[besson3c]

Okay, I'm exaggerating and don't mean this literally. There are all sorts of problems, but it seems that there is one big one that would have a potential positive cascading effect in improving a number of things across the entire political landscape and across our entire society.

Health care.

This is not yet just another health care thread though, I think I have a pretty good idea where the usual PWL contingent stands on all of this... We don't need to get into all of that.

What interests me is the enormity of this problem and the possible cascading effect that us waking up tomorrow and finding this problem fixed would have across our entire society. I know that the chances of this happening are virtually non-existent, but that being said, I don't think this country is going anywhere without daily, constant, complete, diligent, and utter belaboring over this issue. You want one issue to obsess over? This is it.

Think about it, if health care costs were all of a sudden sustainable, we'd be much closer to the ballpark of getting our debt under control sometime in the next eleven billionty years, we'd stimulate a ton of business in not having to provide health care to its employers, we'd stimulate the medical industries in bringing back family doctors and various preventative type medical practices, we'd reduce personal bankruptcies, take the strain off of our ERs, improve our overall health, life expectancies, perhaps we'd be able to increase maternity leave periods if we chose to do so, stimulate the GDP in our having lesser personal medical expenses, and good old besson3c would stop harping about this issue. If somehow our politicians were able to deliver on something like this, chances are our entire political landscape would have been overhauled to permit something like this to happen.

What I want to know is, why aren't people more riled up about getting our politicians to work on this issue? Do Americans think that what we have is somehow normal and/or healthy? Is there anyone here that does not realize what kind of bullshit we are in now, Obamacare or no Obamacare? Sure, there are people that grumble about Obamacare, but there should be more of that, and even more importantly, political pressure to actually replace Obamacare (if you aren't a fan) with something that may eventually someday resemble something remotely resembling a solution.

Where are the pitchforks?

[Athens]

The biggest thing that could ever solve American Politics is removing corruption from the system. Cap and transparent spending on lobbiest, contribution limitations and caps. If A person could only donate $1000.00 to a person, and a company only $5000.00 and all contributions was public with corporations having to be at least 5 years old and subject to audits to validate its a real business and not some front the government would start working for the people again because votes could not be bought by powerful people or corporations. All finances of members of the government should also be public accessible for accountability from bribes. Fix that and you will have judges that do there jobs. Senators that do there jobs. The government would function for what the voters want, not who paid them the most to get them in power.

[besson3c]

Originally Posted by Athens 

The biggest thing that could ever solve American Politics is removing corruption from the system. Cap and transparent spending on lobbiest, contribution limitations and caps. If A person could only donate $1000.00 to a person, and a company only $5000.00 and all contributions was public with corporations having to be at least 5 years old and subject to audits to validate its a real business and not some front the government would start working for the people again because votes could not be bought by powerful people or corporations. All finances of members of the government should also be public accessible for accountability from bribes. Fix that and you will have judges that do there jobs. Senators that do there jobs. The government would function for what the voters want, not who paid them the most to get them in power.

Maybe a good topic for another thread? I don't mind the derail, but perhaps it would be good to give the original topic a fighting chance first?

Besides, a fixed health care pretty much implies that the government is actually able to function enough to actually fix something this significant and large.

[ebuddy]

Originally Posted by besson3c 

Okay, I'm exaggerating and don't mean this literally. There are all sorts of problems, but it seems that there is one big one that would have a potential positive cascading effect in improving a number of things across the entire political landscape and across our entire society.

Health care.

This is not yet just another health care thread though, I think I have a pretty good idea where the usual PWL contingent stands on all of this... We don't need to get into all of that.

What interests me is the enormity of this problem and the possible cascading effect that us waking up tomorrow and finding this problem fixed would have across our entire society. I know that the chances of this happening are virtually non-existent, but that being said, I don't think this country is going anywhere without daily, constant, complete, diligent, and utter belaboring over this issue. You want one issue to obsess over? This is it.

Think about it, if health care costs were all of a sudden sustainable, we'd be much closer to the ballpark of getting our debt under control sometime in the next eleven billionty years, we'd stimulate a ton of business in not having to provide health care to its employers, we'd stimulate the medical industries in bringing back family doctors and various preventative type medical practices, we'd reduce personal bankruptcies, take the strain off of our ERs, improve our overall health, life expectancies, perhaps we'd be able to increase maternity leave periods if we chose to do so, stimulate the GDP in our having lesser personal medical expenses, and good old besson3c would stop harping about this issue. If somehow our politicians were able to deliver on something like this, chances are our entire political landscape would have been overhauled to permit something like this to happen.

What I want to know is, why aren't people more riled up about getting our politicians to work on this issue? Do Americans think that what we have is somehow normal and/or healthy? Is there anyone here that does not realize what kind of bullshit we are in now, Obamacare or no Obamacare? Sure, there are people that grumble about Obamacare, but there should be more of that, and even more importantly, political pressure to actually replace Obamacare (if you aren't a fan) with something that may eventually someday resemble something remotely resembling a solution.

Where are the pitchforks?

In order to do it right, you have to first undo what is wrong. There are literally hundreds of ideas on health care reform. If your focus remains on health care insurance reform, you'll reform health care insurance while doing absolutely zero for all the necessary items you indicate above.

[BadKosh]

How about more strict standards from the press?

[besson3c]

Originally Posted by ebuddy 

In order to do it right, you have to first undo what is wrong. There are literally hundreds of ideas on health care reform. If your focus remains on health care insurance reform, you'll reform health care insurance while doing absolutely zero for all the necessary items you indicate above.

The problem is, anymore that seems to be the end goal, and not the stepping stone.

What are some of these ideas (other than your own which you have shared in the past)?

[Athens]

Thread Title: American politics really only has one problem that needs fixing

My post was not a derail....

The political problems I pointed out directly related to health care. Health care is the way it is now because of corruption. Corporations are making killer profits off it.

[besson3c]

Originally Posted by Athens 

Thread Title: American politics really only has one problem that needs fixing
My post was not a derail....
The political problems I pointed out directly related to health care. Health care is the way it is now because of corruption. Corporations are making killer profits off it.

