Wages

Health Care Costs Are the Reason You're Not Getting a Raise

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Every Labor Day, you can count on seeing a spate of news stories saying that "real wages" in the United States haven't grown since the 1970s. That's true, more or less, but the reason for the stagnation might surprise you. It's a complex story, but it boils down to this: Blame health care costs.

According to the Federal Reserve Bank of St. Louis, inflation-adjusted wages have grown by just 2.7 percent in the last 40 years. But inflation-adjusted total compensation—wages plus fringe benefits, such as health insurance, disability insurance, and paid vacation, along with employer-paid Social Security and Medicare taxesincreased by more than 60 percent in the same period.

Wages still make up a significant share of your total compensation: 68.3 percent, according to 2017 data from the Bureau of Labor Statistics, vs. 31.7 percent that goes to benefits. But that latter piece has grown significantly, in no small part due to the rising cost of health insurance. And that trend is only going to get worse.

This has political consequences, since most workers don't appreciate how hefty the non-wage share of their compensation is, nor do they generally realize just how much of the money their employer is shelling out on their behalf gets eaten up by health care. As a result, they demand that politicians intervene to deliver more raw pay.

To control health care costs, Americans will have to stop relying on third-party payers to cover small, routine expenditures (as opposed to large and unforeseen ones). According to the U.S. Department of Health and Human Services, out-of-pocket spendingcopays and the likewas only 11 percent of all health care spending in 2015, down from 43 percent in 1965.

It's an economic truism that if someone else is covering the bulk of the cost of something, you're likely to use more of itespecially if you don't realize that you're paying for it with foregone wages and higher taxes. This increases the overall demand for health services, which in turn increases the cost. It also creates an incentive for whoever is paying, be it the government or your insurance company, to start putting constraints on which services you can and cannot consume. The end result is that patients have become minor players in many of the financial and medical choices that deeply affect their lives.

Reversing this trend would be hard without a reduction in health care costs big enough to get people to stop expecting their insurance to pay for every little thing. Lower costs would also make it possible to free employers from the responsibility of providing coverage to their workersbecause if quality care is cheap and abundant, you don't need to look to your boss to make sure you can get it. That in turn would reduce the gap between compensation and wages. Controlling costs, then, really is the key.

Easier said than done? Yes and no.

This is, of course, a long-term project. It requires bringing to health care the kind of innovation we've seen in other sectors over the last few decades. And that means reducing the influence of government bureaucrats and special interests, which routinely obstruct new technologies and resist innovative ways for consumers to interact with their doctors.

Introducing novel tools and services can make health care more expensive at first. But as long as the government refrains from setting price controls, costs will eventually go down, just as with consumer goods, allowing ever more people to gain access. And some cost-saving steps can be taken immediately. For instance, why not allow medical tourism, reform the onerous Food and Drug Administration approval process, and end regulations that stop highly trained nurse practitioners and physician assistants from treating patients?

By freeing the health care sector from the grip of government and special interests, we can unleash the kind of innovation that has rocked the world of information technology in the last 25 years. Workers should be all for that.

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158 responses to “Health Care Costs Are the Reason You're Not Getting a Raise

  1. Wait, isn’t the libertarian healthcare plan to snap a pool cue in half, drop it in front of a half-dozen leukemia patients and tell them to “make it fast”?

    1. Don’t be silly, no need to snap the cue in half.

    2. I don’t get it.

      1. Get more drunk and depressed then see if the joke makes sense.

          1. You mean “why so cereal?”

            1. You wanna know how you got those scars?

  2. No, the libertarian position is to protect all American’s rights by using the free market to develop cures and lower Dr and hospital charges through competition and innovation. Furthermore, it is also to encourage far less political influence that wastes resources and destroys private wealth that could be more competently utilized for the purpose of better health outcomes for all maladies. The typical statist assumption that Libertarians are heartless simply because we reject government force to solve all human problems displays an abjectly ignorant and false narrative.

    1. Heartless, or just clueless. No where in the world is the “free market” leading to good healthcare outcomes at the systemic level. Yet libertarians keep going on about this fabled unicorn.

      1. mortiscrum|9.23.17 @ 9:34AM|#
        “Heartless, or just clueless. No where in the world is the “free market” leading to good healthcare outcomes at the systemic level. Yet libertarians keep going on about this fabled unicorn.”

        Nowhere in the world is your fave health-by-theft doing anything but allowing the patients top die while in line.

        1. Switzerland, France, and Germany are doing pretty well for themselves, healthcare-wise. Switzerland and Germany especially have a system that is not unlike the ACA. Fun facts.

          1. Yes. The ACA has had an impact on less than 10% of Americans yet one would think the government took over all the docs and hospitals.

            Some of the Peanuts blame their premium increases on the ACA but premiums increased faster before the ACA.

            Health care reform in the form of Single Payer is to be avoided though.

            1. Has anyone noticed the prices of lasik and breast augmentation have fallen drastically over the years? It’s due to the fact even though they are popular procedures, they aren’t covered by insurance .

              1. Dental procedures (mostly uncovered) have gone up though. A crown is north of $1200 now – about twice what they were 20 years ago. And crowns are mostly elective.

                Certainly the market works best but patients seldom care if they don’t pay actual costs.

                1. So single payer would fix that how?

                2. That’s because dentists run incredibly inefficient offices and they are regulated to do so. By comparison, an American dentist operating just over the border in Mexico will charge less than half of what dentists ten miles away in America charge.

                  I avoided crowns because of the expense until recently when I found a dental HMO. Two crowns (which my previous dentist said were not possible because of the damage to my teeth) cost me $750 instead of the $3000 that had been quoted before. I had been paying $900 per year for dental insurance but the HMO price was $500 per year for me and my wife. I have had no problems with either crown and couldn’t be happier with the result.

                  There hasn’t been a free market in medicine in the US for over 90 years when the AMA started restricting the number of doctors. Protectionism always results in higher prices and inferior service.

                  Finally, I wish that people would stop calling socialized medicine “single payer”. It should be called what it is – government medicine that combines the efficiency of the DMV with the service of the Post Office.

                3. Dental procedures (mostly uncovered) have gone up though

                  No, dumbfuck–dental insurance is a ubiquitous feature of paying for treatments now, too.

            2. Yeah, I’m for single payer. The single payer being me. You can pay for your health care too, as can Jimmy Kimmel. For those who can’t afford it, I believe in charity – like Shriners Hospitals, McDonalds raising money, etc. etc. The church I attend raises all the funds to send doctors to a dental surgery clinic in Honduras. No reason they couldn’t do the pro bono work locally.

              1. Catastrophic insurance is the only sane solution.

                1. RE: Catastrophic insurance is the only sane solution

                  This isn’t a solution at all. For starters, even catastrophic insurance is prohibitively expensive. Many can’t afford even that, and for most it’d still be a huge line on their budget. Plans with a $13,000 deductible are “catastrophic coverage” by anyone’s measure – and those plans still have a $1,200+ monthly premium.

                  The idea of catastrophic coverage being a solution is that some basic health plan would be cheap enough that most people would buy it. As shown, that’s not the case at all. Further, those plans are terribly for people who know they’ll need to use it. Who does that plan actually serve? No one.

                  1. For starters, even catastrophic insurance is prohibitively expensive.

                    Yeah, now it is. It wasn’t that bad before they made it Affordable.

                    1. ^ THIS

                      That was my experience in the eight years before ObamaCare: High deductible. Relatively stable, low premiums. Guaranteed renewability. Large network of providers. Million dollar cap.

