I’m not going to pound on the fiasco that is the “socialist convention named” Affordable Care Act. (There is no affordable in the care act, just like there was no Democratic in the Deutshe Republic and there certainly is very little input from the people in China’s People Republic.)
I’m not going to pound on it, only examine why our reaction to the fiasco it is (and likely will continue being) is so immediate and in your face, when it is true that in most countries with centralized health care, people are fond/proud of it in some way.
Honestly, I think the left had convinced itself that even if it were a very rough start, as this is proving, we would swallow and go along, because other countries have/had. They thought we would grumble, and moan, but eventually we’d be happy to have that government-provided-health care and not mind too much that it’s not the best it could be, that innovation is stagnant or that it turns out to be very expensive indeed, and have strangers dictating what we could and could not have.
It might still turn out that way, but I don’t think so.
Remember the nineties, when HMOs were the worst thing evah, because some anonymous bureaucrat decided some treatment you thought you needed was too expensive/risky for you? Yeah, part of this was driven by the media-industrial complex and their continuous pounding on HMOs in service of promoting (then) Hilarycare. But part of it was that people also felt a certain amount of resentment towards the more restrictive portions of the service and the fact that someone else decided on the treatment. I think that they’re not going to feel any better towards something that is in essence a centralized HMO writ large and with the force of the government behind it.
It’s not just that it will have some problems, or whether those problems are massive or not…
I think it’s a matter of timing.
Look, over here we look at the problems of the NHS and other bureaucratized, centralized medical systems, and we shake our heads and go “Oh, that’s terrible” while over there (and occasionally on this blog) they go “yes, it has problems, but it’s good.”
But what I want you to keep in mind is what they have to compare it to. NHS was introduced just after WWII. If the books of the period are right, what existed before was patchy, not particularly good, and rural areas might have not particularly competent doctors. It wasn’t modern medicine. Modern medicine – and antibiotics – came in with the NHS. So what people retained was the idea of how much better it got.
It’s kind of like Communism in the USSR. It was awful and clamped down on society and took it on a poverty spiral, but what they compare it and contrast it to is not a free Western society but… feudalism. In comparison to THAT, communism, at least while its predatory empire could assimilate resource rich places like Cuba and Africa was an improvement.
In most other countries, socialized medicine in a form or another, was introduced around that time. Later in Africa and Australia, but then Australia has a massive interior which was probably as patchily served before as some parts of Africa.
What I’m trying to say is: what the people pushing for socialized medicine failed to comprehend is that it’s not the way of the future NOW. It was the way of the future fifty years ago. And if it had been introduced fifty years ago, it would probably have represented an improvement. If nothing else, the very fact that antibiotics were introduced then would have made a difference towards better outcomes.
While people aren’t blind to the bad outcomes, they also compare them, not to what free-market medicine would be now, but to what it was when socialized medicine came into being in their country. They compare it to patchy medical services and results, and they go “Well, it’s not wonderful, but—”
The problem from its advocates point of view is that, flawed and odd as the insurance market and therefore the medical market it distorts, is in the US, we have a system that’s better (or at least has more choice) than most socialized systems.
Oh, sure, if you don’t have insurance you can hesitate to go to the doctor sometimes with awful results. And if you don’t have insurance, you might use the emergency room as your physician (but not, most of the people who do this live at the margins of society. Most of the middle class who doesn’t have insurance goes to equivalents of emergicare, or as my friend Amanda calls them “doc in a box.” We did, for the most part, till our mid thirties, and we still go there if our regular doctor is closed.)
Again, the problem is that we’ve experienced this. All of us have some relatively bad experiences, but when it’s something really serious and really bad, we can usually get medical care. Yeah, it might be expensive, but it’s there, and you don’t have to wait for months and get approved, and have the opinion of some total stranger on whether you CAN have it or not. You can have the opinion of a stranger (insurance bureaucrat) on whether you have to pay for it or not, but that’s different from telling you you can’t have it.
All centralized systems end up restricting access to care, and the (UN)Affordable Care Act is not different, and I bet even if they can patch it (And frankly, they’d have stood a better chance of this if they’d introduced it in a time of great prosperity and money. Right now most of the people simply can’t afford the extra fees) Americans aren’t going to take any too well to being told their cancer has too little of a chance of remission. Go home and take pain killers. I don’t think we’ll take at all well to that. Because we won’t be comparing it to pre-WWII medicine. We’ll be comparing it to two years ago. And we’ll get mad. This whole idea that you’re helping the unfortunate have care is all very warm and fuzzy, but not when it’s your life on the line.
So, how can they have made such a miscalculation? Very easily. If you realize they are going from the idea that centralized statism is “progress” and that everything moves towards it. In other words, they’ve internalized this time table, where the state holds primacy and extends its power and hold over the individuals. The only difference between their vision and that of fascists and communists is that in their imagined future, the government is always benevolent.
But the time line is there in their heads. And when you measure progress not by better outcomes but by “is it being done by government with good intentions” the (U)ACA sounds like wild progress.
Only in real life people don’t judge you on your intentions or the time line in your head. And just like they couldn’t have imposed soviet-style communism in England, with its Free, Western society, but they could impose it in Russia where it involved the transition of one feudalism to another – in the same way imposing centralized medicine on a country that has had the experience of (however flawed) choice in medical care is going to be tough.
More importantly, it’s a challenge they never anticipated.
Which makes this moment so uniquely interesting in history.
Will people see the flaw in the statist version, and realize it’s a dream whose time has passed? Or will they forge ahead towards the future of the past – and the abyss?
The thing is, people don’t revolt against confiscatory tax systems even if you show them that — hypothetically — it has cost them colonies on Mars and vacations on the moon. But if they had all that, and you took it all away and shuttered it, in favor of a confiscatory tax system, I think the reaction would be completely different.
And, metaphorically speaking, that’s what we’re facing.
According To Hoyt 
Reblogged this on Music of the Spheres and commented:
This is the first original explanation explaining the passage of the “A”CA I’ve yet seen. Everything else looking at the difference between European state-run health care systems and the US one has basically boiled down to either “American Exceptionalism” or “Insufficient Progress” depending on the opinion of the possessor.
I think Hoyt might have really hit the nail on the head with this one.
Exactly right. This year I have insurance. It has a high deductible for most things, but a low deductible for prescriptions, and it has a manageable premium. The ACA canceled this “junk” plan, and offers me as a replacement a plan that cost almost $5K a year more in premiums and probably another $5K or so in new out-of-pocket charges for prescriptions, which at present is usually our only large medical cost in a given year. Perhaps if these changes had happened gradually over a decade or more we’d have absorbed them without fighting back too hard, or identifying too carefully the culprit in the story. But an overnight change is a powerful stimulus to resist.
