Medicaid

The Myth of Free Medicaid Money

Advocates are pitching Medicaid expansion as another painless free lunch.

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To hear the advocates of expanding Medicaid tell the tale, Virginia and other states would be dumber than a sack of hammers to turn the idea down. It is, proponents say, a win-win situation: The state gets to increase insurance coverage for tens of thousands of people—and hand the bill to the federal government. Throw in the savings from the economic stimulus from all that new money, along with offsetting cuts elsewhere, and the state comes out a clear winner.

But it's a rare coin indeed that has only one side. Flip this one over, and expanding Medicaid doesn't look quite so wonderful. Here are three reasons why.

First, there's the myth of free money. In Virginia, officials estimate expanding Medicaid would cost the state $137.5 million over nine years, while the state would receive $23 billion from Washington.

Other states report similar figures. California expects to enroll up to 910,000 residents for a cost beginning at only $46 million a year, while collecting $44 billion in federal funds over a six-year period. An Illinois study estimates that state would spend about $2 billion on expanded Medicaid over the next decade, while reaping $22 billion in federal funds. According to Danielle Holohan, who is in charge of New York's insurance exchange, Medicaid expansion "actually works out to be an enormous savings" for the Empire State. And so on.

This all sounds great—if you are a state official. But if you are a lowly taxpayer, it leaves out one rather significant point: Where is all that federal money coming from?

No great mystery: Most of that money would come from taxpayers who live in the very states that are looking forward to these supposed windfalls. According to the Kaiser Family Foundation, if every state signed up for Medicaid expansion, then the federal government would spend nearly $1 trillion over the next nine years—paid for by you.

So you don't have to wait for Medicaid expansion to reap this sort of "windfall." Just take 5 bucks out of your left pocket and put it in your right. As far as your right pocket is concerned, you're 5 bucks richer. It's free money!

No wonder Congress wanted to make Medicaid expansion mandatory.

This brings up the second concern: implausibly aggressive predictions of economic stimulus. Expanding Medicaid in Virginia "pays for itself," says Jill Hanken of the Virginia Poverty Law Center, ostensibly because it would bring $4 billion a year in economic benefits, including 30,000 jobs.

Those figures come from a study paid for by the hospital industry, which has a huge financial stake in the debate outcome. Progressives, who are deeply skeptical of studies funded by the oil or tobacco industries, should be equally skeptical of this one. So should conservatives, who scoff at the stimulative effects of government spending in every other realm (except defense—but that's another column).

Third, Virginia—like many states—predicates its projected gains from Medicaid expansion partly on the assumption that cuts in other programs would soon follow. For instance, state officials predict Virginia would save more than $637 million on charity care for the poor and indigent who sign up for Medicaid.

But this is another left-pocket/right-pocket switcheroo. Federal Medicaid gets its money from the same source as state appropriations for indigent care: the taxpayers. In any event, experience elsewhere suggests the prediction of big savings could be too optimistic.

In 2009, Colorado expanded Medicaid, with a federal match. The Denver Post reports that since then, uncompensated treatment for the poor has fallen $214 million—"but still surpasses $1 billion annually." Or take Massachusetts, where Obamacare's precursor, Romneycare, also was supposed to reduce charity care by expanding insurance coverage. But hospitals successfully lobbied for $200 million in continued charity-care payments, and a report by the National Association of Public Hospitals and Health Systems says experience there "raises the question of whether statewide health care costs have been contained or merely shifted."

None of this means expanding Medicaid is not worth doing. That's a judgment call about how much social-welfare spending government should provide, and how it should balance the moral imperative of caring for the poor with its other obligations. No, the problem is this: Advocates are pitching Medicaid expansion as a painless way for everyone to eat another free lunch on Uncle Sam's dime—when Uncle Sam doesn't have a penny to his name. And that's what got America into such a deep fiscal hole in the first place.

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  1. A. Barton Hinkle-heimerschmidt.
    His name is my name too.
    Whenever we go out
    The people always shout,
    “There goes A. Barton Hinkle-heimerschmidt
    Tra-la-la-la-la-la-la.”

    (It’s been a while.)

    1. are the MLs broken today?

      1. You don’t get any MLs today. It’s a sacred day. A day in which Imperator Barry I Obama is once again crowned in power and glory to rule and reign over us poor sinners and lead us to the bright future which is just over the horizon.

        FORWARD.

          1. I kneel before your superior intertubes skills and beg for your blessing.

  2. I love twitter.

    Miguel Bloombito:

    Tengo un dreamo. Que that todos will be judgero not by el color de los ski?o but by los contents de los pockets during un stop y frisko.

    1. That is awesome

      1. My favorite tweet of his is legendary. He tweeted it right about the time The Hobbit was released.

        Uno Ringo to que rule todos all,
        Uno Ringo to que findo them,
        Uno Ringo to bringo todos all
        Y en el darko stop y frisko them

        1. He opened a bottle of awesome for that one.

  3. My God journalists are stupid

    What might a more ambitious and activist liberalism try to accomplish in the coming years? More than anything else, I would argue that it means taking on the problem of inequality. Since the 1970s, the fortunes of wealthier Americans have diverged dramatically from the middle and bottom, producing a more class-bound society and undermining common institutions of all kinds. But Democrats remain wary of taking on this problem directly for two reasons. The first is that beyond national health insurance and higher taxes on the wealthy, they really don’t know what to do about it. The second is their underlying fear that equality has fallen in the hierarchy of American values.