I see your point. I would say that health care is one of many reflections of corruption (in addition to some other factors), but I'm not really sure you can fix corruption by going on a corruption witch hunt. Maybe you can drive it out by working on big problems like health care if you can find some way to be productive working on a problem this complex.

[Laminar]

Originally Posted by Athens 

Thread Title: American politics really only has one problem that needs fixing
My post was not a derail....
The political problems I pointed out directly related to health care. Health care is the way it is now because of corruption. Corporations are making killer profits off it.

The thread title was not "What is the one problem that you believe needs fixing?".

[Dork.]

The biggest problem is not necessarily Health Care, it's the fact that Health Care here is tied to employment. What's up with that? Why should I have to change health care plans when I change jobs? Why should employers be burdened with the huge cost and responsibility of providing health care for all its workers? And people who are advocates of small business must realize how hard it is to take that jump into self-employment and having to go out and get your own health care coverage. Everyone I know who has gone the small-business route can only do it because their spouse is a working stiff with good benefits.

I am surprised that employers are not lining up in support of a health care concept (like SIngle-Payer) that relieves them from the burden of coordinating these health care plans for employees. Heck, take the money that was going into Health benefits and channel it directly into the Single-Payer bank account. That alone ought to pay for the whole thing....

[ebuddy]

Originally Posted by besson3c 

The problem is, anymore that seems to be the end goal, and not the stepping stone.

What are some of these ideas (other than your own which you have shared in the past)?

I hope you didn't get the impression I made those ideas up. I didn't.

Here's 70 of them listed by bill #.

[ebuddy]

Originally Posted by Dork. 

The biggest problem is not necessarily Health Care, it's the fact that Health Care here is tied to employment. What's up with that? Why should I have to change health care plans when I change jobs? Why should employers be burdened with the huge cost and responsibility of providing health care for all its workers? And people who are advocates of small business must realize how hard it is to take that jump into self-employment and having to go out and get your own health care coverage. Everyone I know who has gone the small-business route can only do it because their spouse is a working stiff with good benefits.
I am surprised that employers are not lining up in support of a health care concept (like SIngle-Payer) that relieves them from the burden of coordinating these health care plans for employees. Heck, take the money that was going into Health benefits and channel it directly into the Single-Payer bank account. That alone ought to pay for the whole thing....

Many conservatives, including myself favor decoupling health care from employers. You don't need a monolithic, single-payer system to do this, but to your point; decoupling health care from employment can't be done piecemeal at this point. I believe we need to stop thinking of health care (the overwhelming majority of it) in terms of health insurance. As long as we're stuck in this rut, I don't think we can move to real progress. Insurance should exist to cover the catastrophic issues, not the day-to-day. If your auto insurance were isolated to single states, had to cover windshield washer fluid, new tires, oil changes, etc... it'd be a lot more costly and all those providing those services would charge a great deal more because the consumer (the only true check and balance) would be separated from the actual cost of the provision.

[turtle777]

Originally Posted by Laminar 

The thread title was not "What is the one problem that you believe needs fixing?".

That's right. Besson's threads deserve not to be derailed. And please, no original or deviating thoughts either. You'd run risk of creating a discussion. Eeew.

-t

[besson3c]

Originally Posted by ebuddy 

I hope you didn't get the impression I made those ideas up. I didn't.
Here's 70 of them listed by bill #.

Maybe the problem is that whole big bill vs. small bill debate then?

I only skim read some of this list, and several of these seemed like they could be good ideas, but they also seemed like they would be an individual component of a larger solution, not a complete standalone solution in and of themselves.

I don't know how long this "the bill is too big and therefore overly complex and therefore filled with crap" stuff has been going on, but maybe American politics is really best suited for little individual pieces of small legislative changes? The problem is, American health care is a big mess, so it requires a little more than just a trivially simple bill to fix. So, do you cobble together a bunch of little bills, or put together a big one?

[besson3c]

Originally Posted by turtle777 

That's right. Besson's threads deserve not to be derailed. And please, no original or deviating thoughts either. You'd run risk of creating a discussion. Eeew.
-t

You never fail to impress me how little time it takes for you to sniff out a fight to wage here on MacNN

[besson3c]

Originally Posted by ebuddy 

Many conservatives, including myself favor decoupling health care from employers. You don't need a monolithic, single-payer system to do this, but to your point; decoupling health care from employment can't be done piecemeal at this point. I believe we need to stop thinking of health care (the overwhelming majority of it) in terms of health insurance. As long as we're stuck in this rut, I don't think we can move to real progress. Insurance should exist to cover the catastrophic issues, not the day-to-day. If your auto insurance were isolated to single states, had to cover windshield washer fluid, new tires, oil changes, etc... it'd be a lot more costly and all those providing those services would charge a great deal more because the consumer (the only true check and balance) would be separated from the actual cost of the provision.

This makes sense to me!

[ebuddy]

Originally Posted by besson3c 

This makes sense to me!

Okay. Could HSAs, backed by a compatible catastrophic plan; be used by the individual to save for their health care expenditures, savings rolled into subsequent plan years to encourage shopping, and allow contributions from employers, family, and the government in a means-tested fashion?

[NewsPosteur]

MySQL error #45

[besson3c]

Originally Posted by ebuddy 

Okay. Could HSAs, backed by a compatible catastrophic plan; be used by the individual to save for their health care expenditures, savings rolled into subsequent plan years to encourage shopping, and allow contributions from employers, family, and the government in a means-tested fashion?

That could be a part of a solution, but it is going to be insufficient without significant cost controls, I think. Otherwise, this is sort of like plugging a small hole in a massive dam breach given that the main problem we have right now is not so much the organizational structure of who provides health care, but the insane costs.

[lpkmckenna]

Originally Posted by ebuddy 

Insurance should exist to cover the catastrophic issues, not the day-to-day.