Proponents of the law are still trying to tell me they’re doing me a favor, many with unflagging devotion to dogma. But I see encouraging signs that the country is turning against them in a dramatic way. Not only is the American public refusing to buy the idea that 5 million of their fellow citizens in the individual market are an unimportant fringe demographic, but they’ve quickly realized that the same fate awaits their own employer-provided insurance coverage. That hits people in two very sore spots: their pocketbooks, and their anxiety about their health. The atmosphere is explosive.
Ah, but your old one was nothing but a gocart. . . you’re not supposed to notice your new one is nothing but a shoe box on a rollerskate.
Really. The gocart analogy was one I was actually offered by what looks like a paid shill on Megan McArdle’s posts on Bloomberg. You want to know how crazy that place is? The Obamacare post — every day or two, or more than one a day — regularly garner more comments than anything else. As in, there was a post about rape that got fewer.
Ouch. That’s worse than the change that I am facing*, which is overall “only” about a $5k per year increase.
*Note: I found out that I will be able to open an FSA (which I didn’t think I was going to be able to do, because the company was going to open an HSA and make a tiny contribution it, but I was able to NOT have this done) to pay for the prescriptions up to (almost) the deductible amount, and not have that $2000 bill staring me in the face in January, like I thought, so I will be able to keep paying my mortgage for an extra three months to give me more time to get the house ready to sell.
Yeah. If we get hit with a health care bill on top of the kids tuition, even if it’s “a couple thousand dollars” unless my income — please G-d — goes up, it’s curtains.
And most people I know are THAT tight.
I’m comparing numbers to see if we should go without compliant health insurance, and pay cash for ordinary medical costs with some sort of ACA-non-compliant true catastrophic policy.
At least here in CA, the state insurance commisioner is only allowing ACA-compliant medical insurance plans to be sold, period, so since we’re dumped into the private market as of January, we only get to choose from the Bronze-Silver-Gold-Platinum ACA plan menu. No catastrophic plans allowed.
I have a insurance agent who claims to have such policies in my state. We meet that agent after Thanksgiving to see if its true.
I had an insurance broker who claimed to know of such policies here in Texas, too, until he and I both researched it and he concluded that they were gone after 12-31-14.
That’s my suspicion too. We’ll see. With luck, this fiasco will be repealed by 12-31-14 …
Not by 12-31-14, the current Congress will still be there. But if the Dems get absolutely shellacked next year we could see the necessary veto-proof majority for the GOP. It’s really, really unlikely, but it could happen. Fingers crossed.
It would also be a great big lesson. With a stick.
Unfortunately the only lesson the people who need to learn will take away from it is how racist America is. Because the only reason we could possibly hate a black incompetent in the White House is his skin color.
On 12-31-14, maybe President Biden will be too busy shooting shotguns in the air to remember to veto the repeal …
Did you just throw up a bit in your mouth? I know I did …
Julius — DO YOU WANT ME TO GO POSTAL?
I’ve got to say that at this point President Biden would hardly make the situation worse.
yep. President Biden holds NO terrors.
And that’s really the worst indictment of Obama, isn’t it?
There is an old Saturday Night Live skit, where they are interviewing America’s black president at the end of his second term. They ask him how he survived 2 terms when everyone thought he’d be assassinated.
His answer was “I kept Dan Quayle as my Vice President.”
seems to be working for BO…
You know they never seem think that I might hate the incompetent in the White house because he’s WHITE.*
*Even if the only reason I could possibly hate him is because I’m racist, reason would say that there is 50% chance that I hate the white half of him, since that is an equal percentage of him as the black half.
No, you forget that Democrats have always subscribed to the “one drop” rule.
He may be 50% black, but he’s 100% stupid. That’s the part I hate.
Is there such a thing any more as a non-compliant policy? For 2014, maybe, but my understanding after calling a zillion people this last few weeks is that after 12-31-14 that’s all gone. It will be illegal to issue any medically underwritten plan or any plan that is not ACA compliant in terms of maximum deductible or mandatory coverage of things like mental health, drug treatment, and pediatric dental. You can’t go to Lloyds of London. You can’t buy it anywhere.
If you find out different, please post here! I would absolutely be in the market for such a plan and would (more or less) cheerfully pay the fine to get it. Because otherwise my choices are a Bronze plan at more than $10K a year in premiums and $12K a year in deductibles for a couple, with no prescription exceptions, or a Silver plan at more than $14K a year in premiums, $6K in deductibles, and some prescription non-deductible copay protection.
I’ve found the Marquis de Custine’s La Russie en 1839 in translation only in redacted versions. However, the edition I own has a preface by someone in the American embassy who recommended it as the best book for understanding the Soviet Union.
I’m worried about folks like my sister who are having their hours cut, but have to have it pointed out that it’s so they aren’t counted as full-time employees.
Sigh. Some people will need that. Others will “get” it.
Anyone who has studied history can’t help but be aware that death, destruction, suffering, and poverty are the true natural order of things. Rarely, mostly due to Western culture’s new way of looking at things, do civilizations rise above that natural order and their citizens achieve some measure of peace, contentment, and success. This trend was enhanced and carried to its highest levels with the rise of American exceptionalism. Since such is contrary to all good socialist and Marxist belief, it must be beaten down and America brought to a more fair and equitable level consistent with the rest of the world.
As was generally the case, Heinlein said it best:
Throughout history, poverty is the normal condition of man. Advances which permit this norm to be exceeded — here and there, now and then — are the work of an extremely small minority, frequently despised, often condemned, and almost always opposed by all right-thinking people. Whenever this tiny minority is kept from creating, or (as sometimes happens) is driven out of a society, the people slip back into abject poverty.
This is known as “bad luck.”
So, let’s us all just put the web failure, the cancelled policies, raised premiums, and cutbacks to part time work down to bad luck while giving our betters credit for their good intentions.
For the visiting trolls this last is dripping with sarcasm in case you missed it.
The insurance companies and the regulators have prepared for Obamacare. The illegal policies are GONE. It will take weeks if not months to bring them back.
Obama’s “solution” to the crisis, “un”cancelling crappy substandard policies which so many people were so stupidly gullible as to buy is the economic equivalent of “un”-breaking an egg. And will work about as well. I’ve worked for alcoholic bosses who displayed greater business smarts than President Out-to-lunch..
It’s not just “crappy substandard policies” (are there really any of those?) he would be uncancelling. My policy is neither crappy nor unstandard. It covers everything it should, has no lifetime limit, and can’t be cancelled unless Blue Cross cancels the entire plan, in which case we have a guaranteed re-issue right (regardless of pre-existing conditions) into a variety of similar plans in the same family. If its cancellation is not undone in time, we will never again be able to buy affordable insurance, because in the time between when we bought this prudent plan and today, we both developed disqualifying medical conditions. That was the whole point: to get reliably insured BEFORE we got sick.