    Obama needs to tackle inequality and not just preach stand pat liberalism. So he needs something new, like taxing the rich and giving away to the poor.

    http://www.slate.com/articles/…..alism.html

    1. And the top comment is priceless

      Porter Browning
      The only way to create equality is to erase the stacked deck. The beginning of that is vastly higher taxes and a vastly higher minimum wage. $20 an hour, anyone?

      this is Slate, so that guy was likely not trolling. They really are that stupid.

      1. The beginning of that is vastly higher taxes and a vastly higher minimum wage. $20 an hour, anyone?

        So, everyone gets paid $20/hr regardless of the job and then gets to pay, I’ll just guess a number, 75% income tax. WHAT A BARGAIN! Where do I sign up?

        1. Why stop at $20/hr? Do I hear $100? Why not?

          1. Fuck yeah! If we jack it up to $100/hr, we can jack the tax rate up to 90%.

          2. Ok, this is too easy, I can prove what a brilliant plan that is.

            You make $4000 a week, taxed at 75%, so that leaves you $1000 take home. We just raised the minimum wage more than 10x.

            So you have $1000 a week and you are now paying $40 for a gallon of milk, and $600 to fill up your car with gas.

            Wait, something is wrong here…

            But what’s important is that the government now has lots more money to do great miracles with! Equality for all!

            1. “Equality for all!”
              Prisons in North Korea
              http://en.wikipedia.org/wiki/P…..orth_Korea

            2. That’s only if the Fed prints enough green slips of paper to cover all that. If they don’t, it means crushing unemployment.

      2. The only way to create equality is to erase the stacked deck.

        Gee you think that stacked deck has anything to do with the growth of government in the last four decades.

        1. Exactly. It’s progressives who have stacked the deck via the Federal Reserve and the gargantuan regulatory state.

          1. and cronyism

            1. I include cronyism in the gargantuan regulatory state.

          2. Importing tens of millions of Third World peasants and encouraging “multiculturalism” hasn’t helped.

      3. Anyone re-read Atlas Shrugged lately?

        Welcome to the only outcome possible.

        1. Ayn Rand is for idiots.

          1. Well reasoned retort!

            1. Randists have a seriously distorted understanding of what constitutes reason.

              1. Which coming from you is more or less like being called histrionic by Piers Morgan.

              2. T o n y| 1.21.13 @ 5:07PM |#
                “Randists have a seriously distorted understanding of what constitutes reason.”

                You’re just jealous, shithead; they do far better than you.

          2. T o n y| 1.21.13 @ 3:58PM |#
            “Ayn Rand is for idiots.”

            In which case, shithead, I presume you have a large stock.

            1. I’ve read ’em. I’ve also read Dan Brown. They’re both for idiots.

          3. It used to be easy to dismiss Rand. Used to.

          4. Have you ever read the book?

            No? Shut the fuck up retard!

      4. It’s a better idea than any of the fantasy-based nonsense coming from the right. It’s something that has at least a small potential of doing something about the problem. Enacting the thoroughly un-thought-out wishes of the stupid antigovernment cult that has overtaken the other side is hardly an improvement over those ideas.

        There’s a reason small-government BS is dying. It’s not because it never worked, but because it doesn’t actually mean anything. It’s just a bunch of slogans. Which works for people who think in slogans.

        1. Sock. Puppet.

          1. We’re all sockpuppets. It’s not like the pablum you guys believe in came fresh to your minds from nowhere.

        2. Better how exactly? Those ideas won’t work, will produce more problems, and further compound the ones we have. What fantasy-based nonsense are you referring to, specifically? It seems like we did pretty well for a long time with less government than we have now. Small government means small government with a limited scope. That is a pretty clear meaning.

          1. True in practice it means eliminating most of the 20th century’s developments in human civilization. Why that would be a good thing is beyond me. Which golden age of limited government are you referring to in which human beings lived so much better?

            1. Incorrect. Most of the developments that we enjoy, such as computers, the internet, increased agricultural production, highway paving, the automobile, refrigerators, and so forth, were developed privately. The internet may have had its origins in DARPANET, but what it has become has been driven by private industry and lack of government intervention, despite its best efforts. If the government was smaller, we’d still have these things. Your argument is wrong on its face.

            2. Oh, and before I forget, as usual you ignored the questions I posed. That’s why your arguments are so flimsy. You refuse to think.

            3. Which golden age of limited government are you referring to in which human beings lived so much better?

              Shit, I’d settle for scaling government spending and regulatory reach to the Clinton years. Remember the bad old 1990’s? Old people eating cat food on the streets while being thrown into stocks and spat upon by monocled robber barons while their grandchildren were carted off to the oil rigs…

              1. And the tax rates surely?

                1. I’ve made that deal to countless left-wing cretins such as yourself, and not one has taken the deal: Clinton rates for Clinton spending. Not one.

        3. What problem?

          1. The problem of capitalism rewarding a tiny few while forcing the rest to struggle to live an even modestly decent life. Your narrative would have it that the affluent few worked hundreds of times harder over the past three decades and everyone else had a spontaneous mass outbreak of laziness.

            1. T o n y| 1.21.13 @ 4:41PM |#
              “The problem of capitalism rewarding a tiny few while forcing the rest to struggle to live an even modestly decent life…”

              Shithead, obvious lies don’t help your argument.