Completely, utterly, bone-headedly wrong. The best spent healthcare dollars are on preventative care. It's way, way cheaper to catch issues early than to allow them to fester into catastrophic issues. That's why insurance companies love preventative care so much: it saves money.

[Snow-i]

Originally Posted by lpkmckenna 

Completely, utterly, bone-headedly wrong. The best spent healthcare dollars are on preventative care. It's way, way cheaper to catch issues early than to allow them to fester into catastrophic issues. That's why insurance companies love preventative care so much: it saves money.

That isn't insurance.

[turtle777]

Minor detail. Proponents of a all-in government-run health care scam don't understand that insurance and preventive care are two topics that can be easily separated and dealt with each on its own.

But what they completely fail to understand: if you absolve people from the effects and consequences of their own actions and choices, government will not be able to fix the aftermath. Personal responsibility needs to be part of the equation, not a sheepish hope in a nanny state, saving the day.

-t

[besson3c]

Originally Posted by turtle777 

Minor detail. Proponents of a all-in government-run health care scam don't understand that insurance and preventive care are two topics that can be easily separated and dealt with each on its own.
But what they completely fail to understand: if you absolve people from the effects and consequences of their own actions and choices, government will not be able to fix the aftermath. Personal responsibility needs to be part of the equation, not a sheepish hope in a nanny state, saving the day.
-t

We've had this conversation before.

Hoping for personal responsibility is naive and impractical. It puts your sense of ideology above what is practical and realistic. It simply isn't going to happen, ever.

[lpkmckenna]

Originally Posted by Snow-i 

That isn't insurance.

So what? The insurance industry still does it because it saves them and everyone else money.

Originally Posted by turtle777 

Minor detail. Proponents of a all-in government-run health care scam don't understand that insurance and preventive care are two topics that can be easily separated and dealt with each on its own.

Did you miss the part when I pointed out that private insurance companies love preventative care? There is no "easy" way to separate the two concepts in either an all-private or all-public system or one in between. It's completely undesirable to even consider it. What part of "catching medical problems early saves money" don't you understand?

if you absolve people from the effects and consequences of their own actions and choices

Which has absolutely nothing to do with incorporating preventative care into insurance plans. It's just an empty-headed conservative mantra your mouth squirted out with no relevance to the issue.

[turtle777]

Originally Posted by besson3c 

We've had this conversation before.

Hoping for personal responsibility is naive and impractical. It puts your sense of ideology above what is practical and realistic. It simply isn't going to happen, ever.

We've had this conversation before.

You think politicians can fix the lack of personal responsibility. LULZ. How has that worked out so far ?

-t

[Athens]

Originally Posted by besson3c 

I see your point. I would say that health care is one of many reflections of corruption (in addition to some other factors), but I'm not really sure you can fix corruption by going on a corruption witch hunt. Maybe you can drive it out by working on big problems like health care if you can find some way to be productive working on a problem this complex.

You can't fix big problems which steam from corruption. The problems you see in US healthcare today comes from the corruption. Its a end result.

Originally Posted by Laminar 

The thread title was not "What is the one problem that you believe needs fixing?".

Get bent, stop harassing me.

Originally Posted by lpkmckenna 

Completely, utterly, bone-headedly wrong. The best spent healthcare dollars are on preventative care. It's way, way cheaper to catch issues early than to allow them to fester into catastrophic issues. That's why insurance companies love preventative care so much: it saves money.

Insurance companies do not like preventative care. They like finding loop holes to drop coverage period if some one gets sick. But I agree with you totally beyond that part.

Originally Posted by turtle777 

Minor detail. Proponents of a all-in government-run health care scam don't understand that insurance and preventive care are two topics that can be easily separated and dealt with each on its own.
But what they completely fail to understand: if you absolve people from the effects and consequences of their own actions and choices, government will not be able to fix the aftermath. Personal responsibility needs to be part of the equation, not a sheepish hope in a nanny state, saving the day.
-t

What about the responsibility of the product producers that is causing every one to be sick. Or the government that put a focus on corn crops to make food really cheap at the cost of health. High health costs are symptoms of a broken and damaged food supply. Its not just personal responsibility the people have been put into a health costly experiment.
Yet that is not what happens in systems like Canada and the UK and Holland...

[Chongo]

My fellow employees are waiting to see how the 40% "Cadillac Plan" tax will affect our premiums. (Our company self insures) I asked at our annual open enrollment meeting if we were going to fall under the tax and the answer was yes.

[ebuddy]

Originally Posted by besson3c 

Hoping for personal responsibility is naive and impractical. It puts your sense of ideology above what is practical and realistic. It simply isn't going to happen, ever.

IMO, that's a hopelessly defeatist and cynical view. I believe people have been made less vigilant in seeking their own provisions due to a system that perpetuates a moral hazard. There's nothing to suggest you and I are somehow more capable than the rest of the majority collective. We have to stop pigeonholing people into stereotypes that do not lift them up. Yes, this includes words like "lazy" and the like. While we do nothing, but spend more on provisions for the collective, the collective is not gaining ground, it is losing ground. Greater poverty, greater number of children born into poverty, greater wealth disparity, etc. Whether we believe it naive or not, we're seeing the same problem play out across the globe and at some point have to face the fact that our methods of compassion are not working.

People need to be allowed to fail. The safety nets afforded those in need should be very temporary and very conditional.
Businesses need to be allowed to fail. There should be no safety nets for failed businesses. They will have to rely on a solid business model that maintains a good labor force and produces a good product at a fair price. This is not only possible, but inevitable when their own survival depends on it.

[ebuddy]

Originally Posted by lpkmckenna 

Completely, utterly, bone-headedly wrong. The best spent healthcare dollars are on preventative care. It's way, way cheaper to catch issues early than to allow them to fester into catastrophic issues. That's why insurance companies love preventative care so much: it saves money.

Only a moron would insist the only way to get preventive care is through a third party. You wanna see a doctor about your restless leg syndrome? Go and see a doctor about your restless leg syndrome to ensure it doesn't grow into lung cancer.

Otherwise, it's clear you're not reading my posts and are more interested in being disagreeable than engaging an actual discussion.