The damage to us from the ACA will be irreversible if it’s not fixed soon, or if a fix cannot be made retroactive.
And I keep losing track of whether all this is being done to me because I was too dumb to understand what I really needed, or so undeservedly lucky in my previous prudence that I deserved to have it taken away so I could empathize more with the typical Obama supporter.
“Experience keeps a dear school, but fools will learn in no other, and scarce in that.”
Another reason this is going down in flames is because this is being introduced when the Boomers are in their 50’s and 60’s–when people need more healthcare. Restricting access to healthcare when people need it more is a recipe for disaster.
The problem is that no matter how hated or badly run, no matter how self destructive, it WON’T go away. No government program, especially one this big, ever goes away.
vis- TSA
vis- Total Informational Awareness/CAP/CAP II/Trusted Traveller
vis- Rural electrification board
vis- war on drugs
vis- all the “temporary measures” like the income tax, welfare, unemployment insurance….
vis- most of the New Deal
Once it is established, we’ll never root it out. (And I think it’s too late. It’s already established.) The only exception I can think of is Prohibition (for a law) and the Interstate Commerce Commission was finally disbanded after 90 years but many of it’s functions were transferred to a new agency (for a regulatory body).
Waiting 3 more years, and then hoping to change it, is not going to work. It will grow and morph, and twist and turn in that time until it is even more impossible to remove.
I don’t have any idea what to do about it either. In a world where the President openly attacks the very Constitution he swore an oath to uphold, where expressing faith in the primacy of that Constitution will get you put on a terrorist watch list, where a decrease in the rate of INCREASE is called a drastic budget cut, I can’t help but feel like taking my marbles and going home. Withdraw, hide, wait. This insanity will pass like all the others.
Won’t it?
I suspect that what will actually eventuate is some form of what Instapundit has pointed out as Irish Democracy. People will simply opt out. Make their own arrangements. Go on the gray/black market. Screw the government any way possible. And government of, by, and for the people will vanish from the earth.
I suspect it’s well underway already, and the (U)ACA will be the near-final push. I know some physicians who were going to cash only/ payment plans ten years ago. The number is pretty evenly divided between generalists and specialties (dermatology, cosmetic surgery, opthalmologist). I had a high-deductible plan that was cancelled and will be replaced with a higher-deductible plan (3k, no out-of-pocket to a 5K and 5K out-of-pocket).
People have been mentioning a Medicare expansion that took place in 1989 (iirc)… and that promptly got nuked the very next year when the seniors ended up not liking it. And there’s an awful lot of people who *really* don’t like the ACA. So it’s possible that we’ll see this current monstrosity disappear. The problem is that the longer it stays around, the harder it will be to get rid of. And barring veto-proof majorities against it in both the House and the Senate, it won’t go away before 2017. Obama’s ego – if nothing else – will cause him to veto any attempts to get rid of it no matter how unpopular it becomes.
Yes, that’s the famous one that caused little old ladies to mob Dan Rostenkowski’s limousine and beat it with their umbrellas. The reform started off as a straightforward stop-loss protection against catastrophic bills, then had a bunch of expensive bells and whistles added. In the end, it excluded coverage for the one thing that had seniors really terrified, which was the lack of affordable nursing home care in a decent facility. Most seniors had some kind of private supplemental protection against that disaster, so when they rolled out the new mandatory cat care at a price of $800-$1,600 a year, seniors went ballistic.
You need to make a more detailed reading of history.
The crap that went on in WWI America under Wilson was something that moderns only associate with full-blown police states, and yet it went away aside from a few lasting institutions like Prohibition and the income tax.
Same-same with FDR’s massive arrogation of power. Can you imagine the result if Obama tried something like nationalizing the nation’s gold bullion? In terms of up-front arrogance and arrogation of power, he’s a piker.
And, yet… Wilson was followed by Harding and Coolidge, and FDR was followed by Truman and Eisenhower. Obama will be followed by someone else yet to be identified, and the pendulum will swing back.
What concerns me is that these idiots who are pushing the pendulum right now don’t seem to realize that the further the push it, the further and more powerful the backswing will be. That’s always been the case; a period of libertinism is always followed by a period of collapse and reformation, as the inherent flaws in extremism expose themselves. You don’t get Victorian values and mores without there first being a period of Georgian excess.
Read enough of the details of history, and you develop a certain sense of perspective, as well as despair. The idiots will do what the idiots please, and the rest of us reasonable and balanced types get to live in the midst of their stupidities. ‘Effin joy that it is.
I swear, if I ever join in a shooting revolution in the US, it’s only going to be one where I take the side of people with common-sense, and the groups we put against the wall are going to include the progressives, right along with the Westboro Baptist sorts.
A pox on all their houses, say I. If you can’t play well with others, get the hell out of the pool.
Part of that, I think, is that the speed of communication was much, much slower back then. People felt, I think, somewhat isolated – and your only means of mass communication were the papers. If the paper didn’t print it, it didn’t happen. It’s much easier to control a population when they don’t know what’s going on.
Not so with the Internet. People are going “WTF?!”, and OTHERS are seeing it and asking their own WTF questions – and not appreciating being blown off by the incompetent likes of Pelosi and Reid.
Like you said, there’s going to be one hell of a backswing.
This reminded me, has anyone else seen Pelosi rambling in incoherent talking points on David Gregory’s show? Himself no friend of rationalism, he kept trying to get a straight answer out of her, and failing.
A simple truth I remind myself of every day: Progressives are not a majority in their party, much less in America.
Yeah, it was one of her more memorable performances, but not in the positive sense.
I saw that and was going… “Okay, she needs to retire. Today. Before she does something incredibly stupid.”
Come to think of it, she should have retired before the ACA was passed. More and more she’s acting like someone’s elderly aunt that people tread very lightly around because they’re afraid she’ll get upset and angry.
Have you seen her liquor bill while speaker? There’s more than age going on here.
Kirk, you are right in that a closer look shows many of the “alphabet agencies” did go away. Many were found to be unconstitutional after a couple of years… But far more than just prohibition and federal income tax survived. (NLRB being a good example, and also relevant to Obama in that the power it gave to unions led to their incredibly distorting effect on politics. Not to mention SSA, which I believe is our single biggest non-defense budget item.) And most of what went away was by nature short lived (WPA, CCC, etc- as soon as jobs were available, people preferred them to the make work projects.) We still have price controls and subsidies to farmers that affect what you pay for food every week.
