now and the bill is coming due and you want one more round so a bigger bill lands on my kids?
Shame!
Old Mexican what in the world are you thinking. There are many seniors who do not have any family. I have two in my small neighborhood, neither had any kids. So I guess in your world since they did not have any kids, they are screwed.
HERP DERP
The problem here is that most people want to find a way to make sure all people over 65 get some basic coverage regardless of their ability to pay and many libertarians don't care about that.
Personally, as more of an incrementalist type, I count myself as a libertarian who could support a Ryan-style premium support for old folks.
Political realities are what they are. If you don't recognize that simply setting off a neutron bomb over CMS isn't going to happen, but that's all you'll support, then you're going to be stuck with what we have until it hits the wall and collapses.
I don't know much about Ryan's plan, but from the words you use "premium support" I might not be opposed. It seems to recognize that markets are not going to insure all of our old people (why would they?) and acts in a humane way to address that gap.
Not quite true. Many libertarians are ok with providing for the less fortunate. But if someone spent 40 years working and refused to save up enough money for their retirement, then we have no problem telling them "You should have planned ahead."
That's the big issue here. Many seniors earned enough over their lives that they should be able to take care of themselves in old age. It's not like they didn't know it was coming! Those who did not prepare aren't 'less fortunate.' Why should the rest of us have to make up for their inability to plan ahead?
These Democrats just don't seem to get it. Their consensus view seems to be that Republicans like cutting things because it hurts people. And they're awesome because they protect these plans that help people. Costs? What are those?
You'll see it clearly if you watch Tuesday's Daily Show. Stewart criticizes Democrats not because they won't cut enough, but because they aren't "standing up firmly for their vision of government efficacy" (barf!). By which he means they approved $33 billion in cuts. Out of $3.8 trillion in spending, $1.7 trillion above revenue. WHAT THE FUCK???
When a Ponzi scheme runs out of victims, it ends in tears.
Or prison.
Nonsense Bernie, you should know that great Ponzi schemes like yours never run out of victims. There are too many dupes in this world for that to happen.
They're suckers. And there are NEVER enough of them to prop up a Ponzi scheme. Ever.
If you don't buy into our Ponzi scheme we'll send nice men with guns to your home to drag you into court.
If you resist you will be shot dead.
Yes sir, may I have another?
I WILL LIVE FOREVER!!!!
No, but your debt will. Thanks.
Why yes, yes you will.
Okay, that was funny.
Ultimately, someone is getting "screwed," we just need to decide who.
The only way to maintain the status quo, will be to take more income from those in the labor force. Under Ryan's proposal, retired folks may have to fork over some cash, in addition to their government subsidy, to purchase health insurance. In either case, their is no free lunch.
For those who feel we need to provide assistance to the elderly, that won't change. It's not like we're going to leave seniors high and dry. I doubt that the program will be structured in a way that seniors would be required to provide the majority of their health insurance premiums.
The fantasy is over. People need to start accepting more responsibility for their own future. That requires living with in your means, having a plan, and taking responsibility for the decisions we make in life. Is that really such a horrible way to live?
Yeah, but on the same token, if the Fed didn't inflate the currency, and keep interest rates artificially low, I could put my savings into CDs or something "safe" that can roll over and actually earn money faster than price inflation steals it away.
Yes, since there's a relatively painless alternative: cut defense spending, raise revenues. Reforming healthcare to control its inherent cost increases wouldn't hurt either.
"Yes, since there's a relatively painless alternative: ...raise revenues."
Relatively painless... unless you're the one supplying those revenues.
living with in your means, having a plan, and taking responsibility for the decisions we make in life. Is that really such a horrible way to live?
Why do you hate the irresponsible?
Because Jonathon Chait would say it is cruel!
Because they get away with it.
The baby boomers will be the death of this nation.
LBJ passed Medicare. He wasn't a baby boomer.
What does that have to do with anything?
It's the boomers who want all the programs without any care as to how they get paid.
Hippie red diaper doper baby commie sixties worthless piece of shit smelly need to die collectivist scum.
In twenty or thirty years when the shit hits the fan they'll be dead.
It's their kids and grandkids who will be picking up the pieces.
They don't give a fuck as long as they get theirs.
Selfish fucks.
