US politics 2

[Ser Greguh]

That is correct. They provide a good or service that is demanded and valued highly by the public. The violence is a result of violence first used against them to prevent the legal practice of their trade. Violent drug dealers are a condemnation of government on behalf of the market, not vice-versa.

First two sentences are an A+. Third and fourth sentences are an F. Drug dealers are violent because the legal prohibition of their practice relegates them to a black market where violence is the only method of resolving disputes; they are a case study of how the free market truly works when left on its own outside of the rule of law. This is a good argument for drug legalization, but certainly doesn't translate to their presence being a net positive in an environment where their trade is prohibited.

[Arthmail]

That is not true. Other options are that medical professionals can choose to offer a certain amount of free treatment on their own, or voluntary charitable organizations can do that as well.

That is not an option, that is a hope and a prayer. You go from a country that has the money to afford health care for everyone, if it would cut back on entitlements for the rich and take a razor to its retardidly over inflated military budget, to one that relies on medical ships from other countries to cure children of cleft lips and other maladies. Besides, there are organizations that offer free services for the poor, but there are not enough of them, and they are overwhlemed at the cities that they show up. It is a disgrace that a first wolrd country has to even consider the option.

[Brienne the Beauty]

That is not true. Other options are that medical professionals can choose to offer a certain amount of free treatment on their own, or voluntary charitable organizations can do that as well.

Or benevolent aliens could land and cure all disease. Or the Second Coming could heal everyone miraculously.

Charity is insufficient to supply all healthcare needs. The US spends about 2.5 trillion annually on healthcare, and donates a total of about 300 billion to charity (not just health charities.)

[Former Lord of Winterfell]

Or benevolent aliens could land and cure all disease. Or the Second Coming could heal everyone miraculously.

Except doctors who treat patients for free do exist, and charity hospitals do exist as well. If you're going to represent the "right-wing" position, then the proper way to do it would be so say they place too much reliance on charity, not to pretend that option doesn't even exists in the first place.

Charity is insufficient to supply all healthcare needs. The US spends about 2.5 trillion annually on healthcare, and donates a total of about 300 billion to charity (not just health charities.)

That actually makes my head hurt.

First, charity need not supply all healthcare needs because the vast majority (yes, it's true) of people already have coverage, and therefore don't need charity. So, charities need only cover that percentage of people who were uncovered. So, comparing total healthcare spending to total charitable spending is nonsensical.

Second, since you subscribe to the belief that the market system of health care is overpriced, then a "single-payer" charity should make much more efficient health care decisions than a for-profit entity, and those charitable dollars would go much further than private health care dollars.

[Tempra]

Why not? What consequences pressure a typical government agency to be more efficient? It's budget is determined by congress, which means that (within limits) the fewer people served by the agency reduce it's costs but don't affect it's budget. So there's no pressure on a government agency other than to deliver the bare minimum that will allow it's directors to get next years budget approved by congress.

But there's a correlarly problem here: government agencies, by their nature, have less pressure to deliver efficiently on the services that they provide, meaning that we pay more for those services through taxes than we would if the market was providing those services and we were consuming them. If your position is that that's necessary because rich people should be subsidizing poor people, I can understand your perspective although I'm dubious.

One notable exception is legal services. Attorneys in private practice have every incentive to be as inefficient as their client will tolerate. Attorneys for the government, however, have every incentive to be as efficient as possible because 1) we do not get paid by the hour at exorbitant rates, 2) we are generally understaffed, and 3) we have legal obligations to provide timely, competent legal services.

[lupis42]

Well, this is the part that drives libertarians nuts: in most cases, you can't really gauge these things objectively, certainly not at a level of pure dollars. How do you grade the productivity of the military, for example? How do we grade the productivity of the educational system? How do we grade the productivity of a police force? On what scale do you gauge, say, the necessity of a fire department? Does it change after a single fluke year where you have minimal or no fires in a city? These are philosophical, not fiscal, questions, and what they provide can't often be measured in simple financial terms.

It's a maddeningly difficult question, but reducing them to a scale that people can understand ($) doesn't do anything to help their real productivity, and often hinders it. To give an example, a police force under pressure to turn a profit (or at least, cost less) will inevitably turn to things like traffic tickets and parking fines in favor of real policework. They might make more money, but become far less effective at achieving their mandate in the process. So they succeed by the libertarian model but fail by any reasonable model.