[besson3c]

Originally Posted by ebuddy 

IMO, that's a hopelessly defeatist and cynical view. I believe people have been made less vigilant in seeking their own provisions due to a system that perpetuates a moral hazard. There's nothing to suggest you and I are somehow more capable than the rest of the majority collective. We have to stop pigeonholing people into stereotypes that do not lift them up. Yes, this includes words like "lazy" and the like. While we do nothing, but spend more on provisions for the collective, the collective is not gaining ground, it is losing ground. Greater poverty, greater number of children born into poverty, greater wealth disparity, etc. Whether we believe it naive or not, we're seeing the same problem play out across the globe and at some point have to face the fact that our methods of compassion are not working.
People need to be allowed to fail. The safety nets afforded those in need should be very temporary and very conditional.
Businesses need to be allowed to fail. There should be no safety nets for failed businesses. They will have to rely on a solid business model that maintains a good labor force and produces a good product at a fair price. This is not only possible, but inevitable when their own survival depends on it.

But none of this moral stuff matters. At all.

It doesn't matter how good people are at seeking their own provisions, virtually the entire poor and middle class income brackets could potentially "fail", to use your word, with unexpected health care expenses they can't afford. A family could tuck aside tens of thousands upon thousands of dollars, and still face troubles so long as health care costs are so out-of-control as they are. I'm repeating myself here, I'm hoping that we can agree that a) costs are out of control right now. This is not normal, and none of this has anything to do with virtues of personal responsibility.

Do you fully appreciate just how insane this system has gotten as far as overall costs go? I mean, really? Don't just give an empathetic yes to lubricate this conversation, do you *really* see that what we have is a mess? I don't mean to press you and imply that you don't, it would just be really interesting for a conservative to acknowledge this, because I don't understand why the urgency of all of this seems to be the domain of your archetype Democrat. Maybe that is just a skewed perception of mine.

As far as the concept of being allowed to fail, nobody is suggesting some sort of absolute system that doesn't allow a single person to fall through the cracks. This will happen. There has to be a middle ground between calling for something that will simply never happen (widespread personal responsibility, which as I said, is not a sustainable solution given the costs alone, leaving aside the tendencies of humanity to fold on persona responsibility in general), and some sort of "perfect" system where nobody falls through the cracks.

The thing that I don't see many conservatives acknowledge without invoking knee jerk reactions involving socialism is that we *are* all into this together, moral or not, that is just the way society is. My abusing the ER, going into bankruptcy, spreading untreated disease, raising kids in unhealthy lifestyles, whatever, it doesn't matter what you add to this list, *is* going to have an impact on you and society as a whole. People like Turtle love to play the moral card and bitch and moan about reality as it is, but this is such a complete and utter waste of time - this is not going to change no matter what. There will always be people that do things that we hate that affect others, whether this is health savings related, or just bad choices such as drinking while driving, getting pregnant, becoming obese, whatever.

What I'm saying is not that we should prop these people up because it is the moral thing to do, I don't care about morality or these people's individual lives. I'm saying that to make this overall system work best, we need to find the best balance so that when these sorts of problems inevitably happen, and they will, that they have a minimum impact on the rest of us.

The weird irony here that Turtle doesn't seem to get is that ultimately he doesn't want the poor decisions of these people to have an impact on him. The way to minimize this impact is to do exactly what I'm saying here. He mostly seems unwilling to concede that reality is as it is as far as people generally and inevitably making choices that he (and probably I) would disagree with, and going from there without letting moral rage take over.

Is this clear? You may disagree with some of this, but please make me happy by saying that this is at least understood, because I've expended a considerable effort trying to make this point in the past.

[Uncle Skeleton]

Originally Posted by besson3c 

But none of this moral stuff matters. At all.

It doesn't matter how good people are at seeking their own provisions, virtually the entire poor and middle class income brackets could potentially "fail", to use your word, with unexpected health care expenses they can't afford. A family could tuck aside tens of thousands upon thousands of dollars, and still face troubles so long as health care costs are so out-of-control as they are. I'm repeating myself here, I'm hoping that we can agree that a) costs are out of control right now. This is not normal, and none of this has anything to do with virtues of personal responsibility.

Undermining personal responsibility is exactly why costs are out of control. Until you/we accept this, you/we will never make any progress at setting costs right. At all.

The middle-men who push costs ever higher can only do that because they are endlessly propped up by the continual bail-out. Joe Pharma knows that the almighty .gov would never allow there to be a circumstance where people can't buy his product, so he can safely jack up the price to ridiculous extremes, and the "social safety net" will ensure that he gets paid whatever he asks. Just like BofA knows that they can take whatever crazy risks imaginable, and the "too big to fail" backstop will save them. They would be incredibly stupid not to profit from this situation, and if by some miracle they put the country's interest above their own (by not taking these risks), it would make no difference because someone else would jump in to do it for them.

If the government forces them to lower prices artificially, all they will do is stop producing innovative medical technology. The more rigid the regulation, the more corporations will simply waste resources "teaching to the test" instead of creating value. The proper solution is to make use of the natural barrier to price-gouging, which is competition, including competition from "no sale." This is the only method that actually gets results.

The "moral stuff" you are so scornful of isn't really about morals, it's about results. You're wondering why we can't get results, while scorning the only effective method of getting them. Further divergence from this "moral stuff" is akin to treating fever with leeches: your proposed treatment is worsening the ailment, even if you don't realize it.