Obamacare seeks to change a huge portion of our economy, and in fact already is. It’s big enough that I’d put it nearly up there with the abandonment of the gold standard in the power it gives to the government over the people. (I declare that this piece of paper has this much value ==>I declare that THIS person’s life has this much value.) That this massive change comes after a long period of increasing power grabs, and usurpation of power over our lives is the only thing that blunts the perception of how big a change it is. It grants unelected official the literal power of life and death over you and IT IS NOT OPTIONAL. Oh, the fines for not participating are low now, but it only takes a stroke of the pen (or a press conference announcement to change that.) Watch the fines increase dramatically. Watch CPS try to take away kids from their “non-compliant” families. Watch the required hours for employers fall until ANY employment triggers the healthcare requirement. And if that doesn’t do it, watch for more coercive measures including arrest, asset forfeiture, and imprisonment. <– sounds extreme? Well, that's how incrementalism works. We've seen it with other laws. Why would this one be any different?
I agree that the pendulum swings. I agree that history is cyclical. I worry that the difference this time is that a larger percentage of the population is dependent on the government for their daily bread. I worry that the social progressives have accomplished their goals in the educational system and that we no longer have a large enough population that knows or CARES that things can and should be different. So do we face 10 years? 20 years? More than a generation, until the "Usaians" can rebuild and retake the land? Is there a tipping point beyond which everything really IS different?
I think there is. I think we are close or possibly there. If you look at the election results county by county, instead of state by state, the map looks very different than what we saw on TV.
http://www.google.com/imgres?imgurl=&imgrefurl=http%3A%2F%2Fcommoncts.blogspot.com%2F2012%2F11%2Fus-2012-election-results-map-by-county.html&h=0&w=0&sz=1&tbnid=Aq2wm5WDkCO2lM&tbnh=175&tbnw=288&zoom=1&docid=pk3R6C6OOEZgbM&ei=49CLUoGKOKmysAT_xYHIDw&ved=0CAIQsCU
VS:
http://www.politico.com/2012-election/map/#/President/2012/
I think the tipping point is reached when you ONLY have to win a few counties to win the whole thing. I don't have the math, or numbers, to see where that point is population-wise. But if taking the 10 biggest counties gives you the nation, the electoral college system will have failed, and we can kiss our idea of a representative republic goodbye.
And that is why I do sometimes drift into the sin of despair.
z
And, since I linked to maps, look at how similar the Concealed Carry Reciprocity map is to the map of Election results.
http://www.usacarry.com/concealed_carry_permit_reciprocity_maps.html
(click on Texas as your home state)
If winning a few counties can give you the presidency, can winning those same counties give you the win in the second amendment fight?
z
Zuk, I hear what you’re saying. I really do. But, reflect on this: For your worst case to happen, these idiots would have to demonstrate competence in handling this stuff, for at least the first few years. If the wheels came off in a generation or two, yeah… But, this whole thing is crashing and burning as it comes off the launchpad.
Had they demonstrated competence, I think your concerns would be valid. However, they did not. Signally, did not. For Ghu’s sake, they had internal reports back as far as March 2013 that this thing was a disaster, and they did not even have a “Plan B” ready to go, or a workable plan to spin it. The whole thing reminds me of that bit from South Park, where the Underpants Gnomes reveal their business plan. You know, the one where Step 1 is identified as “Steal underpants”, Step 2 is a question mark, and Step 3 is “Profit”? These idiots weren’t even bright enough to realize that “Softly, softly catchee monkey” requires that there be a bit of “softly” included in the trap plan.
Frankly, I’m not sure if I don’t find the demonstrated incompetence even more frightening than the idea that they really had these nefarious plans to ensnare the country in socialism. In order to do that, they’d have to be making sure that the opening phases were working well enough to convince the masses to keep moving further into the trap. When Obamacare blows up on the launchpad, that’s not conducive to that scenario working, at all.
I’m not thinking of it succeeding as a path to more socialism, I’m thinking of being COERCED further down that path. With coercion, their ability to actually provide the promised benefit is moot.
I’d love to see it end in a fiery crash on take off, but I think we’re already too far along for that to be the end of it. There are already consequences. Plans have been cancelled. Coverage has been dropped. People will not be able to enroll in alternatives in time. The political solution is always to continue, to “fix”, to tweak/ refine/ extend. Ego won’t let them say “wow, we made a mistake, let’s start over.”
We’ve seen it again and again on large govt projects. Initial cost estimates are rapidly exceeded. Someone says “we’ve spent too much to stop now.” New funding is found. Promised goals/features are reduced or eliminated. New contractors are brought in. Rinse and repeat until you have a giant crufty mess. Whether it’s software, a new hardware platform, a downtown stadium, or a new social program, the pattern holds.
So I don’t think we can dance in glee when it blows up, unless we have a simple clear path to somewhere better ready to go. And I haven’t heard ANYONE propose what to do after….
Granted, it was proposed long before Obamacare was implemented, but:
http://online.wsj.com/news/articles/SB10001424052970204251404574342170072865070
That does a pretty good job of summing up most of what I’d like (though no one is likely to ask me.) I spent a few years with a high deductible plan and an HSA, so that part at least happened. Tort reform is tricky. Medical malpractice is real, kills as many as 80k Americans a year (IIRC), and there need to be strong disincentives for bad doctors. Unfortunately, tort reform has become a rallying cry, so I’m pretty sure the REAL goal of it’s proponents is something other that what might be generally understood by the average joe. On the other hand, defensive medicine is expensive and drives up costs for everyone. Buying across state lines is tricky. It sounds good on it’s face, but I’m not sure how it fits with State’s Rights. Of course, federal mandates about healthcare don’t really fit at all. Taking a step back, I sure would like to think about this from that perspective…
And his last couple of paragraphs about eating right to cure our ills sounds (4 years later) a lot like Bloomberg nanny-ism….at least when projected into official policy.
I’m not sure how we’d get there from where we currently are though. Any royal decree would be unacceptable, and the lawmaking process pretty much ensures that those simple points would morph into something unrecognizable if done all at once.
The great mass of America has proven time and again to be a slumbering giant, that no one really wants to wake, but what would be the Pearl Harbor in this case? What could wake the giant and keep it up and stomping around long enough to make the change?
z
And his last couple of paragraphs about eating right to cure our ills sounds (4 years later) a lot like Bloomberg nanny-ism….at least when projected into official policy.
Well, he IS a liberal, so it’s not going to be completely devoid of Government overreach. Still, even this reasonably moderate plan had him getting all kinds of flack back in 2009, when he originally proposed it.
There are others out there. Republicans have presented something like 5 plans in Congress, but no one ever hears about them.