          2. Would it still be a problem if everyone was being “forced” “to struggle to live an even modestly decent life”?

            There’s nothing inherently wrong with inequality. And I’d never subscribe to a narrative that even alludes to the ridiculous labor theory of value. The LTV is only useful for making up grade school level math problems.

            1. Of course it would be a problem. An even bigger one. But there is not a single policy proposal or institution in existence that will do any harm to the lifestyles of the very rich–whose welfare you guys seem bizarrely fixated on at everyone else’s expense.

              The point is–and this is especially the case if you don’t buy the “LTV”–capitalism is a human invention, a constructed way of doing things like any other form of economy or society, and as such it should have a purpose. If all it’s doing is rewarding the lucky few, rather than distributing well-being to the society as a whole, then what good is it?

              1. …whose welfare you guys seem bizarrely fixated on at everyone else’s expense.

                Well, there’s your problem. You think economic output is a fixed quantity, such that one can only gain by making another worse off.

                This is why rudimentary economics should be required, even in fields like Queer Studies.

                1. Don’t bother PM. It’s been explained to him again and again. He is contently ignorant.

              2. Tony, you are an ignorant cunt and you deserve everything that’s coming.

                You ARE James Taggart incarnate.

            2. You seriously believe that everyone but a tiny few is struggling so much that it’s a problem? You think the median standard of living in the US is that bad?

              Why should capitalism have a purpose? It’s simply what has occurred in any free society (and in many non-free societies).

              1. No, capitalism is not a natural process. It requires massive intervention by governments in even its most rudimentary forms. You can’t have capitalism without law and order, contract enforcement, liability subsidies, and currency, to name the first few things off the top of my head.

                A “natural” economy consists of rudimentary bartering. It’s collective government organization that makes capitalism work, and all I’m saying is that it takes a little more than you guys endorse to make it work well.

                1. You really are dense. The government does not have to intervene for capitalism to work. Indeed, it has been intervening like hell since the progressive era, and none of the harms it cited as reasons for intervention have ceased. It can easily be argued that they’ve gotten worse.

                  We don’t need government currency to have capitalism. As long as we have a recognizable unit of trade, like gold or silver, we can engage in capitalism. Observe Bitcoin. It could be used as a basis of a capitalistic system, and it’s a private concern.

                  Government, again, has a legitimate function. It exists to protect citizens from harm by force or fraud. A society with no government is anarchy, not libertarian. You don’t seem to be able to grasp this rather simple concept. You think it’s a choice between no government and the grossly bloated thing we have today. It’s not.

                  1. You don’t seem to be able to grasp this rather simple concept.

                    Sock puppet has a really hard time grasping much of anything he can’t readily copy and paste from DemocraticUnderground. But his conflating libertarianism and anarchism is entirely intentional – he’s had both concepts explained to him extensively in the lengthy course of his buffoonery here at Reason. Engaging straw men is a whole hell of a lot easier than engaging actual arguments – particularly when your mindless copypasta comports much better with the caricature than reality.

                  2. Anarchy is stupid, but at least it’s consistent. Libertarianism holds that the only definition of freedom is “freedom from government.” Libertarianism’s single premise is that less government is better than more. But for practical reasons we need a little evil government…? Meaning either you don’t believe government is inherently bad (in which case why not use it for a couple other proven, practical purposes), or you’re a big fat hypocrite. One who makes caveats to his most basic premises only when it puts government goons between wealth and thieves.

                    Yeah I get that libertarianism isn’t anarchy. It’s all the government you need to secure your property and wealth, but if you’re sick, ignorant, or poor, fuck off and die parasite. Yeah I get it, really.

                    1. Tony said:

                      Libertarianism’s single premise is that less government is better than more.

                      But, then, later, he said:

                      Yeah I get that libertarianism isn’t anarchy.

                      I don’t think you do get it. Because, if libertarians believe that less government is always better, than the optimum government is none at all. This implies that they are anarchists. Yet, you say that libertarianism isn’t anarchy.

                      Your two statements contradict each other, so your argument is inconsistent. This implies that either libertarians are anarchists, or that the single premise is not that less government is better than more.

                      This has been explained to you so much, and yet you still cling to this. You must have problems with logic, reason, or reading comprehension, or perhaps this hypocrisy argument is something you have to hold on to due to dogma.

                      We can keep explaining it to you, but we can’t make you understand.

                2. No, capitalism is not a natural process… A “natural” economy consists of rudimentary bartering.

                  Hmmm, let’s examine the elements of rudimentary bartering.

                  One person exchanges something he produces for something he needs that he can’t produce himself. He does so voluntarily with another person who is acting in exactly the same manner, such that each of them benefits by the transaction.

                  Nope, that doesn’t sound like a market economy at all.

                  1. It doesn’t quite encompass the complexity of modern capitalism, does it?

                    1. It describes pretty much every single transaction that takes place every day.

                3. T o n y| 1.21.13 @ 5:56PM |#
                  “No, capitalism is not a natural process…”

                  All pray to your fantasy of “nature” shithead?

    2. “The second is their underlying fear that equality has fallen in the hierarchy of American values.”

      Who says “equality” – was ever an “American value” in the first place.

      Liberals are always trying to rewrite history and retroactivaly place their ideology in the mouths of the nation’s founders.

