And the winner of tonight's Republican debate...

aircooled wrote: I suspect most of the "fixing" that would be done in government would be some of the oppressive oversight and regulation. So, you could also ask: Why don't we fix companies so that we don't have to make all these stupid laws to keep them from doing stupid things. It is a rather circular problem.

Greed maybe considered a problem (by some), but it is a social and cultural problem. Government success in altering behaviours like alcohol consumption, tobacco smoking, drug use and prostitution is barely measurable.

Well, I am just referring to the business related regulations of course. But most government regulations have a similar "circular" aspect. They are created to keep people from doing something, or perhaps encourage them to do something (don't hurt people, pay your taxes etc.), theoretically ( ) for the common good (yes I know, even mentioning that makes someone a socialist ( ) .

If everyone just did these things on their own the regulations would not be needed. Obviously there are a number of things that people don't want the government to tell them what to do, kind of the source of the issue in this thread, but there are many other things that don't enter into that area.

I guess the main point is. You can't really trust people (businesses also) to do " the right thing", so, for that reason, you cannot expect government to "stay out of it". If that makes sense, in a circular kind of way.

In reply to madmallard:

That's tough. Which is a trite way of admitting I don't have a great answer.

I guess I don't see it as circular as much as parallel. We have issues trying to get either industry or government to do what it ought to do without it seeming to abuse the populace in some way. Government is wasteful and bloated. Industry is frequently somewhat less wasteful and bloated (but not always), but makes up for it with a legally-binding requirement that the shareholders' pocketbooks come before any other concerns. Either system in its current state is a loser for most of us.

With respect to your question of why don't we fix it first, my take on it would be a matter of perceived urgency: Government has always been wasteful, but I'm more immediately concerned about the terrible things happening to uninsured/underinsured individuals on a daily basis. That being said, our economic standing makes it clear that there is no shortage of urgency regarding the government waste issue. As usual, we need to fix it all and are going to have a hard time of fixing any of it. I'm trying not to succumb to the mindset that anybody who thinks it can be fixed immediately loses all credibility...

Regarding the requirement to purchase insurance: That's not something that should be taken lightly. That being said, not buying insurance is untenable. If you have enough money to buy insurance, you have too much to lose to not buy it. If you don't have enough to buy insurance and have a condition that can't be managed with emergency room visits... And of course anybody not buying insurance and unable to pay is costing the rest of us with those trips.

Sort of following into my previous post, but wanted to note this separately as I work through things said by madmallard and racerdave...

One of the things we run up against is a "lesser of two evils" problem [EDIT: and the crux of a lot of disagreement is which is less evil]. Although I recognize government's bloatedness and ineptitude, I'm more worried about the predatory behavior of unregulated industry.

I also tend to think that a lot of the corruption in government is the result of shady but cost-effective behavior by industry. The ineptitude and bloat, I'm afraid, I can't blame on external forces

So we have to fix everything. Neither government nor industry will behave themselves correctly without fixes. Government is our tool for shaping both government and industry in cases like health care wherein we can't readily vote with our dollars, because for the system issues that we see, moving from insurer to insurer makes to real difference. And we can't readily opt out.

Does that capture some of the core of the problem? Can it be stated even more simply?

In reply to aircooled:

I understand what you're saying and I understand the will to see government as a benevolent institution.

But, racerdave600's post illustrates the pitfalls of intervention. It's not the intent that is bad, it's the execution and administration that creates skepticism.

ransom wrote: In reply to madmallard: That's tough. Which is a trite way of admitting I don't have a great answer.

I didn't say it was easy. ;p And that may be an answer in of itself. Its easier to do A than B.

Regarding the requirement to purchase insurance: That's not something that should be taken lightly. That being said, not buying insurance is untenable.

If we're going to have socialised medicing, no its not tenable. You need healthy people to pay for the unhealthy, and thats just the fact of it.

