U.S. Debt discussion

[Calgaryborn]

Originally Posted by pepper24

What are his/her motives? I am missing what you are getting at? He/she calls you out for not being uninformed and parroting right wing talking points without understanding the repercussions. Sounds like a fair comment that at least I could agree with.

You response is that he/she is some nonsense about "angry muslim". Not sure where that came from. What are your motives?

I guess since you're leaving it at that for now you can dodge another question.

Not so much dodging as not wanting this thread to go off topic. I was commenting on a pattern in this fellow's posting. If you want to look back and see if I'm imagining things or not you can. You can also chose to not look and just conclude what I said was groundless. I'm OK with that as well.

What I'm not going to do is defend my statement by digging up the posts that support it. I don't care enough about whether you or others believe me to do that and again it would be off topic.

My only motivation was to let FlamesFan, Ph.D know I'd noticed.

[Azure]

Please don't derail what has actually been a fairly interesting thread so far.

Thanks.

[Flames Fan, Ph.D.]

re: US debt and healthcare spending

These two elements are intertwined and I think they make for an interesting discussion regarding society and policy.

The big push from the right in the US is to turn healthcare into a free market enterprise. This is embodied in policies such as Paul Ryan's voucher system and other little initiatives like selling insurance across state lines. Both policies are really a means to minimize any governmental healthcare spending without regard for public health. Yet for those who haven't delved into and investigated the proposals, they seem on the surface to be ways for people to "empower" themselves in regards to their health choices. For example, Ryan's voucher system is designed, by definition, to trail the rate of inflation in the healthcare sector, in turn pretending like it can put downward pressure on prices. This is proven wrong by simple history: people in the US are much more likely to not be able to afford healthcare, and they are overwhelmingly constrained by their budgets, yet healthcare inflation in the US has always outpaced simple inflation. So Ryan's plan is really just to limit government spending, period, without regard for healthcare; he'll just give people less and less money over time. Other initiatives like selling across state lines are similar dog whistles that allow the government to offload costs. Since states do not have any baseline requirements for healthcare policies, opening up cross-border policy shopping would simply mean that a healthy person would buy a $5/month policy from some state (probably texas) and this would suck up all the healthy policyholders. Those with congenital chronic diseases would be pooled together (and, in turn, apart from the healthy pool) and be left with insurmountable monthly premiums*. So really, those advocating for such policies are, at their root, advocating for government to completely shed any role in national healthcare in favour of letting the "market economy" handle it. If that's their motive, it's fine; if they advocate it in the sense of improving the system, then they're lose and heavily deluded.

The major problem is that healthcare is not well served by a purely market economy initiative. People do NOT have the power to make appropriate choices, simply because 1) your health needs are too complicated to understand unless you have extensive training (and difficult even then), and 2) the point when you need healthcare is often the time when you're least capable of making rational decisions.

In regards to 1, this refers to the difficulty in determining what is important for coverage. Comprehensive coverage (any and all incidents) would put you into a high risk / chronic treatment pool where your premiums would be insurmountable. So in effect, people will begin to try and check off what they need and what they perceive they don't. But this is where the danger is, and why this type of situation is not one that citizens should want to engage private companies for. If a simple mortgage agreement is as complex as it is, then consider one that pertains to your health coverage and what part is covered and what isn't. How much coverage do you want for kidney failure? Heart failure? Do you want coverage for hypertension? If your heart failure is due to chronic hypertension, and you didn't get coverage for chronic illnesses, will your insurance cover it? How long until a policy maker wants to take a blood sample and see if you're at higher risk for chronic hypertension, and they want to tailor your costs along this risk? Spleen issues? Do you want to cover traumatic brain injury? Stroke? Is your stroke secondary to persistent hypertension that you're not covered for? Basically, none of us can make all of these decisions in an informed manner, which a purely private enterprise would force us to do. In effect, it would result in a system of the rich getting full coverage and the middle class and lower class taking minimal coverage that sends them into bankruptcy at the moment of an urgent medical need.

