The Pending Doom of Obamacare

[Phoenix_person]

1 hour ago, NeuroTypical said:

Here's where we agree: Capitalism, when paired with a representative government of some form, inherently creates an elite class with concentrated power and wealth and control.

Here's where we don't agree, but only because you haven't thought things through enough: You know what else inherently creates an elite class with concentrated power/wealth/control?  Literally every single other great structure human beings have ever attempted, across all of recorded history, with zero exceptions (unless you're willing to take the biblical story of Enoch as fact).  

I'm in favor of the capitalism/representative pairing, because it's the least worst.   The more you look outside of your anticapitalist narrative and avail yourself of the history of the world's great socialist experiments, the more you must come to realize I'm right.  The Politbureau's dachas and nepotism.  China's ornately decorated gold plated seats of government power.  Venezuela's Miraflores Palace.  The cushiony perks of nazi party membership which continued until the end of WWII.  Google up which nations are brutal murderous dictatorships, then google up how their ruling class lives compared to their people.  Everywhere.  All the time.   Heck, even at it's most poverty-stricken and tribal, humans have chiefs with greater access to the best food and women, the finest clothing.  It's a human thing.

It doesn't matter how noble the origins, how pure the intentions, how selfless the organizers, it's what you get.  From what I can tell, you sir, are one of the most Christlike individuals with the most pure love of your fellow man that I've ever met online.  I have zero doubt you want to ease the suffering of those who suffer.  I have zero doubt that you busy yourself with such activities and search deeply for the right solutions.  So maybe pay a little heed to a little warning: The greatest and most murderous evil governments all started out with plenty of people like you.  Cambodia's killing fields, Russia's purges and gulags and starved Ukrainians, China's various atrocities, Hugo Chavez's Venezuela, Germany's National Socialist German Workers' Party, and endless other examples.

You're very big on the USA's dirty fingers in everyone's pie.   Feel free to compare death tolls and the overall impact on personal freedom to get a sense of what I mean.  Capitalism is better, especially when paired with a meritocracy that allows people to move up and down the social scale.  And the more you give poor people money and services and stuff, the less incentive they have to go get the things for themselves.  You get what you pay for.

Anyway, I'm glad you're here.  You help keep me honest and humble, whenever I get too proud of capitalism.  But you'll have to show me where my larger perspective is incorrect if you want to have a bigger impact. 

I have a lot on my plate today, so I'll simply remind you that the goal for most of today's American left isn't communist Russia or Venezuela. It's Denmark. It's the UK. It's France. CANADA. Maybe that's why the Minnesota DFL is so refreshingly progressive, eh? 😉

So I'll ask again, what's stopping the US from abolishing for-profit health insurance? Because the UK has nationalized healthcare AND ~160 billionaires with a combined net worth higher than the GDP of Poland. Why can't that be the case here? We'd be far more tolerant of the billionaire class if there was more equity in the healthcare field ALONE. That stance isn't anti-capitalist, nor does it ever need to be. I don't know why you're stuck on the finality of communism when so many of our European and Israeli allies have already implemented versions of what I'm getting blue in the face asking for without compromising the integrity of their capitalist systems. And if you're wondering why I don't move there, my serious answer is that we'll see where things stand in 7 years when my son turns 18. Because right now there isn't much else stopping me. Heck, I already speak some German and have a friend in Berlin. Maybe it's time to meet my exteeeeeeended family, if I still have any over there.

[NeuroTypical]

2 hours ago, Phoenix_person said:

I'll simply remind you that the goal for most of today's American left isn't communist Russia or Venezuela. It's Denmark. It's the UK. It's France. CANADA.

And I'll either remind you, or give you a challenging fact to disprove: There is no such thing as a "lefties with the goal of communist Russia or Venezuela".   Stalin didn't start with the goal of purges and gulags.  Venezuela didn't start with the goal of empty shelves and hyperinflation.   Dark humor summary: You can vote your way into socialism, but you have to shoot your way out.

It's a disagreement about the nature of humanity.  I figure humans are best when they plan for themselves.  And they run a substantial risk of reaching their absolute worst when they decide to plan for others.  You have this (inherently good and noble) idea that you can ease the suffering of folks by doing for them.  The bigger those goals get, the more power held by the administrators, next thing you know, a gazillion Ukranians starve because you're evolving to a better method of farming.  Hehheh, whoops!  My bad!  Our next reform will fix it all!

As for Denmark, how much looking into the nuts and bolts of the flirting with socialism done by Scandinavian nations, and how they've been paring back since the '90's?  This isn't sourced (and it's full of snark), but the sources for all these claims is available: 

 

2 hours ago, Phoenix_person said:

So I'll ask again, what's stopping the US from abolishing for-profit health insurance? Because the UK has nationalized healthcare AND ~160 billionaires with a combined net worth higher than the GDP of Poland.

Sorry if you didn't pick up on my answer - here it is again: Tens of millions of Americans who distrust socialism are what's stopping you from nationalizing health insurance.  I hope we keep winning, or at least, delay the losing as long as possible.  Lord preserve me from retired military people who want to take my employer-provided for-profit healthcare and replace it with tricare.