                      After ObamaCare: High deductible. High and rapidly escalating premiums. Insurers leaving market every year and must change plan every year. Very few providers in network. My primary care doc changes every year. It takes a year to get on his schedule for a physical. Basically, it’s carwreck insurance. But I do get free birth control pills.

                    2. I get free birth control pills too which is of great benefit to my 65 year old wife who’s had a hysterectomy.

                  2. Wrong. Catastrophic insurance was the cheapest form of coverage. I would have it, but I am not ALLOWED to buy it.

                  3. The problem is that the system does not accommodate those of us who would prefer to pay out of pocket for routine medical expenses and maintain catastrophic coverage. Call your local hospital or clinic and ask for the cost of any basic non-elective procedure. They will refuse to tell you. If you tell them you’re prepared to walk in the door with the entire payment due in cash they will probably refuse to set an appointment. If they do agree to treat you the price will be much higher than any insurance company would agree to pay. Of course these “prices” are known to the provider and the insurance companies, but they don’t function as prices in the economic sense because the consumer won’t know the cost until after the fact. If they can decipher the opaque billing. And the only cost they give a shit about is the “patient responsibility”.
                    As the article notes, the healthcare system has sucked up virtually all increases in worker productivity for nearly half a century. It is a dysfunctional system on the verge of collapse and it will take down the entire economy with it. When it does, we’ll look back on the great recession as the good old days.

                  4. I had a catastrophic plan for about 5 years in my 20’s, it was $45 a month with a $5000 deductible, $10000 max. If you have to blatantly lie to support your position, maybe you should rethink your position.

                  5. I had a catastrophic plan for about 5 years in my 20’s, it was $45 a month with a $5000 deductible, $10000 max. If you have to blatantly lie to support your position, maybe you should rethink your position.

                2. Catastrophic insurance is basically what people buying their own individual insurance currently get.

                  I’m self-employed and don’t qualify for subsidies. My policy has a $5k deductible. Sure I get a “free” physical as part of the deal, but otherwise I’m completely on my own for the first $5k of healthcare spending.

                  This is the same deal I had before Obamacare. When I first got my individual policy, the premium increase to choose a plan with a lower deductible ($2500 instead of $5k) was almost $2k per year.

                  Basically, the math worked out that unless you knew you’d hit the deductible every year, it was better to get a high deductible plan. Of course, since you had to pass underwriting, if you were likely to hit your deductible each year, you couldn’t get a policy at any price.

                  1. You guys must be in cheap states.

                    My “gold” plan this year on the exchange was $2,200 per month for a family of five, with a $13,500 max out of pocket – $7,500 per person deductible. ( prior to Obamacare, I was at $690 per month for a high deductible plan – deductible of $3,500)

                    And even with that insane cost, it was difficult to find specialists who would take the plan. From freaking Blue Cross for crying out loud. They are normally accepted everywhere.

                    So I dumped the whole thing and went with a cooperative – MediShare. $500 per month with a $5,000 deductible. The only down side is that they don’t cover me if I get injured due to drug or alcohol use, I can’t smoke (don’t any way) and I have to avoid getting pregnant out of wedlock (not a woman and married, so less of an issue for me personally)

                    In the process I was uninsured for a period and I learned that my pediatrician’s “discount price” for cash customers is $89 for an office visit. The price under the PPO that MediShare uses is $35 for the same service. I also learned that the prices listed prominently for cash customers at the doc-in-a-box walk-in clinic down the street are highly misleading. A simple procedure that didn’t even require a stitch ended up ticking off a bunch of those “$135.00” and “$75.00” boxes and adding up to over $900. They had a max of $500 for cash customers, so that’s what I paid.

                    This is what healthcare costs these days if you don’t pay the insurance vig.

              2. The single payer being me.

                Fine. Let’s get rid of Medicare first then. It costs taxpayers the most by far.

                1. Deal.

                  1. Deal.

                    I’m serious. The GOP and posters here howl about the ACA but Medicare is the beam stuck in the eye.

                    In fact, I support converting Medicare to the ACA format where people have to buy their Medicare in a market place from private insurers and only the indigent receive premium support.

                    1. No deal.

                    2. ACA is a fraud, sold with lies. Jonathan Gruber pulled back the curtain. We know you’re lying.

                    3. That way you’d get your entire Social Security check instead of having your Medicare premiums withheld.

            3. Yes. The ACA has had an impact on less than 10% of Americans yet one would think the government took over all the docs and hospitals.

              Provably false. Just starting with the new need every employer now has to prove compliance, which gets passed on to every employee. Much less the sweeping new regulations themselves for insurers and practitioners.

            4. The ACA has had an impact on less than 10% of Americans

              How do you come up with this crap? It affected anyone with health insurance, which is almost everyone.

            5. Palin’s Buttplug|9.23.17 @ 10:21AM|#
              “The ACA has had an impact on less than 10% of Americans”

              Turd, do you ever post without lying? Ever?

              1. On the medicaid/insurance side, that 10% figure is probably about right. If you ignore medicaid and just look at the non-group insurance market, we’re talking about less than 5%.

                ACA’s impact on the employer market has been pretty small.

                This article from the right-leaning RealClearHealth.com complains a lot about the huge impact of Obamacare on employer plans, but then goes on to say that including direct and indirect costs, the total cost of Obamacare’s impact on employer provided insurance was only about 5.8% or $330 per employee.

                http://bit.ly/2g1MGZY

                The bulk of that cost comes from forcing plans to allow kids to stay on their parents’ plans until age 26.

                1. “On the medicaid/insurance side, that 10% figure is probably about right. If you ignore medicaid and just look at the non-group insurance market, we’re talking about less than 5%.”

                  Pulled that out of your butt?
                  “On October 29, 2013, NBC News reported that 50 percent to 75 percent of the 14 million Americans with individual healthcare plans would receive a cancellation notice in the next year.”
                  https://ballotp edia.org/Health_insurance_poli cy_cancellati ons_since_Obamacare
                  ——————————–

                  “This article from the right-leaning RealClearHealth.com complains a lot about the huge impact of Obamacare on employer plans, but then goes on to say that including direct and indirect costs, the total cost of Obamacare’s impact on employer provided insurance was only about 5.8% or $330 per employee.”

                  IOWs, it has “impacted” every one with employer-selected insurance.
                  And as regards costs:
                  “”The cost of health insurance under the Affordable Care Act is expected to rise an average of 22 percent in 2017, according to information released by the Obama administration Monday afternoon.”
                  http://www.npr.org/sections/he…..-subsidies

                  1. “Pulled that out of your butt?”

                    14 million people divided by 323 million Americans equals 4.3%. I rounded up to 5%

                    1. magellannh|9.23.17 @ 8:18PM|#
                      “14 million people divided by 323 million Americans equals 4.3%. I rounded up to 5%”

                      Which is the reason I included the *second* link, but don’t let that get in the way.

                  2. IOWs, it has “impacted” every one with employer-selected insurance.”
                    The impact of Obamacare on employer policy premiums is 5.8% all in. In exchange kids get to stay on their parents insurance and plans that had lifetime caps can’t have them anymore. That’s a negligible impact.

                    And as regards costs:
                    “”The cost of health insurance under the Affordable Care Act is expected to rise an average of 22 percent in 2017, according to information released by the Obama administration Monday afternoon.”

                    First, the 22% number applies to the non-group market not employer plans.