In regards to 2, people in the low coverage would be forced into choices at the time of their injury / illness that would be impossible to make. If your husband is having a heart attack, are you going to shop for the best hospital while he's on the floor of your living room? What if your policy doesn't cover the ambulance? If you don't have healthcare coverage at all, and all healthcare providers are private, does society let you expire on your living room carpet? Perhaps dramatized, but the point is that, unlike buying a flat screen TV, the moment of choice for healthcare is sudden and highly of consequence.

In short, healthcare is no place for pure market economics, yet the US is in a tug and war between people who want to treat it like buying a TV versus people who want to treat it as an area of profligate spending that shall not be touched. Compounding this point is that the world's healthcare system relies heavily on the US subsidizing the research and costly drug development that is improving healthcare and healthcare delivery. Countries like canada, england and france can keep their costs down in part by telling a company like Pfizer that they can only sell drug X at price Y. These prices will often not allow meaningful cost recovery for the company, meaning that they in turn raise prices in the US system to help subsidize low priced sales in other countries. So to a certain degree, for spending to decrease in the US, spending in countries like Canada needs to increase.


So really the choices to be made in healthcare vs the debt are very complex and are not well captured by left wing and right wing sloganeering. My preference is to begin to implement regional / cooperative initiatives like those in the ACA so that we can begin to figure out what works and what doesn't.



* the best analogy I can think of is an auto insurance market where, once you make a claim, you're moved out of the zero claims pool and into the "those who have made claims" pool. As you continue to segregate low risk and high risk, the low risk pay less and less and the high risk pay more and more.

[Calgaryborn]

Originally Posted by Flames Fan, Ph.D.

re: US debt and healthcare spending

These two elements are intertwined and I think they make for an interesting discussion regarding society and policy.

The big push from the right in the US is to turn healthcare into a free market enterprise. This is embodied in policies such as Paul Ryan's voucher system and other little initiatives like selling insurance across state lines. Both policies are really a means to minimize any governmental healthcare spending without regard for public health. Yet for those who haven't delved into and investigated the proposals, they seem on the surface to be ways for people to "empower" themselves in regards to their health choices. For example, Ryan's voucher system is designed, by definition, to trail the rate of inflation in the healthcare sector, in turn pretending like it can put downward pressure on prices. This is proven wrong by simple history: people in the US are much more likely to not be able to afford healthcare, and they are overwhelmingly constrained by their budgets, yet healthcare inflation in the US has always outpaced simple inflation. So Ryan's plan is really just to limit government spending, period, without regard for healthcare; he'll just give people less and less money over time. Other initiatives like selling across state lines are similar dog whistles that allow the government to offload costs. Since states do not have any baseline requirements for healthcare policies, opening up cross-border policy shopping would simply mean that a healthy person would buy a $5/month policy from some state (probably texas) and this would suck up all the healthy policyholders. Those with congenital chronic diseases would be pooled together (and, in turn, apart from the healthy pool) and be left with insurmountable monthly premiums*. So really, those advocating for such policies are, at their root, advocating for government to completely shed any role in national healthcare in favour of letting the "market economy" handle it. If that's their motive, it's fine; if they advocate it in the sense of improving the system, then they're lose and heavily deluded.

The major problem is that healthcare is not well served by a purely market economy initiative. People do NOT have the power to make appropriate choices, simply because 1) your health needs are too complicated to understand unless you have extensive training (and difficult even then), and 2) the point when you need healthcare is often the time when you're least capable of making rational decisions.

In regards to 1, this refers to the difficulty in determining what is important for coverage. Comprehensive coverage (any and all incidents) would put you into a high risk / chronic treatment pool where your premiums would be insurmountable. So in effect, people will begin to try and check off what they need and what they perceive they don't. But this is where the danger is, and why this type of situation is not one that citizens should want to engage private companies for. If a simple mortgage agreement is as complex as it is, then consider one that pertains to your health coverage and what part is covered and what isn't. How much coverage do you want for kidney failure? Heart failure? Do you want coverage for hypertension? If your heart failure is due to chronic hypertension, and you didn't get coverage for chronic illnesses, will your insurance cover it? How long until a policy maker wants to take a blood sample and see if you're at higher risk for chronic hypertension, and they want to tailor your costs along this risk? Spleen issues? Do you want to cover traumatic brain injury? Stroke? Is your stroke secondary to persistent hypertension that you're not covered for? Basically, none of us can make all of these decisions in an informed manner, which a purely private enterprise would force us to do. In effect, it would result in a system of the rich getting full coverage and the middle class and lower class taking minimal coverage that sends them into bankruptcy at the moment of an urgent medical need.