More food for thought:  https://www.ineteconomics.org/perspectives/blog/us-tax-dollars-funded-every-new-pharmaceutical-in-the-last-decade

Socialism stifles innovation, rewards idleness, is at least as corruptible as capitalism, and has spawned some of the greatest evils known to mankind in the last 150 years.   Capitalism  paired with representative democracy rewards innovation, encourages people to deal with their own crap, has provided the largest number of humans with the largest amount of freedom and the greatest economic expansion known to all humanity.   Both ideas started with the locomotive.  One is the clear winner. 

Edited December 9, 2024 by NeuroTypical

[NeuroTypical]

 Oh - this guy is pretty good at explaining things too, even if he is a fan of public healthcare:

 

 

Edited December 9, 2024 by NeuroTypical

[Phoenix_person]

33 minutes ago, NeuroTypical said:

 Oh - this guy is pretty good at explaining things too, even if he is a fan of public healthcare:

 

 

 

I mean, I'm literally JUST talking about public healthcare. You're the one who seems fixated on arguing against a full socialist economy despite the fact that at no point have I advocated for that. And no, I'm not buying your slippery slope argument.  Socialized healthcare and a billionaire tax can exist in a capitalist economic system. 

As for Scandinavia, I fully agree that strong unions would go a lot further than government mandates in securing better wages and health benefits. So can I get you to back unionization of employees who live on subsidized wages, like those at Amazon and Wal Mart? Because if we can agree on that, then we can agree that government doesn't need to intervene in wages and healthcare. From where I sit, current pro-social program leftism can be traced to the decline of unions. If you back one, the other won't be such a nuisance. The problem is that mob activity 50+ years ago soiled the reputation of our unions and made it easier for the anti-union donor class to beat back organized labor, and organized labor still hasn't recovered in many states. Hence, people are turning to socialism. If we had strong unions, we wouldn't need socialism. But we need one of those things. Right now we have neither of them.

[Phoenix_person]

57 minutes ago, NeuroTypical said:

Lord preserve me from retired military people who want to take my employer-provided for-profit healthcare and replace it with tricare.

Funny, my VA plan is administered by UHC...

[Phoenix_person]

Btw, they caught the CEO shooter. Get your popcorn out, cuz the legal proceedings could get interesting.

[Ironhold]

7 hours ago, Phoenix_person said:

So I'll ask again, what's stopping the US from abolishing for-profit health insurance?

1. The United States Military's health care system.

2. The United States Veterans Administration's health care system.

Both are *synonymous* with malpractice, malfeasance, and bad faith. 

In the case of the former, I'm one of the untold number of people who experienced gross malpractice at the hands of the military health care system, the result of abysmal treatment I received at the tender age of 8. I was left with life-altering injuries as a result of what happened, but at the time we were *openly lied to* by officials who told us that since the military = the US government it was *literally illegal for us to try and sue*. Between the medical episode in question and the aftermath, I stopped being a child within a single week.

In the case of the latter, people actually died because the VA kept playing ping-pong with their appointments in order to meet arbitrary numbers for clearances. https://en.wikipedia.org/wiki/2014_Veterans_Health_Administration_controversy . I'm in a military town, and you can still see the occasional person noting how the VA gives veterans a second chance to die for their country. 

[Phoenix_person]

3 hours ago, Ironhold said:

1. The United States Military's health care system.

2. The United States Veterans Administration's health care system.

Both are *synonymous* with malpractice, malfeasance, and bad faith. 

In the case of the former, I'm one of the untold number of people who experienced gross malpractice at the hands of the military health care system, the result of abysmal treatment I received at the tender age of 8. I was left with life-altering injuries as a result of what happened, but at the time we were *openly lied to* by officials who told us that since the military = the US government it was *literally illegal for us to try and sue*. Between the medical episode in question and the aftermath, I stopped being a child within a single week.

In the case of the latter, people actually died because the VA kept playing ping-pong with their appointments in order to meet arbitrary numbers for clearances. https://en.wikipedia.org/wiki/2014_Veterans_Health_Administration_controversy . I'm in a military town, and you can still see the occasional person noting how the VA gives veterans a second chance to die for their country. 

I was a reservist, so I was never eligible for Tricare without paying in. Currently, my UHC-administered VA coverage is my only health insurance. It's not ideal. But insurance-related headaches aren't exactly unique to military plans. It's just a different flavor of headaches for us.

[Just_A_Guy]

@Phoenix_person, I'm sort of cutting up and splicing together elements of several of your recent posts in hopes that I can craft a more thematically-cohesive response.  I hope you don't mind.  

On 12/8/2024 at 5:17 PM, Phoenix_person said:

Serious question: what purpose does the for-profit health insurance industry serve? Because it seems to me that the main cause of increasing premiums and denials is companies trying to protect their profit margins in the face of increased government intervention. Which begs the real question: is it ethical to profit from health care? Every other first world country on the planet has nationalized health care (and yes, they have their various hiccups). Is there a reason not to burn it down here that doesn't boil down to "American Exceptionalism"? Folks seem willing to cause short term pain for potential long term prosperity when it comes to international commerce. Why not health care? Obamacare was created because too many Americans were being left behind by for profit health insurance companies. Now the for profit companies are having their profits threatened by government subsidation. Their "solutions" include higher denial rates (perpetuated by a shady AI program in the case of UHC), higher premiums, and putting time limits on coverage for anesthesia.

. . . . 

I don't think there's widespread thought on the left that doctors shouldn't be very well-compensated for their labor. The category of leftists who thinks that doctors should be paid the same as line cooks is fringe at best. And labor cost =/= profit. I'm asking why shareholders are influencing medical decisions.