                    Also, the article doesn’t attribute the cost problem to Obamacare at all, it attributes it to increased generosity of employer plans:

                    “According to the U.S. Department of Health and Human Services, out-of-pocket spending?copays and the like?was only 11 percent of all health care spending in 2015, down from 43 percent in 1965.”

                    Employer insurance plan costs have increased so much is because copays and deductibles have dropped from 43 percent of total spending down to just 11% since 1965. Employer plans are more generous so they cost more.

                    1. I don’t know where you get those statistics, but they in no way resemble my experience. My employer provided insurance has gone up by considerably more than 8.5%, and the deductible has gone from $2,500 to about $13,000 (and about twice what I am allowed to put into my HSA in a year). Effectively, we only have catastrophic coverage except for a short list of items, most of which I and my wife don’t use, and which should have an annual cost less than one month’s health insurance payments.

                      And the lower-paid employees at my employers, who are pretty much living hand to mouth, don’t really have coverage at all. They can’t pay the $13,000 deductible, so they’ll only get any substantial amount from their health insurance if they are hospitalized and the hospital is willing to overlook that they’ll lose $13,000 on the case.

                    2. magellannh|9.23.17 @ 8:31PM|#
                      “IOWs, it has “impacted” every one with employer-selected insurance.”
                      The impact of Obamacare on employer policy premiums is 5.8% all in. In exchange kids get to stay on their parents insurance and plans that had lifetime caps can’t have them anymore. That’s a negligible impact.

                      So now the claim is not whether they are impacted, but whether you think it is a negligible impact? How far are you going to pus that goal post?
                      ————————————
                      And as regards costs:
                      “”The cost of health insurance under the Affordable Care Act is expected to rise an average of 22 percent in 2017, according to information released by the Obama administration Monday afternoon.”
                      First, the 22% number applies to the non-group market not employer plans.”

                      So what?
                      ——————————-
                      “Also, the article doesn’t attribute the cost problem to Obamacare at all, it attributes it to increased generosity of employer plans:
                      “According to the U.S. Department of Health and Human Services, out-of-pocket spending?copays and the like?was only 11 percent of all health care spending in 2015, down from 43 percent in 1965.”
                      Employer insurance plan costs have increased so much is because copays and deductibles have dropped from 43 percent of total spending down to just 11% since 1965. Employer plans are more generous so they cost more.”

                      Where did THAT come from? And WIH is it supposed to mean?

                    3. Copays and deductibles are decidedly higher now than they were 20 years ago. Or 40 years ago.

                      I suppose if you go all the way back to 1963, when insurance was still a relatively new thing – The Elks, Moose Lodge, Shriner’s, Masons, etc. were still big players in the paying for healthcare arena – you could say that. Most polices way back then were probably an 80/20 split for all costs. This kind of insurance still exists, but it is much less common than either fixed copay or fixed deductible plans.

                      But by the 80’s fixed copays were already becoming very popular, and by the 90’s I”d say that was standard, with high deductibles coming in later in the 90’s because of government tax incentives.

                      I switched to a high deductible family plan in the late 90’s because the tax advantage and my relative health made it financially beneficial. At that time the policy cost $450 for a no lifetime limit, pays 100% after $3,000 deductible policy with included wellness visits and vision.

                      They picked 1963 because it made their point. Switch them to 1995 and you’ll get a very, very different answer.

                      Except that actual cost of care is through the roof too – so even if you are paying 3x in out of pocket expenses, the insurance still has to pay more. Also, doctors have learned to play the game and file a crap-ton of codes to get to their desired dollar amount. 1 visit becomes 3, etc.

                    4. “So now the claim is not whether they are impacted, but whether you think it is a negligible impact? How far are you going to pus that goal post?”

                      In my original post, I said “ACA’s impact on the employer market has been pretty small.”

                    5. “Where did THAT come from? And WIH is it supposed to mean?”

                      It came from the text of the original article. The article doesn’t blame Obamacare for higher costs in the employer market, it blames more generous coverage with lower co-pays and deductibles compared to the 60s.

            6. yet one would think the government took over all the docs and hospitals

              Who allows the AMA to control medical schools, and issues “Certificate of Need”s for hospitals?

              Come back after you pull your head out of Palin’s asshole.

          2. mortiscrum|9.23.17 @ 10:06AM|#
            “Switzerland, France, and Germany are doing pretty well for themselves, healthcare-wise. Switzerland and Germany especially have a system that is not unlike the ACA. Fun facts.”

            “Redefining German Health Care”
            […]
            “The Health Care Problem
            ?
            Increasing demand
            ?
            Aging populations and increasing burden of disease
            ?
            More treatable diseases
            ?
            Rising costs
            ?
            Health spending has risen faster than economic growth in most OECD countries since 1970
            ?
            Significant challenge to government budgets
            ?
            Inconsistent quality and low efficiency
            ?
            Limited or non-existent measurement of costs or outcomes
            ?
            Zero-sum competition that is not focused on patients or patient outcomes”
            http://www.hbs.edu/faculty/Publication Files/2012.3.1_Rede fining German Health Care_Por ter_Guth_FINAL_86b6216 4-573c-487b-ab3f-8d4 4083f744d.pdf

            Weren’t you the gullible twit who bought that story about how ACA would have people involved in preventative care and that would lower the costs?

            1. I am perhaps a gullible twit, but I’m not the gullible twit who did that. Preventative care is overrated.

              What is your link supposed to be to? It brought me to the Harvard Business School search bar, but nothing related to Germany or healthcare.

              Healthcare is a tough nut to crack, and if your point is that no country has gotten it exactly right yet, I’m at least sympathetic to that position. But some countries are doing it a lot better than others, and the countries that are doing it better all have something in common: the government is heavily involved. It doesn’t have to be single payer – not by a long shot – but the government absolutely has a roll to play.

              1. “What is your link supposed to be to? It brought me to the Harvard Business School search bar, but nothing related to Germany or healthcare.”

                Remove the spaces and you’ll find a PDF which pretty much makes the German system every bit as miserable as ACA.
                —————————–
                “But some countries are doing it a lot better than others, and the countries that are doing it better all have something in common: the government is heavily involved.”

                Assertion posing as argument.

          3. Then why is ACA such a miserable failure in the US?

            Of course, ACA works for a small fraction of people who have pre-existing conditions and for a much larger fraction of people who seem to be getting something-for-nothing. But, if you actually pay for ObamaCare, it’s far worse than the status quo ex ante. Not such a fun fact.

            1. Not that I accept the miserable failure part (the ACA could be better, but it’s not an abject failure), I’ll give my ideas about why the ACA wasn’t more successful: Because when the Democrats ACA’d they didn’t ACA hard enough. The subsidies for buying private insurance should extend further up the income ladder, tax incentives for employee-sponsored care should be eliminated with extreme prejudice, and the individual mandate should have some real teeth. These three things would vastly increase the amount of people buying insurance on the exchanges and let them function more like the proto-markets they were intended to be.

              The overall idea of the ACA is good, as shown in Switzerland and Germany. But here, for political reasons, the ACA is kind of half-assed. Rather than creating a large, healthy market, we’ve basically maintained the fractured healthcare state we had before, to our detriment.

              1. Not an abject failure? Where are the $2500 savings in medical plans? Who got to keep their insurance and their doctors? That’s what was promised and that is what makes ObamaCare the hideous disaster that it is.

                1. I suspect that mortiscrum doesn’t really have first-hand experience with an ObamaCare policy purchased on Healthcare.gov or a state exchange. Either that, or he’s getting a significant subsidy.

                  There are two ways to believe that ObamaCare is a success: 1) Believe MSM propaganda but have no first-hand experience; or 2) get ObamaCare with huge subsidies.