On what I consider to be moral and ethical, it is untenable. It is ultimately forcing a very large number of people to become responsible for life choices of a decreasing minority, intentional or not. Social Security Disability is the body we setup for those who need help being able to contribute to society in their own way due to various circumstance that do not involve a choice.

oldsaw wrote: In reply to aircooled: I understand what you're saying and I understand the will to see government as a benevolent institution. But, racerdave600's post illustrates the pitfalls of intervention. It's not the intent that is bad, it's the execution and administration that creates skepticism.

Well, I guess I should be be more clear. I was commenting on the note that the government "process" needs to be cleaned up / addressed. My point was that the government "process" is simply (in most cases) a reaction or anticipation of business / personal actions. This of course also includes the personal actions of people Within the government (argg) So to address their process, you might as well address the other side also. You are right though, I really do wish they were truly benevolent.

In either case, I don't think you can do anything about it, it's just the way it is.

You might say, the governments job is to create laws to control the populace, the populaces job is to create reasons why the government needs to control them.

Vast oversimplification and no comment on What they are trying to control, just the fact that it is a two way street (circular / self energizing process). Just one way to look at the situation.

madmallard wrote:

ransom wrote: Regarding the requirement to purchase insurance: That's not something that should be taken lightly. That being said, not buying insurance is untenable.

If we're going to have socialised medicing, no its not tenable. You need healthy people to pay for the unhealthy, and thats just the fact of it.

Forgive me, I got lost here. I wasn't very clear about it, but I was referring to the current situation, wherein it seems to me to be essentially a non-choice: If you can get health insurance, you do. The step to having a mandate shouldn't be glossed over, but my impression is the reality of the current situation mandates purchasing insurance; there just isn't a law that says so.

Given the primary importance of staying alive, in terms of important things in life, I've been one of those inclined to treat health care as a right. However, ignoring that for now, we need people who don't have house fires and people who don't have need of the police help pay for those services. Fires are usually preventable, with a continuum ranging from dumbass to dumb luck as the root cause. Is the only motivation for tax-funded fire departments that house fires are contagious, so to speak? Or have we deemed it worthwhile to not let people lose their homes and/or die when we can prevent it, because we as a culture feel that spread out across the population, the cost is worthwhile?

On what I consider to be moral and ethical, it is untenable. It is ultimately forcing a very large number of people to become responsible for life choices of a decreasing minority, intentional or not. Social Security Disability is the body we setup for those who need help being able to contribute to society in their own way due to various circumstance that do not involve a choice.

There are an awful lot of cases of health issues not caused by life choices. I raised a couple recently, but I won't harp on them. Do we know what the proportion is of the cost of covering the fallout of cheeseburger abuse vs unforeseeable issues? Is there a proportion wherein making sure we never pay for someone's idiocy outweighs the lives ruined or lost due to lack of care of those who didn't do anything wrong?

ransom wrote: Forgive me, I got lost here. I wasn't very clear about it, but I was referring to the current situation, wherein it seems to me to be essentially a non-choice: If you can get health insurance, you do. The step to having a mandate shouldn't be glossed over, but my impression is the reality of the current situation mandates purchasing insurance; there just isn't a law that says so.

Ah, here's the problem. In the law just passed, you are required to buy insurance or pay a penalty to the federal government for not having insurance.

The federal government claims this authority by referencing the Interstate Commerce Act.

This is (one reason) why 'Obamacare' as its known is being fought against in the Supreme Courts; the Interstate Commerce Act has never been used to 'force' someone to buy a private party product under penalty of law.

Given the primary importance of staying alive, in terms of important things in life, I've been one of those inclined to treat health care as a right. However, ignoring that for now, we need people who don't have house fires and people who don't have need of the police help pay for those services. Fires are usually preventable, with a continuum ranging from dumbass to dumb luck as the root cause. Is the only motivation for tax-funded fire departments that house fires are contagious, so to speak? Or have we deemed it worthwhile to not let people lose their homes and/or die when we can prevent it, because we as a culture feel that spread out across the population, the cost is worthwhile?

That depends entirely upon the community itself. Take for example that thread that popped up here a while back where a local municipal fire department offered to cover their neighboring municipality which had no fire department of its own, as long as the residents paid for them to be available in the form of a tax that went back to that other municipality.