But I'm talking about the insurance industry, specifically. I'm not talking about the doctors and hospitals, though there are certainly conversations that can be had about those as well. Why do we need a for-profit insurance industry? Yes, people should be able to profit from their labor, but how valuable to society is the labor of a health insurance broker? That's a great question to ask our capitalist allies with nationalized health care, literally ALL of which have nationalized health care.

. . . . 

So I'll ask again, what's stopping the US from abolishing for-profit health insurance? Because the UK has nationalized healthcare AND ~160 billionaires with a combined net worth higher than the GDP of Poland. Why can't that be the case here? We'd be far more tolerant of the billionaire class if there was more equity in the healthcare field ALONE. That stance isn't anti-capitalist, nor does it ever need to be. I don't know why you're stuck on the finality of communism when so many of our European and Israeli allies have already implemented versions of what I'm getting blue in the face asking for without compromising the integrity of their capitalist systems. 

. . . . 

I have a lot on my plate today, so I'll simply remind you that the goal for most of today's American left isn't communist Russia or Venezuela. It's Denmark. It's the UK. It's France. CANADA.

. . . . 

I mean, I'm literally JUST talking about public healthcare. You're the one who seems fixated on arguing against a full socialist economy despite the fact that at no point have I advocated for that. And no, I'm not buying your slippery slope argument.  Socialized healthcare and a billionaire tax can exist in a capitalist economic system. 

When you talk about abolishing for-profit health insurance companies, I think it's helpful to pin down:  What would you do about private non-profit health insurance companies (like IHC/Select Health, here in Utah)?  

If private non-profit health insurance companies are permitted to remain in business, then I really don't see the urgency in going after the for-profit ones.  What's the harm in allowing for-profit insurers to compete with the nonprofits, if they can?  If nothing else, it keep the non-profit players honest (their providers and administrators, after all, are still working for a salary and still have incentive to gouge their customers; and the fact that they don't have shareholders to placate doesn't make them saints).  If the for-profits can provide a better product for cheaper--good for them.  If they can't--then, assuming we can establish a truly free marketplace, in time they'll peter out of their own accord.

But I continue to maintain that nationalized health care is a terrible alternative overall.  You may get some advantages of scale using that method; and you certainly have the advantage of being able to use the contributions of the healthy--all of the healthy--to subsidize the costs of the sick.  But there are a few things to bear in mind:

• So long as the medical professions continue to provide an improving product utilizing the services of more and more people and requiring more advanced equipment--to some degree, costs are inevitably going to go up.  And as you point out, the medical professions already require an advanced degree of training.  You want these people to be very good at their jobs, and they will expect to be compensated accordingly.  
• Artificial price ceilings cause supply shortages.  That's just basic economics.  American surgeries are expensive, but--assuming you can fund them--you can usually get them within a month or two of when you need them.  I still remember, by contrast, a special about a guy in the UK who had renovated his apartment to look like a Star Trek crew cabin (I watch weird stuff.  Don't judge me) and he mentioned in passing that he hadn't bothered to create a bed because he had sciatica and his (presumably NHS) doctor had told him he needed to be sleeping on the floor to alleviate the symptoms.  Meanwhile, my brother-in-law got diagnosed with sciatica around the same time and was cured by a surgery that took place three weeks after the diagnosis.
• One of the primary complaints about private-sector health insurance companies is that most clients pay far more into the system than they get out of it.  The thing is--that's how health insurance (whether public or private) is supposed to work.  The whole idea is that to be sustainable, you've got to keep exploiting 60-70-80% of your clients in order to subsidize the other 20-30-40%.  That fundamental dynamic doesn't change just because you nationalize the system; all you're doing is making sure that the people getting exploited can't choose to remove themselves from the system.  
• Government bureaucrats are going to tend to be less responsive generally to consumer preference and market shifts.
• At the same time, government bureaucrats do get, and respond to, pressure to lower costs/improve the financial health of their programs; just as the private sector does.  Any sustainable health insurance cost-sharing system is going to have to disincentivize frivolous/unnecessary uses of medical services--there's got to be a bean counter, at some point, saying "no, we won't pay for that."  But those bean counters are sometimes wrong, and there's got to be a way to get some form of care independently of the bean counters.  Government agencies sometimes manage costs in brutal ways; particularly when they have some degree of legal immunity and/or they don't have to worry about some private-sector competitor that may be offering a better (or more humane or ethical) alternative that would highlight the bureaucrat's own incompetence.  Witness, for example, the experiences of Alfie Evans and Charlie Gard in the UK; the not-insignificant amount of assisted suicides in the Netherlands by twenty-somethings whose ailments were primarily mental, not physical, in nature; and the mad rush for nationalized health services in much of the Anglosphere to approve euthanasia. 

It's kind of ironic that Sarah Palin was so roundly mocked by the left for raising the spectre of critical-care-denying "death panels" that, the left now concedes, do exist in the private sector but somehow magically won't exist in the public sector (at least, not the American public sector.  Talk about American exceptionalism!).