                  1. RE:I suspect that mortiscrum doesn’t really have first-hand experience with an ObamaCare policy purchased on Healthcare.gov or a state exchange.

                    I get coverage through my employer, so I have no first-hand experience with the exchanges, but my parents buy coverage through the exchanges. It’s really expensive…? I’m not sure what that exposure is supposed to show me as far as the overall effects of the bill.

                    To try and make some common ground, I’ll say it: yes the ACA is bad. There’s some really obvious things to change that could improve it, and our political leaders are unable/unwilling to do so. From that perspective, it’s hard to not just hate on it. But it’s built on top of an unbelievable amount of crap that was around from long before the ACA. It’s not exactly fair to judge the bill in a vacuum and not factor in the state of healthcare prior to it passing. The ACA was slapped on top of an existing system that was in need of a lot more than the ACA, and narratively been charged with all of the failings of the things that came before it. It’s a small step in the right direction.

                    1. I’ll take you up on that common ground and agree that the existing system was crap. But the ACA did nothing to address the crap. I have first hand experience with the exchange and it is one of the most miserable and expensive ordeals I’ve ever had. What ACA accomplished was to impose a huge pile of expensive mandates on top of a system already could not function in a marketplace. The only beneficiaries are the medical industry and insurance companies that helped write the legislation, those with pre-existing conditions who could have been accommodated much more simply, and the uninsured working poor, another group who now thinks healthcare is a free lunch. The middle class, and particularly the self employed middle class, are taking it on the chin. The overall crappy system is more entrenched and dysfunctional than it was before. Legislation that makes a failing system even worse is an abject failure in my opinion.

                  2. CatoTheChipper|9.23.17 @ 2:26PM|#
                    “I suspect that mortiscrum doesn’t really have first-hand experience with an ObamaCare policy purchased on Healthcare.gov or a state exchange. Either that, or he’s getting a significant subsidy.”

                    mortiscrtum has been showing up pretty much on cue when we get a medical-care thread and he’s been (passive-aggressively) shilling for O-care and socialized medical in general.
                    He tries to keep the mask in place, but it slips.

                    1. …..He’s on to me!

              2. mortiscrum|9.23.17 @ 12:57PM|#
                “…(the ACA could be better, but it’s not an abject failure),…”

                It is an abject failure by the standards of those who proposed and passed it. It takes a certain sort of apologist to claim otherwise.

                1. If one understands the the real objective of ObamaCare was to fail forward to a Canadian-style single-payer system or a UK-style national health system, it has been a marvelous success.

                  In fact, it has been a spectacular success when one considers how the failure of the ObamaCare system has simultaneously wrecked the GOP.

                2. RE: It is an abject failure by the standards of those who proposed and passed it. It takes a certain sort of apologist to claim otherwise.

                  There’s an argument for that, I’ll admit. No one would call the ACA a smashing success, even if they really wanted to and squinted hard. But it’s also not as bad as you and others apparently want it to be

                  1. mortiscrum|9.23.17 @ 3:03PM|#
                    “No one would call the ACA a smashing success, even if they really wanted to and squinted hard. But it’s also not as bad as you and others apparently want it to be.”

                    How much practice does it take to weasel to that degree?
                    Let me repeat:
                    It is an abject failure by the standards set by the originators, regardless of my opinion.

                    1. RE: How much practice does it take to weasel to that degree?

                      Good amount. I’m planning on running for office, so in that regard my weasel skills need to be significantly better, but they’re getting there.

                      /joking

              3. You probably should actually learn about the Swiss system.

                First, people have to pay up to 8.5% of their income for healthcare before they get any subsidy. That is LESS generous than the USA.

                Switzerland also has a brutal penaltax: insurers can actually sue you to get their payments, and you get signed up automatically.

                Oh, and Swiss doesn’t have medicare, so old people still are paying 8.5% of their income.

                The ACA’s problems are mainly because Democrats were too generous and didn’t want to be the meanies.

                1. Germans are required to pay 9.3% .

                  Leftists don’t seem to know much about the countries whose systems they purport to admire.

          4. Switzerland’s system is actually far less statist than our own; there is much more competition among insurers and greater requirement for payment by the consumer.

            And France is doing terrible; don’t know what you’re talking about. Their healthcare system burns through money providing redundant services (homeopathy, brand name drugs to all, massages) while their economy slowly rots:

            There are plenty of countries in which the state plays a much smaller role in healthcare than the US but enjoy better outcomes. Australia, New Zealand, Switzerland, etc. it’s a leftist myth that developed countries all have socialized medicine.

            1. In Switzerland:
              – Everyone is required to buy basic insurance, which provides coverage for illness, accident, pregnancy, and hospital stays. Insurance companies are not allowed to make a profit off of this basic insurance.
              – If anyone pays more than 8% of their income for the premium, the gov steps in and pays the rest.
              – The deductible maxes out at ~$1,500, at which point the patient only covers 10% of cost until an additional ~$450 are spent.
              – Insurance companies are required to offer this basic plan to everyone, regardless of age, health, etc.
              – Insurers and providers negotiate prices every year. Prices are constrained and guided by federal law, and if they can’t reach an agreement the local government will step in and set prices.

              The Swiss system is super interesting, but it’s utterly false that the government is only marginally involved. The government is extremely involved, especially once you “pop the hood.” The US government needs to get out of healthcare to the degree that it’s intruding in some bad ways, but it’s also NOT doing some things it should be doing – as demonstrated by the Swiss and other similar countries.

        2. No where in the world is the “free market” leading to good healthcare outcomes at the systemic level.

          The opposite is true, since every one of those socialist systems utilizes technology developed in a “free market”. A least a much freer one.

          Simple economics question: do you think there is no unseen cost of all this socialism and state control of healthcare?

      2. Nowhere is the world is the free market being ALLOWED to lead to good healthcare outcomes. Every government on earth is absolutely sure that it knows what its subjects need in healthcare…and every government on earth is screwing up.

        Seriously; road maintenance is at least an order of magnitude less complicated than healthcare. Yet the federal government, charged with funding and overseeing the maintenance of the interstate system, has been pounding the funding down assorted ratholes (or allowing State governments to so pound) for decades. I remember people saying that we needed to stop spending highway fund money on anything other than highways maintenance and construction DURING THE REAGAN ADMINISTRATION and every administration since. Nobody listened. Now the highway fund is empty, the roads are falling apart, and the swine who caused this state of affairs are busy telling people who don’t want to pay higher taxes because the government pissed the money it already had away that if they want good roads they will have to pay for them.

        Now, apply that to healthcare. I don’t want the government out of healthcare because I expect that to magically make things all better. I want government out of healthcare before they return us to the days of cupping and seasoned scalpels.

        1. I swear, the overlap between libertarians on healthcare and communists generally is uncanny. “The only reason it doesn’t work is because it’s never been tried! No, really, I promise it’s a great idea!”

          If free market healthcare is so great, why have veterinarian bills increased so much? More to the point though, what makes you so confident that a free market will work at all? Yes, there’s lots of particular things that could be improved, but that’s not the same as saying government should be divorced from healthcare entirely. The rise of health insurance and government intervention didn’t happen because a bureaucrat said “hey, I’d like to fuck with the people!” It happened because the market was proving unsustainable and ill-equipped.

          This is a really good article about cost disease. It covers why government intervention on its own is a poor explanation for rising costs

          1. So put the government in charge of smart phones.

          2. You misread me. I don’t want government out of healthcare because free market healthcare is so great – as you point out, I don’t know – I want government out of healthcare because I have plenty of evidence that government healthcare is goddamned awful.