In regards to 2, people in the low coverage would be forced into choices at the time of their injury / illness that would be impossible to make. If your husband is having a heart attack, are you going to shop for the best hospital while he's on the floor of your living room? What if your policy doesn't cover the ambulance? If you don't have healthcare coverage at all, and all healthcare providers are private, does society let you expire on your living room carpet? Perhaps dramatized, but the point is that, unlike buying a flat screen TV, the moment of choice for healthcare is sudden and highly of consequence.

In short, healthcare is no place for pure market economics, yet the US is in a tug and war between people who want to treat it like buying a TV versus people who want to treat it as an area of profligate spending that shall not be touched. Compounding this point is that the world's healthcare system relies heavily on the US subsidizing the research and costly drug development that is improving healthcare and healthcare delivery. Countries like canada, england and france can keep their costs down in part by telling a company like Pfizer that they can only sell drug X at price Y. These prices will often not allow meaningful cost recovery for the company, meaning that they in turn raise prices in the US system to help subsidize low priced sales in other countries. So to a certain degree, for spending to decrease in the US, spending in countries like Canada needs to increase.


So really the choices to be made in healthcare vs the debt are very complex and are not well captured by left wing and right wing sloganeering. My preference is to begin to implement regional / cooperative initiatives like those in the ACA so that we can begin to figure out what works and what doesn't.



* the best analogy I can think of is an auto insurance market where, once you make a claim, you're moved out of the zero claims pool and into the "those who have made claims" pool. As you continue to segregate low risk and high risk, the low risk pay less and less and the high risk pay more and more.

You might have posted this without left wing slogans but, it certainly betrays a left wing heart. You don't believe that either an individual or a State can make appropriate health care decisions. You believe the Federal government must save Americans from themselves; and all for the low low price of personal freedom and choice.

I like Paul Ryan believe that regulation and choice should be in the hands of the individual and the State. Allowing out of State insurance purchases doesn't mean the State can't predetermine what conditions must be covered.

[SebC]

Originally Posted by Calgaryborn

You might have posted this without left wing slogans but, it certainly betrays a left wing heart. You don't believe that either an individual or a State can make appropriate health care decisions. You believe the Federal government must save Americans from themselves; and all for the low low price of personal freedom and choice.

I like Paul Ryan believe that regulation and choice should be in the hands of the individual and the State. Allowing out of State insurance purchases doesn't mean the State can't predetermine what conditions must be covered.

Of what use is freedom and choice if you're dead/crippled/bedridden and/or bankrupt?

If the federal government wasn't willing to save Americans from themselves, they'd still be using leaded gasoline, DDT and asbestos. There'd be no FAA, EPA, FDA... allowing people to buy crappy/no health insurance is like letting them drive without car insurance, letting them operate unsafe vehicles, or eat, drink and breathe whatever products the market chooses to put out.

[Calgaryborn]

Originally Posted by SebC

Of what use is freedom and choice if you're dead/crippled/bedridden and/or bankrupt?

If the federal government wasn't willing to save Americans from themselves, they'd still be using leaded gasoline, DDT and asbestos. There'd be no FAA, EPA, FDA... allowing people to buy crappy health insurance is like letting them drive without car insurance, letting them fly unfit airplanes, or eat, drink and breathe whatever products the market chooses to put out.

You should of finished your question with "because only the federal government can make responsible decisions". It would have been more complete because that is what you believe.

[Flames Fan, Ph.D.]

Originally Posted by Calgaryborn

You don't believe that either an individual or a State can make appropriate health care decisions. You believe the Federal government must save Americans from themselves; and all for the low low price of personal freedom and choice.

I like Paul Ryan believe that regulation and choice should be in the hands of the individual and the State. Allowing out of State insurance purchases doesn't mean the State can't predetermine what conditions must be covered.