My personal plan would include:
1) Unlimited pre-tax HSA contributions.
2) FSA Accounts which are NOT forfeited at the end of the year, but roll over into an HSA (could be substituted by creating a limited credit line tied to the HSA, in order to cover large bills early in the year, before contributions to the HSA have accumulated enough to cover it)
3) Require providers to publish prices for most normal procedures (which must be charged to at least 51% of customers to establish it as the normal price), then allow them to deduct whatever portion of the normal price they deduct when providing services for those with financial troubles from their income for tax purposes.
4) Allow employees to purchase insurance plans on the open market, and allow the employer to still deduct the amount they contribute to the purchase of this plan.
5) Tort reform – yes, malpractice is real. However, millions of dollars in punitive damages lead to massively increasing both malpractice insurance and defensive testing.
That’s pretty much it, really.
Treat employer-provided medical insurance as the compensation it is, and tax it (if we’re going to keep the income tax…I’d prefer we abolish that an use a National Sales Tax on first-time retail sales, with no exceptions for any products). Tell employers that they must offer their employees a choice: medical insurance, or a higher salary, with the salary differential being equal to the cost of the medical insurance.
I think there’s one important difference between what happened with Wilson and FDR, and what will probably happen with Obama.
Both Wilson and FDR had to deal with huge international wars during the course of their respective presidencies. But when the wars ended, people expected that restrictions on their freedom that had been put in place would be removed. Those restrictions might not have been as a specific result of the associated war (particularly with FDR and all of his various programs during the Great Depression). But people expected easing of the restrictions when the war ended.
And we still kept Social Security.
There’s no great and terrible international war today. There’s no event that can be expected on the immediate horizon that will so clearly mark a defining line that people can be expected to say, “Yes, I know things were pretty restrictive yesterday. But things changed on the deck of the Battleship Missouri today, and I want everything back to normal now.”
Also, it likely would have been more difficult to reverse what Wilson and FDR had done if they hadn’t suffered from administration ending health issues while still in office (Wilson’s stroke, and FDR’s sudden death).
There is a US medical program that was passed by President Reagan, then repealed 18 months later. I found a pointer just today in Megan McArdle’s posting http://www.bloomberg.com/news/2013-11-19/wishful-thinking-can-t-hold-obamacare-together.html.
The catastrophic-care program, or “Cat Care”.
And there is wage and price controls, which worked better than Ocare (that is to say, it was the Vasa) and yet it was rolled back.
As I’ve come to expect reading your blog and the comments, I’m LEARNING things, and that is awesome!
z
Many of the basic claims made to support ACA were simply false. A study of Medicaid expansion in Oregon showed that – contrary to claims – insurance showed no measurable improvement in health.
The claims about medical bills causing bankruptcies – fraudulent horse manure from Elizabeth Warren.
One of the reasons we’re in this mess is the way we’ve conflated health care and health insurance. Once upon a time insurance paid for catastrophic events, your doctor visits were all out of pocket. Rich folks paid up front and the rest of us set up a payment plan. Then our all wise and benevolent gubmint set up wage and price controls long about WWII and business used benefits such as medical insurance as ways to entice the best workers. Among other things that resulted in folks going to the ER for head colds because their work policy paid the bill while a doctor’s visit required a co-pay.
The ACA, or ObamaCare, is nothing more or less than a huge step towards socialized medicine by means of controlling health insurance. Any insurance company survives by always collecting more in premiums than it pays out in claims. IMHO the end game is for our government to take on the role of health insurer for the citizenry. To be successful it must collect more than it pays out. We’ve all seen where that takes us with Social Security and various other pseudo Ponzi schemes. I told anyone who would listen the first time I heard that they were trying to add upwards of 30 million uninsured to the roles that the funding to cover them had to come from somewhere, and the only two possible sources were higher premiums from those who could pay or subsidies via tax monies.
People don’t have health insurance for one or both of two reasons: don’t want it or can’t afford it. Those that don’t want it may be foolish or just playing the odds. In a free society that’s their privilege. Those that can’t afford it are either in poverty or in high risk categories that price them out of reasonable coverage. And anyone can still be carried into an ER and get the best medical care available regardless of their ability to pay. The hospital will of course dun them for the rest of their natural lives should they default, but it’s still an arrangement we’ve all agreed to for the sake of those less fortunate.
I very much suspect that for the committed socialist the ACA is mostly about seizing control of a large portion of the economy and grasping an enormous amount of leverage against the lives of our citizens. To them this is the reasonable and natural order of things and what are a few lies or the deaths of a few individuals caught in the gears of transition when it’s all for the greater good.
As for those told: “your condition is too expensive to treat, here’s an unlimited script for pain meds.” How long before a few of those chose to consider that verdict as a hunting license?
“Only in real life people don’t judge you on your intentions or the time line in your head.”
Heh. My home page gets a new quote every morning, and this morning it was Thomas Sowell, from Vision of the Anointed:
“Systemic processes tend to reward people for making decisions that turn out to be right—creating great resentment among the anointed, who feel themselves entitled to rewards for being articulate, politically active, and morally fervent.”
I’ve just downloaded this book via Kindle. It sounds like what I need today.
Excellent book.
You call it the media-industrial complex. Michael Crichton’s term was “politico-legal-media complex”. I sometimes wonder how our democracy can survive when so much of our media is a propaganda arm of the Left.
The bottom line is that this is no longer a government of the People, for the People and by the People. This is no a government that does what it wants because it can and a nation full of people who don’t know enough to realize that it’s possible to stop it. I put Obamacare down to a nation that is uneducated enough to know what rights they actually have.
I recently had a conversation with a co-worker. Her exact words were “That’s the government. It can do whatever it wants.” That’s a direct quote and, no, I’m not making it up. I wish I was. But, in a country where the president can use the IRS to strangle his political rivals, where the NSA can take all of a citizens phone data and listen to their conversations with no backlash and where the administration can give guns to Mexican drug cartels while taking gun rights away from law-abiding Americans, how can I argue with her?
The bottom line is that so much has been taken from the people in this country that far too many of them have lost the willingness to fight. I don’t mean that necessarily in a physical sense either. Court challenges, protests, etc. just get ignored. Don’t get me wrong, Obamacare is damn sure a symptom of the problem, but that’s all that it is.
This would seem to be a good place to start the fight IF we can get some help from the general populace at large. Dedicated people are not just nice to have, they’re an absolute necessity. Until we can educate enough of the people around us though, we’re fairly useless in the fight. We need to find a way to take the fight viral. We need either a viable third party or an effective way of giving the two that we have a finger in the face (preferably the middle one.) Of course, if we can’t have one or the other I’ll take both.