Hey, man, we didn't start the fire -- it was always burnin'.
sarcasmic, as a baby boomer, my point was that it wasn't my generation who started this program. This entitlement mentality started with the FDR administration. So this was started well before boomers were in power. As for you your comment suggesting that the boomers want these programs without any care as how they are paid for that is not true. Most of the people with whom I associate recognize that the current path is unsustainable. We don't want to burder our children and grandchildren with the massive expenses of those "entitlement" programs.
Who started it doesn't matter.
Who breaks it is what matters.
It is your generation who will bankrupt the country, not your parents.
While you and your cohorts may recognize that the current path is unsustainable, you sure don't want to DO anything about it.
You don't want to burden me and my family with massive debt, but you are unwilling to give up anything either.
You can't have it both ways.
YOU are the problem.
And if Mom and Dad are reading this ... FUCK YOU!
Get your government hands off my Medicare!
Stop acting like a two year old, sarcasmic. You don't know me and what I stand for. You merely assume I am not willing to give up anything. Just because you weren't lucky enough to have a parents like those of my children, don't blame all of us. As for broken, the system was broken the day it was put in place.
Tell me George, would you really give up Social Security and Medicare?
Really?
Despite paying in all your life you would give those things up?
Really?
I don't believe you.
I would give it up. Just give me what I put in and I'll be gone.
What you put in isn't there.
It has already been spent.
That's how Ponzi schemes work.
The only possible way for you to get anything from those programs is to have it taken from someone else - i.e. burden your children and grandchildren with massive expenses.
YOU are the problem George.
You and your generation will destroy this nation.
That's not true. The money I would get would allow my children to go to college without taking loans, so I would actually be saving them money.
And sarcasmic, stop being so indignant to the point that you bite the hand that has fed you for years. You can't even realize when someone my age (55) is on your side. How old are you?
George - any money you "get" would have to be taken from someone else.
There is no "lock box".
It's not there.
You say you don't want to burden your kids with massive expenses, yet the only way for you to get what you "put in" is to burden your kids with massive expenses.
Don't you see the contradiction?
You can't have your cake and eat it too.
sarcasmic, you didn't answer my question. How old are you?
I didn't answer your questions because I do not give personal information.
How old am I? None of your effing business.
So you have to hide behind the anonymity of a website. You are a coward.
"So you have to hide behind the anonymity of a website. You are a coward."
Fuck you George.
The fact is that these programs are Ponzi schemes, and in the end someone must lose.
Unless you are willing to be the loser you are forcing the next generation to be the loser.
That next generation is me and your kids.
The difference between us is that I am willing to kiss that money goodbye. I recognize it for what it is: generational theft.
I may be a coward for not answering your personal questions, but at least I'm not a thief.
You know George, it sucks that that money you "put in" has already been spent.
It's gone.
Never to be seen again.
The only way these programs can give you any money is to have someone else "put in" some dough, which presumably they will want to see again meaning the next generation will "put in", and so on and so forth.
The only way it will end is when someone is willing to kiss it goodbye.
Life isn't fair.
So if you were my child, and I kissed everything good bye, would you help me out if I were no longer physically, mentally, or financially able to care for myself. I am not talking about a government program, but rather merely taking care of your family.
I would help my parents out if it came down to it, yes. That's what family is for.
There is also charities and churches to help those without family.
It isn't perfect and some will fall though the cracks, but it is moral and doesn't involve institutionalized generational theft.
sarcasmic, that is what I was trying to get to all along. As someone 55, I have been paying all my life and haven't received a dime. So to call me a thief is far from the truth. You blamed the baby boomers. The fact is the people running the show until very recently have not been baby boomers. Nancy Pelosi, Barney Frank, and Harry Reid are not baby boomers. Yes, our last 3 presidents have been baby boomers but the rest of the power structure had not been baby boomers. The baby boomers have paid for their parents and grandparents. We are now paying for our children. But your attitude is FY baby boomers. And I do agree there are plenty of boomers who deserve a big FY because they don't want to give anything up.
Now earlier I asked you a simple question and you were indignant about it telling me to FY and calling me a thief. It was a simple question to get a point of reference. My children are 16 and 18. I have been teaching them that things have to change because I didn't want to see them saddles with the folly of the last 80 years of progressive government. And I have done my best to care for them because I may need them some day.