You misunderstand the libertarian model - if an agency isn't engaging in voluntary transactions, their making money is not a good thing.

To the more general point, the fact that evaluating the performance of a government agency is difficult does not obviate the need to do it. I agree that some of them (fire, police, military) are extremely difficult or impossible to measure the efficiency on, because the results are so dependent on external variables, and that it's ludicrous to judge the army in terms of #invasions prevented/$spent in 2011 vs 2010, etc. But are you going to tell me that it's impossible to determine whether our level of military spending is too high, too low, or about right? If not, than how would you propose to look at it?

These sorts of reforms are in no way cyclical; they require activism and intervention from authorities. The allowance of labor to unionize, for example (another huge pet peeve of libertarians), was all that allowed working conditions to improve in the US; the government had to step in and allow for a system to mitigate a company's greed, because a company's greed sure as hell is never going to mitigate itself. If the choice for the worker is between working in a sweatshop and starving on the street, then sure, the sweatshop improves things (marginally), but that is a false choice.

That choice is not false for the millions of people working in sweatshops in those countries now.

Also, I think you're confusing libertarians for Republicans, because libertarians don't generally oppose private unions - they oppose public worker unions because the taxpayers are the ones paying the cost, but the taxpayers aren't doing the negotiating.

As to the US history, yes - our government did step in. But even if they hadn't, market forces would have had the same effect, and it is happening right now in a number of Asian countries.

It's very simple, it's a function of supply and demand - as long as the supply of people who would rather work in a sweatshop than continue subsistence farming is higher than demand, wages stay low. As demand rises, wages start rising. As long as the company in question wants to keep making more widgets, they have to pay higher wages. The greed of the employees balances the greed of the company.

It's the difference in accountability. A government official is accountable (either directly or in a removed fashion via appointment) to an elected official, who is then accountable to the public at large. Theoretically, at least, people won't vote for people who keep people in power who abuse them, and so they do have a form of power (however imperfect) for reform. They have no say when it comes to such power in non-governmental forms.

On the contrary, they have the power of the purse - which is often more directly effective.

[Brienne the Beauty]

That actually makes my head hurt.

I can imagine.

First, charity need not supply all healthcare needs because more people have coverage. It need only cover that percentage of people who were unconvered. So, comparing total healthcare spending to total charitable spending is nonsensical.

OK. 16% of Americans are uninsured. That means you'd need 400 billion to insure them all, which is more than the total amount of all charity donated in the USA.

And if you were to get rid of medicare and medicaid, you'd also find another 26% uninsured, for which the charitable folks of America would have to find another 600 billion or so.

In total, the USA would have to more than triple its charitable giving, and stop giving any charity to anything else. They'd have to shut all the churches, for a start, because donations to a church are charity.

These are all ballpark figures, but you get my drift.

Second, since you subscribe to the belief that the market system of health care is overpriced, then a "single-payer" charity should make much more efficient health care decisions than a for-profit entity, and those charitable dollars would go much further than private health care dollars.

Why would charitable health care be single payer? Are you just going to have one huge charity in the whole country? The whole point of charities is that they are diverse.

[Just a peasant]

An American former Marine translator of Iranian ancestry has been sentenced to die in Iran for spying.

Another pawn moved in that chess game.

[Former Lord of Winterfell]

Why would charitable health care be single payer? Are you just going to have one huge charity in the whole country? The whole point of charities is that they are diverse.

Er, what? The patients aren't paying. There are no insurers. There is simply a charity providing health care, whether it is a hospital, free clinic, whatever. How is that not single payer with respect to the patients they are treating?

[Former Lord of Winterfell]

An American former Marine translator of Iranian ancestry has been sentenced to die in Iran for spying.

Another pawn moved in that chess game.

This looks to be b.s. But FFS, going into Iran with his background wasn't exactly the smartest move in the world.

[Shryke]

The health insurance the US government provides looks very efficient if you completely ignore the cost of billing the consumer. The government can do that because the IRS is a different agency, but no private company could. Also, medicare doesn't have to employ a large number of expensive lawyers to make sure it's in regulatory compliance. If you factor those in, it won't look nearly so rosy for public insurers.

Doesn't it? Based on what numbers?

And really, this doesn't matter because you haven't negated the point, just given one of the reasons WHY the government is more efficient at the job.

I mean, in general it doesn't matter where you look, inside the US or elsewhere, the government having a large role in health care brings costs down.