• One of the perennial flaws of progressives is that they tend to assume that the "progressivism" stops with them.  (Or maybe they realize that it won't, but they don't dare say it aloud.)  Once we've embraced the fundamentals of collectivism--one individual can go hang for the sake of the "greater good"--why should we stop at being Denmark or the UK or France or Canada?  Why shouldn't we go on to embrace the Venezuelan, Cuban, and/or Russo/Soviet models?  As I note above:  Many of these western systems you laud are already denying life-saving care (probably at least in part for financial reasons), already blocking people from getting it elsewhere, already nudging people into euthanasia.  (Robert Bork's Slouching Towards Gomorrah is an interesting meditation on this--he argues that two fundamental, paradoxical values baked into the founding of the US are "radical egalitarianism" and "radical individualism"; and that the logical implications of those values cannot help but lead to collectivist tyranny and social destabilization, which then become cyclical--the tyranny increases to control the behaviors through which the moral rot manifests itself.)
• Another of the perennial flaws of progressives is that they seem to assume that their enemies will never obtain control of the state apparatus they themselves have built. 
  • Do you really want Donald Trump's administration making end-of-life care decisions for Latinos, or Marine LePen deciding which Algerian immigrants do or don't get treated at French emergency rooms?   Are you sure national health care systems won't devolve into the sorts of regimens where these kinds of decisions are routinely nakedly politicized?
  • Do you really want to make the State the only game in town when it comes to health care?  The state, and the state alone, decides who is and isn't eligible to have their pains alleviated or their lives saved?  Especially when there are still people living in those European countries you laud who once lived under--or were within a hair's breadth of living under--the regimens of Hitler, Stalin, or both?
  • Do we really trust in our ability to recognize the monsters who would abuse this sort of power?  Look at Assad--ten years ago, he and his wife were the darlings of the progressive media establishment.   And now it turns out that one of his preferred methods for dealing with his enemies was sticking them underneath a hydraulically-powered slab, and crushing them to death.  We spend fifty years freaking out about how every Republican presidential candidate is Literally Hitler--and then we get an honest-to-gosh Hitler in Syria, and we put his wife on the cover of Vogue.  
• Liquidating the billionaire class and re-distributing the proceeds into a nationalized health care system might make us feel righteous and indulge our more sadistic aspects of our natures; but isn't going to sustainably improve the lot of any American health care consumer.   
  • As I noted recently in another thread, the federal government spent $1.8 trillion on PPACA last year alone (source).  The US has approximately 800 billionaires with a collective net worth of about $6 trillion.  Assuming you got the full value of their holdings when you confiscated them (which you won't, because liquidating their holdings turns them into penny stocks that will flood the market just as investors, wondering what fresh communist Hades might be coming for them next, would be fleeing both the market and the country):  you can subsidize PPACA through 2029 at the latest; and then we're back to square one--but with no more golden geese left to kill.  

Quote

[Re the idea that no one has the right to another person's labor]

If that were true, there wouldn't be a Hippocratic Oath. Health care labor is unique in that regard.

. . . Some professions are more about service than building wealth. Yes, a lot of doctors in particular sign up for both, and there's plenty of wiggle room for that. But their oath is about saving lives. I'd wager that most good doctors probably don't view the HO so much as a set of ethical guidelines as they do a moral imperative.

I don't see anything in the Hippocratic Oath that requires medical professionals to render services involuntarily or for a lower rate than they would prefer to charge.  If a critical mass of doctors truly read the oath as you suggest they should/do, then we wouldn't be in the mess we're in.  (Leaving aside for the notion that while [most] doctors take the oath, the folks who develop your vaccines and design and build your MRI machines and spin out your blood samples take no such oath.)

Certainly there's an implicit generalized awareness that the profession is intended to provide a crucial, even sacred benefit to others--but then, my oath as an attorney (see p. 2) has a similar awareness; and we certainly don't expect lawyers to render services for free.  

Quote

So no, you're not going to convince me that rising costs of private health care is the fault of Obamacare. That's exactly what the Brian Thompsons of the world want you to think. A lot of us are ready to move on from them, and they were never going to go quietly. 

Frankly, PPACA was a poison pill to begin with.  The only way they were able to make the federal numbers look "revenue neutral" back in 2009-2010 was by comparing ten years of revenues against five or six years of outlays.  The cost was always going to be net-negative in the long haul.*  Forcing the HMOs to take clients who they knew were going to cost them money, was always going to force those HMOs to either inflate premiums (stoking the sort of Moral Panic we're now witnessing) or go bankrupt in the end.  We all knew even then that Obama and his supporters wanted single-payer, and that PPACA was seen by them as a stepping-stone to get us there.  Their hope was that the HMOs would mute their opposition if they got enormous payoffs in the very short term.  

*That said, conservatives should also acknowledge that Trump sort of accelerated things by unilaterally exempting Americans from the individual-mandate portion of PPACA and thus pulling a lot of potential revenue out of the system.

On 12/8/2024 at 6:44 PM, Phoenix_person said:

Indeed. And the health care industry is literally a life-and-death business. I think it's easy to make an argument that it's the one industry that shouldn't be accountable to shareholders. That doesn't mean my burn surgeon can't drive a Mercedes. But maybe he doesn't need a yacht. Do *I* think he deserves a yacht for rebuilding my legs with skin from my back? Heck yeah. He deserves a spaceship if he wants one. But I didn't pay him to do all that, you did.

And this sort of hints at another issue with the health care business.  We've undergone something of a cultural shift in the last sixty years where we believe that we each have the right to the very best medical care that's out there, we have a right to be pain-free, and we have a right to have every potentially-relevant test from a smorgasboard of available serum panels run on us any time we feel "off" becuse "you can never be too careful".  And money is no object when it comes to keeping us in tip-top physical condition; particularly when the money involved is other people's money.  