Last election, I voted for myself for president. I am, to the best of my knowledge and belief, the only person who did. Given the fact that I’m just some guy and have no following that’s hardly surprising. I did it because it was a choice between Zero and the RINO. Neither one earned my vote, and there was no-one else on the ballot. I decided to go with the only person who I thought would represent me. Maybe this is an idea we could take viral? Anyone have an idea how to do that? Just as a message that, “Hey, both parties: YOU SUCK!!!!!” It’s just a thought.
One day soon, I think I’ll have to share my thoughts on Congress as well. Hey Sarah, would it be ok if I sent you a guest blog?
I bet King Barry and Mittens also voted for themselves for President in the last election.
OK, maybe Mittens didn’t, as part of a Clever Plan.
New and hopeful cant on the idea. I hadn’t quite seen it that way. I’ve been hoping people would see (somehow) the miracle that is American medicine and would wish to keep it. Now I’ve got a little better framework for that hope.
Uncle Lar discussed the problematic conflation of insurance and healthcare up-thread, I’d just like to add the dangerous conflation of ‘health care’ and medical treatment. For most people, for most of their lives, doctors are not essential to health. The belief in the need for a codified dispensing authority for ‘health’ is actually damaging to the interrelated medical system.
If we could break those two damaging assumptions we might actually fight our way out of this mess.
As for “Affordable Care”, we Canadians have long had healthcare. Which sucks. Which even liberals up here complain about, even as they praise Canada for having healthcare. You aren’t missing anything but heartache, believe me.
And you’ve got a safety valve for your healthcare system south of the border. The health care system in the US lets Canadians get treatment when they can’t afford to wait for the Canadian system to help them.
But that’s probably going to disappear if Obamacare sticks around.
The Canadians applauding Obamacare haven’t thought of that.
Yet.
You might casually bring up in conversation with your pro Obamacare friends what they think will happen when the wait for treatment become as long in the US as they currently are in Canada.Or for that matter whether they will even be allowed to cross over and pay cash for service. Not an issue yet, but with the push to bring all doctors under formal health organizations, ie hospitals and HMOs, it’s only a matter of time before a doctor may very well be told who the can and cannot treat. Of course some provision will naturally be made for illegals, so advise your friends to practice up on their Spanish.
Medical tourism is in that logical progression, and that’s already here. I understand Thailand is already ramped up for treating foreigners, with full support of the government since it’s such a good source of foreign exchange, and as a side effect it provides a first class medical infrastructure for local elites.
Of course, in response the government here would be forced to control overseas travel to keep that money from escaping the domestic medical system. Papers, citizen. It’s for the children, you see.
The only reason the collectivists think that socialism would work in America is that they haven’t really tried it, here. Yet. After they do, they’re going to be so frustrated with the idea that they actually have to make it work that they’re going to give the whole thing up for a bad job. At least, for a few generations. Until everyone alive forgets about the foolishness of trying such with the American public.
See, the problem is, Americans have a really unrealistic expectation, compared to everywhere else they’ve tried this idiocy: They expect things to ‘effin work. This is a metric that socialists are unused to, and which they haven’t been held to elsewhere in the world, precisely because of the point that Sarah makes–Elsewhere, the basis of comparison could only make socialism look good. It’s precisely why we remember FDR so fondly, and forget the ideological idiocies of his administration that made the Depression what it was. The basis of comparison was that bad, and the people were that scared. If FDR had tried half of that crap during a time of prosperity, he’d have been lynched.
Likewise, the comeuppance due the Obama administration in the regard of the ACA, AKA “Obamacare” is going to be epic. They’re only now beginning to feel the first twinges of revolt, because it is only now that the low information general public is paying attention to things. Why are they paying attention? Well, the bills are literally coming due, and a generation or two is getting an education on why they need to listen carefully to the politicians, and pay attention to what they’re doing. If I had a dime for every idiot LIV I’ve talked to lately who has had the signal experience of finding out just how “affordable” the ACA is, I’d be able to retire tomorrow. They’re all “I was lied to…”. They also really don’t like it when I point out that the lies were readily apparent when they were told, and that I’d told them so, time and time again. I’ve seen more than a few lightbulbs pop on, behind eyes.
My guess is that this whole thing is going to either die under its own weight, or be repealed within two years, if not faster.
The point I make about Americans expecting things to work is what’s going to do this in. You could, I suppose, convince a majority of us that socialism is the way to go. But, when we got done with it, it wouldn’t look like any other “socialism” on the planet, and I suspect that the resulting broken eggs that would accrue from such an attempt would make the things that happened in the rest of the world look tame by comparison. Americans are, in the final analysis, extremists. We take things too far, and if we get to the point where we believe in and/or try things out, we tend to go way, way too far. No other nation would have even attempted Prohibition. We did. Think about that, for a second. The Temperance movement was just as strong in the UK as it was here, and it never managed to get something like Prohibition put into place. “Only in America…”.
Too many people fail to recognize that that is a curse, as well as a blessing.
Socialism here in the US would not tolerate slackers, and the social logic behind American behavior would probably end with the slacker portion of society either being ostracized and allowed to die off, or its outright destruction. That’s the way the American mindset works–If we adopted socialism, really and truly adopted it, then we’d take it so far that the rest of the world would recoil in sheer horror. And, they’d be right to do so. Show trials for people like Michelle Obama, who took “do nothing” jobs on the public fisc? Won’t happen. There’d be a committee that looked into such things, and she’d either wind up in front of a wall, or in a lifetime of indentured servitude, paying those ill-gotten wages back. You really don’t want to see what will happen, once the rule of law breaks down here. There’s entirely too much drive for vigilantism here.
That’s just the way we are. Which is why I don’t think there’s a hope in hell they’re going to be able to re-wire American society into a socialist mode without there first being a world-shattering disaster, first.
Which, looking at this administration, may well be what they’re looking to create. My only consolation is that the groups behind this administration, and its major backers, are likely to be the first up against the wall, in the new era. It’s too bad that they’re not smart enough to realize that, and comprehend that academia and the so-called intelligentsia are really luxury items, for a society.
America’s Stakhanovites are not going to tolerate the idea that there are those whose sole role is to sit on the sidelines and opine wisely, running things. They’re going to be expected to a.) work, and b.) make things work. If they fail, the wall is going to be the least of their worries.
Trust me on this: You do not want to see what the US would look like, or what it would do, if we ever adopted a brand of socialism. It would be a uniquely and truly charismatic brand, one that would brook no compromise and tolerate no limits on extremism. In all likelihood, it would also be extremely evangelical. That sort of conversion usually comes with a brand of proselytizing that will make the world shudder.