            Now, address THAT point, or back down out of my face.

            1. Government healthcare is NOT goddamn awful. Lots of countries are doing different and creative things and getting good outcomes. The bar for success can’t be utopia. Healthcare is just a hard problem.

              1. Venezuela is a fine example of government healthcare at its best. Cuba, where tourists are begged for aspirins, is another fine example.

                Want medical care after the age of 70 in Great Britain? You’ll die waiting for it just like American veterans died waiting for the VA to examine them. Want the cancer cure rates of France? If we had those rates we’d bury another hundred thousand people a year.

                Read Ezekiel Emanuel’s paper on how to distribute medical care. He would seriously limit all “scarce” care after the age of 60 except, of course, for certain “valuable” individuals. The elite gets care and the rest get grave stones.

                1. RE: Read Ezekiel Emanuel’s paper on how to distribute medical care. He would seriously limit all “scarce” care after the age of 60 except, of course, for certain “valuable” individuals. The elite gets care and the rest get grave stones.

                  If this is meant as an example of a more optimal state of healthcare, than I think it’d be self-evident why most people reject libertarian proposals. Even if you think that is morally correct, surely you’d be able to figure out why it isn’t exactly popular.

                  Why is Venezuela a “fine example of gov’ care at it’s best”? Why do you feel the need to refer to a failing state to make your point? Under what metric is Venezuela the “best” example of government care? I’ll answer: because it makes the point you need it to.

                  1. “Why is Venezuela a “fine example of gov’ care at it’s best”? Why do you feel the need to refer to a failing state to make your point? Under what metric is Venezuela the “best” example of government care? I’ll answer: because it makes the point you need it to.”

                    Because Venezuela is a fine example of what happens when the state takes full control of most anything, medical care included.
                    Do you find that surprising?

                  2. I’m quite certain Bob was referring to Emanuel’s paper as an example of what’s wrong with centrally rationing care, and was not supporting only elites getting care.

                    You don’t seem to have any idea what your opponents actually want; most libertarians very much oppose state rationing of care, which is what Emanuel favors.

          3. The linked article is anecdotal drival. Its only empirical claim is that consumer spending on vet services has increased faster human medical service, not that per-unit costs of vet services are escalating faster than costs of human medical services. It shouldn’t be surprising that people spend more on pets as incomes increase. I just spent $2000 for emergency GPV surgery for my dog. Thirty years ago, my less affluent, but no less dog-loving, dad would have had him euthanized without hesitation. My own experience with routine vet bills is that they have not escalated nearly as fast my medical insurance premiums — like an order of magnitude in difference in escalation. And the cost of my doctor’s office visit has escalated far more rapidly than the cost of my dog’s vet visit. I admit that’s anecdotal. I don’t have any macro-level statistics on per-unit escalation, but neither does the author of the article or the article that she cites.

            1. I was wrong about per-unit costs. The CPI-U in fact does itemize veterinary services.

              In December 2016, the CPI-U indexes (1982-1984=100) were as follows:

              All items……………. ………… ………………… 242.8

              Medical care ……… ………. …………………. 471.3
              Professional services ……………………. 376.6

              Pet services ………… …………. ……………. 234.5
              Veterinarian services …………………….. 245.5

              Thus, it can be demonstrated from the CPI-U data that per-unit veterinary services have only escalated at the rate of inflation where as medical services have escalated at a much higher rate.

          4. Re: mortiscrum,

            If free market healthcare is so great, why have veterinarian bills increased so much?

            Compared to what? The fact that demand for animal healthcare has outpaced the number of veterinarians seems to be a never mind to you, first of all. The opportunity for foreigner veterinarians to cover the gap seems to be blocked by an extremely arbitrary and bureaucratic (and expensive) immigration system is another. Veterinary schools are expensive, limiting the number of doctors by price. But even so, to what are you comparing these costs?

            The rise of health insurance and government intervention didn’t happen because a bureaucrat said “hey, I’d like to fuck with the people!” It happened because the market was proving unsustainable and ill-equipped.

            That’s actually a lie. The government didn’t intervene because “the market was ill-equipped”. It intervened because a bureaucrat WANTED to fuck with the people. The bureaucrat simply didn’t think it in those terms.

          5. You know my dog recently blew out both knees, the veterinary surgeon said it would cost $4000 to fix both and did both surgeries within budget. It was a fairly simple, straightforward process. Meanwhile, my wife was beating cancer over the summer and we never knew exactly what we would owe. Frankly, I don’t see why doctors and hospitals can’t give you an estimate ahead of time.

          6. why have veterinarian bills increased so much?

            Because most people don’t have the balls of the kid in “Old Yeller”?

          7. why have veterinarian bills increased so much?

            Because most people don’t have the balls of the kid in “Old Yeller”?

          8. “You Liberal-Democracy advocates sound just like the Jacobins! If Liberal Democracy were so much better than Monarchy, where are all the successful Liberal Democratic systems around the world, huh?”

      3. Where in the world is there even close to a free market health care system?

    2. Was this meant as a reply to my post? Cuz, if so: WHOOOOSH!

  3. It’s depressing that with control of Congress and the White House, not one of the Republican Obamacare repeal bills even mentioned the tax subsidy for employer provided health insurance.

    According to the CBO, annual federal government healthcare spending for people under 65 in the US breaks down as follows:

    $287 billion – Employer provided healthcare tax subsidy
    $225 billion – Traditional Medicaid and CHIP
    $72 billion – Obamacare Mediciad expansion
    $34 billion – Obamacare premium tax credits
    $7 billion – Obamacare cost sharing subsidies

    Republican plans did try to cut Medicaid spending, but all of them left the biggest piece of the subsidy pie completely untouched.

    Instead, conservative talking heads focused on generating over the tiny $7 billion spent on cost sharing subsidies.

    It was a great head fake, but doesn’t get us any closer to solving the health care cost problems we have.

    Also, during the Obamacare debates, we heard a ton from the right about malpractice reform. What happened to that idea?

    1. Agreed. The entire healthcare debate has calcified over a few specific topics: single payer, Medicaid expansion, and cost sharing subsidies. There’s a depressing lack of talk of structural reform that’d have a real chance of fixing healthcare and putting the country on a new path.

      Bernie Sanders is doing that, but it’s entirely in a “burn it all down” way, which I don’t like. His plan is also preposterous and hand-wavy.

    2. Tort reform is a state issue.

      1. So? Use the commerce clause to lean on the states to get shit done. Aren’t you guys a big fan of that method?

    3. The overlooking of the employer subsidies and the employer provided care tax deduction is indeed infuriating. Apparently those have passed into the realm of entitlements republicans now like.

  4. I hate hate hate having to choose a doctor based on my insurer, filling out forms every time I have to find a new doctor, playing games with my insurer over who covers what, getting my wunnerful insurance through my employer, and getting briefed by my employer every other month or so on the latest changes to their insurance benefits. It’s f***ing stupid.

    1. Wait until government controls it, we will be treated to the smooth and efficient style of operations that is enjoyed by customers of the motor vehicle licensing branch, patients at the VA and postal patrons.

      1. Wait until government controls it

        Too late.

        1. Yeah the govt regulates and regulates and regulates, till now they have a hand in every damn thing that anyone thinks or does, not to mention directly socializing half the system already.

          And when the result sucks we only get to choose whether they will do a little more of the same or a lot more of it.