This creates a lot of tension in the American system, and needs to be checked in some ways.  But it also has its merits.  I don't know your full story--just snippets from posts you've made elsewhere.  But--if I may tread softly--my understanding is that at some point you got into a really dark place, and you tried to end your own life; resulting in the injuries you mention above.  I'm genuinely, sincerely glad that your attempted suicide was unsuccessful.  I don't even mind that the American health care system likely poured fabulous amounts of resources into your treatment and recovery.  I hope things never get that dark for you ever again.  It sounds like you've put a lot of effort into being a contributing member of your own community, I personally value your thought-provoking contributions to this forum, and--while I know it's not really your thing--I strongly believe that you are a beloved child of God whom He views as having infinite worth and potential; and I hope the way I communicate with you consistently reflects that belief.

But for the purposes of this discussion, I will say:  I rather suspect the American system is probably one of very few systems in the US that would have put so much time and effort into preserving your life at a time when you yourself were thinking that it would be best ended.  I  hope you don't relocate to Germany; because if (heaven forbid) you have a relapse--I'm not convinced they'll do for you what America would do for you.  And if you do relocate, and some NHS bureaucrat suggests euthanasia at some point--I hope you punch 'em square in the nose, and catch the first flight back to 'Murca.

On 12/9/2024 at 12:32 AM, Phoenix_person said:

You're right, we're never going to see eye-to-eye on this. Forbes' list of billionaires includes 34 in the healthcare field worth a total of around $120, mostly in the pharmaceutical and medical supply sectors, specifically. The top 5 health care billionaires on the list are worth a combined $60B. There's a saying in my circles "There are no ethical billionaires". Do you agree? And before you answer, consider the amount of money that ONE billion dollars is. Think about how life-changing a TENTH of that would be to someone like you or me. I know you're very anti tax in general, including the ultra-wealthy. I'm putting you to task to tell me why every cent above $999M shouldn't be either taxed or donated to charity. Not just for healthcare billionaires, but for all of them. The limit we're willing to accept in human suffering is directly correlated with the limit of how wealthy we allow our wealthiest citizens to become. A billionaire tax like the one outlined above could do a lot of good in our society. It boils down to one simple belief: billionaires shouldn't exist alongside widespread poverty. You can still live a life of obscene excess on $999M. Why are we so adamant about the inherent right for people to be billionaires when poverty exists? You seem to have a very strong belief that profit = good most of the time. We're actually in agreement there, believe it or not. I absolutely believe that every person has a right to build wealth for themselves. I also believe that there is no ethical reason to allow wealth accumulation beyond a certain (very) extreme point. If you disagree, I'd love to hear why.

I would refer you to my point about billionaires above, and also suggest you watch this video--it's very dated now, but still does a very good job of showing that a) the amount of money our government spends is quite unrelated to how much tax revenue it actually raises or could raise; and b) while we may resent the existence of billionaires and even millionaires, eradicating all of them and redistributing their assets won't really improve the quality of our lives all that much. 

I defend the rights of billionaires to be billionaires because I understand that fundamentally, the folks who criticize billionaires most harshly aren't going to effect meaningful change and aren't really mad just at the uber-wealthy.  They're mad at anyone who's doing better than they themselves are--and as a relatively solid, state-employed member of the middle class who owns a house and a sailboat that its manufacturer classifies as a "yacht", that probably includes me.  

Quote

And if individual wealth-building is important to you, I urge you to look up how many FULL-TIME Wal Mart and Amazon employees are currently on food stamps. Then look up the net worth of Jeff Bezos and the Waltons. Tell me with a straight face that that's an ethical way to run a company. You hate taxes and love wealth. Your taxes are literally subsidizing the business practices of companies who refuse to pay a living wage (which is $20/hr minimum in all states, $25+ in most), denying opportunities for building wealth to the people who built theirs. Are you okay with that?

. . . . 

As for Scandinavia, I fully agree that strong unions would go a lot further than government mandates in securing better wages and health benefits. So can I get you to back unionization of employees who live on subsidized wages, like those at Amazon and Wal Mart? Because if we can agree on that, then we can agree that government doesn't need to intervene in wages and healthcare. From where I sit, current pro-social program leftism can be traced to the decline of unions. If you back one, the other won't be such a nuisance. The problem is that mob activity 50+ years ago soiled the reputation of our unions and made it easier for the anti-union donor class to beat back organized labor, and organized labor still hasn't recovered in many states. Hence, people are turning to socialism. If we had strong unions, we wouldn't need socialism. But we need one of those things. Right now we have neither of them.

This could be a really interesting collateral discussion; but suffice it to say:  I absolutely endorse the right of employees to unionize; so long as they aren't infringing on a) the rights of would-be employees to work for cheaper or b) the rights of their employers to higher those would-be employees.  I don't understand why efforts to unionize Amazon and Wal-Mart haven't borne more fruit.  (Maybe they have and I haven't been paying attention; I don't know.)  At any rate--this is a significant reason why I also support limiting the numbers of economic immigrants that we accept each year from the third world. 

I'm skeptical of the notion that all employers should be legally required to pay a "living wage"; simply because a lot of teenagers and part-time workers don't need a living wage and they should be able to sell their labor for whatever price they are willing to accept from their employers.