      I don’t recall James Madision ever cheerleading the idea that the federal government should be in the business of trying to rearrange how much wealth individual citizens have in relation to each other.

      1. Equality before the law was the idea, not equality of wealth.

        1. Equality before law was the founders idea. Equality after the law is the progressive left’s interpretation.

          1. The founders owned people. Economic justice came about with FDR. And it was a good thing.

            It turned out you can’t just put “no titles of nobility” in the constitution and then aristocracy would be abolished. The monopoly of wealth by a lucky few is just aristocracy started up again. In Europe the titles came after the conquering of the resources. Turns out Americans realized the titles don’t matter all that much when you have all the resources anyway.

            Then there’s pathetic little toadies who defend every cent in the pocket of every aristocrat even though they will never, ever benefit from the system that put it there. We call those libertarians.

            1. Not all of the founders did. And even if they did, what does that have to do with the ideas being discussed? As for the monopoly of wealth by the lucky few, the standard of living of the poor in America is much better than the middle class in most of the world. There is no such thing as luck. I make a higher income than the average American, but I was also in school and training nearly a decade longer. There’s no luck involved in that.

              You seem particularly pissed off today, Tony. Did a monocled libertarian kick you in the balls?

              1. No such thing as luck? So if you’re diagnosed with an expensive and disruptive healthcare problem tomorrow, or a natural disaster claims your home, you’ll kick yourself for not being entrepreneurial enough to avoid it? I suppose you chose to be born in an advanced society and time in history too?

                Having a safety net does not diminish the will to work hard and succeed, and I think the last 50 years is pretty strong proof of that. In fact having a safety net allows for more people to do more advanced forms of hard work and have a greater chance of success. A more social Darwinian setup naturally rewards the few and more because they are lucky than hardworking.

                1. Luck is generally not a factor in prolonged economic success. Sure, you could argue that health problems and so forth are factors, but those can be insured through privately. Thank you for proving my point.

                  You claim that the last 50 years have been great, with plenty of success for those who work hard, but then turn and say now income inequality, which has been increasing over that same span, is this horrible problem. You are arguing to opposing views at once. Sounds like you have no coherent argument, as usual.

                  Most people on this board don’t even bother to argue with you, because it’s pointless. I mainly do it for my own amusement and because newcomers to the board need to be shown how feeble your arguments are.

                  By the way “hardworking” is a nonstarter. Sysiphus worked hard for eternity, pushing a rock up a hill. He didn’t get ahead because he had a poor choice of vocation. Lots of people work hard, but there’s a lot more to success than that. There’s discipline and planning, and choosing the right career.

                  1. The postwar 20th century saw exponential advances in technological progress and the human condition, and it never involved a limited government. Not a minute of this country’s existence, be it a time of success or shame, had a limited government presiding over it. Your claim is neat, it’s just completely lacking in relevance to the real world.

                    We did not have limited government after Reagan declared government to be the problem and the Republicans got their knives up ready to carve up the FDR model and replace it with neoliberal Ayn Rand fantasy. Yet even their relatively modest lurches in the direction of a more laissez-faire economy resulted in a disaster for economic justice, not to mention a global economic crisis. This is all completely predictable. You cut taxes for the rich and cut programs for the poor, there will be richer rich people and more poor people. It’s a pretty simple mathematics. Your problem is making it out to be a moral story of biblical simplicity. Ingenuity leads to success, thus success is proof of ingenuity, thus failure is proof of a lack of a will, and you deserve not just the indignity of food stamps, but to starve to death for your crime.

                    1. Wrong. The late 19th century saw explosive growth in America and the government was extremely limited compared to today. Even in the 50s government was extremely small in scope when compared to today’s behemoth.

                      I’m sorry, I missed where “economic justice” is some sort of entitlement. In reality, all of us have gotten richer. Plus, it’s only poverty in a relative sense. Even the poor in this country overwhelmingly have cell phones, refrigerators, and color televisions. The well off in the 70s did not. Our standards of living have all increased. And by the way, the rate of poverty was declining in America until the Great Society. It remained constant thereafter. Your argument is simply wrong when you look at facts, as opposed to your simple mathematics which you didn’t bother to cite.

                    2. But we haven’t all gotten richer, at least not by very much. Incomes have been stagnant for almost everyone, but exponentially higher for the top percent or two. This is not, I’m sure you’d agree, the outcome of a free market (since we don’t have one).

            2. T o n y| 1.21.13 @ 4:05PM |#
              “The founders owned people.”
              Yes.

              “Economic justice came about with FDR.”
              No.
              Shithead

            3. These mythical aristocrats responsible for maintaining the “monopoly of wealth” are doing one really, really piss poor job of it. They can’t even keep the 3rd tier losers and drop outs out of their exclusive club. Next thing you know, there’s going to be land millionaires from the scummy working class just because they happened to buy a house in the right place at the right time. Think of it?! My god, the horror…

              1. The aristocracy of wealth explains why today we are all ruled by the descendants of robber barons like Gould, Carnegie, Astor, Crocker, Frick, Pullman, etc.

            4. You’ve done well tonight sock puppet. I found myself becoming enraged by your idiocy…

              …right up to the point I reminded myself you are someone’s alter ego, as no one could actually be this stupid.

              Well done.

      2. Who says “equality” – was ever an “American value” in the first place.

        The stupid see “equality of opportunity”, which is an American value, and drop off the “of opportunity” part, because thinking in phrases as opposed to individual words is hard.