That's not to say that government health insurance couldn't be run well - Singapore is an excellent example - but it would require the government care advocates to accept that money should be allowed to buy better care, and it would require the privatization advocates to accept a role for government in the business.

Yes and? Money buys better care in most government run systems too. Or, rather, it buys extra care on top of what the normal system already provides. And I don't see why I should give a shit what the privatization advocates have to accept.

What I would like to see is a massive reduction in the role of insurance in the first place - it would involve a role for the government, and possibly some regulation, but if hospitals/doctors/etc. were required to publish their prices, and charge everyone the same price, I doubt it would take very long before competition started forcing prices down - as it has in all the medical areas where treatment is voluntary, not covered by insurance, such as plastic surgery. In addition, if you stop tax subsizing health insurance, it becomes much more pratical for indibiduals to purchase "emergency only" coverage, and use a health savings account or similar for predictable routine costs.

Health savings accounts don't help with dick for people who can't afford care in the first place. "Emergency only" coverage is also a problem since it ignores long-term care costs that are a large part of health coverage.

The rest of your suggestion is much like the Swiss system, which many people were suggesting back during the health care reform stuff a few years back. But that itself involves government setting the price of certain treatments, not just forcing their prices to be advertised afaik.

Health care is a market that inherently does not work on it's own. Even with prices advertised, there's simply too many issues with time constraints and lack of expertise for any sort of free market effects to function.

[Brienne the Beauty]

Er, what? The patients aren't paying. There are no insurers. There is simply a charity providing health care, whether it is a hospital, free clinic, whatever. How is that not single payer with respect to the patients they are treating?

This argument is nonsense, and a distraction from my real point which you are clearly trying not to think about.

Do you really think that the American people are likely to more than triple their charitable giving if all government health care was removed? Would you?

[Shryke]

One notable exception is legal services. Attorneys in private practice have every incentive to be as inefficient as their client will tolerate. Attorneys for the government, however, have every incentive to be as efficient as possible because 1) we do not get paid by the hour at exorbitant rates, 2) we are generally understaffed, and 3) we have legal obligations to provide timely, competent legal services.

The current billable hours scheme in alot of private law is a hilarous example of market failure. The only people who benefit are the top partners at law firms. Apparently it's only since the late 80s too that it's come around.

[Shryke]

Except doctors who treat patients for free do exist, and charity hospitals do exist as well. If you're going to represent the "right-wing" position, then the proper way to do it would be so say they place too much reliance on charity, not to pretend that option doesn't even exists in the first place.

He's not pretending it doesn't exist, he's pointing out that unless charity is 100% guaranteed to cover everyone who's not covered already, it won't be enough.

And there's little to indicate charity can fill that gap.

[Shryke]

He's a million times better than your current options. The only objection I have is that he signed anti-abortion legislation that was clearly against legal precedent, which is just kind of waste of time, but I imagine he was having a hard enough time dealing with the rabid-right Congress he's been stuck with since the 2010 mid-term elections. Funny, it kind of seems like he was doing a lot better with a Democractic state legislature.

So, it's pretty clear now that Gingrich only cares about winning to the next extent that it'll allow him to screw with Romney, but who on earth with Gingrich really throw his support to? Santorum? Really? IMO, Gingrich and Paul have overlapping voters as do Perry and Santorum, and so for my money, it's over for everyone but Romney moving forward.

Gingrich won't throw his support to Romney. He's just pissed off cause of Romney's attacks now so he's in it out of spite now.

Of course, the reality is Romney pretty much has this sewn up. Santorum isn't polling well enough and neither he nor anyone else has the funds to really compete.

[Brienne the Beauty]

He's not pretending it doesn't exist, he's pointing out that unless charity is 100% guaranteed to cover everyone who's not covered already, it won't be enough.

The right like to think it will, because if not they'd have to admit to themselves that either the state pays, or the people who fall through the cracks suffer/die. I just looked it up and even Ron Paul is for the cop-out of "charity."

Kind-hearted Republicans believe that somehow there will be a miracle of generosity and somehow no-one will be forced to go without needed treatment. Unfortunately, they are lying to themselves to salve their consciences. They provide no justification as to where this charity will come from, and just assume optimistically that it will work out somehow. Cheery optimism is good for the soul, but running a country takes more hard facts.