Someone in that neighboring district who declined to pay the tax had their house catch fire. The department showed up, and let the house burn, only making sure it didn't spread.

The stupidest part of the reporting I saw on this was mentioning the guy offered to pay the firefighters at the scene. This is analgous to driving without insurance, crashing your car, then expecting to buy insurance a week later and be covered after one payment.

There are an awful lot of cases of health issues not caused by life choices. I raised a couple recently, but I won't harp on them. Do we know what the proportion is of the cost of covering the fallout of cheeseburger abuse vs unforeseeable issues? Is there a proportion wherein making sure we never pay for someone's idiocy outweighs the lives ruined or lost due to lack of care of those who didn't do anything wrong?

You can read the morbid obesity statistics in the United States to derive even a partial opinion on that.

madmallard wrote: Ah, here's the problem. In the law just passed, you are required to buy insurance or pay a penalty to the federal government for not having insurance.

I guess with all the hoopla, I haven't been considering this a done deal 'til things are done being hashed out in the courts.

The federal government claims this authority by referencing the Interstate Commerce Act. This is (one reason) why 'Obamacare' as its known is being fought against in the Supreme Courts; the Interstate Commerce Act has never been used to 'force' someone to buy a private party product under penalty of law.

That particular legislation hasn't been used to do so, and I guess it's never been done at the federal level (?), but we certainly require people to buy auto insurance. Of course, we don't compel people by law to drive, even if it's effectively necessary in some cases.

The parts of auto insurance which are required are there to protect other motorists or the people who actually own the car we're paying off. But at this point not having insurance incurs a cost on society at large, so that part of it doesn't strike me as being as different as it might look at first glance.

If instead of a required insurance everyone had to buy, a tax was levied and vouchers handed out which could only be used to buy insurance, thus avoiding the particular usage of the Interstate Commerce Tax and if we also avoided the use of the word 'right' to describe health care, would that be significantly more palatable?

That depends entirely upon the community itself. Take for example that thread that popped up here a while back where a local municipal fire department offered to cover their neighboring municipality which had no fire department of its own, as long as the residents paid for them to be available in the form of a tax that went back to that other municipality. Someone in that neighboring district who declined to pay the tax had their house catch fire. The department showed up, and let the house burn, only making sure it didn't spread.

Is it out of line to assume that the FD-less community was particularly small? I.e. so small that it would be more expensive to maintain a fire department than to let the occasional building burn down?

The stupidest part of the reporting I saw on this was mentioning the guy offered to pay the firefighters at the scene. This is analgous to driving without insurance, crashing your car, then expecting to buy insurance a week later and be covered after one payment.

Totally correct. And an excellent example of the repercussions of not having a pooled resource to help with this sort of thing. He opted out where it was available, and now his home is a pile of cinders, and he's doubtless going to have to rely on his friends/family/community/red cross while putting the pieces back together.

Is there a proportion wherein making sure we never pay for someone's idiocy outweighs the lives ruined or lost due to lack of care of those who didn't do anything wrong?

You can read the morbid obesity statistics in the United States to derive even a partial opinion on that.

While I don't doubt it would be alarming, disturbing, and frustrating (except to Jack In The Box execs), that by itself isn't a good indicator. The answer to that question lies only with the full set of data regarding both types of care; baconator-caused or happenstance/genetics/etc...

ransom wrote: That particular legislation hasn't been used to do so, and I guess it's never been done at the federal level (?), but we certainly require people to buy auto insurance. Of course, we don't compel people by law to drive, even if it's effectively necessary in some cases. The parts of auto insurance which are required are there to protect other motorists or the people who actually own the car we're paying off. But at this point not having insurance incurs a cost on society at large, so that part of it doesn't strike me as being as different as it might look at first glance.

They key here again is you aren't forced to drive a car on state roads, or take a loan out on it where you agree to insure the value of the car loan. It is immaterial what the costs are to the bank making you get the insurance.

