Democrat Strategy vs. Trump

[Baruch]

Reasonist ... Well I know you pretty well, that in the Common Interest ... along with Shiranu you would side with dictatorship of the virtuous (includes you and Shiranu virtue signaling each other like Shea L).  Can't have the dictatorship of the anti-virtuous, right?  It is a black/white open/shut case in your favor.  I keep confusing you with Unbeliever ... but you live in Austria, if I recall correctly, or hale from there.

[reasonist]

Reasonist ... Well I know you pretty well, that in the Common Interest ... along with Shiranu you would side with dictatorship of the virtuous (includes you and Shiranu virtue signaling each other like Shea L).  Can't have the dictatorship of the anti-virtuous, right?  It is a black/white open/shut case in your favor.  I keep confusing you with Unbeliever ... but you live in Austria, if I recall correctly, or hale from there.

I live in Canada for 36 years, originally from Austria.
Why does it have to be a dictatorship? You saying that France or Italy or Germany is a dictatorship? Why not copy what works everywhere else??? Is your mandatory car insurance dictatorship? If you don't have house insurance, it's your problem when it burns to the ground. If you have a heart attack and need emergency care, it's everybody's problem if you don't have coverage. Or maybe you get turned away and you die in a gully a slow death. That would be a choice too.
I know you well too, Baruch, and sometimes I question your logic. Especially when you claim that the US is different than any other country when it comes to health care for example. The only difference is greed and profiteering on the backs of the sick.
There should be only one overriding principle in every politicians decision making: What is best for the people!

[PopeyesPappy]

Alright, I'll try this one more time. Greed and profiteering are only part of the problem. A small part of the problem. Eliminating greed and profiteering completely, probably an impossible goal given human nature, wouldn't get us close to what most other countries spend on healthcare by itself. There are other issues contributing to cost, and they all need to be addressed. The black money hole that is our healthcare system took generations to dig. I doubt if it can be filled in overnight. Attempts to do so are more likely to end in disaster than success. We need to analyze the problem, come up with real solutions that don't include magic, i.e. simply declaring we are going to have a single payer system, and implement them over time. That will take years if not generations to do without running the risk of fucking everything up even worse than it is now.

According to the article I just read America spent $3.35 trillion on healthcare in 2016. According to them that's $10,335 per person. That's $3.35 trillion divided by everybody so it includes a bunch of people that needed reasonable healthcare, but didn't get it because they couldn't afford it. If they had gotten care the bottom line would have been larger. The article also said we could expect a 4.8% inflation rate for healthcare. Tie that to a 0.7% population growth rate and by 2050 we are looking at $20.9 trillion total and $50,886 each per year not including the percentage of people that don't get healthcare today. That is unsustainable so I guess we'd be safe calling it unreasonable.

So how do you determine what it would take to provide reasonable care for people? A large percentage of the cost is driven by care for old and dying people. A few years back we lost my 95 year old uncle. The bill for his healthcare the last for weeks of his life was probably more than the cost for the previous 95 years. Is that reasonable? Do we just tell our parents and grand parents sorry we can't afford you so just go home and die?

Do we just set an arbitrary number? Do we just say healthcare in Germany costs half of what it does here so we are going to set medicare taxes to raise $1.675 trillion (a huge fucking increase) and call it good? The revenue target might be reasonable, but I don't know if many of our healthcare providers could survive if we cut their revenues in half. I was at the smaller of our two local hospitals last Friday. While there I walked through the doctor's parking area. I was surprised by the large percentage of old Buicks and worn old Toyotas I saw. Our doctors and hospitals have to carry huge amounts of liability insurance to protect them. Many of the doctors graduate college with a medical degree and hundreds of thousands of dollars worth of debt that most doctors in Germany don't have. How do we insure they make enough revenue to survive? Many healthcare providers, especially the young ones don't make so much money that they can afford to see their income cut in half. How do we protect them?

It's a complex problem. There is no easy way to implement a sustainable single payer system in the US without putting the health of our healthcare system at risk. It can be done, but it is going to require some fundamental changes in other areas such as education and tort reform. Changes like that take time and careful planning. I have my doubts whether or not our elected government is up to task even if they had the will.