  4. beyond national health insurance and higher taxes on the wealthy, they really don’t know what to do about it. The second is their underlying fear that equality has fallen in the hierarchy of American values.

    Maybe, just maybe, they don’t have a clue how wealth is created.
    Making it nearly impossible for anybody who doesn’t already have a lots of money to create a business enterprise has this weird effect of further separating the have-nots from the haves.

    1. Making it nearly impossible for anybody who doesn’t already have a lots of money to create a business enterprise has this weird effect of further separating the have-nots from the haves.

      Blasphemy! Obama is The Smartest Man in the Room?. He would NEVER advocate for a system where only the already rich and powerful can get around the hurdles of business.

  5. Maybe, just maybe, they don’t have a clue how wealth is created.

    Don’t be silly. They all know it’s created on a press in the basement of some building in Washington, DC.

    1. I think it was the NYT a few months ago that had an entire article on how great the Washington Dc economy is and how it is a model for other cities on how to create economic growth. I am not kidding.

      1. Well, I found very illuminating the comments on that I was suicidal so no one should have gunz article you linked to.

        The NYT commentariat seems to be dominated by people who actively pine for rulers to tell them what to do.

        1. The NYT commentariat seems to be dominated by people who actively pine for rulers to tell them what to do.

          It’s a sentiment that is spreading fairly quickly through much of the country.

          1. Can a republic survive with so many people who want to be slaves?

            1. Someone may be able to answer that question in the near future without it being speculation.

        2. The NYT commentariat seems to be dominated by people who actively pine for rulers to tell them what to do.

          It’s really just T o n y sockpuppeting under 50 different names on there…

      2. Every city should have the power to tax the fuck out of everyone else in the entire country in order to fund their largesse?

        1. They honestly seem to think Washington’s power to tax and steal had nothing to do with it being so rick. Liberalism really is a cargo cult.

          1. I haven’t been to anywhere else in the country where you will see shopping malls and restaurants filled to capacity at 10pm on a weekday, like they are in NOVA.

            1. The top three richest counties in the country, and 7 of the top 10, are DC collar counties in MD and VA.

              Imperial capitals look like that. The capital of a republic does not.

              1. Howard County, MD is in the top 3, at least it was last year, if I recall correctly.

                1. Like Insty says, we’re living the Hunger Games as we speak.

        2. Every city should have the power to tax the fuck out of everyone else in the entire country in order to fund their largesse?

          YES!!!!!!1!!1!11!!

          /Detroit.

  6. an entire article on how great the Washington Dc economy is and how it is a model for other cities on how to create economic growth. I am not kidding.

    They advocate secession, and formation of of corporatist city-states?

    How… enlightened.

    1. Plato agrees. Say, how is Greece doing these days?

      1. Just bombing along!
        http://www.sfgate.com/world/ar…..210230.php

      2. “Plato agrees”

        Well, sort of. Since city states were the status quo in his time, it’s hard to say what he would have thought of the modern state of Greece.

        Anyway, I’ve always thought The Republic was more of communist style central planning and fantasy of drastically changing human nature.

    2. it is a model for other cities on how to create economic growth

      So, this author actually believes that other cities around the country can tax everyone else in the country to fund these projects?

      1. It’s just one, big round-robin purse snatching tournament.

  7. This is just another manifestation of the ‘free’ stuff that this nation is being dragged down by.

    I just had to explain to a friend again how that ‘tax return’ he is getting is actually a subsidy when you don’t work all year and pay in nothing, and once again explain that it’s the people who actually paid taxes that are subsidizing that because the government doesn’t have any money besides what they took from tax payers. It’s unbelievable how many people don’t have a clue how this works.

    1. It was a clever idea to hide welfare in the tax code.

      Though I do tend to agree with those who think that a negative income tax sort of thing is preferable to more targeted welfare programs.

      1. What would really be nice is if able bodied folks in their 20s and 30s with 5 kids and another on the way would actually have to look for a job as a condition of taking tax payer funded assistance. But the Democrat voting base might take a hit, so that’s not going to happen.

        1. I saw a 20 year old kid panhandling the other day. I was fucking aghast. There is no reason a 20 year old able bodied male shouldn’t be able to find work of some variant.

          1. I disagree. Worked with homeless youth for years. Some struggle with mental-health issues, making employment unlikely.

            1. If they are really disabled, then they are the ones that should be getting government assistance. The problem is, is that anyone can get it, just because they don’t want to work.

              1. “If they are really disabled, then they are the ones that should be getting government assistance from charities like the one I worked for.

                1. Everyone knows libertarians don’t work for charities. I’m afraid we’re going to need to collect your monocle and top hat. We will also be needing the address of this charity which brainwashed you so that we can send out our all-child-labor fire brigade to burn it to the ground.

    2. It’s unbelievable how many people don’t have a clue how this works.

      Actually I think the problem is that most of them don’t care how it works as slong as they are the ones getting ‘free money”.

  8. According to the Kaiser Family Foundation, if every state signed up for Medicaid expansion, then the federal government would spend nearly $1 trillion over the next nine years?paid for by you.

    Sadly, this isn’t true, and that’s the problem. By running on IOUs, the government convinces us this stuff is free. We don’t pay the price for it, so why not want it? If we paid for it, we might find our appetite is smaller than it seems.

