Jason Soon is very angry that I dared to criticize John Lott in this post. I wrote about Freedomnomics (where Lott claims that women's suffrage caused a massive increase in the size of the government):
Lott doesn't like women's suffrage
Soon writes:
His basic thesis is that the size of government expanded after women's suffrage. It's an interesting thesis. It may be right or wrong. But it does not follow from it that Lott is advocating that women be deprived of the vote since there are far more systemic and less illiberal views of checking the growth of government than arbitrarily limiting voting rights based on dissatisfaction with its outcomes.
Soon seems to accept that Lott would prefer a much smaller government and hence that Lott would think that women's suffrage has had a bad result. As for other ways of "checking the growth of government", this is not an argument that Lott makes, and Soon does not tell us what they are. Presumably these involve libertarians uniting and using their mighty political power or something.
To repeat - the proposition that women's suffrage led to bigger government is a positive statement, not a normative statement. It is either true or false and the belief that it's true is separate from the belief that women should therefore be deprived of the vote. Lambert decides to elide the two to smear Lott.
Hmmm, what did Lott's sock puppet, Mary Rosh, write at FreeRepublic?
You have got to download this paper. Lott has done an amazing piece here. Fits in perfectly with Rush Limbaugh's program today. Click on source URL above to get the paper.
How Dramatically Did Women's Suffrage Change the Size and Scope of Government?
John R. Lott, Jr.
Abstract:
This paper examines the growth of government during this century as a result of giving women the right to vote. ...
Lott does it again.
It's pretty obvious that Rush Limbaugh was arguing that women's suffrage was a bad idea.
Soon continues:
Yet, Lambert has been overwhelmingly positive about Freakonomics despite the fact that its most famous thesis is that legalised abortion led to lower crime rates. But if Lambert were to apply the same treatment to Levitt that he applied to Lott (i.e. mixing positive and normative conclusions) given the obvious racial bias in the US crime statistics and the rate of black illegitimate births compared to white illegitimate births, Lambert should be characterising Levitt's argument as the argument that 'we should pre-emptively kill black babies before they get born and become criminals' . Yet I don't see him huffing and puffing about Levitt's alleged racism as he has been doing about Lott's alleged sexism (of course just to clarify I believe that these ways of characterising BOTH Levitt's and Lott's arguments are silly and a distortion of their original intent).
Anyone who has read Freakonomics would know that Levitt argues that his thesis has no normative implications because other considerations trump the abortion/crime link. Lott makes no such argument.
Notice the hypocrisy and inconsistency. I used to think Lambert was a class act but since my recent run-in I've concluded that he is in fact a dishonest egotistical prick.
Charming. It seems that Soon doesn't think it possible for anyone to honestly disagree with him. (My previous post on Soon's conduct is here.)
I think you're off your mark here. Even if Lott doesn't mention other considerations, he doesn't need to, because he's not (explicitly at least) making a normative argument.
(disclaimer: I haven't read Freedomnomics and I don't plan to.)
Lott's use of the "Mary Rosh" sock puppet in this case is unethical, but you haven't proved that Lott opposed women's suffrage. All the "Mary Rosh" sock puppet appears to be doing is spruiking Lott's "brilliant" research. Lott is undoubtedly an unethical sleaze but you are barking up the wrong tree this time.
This isn't about honest disagreement, this is about you smearing Lott for things he didn't say (and no, that thing you linked to doesn't imply that Lott endorses Rush on denying women's suffrage).
And now you choose to smear me again. There is nothing in the original source which has Lott arguing against women's suffrage. And Lott has explained his position here - care to respond to it?
http://catallaxyfiles.com/?p=2990#comment-43864
Women voting is more effective at increasing government size than two world wars, a massive depression and the work to get out of it, and dramatic increases in the size and scope of enterprises that government regulates?
Helen Reddy was right!
Ed, you're missing the important wingnut fact that giving women the vote caused those two world wars, and the depression.
Oh here we go, another 100+ comment thread circling forever around the plughole of Plausible Deniability. Hooray.
Wow, Jason. These are some of the comments you've recently made about me:
>"Tim's beliefs are faith-based", "Bird and Lambert are mirror images, each with their monomanias", "fucking dishonest Tim", "Gaian Inquisitor", "Pope Pius III", "you people must be for torture and secret trials" "LamBird", "alarmist", "Pope Pius Lambert the Third" "looks like Pope Pius the Third has been caught out telling more lies", "intellectual hobbit", "little man", "absolutely dishonest runt", "propagandist" and "corpulent hobbit".
And then you turn around and whine that I am smearing you, just because I accurately describe your habit of accusing people of dishonesty for daring to disagree with you. You need to learn from Melaleuca, who has the mental flexibility to disagree with my interpretation of Mary Rosh without accusing me of dishonesty. Mary Rosh doesn't explicitly agree with Limbaugh on women's suffrage but there is certainly implicit agreement.
Lott's comment does not explain his position, but rather carefully avoids mentioning what his position is. Does he like the massive increase in the size of government that he believes was caused by women's suffrage?
I suppose that if I suggested that Lott supports concealed carry laws you would accuse me of dishonesty since "more guns, less crime" is just a positive statement and there are other ways to reduce crime...
jade, in this case it is implausible deniability.
The thread over at Jason's place has taken a twist. I've asked Lott to explain the "the oestrogen - big government link". He has responded. Sort of. Awaiting futher developments:
http://catallaxyfiles.com/?p=2990#comment-43983
Mr. Lambert:
I am at a loss as to why you respond, ever, to this stuff. Or that utterly irrelevant nest of right-wing flakes.
Yeah you just know that people with that much time to spend chattering at each other and calling you names like Jason does - they're not actually in positions to do anything useful or to influence policy or anything. I mean good luck to the bright and the civil over there they're doing OK, while Jason's being unpleasant and witless.
From Catallaxy:
"Maybe the bottom two levels (state and local) could be working on DOLLAR-VOTES and only the feds be working on ONE-MAN-ONE-VOTE."
People in the old Eastern Bloc used to distinguish between "communism" - the Utopian state promised by The Party - and "actual communism" - the shitty oppressive state of all real communist societies.
Let's all thank "GMB" for giving us a preview of what "actual libertarianism" would look like.
Ian
if you want to know what Libertarism looks like why don't you visit the LDP website? There you will find LDP policies that reflect the political side of libertarians.
It's pretty woeful skulking around picking up one comment here another there and then try to present " a preview of what "actual libertarianism" would look like."
But then I shouldn't expect anything else.
It must be the analytical side coming again, hey?
Jc wrote, if you want to know what Libertarism looks like why don't you visit the LDP website? There you will find LDP policies that reflect the political side of libertarians.
There are two types of libertarians.
(1) Freedom-hating feudalists. This appears to comprise the majority of so-called libertarians.
(2) Freedom-loving geolibertarians.
For details, see "Are you a Real Libertarian, or a ROYAL Libertarian?".
Jc wrote, if you want to know what Libertarism looks like why don't you visit the LDP website? There you will find LDP policies that reflect the political side of libertarians.
After some googling, and taking into account that this blog originates from Australia, by LDP I figured you mean this LDP.
Given their policy position on land, it's clear the Australian LDP despises freedom, because they think certain privileged individuals should be able to "own" natural resources and thus forcibly strip others of their freedom to access those resources without any form of compensation.
Furthermore, not only is their position morally despicable, it's incoherent. They write, The LDP believes the ownership of property is a fundamental right that precedes the power of government. But without government there is no such thing as "property," rather merely possession, and one of the prime reasons for creating governments is to define a just order which includes definitions of and laws regarding property.
Though I guess there are empirical examples otherwise, which must be why so many so-called libertarians are voting with their feet and moving Somalia.
I'm not sure I see the distinction. The definition of property is "something owned or possessed".
nanny_govt,
the difference between "property" and "possession" suggested by liberal is whether you can get it back if a bunch of people come in, beat you up, and kick you out.
Without government, you don't keep it. With government, you do. Personally, I'd more quibble with the LDP's use of "ownership". Without government, you only own that which you are strong enough to keep from others. But I'm really quibbling over semantics here.
Who says there isn't a role for government in a libertarian state.
National security and property rights protection come to mind. This is a silly straw man argument.
"If you want to know what Libertarism looks like why don't you visit the LDP website? There you will find LDP policies that reflect the political side of libertarians."
Yes and if you want to know wht life's like in North Korea you should read the policies of the Worker's Party of the People's Democratic Republic of Korea.
Ian Gould now thinks the desire for increased human freedom is the equivalent of Stalism.
How novel. How so full of new ideas.
Ian, it's the blue pills in the morning.
Tim L. says:
Perhaps, because from the point of a libertarian women do want more govt than is good for them. But Tim L. jumps to the conclusion that some libertarians such as
However this does not follow from the libertarian "feminism = statism" premise. Because even a libertarian may concede that womens suffrage might have political benefits that out-weigh its economic costs.
This is, from what I can gather, Jason's position. Or at least thats what he would like people to think he thinks. No one wants to be put in the same boat as the Taliban or other antediluvians, which appears to be the notion behind Tim L.'s bit of moral equivalence.
Or can Tim L. point to anything that Lott has written where he explicitly endorses the thesis that womens suffrage was a mistake and should be revoked or restricted? Instead of just making mischievous inferences, I mean.
That would clear things up, finally.
PS I do sympathise a bit with Tim L. on the subject of Jason Soon's habit of going in over the top at the first hint of disagreement. Jason is as nice a person as could be in actual life. But his virtual persona is a cranky, twitchy, paranoid pyschotic ever keen to take offence, rather like Joe Pesci in Goodfellas.
Jack
While I think most of your recent post makes some reasonable points, I was astonished to read "from the point of a libertarian women do want more govt than is good for them"
What's going on then - false consciousness? Or do you mean that women (and lots of men) want more government than libertarians think is good for them? Or really " than libertarians prefer".
Jc,
your reading comprehension is very low. Ian Gould is implying that what passes for the "theory" of libertarianism will never apply in practice, just as the theory of communism often hasn`t worked in practice.
Ian would probably suggest this is because of some kind of inherent failing in any political movement based on ideology. I would be less charitable: it`s because libertarian ideology is a fig leaf over naked jealousy and arrant stupidity.
Perhaps you could be kind enough to let Ian speak for himself, SG. However i admire your skills at fiction.
"it`s because libertarian ideology is a fig leaf over naked jealousy and arrant stupidity."
Let's take the jealousy part first. It's shocklingly delusional to think an ideology that tries to prevent taxeating and tax eaters taken confisacting people's wealth is a mark of jealousy. I would think it is quite the oppposite.
"vote for me and I will tax others for your benefit" is not the same as "vote for me and I will limit the amount of wealth that is confiscated from you".
Stupidity?
Oh, so things like the Hanseatic League was stupid and the original document setting up the US as a limted government constitutional republic was just a dumb idea. Okey-dokey.
Any other bright ideas?
Posted by: disinterestedobserver | July 18, 2007 02:06 AM
The last option. I was paraphrasing what I take to be a generic libertarian position.
My own political philosophy is common-or-garden variety social democracy, spiced with the occasional bout of hysterical right-wing Culture War fever.
Jack, if Lott thinks that women's suffrage has had a good result, he just has to say so. He's been careful to avoid making such a statement. The Mary Rosh comment I posted seems to me to be an implicit agreement with Ruch Limbaugh on the topic.
I don't know what Jason Soon's problem is, but he sure ran away from this discussion quick enough.
slightly_peeved wrote, the difference between "property" and "possession" suggested by liberal is whether you can get it back if a bunch of people come in, beat you up, and kick you out.
That, plus a common recognition amongst the governed that government's definition of property, and the rights accruing to the owner, are part of a just order.
E.g., it was once thought by many that ownership of humans is compatible with a just order. Now it isn't.
JC wrote, Who says there isn't a role for government in a libertarian state.
Depends on which strain of libertarianism you're referring to.
All the strains I've seen other than geolibertarianism (basically a form of Georgism), however, either (a) would slide into a Hobbsian war of all against all if actually instituted (because of a lack of government), or (b) would result in a regime of no true freedom or justice, because the form of government instituted would protect only the interests of the powerful, in particular their theft of natural resources.
JC wrote, Ian Gould now thinks the desire for increased human freedom is the equivalent of Stalism. How novel. How so full of new ideas. Ian, it's the blue pills in the morning.
But for the little detail you omitted that almost all strains of libertarianism actually represent a desire for oppression and the stamping out of freedom. This is described in the essay I linked to above, "Are You a Real Libertarian or a Royal Libertarian?"
JC wrote, It's shocklingly delusional to think an ideology that tries to prevent taxeating and tax eaters taken confisacting people's wealth is a mark of jealousy. I would think it is quite the oppposite.
Huh?
Most libertarians think it's fine for someone to charge me land rent for using a parcel that they "own," despite the fact that they didn't put the parcel there (God/Mother Nature/etc did) and they didn't contribute the labor or capital that makes the parcel valuable.
"vote for me and I will tax others for your benefit" is not the same as "vote for me and I will limit the amount of wealth that is confiscated from you". Stupidity?
Yes, if accompanied by a lack of understanding of "wealth" and "confiscation".
Under the current regime (speaking as a resident of the US), I have to pay a landowner for use of land. The government forces this choice; if I simply assert my natural right to access to land, I will be jailed for trespass. This in itself would be OK, because the nature of land is such that it cannot (in most cases) be productively used unless exclusive use is provided for. And paying for this use is right, because of the benefits of a system market prices and exchange, etc; and because by using the land, I'm excluding others from using it, so I ought to pay for the right to use it.
What's not right is that the payment go to the current landowner in his role of landowner. (That is, I'm not referring to rental payments for the structure or other capital improvements.) The landowner qua landowner didn't create the land; he didn't even create the value behind the land.
So in forcing me to pay the landowner, the government is indeed unjustly seizing my wealth and giving it to someone for doing nothing.
In fact, what really sucks is that, at least in the US, taxes on the productive (primarily income taxes and sales taxes) are used to fund government, which creates much if not all of land value. So taxes on the fruit of my labor are used for purposes which boost the value of land, which I then have to pay some parasite for access to, even though that parasite contributed nothing of value. (Not true, of course, to the extent that the landowner pays property taxes that fall on the land, but at least here in the US, and probably in most parts of the civilized world, the land tax component of property taxes falls far short of the rental value of the land.)
In this sense---one which the classical liberals understood---most strains of libertarianism represent thuggery.