I blame the boomers because they are the ones who openly embraced Marxism.
I blame the boomers because they are the ones who will send these programs over the tipping point.
I blame the boomers because they are the ones who have the power to do something and will not.
My generation has no choice in the matter.
Yours does.
So when this once great nation goes to shit it will be your fault.
what a class act you are, sarcasmic. You act like an a-hole to people who agree with you.
"As someone 55, I have been paying all my life and haven't received a dime."
But you have received quite a bit. Part of that money you put in went to your parents, the rest was spent by politicians on goods and services provided to you. To get those same goods and services you would otherwise have had to pay more taxes. See? You already got something in return for your FICA payments. To ask for Social Security and Medicare benefits on top of that would be a classic "double dip."
The only way we're going to "fix" our entitlement programs is if each generation pays part of the price. That means reduced benefits for current retirees; Reduced expected benefits for near retirees; No benefits for young folks like me; and no one complaining about who got screwed by the baby boomers. We all did.
I agree 110% with sarcasmic, and quite frankly, I wish his view were more widespread. Just because George was ignorant enough to believe in the Ponzi scheme, DOES NOT GIVE HIM CAUSE TO ENSLAVE ME BY FORCING ME TO HONOR A CONTRACT TO WHICH I HAD NO PART IN CREATING.
I have no sympathy for you. I will not receive a dime from social security, and yet you boomers WILL AND ARE RECEIVING BENEFITS. When you are rightfully called theives, you look down your nose and pontificate about "duty to family."
Your money was stolen. You HAVE NO RIGHT TO STEAL MINE TO MAKE YOU WHOLE.
Quoting Michael Savage? On purpose? Egads.
I support Ryan but somebody should tell him he has Eddie Munster hair.
One aspect I rarely see mentioned is that if people are required to take responsibility then they may become *healthier* -- out of necessity, as it were. "If I knew I was going to live this long have to pay this much, I would have taken better care of myself."
I am self-employed, and being so, I must buy my own health insurance. Ya know, they charge you more if you are a smoker. That's just so unfair!!!11!!
Any reason we can't just give everyone a check for their lifetime contribution to Medicare/Medicaid/social security, with interest, and shut the fucker down? It seems to me we'd incur a huge cost up front which would be recouped in savings in 15 or 20 years.
Any reason we can't just give everyone a check for their lifetime contribution
You a funny guy!
You'll never get any votes that way.
Are you serious?
Don't you know how Ponzi Sche... Medicare works?
What would that cost? I mean, just how big of a number would it be? Assume no interest, just the amount of the contributions.
How would the markets (financial, medical insurance) react to the funds disbursement and total dissolution of those three? Also, how many people do SSA and those parts of HHS employ?
$7.65 trillion (average work life - 20 years; average salary $50,000: FICA - 7.65%). That's less than 5 years of Obama's debt.
Thanks for the quick work, George. That's average salary subject to FICA/SSI, right?
I first thought "Jesus! That's expensive." About a $32,000 check to everyone, assuming 240 million workers. Then I realized that it's only 2 years of Obama's budget. And not quite 4 years of projected tax income. What would bond investors think of the tradeoff between that kind of an initial outlay versus lopping off 40%+ of each subsequent federal budget? Never mind the economic boost from workers receiving a 16.5% raise. Inflation would skyrocket, of course, but that's going to happen anyways.
"They should pay, the ungratefull bastards! After all I did for them, like placing them in those welfare schemes for unionized thugs we call (with a sick sense of humor, I might add) public schools, and giving them the thrill of pushing them out of the house at 18 so I could sleep in my own bed away from that hag they call their mother!"
lol, I am sure it will go over like a lead ballon, I mean just look at health care reform in general lol. Pathetic. America is run by the rich, FOR the rich!
http://www.being-anon.int.tc
Forget all the bull about who-shall-pay, and how cruel it is. The chief reason for outsourcing this (which it sounds like they are doing) is to get our payments away from Congress before they spend them.
I REALLY hope our retirement can be outsourced.