[besson3c]

Originally Posted by Uncle Skeleton 

Undermining personal responsibility is exactly why costs are out of control. Until you/we accept this, you/we will never make any progress at setting costs right. At all.
The middle-men who push costs ever higher can only do that because they are endlessly propped up by the continual bail-out. Joe Pharma knows that the almighty .gov would never allow there to be a circumstance where people can't buy his product, so he can safely jack up the price to ridiculous extremes, and the "social safety net" will ensure that he gets paid whatever he asks. Just like BofA knows that they can take whatever crazy risks imaginable, and the "too big to fail" backstop will save them. They would be incredibly stupid not to profit from this situation, and if by some miracle they put the country's interest above their own (by not taking these risks), it would make no difference because someone else would jump in to do it for them.
If the government forces them to lower prices artificially, all they will do is stop producing innovative medical technology. The more rigid the regulation, the more corporations will simply waste resources "teaching to the test" instead of creating value. The proper solution is to make use of the natural barrier to price-gouging, which is competition, including competition from "no sale." This is the only method that actually gets results.
The "moral stuff" you are so scornful of isn't really about morals, it's about results. You're wondering why we can't get results, while scorning the only effective method of getting them. Further divergence from this "moral stuff" is akin to treating fever with leeches: your proposed treatment is worsening the ailment, even if you don't realize it.

So, are you using my words as a launchpad to make your own separate points while setting this up as a direct response to me, or is this actually intended to be a direct response?

My response related to the lowest level Joe Sixpack and his choices and the concept that no man is an island, not the choices of middle men and Joe Pharma, and not the government and government regulation.

If your point is that you can't divorce the one from the other, I acknowledge that, but I'm not interested in conversing with you on this level when it seems like we are talking past each other and making zero progress in understanding each other.

Was this your point?

[Uncle Skeleton]

Originally Posted by besson3c 

My response related to the lowest level Joe Sixpack and his choices and the concept that no man is an island, not the choices of middle men and Joe Pharma, and not the government and government regulation.

Ok, let me try to walk you through it.
Question 1: why are medical prices so high (hurting joe 6-pack (j6p))?
Answer 1: because suppliers can charge whatever they want and still be assured of payment.
Question 2: how can they be assured of payment?
Answer 2: because the government will rig the game any way they can to avoid j6p going without the product.
Question 3: how can we keep prices from spiraling out of control? how is this problem dealt with in every other industry?
Answer 3: abstainers. J6P is a MASSIVE market. If every one of them must buy the product, then the product will make a killing. Doesn't matter what the product is, doesn't matter if it works. If everyone buys one, instant fortune. This doesn't happen in most markets because most markets have the option of "no sale." If the product isn't worth the cost, someone can decide not to buy it. But if the "no sale" limit on costs is removed, costs skyrocket.
Question 4: can we substitute the "no sale" cost control with another cost control?
Answer 4: yes, but the side effect is an end to innovation. The "no sale" cost control is a mechanism for selecting quality products, products that are worth a sale. Artificial cost controls are a mechanism for gamesmanship, and the incentive to product a quality product is overwhelmed by an incentive to meet the rulebook. Medicine would become the tax code, where the entire industry is centered around advantageous manipulation of the rules and not about producing anything of inherent value.
Question 5: then how do we revive the "no sale" cost control?
Answer 5: J6P has to be brought back in to the decision on "worth," about what products are worth their costs and when a "no sale" should happen.

Do you see now why I am not going off (your) topic? J6P using "personal responsibility" and weighing the "worth" of his own treatment is absolutely vital to addressing the problem of out-of-control costs in the industry, which is a root cause of all this distress that we both (and I'm sure most people) can agree on.

[besson3c]

Originally Posted by Uncle Skeleton 

Ok, let me try to walk you through it.
Question 1: why are medical prices so high (hurting joe 6-pack (j6p))?
Answer 1: because suppliers can charge whatever they want and still be assured of payment.
Question 2: how can they be assured of payment?
Answer 2: because the government will rig the game any way they can to avoid j6p going without the product.
Question 3: how can we keep prices from spiraling out of control? how is this problem dealt with in every other industry?
Answer 3: abstainers. J6P is a MASSIVE market. If every one of them must buy the product, then the product will make a killing. Doesn't matter what the product is, doesn't matter if it works. If everyone buys one, instant fortune. This doesn't happen in most markets because most markets have the option of "no sale." If the product isn't worth the cost, someone can decide not to buy it. But if the "no sale" limit on costs is removed, costs skyrocket.
Question 4: can we substitute the "no sale" cost control with another cost control?
Answer 4: yes, but the side effect is an end to innovation. The "no sale" cost control is a mechanism for selecting quality products, products that are worth a sale. Artificial cost controls are a mechanism for gamesmanship, and the incentive to product a quality product is overwhelmed by an incentive to meet the rulebook. Medicine would become the tax code, where the entire industry is centered around advantageous manipulation of the rules and not about producing anything of inherent value.
Question 5: then how do we revive the "no sale" cost control?
Answer 5: J6P has to be brought back in to the decision on "worth," about what products are worth their costs and when a "no sale" should happen.
Do you see now why I am not going off (your) topic? J6P using "personal responsibility" and weighing the "worth" of his own treatment is absolutely vital to addressing the problem of out-of-control costs in the industry, which is a root cause of all this distress that we both (and I'm sure most people) can agree on.

I guess I see your point, although I don't agree with it.

What about when a no sale is not an option for J6P? A company can still be as profitable relying on higher profit margins at lower volumes. When the choice is between buying a large TV vs. buying a smaller TV or no TV at all, a no sale can bring costs under control. When the choice is between getting a procedure done or possibly (or inevitably) dying, what choice is there?

I also think you are over simplifying your answer as to why costs are so high.

[Uncle Skeleton]

Originally Posted by besson3c 

I guess I see your point, although I don't agree with it.

I welcome a debate instead of the usual dismissal.

What about when a no sale is not an option for J6P? A company can still be as profitable relying on higher profit margins at lower volumes. When the choice is between buying a large TV vs. buying a smaller TV or no TV at all, a no sale can bring costs under control. When the choice is between getting a procedure done or possibly (or inevitably) dying, what choice is there?

There is the same choice. Believe it or not, people are capable of making a choice to die. Gasp! It's been going on for millions of years. Everyone dies eventually. People know this. Some people can choose to leave more for their families, rather than prolong their life for a few extra years. Do you believe it?