We would, in short, expect and enforce everyone living up to the standards. Everyone. No matter what. “From each according to his abilities; to each according to their need” would turn into an ‘effin nightmare, because that first clause, ignored in every other iteration of socialismus, would become the battle cry of every American. Asses like Barak and Michelle would find themselves worked to death, in all likelihood, and they’d be expected to produce something meaningful and worthwhile. I don’t think they’d like that sort of world.
What we really have here, right now, is a parasite class that’s forgotten that it’s a parasite. They’re about to find out why it’s better to stay in academia and write cutting papers, smoke the ganja, and bullshit in the faculty lounge. The results aren’t going to be pretty.
I’m not going to be surprised if Obama is impeached, and with a majority vote of the Democrats in the Senate, to boot. Reid is, if I’m not mistaken, up for re-election in 2016. He is, in other words, a lame duck. He’s got a short window of control, and if the rest of the Democrat Senators feel the hot winds of election loss bearing down on their necks, they’re not going to give a rip about Harry, or protecting the incumbent President. Party solidarity only runs so far as the Party can do things for you, and if it becomes brutally apparent that they’re going to lose their seats, bang goes their loyalty. None of these guys are dumb enough to want to live under a Congress filled with insurrectionist Tea Party types, and the establishment is going to be smart enough to figure out that if they throw Obama and crew to the wolves, they may be able to save themselves. Think “sacrificial king”, here.
As an aside, the unique American extremism on things is one reason I don’t think the Islamics really understand what they would get, if their goals of converting America to Islam actually happened. Islam would be unrecognizable, within a generation or two, because the American converts would demand, and enforce, actual compliance with Sharia, and the Koran. All of it. Every little detail… There would be no space for an Imam, of any brand, to conduct himself in anything other than in accordance with the Book. I don’t think they’d like that, at all. Islam is a lot better off, not adding the American outlook to its conquests.
Socialism here in the US would not tolerate slackers, and the social logic behind American behavior would probably end with the slacker portion of society either being ostracized and allowed to die off, or its outright destruction.
I suspect that once actual, nearly-full-scale Socialism got implemented, and the slacking off got to be too much, there would be forced labor implemented.
Precisely. And, the American mentality would make a huge difference in precisely who it was that got “forced”. There’s no other victim class available, aside from the current mob of progressives and their sycophantic followers.
Which is something they might want to start thinking about. American socialism has no nobility to victimize, and nobody else to loot after they’re done with the successful business class. That would leave the current mob of genius progressives and celebrities holding the bag…
Which I don’t think they realize. Sean Penn won’t be a hero of the revolution, here–He’ll be a victim of it.
Part of the issue is the fundamental childishness of the Progressives. Look at how much of their argument for Nationalized Health Care is essentially a more sophisticated phrasing of “But all the other cool countries have it!” For that matter, many of their arguments against gun rights, effective policing and a functional military boil down to “But none of the other countries have to defend themselves!”
What we are seeing is little more than a societal expression of CTS (cool toy syndrome) and tantrums against regular bed time.
Don’t forget the “do it for the children” defense for everything they do.
I’ve noticed they never specify which children they are referring to. They sure ain’t doing it for my children. “My government blew a billion dollars we don’t have on a healthcare website and all I got was this stupid debt, not even a T-shirt.”
Exactly– A friend’s husband just got a T-shirt that says “Mr. President. Take your hand out of my pocket. I can stimulate myself.” 😉
The experience of the UK with its global healthcare system is that it now dominates political discourse, yet can never achieve its intended end product which is “affordable health care” here. It consumes billions upon billions and produces heart-rending stories how patients are left to drink water from flower vases because no one can tend to them. Ten minutes ago on the flagship evening news programme from the BBC they headlined with yet another new initiative to make our National Health Service better, yet parliament for this all important ‘big step forward’ was barely a quarter full. We are numbed by the continual re-evaluation of the Health Service’s role and purpose and its doubtful ability to keep people alive.
I think the US will start to experience this before too long; perhaps you already do. In short, you will soon talk of few other things in Washington. Of course there will be initiatives and reports and fixes and it will roll on as it will, consuming money and time and getting nowhere but eating itself.
In the UK we are bedevilled by the problem of bringing in medical staff who can’t speak little English, the never-ending stream of ‘health tourists’ arriving for free treatment and a ‘postcode lottery of which service does better in which area. Now this is not your system (we are told the NHS is ‘the envy of the world’ but no one copies it) and it has its own problems, but trust me you will in the near future be seeing it consume vast amounts of money, time and energy.
Of course, the next election on those shores will as usual be based on loud yelling strenuously dedicated to ‘preserving’ or ‘improving’ the NHS without ever looking at some of the core issues. You will get the same, and with it you will get all the vast effort aimed at keeping people out of hospitals: demands that you don’t do this, please eat that, don’t take that and so on. Huge advertising campaigns that basically say “Stay well because we don’t want to have to heal you or care for you.”
Your president may yet be most remembered for being the man who changed politics in the USA by simply making it spend so much time on health issues and costs and what to do that nothing else will get a look in. Good luck.
I had not thought about the post WW2 climate as a reason for successful introduction of the NHS but you make a very strong case for it. The UK was in 1945 in a real mess. Yes it won the war but the economic cost was enormous and the country was practically bust. Moreover the war allowed, indeed arguably required, an almost fascist control of the economy and society. But since in most cases people voluntarily let the government take control and actively worked to fix the worst of the problems such control caused – because the alternative to doing so was speaking German – the bad parts of state control were obscured.
It might have been easier in some ways if we’d lost or at least invaded because what we had were large chunks of the economy that had been utterly mangled from what made sense to handle the demands of total war. But yet because we weren’t invaded people still thought things could return to normal quickly without thinking about all the dependencies.
The labour party took advantage of that mess to introduce many ideas that ended up hurting the UK, mostly mass nationalization (which includes the NHS). Given the utterly bollixed up economy nationalization may actually have helped a bit because it allowed for things to start over with a reasonably clean sheet. I’m sure that applied to healthcare as much as it did to coal, steel, railways and so on. And I’m sure you are right that the addition of antibiotics and other simple cures like mass vaccinations made the country as a whole a lot healthier. And that combination does seem like a reason why people thought the NHS was wonderful.
Humans are pretty good at pattern matching and extrapolation. It’s mostly a valuable survival skill but it also leads to all sorts of superstitions and other non-optimal behavior because we think that A caused B just because A happened before B. The worship of the NHS is probably another good example of that superstition.
However it is also worth noting that the NHS did not forbid alternative health insurance or non-NHS doctors/hospitals etc. And because it is paid for via taxes the cost of it is not immediately obvious. Neither of these is true with the UnACA.