Sounds good. Private companies will compete for business, thereby cutting costs. The only thing -- what if costs are cut by simply administering the contracts in their own favor, or breaching the contracts altogether? What I've seen of the insurance industry so far does not inspire confidence that patient care dollars won't be spent on marketing instead of care.
That's why we need HSAs and insurance for catastrophic care.
Try this; replace Social Security and Medicare, and ALL the entitlements, with exemptions in a reformed tax code.
1. All persons residing in the U.S. shall come together in households for the purpose of reporting all income from any source, each item to be identified by payer's and payee's tax number, and for receipt of federal and state benefits. Members of a household need not be related, need not reside together, and a household may consist of as few as one person.
2. Each year congress shall set by legislation a "minimum wage" and a "tax rate".
3. The following income shall not be subject to taxation:
? An amount equal to a year's earnings at the minimum wage rate, for each adult (age 20-65) member of the household, decreasing 10% per year to 50% at age 15, and increasing 10% per year to 150% at age 70.
? All payments for what is classified as necessary health care for all members of the household including medical care, any pharmaceuticals prescribed by a recognized health care professional, vision and hearing aids, and membership fees for health-enhancing entities such as gyms or other exercise facilities. Health care insurance premiums may be deducted but not health care expense paid for by such insurance.
? All educational expenses including day care for young children or legally incompetent persons, that portion of state and local taxes identified as spent on education, that portion of parochial school tuition, fees and other expenses identified as going for non-sectarian education, tuition, fees and educational materials for private school education at any level, and a per-diem allowance for students traveling more than 50 miles from primary residence for education.
? All income saved into an identified account from which investments may be made. All withdrawals from this account for the benefit of any member of the household shall be reported as income to that member.
4. The "tax rate" shall be applied to any income over and above the deductions listed above, regardless of amount.
5. At the request, by legislation duly enacted by any municipality having greater than 100,000 inhabitants or any state, a surtax may be imposed on citizens of that municipality or state which shall be applied in a manner exactly as applied for the Federal tax.
6. For households whose deductions exceed total income, the Federal Government shall make payment equal to the tax rate multiplied by the shortfall in income, as shall municipalities and states.
7. There shall be no federal tax on corporations or other business entities.
8. The Office of Management and Budget shall compute revenues to be expected using the newly set tax rate and minimum wage, applied to the previous year's reported incomes. No expenses in excess of that amount may be authorized or made by the federal government without approval by 75% of each house of Congress.
Negative income tax?
Yes, that's exactly what section 6 provides in lieu of welfare and he patchwork of entitlements to aid the neediest. First proposed by Daniel Patrick Moynihan, Nixon cabinet member, later democrat Senator.
I would prefer to see a plan where anyone can opt out of Medicare.
If they have already paid into it when they opt out then they get back what they paid in plus some interest.
In any case the folks who opt out would have to find a way to get their own medical insurance at retirement through the private market, pay medical care with their own funds or get medical help at charitable institutions.
i'm surprised the obvious fourth option is omitted. that would be to cease the federal governments involvement in our healthcare entirely. why should i have any expectation that my neighbors should involuntarily pay for my healthcare? this option would allow for the elimination of the tax, the administration of the system, fraud, and so on. the government savings would be enormous and individuals would clearly be responsible for their own health.
http://www.pradahandbagsonsale.com
"You mean you want old people to go without healthcare and die?"
Not really, but there's an economic elephant in the room that says that's exactly what's going to happen to future generations if you don't seriously consider making some long-lasting reforms to entitlement programs.
(Why is it that selfish people that want to take my money now can't understand why I'd be concerned about my future?)
Securing a health insurance is a very wise decision. Lucky are you that you have been given a big opportunity for access to medicare. Back in our country, only people who can afford can gain access to the health services. For your comments on this issue, check out http://ithinkrevolution.com.
Judges Vinson, Hudson find m.care
UNconstitutional.
. . . US has highest healthcare
costs. . . cant continue. dont
pay for sports, cig smoking, obesity etc
see cheaper EU Asian hmo care
thank u
ai sile
This movie has some nike sb skunk dunks for sale of the same flaws I saw in another attempt at a faithful adaptation of a work of fantastic literature long thought unfilmable, Zach Snyder's 2009 version of Watchmen...That is, it kobe 7 for sale struck me as a series of filmed recreations of scenes from the famous novel