[Baruch]

Reasonist - What is best for the people?  Move to Canada .. unfortunately we are sending you all of our Mexicans, and you are tossing them back, as too immature to catch and fry (fish).  Canada and the US are not alike, except superficially.  And no, Canada isn't an explicit dictatorship yet.  But all modern countries, including the US, are totalitarian since the middle of the 20th century.  You might not be aware of it .. because the symptoms happen to be things you favor.

Pops - People do magical thinking.  They don't reason, even the reasonable people don't, they rationalize their emotional sourced clap trap.  And then deny what they are doing, because their ego might get hurt.  And yes, legislation is always like working on a car, while it is moving down the highway.  The current situation is the result of 200+ years of accidents and road rage.  Think Road Warrior, but with nicer clothes.

[SGOS]

It's a complex problem. There is no easy way to implement a sustainable single payer system in the US without putting the health of our healthcare system at risk. It can be done, but it is going to require some fundamental changes in other areas such as education and tort reform. Changes like that take time and careful planning. I have my doubts whether or not our elected government is up to task even if they had the will.

Indeed, it's a complex issue with many factors involved.  There may be some that say a single payer insurance will solve all the problems, but I'm guessing most people realize there is more than that.  Obviously, we aren't going to address all the problems at once, and come up with a finalized plan with all the problems solved, but we should take steps, accept the fumbles and move forward. 

Our current political structure centers around congress doing something (albeit not very often), almost always in a partisan way, which will certainly not be perfect, and allowing the other side to do an "I told you so," and criticize.  Fixing the fumble is practically never the action taken.  The opposing side just points at it, and campaigns for the next election.  This helps preserve the status quo, a dynamic built into a corrupted self serving legislative body, without the good of the country as its primary goal.

Considering at how well we do this (doing nothing), the first danger of single payer I see would be passing it and then not taking additional steps.  Medical costs will go up since insuring everyone will drive up demand.  That's the human nature you referred to.  Doctors, hospitals, lawyers are going to want a bigger piece of the action.  I'm not sure how other countries deal with this.  God forbid we should actually go and ask them and get some advice and caution from our inferiors.  I don't mean they are losers, but that seems to be the typical egotistical American position.  We can't do it their way.  Heaven forbid!  Unfortunately the argument often ends there.  Not necessarily with that specific example of course.  What I'm saying is that arguments for preserving the status quo, a failing one at that, are often red herrings, and we need to evaluate those in ways not involving partisan ideologies.

I don't think we should throw out single payer, or even the ACA, on the grounds that we will fumble and make mistakes, but it's getting kind of late in the game, and we should be taking actions, one issue at a time, but lets not wait around until someone comes up with a perfect plan that correctly anticipates all possible problems.  And yes, I expect some people will have to make concessions and sacrifices, although much of it would be the fake sacrifice of letting go of a some utopian ideology that wasn't all that hot of an idea in the real world to begin with.

[reasonist]

Your numbers are correct. That proves my point though. Every other country can do more for half the cost. If the US would spend as much or as little as other countries, it would save 1.4 trillion! And again, there should be coverage provided by the government for everybody! Private insurers can be competing with the government, but they won't be competitive because as a corporation your one and only goal is to provide profits to shareholders.
Our doctors drive fancy cars, I know for a fact. GPs with a private office get $ 75 per visit and in the case like my own, he/she can see 40 patients a day easily and mine does. You do the math for the year. Yes, a receptionist and the office with waiting room and 4 small rooms for consultation cost money. But there are no poor doctors in the land. Hospital doctors make even more but also are under more stress.
And it should be treated the same as car insurance. Government first, then private insurers to compete. That is the only healthy environment for consumers. Adjust premiums to the brake even point, no profits, no losses. If private companies can compete, they will get business. If not, they are done. Doctors in return will sign up with whoever pays them more, government or corporations.
Yes, the elderly cost more money than the young. But that's why it's called 'insurance'. I pay fire insurance for my house all my life but never used it. So I pay for somebody else. If I don't have children, I shouldn't have to pay for the education of other people's children. If I don't drive a car, I shouldn't have to pay for roads, etc etc. same principle.