And lest you think that this is a small matter, ask yourself what fraction of income people pay for housing these days. (Economists' claim that land rent comprises about 2% of GDP in the US is a sick joke; the actual number is probably more like 10--20%.)
liberal, thanks for providing an interesting post to this site. I'm not sure I totally understand what you are saying, but I am certainly interested. What I guess I don't understand is the 'right' to access land. For example, say I own the land, and I do nothing with it that adds value to it. I set up a lawn chair and enjoy the sun. You want to set up an office complex. I say fine, just pay me rent. In that case, am I considered a parasite? Should I be forced to move my lawn chair so you can bring in the bulldozers? Lets say I farm the land. You approach me and say that you will farm the land next year and pay me rent. I can collect the rent and save the effort. So, ignoring minor things like fences or an access road I may have built, I really haven't added any value to the land. You, as the farmer are adding the value this year (I guess I added value last year). Should you still have to pay me the rent? Am I a parasite in this case? Is there some case where I may have added value to land in the past the actually provides me with the right to charge rents in the future, even though I am no longer adding value? Also, at some point, I am guessing that all land in this country was originally purchased from the government (ignoring land grants, which the government [eg, the community] had their own reasons for granting). Since my ancestor (or I) purchased the land from the community, we did, in effect, add value to the community at a time when the community really needed it. Is it possible that this is a case of the condition I described above where adding value to the land (which I am going to equate with adding value to the community. If you disagree with this point, that seems fair. I'm willing to discuss it) at some time in the past gives me 'landowner rights' which allow me to charge rents without being a parasite?
Then they would be, by definition, non-libertarian.
Certainly that is possible without the aid of politicians and bureaucrats, and often times, it is the politicians and bureaucrats that do the coming in, beating up, and kicking out!
Hey nannny, wanna tell us how that is possible without politicians and bureaucrats, and remember the guys who kicked you out have a bigger arsenal.
Eli, what you do is you take a portion of your income and spend it on security. It is likely that this will cost you much less than the ~40% or more of your income that the politicians and bureaucrats take from you in taxes in exchange for a facade of security.
When it comes to big arsenals, no one can beat the politicians and bureaucrats. They have the police, the FBI/CIA/ATF/etc..., the F-16's and the tomahawk cruise missiles. When they decide they want your property, they'll take it and it is likely there is nothing you can do about it.
The dystopia proposed by Libertarians resembles a post apocalyptic 'mad max'(or road warrior for the American viewers) type world.
Unfortunately the internet often amplifies the importance of certain fringe groups. Certainly in Australia, if one were to only rely on the blogosphere, you could be led to believe that the LDP is a party of some note. In reality, they are a totally unelectable group of misanthropic economists whose popularity is only marginally more than anaesthetised root canal surgery.
Having said all that, I actually think Jason is a really good guy, and am surprised by these turn of events.
There were a few things left out of my favorite SF film you mention above. Exactly where did everyone eat? Had the nomads considered that maybe trading for petrol was a better deal than having to fight and die for it? With a variety of vehicles at their disposal, they could easily have transported food from the farming areas (that must have existed) to the refinery and earned a handsome profit in the process. No point in killing off all their customers. So add in a little dose of reality (people need to eat) and you get a libertarian society out of all that outback chaos.
Eli, what you do is you take a portion of your income and spend it on security.
What if the people you pay for security decide they just want the other 60% of your money? Presumably, if you're paying them for security in the first place, they're stronger than you.
That doesn't sound like it would be a very good move for their security business!
Hopefully you've checked around and found a security company that is certified by an organization that you trust. Kind of like electronics with that "UL" mark on them. You know they're not just going to blow up when you plug them in.
"Hey nannny, wanna tell us how that is possible without politicians and bureaucrats, and remember the guys who kicked you out have a bigger arsenal."
Eli just took off his we'll all be rooined hat and placed the taxeating cap firmly on the pointy end.
Eli, the nation would be a far more efficient place with only 10% of the tax eating jobs while the rest were fired.
Every single indicator shows we would be a better bang for out buck if industries like ed and health were allowed to experience the forces of competition.
The churn rate for every dollar going into the government's coffers is 40%. That means it costs $40c more for every dollar spent.
It's funny how most of you think we need Howard or Rudd to run our lives for us.
Alex says:
"Certainly in Australia, if one were to only rely on the blogosphere, you could be led to believe that the LDP is a party of some note.
That's true Alex, but it has to start somewhere. Take an extremist party like the Greens for instance who are able to manage 5% of the vote simply because there are enough people around who don't know what they actually do stand for.
There's plenty of room for the LDP to grow.
That doesn't sound like it would be a very good move for their security business!
It appears to be the normal move for such businesses in such libertarian paradises as Zimbabwe or Somalia. Without law and police, whoever is the biggest security business - whoever has the most guns - owns everything. Who can stop them?
Hopefully you've checked around and found a security company that is certified by an organization that you trust.
What force does a certification have when no agency has the ability to make the security company accountable for their misdeeds?
jc, if you think that the LDP is going anywhere, you're dreaming.
Tim
If you said Family First was going anywhere at the last election I would also have thought you were dreaming.
There's at least 2% to 5% of the voting public who would easily fit into the libertarian mold in Oz. That would be enough to get Humphreys (and possibly a few others) a seat at the table.
I assume you're talking here about how white farmers were kicked off their farms by Mugabe, and the farms were given over to friends and relatives of Mugabe who didn't know squat about farming, thus leading to food shortages, etc... It can be a bummer when you depend on politicians for security.
Withdrawing the certification could have a distinctly negative impact on the company's income forecasts. When no one contracts with the security company anymore because of their lack of certification, it is likely they'll try some other line of business.
Withdrawing the certification could have a distinctly negative impact on the company's income forecasts.
No it wouldn't - they'd just take people's stuff.
This is the point - without a government, whoever has the most guns runs everything. How one could consider "certifications" to be an effective form of control in such an environment baffles me.
JC, Family First has the money and dedicated people of organized religion behind it. Libertarians couldn't organise a picnic without breaking up into bitter infighting.
"It appears to be the normal move for such businesses in such libertarian paradises as Zimbabwe or Somalia. Without law and police, whoever is the biggest security business - whoever has the most guns - owns everything. Who can stop them?"
You seem to be forgetting the one thing that distinguishes civilization from savagery. It's called the rule of law.
No society can function without laws and private contract enforced by ( in libertarian state) a government adhering to the principles of a cosnstitutional republic.
Try enforcing a contract in Zimbabwe or Somalia?
Nanny,
I'm all for a mad max future run by libertarians, as long as you can secure me one of those pursuit special XB falcons. Deal?
JC, Family First has the money and dedicated people of organized religion behind it. Libertarians couldn't organise a picnic without breaking up into bitter infighting.
Now that's funny. Yes herding cats is very difficult. However there are a broad set of things libertarians agree. The bitter fighting? I would love to be a fly on the wall at Caucus meeting.
It's not a shoe in but I think there's good shot for one or two senators. Who knows Tim, maybe I'll be taking a seat alongside Senator Bob Brown as i'm punching him in the ribs to make him cry. hahahha
I know that thought just rooined your day. Hey, but I scrub up nicely in suit and I would donate the entire salary to charity
"Ian Gould now thinks the desire for increased human freedom is the equivalent of Stalism.
How novel. How so full of new ideas.
Ian, it's the blue pills in the morning."
Ever listen to the interview where Leni Riefenstahl tried to explain why she voted for Hitler?
Apparently it was out of a desire for "peace and full employment".
Listen to The Internationale and consider where the desire to "unite the human race" led.
"Ian would probably suggest this is because of some kind of inherent failing in any political movement based on ideology. I would be less charitable: it`s because libertarian ideology is a fig leaf over naked jealousy and arrant stupidity."
It'a little from Column A and a little from Column B.
Fortunately the chances of libertarians ever actually being in a position to implement their polices are roughly on par with those of the Natural Law Party.
"Hopefully you've checked around and found a security company that is certified by an organization that you trust. Kind of like electronics with that "UL" mark on them. You know they're not just going to blow up when you plug them in."
And the security companies would never form a cartel that extorted money from its clients and prevented the emergence of competitors.
Because...
Because!
They just wouldn't.
Similarly, there's absolutely no way that the rating agencies (which would themselves be in need of protection services)would be suborned by the protection companies in exchange for a cut of the economic rents they could extract from their vassals (oops, sorry "clients").
"I assume you're talking here about how white farmers were kicked off their farms by Mugabe, and the farms were given over to friends and relatives of Mugabe who didn't know squat about farming, thus leading to food shortages, etc..."
most of Mugabe's victims are black. Some of his closest cronies and hatchmen are white.
The white commercial farmers are being targeted because they have money and land not because they're white.
But thank you for illustrating the strain of underlying racism in so many libertarians.
"It's funny how most of you think we need Howard or Rudd to run our lives for us."
It's even funnier how you think you should have that job instead.
Ian
For someone educated you sure come out with some howlers and distortions. SG was trying to save your bacon and eggs and now you have made him look silly.
The modern history of libertarian ideals arise from people like Heyak, Popper, Mises, Schumpter etc. These are people who spent their lives trying to convince people that maximum human freedom such as the freedom of exchange and limited government is the best way for a society to organize itself.
Modern socialism has its roots in Marx- a fraud that eventually wiped out over 100 million people.
How on earth you can conflate maximizing freedoms/rule of law and the rule of the jackboot is beyond. I guess you meet all types on the web.
Perhaps you could explain to us how you think someone like Hayek should be considered a Nazi like figure in history. Was his Nobel Prize in economics also a fraud?
You seem to be morphing into 1984's big brother. War is freedom and liberty is slavery.
Wake up, Ian.
And no, I'm not a candidate for the senate and never will be. I was just trying to scare the daylights out of Tim. It was a joke.
"But thank you for illustrating the strain of underlying racism in so many libertarians."
Are you slowly losing it, Ian. Most libertarians believe in open borders.
JC, tyrants and oppressors always start out believing they're going to liberate the people for their own good.
Read the writings of the National Socialists and the Fascists, they made much the same claims.
"Most libertarians believe in open borders."
And when asked to explain why America's gun culture doesn't result in a lower murder rate and why America's health-care system delivers outcomes no better than universal health-care systems but at a much higher price about half of them will cite "minorities".
JC said: "There's at least 2% to 5% of the voting public who would easily fit into the libertarian mold in Oz. That would be enough to get Humphreys (and possibly a few others) a seat at the table."
Yes, but what would they say when they had their seat?
In fact, we all know what they would say - cut taxes! Now this approach has the virtue of consistency, but we don't actually need them at the table to know this is what they would say. From observing various other blogs, this is virtually all that libertarians ever say.
Perhaps if libertarians could come up with more nuanced policy positions, for example, on health care or child care or superannuation, or any of the hundreds of other complex issues that governments - however inadequately - must deal with, then it may be interesting to have them at the table.
"JC, tyrants and oppressors always start out believing they're going to liberate the people for their own good.
Read the writings of the National Socialists and the Fascists, they made much the same claims"
You left out Stalin, Pol pot, Mao and the rest of the leftist ilk.
Just what Hayek/ Popper has to do with totalitarianism you haven't yet explained. Why? It would be interesting to see this contortion.
---------------------------------
"And when asked to explain why America's gun culture doesn't result in a lower murder rate and why America's health-care system delivers outcomes no better than universal health-care systems but at a much higher price about half of them will cite "minorities"."
You mean.... that it's racist to observe the black murder rate is 8:1 higher than whites? I would say it's suicidely racist not to even make that observation. What's your problem?
Health Care.
So if the provision of health care is so good in government hands why don't we just turn our food supplies to the government as well? We can't live without health care and we certainly can't live without food. If government provides the better outcome lets nationalize the entire food business as well.
In any event bringing up the US is a pretty pathetic attempt at a strawman. Surely you could do better than that.? I know you can.
DO
Tax policy... 30/30 rule. Raise the tax free threshold to $30,000 negative income tax those below this threashold.
30% flat income tax rate. Raise the cap gains to 30%. Maintain the corp tax rate at 30%.
A lot of public sevants tax churn would be eliminated in one fell swoop.
------------------
Very limited market regulation excepting saftety etc.
-------------------
Voucher system for ed and health along with the elimination of medicare except for the those who don't reach the threshold.
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All middle class programs eliminated.
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Privatize higher education
Go read the pretty extensive policy manual at the LDP website DO.
Yes JC - we all know what the LDP tax policy is, but you are simply proving my point. Your policy is to cut taxes and to get out of everything else.
However, have the LDP done a distributional analysis of winners and losers from the 30/30 system? What is the effect of the new system on the budget deficit?
However, have the LDP done a distributional analysis of winners and losers from the 30/30 system?
Why would here be any losers DO? The obvious losers would be the public servants that currently administer the churn. They would have to find althenative employment int he private sector.
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Why immediately assume there would be a deficit. I can think of dozens of programs we could cut. Spending would altimatley have to fit the receipts.
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Tell me Do, how much governmen policy is currently not directly imnpacted by tax funding. Why should libetarians think itis any less so.
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Drugs is one good exmple of the road leading to nowhere. Libertarians think recreational drugs opught to be immediately decrimininalized seeing the current policy is a total farce.
This is probably not the right blog to discuss this, but as I recall the negative income tax involves lower payments to age pensioners and disability pensioners, plus it doesn't have payments for children, so potentially a rather large segment of the population could be made worse off. In contrast, of course, rich people get to pay a lot less tax.
"You left out Stalin, Pol pot, Mao and the rest of the leftist ilk."
Yeah, that's why I referred to The Internationale in comment #51.
"Just what Hayek/ Popper has to do with totalitarianism you haven't yet explained. Why? It would be interesting to see this contortion."
Well for starters, Hayek was an advocate of a limited franchise in order to ensure that only the "right" people voted.
You know, the male property owners who could be counted on to support sensible economic policies.
No, your're right it's not the blog to discuss this.
It doesn't mean less less payments to the aged etc. There have been enough costings to show that those funding requirments will be met.
The point is that dismantling the welfare state will take some time and a sudden jerking wouldn't happen. But let there be no mistake, there would be a gradual dismantling of the welfare state over a period of time.
Rich people could actually end up paying more in taxes as the US found out after Reagan enacted the changes to the tax code. Receipts went skywards as the scales dropped. So did spending but that's another story.
If you wish to discuss more there is always Jason's site at the open forum.
And lets not forget his support of Pinochet.
But The General was supporting True (i.e. Economic) Freedom so a few thousand people tortured to death here and there were a mere detail.
As for the closet racism of many American libertarians.
Let's consider Ron Paul:
"I think we can safely assume that 95 percent of the black males in that city [Washington DC) are semi-criminal or entirely criminal."
http://www.thedailybackground.com/2007/06/04/racism-in-ron-pauls-past-w…
Of course that was before Ron achieved the ultimate dream of many American libertarians - a public sinecure where he could rub shoulders with such fellow champions of liberty of Trent Lott and Strom Thurmond.
Jc, you are answering all the concrete points with pointless ideological questions ("why don't we put the govt in charge of food!" and "but WHY would there be losers?"). Sure sign you don't know what would happen in your ideal society. Why would we trust you?
"Receipts went skywards as the scales dropped."
No they didn;t they crashed.
After about seven years, they reached the same level in nominal terms (i.e. before adjusting for inflation) that they reached in 1980.
BTW, why didn't tax revenues fall when Bush 41 and Clinton raised the tax rates again?
Well for starters, Hayek was an advocate of a limited franchise in order to ensure that only the "right" people voted.