    I believe deficit funding is fraud, while taxes, however abhorrent, are not fraud. So libertarians should be advocating that we pay for everything *now* and raise taxes to the levels needed to fund all the crap the government does *now*. It would crash the economy and cause a lot of pain, but at least then people would see what their policies reap. Instead we pretend its not happening and when it does, it will be even worse.

    1. I think all the zeal for big government would evaporate immediately if current taxpayers had to pay for all the government they’re getting today.

  9. libertarians should be advocating that we pay for everything *now* and raise taxes to the levels needed to fund all the crap the government does *now*.

    Actually, no, libertarians should be advocating that we drastically cut spending now and start paying off this debt.

    1. Given that cutting spending won’t happen when we discount the cost of government, what we want won’t happen.

      I’m talking about a strategic way to get there: if people have to pay for it rather than charge it, they might actually start to demand some restraint. But until they have to actually feel pain for all the “free” crap, they have no incentive not to want it. So we should demand the fraud stop and we pay for what we get. That would be much more effective than just advocating that we cut spending without a mechanism to make the alternative painful.

      1. So, exactly how do you plan to make all those folks who are not paying any taxes and demanding more and more welfare from the state, to feel the pain?

        The rest of us are already feeling the pain, that’s not the issue.

        1. Flat tax that is automatically set to the rate that Congress spends money at.

          1. “Flat tax that is automatically set to the rate that Congress spends money at.”

            So a tax rate of 140% then?

            1. At current spending levels, looks like about 40% (payroll tax is abolished, single rate for all income).

              Of course, the point is that everyone would suddenly be interested in not spending as much if they were paying 40%.

          2. I like that idea, but it’s not progressive, so progressives hate it.

            Progressivism is impossible without a huge centralized government and a large majority of people completely dependent upon that huge centralized government.

  10. No, fuck you, cut spending!

    1. It won’t happen if it’s discounted. I want to cut spending dramatically, but when we talk about cutting spending it doesn’t happen. So force it from the other side and say, “OK, if you really want all that crap, you gotta pay for it now, no more credit card.” I bet then people scream about it and realize they need to cut it. So the result is we will cut spending and we will remove the ability of politicians to game the system.

      1. The problem is, again, those who are demanding all of this free government funded stuff, aren’t paying for it. They have EBT cards, not credit cards. I am not sure what your point is, really.

        1. I think his point is that the people who are net taxpayers will wake up when tax rates are required to increase at the rate of 40% in order to fund the lavish EBT welfare state. Moreover, there will be a portion of people who are net tax drains right now who would find out that in order to fund the lavish welfare state, they’ll be forced onto the other side of the coin.

          Of course, I think LemonMender has far too much faith in the ability of people to get pissed off at being robbed.

          1. “Of course, I think LemonMender has far too much faith in the ability of people to get pissed off at being robbed.”

            That’s the part that amazes me about people who advocate all these government programs.

        2. I think the point is that the gov would have to raise taxes on everyone and in a lot of places to cover that kind of shortfall. Poor (working) folks do pay SS/MC tax, fed gas taxes, and a host of other fees buried into the prices of products they buy. When their paycheck shrinks and they can’t afford to put gas in the car due to excessive taxes, maybe people will open up their eyes.

          I’ve often thought that we’d have a country full of fiscal conservatives if folks actually had to pay the true price of government services.

  11. This all sounds great?if you are a state official. But if you are a lowly taxpayer, it leaves out one rather significant point: Where is all that federal money coming from?

    From the perspective of a taxpayer in any given state, turning the money down only makes sense if you can get all the other states to turn it down, too.

    1. Ah, game theory. Of course, the modern incarnation of game theory is nothing other than the realization that we’re all getting played.

      1. Everybody knows that the dice are loaded
        Everybody rolls with their fingers crossed
        Everybody knows that the war is over
        Everybody knows the good guys lost
        Everybody knows the fight was fixed
        The poor stay poor, the rich get rich
        That’s how it goes
        Everybody knows

        Everybody knows that the boat is leaking
        Everybody knows that the captain lied
        Everybody got this broken feeling
        Like their father or their dog just died
        Everybody talking to their pockets
        Everybody wants a box of chocolates
        And a long stem rose
        Everybody knows

  12. https://sites.google.com/site/sophieinnorthkorea/

    Awesome North Korea travel log done by Google CEO Eric Schmidt’s daughter Sophie. They went with Bill Richardson on some kind of humanitarian mission. The girl is actually sharper and more interesting than Richardson or her father.

    1. Got that the other day; her description of the droids in the computer library is scary.

  13. State officials rue the day when their citizens pick up an Econ 101 book.

  14. I am sympathetic to concept of the “pay-as-you-go” argument on taxes.

    Unfortunately, even with tax receipts at or equal to spending, there is no real concrete connection between cost and service.

    To use a really shitty analogy, standing with the refrigerator door open for ten minutes while you decide what you want to drink is not a line item on your electric bill at the end of the month.

    A lot of people think trash collection is “free” because the cost is buried somewhere in their property tax bill (or rent).

    The true cost of the school system is concealed by a variety of ruses. What’s worse is nobody cares about quality, because it’s free.

    I want fee for service government to the utmost degree. I don’t have any children in the school system. Fuck you, pay those teachers yourself. If I don’t voluntarily opt into the government’s retirement fund, fuck me if I run out of money before I croak.