In closing--because it's late and I'm tired, and because you said "Scandinavia", I will close with this joke:

Did you hear that Norway has started putting bar codes on the side of all their warships?

That way, when the ships get back to port, they can scan the Navy in.

Edited December 10, 2024 by Just_A_Guy

[Ironhold]

12 hours ago, Phoenix_person said:

I was a reservist, so I was never eligible for Tricare without paying in. Currently, my UHC-administered VA coverage is my only health insurance. It's not ideal. But insurance-related headaches aren't exactly unique to military plans. It's just a different flavor of headaches for us.

Basically, so long as the US Military and US Veteran's Administration health care systems - both of which are government-run - are disaster areas, then they'll be cited as examples for why the government can't be trusted to run health care. 

Most people see it as either for-profit or government-run, so they'll go to the for-profit side instead. 

[NeuroTypical]

On 12/9/2024 at 12:44 PM, NeuroTypical said:

Lord preserve me from retired military people who want to take my employer-provided for-profit healthcare and replace it with tricare.

On 12/9/2024 at 1:41 PM, Phoenix_person said:

Funny, my VA plan is administered by UHC...
...
I was a reservist, so I was never eligible for Tricare without paying in. Currently, my UHC-administered VA coverage is my only health insurance.

So, perhaps I could just take a moment and point out that even Mr. lets-get-rid-of-for-profit healthcare himself, when he has a choice between socialized and for-profit, choses the latter.

I was discussing this stuff with my wife, who identifies as politically homeless.  She had a suggestion which I find worthy of passing on to @Phoenix_person.

You want socialized healthcare so much, pick a state and have them do it.  Zero federal involvement/rules/money.  All run completely by the state.  If it's going to be so popular, surely it'll win over the residents of that state. 

I mean, we hear so much about the UK and Denmark, well, Cali's economy is larger than both I believe.  It should be easy for them.   Let's run the test and see how many CA house seats are lost after the next census. 

[zil2]

On 12/9/2024 at 10:45 AM, Phoenix_person said:

CANADA

Maybe they've caught up since 2008, but this has always stuck with me Hillsdale College's Imprimis, January 2008:

Quote

Canadian dependence on the United States is particularly true in health care, the most eminent Canadian idea looming in the American context. That is, public health care in Canada depends on private health care in the U.S. A small news story from last month illustrates this:

A Canadian woman has given birth to extremely rare identical quadruplets. The four girls were born at a U.S. hospital because there was no space available at Canadian neonatal intensive care units. Autumn, Brook, Calissa, and Dahlia are in good condition at Benefice Hospital in Great Falls, Montana. Health officials said they checked every other neonatal intensive care unit in Canada, but none had space. The Jepps, a nurse and a respiratory technician were flown 500 kilometers to the Montana hospital, the closest in the U.S., where the quadruplets were born on Sunday.

There you have Canadian health care in a nutshell. After all, you can’t expect a G-7 economy of only 30 million people to be able to offer the same level of neonatal intensive care coverage as a town of 50,000 in remote, rural Montana. And let’s face it, there’s nothing an expectant mom likes more on the day of delivery than 300 miles in a bumpy twin prop over the Rockies. Everyone knows that socialized health care means you wait and wait and wait—six months for an MRI, a year for a hip replacement, and so on. But here is the absolute logical reductio of a government monopoly in health care: the ten month waiting list for the maternity ward.

 

[Phoenix_person]

23 hours ago, NeuroTypical said:

So, perhaps I could just take a moment and point out that even Mr. lets-get-rid-of-for-profit healthcare himself, when he has a choice between socialized and for-profit, choses the latter.

I literally did not have a choice. The VA is my ONLY medical lifeline. I don't have a say in how they administer health plans or which companies they go through. During one inprocessing session for a former job, my boss (who was also a long-time friend of mine) told me he hoped my wife had good insurance (she did), because he didn't and neither would I if I used their insurance provider.

I think I stated elsewhere that I estimated my personal "repair costs" to possibly be in the hundreds of thousands of dollars. I don't actually know the full cost because all of the inpatient costs were covered and I was on too many opioids to read stacks of EOBs. 

I stumbled across my EOB from an inpatient procedure I had this past April. It was fully covered by my VA plan, but I went ahead and looked at the total cost for that one procedure. It was in the ballpark of $120k. What exactly did they do? Technically, it was two procedures. The first was to create an opening in my right arm and stuff it with bovine tissue to improve the natural extension of that arm. Two weeks later, they removed some skin from my upper thigh and used it to close up my arm.

The area operated on is the one circled above. It cost $100k plus to do that. For reference, my other arm looks very similar, and these are my legs:

So yeah, my estimated cost for my care MIGHT have been short by a million or three. And as I said, my VA plan is my only viable option right now. Without it, I wouldn't be able to walk today, mostly because my quality of life would be worse to such an extent that I would have ended up finishing the job. My experience with government-administered care has been exceptional. I recognize that not everyone is so lucky, particularly quite a few non-veterans who have employer-subsidized UHC plans. I'm not far left on this issue because of my personal experiences. I'm far left on this issues because of the stories I've heard from those less fortunate than I am. I'm in this fight for them.