He was also from a very different time, Ian. People had different ideas on the women's vote when he was writing. The Swiss went for universal suffrage about 25 years ago. Yet until recently it was the model for a decentralized, limited governed state. Voting was less important to the Swiss seeing there was far less money to fight over. People didn't even know the name of the federal president.
I think it was Quiggin who brought that up some time ago about Hayek. Did you get the idea there? He failed to recognize that Hayek came from Europe and those ideas were pretty strongly held in Europe during his time. Nice twist.
The point is that Hayek was a good watcher of sociological changes and I'm sure if he were living now his views would have changed.
I do hold the view though that anyone who works in a government paid job should not be allowed to vote. There is far too much conflict of interest. I think that was an excellent idea.
SG this is grown up stuff. The playroom is out back.
Ian says:
And lets not forget his support of Pinochet.
But The General was supporting True (i.e. Economic) Freedom so a few thousand people tortured to death here and there were a mere detail.
What support for pinochet. He offered economic advice like Friedman. Don't be silly. Micheal Moore went to Cuba, does that make him a commo... don't answer that. FDR thought Stalin was a good guy and said so in not some any words, does that make FDR a commie sympathizer?
I don't support Pincochet, but out of the two less people died. Pinochet was a retailer compared to the wholsale slaughter of the left from the past century. I wouldn't be going there to compare.
What is it with you,lefties and torture? You all seem obsessed with it.
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As for the closet racism of many American libertarians.
Let's consider Ron Paul:
"I think we can safely assume that 95 percent of the black males in that city [Washington DC) are semi-criminal or entirely criminal."
http://www.thedailybackground.com/2007/06/04/racism-in-ron-pauls-past-w…
Yea, right. The daily Background is now the paper of record. Any evidence there...... like provable links. You actually are that gullible you think a bigtime Liberal newspaper like the New York Times wouldn't have been all over that painting the GOP candidate as someone worse than Hitler. It's the blue pills at night Ian.
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Of course that was before Ron achieved the ultimate dream of many American libertarians - a public sinecure where he could rub shoulders with such fellow champions of liberty of Trent Lott and Strom Thurmond.
The only KKK chief that I know of in the present Congress is Senator Robert Bird (Dem) who was a grand wizard or whatever they call themselves.
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Receipts went skywards as the scales dropped."
No they didn;t they crashed.
You want to place a bet on that Ian... that they went up by the end of his presidency?
Fact 1 Tax recepits rose 99% between 1980 and 1990 against a GDP growth of 102%
Fact 2 Real GDP between 1982 and 1990 grew by 31% The equivalent of East Germany.
Fact 3 living standards rose by 25%.
Tax recepits rose by spending did more so
Looks like that quote did not come from Paul, but from a ghostwriter:
http://en.wikipedia.org/wiki/Ron_Paul#Newsletter_writings_on_race
So Ron Paul runs away from remarks that appear under his name ("Paul acknowledged that the comments were printed in his newsletter under his name, but said that they did not represent his views and that they were written by a ghostwriter..."). The buck always stops "over there somewhere" for Republicans, doesn't it?
Jc, you obnoxious little skid mark, you are the intellectual giant arguing entirely from your imagination ("receipts went skywards") and your silly ideology. Perhaps it should be you in the play room.
Allow me to explain to you how a debate works. Someone points out to you that people in unregulated free markets for health care pay more (twice as much) and get worse health (shorter life expectancy, higher infant mortality) than people in socialised systems. Your response should not be "Oh well, why don`t we nationalise food too" for three reasons:
1) it`s rude to answer a question with a question
2) health delivery systems in nationalised systems are NOT government owned. only some parts are; and in case you weren`t aware, in Oz and the UK all GPs are private. So your analogy fails
3) good faith debate involves answering comments with the benefit of your knowledge, not rhetorical questions which assume everyone shares your ideology.
So now: can you explain why people in the US pay twice what we do, for worse health care outcomes? And if you can`t explain this, why should we assume that your ability (and that of other libertarians, who can`t answer this question either) to form any kind of policy on a complex issue is better than, say, that of a 10 year old?
If the best answer you can come up with for a real life example of the failure of your much-vaunted completely unregulated free market ideology is either "it isn`t pure!" or "it`s the blacks` fault!", why should we believe that your preferred solution for global warming is going to end up any different? I.e. all the peons paying more than we should and getting higher carbon emissions than we want...?
Is your assumption here that healthcare in the US is unregulated? You can't be serious.
I know Nanny Govt. They think the US medical system is one big unregulated jungle. Isn't that hilarous. They actually believe the tripe.
That's when the comment about black people getting turned away at the door of the emergency room comes in: ususally overlayed with the violin in the background.
"Jc, you obnoxious little skid mark, you are the intellectual giant arguing entirely from your imagination ("receipts went skywards") and your silly ideology."
It's always pleaseant discussing things with the angry left.
Tax recepits rose 99% from 1980 -90.
Be my guest to disprove that, but please note the daily kos won't cut it and a reference point.
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1) its rude to answer a question with a question 2)
Ok. So let me change that into a statement then if it's easier for you.
If outcomes are better under government mandate/ownership. control- you obviously argue they are with healthcare- we should immediately nationalise the food industry as it provide us with cheaper food.
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health delivery systems in nationalised systems are NOT government owned. only some parts are; and in case you werent aware, in Oz and the UK all GPs are private.
Don't be silly. Government ownership and government mandate pretty much allow for the same outcome. The medicare rebate on doctor's vists etc. pretty much shows the level of interference in the medical market. It's riddled with government control. Only a stupid person would argue otherwise. Try ordering an off the PBS medicine and see how many hoops the doctor has to go through.
-----------------------
So your analogy fails 3) good faith debate involves answering comments with the benefit of your knowledge, not rhetorical questions which assume everyone shares your ideology.
If government controlled healthcare provides for superior outcomes then it follows we should nationalise the food suuply immediately. Are you in favour of that or not? If so why, if not why not?
The US healthcare system is a highly regulated deformity that pays little heed to the price signal. They also have a large R&D expenditures in (pahrma) that forms part of the total expense package that we don't have.
It's amusing how you and Gould contort yourselves in arguing that healthcare is somehow different which needs government controls and regulations to maintain it but backpeddle at 100 MPh when confronted with the food supply question.
You're an empty suit SG.
So you back up Ian Gould`s comment nicely. People point out to you that the closest thing you have to a free market in health insurance is a failure, and you argue "but it`s not pure libertarianism."
This is exactly the same as the problem communists have faced over the years. People point out to them that their closest models are always a failure, and they say "but it`s not pure communism." It`s the last slimy defense of an ideologue (except blaming it on the blacks, of course).
This is why you have to fall back on your silly rhetorical questions. You can`t analyse the actual situation as it actually stands in reality because there is no way it can be swung to fit your ideology. So you spout idiocy instead: "why don`t we nationalise food" or "why should there be any losers from our system?"
So you back up Ian Goulds comment nicely.
How so, Angry Anderson? There's nothing Gould and I could possiblky agree with seeing he's wrong 99% of the time and then covers things up by obfuscating and truncating. ... like you.
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People point out to you that the closest thing you have to a free market in health insurance is a failure, and you argue "but its not pure libertarianism."
It's not market based. Nowhere near it. It's a command and control system run with mandates regulations up to the backside and general inefficiency seeing is not a single payer system.
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This is exactly the same as the problem communists have faced over the years. People point out to them that their closest models are always a failure, and they say "but its not pure communism." Its the last slimy defense of an ideologue (except blaming it on the blacks, of course).
Don't be so silly. It is well recognized that markets are superior at delieving better outcomes in the provision of goods and services- like food- yet you and Gould have a mentla block when it comes to health. It's almost comical to watch the contortions ( raice baiting is a great example of this pathetic exercise).
--------------------------------------------
This is why you have to fall back on your silly rhetorical questions.
Not at all. We're after superior outcomes and results. Privatized food supply is a great example. It's you who doesn't want to answer it because you simply cannot and so you resort to all the other dirty little rhetical tricks up your sleeve with abuse being the most obvious.
--------------------------------------
You cant analyse the actual situation as it actually stands in reality because there is no way it can be swung to fit your ideology.
Not at all. See the food supply question again.
-------------------------------------------
So you spout idiocy instead: "why dont we nationalise food" or "why should there be any losers from our system?"
Exactly. We currently have a system which doesn't respond well to price signals, market segmentation or specialization simply because we're saddled with a one size fits all approach that can't possibly satisfy every need.
That's why I don't use medicare and have bought an international Chubb policy that allows me and my family to see any specialist in the world whenever I want or go to any hospital
So i am paying the levy for nought. Enjoy the frebbie.
ah Jc, you do like sparring with your invisible communist opponents don`t you? It hasn`t occurred to you, has it, that a reasonable person might support the idea of a privatised food system (because its been tried and it works) and a nationalised health system (because its been tried and it works)?
But it`s funny, because you as an ideological debater are shackled with a (how do you put it?) "one size fits all approach that can't possibly satisfy every need". And you resort to debating complex policy (health) by providing counter-examples (food privatisation) which no sane person is suggesting. Instead of the obvious technique, which would be to explain patiently how a completely free market in health care would push down costs and improve outcomes.
"ah Jc, you do like sparring with your invisible communist opponents dont you?"
Lol. Isn't it you and Gould who are doing all the commie comparisons/ see the 81 comment:
"This is exactly the same as the problem communists have faced over the years."
Didn't you say that SG? There's plenty more. I sure hope you aren't confusing my comments with yours and Gould's as that would be tragic? It really is silly comparing stalist leftism to free market libertarians isn't it when you think about it.
-----------------------------------------------
" It hasnt occurred to you, has it, that a reasonable person might support the idea of a privatised food system (because its been tried and it works) and a nationalised health system (because its been tried and it works)?"
Well no. No reasonable person could make that insinuation or reach that silly consclusion. If they did they would have to argue that demand curves are not downward sloping and demand/supply doesn't respond to price signals. (yes Ian we know bout Giffen(?) goods)
All I am saying by pointing out the wonderful bounty of our food supply which is cheap and endless is that the same forces at work there would quickly begin to take hold in the health markets if they were left alone without this government meddling. In other words the same forces would also apply. We haven't seen a free market in health because it's never been tried in the modern age but we can reach a reasonable conclusion that market forces would rapidly offer a superior outocme. Offfer vochers to every citizens if the government wants to ensure 100% insurance. Offfer vouchers irresprective of income.
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But it`s funny, because you as an ideological debater are shackled with a (how do you put it?) "one size fits all approach that can't possibly satisfy every need"
Which is our wealth system now isn't it. It has to be because a government mandated command control one cannot do anything other than offer a one ize fits oall. It has to.
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. And you resort to debating complex policy (health) by providing counter-examples (food privatisation) which no sane person is suggesting.
See above
Instead of the obvious technique, which would be to explain patiently how a completely free market in health care would push down costs and improve outcomes.
Comptetive pressure puts downwards pressure on prices in all free unfettered contestable makerts. There is enough litertature on that to make it axiomatic.... Well almost.
Health markets are no different than other markets and no amount of race baiting and silly contorting can change that premise.
So, if this is an incontestable axiomatic fact, are we therefore to conclude that the Australian healthcare market is actually much more competitive than the US market? After all, health care in Oz costs half what it does in the US, and the quality is better. Is that what you are saying? If so, why do you want to change it? Australian health care outcomes are very good and our healthcare system one of the cheapest in the developed world. Doesn`t that mean we must already be highly competitive?
Some other silly comparisons between stalist (?) leftism and free market libertarianism that are "silly":
- both are written down in books
- both are debated on blogs
- both use economic arguments
They must be the same!
Look, Jc, if you can`t tell the difference between the argument "Communism and libertarianism both show a big gap between the ideology and the implementation" and "communism and libertarianism are the same" you really should have got yourself a few more years of home schooling...
SG
So if you think the medical system here is great, why don't you opt for letting people outta the system if they so choose? In other words I'll take care of my own insurance through the market.
Personally I think the system here sucks and I consider the American one superior in almost all respects. I have lived under both.
I note you haven`t answered that question, Jc. Too hard?
Jc, the medical system in Australia does allow you to opt out. You can buy private. But your private insurance companies won`t cover emergency departments and the heavily subsidized drugs you are buying. If you want to triple your health insurance costs for that, fine. The rest of Australia don`t want to, so you just have to suffer with a lower overall health cost in order to support our strange desire for cheaper health care. So terrible for you...
SG
Happy to answer all the "curve" balls. But first I left a few for you. So it's only fair if you go first now.
By the way are you correcting typos now? Oh, well, it keeps you busy I guess.
I don`t know what a curve ball is Jc, but the only question you seem to have asked me is if I think we should nationalise food distribution. Answered. Now...? Is teh Australian system more competitive than the American?
"He was also from a very different time, Ian"
So if he'd lived last century your champion of liberty would have been a slaveowner>?
"What support for pinochet. "
He's on record praising Pinochet ot Thatcher as a model for Britain and lobbying against economic sanctions.
But I guess the 1980's were "another time" too. Human rights were only discovered last week.
By libertarians, of course.
"Yea, right. The daily Background is now the paper of record. Any evidence there......"
Paul has admitted that the comment ran in a newsletter he wrote under his by-line.
Thirteen years later he claimed he didn't actually write it.He's never produced anything to support that claim - liek the name of the real author.
"Fact 1 Tax recepits rose 99% between 1980 and 1990 against a GDP growth of 102%
Fact 2 Real GDP between 1982 and 1990 grew by 31% The equivalent of East Germany.
Fact 3 living standards rose by 25%."
Well if you say it it must be true, mustn't.
Fact 4: 1990 was two years AFTER Reagan left office and after Bush raised tax rates.
"Is your assumption here that healthcare in the US is unregulated? You can't be serious."
I assume nothing.
I observe that the US government role in financing health care is smaller than that of other first world governments as a percentage of GDP.
I observe that despite this, total US spending on health care is significantly higher than in other developed countries.
I observe that despite this higher spending few if any health indicators show the US health system producing superior outcomes.
I conclude from these observations that adopting a health care system more like that of other developed world countries would probably reduce US healthcare costs without impairing health outcomes.
This is the point where many of your fellow libertarians interrupt to insist that the US health system costs what is does because of all those wetbacks and darkies.
Reagan's first budget was fiscal 1982. The first budget to reflect his tax cuts was fiscal 1983.
Total government revenue in fiscal 1981 was $286 billion.
Total government revenue in fiscal 1988 was $401 billion.
http://www.cbo.gov/budget/historical.pdf
Both figures are in constant dollars - i.e. before adjusting for inflation.
US Inflation for the period January 1 1981 to January 1 1989 was 39.2%.
http://inflationdata.com/inflation/Inflation_Rate/InflationCalculator.a…
Adjusting for inflation, 1988 revenue was $397 billion in 1980 dollars.
I'm sure JC will respond with his usual squawking and abuse.
"If outcomes are better under government mandate/ownership. control- you obviously argue they are with healthcare- we should immediately nationalise the food industry as it provide us with cheaper food."
Yeah because there are absolutely no differences between the market for food and the market of health care.