What was life like before this treatment option was invented (whatever treatment is in question)? Were we better off without it, without the temptation of crippling debt (on a personal or societal level), when people simply died a few years earlier, but with positive net worth to pass on to their families? More to the point, what should happen when a new, fabulously expensive treatment option is first invented? Should it go through an "early adopter" phase where only the rich can afford to throw their money away by basically being beta testers, allowing the process to be refined, and supporting it while it matures and ultimately becomes cheaper and more efficient? Or should it immediately be forced to be available for all?

The fact that people might choose to save their own lives doesn't make the costs disappear. It still costs just as much whether the patient can afford it or not. But guess what, after the early adopters give the treatment its trial by fire, in a competitive environment where the product must compete with "no sale," the technology will evolve and become cheaper! Then not only will every J6P be able to get one (like with TVs now), it won't plunge the entire country into crippling debt and become "really the only problem that needs fixing." This is what we see happening in every other market, where government isn't actively destroying the benefits of capitalism. Even if the poor's medicine lags behind the rich's, it still improves over time, just like TVs, cars, computers, air conditioners, food, and every other technology we know of. This is not monstrous, it's not a tragedy, it's actually a triumph.

I also think you are over simplifying your answer as to why costs are so high.

Again, I welcome debate instead of the usual dismissal. Show me.

[OAW]

It would seem to me that things like this ....

- Gunshot wound
- Broken limb
- Blunt force trauma from a car accident
- Heart attack
- Cancer
- Diabetes
- Stroke
- Etc.

... don't particularly lend themselves very well to comparison shopping. Let alone the "no sale" approach. I'm just saying ...

OAW

[besson3c]

Originally Posted by OAW 

It would seem to me that things like this ....
- Gunshot wound
- Broken limb
- Blunt force trauma from a car accident
- Heart attack
- Cancer
- Diabetes
- Stroke
- Etc.
... don't particularly lend themselves very well to comparison shopping. Let alone the "no sale" approach. I'm just saying ...
OAW

Yeah, I lost interest in his post with the whole "making a choice to die" bit, as if that belongs in a conversation about how to improve health care to at least be on par with other first world countries where the general population doesn't have to make these sorts of decisions with treatable conditions like those in the above list.

[Uncle Skeleton]

Originally Posted by OAW 

It would seem to me that things like this ....

- Gunshot wound
- Broken limb
- Blunt force trauma from a car accident
- Heart attack
- Cancer
- Diabetes
- Stroke
- Etc.

... don't particularly lend themselves very well to comparison shopping. Let alone the "no sale" approach. I'm just saying ...

OAW

Why? I don't see any obstacle to comparison shopping there.

Originally Posted by OAW 

It would seem to me that things like this ....

- Gunshot wound
- Broken limb
- Blunt force trauma from a car accident
- Heart attack
- Cancer
- Diabetes
- Stroke
- Etc.

... don't particularly lend themselves very well to comparison shopping. Let alone the "no sale" approach. I'm just saying ...

OAW

Maybe not if you're not prepared in advance, despite these being pretty common occurrences, but even without the option to comparison shop, people today are able to execute a living will. Not "lending well" to comparison shopping doesn't mean you can disregard it, if you consider the issue important. Don't you think that crushing medical debt is a problem important enough to look beyond the absolutely simplest possible solution?

[Uncle Skeleton]

Originally Posted by besson3c 

Yeah, I lost interest in his post with the whole "making a choice to die" bit, as if that belongs in a conversation about how to improve health care to at least be on par with other first world countries where the general population doesn't have to make these sorts of decisions with treatable conditions like those in the above list.

Classic besson3c. Start a thread and "lose interest" if anyone has a different opinion, rather than engage in the topic you started. Don't mind me, just start a few more threads and then abandon the topics when it doesn't turn out to be a huge circle-jerk.

Your behavior is very disrespectful, implying that others' opinions aren't worth mentioning. You deserve all the e-abuse you get for this sort of crap.

[besson3c]

Originally Posted by Uncle Skeleton 

Classic besson3c. Start a thread and "lose interest" if anyone has a different opinion, rather than engage in the topic you started. Don't mind me, just start a few more threads and then abandon the topics when it doesn't turn out to be a huge circle-jerk.
Your behavior is very disrespectful, implying that others' opinions aren't worth mentioning. You deserve all the e-abuse you get for this sort of crap.

The problem I have with your posts is that I can never tell if you are being contrarian for your own enjoyment, or whether you really and truly seem to misunderstand everything I say as often as you seem to do. Take my other thread for instance where you come in and right off the bat say I'm being emo and find modern society unbearable. I don't even know where to begin with addressing this disconnect in our communication. The other problem, as I've stated a number of times, is that you rarely seem to acknowledge many points I make and rarely demonstrate your understanding of what I'm expressing before going off on a tangent. Yes, this is typical conversation fare, but I feel like everything I write is interpreted in a different language by you.

I haven't figured out how to communicate with you. It is often easier to just forge on without you, because it is incredibly time consuming and often frustrating sorting things out with you, which ultimately takes the conversation in directions I wasn't initially interested in going anyway.

No disrespect, I don't dislike you, I'm glad you're here, I just don't understand you.

[Uncle Skeleton]

Originally Posted by besson3c 

The problem I have with your posts is that I can never tell if you are being contrarian for your own enjoyment, or whether you really and truly seem to misunderstand everything I say as often as you seem to do. Take my other thread for instance where you come in and right off the bat say I'm being emo and find modern society unbearable. I don't even know where to begin with addressing this disconnect in our communication. The other problem, as I've stated a number of times, is that you rarely seem to acknowledge many points I make and rarely demonstrate your understanding of what I'm expressing before going off on a tangent. Yes, this is typical conversation fare, but I feel like everything I write is interpreted in a different language by you.

I don't see how any of that applies to this thread. This is my understanding of your OP, and you can tell me where I'm wrong: "health care costs are too high, higher than they need to be, and if we found a way to fix that then it would alleviate nearly every other current crisis significantly. Why aren't people trying to fix it?"

Is that inaccurate?