    1. You’re talking about personal responsibility. That’s not on the table in todays America. It’s all about the collective. We’re all in this together, whether we want to be or not.

      The economy will collapse and we will be living in a 3rd world authoritarian state. I don’t really see any way out of that, except for a large scale rebellion by the states against the federal government.

      1. Enough powerhouses like Texas just don’t go along with the program (and they are joined by the few states that are actually growing, population and economy-wise) and Uncle Fed may run into do-do. I hope for that compared to actual gunplay and such.

        1. I also. The gunplay will turn out really badly for everyone, or at least for most. But if enough states stand up, united, and say enough is enough, then just the threat of gunplay should be enough to make everyone take pause and work things out peacefully.

    2. Why can’t you just become a religion and then opt out and let the rest of us have our modern civilized society in peace?

      Collectivizing risk is a very simple concept. Capitalism works better when people are freed from scrounging for basic necessities or suffering catastrophic loss, not to mention when people are educated. These things allow for more risk taking and a more advanced economy. You guys seem to think that the rewards of capitalism are so meager that the only motivation that gets people to work is the threat of starvation. Which makes it curious why you simultaneously think a 4% increase in the income tax will have dire consequences for capitalism.

      1. Collectivizing risk is a simple concept. When done voluntarily and privately, by means of insurance, it works. The problem comes when you and those who think like you believe they know what’s best for everyone and start forcing everyone to collectivize risks they might not even have. Then comes the political giveaways and you end up with a dysfunctional system, such as we have now.

        Please explain how before FDR everyone was scrounging for basic necessities. Please cite such a time. The evidence is pretty clear that risk taking occurs when those with capital (i.e. the people you’d like to take from) believe that there is a stable environment.

        The reason a 4% income tax hike is bad for the economy is pretty clear. It removes money from people who would otherwise spend or invest it. Spending and investing produces a healthy economy. The lack of it causes economic contraction.

        1. collectivize risks they might not even have.

          Everyone is at risk for healthcare costs, ignorance, natural disasters–not to mention crime, a risk you guys are OK with using government force to mitigate. Let’s not play dumb and pretend that there aren’t some universal basic needs. As universal needs, they are most efficiently handled on a universal scale. Not everyone can afford or has access to unsubsidized private health insurance, not to mention fire insurance or theft insurance (as they would need if you guys were consistent about the use of government force).

          Lots of old people depend on Social Security and Medicare to meet their basic needs. What do you suppose they would do without them? Do you not realize that there was a real-world problem (old people in poverty) that these programs were invented to address? Old people in poverty are a huge drag on an economy. Would-be entrepreneurs, through the bad luck of having parents and grandparents, would be spending their resources on elder care instead of innovating in the market. Unless of course we just dump the poor, old, and sick into ditches.

          The evidence is that even at much, much higher income tax rates than we have today, the economy did very well. It only started stagnating when the silly theory you’re espousing came about. The rich don’t drive the economy with their consumption. There just aren’t enough of them.

          1. “Everyone is at risk.”

            That’s why we have the pricing mechanism to weigh these risks. Wise up.

            1. What is your grandmother’s life worth, roughly?

              1. Well since both of mine are dead, nothing at the moment. To me, they were worth a great deal. I would not expect them to be worth anything to you. Similarly, your grandmother (or whatever relation) is worth very little to me, although I expect very much to you.

                1. Well let’s make a bargain. We both contribute to a system that guarantees no old person will be in poverty, and whether that becomes an actual issue for us or not, we’re set and can focus on other productive work. It’s just the insurance model. Even if you don’t get any direct benefit, you’ll benefit from living in a society in which the fruit of the increased productivity has made standards of living higher overall.

                  1. No. Thank you.

                    Wow, just think if someone actually offered that deal to people. In other words, they could freely agree, or not, to participate. Many undoubtedly would. Many would not. But at least they’d get to choose. You would give people no choice. They must participate. That’s tyranny.

                    By the way, again, standards of living have not increased because of Social Security. And as for your “no old person in poverty” assertion, I treated an old person several days ago that tried to kill herself because she could no longer afford to live in her house on her Social Security payments.

                    1. It’s no more tyranny than is a law against armed robbery. It’s law enacted by the democratic process and enforced by means paid for by taxes. Social Security is no more tyranny than any other government program, and you can’t really explain why it differs. They all involve transferring from one to another.

                      So if that old person couldn’t afford to live the life she wanted on Social Security, how the fuck exactly would she be doing without it?

                    2. Wow, this is stupid even for you.

                    3. Sure I can. Government exists to protect the weak from the strong, not to loot the weak at the strong’s expense. The punishment of those who use force to take from others is a legitimate government function. The government using force to take wealth from others to give to someone else is not.

                      And I noticed you completely sidestepped the fact that I crushed your argument rather easily. If the old lady had not been sold a bill of goods by your ilk her whole life that somehow the government would take care of her, she probably would have actually saved some cash. In fact, she said as much.

                  2. T o n y| 1.21.13 @ 6:03PM |#
                    “Well let’s make a bargain. We both contribute to a system that guarantees no old person will be in poverty,”

                    Gee, shithead, why not wish for pixie dust?
                    You idiot! You do know that’s not possible, don’t you? Well, don’t you?