Every time I buy food I'm shelling out thousands of dollars on technology and pharmaceuticals with which I have only a passing familiarity at best and my life is on the line if I don't take the advice of professionals who are getting massive commissions from the food industry.
"ah Jc, you do like sparring with your invisible communist opponents dont you? It hasnt occurred to you, has it, that a reasonable person might support the idea of a privatised food system (because its been tried and it works) and a nationalised health system (because its been tried and it works)?"
But SG, who needs facts and evidence when you have the infallible light of ideology to guide you?
"I'm sure JC will respond with his usual squawking and abuse."
No, there's no reason too. Tax receipts rose during his prez. They rose 99%. Tax recepits are rarely ever spoken of in real terms and Pved to a past date for the simple reason that expenditure is treated in constant dollars too.
nice slight of hand, Mr. Mirthless.
Oh I forgot
Who did you ask for the discount rate, Ian? It couldn't have Nick Stern and his supporter as that would have been too low.
Tax receipts in 1988 were about 40% higher than 1980, in non-adjusted dollars.
One reason for this was the fact that Reagan raised taxes in 1986, in his reform legislation which reduced the number of incremental tax levels and shifted more of the income tax burden from the upper and upper-middle classes to those making less.
For example, I was making an inflation-adjusted equivalent of the low-100s when the new tax rate went into effect. My income tax went down about $2K that year. My sister and her husband, who combined were making an inflation-adjusted equivalent of the mid-30s combined saw their income taxes go up roughly the same amount mine decreased.
Ironically, she was the Reagan supporter, I hated him. She started voting Democrat after that experience, though.
I'm curious about how someone can opt out of the Australian national health care system. If I were to choose to 'opt out', do my taxes decrease? I assert that all taxes (corporate and otherwise) are actually paid by individuals, so the price of everything I buy includes the corporate taxes paid for my healthcare as well. I live in the US, so I don't know much about the Australian healthcare system. For example, do insurance companies not sell insurance that covers emergency room visits because they don't want to, or because they aren't allowed to? Has anyone ever done a real study on the actual costs per taxpayer for the Australian health care? I searched (albeit briefly) and couldn't find anything?
Can the people who are making all these assertions about US tax receipts during the 80 just post the site you are referencing. It is just silly to argue about a provable fact.
Also, Bush Sr. didn't become president until 89. The first year he could have implemented a tax increase for would have been for '90. I'm not sure, but I don't think he increased taxes until 90 or 91 (meaning that the increase wouldn't have taken affect until 91 or 92).
Financing? US Government? We're talking about regulation at all levels, Ian. Financing at the federal level is just one portion of that. For more see: http://www.amazon.com/Health-Care-Regulation-America-Confrontation/dp/0…
And I know you'll enjoy this piece from Cato, but you should note that it also points out beneficial regulation: http://www.cato.org/pubs/pas/pa527.pdf
Screw regulation. Long live thalidomide. Let those affected wallow in luxury upon winning their lawsuits in true libertarian "don't prevent harm, just pay for the results afterwards" style.
Oconnelc asks:
"I'm curious about how someone can opt out of the Australian national health care system. If I were to choose to 'opt out', do my taxes decrease?"
No you can't opt out. You can't even choose to keep paying the government mandated levy and opt out as there are no provisions for that in the private market and isn't allowed. You got one choice, pay the incomelevy or pay the income tax levy.
The drugs they offer on subsidy are mostly generic crap. The anit-biotics I wouldn't even offer to an animal. If the drug is off the regular subsidy plan the doctor has to go begging the the regulators to allow it. They also don't like to offer tests and try to disuade you at every turn. So your sitting in front of a dude or dudette who's basically playing a guessing game with what is wrong with you.
You have to go through a GP to see a specialist (seriously) and then there could at times be a 3 week wait because they is a closed shop.
That's why I bought an international cover through Chubb.
It's a make believe medical system, here which only people who don't know quality health care would support. In other words it sucks big time.
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Can the people who are making all these assertions about US tax receipts during the 80 just post the site you are referencing. It is just silly to argue about a provable fact.
Yea sure: Bob Bartely's book. Former editor of the Wall Street Journal called 7 Fat Years.
LOL! So the ineptness of the FDA is what makes it so great?
Let's put that red herring to rest:
http://w3.aces.uiuc.edu:8001/Liberty/Tales/Thalidomide.Html
"However much we all like heroic tales and medals, there is actually very little in the record to bear out the official heroic version of the thalidomide story. Upon careful examination it appears that no reproductive tests were done at all on thalidomide before 1961, nor indeed did the FDA ask for any. In fact, it appears that even had any pre-marketing reproductive tests of thalidomide in rats been done, they would have *still* have shown negative results, for thalidomide (as it turned out later) does not cause birth defects in rats. We now know that it would have taken a much more exhaustive set of animal tests to catch thalidomide than was routinely used anywhere in 1961. An honest reading of the facts thus forces the conclusion that (questions of luck aside) Dr. Kelsey's medal was awarded basically for being a delay-causing bureaucrat and thereby allowing Europeans to serve as first-class "guinea pigs" for Americans, in a case where (quite literally) guinea pigs themselves would not have done an adequate job."
The 'reason' health care in the US is "expensive" is a few reasons. The number of drugs developed and recouping the R&D costs etc. The speed with which you can be seen. The large numbers of people with no money using emergency rooms for non-emergencies. Per capita incomes. The amount of government control and intervention. The societal makeup of the country.
The reason the gun culture doesn't reduce the number of murders is just because of what it says; it's cultural. (The idea it does or doesn't reduce murder (or increase it) is meaningless anyway, because it can't be proven or disproven.)
Observation on the lowering of taxes is that it increased GNP and reduced unemployment. Impossible to prove due to the chaotic nature of an economy as a whole, and the lag. e.g. Stock market crash, a boom going bust, when it happens (or why) the results come "later" and is one of many factors.
If those with the biggest guns would take everything over, why doesn't the US military and law enforcement own everything? No matter, you can't compare Miami to London or Buenos Aires to Somalia or Sierra Leone anyway.
The best source for US data are the Statistical Abstracts AFAIK every government issues something similar.
Ian Gould
Do you think market forces don't apply to healthcare? It's not a racist question by the way.
nanny_govt_sucks knocks down a strawman argument as to why Ms. Kelsey refused to approve thalidomide for use in the US.
Not surprising. Here's the real story...
That's from wikipedia, which, while not a perfect source of information, in general might be expected to be a more neutral one than a random website at a university which has been put up by a libertarian.
nanny_govt_sucks is correct in claiming that no reproductive tests were performed on thalidomide in this period, but that has nothing to do with the "heroic" story in regard to Kelsey.
She refused to approve the drug because the company had not done the PROACTIVE WORK to demonstrate safety required by law and the regulatory framework.
My initial comment stands:
Libertarians would free drug companies of the requirement to demonstrate to a reasonable degree that new drugs are safe in a government-mandated regulatory framework.
If consumers are harmed as a result, their solution is that those harmed can sue in civil court. Potential damages are enough, in their eyes, to cause companies to make sure their products are safe without the need for regulation, despite a couple of centuries of data refuting that simplistic point of view.
That nice website linked by nanny_govt_sucks lists the refusal to approve the sale of thalidomide in the United States under its "Tales of Woe" The Many Abuses of Big Government section.
So, tell us, nanny_govt_sucks, do you agree that the refusal to allow sales of thalidomide in the United States an example of an abuse of big government?
Should thalidomide have been sold to pregnant women here in the US?
Is this how you intend to win the hearts and minds of the populace, by arguing that regulation by the FDA unfairly limited the rights of pregnant women to give birth to flipper babies?
Good luck with that.
Oh, yes, another example of a hero of the libertarian movement from the website linked by nanny_govt_sucks.
Well, this isn't quite the story told by the libertarian site linked to by nanny_govt_sucks.
Their tale of martyrdom leaves out the fact that Van Leuzen was warned beforehand that he'd need a permit from the Corps to place fill on his land. And that he continued to fill and do construction on that fill despite numerous warnings that he was in violation of the Clean Water Act.
This is the libertarian world view - people who knowingly break the law are heros as long as libertarians disagree with that law.
dhogaza
Do you think FDA requirements are overly restrictive, still weak or about right?
It costs about $2 billion dollars to bring a drug to market these days.
Cancer patients on their last legs are denied experimental drugs in case they're too dangerous.
You're also have one huge hole in your argument about thalidomide. Even if the US regulator succeeded the Europeans regulators failed.
It seems from your link that the US fluked it because of failed filings rather than the observations of the brave hero.
Would you call this a success or an evens bet, so to speak. A broken clock is right twice a day after all.
The threat of legal action can be used as a risk management tool, you know.
That is the strangest argument for weakening regulation I think I've ever seen.
And proper filings would've raised other red flags, that rather being the point behind their refusal to do the necessary work.
Thank you for confirming my statement regarding the libertarian's approach to product safety. Let companies market products that kill people, then let the surviving relatives sue. They'll be able to afford a nice funeral, after all!
Jc wrote, Do you think market forces don't apply to healthcare?
It's not that market forces don't apply to healthcare. Rather, it's that whatever market forces do apply, it's an empirical fact that gross market failure in healthcare is inevitable because of information problems and perverse incentives: mainly, that suppliers of healthcare have no incentive to provide good long-term outcomes at a reasonable price.
This point is discussed in the excellent article, "The Best Care Anywhere".
nanny_govt_sucks wrote, Financing? US Government? We're talking about regulation at all levels, Ian.
Let me make a wager: you don't consider government-granted monopolies in the health care market (aka "drug patents") to be a form of "regulation."
liberal, I know you didn't ask me for the wager, but I would say that it doesn't really matter if we call drug patents "regulation" or not. If we ever want another drug developed by a pharmaceutical company, we better not get rid of them.
Also, are you still interested in talking about land rents? I had a couple questions I posted above that I was hoping you might want to address. Thanks.
jc is now bringing a whole bunch of silly extraneous arguments into his healthcare polemic. Let's see:
This is not due to the type of health care market in which people operate: it's doctors' self-regulation, to do with the ethics of administering treatment.
Do you mean, for example, zithromax, the current recommended antibiotic for the treatment of pneumonia? Produced by pfizer and on the PBS? real generic crap, that is.
Yes, because the concepts of primary, secondary and tertiary health care are purely the products of a nationalised health service. There is no benefit to this at all... and "they is a closed shop" because of the system of socialised health care - not because they have their own, private industry body which controls certification and registration of specialists.
Hint jc: go to the OECD website and get their stats on relative costs of different elements of national health systems. Drugs are not the main cause of differences between Australian and US prices - the main cause is the extremely large amount of expensive machinery in the US, and the extremely high staff-to-patient ratios.
But in the end your argument here rests on a simple case doesn't it JC? You think that spending 16% of GDP on health instead of 8% is good, and being a good libertarian you want to institute a system in Australia which forces me to pay the same inflated costs as you.
Why should I pay extra so you can have dancing girls in your hospitals?
<>
That doesn't make me feel good about any changes to the US healthcare system. I haven't heard anyone suggest any changes the include destroying existing equipment or forcing hospitals (clinics, whatever) to cancel any purchasing requests that they would make. I certainly haven't heard anything about firing staff. I know this is off topic, so I apologize.
Any such claims would be scaremongering, oconnellc. It's unlikely that if the US moved to a fully socialised health care system tomorrow their proportion of GDP spent on health would change very much (although there is a lot of profit-taking at various levels which would be eliminated). But over time, the cost controls and efficiency improvements of a government-controlled health care purchasing system would contain costs, so that as the US economy grew the costs came more into line with other countries.
You asked earlier about information about the cost of oz vs. US health care systems. I think you can find it easily at the OECD website on health statistics, or by searching the journal Health services review. For example,
http://content.healthaffairs.org/cgi/content/abstract/16/6/163
although probably you need a university subscription to view it. An approximate figure is Australia, 9% of GDP, US, 16%, UK, 8%. It's noticeable as well that over the last 30 years US health outcomes have slid down the OECD list, while their costs have grown. If you visit the OECD website you can find an excel spreadsheet with these figures and a whole bunch of information about health risk factors, for which Australia and the US are almost exactly the same. The big difference is that the US population is younger than the UK or Oz, and so should have better health outcomes, not worse. (you can read about this in the journal Health Affairs too).
For a simple summary though, you could look at this website from General Motors:
http://www.gm.com/company/gmability/workplace/100_news/120_news/healthc…
Big Auto has a big interest in changing the health care system, because it is holding back their profitability. Countries like Japan have much lower health care costs and much smaller burdens of health care payment on their large companies (although I think big auto are kidding themselves if they think this is why they are being out-competed by Japanese car companies).
"Tax recepits are rarely ever spoken of in real terms and Pved to a past date for the simple reason that expenditure is treated in constant dollars too.
nice slight of hand, Mr. Mirthless."
So by this reasoning economic management in Germany post world War I was a brilliant success since nominal tax revenue rose by several thousand percent.
Sure prices rose by several thousand percent too but that's meaningless.
JC, you CAN'T be as stupid as you pretend. If you were, I doubt you'd be able to type.
"Observation on the lowering of taxes is that it increased GNP and reduced unemployment."
And observation from the period 1992-2000 is that raising taxes also increased GNP and reduced unemployment.
Gee maybe there are factors other than tax rates affectign the economy?
Next thing you know people will be trying to tell me that my brushing my teeth at night doesn't make the sun rise. After all, one precedes so the other so it MUST cause it, right?
"I'm curious about how someone can opt out of the Australian national health care system. If I were to choose to 'opt out', do my taxes decrease?"
Here's how the Australian health system works:
- Australians pay 1.75% of income as a Medicare levy on top of income tax.
- Private health insurance is subsidised and tax deductible.
- High income earners who don't have private insurance pay a higher levy. (Or they used too. I haven't paid much attention to this issue over the past few years.)
- Members of the public are free to see whatever doctor they like and doctors are free to charge whatever they like. However, the government pays around 85% of the scheduled cost for medical procedures. If your doctor charges more than that, you shoulder the difference. Doctors are required to treat pensioners fro the scheduled fee.
- The government subsidises the cost of most drugs. But, for example, won't subsidise a brand-name drug if there'd an equivalent generic. Again, if you want a drug that isn't subsidise, you can buy it. You just have to pay the full cost.
- A safety-net arrangement applies where the out-of-pocket expenses for a family exceed a certain level. Above that level the government pays 100% not 85% of the cost.
- Hospital treatment is provided by for-profit private companies AND not-for-profit hospitals (most of them Church-affiliated) AND public hospitals. All three sectors compete for patients - public hospitals take private patients for an additional fee, private hospitals tender to provide treatment for public patients.
Australia screws up in any number of ways but we have one of the best medical systems in the world - that's why 13 years into the reign of the self-described "most right-wing Prime Minister Australia has ever known" the system remains intact.
"In other words I'll take care of my own insurance through the market."
You DO know that you can get private health insurance, right?
And in fact the government will subsidise your premiums?