          1. You nailed it.

  5. I think the premise that if you aren’t paying much (ie, low copay) you will use it much more is unproven and likely bs. Are there really people here who like to waste their day going to the doctor office? The hospital for tests? Sit around sick people just for kicks? Perhaps there are a few but I think most people want to be as far away from the doctor as possible.

    And the % stat quoted is complete bs too – were there MRI and CAT scans back then? Why on earth would you be shocked that copays have dropped so much when we now have significant costs in diagnostic testing that did not exist 50 years ago?

    1. Mid 1960’s Giles cartoons about the NHS routinely referred to an influx of patients in waiting rooms whenever there was a tempting sports event on TV. It isn’t supposition; it flipping happened to the British..

      The British and the Canadians are among the people most like us. They both tried Single Payer, low or no-copay systems. Neither could make it work. Oh, it’s great if you are young and fit. Not so good if you are old and ill.

      It is the hight of hubris to think we can make this work, when the trail of failure is all over the globe.

    2. “And the % stat quoted is complete bs too – were there MRI and CAT scans back then? Why on earth would you be shocked that copays have dropped so much when we now have significant costs in diagnostic testing that did not exist 50 years ago?”
      So expensive testing leads to lower co-pays? Not sure I’m following your logic but let me ask you this. CAT scans and MRIs have been around for quite a while now. The technology is pretty mature. Why does the cost never seem to go down?

    3. Stilgar|9.23.17 @ 10:59AM|#
      “I think the premise that if you aren’t paying much (ie, low copay) you will use it much more is unproven and likely bs.”

      So you are arguing that medical care is not an economic good?
      Bull
      .
      .
      .
      .
      shit.
      Try getting a precedure done in, oh Canada, where it is “free”.

    4. It’s not just a matter of people overusing; it’s a matter of cost consciousness. When you have to pay a big chunk of the price for your procedure instead of a small, fixed copay, you are more likely to get it done somewhere that’s cheaper.

      And this is empirically demonstrated: when consumers bear a fraction of the cost instead of a fixed copay, prices plummet due to competition. See the CALpers joint replacement study.

      1. “See the CALpers joint replacement study.”

        Got a link, please?
        I looked for some cost/use ratio link to show Stilgar was full of it; most required a walk through Econ 101, so it wasn’t gonna tell the story.

  6. Is it possible that health care costs in Prohibitionist Amerika have something to do with “Drugs” being the Avatars of Satan, and doctors coerced into enforcing prohibition beginning with the Harrison Act voted in on the heels of the Income Tax Amendment? In South America drugstores dispense almost all medications with very little coercive meddling, and people can now look up symptoms on the Internet. In North America, doctors for over a decade wrote prescriptions for gin and whiskey, and the Political State still ENFORCES nonsensical and counterproductive prescription requirements and exports prohibition laws. Why is that?

    1. Hank, you apprehend a reality few of us do.

  7. And this is happening under the Affordable Care Act.

  8. Whenever the government makes something “affordable” the price goes up whether it’s housing or education or medical care.

    Pumping money into housing with low interest rates and little required down payments drove prices through the ceiling.

    Spending three times as much on primary education as was spent in 1970 produced no tangible improvements. College loans produced magnificent campuses but few graduates capable of paying those loans back.

    With governments providing 50% of health dollars prior to ObamaCare is it any surprise that adding more money to a governmentally limited market resulted in soaring prices?

    1. ‘Subsidize demand, restrict supply’ is a recipe for skyrocketing prices, who knew?

  9. In 1995 I spent a week in the hospital, including a night in the ICU due to a ruptured appendix. My share of the bill was $700. In June I had surgery for a hernia. One night in the hospital. My share of the bill is $4800.00. Of course, fiat currency builds in inflation, but fuck liberals and their desire to have government control everything.

  10. NFL’s Goodell: Trump’s ‘divisive comments’ show a ‘lack of respect’

    Making a spectacle of disrespecting the flag during the national anthem and accusing the US of (currently) mistreating people of color: glorious free speech
    Suggesting that players who do so are SOBs who should be fired: divisive and disrespectful
    Another Sunday not watching the NFL: priceless

    1. When you have a country whose founding principles, when implemented, has a history of uplifting people, and when ignored lead to oppression, and when you have generations of patriots trying to make the founding principles a reality, and often succeeding, then I think it’s a bit precious to blame the country as a whole for contemporary abuses.

      Yes, you can respect the flag of the USA without endorsing every bad thing ever done by Americans or their government.

      Indeed, as Burke said in a somewhat analagous context, the patriot regards the defects of his country like the wounds of a father, a situation to be dealt with with reverence and skill, rather than the radical approach (based on the Greek legend of Medea) of chopping up old Dad into little bits and sticking him in the “kettle of magicians” in hopes he regenerates.

      1. This is a fair point. However, it can also be argued that the US government has had a net negative influence on the world as well, so saluting the symbol of the government could reasonably be met with protest.

        But none of that is relevant. What’s relevant is Kaepernick wanted people to talk about race and police conduct, and holy shit has he succeeded in that.

    2. They both have free speech. Nobody is getting arrested or anything. People just think the President is King and they get scared he’ll make it a law by fiat.

      1. I don’t think anybody really fears that. They’re just virtue signalling.

        Goodell made a huge fucking mistake. All he had to do was ignore the Trump comment or at most just repeat the silly inapplicable “first amendment” argument that owners are already used to deploying. But he had to virtue signal and strike back at Trump instead, in the most hypocritical choice of words possible.

        They thought the fan losses were bad before… it’s going to get much worse for the NFL unless they can find a way to market pointy football to leftist gender transstudies professors.

  11. The main drivers of cost increases are:

    1. Being able to do so much more to treat diseases now than in the past. In 1932 treating cancer was cheap. The treatment of course being to call an undertaker and a priest to give the last rites. In 2017 there are a dizzying array of expensive drugs, tests, therapies, etc that just might prolong your life a little. Who’s going to turn that down?

    2. Living longer but not healthier. It’s the norm now that people spend more of their lives as senior citizens than as children! That would have been unthinkable not long ago. And seniors’ medical bills are far more than those for children, while their ability to economically produce is getting less and less as the necessary skills change more quickly.

    3. Consumers are insulated from costs of their care.

    1. The problem is not just the new practices and technology, because there’s plenty examples of other markets where prices go down while performance and selection go way up. For example electronics.

      The problem is the incentives of a market with minimal interest/ability to compete on price. Their is a practically unlimited system of subsidies, where if you can’t afford the very best and most expensive technology, someone else will be forced to buy it for you. Indeed if others who a responsible for shouldering your costs try to skimp, they will be destroyed financially or worse. That means R&D is devoted purely to chasing that ultra-high-quality-spare-no-expense segment of the market, because indeed it’s the only segment.

      Back when they were pushing the ACA, the left was running ads or the radio which made the following two complaints (in a odd stoner voice as I recall),
      1. costs are too high.
      2. doctors make too many mistakes.
      Ergo they want both lower cost and higher quality via govt fiat. Zero self-awareness there. Everything the govt does will exhibit this same contradictory combination of demands (and fail at it as usual with predictable results).

      1. I remember on 60 minutes like 10 years ago, they were hand-wringing about the health care system collapsing because all the general practitioners were getting old. Problem is the new MDs primarily become specialists because they can’t pay off their student loans on GP money.

        Fast forward 10 years and the role of the GP is basically obsolete. PAs and NPs do the same job already and, at least in my experience, much better. And it won’t be long before AI takes the diagnosis and treatment decision jobs and does even better, not only from the GP/PA/NP crowd but even from specialists. We should be seeing cost decreases if anything.