I tried to identify the reason this problem exists and in so doing highlight a rational achievable policy-based strategy to fix it. I don't see how any of that is a "tangent" or a "misunderstanding." What did you want people to do if not suggest ways to fix the problem?

The way to attack runaway costs isn't some mysterious voodoo, it's just reduce/reuse/recycle, in that order. You get the most savings by buying less stuff in the first place, and secondarily you get better returns by getting multiple uses out of each thing you do buy, than by selling it for scrap (or whatever), which is still better than throwing it away, which can actually cost more money in disposal fees or fines. But we're not going to make much progress if buying less stuff is declared off-limits. I think that is a grave error. All the more so because medical supplies specifically are notoriously strict against re-use and sharing. It should be top priority to revisit the decisions about how much medicine actually needs to be bought, and who is in charge of making that decision on an ongoing basis.

[turtle777]

Wow.

Discussing with Besson is like running at the Special Olympics...

-t

[Athens]

Originally Posted by ebuddy 

IMO, that's a hopelessly defeatist and cynical view. I believe people have been made less vigilant in seeking their own provisions due to a system that perpetuates a moral hazard. There's nothing to suggest you and I are somehow more capable than the rest of the majority collective. We have to stop pigeonholing people into stereotypes that do not lift them up. Yes, this includes words like "lazy" and the like. While we do nothing, but spend more on provisions for the collective, the collective is not gaining ground, it is losing ground. Greater poverty, greater number of children born into poverty, greater wealth disparity, etc. Whether we believe it naive or not, we're seeing the same problem play out across the globe and at some point have to face the fact that our methods of compassion are not working.
People need to be allowed to fail. The safety nets afforded those in need should be very temporary and very conditional.
Businesses need to be allowed to fail. There should be no safety nets for failed businesses. They will have to rely on a solid business model that maintains a good labor force and produces a good product at a fair price. This is not only possible, but inevitable when their own survival depends on it.

Safety Nets should be just that Safety nets, not Safety Traps. The current systems in most western countries are not safety nets but a trap. Lots of individual expensive programs designed to offer a limited service designed to mother some one.

Food Stamps for Food
Shelter Allowance for Shelter
Insert all the other specialized programs here

Do away with all these programs and issue out straight cash and enough cash to actually survive. Save tax money from the expensive administration of the programs and empower people to make there own choices on where the money they are given goes.

[Athens]

Originally Posted by Uncle Skeleton 

Why? I don't see any obstacle to comparison shopping there.
Maybe not if you're not prepared in advance, despite these being pretty common occurrences, but even without the option to comparison shop, people today are able to execute a living will. Not "lending well" to comparison shopping doesn't mean you can disregard it, if you consider the issue important. Don't you think that crushing medical debt is a problem important enough to look beyond the absolutely simplest possible solution?

I don't know how it works in the United States of a America but generally speaking, when some one has a heart attack or is in a serious car accident here treatment comes first before checking ones ability to pay, or living will for comparison shopping of what the patent will pay for or not. I cringe at the thought of having to negotiate or shop around for medical services while I am sitting there bleeding out from a gun shoot wound.

[Athens]

One of the reasons for high costs in medical system is the higher standards placed upon it. And this is directly related to government regulations. How viable is it for some one to start up a x-ray manufacturing company with the regulations and patents currently in place. Seems the only companies that can engage in big expensive medical equipment is the big companies with deep pockets.

How many choices does one have to purchase medical equipment. How much competition is there in the market to sell it. What regulations make it 10x more expensive in the first place?

[Uncle Skeleton]

Originally Posted by Athens 

Originally Posted by Uncle Skeleton 

Why? I don't see any obstacle to comparison shopping there.
Maybe not if you're not prepared in advance, despite these being pretty common occurrences, but even without the option to comparison shop, people today are able to execute a living will. Not "lending well" to comparison shopping doesn't mean you can disregard it, if you consider the issue important. Don't you think that crushing medical debt is a problem important enough to look beyond the absolutely simplest possible solution?

I don't know how it works in the United States of a America but generally speaking, when some one has a heart attack or is in a serious car accident here treatment comes first before checking ones ability to pay, or living will for comparison shopping of what the patent will pay for or not. I cringe at the thought of having to negotiate or shop around for medical services while I am sitting there bleeding out from a gun shoot wound.

http://en.wikipedia.org/wiki/Do_not_resuscitate

It's really not that onerous to check one or two facts before proceeding with an hours-long surgery, if the system is in place. This is the information age, after all. And the vast majority of what makes modern medicine expensive is not emergency time-frame stuff.

[Uncle Skeleton]

Originally Posted by Athens 

One of the reasons for high costs in medical system is the higher standards placed upon it. And this is directly related to government regulations. How viable is it for some one to start up a x-ray manufacturing company with the regulations and patents currently in place. Seems the only companies that can engage in big expensive medical equipment is the big companies with deep pockets.

How many choices does one have to purchase medical equipment. How much competition is there in the market to sell it. What regulations make it 10x more expensive in the first place?

Totally agree. Government should be actively encouraging the consumerization of medicine, not obstructing it. Once a procedure, treatment or diagnostic has been established and vetted, it should be made over-the-counter (or the sudafed equivalent). Only the cutting edge stuff should still be the domain of the oracles doctors.

[Uncle Skeleton]

Originally Posted by Athens 

Safety Nets should be just that Safety nets, not Safety Traps.
....
Do away with all these programs and issue out straight cash and enough cash to actually survive. Save tax money from the expensive administration of the programs and empower people to make there own choices on where the money they are given goes.

How is that going to avoid being a Safety Trap?

[ebuddy]

Originally Posted by besson3c 

But none of this moral stuff matters. At all.

Are you sure? I mean, did you put a lot of thought into this and come to that conclusion or are you letting stress speak for you because again, this is very defeatist.

It doesn't matter how good people are at seeking their own provisions, virtually the entire poor and middle class income brackets could potentially "fail", to use your word, with unexpected health care expenses they can't afford.