Ian
Private insurance in Oz covers crap. It doesn't cover the gap between the Medicare co-payment and the fee(in most cases). It doesn't cover meds. It more or less covers hospital stays and a couple of other things like vists to the voodoo/witch doctor. In other words compared to the American system it's a pretty poor insurance coverage.
Now to give you and example. Let's compare top of the line cover in Oz/US.
Bascially US top of the line insurance get you a private room, 100% doctors visits, and you can go straight to a specialist and by pass the GP gate keepers that we have in OZ. It also gets you free meds. There are no co -payments in the top of the line insurance. Now compare that with OZ?
Actually this is discussed frequently. Rationalizing the purchase of MRIs and other expensive equipment would be one step towards making the US health care system more efficient. No one's quite figured out how to make it work, though. Hospitals look at their equipment inventory as being a marketing plus, and as long as those in the system will bear the increased cost (transfered to consumers in the form of higher premiums), they aren't going to change.
BTW the description of the oz health care system above sounds much like the french system, as I understand it from my french girlfriend's discussion of it. I think France came out #1 in the rating system mentioned by Moore in "Sicko" (with the US being #37 and poverty-stricken Cuba #39). My GF is living in Spain, which has a fully socialized system of medicine with private care available at your own expense if you choose. Spain ranks in the top 10 in the world, which given her economic ranking in the EU (GDP per capita 13th in the EU, though she's closed the gap and is close to France, Germany etc these days) is quite impressive.
Yeah Jc, and what great insurance coverage you get. A young professional has to pay more than $400 a month to get the stuff you're talking about just for themselves. For a family you're looking at upwards of $1000 a month. The cheapest plans for a family can still be $800 a month, and they have massive deductibles. $800 a month is 25% of the take-home pay of the average Australian. Currently that Australian pays $100 a month in the medicare levy, with zero out of pocket expenses outside the drugs they buy - and that $100 a month is NOT in their take-home pay.
You want Australians to triple the cost of their health care system, and have it come out of their after-tax pay, so you can have a room of your own and not have to pay $15 for drugs? You are stupid.
SG
The levy is but a fraction of the 8% we spend on healthcare.
Do you numbers again and add in the additional money that comes out of general revenues.
"Yeah Jc, and what great insurance coverage you get."
Oh Really:
http://www.reason.com/news/show/120998.html
http://www.kff.org/kaiserpolls/upload/7572.pdf
But his radical prescriptions, which include a call for a British-style, single-payer system, will likely have little resonance with viewers. Indeed, according to a recent ABC News/Kaiser Family Health study, insured Americans are overwhelmingly (89 percent) satisfied with their own care, while broadly concerned about rising costs of prescription drugs and critical of the care others receive
Despite what the girthed one has told you 89% of Americans are happy with their healthcare.
I agree. As I said before it is superior to anything you're used to here. Don't be scared, SG. the big bad market isn't going to make you cry.
Jc, whether the levy is or isn't a fraction of the 8% we pay, we still pay half what the US does. And remember for all the money that private individuals pay in the US, that much again has to come from general revenues because the government still pays for 45% of US health care. So in addition to their huge private bills, Americans are spending as much as we are through general revenues.
And while Americans may be happy with their care, this doesn't change the fact that even though they are a younger population than us with similar risk factors, they have much worse health outcomes.
i asked you before, that if it is axiomatic that increased competition drives down prices and improves quality, does that mean that the almost entirely government run Australian system is more competitive than the largely private US system? If not, how can you explain the discrepancy? If so, why do you argue the US is better?
(And no, I won't answer your question about why health care does not respond to competitive pressures; Ian did. And in any case, if it were true that health care did respond to competitive pressures, can you explain why in the US it does not?)
SG
I'm the good guy here, remember. I have answered numerous questions you have posed and you don't even show gratitude in return.
So I'll ask the question one more time...
Please explain to the kids why you think healthcare does not respond to market forces? This is not a trick question by the way, so don't think I'm trying to place your had in a vice and squeeze hard.
Please try and answer that question in your own words.
thanks.
"The speed with which you can be seen" in the US is another one of those myths. Mark Kleiman recently wrote about how the delays imposed by the US system came very close to killing him
Read the whole sad story (with happy ending)
"The 'reason' health care in the US is "expensive" is a few reasons. The number of drugs developed and recouping the R&D costs etc. The speed with which you can be seen. The large numbers of people with no money using emergency rooms for non-emergencies. Per capita incomes. The amount of government control and intervention. The societal makeup of the country."
Of course, the fact that you need to shave 7-20% off the gross to feed the shareholders does not raise the costs at all.
"The 'reason' health care in the US is "expensive" is a few reasons. The number of drugs developed and recouping the R&D costs etc. The speed with which you can be seen. The large numbers of people with no money using emergency rooms for non-emergencies. Per capita incomes. The amount of government control and intervention. The societal makeup of the country."
Likewise, the need for floors and floors full of clerk types who typically have nursing degrees and command nursing type salaries to tell people on the phone "yes, you are authorized to have your broken leg treated in the emergency room yesterday" has no impact on costs, nor does the floor full of highly paid executives who deliver the overall decisions on that, and the floors full of middle management who pass the decisions on. All multiplied by the number of companies, of course.
Nor does the need for each doctor to spend up to half their highly paid time on the phone negotiating their way through the confusing maze of which company covers what on which date, and which drugs are on each company's fomulary at any given time, and filling out all the variations on billing forms provided by each company.
As I've posted elsewhere, I just recently gave in to my (highly regarded) insurer's nagging to get my annual physical. Which was followed, inevitably, by a bill from the doctor for $250 as my insurer doesn't cover annual physicals, only every 24 months. Which of course was covered by my asking the doctor to resubmit the bill as followups to all the issues previously raised, which it was; which the doctor graciously did, since they have to do it for a huge fraction of their patients anyway. Lucky that none of this impacts costs.
Three months ago a homeless seventh grader in Prince George's County, Maryland, died because his mother could not find a dentist who would do an $80 tooth extraction. Deamonte Driver, 12, eventually was given medicine at a hospital emergency room for headaches, sinusitis and a dental abscess.
The child was sent home, but his distress only grew. It turned out that bacteria from the abscessed tooth had spread to his brain. A pair of operations and eight subsequent weeks of treatment, which cost more than a quarter of a million dollars, could not save him. He died on Feb. 25.
There's a presidential election under way and one of the key issues should be how to provide comprehensive health coverage for all of the nation's children, which would be the logical next step on the road to coverage for everyone.
That an American child could die because his mother couldn't afford to have a diseased tooth extracted sounds like a horror story from some rural outpost in the Great Depression. It's the kind of gruesomely tragic absurdity you'd expect from Faulkner. But these things are happening now.
''People don't understand the amount of time and stress parents are going through as they try to get their children the coverage they need, in many cases just to stay alive,'' said Marian Wright Edelman, president of the Children's Defense Fund and a tireless advocate of expanding health coverage to the millions of American children who are uninsured or underinsured.
Medicaid and the State Children's Health Insurance Program provide crucially important coverage, but the eligibility requirements can be daunting, budget constraints in many jurisdictions have led to tragic reductions in coverage, and millions of youngsters simply fall through the cracks in the system, receiving no coverage at all.
http://select.nytimes.com/search/restricted/article?res=F40715F93A550C7…
Fans of the TV series Lost may recall a plot point wherein the young female protagonist's mother is massively injured in a car crash and she has no idea where she can get the money to care for her; then out of nowhere comes her long lost dad, to cover all the bills. The punchline is, this was supposed to be happening in Australia to Australian citizens. I suspect that in fact, it does not happen in Australia, and the writers are projecting what does occur in the US.
"I haven't heard anyone suggest any changes the include destroying existing equipment or forcing hospitals (clinics, whatever) to cancel any purchasing requests that they would make. I certainly haven't heard anything about firing staff. "
Actually, in the US healthcare organizations including hospitals are pretty heavily regulated. We don't have any for-profit hospitals in my state, but the non-profits are regulated as most nonprofit organizations are in most places in exchange for being considered nonprofits and paying no taxes; in particular, starting a new hospital, expanding a hospital, buying hugely expensive equipment like MRI machines, starting a cardiac surgery center where there had been none, etc. all require submitting a certificate of need to the state, which is then reviewed to see whether there is, in fact, a need for said expansion, or whether it's just a little empire building ploy. They will not approve said application if it turns out that there is not a need for it, and it will only succeed by stealing patients from an already existing facility. And the bottom line is, it seems to work pretty well, there certainly isn't any clamor to get rid of it because the population is underserved. In fact, outcomes in Canada where cardiac surgery centers, etc., are even more tightly regulated, are better, because as one might expect, the success rate of medical providers is closely tied to the amount of experience they have with that type of service, which is closely tied to being one of a few large centers with a large throughput, rather than giving individual care and attention to the only patient in your local hospital's cardiac unit, no matter how lavish and personalized.
"And lest you think that this is a small matter, ask yourself what fraction of income people pay for housing these days. (Economists' claim that land rent comprises about 2% of GDP in the US is a sick joke; the actual number is probably more like 10--20%.)"
Ah, that's the kicker alright. "Nickel and Dimed" by Bárbara Ehrenreich explains it well, but just the summaries page from a Google search tells the tale:
"What percentage of income should go to housing? ... All together it should not be more than 28% of your gross monthly income. ...
Federal housing guidelines recommend spending no more than 30 percent of pre-tax household income on housing. To stay within these guidelines
The federal government states that to be considered affordable, housing should not consume more than 30 percent of a household's income. ...
HUD Families who pay more than 30 percent of their income for housing are considered cost burdened and may have difficulty affording necessities such as food, ...
In New York City, more than half of all renters now spend at least 30 percent of their gross income on housing, a percentage figure commonly used to ...
In Clifton, N.J., the percentage of mortgage holders spending at least 50 percent of their income on housing rose to 27 percent in 2005 from 12 percent in ...
For example, Southern California suburb Temecula had 74 percent of renters paying at least 30 percent of income on housing, while another suburb in the ...
More than 13 million households pay more than 50 percent of their income ...
The MHC report found that one in eight low income families spent more than 50 percent of its income on housing.
Specifically it found that Chicago families with moderate incomes (betweeen $20000 and $50000) spend an average of 55 percent of their income on housing (28 ...
About 28 percent of Latino renters paid over 50 percent of income for housing, and had a median income of just $7700 (see table 1). ...
Some 59 percent of poor renters paid at least half of their income for housing in 1995, compared with 20 percent of renters with incomes between 100 percent ...
In 1990, nearly one-fifth (17.8 percent) of all American renter households devoted more than half their income to housing costs.[31] At least one-third of ...
84 percent of all severely cost-burdened households - those spending at least 50 percent of income on housing - are in this income group. ...
In San Diego County, 1 in every 5 renter households spends at least 50 percent of its income on housing, posing economic burdens that show up in ...
Severe housing affordability problems--needing to spend at least 50 percent of income on housing--are limited almost exclusively to low-income residents. ..."
etc. etc. etc.
"Please explain to the kids why you think healthcare does not respond to market forces?"
Well, that's kind of a tautology; I think what is being discussed is "why market forces in healthcare do not operate so as to reduce costs to a minimum"
As has been discussed, the current setup, wherein you are the ultimate consumer; your employer is the indirect purchaser; and an insurance company is the direct payer has somewhat more complex market forces than shopping around for the cheapest price on toothpaste. Those who decry the concept of single payer insurance in the US need to realize that they are not defending the simple free market ideal they idolize, they are defending the system of employer-paid insurance, which is really hard to defend.
Secondly, there is the problem that economies of scale operate on healthcare in a funny way. On the one hand, as I described above, successful outcomes for risky/difficult procedures are substantially correlated with large centers where the patient is just one small statistic. On the other hand, savings from the kind of blanket pooling of patients done by insurance companies as in "ICD-9 diagnosis 72.33 requires no more than 2 days hospital stay" (numbers made up by myself) cut badly into positive outcomes, as the application of the rule is done by somebody other the actual provider with full information on the case.
Timing of return on investment is another issue; proper treatment of even things with seriously expensive consequences, like diabetes, high blood pressure, circulatory problems, etc. doesn't begin to pay off until years down the line, even decades. Currently, the median US insurance "member" changes companies every 2 years, whether because his employer gets a better deal, or because he got a better employer. Thus, company A is putting money into managing the patient's diabetes in order that company B reap the financial rewards. In fact, it is to the credit of all the major insurance companies that I know of that they do, in fact, sink a lot of money into preventive care, disease management, etc. in the full knowledge that they will not be receiving the payoff from the individual expenditures; however, every company keeps funding analyses to "prove" savings from these procedures, which never pan out because of the lack of longterm followup for enough patients with the same insurer, so even if nobody breaks the unwritten pact and stops providing other insurers with savings while cashing in on the savings from other insurers' good practices, it does stick a pin in the simplified "market forces" balloon; best healthcare requires ignoring what market forces strongly push.
And of course, all the usual and obvious factors regarding the lack of interest in or ability of the consumer to rate the provider vis a vis their charges, the lack of even the vaguest information gathered by most consumers regarding said charges, despite the efforts by the insurers to teach the consumers that if they keep an eye on their medical bills it will pay off (see "tragedy of the commons"); the aforementioned tangled conflict of interest between patient, employer, insurance company, and medical provider; the rather special status of keeping alive in the spectrum of things prioritized by what one is willing to pay for them, and what extra one is willing to pay for higher quality, etc. etc.
Reminiscent of the argument that CEO salaries are not too high, they are set by "market forces". I have yet to see reasonably reliable any ranking of CEOs in terms of competence and quality, let alone any table estimating what it is worth to a company to get the 14th best CEO in the country instead of the 15th best, and therefore what the optimal premium in salary to hire said individual would be.
There you go Jc, the second (and more detailed) answer to your question. Now let`s suppose you`re the genius you claim to be, and z is entirely wrong, i.e. that health care responds to market forces. Why is the cost of US healthcare higher and the outcomes worse than a whole host of government systems which aren`t subject to competition?
Z
Well, that's kind of a tautology;
Hahahah Lol of laughs. Z is now explaining health economics and business finance to the masses when he is isn't busy with AGW.
Asking SG a simple question as to why he doesn't think health economics is responive to market forces is not a tautological, Z. It's a reasonable question to ask someone who thinks the Soviet model of command and control is er, a little out of date.
The last bit is the best:
"Reminiscent of the argument that CEO salaries are not too high, they are set by "market forces". I have yet to see reasonably reliable any ranking of CEOs in terms of competence and quality, let alone any table estimating what it is worth to a company to get the 14th best CEO in the country instead of the 15th best, and therefore what the optimal premium in salary to hire said individual would be."
Shorter Z. Barney Frank and Karl Levin should choose all CEOs'.
Want to look at decent market based system?.... South Africa of all places is doing it well. It's a sysetm that is relatively open, competitive and is repsonive to the price signal somewhat.
http://www.reason.com/news/show/34764.html
"Come back here, I'll bite yer legs off!" - JC
Stay down JC this is a brutal spectacle, about as fair as a chihuahua in a dogfight. I bet you that if you keep going a fellow libertarian will eventually have to weigh in to shut you up.