And if this was as failsafe a system as people seem to think, because it is often brought up as a comparable note to pleading a case for health mandates, why is 'uninsured motorist' coverage available? If everyone is supposed to have insurance, this would negate the need for such a thing.

If instead of a required insurance everyone had to buy, a tax was levied and vouchers handed out which could only be used to buy insurance, thus avoiding the particular usage of the Interstate Commerce Tax and if we also avoided the use of the word 'right' to describe health care, would that be significantly more palatable?

That idea deserves closer examination, as it would continue to allow for selecting a private insurer and force them to compete amongst themselves. However, that idea wouldn't work if they didn't also allow non-employee to band together to buy insurance too. Also, the voucher would have to be good for ANY insurance level (just pay the difference if you want more insurance).

and yes, as I said before, trying to define this as a 'right' ridiculously overstates the power of the government needlessly. The government provides many services without defining them as a 'right,' including Social Security (remember congress and supreme court have ruled you have no right to SS funds.)

While I still oppose it in principal, not defining it a 'right' acknowledges a far wider personal responsibility for ones own welfare.

While those things help, none of that solves the other core problem. It will be insolvent. There is no way to pay for it. The CBO has revised almost everything they release during the debating leading up to the law passing, the administration said it wouldn't be a tax but are using a tax clause to defend its legitimacy, most every economic firm that has looked at this is now saying more people will lose coverage or be simply laid off rather than the bosses be bothered with complying (there is an option to just pay a $2000 annual fine per employee rather than bother providing insurance itself, which usually costs a company around $5000.) Even before its passage, there has been a shortage of health care professionals to meet the demand, and if we use Obama's figures and add a few million people to the 'insured' column without addressing that, there will be another increase in cost.

The stupidest part of the reporting I saw on this was mentioning the guy offered to pay the firefighters at the scene. This is analgous to driving without insurance, crashing your car, then expecting to buy insurance a week later and be covered after one payment.

Totally correct. And an excellent example of the repercussions of not having a pooled resource to help with this sort of thing. He opted out where it was available, and now his home is a pile of cinders, and he's doubtless going to have to rely on his friends/family/community/red cross while putting the pieces back together.

Repercussions of not having a pooled resource? No, I wholly reject that conclusion.

Fire aside, this is only the repercussion of one person's decision making process. He decided he wouldn't need to pay this fee to receive the services associated with that fee. This decision relies soley upon he who made it. Having a pooled resource essentially legitimises his policy of poor decision making.

Protecting that property is his responsibility. Wether directly with a fire extinguisher, or indirectly thru paying for the services of another.

Also in the current law is a provision forcing an insurance company to accept a client with a pre-existing condition before being insured. (this is not the same thing as having a condition with an insurance company already, and then changing insurance, this was already protected in previous law).

I reject a conclusion that allows for detracting of the personal responsibility of this in name of a larger benefit to society, because those benefits have no quantifyable static terms. Even a financial benefit claimed is dubious without some control to compare it to, and the only control most people have is their income, which goes down~

Is there a proportion wherein making sure we never pay for someone's idiocy outweighs the lives ruined or lost due to lack of care of those who didn't do anything wrong?

Thats a question you have to answer for yourself. I'm afraid my answer would hold no value to anyone....

You can read the morbid obesity statistics in the United States to derive even a partial opinion on that.

While I don't doubt it would be alarming, disturbing, and frustrating (except to Jack In The Box execs), that by itself isn't a good indicator. The answer to that question lies only with the full set of data regarding both types of care; baconator-caused or happenstance/genetics/etc...

I can appreciate your skepticism, but seriously. Read up on this one health care cost facet that is the direct result of people's lifestyle. This is beyond alarming.

Of the entire population 1 in 4, to 1 in 3 people are MORBIDLY obese since 2007. Anywhere from 1/2 to 2/3 is overweight in general. The scale of this problem can't be held to the 'being born that way' explanation as the greater cause.

While geneology certainly factors into certain disorders and even a broader sense of metabolic rates, the mass has to come from somewhere.