Let me say this as neutrally as possible:

Regarding the first point: No, you do not have the knowledge or training to know how to shop for healthcare coverage in an unregulated market. There are too many variables in health and disease. Doctors spend years studying individual diseases; to pretend that we, the public at large, could simply read a few brochures and decide what medical coverage we'll need across dozens of diseases is the realm of fantasy. I'm sorry, but those are just the facts. It has nothing to do with limiting your freedom.

Regarding second general point: If you want the state to set coverage guidelines (in other words, set a minimum coverage level), then you're advocating that the state limit your choice! Which is the opposite of what you say you're for. Surprise.

There go your freedoms once again, victims of a poor logical framework.

q.e.d.

[jammies]

I hate living in Canada where I don't have the freedom to bankrupt myself over medical bills.

[SebC]

Originally Posted by Calgaryborn

You should of finished your question with "because only the federal government can make responsible decisions". It would have been more complete because that is what you believe.

If you give people the option to be idiots, some of them will invariably take it. That would be fine if they were just hurting themselves, but some of these people have families and such.

[Thor]

Warren Buffett tells Congress to stop coddling the super rich in America.

OUR leaders have asked for “shared sacrifice.” But when they did the asking, they spared me. I checked with my mega-rich friends to learn what pain they were expecting. They, too, were left untouched.
While the poor and middle class fight for us in Afghanistan, and while most Americans struggle to make ends meet, we mega-rich continue to get our extraordinary tax breaks. Some of us are investment managers who earn billions from our daily labors but are allowed to classify our income as “carried interest,” thereby getting a bargain 15 percent tax rate. Others own stock index futures for 10 minutes and have 60 percent of their gain taxed at 15 percent, as if they’d been long-term investors.
These and other blessings are showered upon us by legislators in Washington who feel compelled to protect us, much as if we were spotted owls or some other endangered species. It’s nice to have friends in high places.
Last year my federal tax bill — the income tax I paid, as well as payroll taxes paid by me and on my behalf — was $6,938,744. That sounds like a lot of money. But what I paid was only 17.4 percent of my taxable income — and that’s actually a lower percentage than was paid by any of the other 20 people in our office. Their tax burdens ranged from 33 percent to 41 percent and averaged 36 percent.
If you make money with money, as some of my super-rich friends do, your percentage may be a bit lower than mine. But if you earn money from a job, your percentage will surely exceed mine — most likely by a lot.

http://www.nytimes.com/2011/08/15/op...ness&seid=auto

[Rockin' Flames]

Originally Posted by jammies

I hate living in Canada where I don't have the freedom to bankrupt myself over medical bills.

I hate living in the US where I don't have the long wait times like they do in Canada.

[SeeBass]

Originally Posted by Rockin' Flames

I hate living in the US where I don't have the long wait times like they do in Canada.

Canadian married couple of 43 and 42 years of age.
Total medical surgeries between us-4 (was unemployed during one)
Total wait times added up, 3 weeks
Total emergency room visits-15
Family doctor wait times to see her max 2-3 days
How many times I have been denied healthcare-0
How many homes I have lost-0
How many times I have had to deal with another person besides my doctor to get an ok to get care-0
Total amount of paperwork I have had to fill out minus the check in form-0

Total amount that I have recieved in bills -$0



I would like to see your results

[VladtheImpaler]

I am definitely what you would term "right wing", but when it comes to health care, I fail to see a better solution than "universal government health care", whether you adopt a Canadian or a European version. Certainly, there are problems with the system, but I have yet to hear of a better option. I like the option of private care, so that one can pay for an elective service if one chooses to do so, rather than waiting.
Hence my criticism of Obama is not that he is "taking away choice", but that, as with many of his policies, it's a half-assed indecisive mish-mash that didn't go far enough...

[MarchHare]

Originally Posted by Rockin' Flames

I hate living in the US where I don't have the long wait times like they do in Canada.

There are multiple studies that have shown (feel free to Google them) that Canadians statistically have better health outcomes than Americans (with health insurance) when treating the same condition. Canada also spends about half of what the US does on healthcare.

Are you really that proud of your healthcare system that delivers worse results at a greater cost?