Why the need for that, Krusty.
"I bet you that if you keep going a fellow libertarian will eventually have to weigh in to shut you up."
Any libertarian would just get a kick out reading gibberish that passes for economic thought and people defending command and control theories such as having a singularly bad experience on a hospital stay is the hard evidence required that demand/supply/price signals stop at the doctors door.
Its funny.
Still no answer Jc? Why?
Jc, your amusing little article in Reason (is that where you get all your info?) links to a company which doesn`t have a website; the recruitment page of a private hospital; so we can`t confirm Reason`s facts. The discovery website, however, has extensive information, which confirms that the cheapest insurance - which excludes a whole bunch of stuff, including the famous hip and knee replacements much beloved of libertarian scaremongers, and visits to all but ONE doctor - costs a mere half of the wage of the average maid.
And of course, Reason neglects to dwell on the fact that private health insurers in South Africa provide a service piggy backing on the state system. I wonder who covers most of the cost of HIV/AIDS management?
And here`s a great quote from the cheapest health cover, in respect of treatments outside the prescribed minimum benefits:
So if you go get a hip replacement off your own back and there are complications, your health insurance company will see you bankrupt or dead before they cover you.
You`re selling snake oil, Jc, snake oil.
SG
Don't even show your face to me if you are too cowardly to answer the question I have posed to you time and time again
Why don't you think Healthcare doesn't respond to market forces?
If you can't answer that you have no busines talking about anything else..
Now tell us in you own words....
Now tell us why the soviet model is superior, SG.
z has answered you. You don`t have an answer for him do you? And as a consequence you can`t answer my question either. You`re a one track record Jc: "competition good! state bad! You`re a stalinist! nyah!"
SG says:
"z has answered you."
He just offered a long winded rant that is difficult to make head of tail of. It's a lot of wind about the US healthcare system and then offers up as desert some patter about CEO salaries being too high, obviously inferring that Barney Frank and Carl Levin should also set CEO pay instead of the market.
Oh and I forgot he also argues that economcies of scale are funny in healtcare implying that similar characteristics don't apply in other ares of commerce.
This isn't an economics argument he's portraying, SG. It's a tale.
So I'll ask you that question again:
In your own words please tell us why you think market forces don't work or don't apply to healthcare?
If you don't know just say so. Don't be scared as I won't laugh at you for not knowing. So stop hiding behind the towel rack put your clothes on and give it your best shot.
I give my word I won't make fun of your answer.
And in the washup from this little cave troll`s excursion into the sunlight:
1. no substanstive rebuttal (except insults) is offered by the troll for arguments as to why health care does not respond optimally to competition
2. no substantive argument (except insults) is given as to why, if health care is responsive to competition, more highly privatised markets deliver lower quality outcomes at a higher cost
3. claims are made that Australian healthcare provides substandard drugs due to cost-cutting, without evidence; when contradictory evidence is proffered it is ignored (or greeted with insults);
4. pricing comparisons between the Australian and US systems are ignored (or greeted with insults) and not rebutted;
5. dubious information about a privatising market is proferred, but mostly cannot be followed up, and when followed up is shown to be misleading (without rebuttal)
6. much yelling and insulting occurs.
Another splendid moment in libertarian "intellectualism". A real truth-seeker aren`t you Jc? And a really professional proselytiser to boot.
SG
Is delusion one of you better qualities?
The abuse sludging off your key board is getting out of hand yet you accuse me of being abusive? It goes past gall and into the realm of medical science when you see this attitude.
LOL
Please answer the question that i have been asking you for a while now. Here I'll remind you
Please explain to us why market forces do not and can't apply to Healthcare....?
Ivé been asking you to put it in your own words but I'll let you plagiarze if that gets it out of you.
You're a smart guy, give it your best shot. :-)
Don't be scared now.
Now you're just being silly Jc, sorry, I'm not biting. z responded to your question and you abused him. If you can't answer z's points with anything except a torrent of insults, why should I bother?
"Bascially US top of the line insurance get you a private room, 100% doctors visits, and you can go straight to a specialist and by pass the GP gate keepers that we have in OZ. It also gets you free meds. There are no co -payments in the top of the line insurance. Now compare that with OZ?"
you left out one rather critical point - what odes it cost?
Oh and gap insurance has been available for several years now.
Let's look at an actual example:
https://secure.medibank.com.au/join/join_result.asp?GID=%7BCC06B408%2D7…
Premium cover via Medibank Private for a single adult, which includes pharmaceuticals; dental; optical; guaranteed same day hospital admission; specialist referral and various "alternate therapies (for what they're worth) will cost you around A$1900 after the government rebate. (That's currently a bit under US$1700 per year.)
For someone on $50,000 a year, the medicare levy will be around A$750 (say US$650).
So the combined total cost for coverage is around US $2400 for full medical, optical and dental. (And yes there's a co-pay for pharmaceuticals which will max out at around A$20 per script. That's subject to the government safety net so your maximum meds cost will be around A$500).
Any Americans want to tell us what a similar level of coverage in the US will cost?
"Yeah Jc, and what great insurance coverage you get. A young professional has to pay more than $400 a month to get the stuff you're talking about just for themselves."
Assuming that figure is representative that's US$4800 per year.
Or double the Australian cost for a similar level of care.
"Indeed, according to a recent ABC News/Kaiser Family Health study, insured Americans are overwhelmingly (89 percent) satisfied with their own care, while broadly concerned about rising costs of prescription drugs and critical of the care others receive
Despite what the girthed one has told you 89% of Americans are happy with their healthcare."
How do we get from 89% of INSURED Americans to 89% of AMERICANS?
"Fans of the TV series Lost may recall a plot point wherein the young female protagonist's mother is massively injured in a car crash and she has no idea where she can get the money to care for her; then out of nowhere comes her long lost dad, to cover all the bills. The punchline is, this was supposed to be happening in Australia to Australian citizens. I suspect that in fact, it does not happen in Australia,.."
You are correct.
Let's take a look at how market forces operate in the US pharmaceutical industry.
The drug companies are rational profit-maximising firms. In determining where to invest their R&D budget they look for the following characteristics:
1. patentable;
2. treats a condition common in the developed world;
3. treats a chronic condition (ensures repeat business)'
4. treats a non-life-threatening/minimally life-threatening condition (reduces the irks of class-action law-suits if something goes wrong.
So, for example, relatively minor adjustments to insulin formulations are attractive. There are millions of rich diabetics who'll be taking the insulin for the next twenty years (or until the next improved version comes along.
Now let's imagine a one-shot anti-diabetes vaccine. One shot at,say US$300 versus 20-30 years of insulin at $8 per week.
As a rational conscientious drug company executive where would you put your shareholders' money?
"In fact, outcomes in Canada where cardiac surgery centers, etc., are even more tightly regulated, are better, because as one might expect, the success rate of medical providers is closely tied to the amount of experience they have with that type of service, which is closely tied to being one of a few large centers with a large throughput, rather than giving individual care and attention to the only patient in your local hospital's cardiac unit, no matter how lavish and personalized."
Next you'll be suggesting for-profit hospital operators have an incentive to perform heart transplants and other high-profile procedures (like separating conjoined twins)almost regardless of their competence in order to get the resulting publicity.
"He just offered a long winded rant that is difficult to make head of tail of."
For you, perhaps.
Let's take a look at a specific new health product - the Humad Papilomavirus Vaccine.
In Australia (where JC assures us that pharmaceutical cover is limited to ineffective generics, the vaccine is being provided free. That's because over the next 20-30 years, the cost will be repaid many times over by the reduced spending on cancer treatment.
http://www.tonyabbott.com.au/news/Article.aspx?ID=2386
In the US, unless you're lucky enough ti live in one of he states which subsidises HPV, the treatment will cost you $140.
Ian
Don't be silly.
The medicare levy doesn't even come close to covering the entire cost the government forks out. The missing funds are paid out of general revenue. You know that.
Private insurance covers sweet FA here. I used to have the top cover and gave it up because all we seemed to get back was $33 dollars on everything no matter the charge with the rest being co-payments. The other thing is that a private room is bullshit. You don't get a private room until one becomes available and they never are.
In any event why do you go straight to the straw man and bring the US into the equation when you have been told time and time again that the US IS NOT A FREE MARKET in healthcare.
Come on have an honest debate without this obfuscation. It simply detracts for getting to the truth.
Now you asked the other day why is US healthcare more expensive than other places seeing they spend around 13% of GNP on healthcare.
Let's leave aside the fact that from a libertarian argument it could very well be because they want to.
Let's leave that aside and go for a few reasons, bearing in mind that it's an extremely complex subject that people like SG would have difficult grasping J
Some reasons:
1. The US spends a great deal more on R&D than other countries that gets factored into the US health costs but doesn't in other places because they simply don't spend as much
2. A lot of what goes into healthcare packages gets prescribed by the states who insist on lots of bells and whistles to cover their political backside.
3. Violence- more deadly violence than other nations
4. Free riders- 11 million illegals riding on the system, turning up at public hospitals and not paying the bill.
5.Injured vets from various wars compared to other places.
6 Malpractice litigation- more so than in many other places.
7. More drug abuse than other places
8. Admin costs- for some reason the level of sophistication in terms of updating this area is behind as there is still a lot of paper flying around.
9 Compensation. Docs and medical staff are more highly compensated than in other places.
10 Doctors in the US have greater freedom in setting rates than they do elsewhere.
11 Drugs. There are laws preventing medicare and medicaid from directly negotiating with the drug companies. The law was set up by the Dems because they think there is too much conflict of interest if they did.
12 technology per patient. The US is streets ahead of anyone else in terms of the concentration of technology per patient. Use of MRI's is 30% the rate for Europe for instance compared to the US
13. Indirect costs. Government mandates in terms of record keeping is much higher in the US. Records have to be kept and layered. See also 8
14 Health- Americans are big junk food eaters and that has an effect on health outcomes for individuals.
14 (a) A lot less physical activity causing lots of related health problems.
15 Employer pays plans instead of single payer system. This has the effect of no one really caring that much about relative costs. Whereas single payer system through a private market would help being a driver in terms of holding down costs.
Anecdotal. Our last kid was born there. I counted 9 people in the delivery room, which I later found out were covering each in case of a problem that would invariably lead to litigation.
I keep telling you that the US medical system is not a free market system and you seem to have this mental block in believing this.
umm dunno what happened to the numbers
Now the last bit about comparisons:
"So the combined total cost for coverage is around US $2400 for full medical, optical and dental. (And yes there's a co-pay for pharmaceuticals which will max out at around A$20 per script. That's subject to the government safety net so your maximum meds cost will be around A$500).
Any Americans want to tell us what a similar level of coverage in the US will cost?"
You're comaparing apples with oranges.
Dentist... that's fully covered in most plans in the US with little co-payment. You end up paying about 45% out of your own pocket here.
That's just one example. In most plans in the US you don't "enjoy" the co-payments we end up getting hit with.
So you have to compare like with like. It's like buying car insurance and comparing the cost when there are different deductibles.
Sg you wanna answer that question I left for you? Don't be a chicken, SG.
Ian says:
In Australia (where JC assures us that pharmaceutical cover is limited to ineffective generics, the vaccine is being provided free
Ian , will you please stop this nonsense. You got to get it out of your head that this is free. it isn't "free". It is paid for by the government. It isn't bloody free.
this is the real problem in Oz (to all our American cousins). The place is littered with people who think like ian: that if the government offeres us something it is free of cost....as though no one is paying for it. You wouldn't believe how deep socialist thinking is here.
You can get a hammer to their heads and they still think the same way.
That's it for me.
Please explain to us why market forces do not and can't apply to Healthcare....?
But... aside from the answers you got but said you didn't understand ("...difficult to make head of tail of"), think about the point given to you over and over:
Australia's system is less exposed to market forces. Yet it is much better. So if healthcare does respond to market forces, then it's in a negative way.
See? If the answer to your question is yes, you lose. If it's no, you lose. Why do you keep asking a question that leads inevitably to your own bollocking?
The stats are in. It doesn't matter how many anecdotes you have about the undiluted awesome of the US system, the stats show it to be worse for outcomes than the Australian model, at a greater cost. If you have stats to show otherwise, planet earth would love to see them.
And just to add yet another answer to your famous question, in case you're planning on bringing it out again: if I have appendicitis, I need my appendix out. That's it. I don't have any other options. So I can choose to have it out successfully, or... what? Can I get a cheap option, where they take out, say, my tonsils instead? Or go to a cheapo place that'll take the right organ, but give me life-threatening complications? No?
There is rarely any choice involved in medical care, and even when there is it is simply a choice between courses of care. You don't "shop around" - you just get the best you can get. Every single time a consumer will simply choose the best possible quality they can afford. It's not a choice, it's an asset test. You can't just die a little bit. Medical care is either best practice, or it's killing people. Those are the options.
Do you see how this is different for food shopping? I might like brand X, or brand Y, I might be happy with the cheaper brand, I might like to buy something completely different tonight. I might buy stupid stuff on a whim that I hate, or forget to buy something I really need. I can wander into the supermarket and just let brand recognition, habit, and packaging guide my purchases. I'll frequently buy something I've never heard of simply to try something new. But I won't die. There's plenty of scope for competition because there is a lot of room for variation.
Importantly, there's no scientific test to say one option is better than the other. In medicine, there is.
If, at the supermarket, brand X was safe, and brand Y killed 3% of the people who ate it, no-one would buy brand Y. Unless, of course, they HAD to pick one or the other, and they couldn't afford brand X.
Once again, this is not a choice, it's an asset test.
Someone want to post outcomes where the US scores better than other industrialized countries on health related issues?
Don't be silly.
"The medicare levy doesn't even come close to covering the entire cost the government forks out. The missing funds are paid out of general revenue. You know that."
Yes ansd neither does the US insurance cost come close to covering the full cost. We're comparing what you as an individual pay. In fact, my figures are overly generous to the US since the US government also pays money out of general revenue for health care costs. So really, US costs are more than double.
"Private insurance covers sweet FA here. I used to have the top cover and gave it up because all we seemed to get back was $33 dollars on everything no matter the charge with the rest being co-payments. The other thing is that a private room is bullshit. You don't get a private room until one becomes available and they never are."
So basically you're claiming that Medibank Private is engaging in fraudulent advertising?
I guess that's one way to deal with unpleasant facts.
"Now you asked the other day why is US healthcare more expensive than other places seeing they spend around 13% of GNP on healthcare.
Let's leave aside the fact that from a libertarian argument it could very well be because they want to."
Riiight - and maybe there are more homeless people in the US because they just happen to enjoy hypothermia more.
The point isn;t that the US spends more on healthcare - its that they spend vastly more with equivalent or inferior results.
If you paid $100,000 for a car would you be satisfied if it did 15 miles per gallon and had a top speed of 100 KPH?