              2. T o n y| 1.21.13 @ 5:52PM |#
                “What is your grandmother’s life worth, roughly?”

                My grandmother died a long time ago. That roach I see out in the street, OTOH is easily 10X what your sleazy existence is worth.
                In fact, when you die, that death will not make up for the harm you caused in your life. You are a net minus in the human existence measure.
                Please die now to prevent further harm.

              3. What is your grandmother’s life worth, roughly?

                I haven’t consulted with the Independent Payment Advisory Board. Let me get back to you.

          2. “crime, a risk you guys are OK with using government force to mitigate”

            We are not anarchists. You seem to fail at grasping even that simple idea. We need government for certain tasks, things that cannot be effectively handled privately. Privately, I cannot imprison you against your will. The government can, which is why it is such a dangerous creature (something you don’t comprehend either).

            “As universal needs, they are most efficiently handled on a universal scale.”

            Please cite how individual needs, which all needs are at their core, are most efficiently handled on a mass scale. You cannot make these blanket assertions.

            “Not everyone can afford or has access to unsubsidized private health insurance, not to mention fire insurance or theft insurance (as they would need if you guys were consistent about the use of government force).”

            Nope. Wrong. I have theft insurance now, despite the pervasiveness of your government. The cost of health insurance is directly attributable to government intervention. Your solution is the cause of the harm. Next.

          3. “Lots of old people depend on Social Security and Medicare to meet their basic needs. What do you suppose they would do without them? Do you not realize that there was a real-world problem (old people in poverty) that these programs were invented to address?”

            So your solution to old people in poverty (which was not that much of a problem and I defy you to find legitimate citations that it was) is to create programs that have destroyed the nation financially? By the way, causing the elderly to become dependent on your program because they didn’t need to make other arrangements, is called indentured servitude/slavery when there’s labor involved. Just thought I’d help you there.

            “The evidence is that even at much, much higher income tax rates than we have today, the economy did very well.”

            Again, incorrect. You are confusing rates with what people actually paid. The two are not the same. Tax revenue as a percentage of GDP has been fairly constant, regardless of rate.

            “The rich don’t drive the economy with their consumption. There just aren’t enough of them.”

            If there aren’t enough, then how is taxing them any kind of solution? You can’t help arguing against yourself, because your opinions aren’t based on any kind of reasoning.

          4. Lots of old people depend on Social Security and Medicare to meet their basic needs. What do you suppose they would do without them? Do you not realize that there was a real-world problem (old people in poverty) that these programs were invented to address?

            If alleviating poverty among the elderly was, and is, the ostensible purpose of those programs, why do guys like, for instance, former president Clinton, Warren Buffett, and Hank Paulson need to collect benefits from them? As I recall, you were opposed to means-testing Social Security and Medicare, which would ensure that only the most needy actually receive benefits from them. Were you being a disingenuous cunt then, or are you being a disingenuous cunt now? Don’t worry, it was a trick question: you’re always a disingenuous cunt!

            1. I’m against means testing for two reasons, for one of which you supplied the exactly appropriate adjective. One, it wouldn’t save hardly any money and every assessment will say that, and two it’s a transparently disingenuous idea, a for Republicans to turn a universal social insurance program into a “welfare” program for poor people, who they are very practiced at demonizing for the purpose of cutting such programs.

  15. Two things here:

    1) The majority of Medicaid money is spent on long-term care for disabled adults and seniors, not children. This explains the spiraling costs, as that kind of care is expensive, and checkups for kids are not.

    2) What are we really getting out of spending this much money on indigent care? What is the goal of it? Can’t we just cap this money at say, $10K per recipient? Why is the taxpayer’s responsibility to be an unlimited charity?

    OK, that was more than two things.

  16. I want to express my delight in the fact that folks don’t respond to the sock puppet.

  17. ‘Preserving our individual freedoms ultimately requires collective action’

    – Barack Obama, January 21, 2013

    1. ‘Preserving our individual freedoms ultimately requires collective action’

      He said that, didn’t he?
      Do you reckon this was a result of one of those refrigerator games where all the words are just stuck to the door and you slide them around until something stupid shows up?
      Hey, at least he didn’t repeat one of the dumbest political slogans of all time:
      “The freedom from want!” From that true ignoramus FDR.

  18. “According to the Kaiser Family Foundation, if every state signed up for Medicaid expansion, then the federal government would spend nearly $1 trillion over the next nine years?paid for by you.”

    That’s the magic of it. Benefits come from your state signing up; costs come from other states signing up. Who says progressives don’t understand incentives?

  19. ‘Preserving our individual freedoms ultimately requires collective action’

    It takes a village to raise an idiot.

  20. Dude is not making a whole lot of seusense dude.

    http://www.Private-Web.tk

  21. “Just take 5 bucks out of your left pocket and put it in your right.”

    No! We borrow 40 cents on the dollar spent. So take $5 out of the right pocket, borrow $2 from the Chinese, waste $6.70 on health care for the poor or those scamming the system that you could have paid for far more cost effectively at community clinics rather than expensive ER departments, put 30 cents back in your left pocket and send the bill to our kids.

  22. If only we could climb upon one of the icebergs and light a small fire. The cold waters of the North Atlantic wouldn’t appear so inhospitable, would they? I know that we will eventually drift into warmer waters where this little frozen cone will melt …. still …. it seems a better fate than immediately perishing here in these frozen northern climes. Did you bring along the crampons and ice axes, dear? I’ve a small flask of Irish Mist and think I’ll toast the lovely, starlit evening. Care to join me?

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