I guess I don't understand what it is that would throw the entire poor and middle class income brackets into "failure" with health care expenses they can't afford. The average medical bankruptcy claim is $11k besson. Not $1 million, not $300k or $100k, but $11k. That's it. Under a strong economy, this kind of money can be saved into a vehicle that could produce $11k in relatively short order. I've already advocated an HSA with compatible plan to cover catastrophic illness. These problems can be addressed and in fact, it does include people seeking their own provisions and utilizing perhaps the best cost control in existence; people.

A family could tuck aside tens of thousands upon thousands of dollars, and still face troubles so long as health care costs are so out-of-control as they are. I'm repeating myself here, I'm hoping that we can agree that a) costs are out of control right now. This is not normal, and none of this has anything to do with virtues of personal responsibility.

Do you fully appreciate just how insane this system has gotten as far as overall costs go? I mean, really? Don't just give an empathetic yes to lubricate this conversation, do you *really* see that what we have is a mess? I don't mean to press you and imply that you don't, it would just be really interesting for a conservative to acknowledge this, because I don't understand why the urgency of all of this seems to be the domain of your archetype Democrat. Maybe that is just a skewed perception of mine.

Don't just give an empathetic "yes" to lubricate the conversation? It'd be nice to see a conservative acknowledge this? You're kidding me right? I've cited 70 health care proposals offered by Republicans besson and those were just the ones Democrats gave zero hearing to. There are a total of some 350 health care proposals offered by "conservatives" and republicans. As for me, I'm about as passionate on this matter as anyone you'll find here and my focus has always been on increasing accessibility to health care and controlling health care costs. My single most vocal complaint is that we've created a massive health care reform package that insures approximately 1/3rd of the uninsured while doing absolutely zero for organic cost-containment.

Of course it has everything to do with the virtues of personal responsibility. Right off the bat we have an obesity problem that correlates strongly with poverty on top of alcoholism, drug abuse, and tobacco usage. Not only are these irresponsible usages of the little money they have, but they are putting themselves in the position of incurring greater medical expenses than are necessary at the same time utilizing health care dollars they never see or manage. This isn't normal besson. You can't see how this is a severely distorted marketplace where people bicker over which health care insurer is going to save the day when they're already at a measly 3.3% profit margin? Yet, we keep pointing at them. Yeah, I fully appreciate how out-of-control health care expenses are and I've been telling you time and again why and reminding people that they've been so duped into the narrative of the evil health insurance company that they're missing the entire crux of the problem. The more symptoms we ease at the Federal and State level through aid, the worse our health gets, and the more expensive health care becomes. Can you not see this? I mean... as a democrat are you able to look beyond the unfounded perceptions and a priori defeatist mentality to understand that health care providers charge what they do because they can? We're not shopping our care and we're not caring for ourselves as if our lives depended on it. It has EVERYTHING to do with the virtues of personal responsibility. This is the middle ground you're talking about, you just, for whatever reason cannot look upon it.

As far as the concept of being allowed to fail, nobody is suggesting some sort of absolute system that doesn't allow a single person to fall through the cracks. This will happen. There has to be a middle ground between calling for something that will simply never happen (widespread personal responsibility, which as I said, is not a sustainable solution given the costs alone, leaving aside the tendencies of humanity to fold on persona responsibility in general), and some sort of "perfect" system where nobody falls through the cracks.

People have to make the best decisions for their care. The less we expect of the collective, the less they'll produce. There are safety nets for those who absolutely cannot. By artificially expanding that threshold, we're just creating more who won't.

The thing that I don't see many conservatives acknowledge without invoking knee jerk reactions involving socialism is that we *are* all into this together, moral or not, that is just the way society is. My abusing the ER, going into bankruptcy, spreading untreated disease, raising kids in unhealthy lifestyles, whatever, it doesn't matter what you add to this list, *is* going to have an impact on you and society as a whole. People like Turtle love to play the moral card and bitch and moan about reality as it is, but this is such a complete and utter waste of time - this is not going to change no matter what. There will always be people that do things that we hate that affect others, whether this is health savings related, or just bad choices such as drinking while driving, getting pregnant, becoming obese, whatever.

How many times have you been to the emergency room besson? Any fat smokers around here that can tell me how often they've been to the emergency room? I'm guessing less than once a year. Let's not conflate the immigration problem with a health care problem, at least for the sake of this discussion. If we're in this together, why do we insist on defining this issue by its lowest common denominator instead of seeking means of encouraging people to take additional, personal responsibility?

What I'm saying is not that we should prop these people up because it is the moral thing to do, I don't care about morality or these people's individual lives. I'm saying that to make this overall system work best, we need to find the best balance so that when these sorts of problems inevitably happen, and they will, that they have a minimum impact on the rest of us.

We had a balance, but over time the government continued to distort and tip that balance by creating the moral hazard of greater dependency. The provisions are no longer means-tested as a safety net. There is no nerf world. The more the government eases symptoms of problems, the less capable the collective of addressing the root cause of them.

The weird irony here that Turtle doesn't seem to get is that ultimately he doesn't want the poor decisions of these people to have an impact on him. The way to minimize this impact is to do exactly what I'm saying here.

What you've been saying here is "more of the same" and "status quo is the way to go" when you and I both know this is impossible at the current increasing costs of health care. With such focus on the "victims" and lowest common denominator (that is already being cared for whether you're able to acknowledge this or not) you're missing the broader scope of the problem and failing completely to understand what it is that drives up costs. We're talking about over 300 million people besson, you'd better ensure your ideals are sustainable monetarily. We've talked ad nauseam about what a mess health care is and it's not getting any better. We need to pull emotion out of this. Your sense of morality may be causing a greater problem and if you're absolutely unwilling to acknowledge this, you're not operating under a healthy degree of compassion and sensibility, but of a dangerously problematic paper-ideology.

[pottymouth]

You can get even more direct than that. I once heard the whole debate narrowed down to "the well-being of the individual vs the well-being of the society". Personally, I'm gonna side with Spock on this one.

I'm all for individual achievements and success, but not at the expense of those around me. The more success I've found, the more I've given back. And hell yeah that makes me feel good about myself.