"The US spends a great deal more on R&D than other countries that gets factored into the US health costs but doesn't in other places because they simply don't spend as much"
Right, because US medical corporations don't sell their drugs and equipment internationally and recover psrt of their R&D costs by doing-so.
Also IS R&D expenditure, as a percentage of GDP actually higher in the US? I'd like to see some support for that claim beyond "I read it in a book".
"10 Doctors in the US have greater freedom in setting rates than they do elsewhere."
You mean their cartel has greater freedom in abusing their market power? Agreed.
"11 Drugs. There are laws preventing medicare and medicaid from directly negotiating with the drug companies. The law was set up by the Dems because they think there is too much conflict of interest if they did."
Actually those laws were introduced by Republicans (Do the names Bill Frist and HealthSouth ring a bell?). The Democrats have now repealed them.
Coming soon from JC-land "Between 200 and 2008. Democrat President George W. Bush massively increased government spending."
Hopefully now the US government agencies will be able to do what governments around the world have been doing for decades - use their market power to force down prices. Of course, in a so-called free market system this would be impossible since there would be no government purchaser of health-care services.
"12 technology per patient. The US is streets ahead of anyone else in terms of the concentration of technology per patient. Use of MRI's is 30% the rate for Europe for instance compared to the US"
Yes, meaning that Europeans aren't being conned into paying for unnecessary full-body scans as a preventative measure. These scans carry with them a (very small) risk of cancer but have next to no medical value.
But hey the doctor gets his kick-back from the pathology company.
"I keep telling you that the US medical system is not a free market system and you seem to have this mental block in believing this."
No, I simply think it's largely irrelevant to the discussion.
The current US system represents possibly the worst imaginable mix of government and market forces. (Worst from the perspective of the people paying the bill, best from the perspective of the people collecting the money. This is where the names Frist and Healthsouth pop up again.)
The question is what should replace it?
1. A system already in place (in various permutations) in dozens of other countries which has been proving to save money and make people healthier or
2. the system which applied through out the world up until the 1930's which delivered far worse outcomes.
"Ian says: In Australia (where JC assures us that pharmaceutical cover is limited to ineffective generics, the vaccine is being provided free
Ian , will you please stop this nonsense. You got to get it out of your head that this is free. it isn't "free". It is paid for by the government. It isn't bloody free."
It is free to the consumer at the point of application.
Now will you stop with the nonsense about how the US doesn't spend massive amounts of government money subsidising health care (in a hugely inefficient fashion.)
After massive hand-outs, Merck STILL gets away with charging $140 a dose in the US. (Oh and the R&D for this one was all done right here in Australia by CSL. Merck is just the licensee.
As I've already pointed out, HPV vaccination should save the health care systems billions. Getting as many women vaccinated as possible should therefore be a priority. In the US system, if the state governments don't step in and subsidize it, who will?
Let's take another example, in Australia insulin and blood sugar testing supplies for diabetics are subsidised. In the US, they aren't.
Guess which country has a much higher rate of blindness and amputation resulting from complications to diabetes?
What do you think makes more economic sense? Subsidising insulin by a couple of hundred dollars a year or losing thousands of people a year from the workforce due to complications from untreated diabetes?
http://en.wikipedia.org/wiki/Universal_health_care#Universal_health_car…
From wikipedia (and therefore subject to the usual caveats)
Doctors per 1000 persons:Australia 2.47; US 2.56; France 3.37%.
So Americans aren't paying for more doctors, they're just paying more for doctors.
Nurses per 1000: Australia 9.71 US 9.37.
Dollar health care cost per person: Australia: US$2519; US $5711.
Percentage of government revenue spent on health care: Oz 17.7% US 18.5%.
Percentage of health care costs met by government: Australia 67.5% US 44.6%.
Got that, people? The US government already spends $5711 x 0.446= $2547 per person on health care. That's more than the combined total cost (public and private combined) in the UK or Australia.
If the US system were as efficient as the British or Australian system it could more than half the total cost of health care while providing universal coverage. Hell if just the government spending component were as efficient as in Australia, you'd save around US$900 per person per year.
That's $270 billion a year - hell that's more than the current US budget deficit isn't it?
But think of the Healthsouth share price!
Oh and those Australian co-payments that JC complains about?
Those are an example of those market forces he claims to love.
This is in opposition to the US system of government-subsidised insurance with minimal co-payments which ensures that the person making the buying decision (the insuree) is largely indifferent to the additional cost of the additional and often unnecessary services the US for-profit service providers pad out their bills with.
At the same time, the person footing a big chunk of the bill (the US taxpayer) has no say.
This is the sort of thing that gives many of us pause when we consider putting the federal government in charge of anything else. What I think many of us would like to hear is something that realistically makes us think that the new health department won't become an equivalent to the IRS or drivers license bureau or passport office...
http://news.yahoo.com/s/ap/20070723/ap_on_go_co/subsidies_dead_farmers;…
You wouldn't need a huge new bureaucracy.
Here's an outline of what I'd do:
1. Convert a stack of existing funding into a credit for every American worth about $1500-2000.
2. People with existing private insurance could use that money to go towards paying for their coverage. People in corporate schemes could either opt out and get private cover or surrender the credit to their employer.
3. Private insurers would tender for the right to provide basic health cover to people currently uninsured. There'd be competitive bidding, minimum service standards and the total premium couldn't exceed the credit.
A thousand dollar credit for every American would cost around $300 billion. You'd get most of that back by shifting people out of Medicare and Medicaid into private insurance. You'd significantly reduce the cost of private insurance and the health costs of private businesses would reduce significantly.
There'd also be major savings from including preventative health care in the basic insurance. What's cheaper - spending $10 on folic acid tablets for a pregnant woman or spending thousands on her premature baby's health care?
Excuse me Ian, but why do you think that would be a far different proposal from the one I would support.
Pity you had to go find the straw man and impugn racism otherwise we could have got there after three comments.
So you do recognize there is a reason to have market forces working in healtcare?
What from I understand of your system:
Offer vouchers and then let the people choose their providers by going to a single payer type system. Is that correct? Is that how I am understanding it?
Pity you don't support that for Oz.
The LDP proposal is a voucher based system too.
If SG is on his medication today may be he could answer the question i posed him.
Market forces can apply in some segments of the health care system and no-one here has ever denied it.
The argument has been over your view that complete unconstrained market forces will solve all problems.
And the system I proposed of government subsidies for private health insurance accompanied by a safety net is quite similar to the Australian system.
But given the different histories of the two countries and the different structures of the health sectors in each (e.g. the much larger role of private hospitals in the US system) you'd expect there to be some differences.
The LDP's policy is hilarious:
"By cutting back the proportion of health care funded directly by government and re-aligning incentives, enormous savings can be made by reducing the waste and excessive costs of a public system."
Yeah just because we have about the lowest-cost health-care service on the planet there's no reason to assume we can't achieve "enormous" savings.
"At the same time, relaxation of regulatory controls will allow new organisations providing health services to emerge that will help to limit costs while improving quality."
Laetrile here were come.
"The LDP will deregulate the health insurance market to facilitate a wider range of innovative policy options. This will enable the introduction of policies based on recognition that good insurance should not attempt to cover for low-cost events that are a threat to nobody's security, but must cover the high-cost events that can cause financial ruin."
Yrah deregulation worked so wonderfully well in the general insurance industry here. its jsut what health insurance needs.
Of course that "...not attempt to cover for low-cost events..." means scrapping cover for most conditions currently covered. So you'll no longer need to worry about "co-" part of co-payments JC, you'll be on your own footing the full bill. Of course, the option of going to public hospital clinics won't be available either seeing as that's where those massive cuts will be being applied. Still the deregulated market in kidneys and corneas will open up exciting new avenues to pay for Little Johnnie's braces and grandma's rheumatism medicine.
I"nsurers will be at liberty to offer incentives for preventive healthcare such as weight control, solar protection, diagnostic screening and ceasing smoking. Consumers will be able choose for themselves whether to take advantage of these."
Private insurers already do this. But if in future they're only insuring for catastrophic life-threatening conditions they'll have less incentive to do so.
"Instead of limiting the availability of screening tests, diagnostic and treatment facilities to what can be made available to everyone - whether people want them or not - an increased range of options would then become available to those who want them. "
Yeah increasing unnecessary testing levels to US levels is obviously the way to limit costs.
"The LDP would reform access to pharmaceuticals so that pharmaceutical prices were deregulated but consumers were able to maintain access to high priced products through insurance."
So the optional private health insurance industry will pay whatever the pharmaceutical industry cartel wants to gouge them for. Of course, people who aren't covered by insurance (or whose policies were with NRMA)will be able to explore the new pain management options opened up by the relaxation of the drug laws.
"Pharmaceutical companies would set their prices according to market forces - "
Yeah because huge unregulated companies with patent monopolies are famous for their lack of market power.
"Injecting competition into health care will assist the disadvantaged."
Yeah, better a quick death than a life of humiliation on the dole.
"while we would all like to assist the poor, we do not wish to encourage over-consumption of scarce health resources by providing blanket subsidies. The poor should be asked to first appeal to the generosity of their local communities. "
The LDP: bravely forging a path froward into the 18th century.
"The LDP believes government should intervene only on a case-by-case basis, where other avenues have been exhausted."
Yeah but obviously making that case-by-case analysis will take zero time and generate zero paperwork seeing as waiting lists and bureaucracy will be eliminated. Maybe it'll be as simple as presenting your Party card at the local LDP Gauleiter's office and hoping he's in a generous mood.
Interestingly, the word "voucher" doesn't appear anwyhere in the policy which rather tends to contradict JC's claim that it's a "voucher-based system".
So let's hope those "massive" cuts are sufficient to offset JC's loss of his 30% tax deduction for insurance premiums and the added cost of all those non-essential tratments no longer covered by insurance. (Although given that we're told endlessly that the insurance industry will be deregulated and consumer choice will be expanded you have to wonder how the LDP can determine in advance that the range of conditions covered will decrease.)
In fact, there's no suggestion I can see after a quick
Continued:
In fact, there's no suggestion I can see after a quick perusal that there would be any form of subsidy or assistance to pay for insurance premiums.
"The argument has been over your view that complete unconstrained market forces will solve all problems."
When did I ever suggest it would solve ALL problems. Stop being silly. I inferred we would end up with a better outcome..... and we would.
I believe the old soviet model of command and control cannot work and ends up with a worse outcome than if the market was allowed to figure it out. So stop being a dinosaur.
What i find hilarious is that you would allow a sort of voucher type system to work in the US (sort of), but you seem to think we are unable to have one here. Now that's racism: a form of inbuilt low expetations.
The LDP policy would offer superior outcomes because it is market based, responsive to conusmer wants and it would allow specialization and segmentation: two elements that create efficiences.
Ian, you need to get it out of your head that our Healthcare is cheap. It isn't cheap and it isn't that fantastic. Just because a great deal of the funding comes from general appropriations doesn't mean it's free. You got a figurative clip over the ears for thinking like that in an earlier comment and you continue to do it. Stop it right now.
Get out of your socialist dinosaur costume and join the modern world. You're smart and will be able to see it.
I guess I'm not convinced about how efficient things will get. From the research I did, it looks like the Commodity Credit Corporation makes about $5B annually in direct payments to farmers (http://www.usda.gov/agency/obpa/Budget-Summary/2006/06.FFAS.htm). Over seven years, that is roughly $35B. During 7 years, they gave about $1.1B to dead people. That is somewhere between 2% and 3% of the budget. And we see this level of accountability from the schmoes responsible:
John Johnson, a deputy administrator for the Farm Service Agency, said there is no indication that the payments were improper
Seems reasonable...
So, the proposal on the table is to create a new government branch responsible for doling out $450-$600B annually (the $1500-$2000/person number). Of course, we spend $5000/person annually, so that puts us at a $3000/person annual shortfall. I can imagine that maybe we don't need all the insurance companies we have, but I can't imagine how many choices I will have left once the CFO's start to do the math. Of course, the government agency responsible not only for doling out the cash but verifying that every policy meets the government standards will not become a big beaurocracy.
There is a lot of hand waving about why costs will go down. I agree that once we get a certain segment of the population to stop going to the emergency room when they have a cold, costs will decrease. But, from reading here, I was under the impression that are costs are due to equipment and number of staff. I keep reading in the paper and hearing from a couple friends who are nurses in hospitals that there is a nursing shortage. And, despite our current luck to be a young country, in the next 20 years, we are going to get real old, real quick. Of course, I agree that folic acid tablets are a good way to spend money. But, that doesn't change the fact that culturally, here in the USA, we are fat lazy slobs who are way overweight, don't exercise and have many health problems because of it. Myself included. I'm sure a bunch of new "Wellness" programs will be created at almost no cost, but in the meantime we will keep eating Doritos and buying those little gizmos that strap around the waist and use electric impulses to work your abs and driving to the Taco Bell drive-through (ummm... Nachos Bel Grande!).
According to this study: http://www.cdc.gov/od/oc/media/pressrel/r040121.htm
about 5% of all health care costs are due to obesity ($75B). I don't see how changing who pays will change that. Also, the prevalence of obesity is much higher in that population we are hoping will see the greatest costs decreases once they get insurance. I don't see that happening. I may get crucified for this, but obesity is due to lifestyle. A small percent may choose to change, but I don't believe that the people with the worst health in this country will suddenly decide to change the way they live.
Sorry, but I'm not convinced that anyone here actually has an idea that will make a difference.
Continued:
In fact, there's no suggestion I can see after a quick perusal that there would be any form of subsidy or assistance to pay for insurance premiums
That's because you stopped right there and didn't read the rest of the platform.
You would find that the party supports a negative tax up to the tax free threshold of Aprrox. $30,000.
The effect is it would immediately end the churning where now 40% of each dollar going in to the government's coffers costs 40 cents more when it comes out to be spent.
That's called churning, Ian, something you and your socialist dinosaur mates seem to think is quite ok despite the inefficiences that are created such as the countless tax eaters working for the government who process all this expenditure.
You got to get it out of your head that money coming from the government is free , ian. You're not getting a bag of goodies for nothing.
oconnellc
You can't change the composition of health spending if people don't get off their butts and exercise. However a recent Harvard study showed that advances in medical assistance has generally reduced weight related illnesses to the extent that fat bubblers are living that average life span.
That's a good thing but it adds to medical costs compared to say Euroland where people like the Frog version of Algore and Michael Moore tell us to consume less. Meanwhile they're gorging on the 6 big macs at one sitting 6 times a day and endangered fish species as desert.
It was Ian who said US med coost were much higher than elsewhere.... If you look up the thread you will see I gave him he reasons why, which he indigantly ignored.
Jc and oconnellc, you might need to look elsewhere for your excuses for bad American Health. They have very similar rates of obesity to, and exactly the same rates of smoking and drinking as, Australia. As for higher drug use - australia has one of the highest rates of heroin overdose death in the world.
However, America has a younger population which means it should have much lower rates of chronic illness and palliative care costs. By your logic America should have better health outcomes even if its health care system were only as bad as Australia's. It doesn't.
If you doubt these facts, look them up at the OECD. Not that jc ever allowed the facts to interfere with a good story.