Also, looking at my care in terms of financial cost reminds me that most of the costs that we associate with healthcare are the result of healthcare providers getting accustomed to having everything the patient needed covered by insurance and inflating costs as a result. Yes, I fully realize that my care would have been prohibitively expensive regardless of how it was broken down. Even so, I never would have guessed the ACTUAL absurdity of the ACTUAL cost. It makes you wonder how much of the taxpayer-funds for my rehab was for the true cost of the care and how much was for the benefit of a P/L statement. It's probably a safe bet that multiple companies profited from my mental health crisis in no insignificant way. 

23 hours ago, NeuroTypical said:

I was discussing this stuff with my wife, who identifies as politically homeless.  She had a suggestion which I find worthy of passing on to @Phoenix_person.

You want socialized healthcare so much, pick a state and have them do it.  Zero federal involvement/rules/money.  All run completely by the state.  If it's going to be so popular, surely it'll win over the residents of that state. 

True single payer on the state level isn't possible without true single payer on the federal level, and single payer is the ultimate goal. Minnesota is doing literally everything it can to build up MNcare within the confines of our federal federal system. We're currently working on a public option. Yes, there are federal funds involved. It's literally what they're there for. There are also state-level tax increases in the works to help fund the public option if/when we get there.

And when we talk about the successes and failures of other nations, it's important to remember that we live in the wealthiest nation on the planet, by a fairly wide margin. Yes, other countries have tried it. Those countries don't have our resources.

https://www.statista.com/statistics/268173/countries-with-the-largest-gross-domestic-product-gdp/

21 hours ago, zil2 said:

Maybe they've caught up since 2008, but this has always stuck with me Hillsdale College's Imprimis, January 2008:

It's interesting to look at comparisons of how other countries compare in administrating health care. All of them have weak areas, but the US seems to ONLY have weak areas unless you're wealthy enough for insurance issues to not matter much.

https://www.commonwealthfund.org/publications/fund-reports/2021/aug/mirror-mirror-2021-reflecting-poorly

As far as nationalized systems go, I've heard that Canada has one of the worse ones. FWIW, I've heard that from Canadian leftists (and the cited study seems to support that).

I wouldn't wish that maternity experience on anyone. Unfortunately, recent SCOTUS activity has created conditions much like the one described above in some US states. And it doesn't always have a happy ending for the women in the equation down here. THESE are the women affected by restrictions on late-term care that could save their lives at the expense of the baby's. And yes, it's tragic regardless of outcome, unless both mother and child overcome impossible odds. 100% of these women, and the women who got care and lived at the expense of the fetus, wanted the baby to live. The women who survive mourn the loss of their baby. I'm sure many have funerals. I wish more conservatives read these stories before voting for late-term abortion bans. I believe that all abortion bans are anti-woman, but late ones especially. Those are never elective.

Edited December 11, 2024 by Phoenix_person

[NeuroTypical]

I think I buddied up with you on Facebook as you were going through a round of surgeries.  First and foremost, thank you for your service.   My family's decades of travails with healthcare doesn't make for such impactful pictures, but I have plenty of stories also.  I remember at one point with 3 of the 4 of us having some hefty medical things happening, I was averaging half a dozen hours a week on the phone with providers and insurance, trying to keep approvals flowing and care paid for.  I think that year I probably averaged at least 2 hours a month of just me, taking notes, following up, staying on hold, re-submitting lost paperwork, and educating people who answered the phone on their jobs.

That said, I'm confused.

On 12/9/2024 at 10:10 PM, Phoenix_person said:

I was never eligible for Tricare without paying in.

2 hours ago, Phoenix_person said:

I literally did not have a choice.

I need a bit of help understanding whether Tricare was available to you if you paid in, or whether it wasn't.  

 

 

[Phoenix_person]

2 minutes ago, NeuroTypical said:

I think I buddied up with you on Facebook as you were going through a round of surgeries.  First and foremost, thank you for your service.   My family's decades of travails with healthcare doesn't make for such impactful pictures, but I have plenty of stories also.  I remember at one point with 3 of the 4 of us having some hefty medical things happening, I was averaging half a dozen hours a week on the phone with providers and insurance, trying to keep approvals flowing and care paid for.  I think that year I probably averaged at least 2 hours a month of just me, taking notes, following up, staying on hold, re-submitting lost paperwork, and educating people who answered the phone on their jobs.

I know my mom has horror stories about Tricare. Plenty of people have horror stories with their fully private insurance. Health insurance in this country is treated like rationed health care, with better health care available to those with bigger budgets. That may sound like the ideal to you. To me, it sounds like an episode of Black Mirror. 

2 minutes ago, NeuroTypical said:

That said, I'm confused.

I need a bit of help understanding whether Tricare was available to you if you paid in, or whether it wasn't.  

It was available to me when I was still in. It no longer is, and I can't afford to pay for health insurance, which is why the one I don't pay for is my only viable option.

[NeuroTypical]

1 hour ago, Phoenix_person said:

I can't afford to pay for health insurance, which is why the one I don't pay for is my only viable option.

Gotcha.   So, my point stands.  You've already got a socialized government run option, and you picked the one administered through the for-profit company.  You have only one choice.  You can't afford one, and you can afford the other.  So you pick the other. Because one isn't viable and the other is.  The socialized government run one is the not-viable one.  The one administered through the for-profit company is the viable one.

And your solution is to get rid of the for profit one, and make socialized government run one the only option for everybody.  

Existing socialized government-run option: Not viable.
VA administered through UHC: Viable.