      2. You and LibEquality are talking about two different things. You’re talking about averages (ie bang for your buck) while he’s talking about totals. While it is true that you can get better electronics for cheaper now, it’s also fair to say that consumers are paying MORE total money for electronics now than they used to. The same is true for health care. So I think his point #1 is still valid.

        1. I didn’t say his point was invalid, I said the real problem was the incentives. I also don’t think quantity is relevant. People undoubtedly scarf down way more food than they ever did before. And it’s a way smaller part of most people’s budgets. And it’s superior quality.

          As for electronics, the early 20th century was all about giant tech bubbles with the rollouts of new electronics technology such as radios, movies, and electrical power. Early radios certainly cost as much as cell phones and could go way higher. Ok subsistence farmers couldn’t afford much of anything then, and now the highly educated and skilled population can actually have a budget for such things. Not really fair or meaningful to compare in that sense though.

    2. I do agree with most of these. But why are places like Canada not subject to the same cost increases?

      1. Because they stop spending money when the budget is exhausted. Patients left on the waiting list have to wait until the next fiscal year to have their treatments scheduled.

        1. Yep. AKA death panels.

          Socialized medicine countries also have the benefit of paying the marginal cost for pharmaceuticals, after the pharmas make back their R&D investments at the expense of the relatively free US market.

          1. No, death panels would involve withholding treatment from those deemed a waste of time and money because of advanced age or severity of condition.

            What I described is rationing. Treatment is withheld because there is no money to pay for it. If the patient survives until the next fiscal year he/she will get treated.

            Two different things.

  12. Health Care Costs Are the Reason You’re Not Getting a Raise

    No, the reason I’m not getting a raise is because I’m usually late, argue with everybody, and have an incredibly poor work ethic.

  13. And it’s not ever going to get better. Prices will go up and up until they can’t and probably tank the economy

    1. I believe they’ll tank healthcare before any politician will let healthcare tank the economy.

  14. Can someone clarify how “wage” is defined in this article? Is it simply inflation-adjusted dollars? If so, I wonder why that’s even relevant. That’s not a true reflection of the standard of living. Our effective wages are not stagnant because the average worker today lives at a higher standard than the average worker 30 years ago.

    1. Pretty sure it is not intended in ways comparable to comparisons of living standards.
      The point is:
      Quite a few lefty sources claim that middle-class “wages” have been stagnant since the conservatives and small-government representatives took over congress about 20 years ago or so; you remember that, don’t you?
      Well, even if by the measure of take-home pay is found to be stagnant, the increased cost of medical insurance as a result of O-care is eating up any raises you might have gotten.

      1. I get that. But I wonder why wages are the target. They’re just a surrogate measure for buying power. If we continue to progress in our standards of living to the extent that we have over the past 20-30 years, then I’ll take stagnant wages all day long.

        1. Well, if you really want to prove you’re Mr. Pedant, have at it.

      2. Actually most of the “declining wage” crowd point to the early to mid-70s as the time when the decline began.

        According to them this was when the “New Deal consensus” broke down.

        1. Or, started to break down, that is.

          The first challenge was the Goldwater campaign in ’64 but LBJ’s landslide reassured New Deal liberals that everything was A-OK. Nixon showed himself a liberal by signing every piece of New Frontier and Great Society legislation that the Democratic congress could dredge up out of JFK and LBJ’s wish lists.

          After Nixon, the chickens came home to roost and the consequences of all the New Deal/Fair Deal/New Frontier/Great Society gimmes started to show. Or at least, that’s how conservatives and libertarians saw it.

          Diehard New Deal liberals, of course, saw it otherwise and insisted that if we just had the right men in charge it would all be OK. They still haven’t got him. And they didn’t get their right woman either.

          1. The “New Deal consensus” breakdown was a twenty year process that began with the Goldwater campaign in ’64 and was pretty much accomplished with the reelection of Ronald Reagan in 1984.

            It’s not that there are no advocates of the New Deal around anymore it’s just that it no longer has the widespread that made it a consensus the way it did in the 40s and 50s.

            And it isn’t just conservatives that challenged it. The Civil Rights and Feminist movements challenged the paternalistic notions that most New Dealers held. And as for gay rights, there was no place for any of that the New Deal who’s supporters saw homosexuals as deviants who need to be jailed or cured.

            1. Who’s your dealer? Are your drugs costly?

              1. What the fuck is your problem?

                1. Isaac Bartram
                  “What the fuck is your problem?”

                  I want to be on a drug-induced high …like you!
                  I even pissed my pants laughing that New Dealers have somehow morphed into crazy right-wing assholes who deny marriage equality … which nobody could say, sober.

                  So, again, who’s your dealer, are his prices reasonable .. and if so, how can I contact him (or her) for a buy?

                  P.S. Ever hear of Paul Krugman, the New Dealer who routinely kicks the shit out of fiscal conservatives … who ALLOW him to?

                  1. New Dealers have somehow morphed into crazy right-wing assholes who deny marriage equality … which nobody could say, sober.

                    The fact that you interpreted anything I said that way reinforces my belief that you should be ignored. Your reading comprehension skills have clearly not advanced since you reached the age of about five. In all fairness to you, of course, this is a trait you share with a huge portion of the US population. It is no wonder that civil discourse is so rare.

                    Times change, Mikey. In 1964 Bill Moyers (the most self righteous prick who ever infested American politics) tried to use the fact that couple of staffers in the Goldwater campaign were homosexuals as dirt for the LBJ team. Forty years later he said he was sorry, but the fact remains that during the time that the “New Deal consensus” held (roughly the 40s thru the 60s) the vast majority of Americans believed “saw homosexuals as deviants who need to be jailed or cured.” Hence also did the New Dealers.

                    If you can quote accurately anything I said and dispute it in good faith, I will engage with you. Otherwise, you can go fuck yourself.

                    1. This is how thugs react when called out as bullshitters. (lol)

                      Issac Bertram
                      Your reading comprehension skills have clearly not advanced since you reached the age of about five.

                      That’s like the Donald bragging about the size of his hands …. while making an even bigger fool of himself.

                      If you can quote accurately anything I said and dispute it in good faith

                      (snort) Since you asked. Let’s compare your original bullshit with your FAILURE to support it.

                      Bend over. This will go up your ass easier!
                      ORIGINAL, which I DID quote accurately: “”New Dealers have somehow morphed into crazy right-wing assholes who deny marriage equality”

                      “Morphed into” Hold that thought (lol)

                      In 1964 Bill Moyers (the most self righteous prick who ever infested American politics) tried to use the fact that couple of staffers in the Goldwater campaign were homsexuals as dirt for the LBJ team. Forty years later he said he was sorry,

                      NOW YOU SAY HE MORPHED OUT OF!!
                      And he’s ONE PERSON (but a fucking librul).
                      GOLDWATER WAS THE FIRST TO DEFEND GAYS (and Reagan)
                      Then you double down on the SAME fuckup!!!
                      Continued

                    2. Part two

                      but the fact remains that during the time that the “New Deal consensus” held (roughly the 40s thru the 60s) the vast majority of Americans believed “saw homosexuals as deviants who need to be jailed or cured.” Hence also did the New Dealers.

                      1) The “majority” morphed OUT OF homophobia!!!!!
                      2) HOW DID NEW DEALERS ELECT EISENHOWER AND KENNEDY?
                      3) HOW DID NEW DEALERS BECOME CONSERVATIVES?
                      (Full of shit that the vast majority felt that way… OR equated with New Dealers ? so”hence” is a wacky but self-serving non sequitur.)