I think that one of the other key factors in the rise of nationalized healthcare (and nationalized anything) in Europe was that in the devastation following 2 world wars, there was a widespread culture of scarcity versus the US’s culture of abundance. I understand that the scarcity was real. It’s long term affects can be seen everywhere once you look for it. (Coin operated heating? Really??)
When resources are scarce, it makes sense to control and restrict access to or use of them. Nationalization schemes do just that. Other than during wartime though, in the US, we’ve almost always had an actual abundance, and hence a culture of abundance. Big cars, big houses, huge streets, cheap electricity, huge supermarkets full of food, 200 channels on TV….)
But with the exception of extremely rural areas (Alaska comes to mind) where the population density is too low, we DON’T have a scarcity of healthcare resources. And even in those areas people can get much better care than the rural areas of most of the rest of the world.
Some folks outside the USA might not understand just how MUCH healthcare we have available. My sports medicine Doctor has his own MRI machine (and I used it 20 minutes after my walk in appointment). We have VETERINARIANS with MRI machines. A quick google map search has 7 Urgent Care (store front, walk in care, for cash or with insurance, see a Dr, get a prescription, dress a wound, stitches, etc.) within a 3 mile radius of my home. I count over 16 Doctors offices, several surgical centers, and 2 hospitals in a 4 mile radius. And I’m not in any special area, like our Medical District. We can get our hearing checked, eyes checked, blood pressure, flu shots and immunizations in grocery stores, wal*marts, and drug stores most within a block or 2 of our homes. We can get prescriptions filled in most of those places too. My family doctor has his own radiology and blood work onsite (small shared practice.) I can walk into a storefront lab and get just about any test I want to pay for (cholesterol level, liver function, tox screen, paternity, you name it.) In fact there are 2 of those labs within a couple of blocks of each other competing for my business. There are 10 of them (same brand) within a 7 mile radius of my house.
Lest I beleaguer the point any longer, we have an abundance of healthcare available to us. Why would we voluntarily adopt a system that is based on scarcity? It goes against our very culture.
z
I haven’t lived in the UK for over 20 years so I can’t comment on the UK. I can say that Germany, Japan and France have a lot of medical clinics, doctors etc. and that those clinics also have MRI machines and all the other things that go beep. My wife had a checkup in Japan recently where they stuck a mini camera down her throat for example (and found out that she had H. Pylori, which explained the indigestion issues).
I have to say that from what I’ve seen the NHS does fine for many day to day things and even most routine surgeries and cancer etc. treatments. It goes horribly wrong for some chronic conditions, has a big problem for anything where you need to stay in hospital for longer than a day or two and anything exotic. Got a weird kind of cancer that has one very expensiev drug that works – sorry. It also has a problem with quality of life. You get a treatment. It probably works. It was probably later than it should have been so you had to wait months longer than you would in other countries (probably in pain) and post-treatment you may still have some minor issues that probably would have been fixed as part of the treatment elsewhere.
And that whole “let’s let hundreds of people yearly die in our hospitals from dehydration because our nurses are lazy incompetents and forget to provide water” thing.
Actually I don’t think that the nurses are or incompetent. They are trying to kill off elderly and chronically ill people.
No I don’t think it’s that bad. They have no incentive to keep them alive might be more like it. The patient is not their customer or the person who pays them or promotes them or anything else. They are just the job/ the product.
“The patient is not their customer or the person who pays them or promotes them or anything else. They are just the job/ the product.”
A variation of this the main problem I see with the US system. The patient is rarely the one who pays. So there is no incentive to minimize costs.
I spent many years without insurance, but saw doctors when needed. It is VERY difficult to get pricing info out of a healthcare provider. Often, they have NO idea what they get paid, let alone what actual costs might be. And what they get paid depends on who they bill, what code numbers they use, and how high their tolerance for jumping thru hoops is. Usually, they end up saying “How does $40 for a visit sound?” or something similar. It is possible to arrange what you will pay for standard procedures ahead of time. I have a friend who negotiated the cost for his wife’s standard delivery. Note that he did it ahead of time. Once they get you on the hook for their extremely high “normal” rate, they will rarely budge.
The best reform I could offer is price transparency, no discounting off published prices, and a true free market. Insurance offered without rates set by actuaries is really just a pre-paid discounted payment plan, and isn’t sustainable.
Oh, and FWIW, we need to change the language of the discussion with regard to “subsidies.” We need a word that makes it clear that any subsidy is tax money taken from someone else.
z
“We need a word that makes it clear that any subsidy is tax money taken from someone else.”
Nonsense. Ben Bernanke just has the gnomes in the basement print some more billion dollar notes.
And now we learn how the underpants gnomes are making their profit…
All of this. But especially the last 2 paras
That would be the “big problem for anything where you need to stay in hospital for longer than a day or two ” part.
Why would we voluntarily adopt a system that is based on scarcity?
So that we can be controlled? Scarcity leads to rationing which is a form of control. On the other hand, the system cannot and will not work, which might lead to a backlash. What it will do and already has done, is throw a lot of grit into the gears of our society. As a method of immiseration it works. You might be able to break our economy if you use this in addition to other really bad ideas.
I read this and I ask myself, based on long conversation with my friends who were escapees from the Soviet bloc, how was what they endured any different and how was the antebellum south different from a Socialist state?:
http://utc.iath.virginia.edu/abolitn/abaufda13t.html
Have you heard of George Fitzhugh? He wrote a book, Sociology for the South, in which he defended socialism as protecting the workers against capitalism, and slavery as the perfected form of socialism. I’ve started reading it, and the opening chapter has all the anticapitalist cliches you could want. Apparently he argued that slavery shouldn’t be just for black people; most white people would also be better off as slaves, in his view. I wonder how much of an influence he was on Woodrow Wilson.
I have to say I am one of those evil people that will cause the ACA to go broke, or more likely to be changed so I am punished more severely, and THEN go broke. I haven’t had health insurance in years, and pay out of pocket for any medical expenses I might have. Frankly who would I pay 5-10K for a plan with a deductible higher than I have ever paid in a year for medical expenses; when I can pay a minimal fine (or not, since their only means of enforcing it is to withhold it from my income tax return, and being mainly self employed I always pay in rather than getting a refund).
This is unsustainable, they know it is unsustainable, and I believe they wrote it this way in order to get it passed, with the idea that would be changed after it was passed to ‘fix’ it. Who will push for that change? The RINO’s who are capable of simple math, but lack the balls to actually buck those in charge and scrap a program that will give the government they are a part of so much extra power. They believe that if they can patch it that will look to their constituents like they are actually fighting for them, “and look see, we can’t get what you want, but we are making some progress.”