[Baruch]

The US can do more ... if we redirect savings from DoD to HHS.  Then the government can pay more of the bill.  And we can force payment for certain prices (as they do in Canada but not in the US).  But we won't do that.

The Athenian democracy didn't work very well, nor did the Roman republic.  Both were hell on their opponents, particularly the Roman Mafia.  The Athenians (and Spartans) were too busy banging each other (the guys were).  Greeks prefer sex to violence, Romans prefer violence to sex.

[reasonist]

The US can do more ... if we redirect savings from DoD to HHS.  Then the government can pay more of the bill.  And we can force payment for certain prices (as they do in Canada but not in the US).  But we won't do that.

Couldn't agree more. But why won't the US do that?

http://www.cnn.com/videos/politics/2017/03/26/sotu-sanders-to-introduce-medicare-for-all-bill.cnn

[PopeyesPappy]

Your numbers are correct. That proves my point though. Every other country can do more for half the cost. If the US would spend as much or as little as other countries, it would save 1.4 trillion! And again, there should be coverage provided by the government for everybody! Private insurers can be competing with the government, but they won't be competitive because as a corporation your one and only goal is to provide profits to shareholders.
Our doctors drive fancy cars, I know for a fact. GPs with a private office get $ 75 per visit and in the case like my own, he/she can see 40 patients a day easily and mine does. You do the math for the year. Yes, a receptionist and the office with waiting room and 4 small rooms for consultation cost money. But there are no poor doctors in the land. Hospital doctors make even more but also are under more stress.
And it should be treated the same as car insurance. Government first, then private insurers to compete. That is the only healthy environment for consumers. Adjust premiums to the brake even point, no profits, no losses. If private companies can compete, they will get business. If not, they are done. Doctors in return will sign up with whoever pays them more, government or corporations.
Yes, the elderly cost more money than the young. But that's why it's called 'insurance'. I pay fire insurance for my house all my life but never used it. So I pay for somebody else. If I don't have children, I shouldn't have to pay for the education of other people's children. If I don't drive a car, I shouldn't have to pay for roads, etc etc. same principle.

It doesn't prove your point at all because you don't have a solution for getting US prices on par with other countries. Cutting profits doesn't get us there. Throwing 100% of our defense budget on top of getting rid of profits doesn't get us there.

If I don't have children, I shouldn't have to pay for the education of other people's children. If I don't drive a car, I shouldn't have to pay for roads, etc etc. same principle.

I don't know if you meant this like you wrote it or not, but I disagree with it the way it is written. Educating the next generations is everybody problem due to the problems that arise from not doing so. And unless you live off the grid in a sod house you cut from the earth with stone tools you fashioned yourself and grow all your own food you use the roads to get things you need even if you never leave the house.

[reasonist]

It doesn't prove your point at all because you don't have a solution for getting US prices on par with other countries. Cutting profits doesn't get us there. Throwing 100% of our defense budget on top of getting rid of profits doesn't get us there.

The answer to your point lays in all the other industrialized countries that have universal healthcare. One would think it would be prudent to copy what's successful everywhere else. But obviously that's too obvious.


As to your other point, I was explaining how insurance is supposed to work. Surely the younger generation has to pay for the older. No guarantee that this younger generation ever sees their 401Ks either and yet they pay in as 'insurance'. One day this younger generation will be the older generation and the next generation will pay for them. That's how the system is supposed to work and it does in all other industrialized countries.
Bernie Sanders explains exactly my sentiment:
https://www.youtube.com/watch?v=TVoC8e6JjbA

[PopeyesPappy]

The answer to your point lays in all the other industrialized countries that have universal healthcare. One would think it would be prudent to copy what's successful everywhere else. But obviously that's too obvious.