[MarchHare]

Hence my criticism of Obama is not that he is "taking away choice", but that, as with many of his policies, it's a half-assed indecisive mish-mash that didn't go far enough...

I think the biggest problem with Obama is that he tries too hard to compromise and reach bi-partisan consensus on many issues but the Republicans (and in particular the insane Tea Party wing of the party) have no interest in cooperation. That's why the healthcare bill, for example, has been criticized by both sides -- people who wanted a government-run single-payer system think it didn't go far enough, and people who think any government program is by definition "bad" think it went too far and will bankrupt the nation.

[Rockin' Flames]

Originally Posted by SeeBass

Canadian married couple of 43 and 42 years of age.
Total medical surgeries between us-4 (was unemployed during one)
Total wait times added up, 3 weeks
Total emergency room visits-15
Family doctor wait times to see her max 2-3 days
How many times I have been denied healthcare-0
How many homes I have lost-0
How many times I have had to deal with another person besides my doctor to get an ok to get care-0
Total amount of paperwork I have had to fill out minus the check in form-0

Total amount that I have recieved in bills -$0



I would like to see your results

Sure I'll take you up on that. I'll even compare my results in Canada to the US.

Married couple 34 & 33 years of age with 2 year old child

Total medical surgeries in the US (not urgent surgery) - 1 Canada - 0
Total wait times - 1 week
Total MRI's - US - 1, Canada - 3
Total wait times - US - 2 weeks, Canada - 6 months per MRI total 1.5 years
Total emergency room visits-US - 0, Canada - 3
Family doctor wait times to see him - US - 1 hour - US - 3 to 7 days
How many times I have been denied healthcare-US - 0, Canada - 0
How many homes I have lost-0
How many times I have had to deal with another person besides my doctor to get an ok to get care-0
Total amount of paperwork I have had to fill out minus the check in form-0

Total amount that I have recieved in bills -US $0, Canada $0

I guess I did have health insurance coverage I had to pay of about $2,400 over that time, which I don't pay anymore because my wifes work offers a great plan so we don't have any premiums. Savings in taxes over the 2 years in the US approx. $3,200. I've waited less time and and am up about $800 in straight taxes alone.

[MarchHare]

Personal anecdotes are meaningless.

Every comparative study I've read has shown that Canadians statistically have equivalent or better health outcomes compared to Americans. If you have a study that shows otherwise, I'd be interested in reading it.

[VladtheImpaler]

Originally Posted by MarchHare

I think the biggest problem with Obama is that he tries too hard to compromise and reach bi-partisan consensus on many issues but the Republicans (and in particular the insane Tea Party wing of the party) have no interest in cooperation. That's why the healthcare bill, for example, has been criticized by both sides -- people who wanted a government-run single-payer system think it didn't go far enough, and people who think any government program is by definition "bad" think it went too far and will bankrupt the nation.

No, he simply doesn't lead. Typically, a president has a "vision" which he seeks to impose/finesse through the Senate and House. Obama essentially says - "see what you guys can come up with, and I'll sign off on it". That's not leadership. He had a perfect opportunity to impose his vision before 2010, and he abysmally failed to lead. Letting the two donkeys (Reid and Pelosi) take the point was stupid and an absolute abrogation of his position. As a result a golden chance was missed - he had the electoral mandate and control of both houses and came up with a bunch of half-measures that will make the system even more expensive.
Obama is a nice man, and he would make an excellent school board chairman, but a President is supposed to be out front a bit more.

[Rathji]

Originally Posted by Rockin' Flames

I hate living in the US where I don't have the long wait times like they do in Canada.

Long wait times for what?

Like sometimes I need to wait 45 mins at a clinic...

[Flames Fan, Ph.D.]

Originally Posted by Rockin' Flames

I guess I did have health insurance coverage I had to pay of about $2,400 over that time, which I don't pay anymore because my wifes work offers a great plan so we don't have any premiums. Savings in taxes over the 2 years in the US approx. $3,200. I've waited less time and and am up about $800 in straight taxes alone.

Generally I understand what you're saying, but I need to make note that you are certainly paying those premiums. Your wife just chose to pay those premiums upfront by accepting a lower salary. The benefit is taken into account by companies when they're offering salaries.