[Ser Greguh]

You misunderstand the libertarian model - if an agency isn't engaging in voluntary transactions, their making money is not a good thing.

Oh FFS, okay, so instead of telling them to focus on traffic tickets you tell them to focus their efforts on a bake sale. There. Voluntary transaction, making money. The point is that their mandate (crime prevention) provides a societal benefit that is essentially impossible to measure in strict monetary terms. By redefining that mandate to artificially stamp a dollar value on it, you reduce their overall societal value while being utterly consistent with libertarian notions of productivity.

The same argument applies directly to health care. The most profitable system is far from the best system for overall public good.

To the more general point, the fact that evaluating the performance of a government agency is difficult does not obviate the need to do it. I agree that some of them (fire, police, military) are extremely difficult or impossible to measure the efficiency on, because the results are so dependent on external variables, and that it's ludicrous to judge the army in terms of #invasions prevented/$spent in 2011 vs 2010, etc. But are you going to tell me that it's impossible to determine whether our level of military spending is too high, too low, or about right? If not, than how would you propose to look at it?

Of course it's impossible to determine these things on an absolutionist scale; "too high, too low, or about right" are intentionally vague concepts that are left open to interpretation as to what the mandate of the military truly is. That doesn't mean that you can't make reasonable subjective judgments as to these things, but that such judgments involve more than the bean-counting.

That choice is not false for the millions of people working in sweatshops in those countries now.

Only because the authorities in those countries don't step in and provide a more reasonable option. On a human scale it's a false dichotomy.

The greed of the employees balances the greed of the company.

Only in your ludicrously oversimplified microeconomic model. The primary problem with your model is that it assumes full linearity and ignores the inertia of the system, which employers become very expert at manipulating. In a real world environment the employer greed is weighted much higher, because they have much greater overall leverage.

On the contrary, they have the power of the purse - which is often more directly effective.

Heh. When was the last time you actually heard of a boycott having an actual, measurable effect? If the free market has shown anything it has shown that it has no measurable morality; people don't care how many people Wal-Mart crushes with its unassailable market leverage so long as it means twenty cents less on a box of cheesy poofs, they don't care how much poison gets dumped into the lakes if it means lower electricity prices. They will however vote for people that they feel is best qualified to look out for society as a whole. The only way to impose morality (for the public good) onto a corporation is to enact it from legislation and regulation, and for that you need public representatives that reflect the greater good. The whole libertarian notion of "voting with your wallet" is pure fantasy.

[Tormund Ukrainesbane]

I just looked it up and even Ron Paul is for the cop-out of "charity."

Ron Paul provided free healthcare for the poor during his time as a physician. I'm not sure that counts as a "cop-out".

[Ser Greguh]

Ron Paul provided free healthcare for the poor during his time as a physician. I'm not sure that counts as a "cop-out".

For the whole country? Busy guy.

[Former Lord of Winterfell]

This argument is nonsense, and a distraction from my real point which you are clearly trying not to think about.

I don't know what your "real point" is. I just know what you actually wrote, which was this:

Ultimately, if the poor cannot afford medical care, either the country can pay for their care, or they can be left to suffer/die. Most right-wingers reject both options, which is illogical.

You were playing a logic game. You are attacking "right-wingers" as being illogical for rejecting the only two options you give them, while ignoring that they perceive there to be a third option. You may not agree that is a workable third option, but it is false to claim those are the only two options they see, and therefore are illogical for not choosing one of the two you give them.

Do you really think that the American people are likely to more than triple their charitable giving if all government health care was removed? Would you?

No. I also don't believe that would be remotely necessary, but I'm growing tired of having to deconstruct everything you say to dig down through all the assumptions built into your point. But I'll do it for a bit one last time.

I have said here, repeatedly, that I believe the U.S. health care system is expensive because most Americans demand fast, easy access to first class, cutting edge health carem, and I think we tend to overuse a lot of those more expensive assets. I also believe that "pretty good" quality health care is available for much less. Essentially, only generic drugs, devices out of patent, etc. And morally, I have no problem with a "two-tiered" health system, where people who can afford it get that first-class care they want, and those who can't get a lesser level of care that is still significantly better than nothing. There is no earthly reason that basic health care needs to be that expensive.

So, based on my support/recognition of two-tiered health care, I believe extrapolating current costs on a per patient basis to the uninsured is not mathematically valid.

You want really good health care, you have to pay for it. Otherwise, you're going to get something less.