                      And, regarding your bullshit about the New Deal being dead, you IGNORED this.

                      P.S. Ever hear of Paul Krugman, the New Dealer who routinely kicks the shit out of fiscal conservatives … who ALLOW him to?

                      Coward

                      … I will engage with you.

                      Don’t bother. since you’ve made a TOTAL public ass of yourself. And it already feels like I’m kicking a cripple.

                      Mikey

                      (sneer)

                    3. WTF

                      “ORIGINAL, which I DID quote accurately: ”

                      Where did I say, “New Dealers have somehow morphed into crazy right-wing assholes who deny marriage equality”?

                      Seriously, you should stay on your meds.

                    4. Furthermore, absolutely nothing you have written is in any way a reasonable response to anything I wrote anywhere so beyond my response above I have nothing to say to you again ever.

                      Since you seem unwilling to quote accurately anything I said and dispute it in good faith, I will not engage with you again.

                      You can go fuck yourself.

                    5. Bend over AGAIN … jammed up your ass again.
                      .
                      WHEN DID NEW DEALERS OPPOSE GAY RIGHTS … AND WANTING TO JAIL THEM AS SEXUAL DEVIANTS? WHEN DID NEW DEALERS ACT LIKE RIGHTWING FASCISTS? (vomit)

                      Where did I say, “New Dealers have somehow morphed into crazy right-wing assholes who deny marriage equality”?

                      That was MY phrasing, dipwad, as I said..
                      Here’s YOUR shameful bullshit: With the link, chump.

                      https://reason.com/archives/201…..nt_6974466
                      “And as for gay rights, there was no place for any of that the New Deal who’s supporters saw homosexuals as deviants who need to be jailed or cured.

                      TOTALLY psycho bullshit
                      Roy Moore — who just won the Alabama GOP Primary for the US Senate is … wait for it … a NEW DEALER!!! (OMFG)

                      And, regarding your bullshit about the New Deal being dead, you IGNORED this.

                      P.S. Ever hear of Paul Krugman, the New Dealer who routinely kicks the shit out of fiscal conservatives … who ALLOW him to?

                      Coward

                      HOW DID NEW DEALERS ELECT EISENHOWER AND KENNEDY?
                      HOW DID NEW DEALERS BECOME CONSERVATIVES?

                      STILL WAITING FOR YOUR SOURCES, BELLOWING BLOWHARD

                      (I CANNOT be bullied, punk.)

    2. It’s the same math screwup that progressives use to “prove” middle-class oppression — caused by the slow loss of higher-wage jobs. This reduces both the average and mean income.

      Do the math. If only one worker replaces an $80,000 job with a $40,000 job, then average wages decline and the rich have a higher share of what’s left ,…. even if nobody else has any change at all. In other words, hysteria.

      We may need 20-30 decimal places to see it, but the math is junior high. Simple.

  15. (yawn)
    Yet another anti-gubmint rant at Reason that misses the entire point!
    The higher insurance premiums are tax-free income. Change that and the rest is easy.
    Anything else?

    1. So, add another layer of regulation to tax benefits as income and increase the tax burden? Brilliant! There couldn’t possibly be any downside to that!

      1. WTF? I published one (of many) versions a mere 23 years ago.

        Treat employer-paid insurance as taxable income. But increase the Personal Exemption on federal tax returns by the average cost of these benefits; plus an equivalent change in FICA taxes. That’s a tax cut for the uninsured, paid for by taxing excessive benefits, all revenue-neutral to the federal treasury. Neat, eh?

        Insurance premiums would become a payroll deduction. Take-home pay and taxable income would remain the same, if you have average benefits. You’d own the insurance. You could stay with an employer-based plan, or select from dozens of new choices not permitted in today’s over-regulated market. Any savings would be pocketed by you, in after-tax dollars. We’d repeal the current discrimination caused by employer-based insurance.

        Employer-basing discriminates against the majority of workers in small-medium businesses. Large employers sponsor a wide variety of choices. And most federal employees select from a dozen or more different plans. But the total number of market choices is useless to small business.

        The concept dates to the 70s, among Pro-Liberty Libertarians — who I’ve shown are MUCH smarter than the Anti-Gubmint Gomers (and today’s libertarian establishment)

        And it solves PART of the wage issue. (High-wage jobs were fucked in the 1986 “tax reform”)
        Anything else?

    2. So, add another layer of regulation to tax benefits as income and increase the tax burden? Brilliant! There couldn’t possibly be any downside to that!

      1. WTF? I published one (of many) versions a mere 23 years ago.

        Treat employer-paid insurance as taxable income. But increase the Personal Exemption on federal tax returns by the average cost of these benefits; plus an equivalent change in FICA taxes. That’s a tax cut for the uninsured, paid for by taxing excessive benefits, all revenue-neutral to the federal treasury. Neat, eh?

        Insurance premiums would become a payroll deduction. Take-home pay and taxable income would remain the same, if you have average benefits. You’d own the insurance. You could stay with an employer-based plan, or select from dozens of new choices not permitted in today’s over-regulated market. Any savings would be pocketed by you, in after-tax dollars. We’d repeal the current discrimination caused by employer-based insurance.

        Employer-basing discriminates against the majority of workers in small-medium businesses. Large employers sponsor a wide variety of choices. And most federal employees select from a dozen or more different plans. But the total number of market choices is useless to small business.

        The concept dates to the 70s, among Pro-Liberty Libertarians — who I’ve shown are MUCH smarter than the Anti-Gubmint Gomers (and today’s libertarian establishment)

        And it solves PART of the wage issue. (High-wage jobs were fucked in the 1986 “tax reform”)
        Anything else?

    3. So, add another layer of regulation to tax benefits as income and increase the tax burden? Brilliant! There couldn’t possibly be any downside to that!

      1. WTF? I published one (of many) versions a mere 23 years ago.

        Treat employer-paid insurance as taxable income. But increase the Personal Exemption on federal tax returns by the average cost of these benefits; plus an equivalent change in FICA taxes. That’s a tax cut for the uninsured, paid for by taxing excessive benefits, all revenue-neutral to the federal treasury. Neat, eh?

        Insurance premiums would become a payroll deduction. Take-home pay and taxable income would remain the same, if you have average benefits. You’d own the insurance. You could stay with an employer-based plan, or select from dozens of new choices not permitted in today’s over-regulated market. Any savings would be pocketed by you, in after-tax dollars. We’d repeal the current discrimination caused by employer-based insurance.

        Employer-basing discriminates against the majority of workers in small-medium businesses. Large employers sponsor a wide variety of choices. And most federal employees select from a dozen or more different plans. But the total number of market choices is useless to small business.

        The concept dates to the 70s, among Pro-Liberty Libertarians — who I’ve shown are MUCH smarter than the Anti-Gubmint Gomers (and today’s libertarian establishment)

        And it solves PART of the wage issue. (High-wage jobs were fucked in the 1986 “tax reform”)
        Anything else?

        1. Thanks, Michael. I believe we had several transition proposals, before Ron Paul destroyed the movement with his anti-government hatred. It now looks too late to restore a genuine love of liberty, which once saw us fighting and scrapping to advance individual liberty, by even one millimeter, if that was all we could get at any given time,

  16. How about California pass a law prohibiting the importing of products made by people paid less than their state minimum wage and see what happens…

    1. Do you get paid well for such blatant trolling?
      Or did you post that under the wrong article?

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