Right?

[Phoenix_person]

1 hour ago, NeuroTypical said:

Existing socialized government-run option: Not viable.
VA administered through UHC: Viable.

Right?

In the current system, yes. Bolded for emphasis because I've been subtly trying to say this for some time. Realistically, my ideal model only happens in its entirety if private insurance is abolished entirely. And yes, that is currently on the table for MNcare. It's highly unlikely to go our way, considering where UHC's hq is. But there it is, the ideal model for nationalized healthcare means the abolishion of private insurance. I have no expectation that it will happen in my lifetime, but that doesn't mean it's not worth advocating for. Change doesn't happen without demand for it.

[Vort]

4 hours ago, Phoenix_person said:

Realistically, my ideal model only happens in its entirety if private insurance is abolished entirely.

You just have to step off the ledge and have some faith, man. Some of that good old atheist faith. It will work if you want it to bad enough. Never mind the details! We need to pass this legislation to find out what it contains! Be proactive! Abolish private insurance and socialist nirvana will come.

Trust me.

[JohnsonJones]

18 hours ago, Phoenix_person said:

In the current system, yes. Bolded for emphasis because I've been subtly trying to say this for some time. Realistically, my ideal model only happens in its entirety if private insurance is abolished entirely. And yes, that is currently on the table for MNcare. It's highly unlikely to go our way, considering where UHC's hq is. But there it is, the ideal model for nationalized healthcare means the abolishion of private insurance. I have no expectation that it will happen in my lifetime, but that doesn't mean it's not worth advocating for. Change doesn't happen without demand for it.

 

I'm not sure I followed the entire conversation correctly, but if I understand right, you, as a Veteran have the ability to have a type of universal healthcare.  The VA (at least until Trump guts it) currently has healthcare for Veterans who desire it. 

It's been awhile since I've gone to one (so, I'm not sure of all the protocols and costs, I have health insurance through work which covers 80% of costs...used to cover 100% until Obamacare destroyed the platinum plans...which I disliked tremendously), but I think it charges something around $25 per visit or per subscription or something to that effect for Veterans.  I also hear that it will cover 100% of in-service injuries if one qualifies for them (I've heard it's a pain to try to do so).

The sad thing about the VA is that how good your healthcare (from what I've seen) is directly proportional to how well they are funded.  A well funded VA that has a decent money/doctor to Veteran ratio actually appears to have equal or superior healthcare to many healthcare industries around them.  They also tend to have good connections to the community in case they need to do referrals.

The same can also apply to Tri-care for those who have it.  (Since this is a Church board, I hear that the one in Salt Lake City is actually pretty good of a VA center)

On the otherhand, when it has a bad funds/Doctor to Veteran Ratio (I've heard some bad things about Oakland over the years, though perhaps it's improved), medical care tends to go down.  In these instances, it can be far inferior to other forms of healthcare in the surrounding area.

This should make obvious sense as to why, but it seems to elude various directors and government officials.  Money invested and good Doctor to patient ratios make for better healthcare.  Less money and bad Doctor to Patient ratio makes the quality of healthcare go down.

There are several problems with the US healthcare system today. 

I know that my German relatives can see a Doctor very quickly, and for serious surgeries and operations they actually get in quicker to them than the average US citizen does.  German healthcare (socialized...oooo...loook...there's a scary word for some Americans) actually does better than the US in many categories.

There are several facets of this though.  Part of the problem I see is that the Medical profession protects their paychecks.  What I mean by this is that they keep the number of Doctors down on purpose (there are many ways they could increase the number of Doctors in the US, and educating them to have a greater number...but that would also decrease the amount of pay since supply and demand is always prevalent in a capitalistic society).

However, that is actually small change to other factors which boosts costs even more, such as unreliable billing from Hospitals (and that isn't what the Hosptal bills, it's what the Hospital can reliable get...for example, they don't have guarantees that a patient will pay as care is billed afterwards.  Due to this insecurity, they massively overcharge those that they can in order to make up the differences, as there are many that will not pay the bill afterwards).  Other parts are that hospitals will pay for medical items and medications, but are being price gouged by pharmaceutical companies and medical equipment companies...so that when a basic piece of medical equipment that costs 10K to make, but the hospital has to pay 2 million to buy...well...guess how they are going to pay for that (actually, it's no secret, they pass it on to those that will pay the bills). 

There's a lot of rotteness in the medical system today, a lot of corruption, and a lot of wickedness and evil men (and women).  However, that applies to many companies out there. 

The question is how much government reach do we want to allow to bring the medical industry to heel?  Do we want the government to be allowed to dictate who our doctor is (and with the VA system, you are told who your primary care physician is, and it is only they who can refer you to other treatments, the same applies to those in the military and their military medical care.  With Tri-care, you can have something similar as a retiree, though if you get Tricare standard (I think that's what it is) you do get a choice of your doctor, but then Tricare Standard only covers 80% of the costs)

Right now I get to select a doctor and if I do not like the doctor, I can choose another doctor.  If we went to single payer healthcare, I'm sure the costs associated with our medical care would go down, we probably would have a better care for those who don't have money or are poor, but our freedom of choice would go down as well, and the ability for those who do have money to get the best care would also be reduced as the healthcare would be spread out in a more general fashion (which probably would improve health in general nationally, only certain specific individuals would have healthcare go down). 

There are pros and cons to each type of situation.