You are waving that magic wand I mentioned earlier. We can't simply copy what other countries are doing because that would destroy our economy. We have to reduce costs before implementing anything resembling a single payer system with healthcare available to everyone. The only way the government could implement a single payer system without reducing cost first would be to at least double tax revenue. That would destroy our economy and probably wouldn't be enough to add those who are currently without coverage anyway. We can't simply tell the providers you have to take half of what you get now either. That would cause most of them would go out of business. 10% of our workforce would be out of work, and no one here would have healthcare because there wouldn't be anyone to provide it. Tax revenue would plummet. We'd go into a depression that would make the last one look like a Christmas party and we'd be lucky if the US didn't become a third world shit hole.

I'm not saying that we can't or even shouldn't have a single payer system with healthcare available for everyone. I believe that is the way to go. I'm just trying to get you to understand that any attempt to implement such a system without reducing the costs associated with our healthcare system is doomed to spectacular failure. Simply coping what they do in Canada, the UK, Germany or France isn't going to work.

[Baruch]

Couldn't agree more. But why won't the US do that?

http://www.cnn.com/videos/politics/2017/03/26/sotu-sanders-to-introduce-medicare-for-all-bill.cnn

US =  evil rejects from European slums.  Think Gangs Of New York.  But I am resigned to be proud of my criminality, and that of my fellow citizens.

https://www.youtube.com/watch?v=qHVUPri5tjA

I am not ashamed of my Irish ancestors ... or any other ancestors either.  Early version of D vs R.

[Baruch]

You are waving that magic wand I mentioned earlier. We can't simply copy what other countries are doing because that would destroy our economy. We have to reduce costs before implementing anything resembling a single payer system with healthcare available to everyone. The only way the government could implement a single payer system without reducing cost first would be to at least double tax revenue. That would destroy our economy and probably wouldn't be enough to add those who are currently without coverage anyway. We can't simply tell the providers you have to take half of what you get now either. That would cause most of them would go out of business. 10% of our workforce would be out of work, and no one here would have healthcare because there wouldn't be anyone to provide it. Tax revenue would plummet. We'd go into a depression that would make the last one look like a Christmas party and we'd be lucky if the US didn't become a third world shit hole.

I'm not saying that we can't or even shouldn't have a single payer system with healthcare available for everyone. I believe that is the way to go. I'm just trying to get you to understand that any attempt to implement such a system without reducing the costs associated with our healthcare system is doomed to spectacular failure. Simply coping what they do in Canada, the UK, Germany or France isn't going to work.

Killing off most of the undesirables in war and plague ... reduces the problem considerably.  And yes, people resist being enslaved, unless they are Europeans ;-)  Canada is simply more European than the US.  That isn't a bad thing, just means they are different.  Free trade works fine, if everyone is an impoverished Chinese and we are all using just one currency, the Yuan.  After the war, only the Chinese will be left, so we will get there, just be patient ;-(

[reasonist]

I'm not saying that we can't or even shouldn't have a single payer system with healthcare available for everyone. I believe that is the way to go. I'm just trying to get you to understand that any attempt to implement such a system without reducing the costs associated with our healthcare system is doomed to spectacular failure. Simply coping what they do in Canada, the UK, Germany or France isn't going to work.

Rather sooner than later you won't have a choice. It won't be without major adjustments, but better an end with pain than pain without end. :-)

[Baruch]

Rather sooner than later you won't have a choice. It won't be without major adjustments, but better an end with pain than pain without end. :-)

i am not far from natural termination.  I certainly don't want to live forever always getting older.  Just ask my Mom in the nursing home ;-(  But better than putting her on an ice flow with the other Eskimos.

History requires major adjustments.  Turns out, when you come out of the Matrix, disorientation results.  Followed by reOrientation, Chinese style.  We won't be adjusting to turning into Canada.  Maybe turn into Mexico instead.  Gangs of Juarez.  Depends on what the Tongs/Triads of Beijing want.  The fantasy of the Progressives, and their Manifest Destiny ... laughable if it did't hurt so much.  We don't live in the world we want (good and bad thing) ... such a thing is a denial of empiricism, and a childish wish fulfillment.  Maybe Santa will come down from the N Pole to Canada (first stop along with Russia and Norway and Iceland) and drop off more toys for y'all.

Reality are the slums of London, and Oliver Twist.  You  get your bowl of gruel, and don't ask for more, punk!