And JC, in response to your question that you still seem to think hasn't been answered (or is this a personal vendetta?) I give you the wisdom of SmellyTerror (which of course you conveniently ignored):
Here Jc, is a response to some of your other points (the ones Ian didn't cover), which are strangely reminiscent of a Republican talking-points paper (though more poorly written).
So state intervention pushes up the price of healthcare. Meanwhile, here in our command and control socialist health system (or should that be stalinist?) where there is more state intervention, prices are ... lower.
If you ask Ben you'll find that the US has a similar rate of assaults to the rest of the developed world, but a higher rate of gun deaths. In any case, these people are much less likely to be insured and are covered in these cases by the state system or by state emergency departments, so there is no particular reason to think they are pushing up the price of private health cover.
Ah, blame the foreigners... thought you didn't do race baiting? And if these people are turning up at public hospitals how are they pushing up the price of private health care?
Now, is it not the case that the Department of VA is the cheapest health care provider in the US? And isn't it held up by conservatives everywhere as a model of the evils of cheap and nasty socialised health care...? So how is this pushing up the price?
I'll grant you that. But if you fiddle around on the web you'll find papers discussing this, which argue that ultimately it doesn't reduce the rate of serious injuries much at all relative to no-fault systems.
Drug abuse goes in cycles, so how come health prices just keep rising? Also, see my previous comment - heroin overdose in Australia is extremely high by world standards but strangely hasn't inflated our prices. I wonder if this is because they their narcan free, so mostly don't end up at emergency wards? That'd be that old $100 vs. $10,000 dilemma.
Once again we see how the market always extracts maximum efficiency from its participants. Perhaps if the government mandated efficiency to these market players they would pick up their game?
This is padding. It's the same as 2 and 8.
Australia and the US have very similar profiles of risk factors for lifestyle diseases, but Australia has lower rates of these diseases. You could work this out for yourself if you knew how to research facts. See Ian Gould's example of diabetes for more information.
Yes, because those private enterprises like GM and Ford have absolutely no interest in keeping down their costs, and won't be using their role as a bulk buyer of health insurance to force down prices as much as they can. And it certainly is the case that GM have no interest in health care costs...
Really Jc, is this the best you can do? Mindlessly reciting idiotic excuses for mediocrity from republican health industry shills? Or did you read these pearlers in Reason magazine, home of the broken link?
SG, you come out of the swamp every day or so fling around figures you think sound good, throw abuse around, and pretend you're an expert but are still unable to answer the question. Other than kneejerking back to your socialist reference guidebook, you're unable to answer the question.
I've told you more than a few times that using the US as a comparison does not substantiate why market forces wouldn't provide a better outcome, yet you continue to go back to that coffin trying to resuscitate a dead corpse.
Let's offer a hypothetical for a moment. Let's say that every single comment you have made is right on the ball (they aren't of course but let's pretend). You have still been unable to answer the question as to why you think market forces don't apply to health care.
That's because you can't.
Old socialist dinosaurs like Ian at least try to debate and isn't afraid to answer questions. He inadvertently (AlMOST) got to the market solution by arguing for competitive tender in the US health market (incidentally, Reason argues the same thing... of sorts)
I'm afraid your socialist knee jerk response has let you down, SG. You can't answer the question because you're unable to. Now please dive back to that sorry swamp you live in.
If you have a change of heart and decide to take a stab at it here's a clue for you.
You need to tell us why the price signal wouldn't work in healthcare and why the command and control system is better.
Come on now: don't be scared. Give it the old socialist bash. Everyone's supporting you. Even me and I gave you my word as a gentleman that I won't laugh at the final result.
SG says
"because those private enterprises like GM and Ford have absolutely no interest in keeping down their costs, and won't be using their role as a bulk buyer of health insurance to force down prices as much as they can. And it certainly is the case that GM have no interest in health care costs..."
SG
Do you even understand what it is you're saying here? You are actually trying to suggest that GM and Ford both of whom may end up going broke because of the healthcare issue aren't interested in keeping their costs down in healthcare.
Now I'm not going to add this to the other sorry comments you've made because I don't like seeing blood in this quantity splattered all over the floor.
I'll just kindly ask to take it back and nothing willl ever be said about this again.
Ian can you please help him? He seems to listen to you for some unknown reason.
Jc, I have been trying to argue with you in good faith. Not the good faith that you actually care about exchanging ideas, or even earnestly responding to a point. But the good faith that you can read. Yet here you are interpreting my response to your last point as serious.
You can't read irony? That means you have misunderstood probably upwards of half the comments directed at you on this thread. I can only assume you've misunderstood all of them, because that last comment was so obvious only a drooling idiot could miss it. See those little ellipses at the end? I even included them to make the hint and you still missed it.
My god.
Oh and Jc, now SmellyTerror has also answered your question. That's 3 times your question has been answered and ignored. Yet you still want me to have a bash?
SG
That was supposed to be funny? Yep your right the thre "dots" gave it away.
Errrr, ok. If you say so SG. It's hilarious.
"Yet you still want me to have a bash?"
Why not? Let's judge you from the your serious side of irony then.
---------------
I missed the Rmelly Rat's response. It's a truly pathetic attempt at explaining the economcis side. It's another rant this time adding the violin teasing comment about needing to get your appendix out and other drivel about how best practice etc. is somehow analogous to the question asked.
You give it a try, SG. Even someone semi-literate in economics could do better.
Now, given there actually IS a field of health care economics (like, with journals and EVERYTHING), JC and Oconnelc might be able to look up the information they want on this topic, to inform their opinions from folks in the field.
Really, there is no such thing as a free market in health care, for the reasons Ian Gould mentioned above, as well as the reasons that the most effective health care interventions are typically the ones delivered at community level, and the people most in need of health care interventions are the ones with least money. If you can get used to stepping over sick people in the street, you can substantially reduce costs.
I think this goes to the point of this and the next post. Libertarians are committed to an ideology, to the point of beleiving it applies everywhere, good and hard. All who disagree are fools and frauds (what was that about climate science, or health care..) Or, if it conflicts with another belief (say, Al Gore is the antichrist), then they'll dump their libertarian positions (that markets can provide informations about better and worse options) and argue that 'food labelling is all nonsense, you'd have to check the whole supply chain yourself'.
I can see libertarianism working quite well in a 4 to 5 person, all-adult household. I just can't see it working well beyond that, based on the reactions I see on this blog.
So, about that Jason Soon... perhaps response number 1 (disagreement must be with malice and stupidity aforethought?)
Time for another open thread,Tim? We can even mention the Canadian health care system again.
perhaps the hilarious Jc doesn't understand that irony isn't always meant to be funny? I wasn't trying to make a joke, dear.
Oh and look, having asked me to answer a question you insult someone who has without responding to the points contained therein. Yet strangely you think I'll bother...
No Jc, I think you've done your dash here. You can crawl back to your slimy little libertarian burrow and pretend you won the mighty health care argument, having proven to all and sundry once again that libertarianism is nothing but piss and vinegar, and its adherents ignorant pigs. Well done!
Hmmm. The mighty morphin' Jc (or is it jc?) cannot understand irony. Maybe it's a bot? Would explain its rather mulish behavior as well.
Stewart
I don't think you can say that all libertarians think AGW isn't a potential problem. After giving it some thought i think there is a cause to be concerned.
However where a lot of us part comppany with the socialists is the ways in confronting it.
Forgive me for saying this but spending $us trillions of dollars over this century through a socialist plan such as Kyoto to achieve a tiny fall in temps isn't going to cut it.
It will impoverish us and not get the job done.
There is tons of better ways to do it.
The issue with healthcare economics isn't a free market doesn't exist in the modern world but that people seem to think that it wouldn't work with a superior outcomes. It's not factual that we have never had a free market in healthcare. Healthcare only recently became socialized whereas historically it has always been a free market.
It is however quite difficult to make comparisons to earlier times for the obvious reasons to do with relative per cap population wealth etc. But the point is that there has been a free market in healtcare from a histoical perspective longer than the current soviet style command and control system people like SG slavishly adhere to.
It's just that socialist dinosaurs use myths and lack of knowledge of economics to disguise the fact they know sfa about the subject and try to scare the kids.
However healthcare is a great place for the free market to to its thing. Its very large so economies of scale would set in along with the interplay of the price signal and people would take advantage of the various points of the demand and supply curves. You would see a lot more specialization and consumers would have a great deal of choice.
--------------------
SG, you asked if I wanted you to answer the question. I repsonded in the affirmative and now you again play these silly childish games. You're a joke.
JC, you've refused to listen to plain english descriptions of why you're wrong, phrased in multiple ways by multiple posters. You fail over and over again to address the issues, and simply resort to incomprehensible insults ("Rmelly Rat"? What does that even mean?). Do you honestly expect to convince anyone of your position by repeatedly unzipping your ignorance and waggling it around?
The Australian system is better than the US one, and it costs less. http://www.who.int/whr/2000/en/whr00_en.pdf All your theory-crafting can't get you over this plain, simple fact. It doesn't matter how you think economies "should" work. You're wrong. Look at the facts.
It's like a guy saying the sky can't be blue, because air doesn't have a colour. All his theories and extrapolations can be vigorously argued, and he may even convince himself that he's right - but only if he ignores the shouts of everyone else to just LOOK OUT THE DAMN WINDOW!
ST
Surely you are kidding aren't you? I have been called all sorts of names here. Being referred to as an ignorant pig by SG is the latest example.
Look, let me explain this one more time and hope the kids here learn something. I have explained to you that the US is not an example of a free market in healthcare ad nauseum and yet the tipsters bring up that straw man as some sort of affirmation it is. It's not. Period.
I blame the Gould for that shallow bit of obscuration as he tried to conceal realities. I explained to him why I thought the US system is superior to ours from a personal perspective and he turned that into some quasi racist routine. (Superior but not a free market one). It is ok to compare to rigid socialist models and argue which one is better.
We have then gone back and forth enduring this silly comparison between fairly complex systems of command and control.
In all that I asked SG (happy feet) a very simple question seeing he's like a member of the ancien regime (trying to protect the Bastille from being overrun by "ignorant pigs") as to why he thinks market forces and the price signal (later added) didn't work when it came to health care.
He's literally frothing at the mouth that I had the nerve to ask him that question. Did you see him? Foam is pouring between his fangs s he darts in and out of the dark swamp.
It's an honest question that doesn't deserve all that tactical abuse he's thrown my way. You either answer the question or you say you can't. It is not as though I haven't tried to answer his. He even asked me if I wanted him to offer answer but he just slinked away into the cloudy water again.
Now quite honestly I took a look at your comment and it would grade it an F because it didn't answer the question. It isn't asking about comparison shopping between various systems or just how terrific the OZ system works. I'm asking you to explain how the price signal would fail to work, why a demand curve wouldn't slope downward (Giffen goods, Ian....I know about them) and why we wouldn't experience all the factors that impact markets. It's about service delivery and the cost of such delivery.
Forgive my naivety but I was always lead to believe that market based outcomes were always superior to the soviet model of command and control. The most obvious place you would see competition is through insurance providers. Arguing there would not be any competition is like suggesting the sun won't rise tomorrow. Even Ian recognized that but suggested we don't need it because ours works just fine while the US needs a change to a competitive model. How slick!
Sorry about scoring your comment so low but SG forced me to as he thought it relieved him from having to present his thesis as to why a socialist system is superior. Funny isn't it: that's what he believes in but can't articulate why.
Why is that SG?
Healthcare does not follow the usual form of competition because the options are often "live" or "die". No-one picks "die" if they can afford "live", no matter the inducements. There is the scientifically determined best-practice, or there is sub-standard care. That's it. There's no room for competition in there. What product could you possibly offer that could substitute for best practice?
"Oh, this treatment is less likely to cure you, but it comes in a great range of flavours!"
The same set of trade-offs and cost-benefit analyses you can have for other products can't apply here. There is one best option. Any room to move in product differentiation has to be outside the basic healthcare outcome. And that's where we get the bounds of Australian private health insurance. You can pay more for a nicer room, or faster non-essential surgery. You can't pay more to live when someone without money would die.
No-one, not one person on earth, would choose to tick the box that says "this product may result in you watching your child needlessly die in pain". Every single person wants the option that gives their kid the best chance. Every one. So by giving people the "choice", you get UHC.
The free market does not provide choice in this case, it limits it. It means that some people can't afford the thing they would choose if they could. If there are people who can't afford care, then you have removed their choice.
Does anyone, anyone at all, who wants "free market" healthcare, who wants to get rid of UHC, actually want to do that so they themselves can have less cover, or no health care at all? Are you chafing at the bit to go un-covered? No? So why the hell do you think anyone else wants to make that choice? You are offering a "choice" that no-one would voluntarily make.
It seems to me that you are merely trying to take cover away from others in the hopes that it'll make your own cover better. That's just repellent.
Actually, I don't know why I'm bothering to make any kind of coherant reply to JC. It's not like his posts actually make any sense. Any point he's trying to make seems to be buried under kind of surly, half-assed ramble.
Here, I'm going to try to translate the last JC post. Please let me know where I've misunderstood...
From #191:
ST Surely you are kidding aren't you? I have been called all sorts of names here. Being referred to as an ignorant pig by SG is the latest example.
I got called names, so I can call other people names. The fact that the names I call people make no sense is a sign of my superiority.
Look, let me explain this one more time and hope the kids here learn something. I have explained to you that the US is not an example of a free market in healthcare ad nauseum and yet the tipsters bring up that straw man as some sort of affirmation it is. It's not. Period.
The US system can't be used to compare because it's not free...
I blame the Gould for that shallow bit of obscuration as he tried to conceal realities. I explained to him why I thought the US system is superior to ours from a personal perspective and he turned that into some quasi racist routine. (Superior but not a free market one). It is ok to compare to rigid socialist models and argue which one is better.
...but it can be used to compare when I use it. I also blame Gould for using the issue to obfuscate, even though I use it too, presumably to clarify.
We have then gone back and forth enduring this silly comparison between fairly complex systems of command and control.
The system I say is better is too complicated for me to prove it's better. You just have to trust me.
In all that I asked SG (happy feet) a very simple question seeing he's like a member of the ancien regime (trying to protect the Bastille from being overrun by "ignorant pigs") as to why he thinks market forces and the price signal (later added) didn't work when it came to health care.
SG (insert random nonsensical insults - is "happy feet" even an insult?) got asked a question...
He's literally frothing at the mouth that I had the nerve to ask him that question. Did you see him? Foam is pouring between his fangs s he darts in and out of the dark swamp.
...and was strangely annoyed when I ignored the answer over and over again, seeing as I was too busy mindlessly flinging insults that make absolutely no sense.
It's an honest question that doesn't deserve all that tactical abuse he's thrown my way. You either answer the question or you say you can't. It is not as though I haven't tried to answer his. He even asked me if I wanted him to offer answer but he just slinked away into the cloudy water again.
Now SG doesn't like me, and actually seems offended at my repeated insults and refusal to address the issues (see this post as an example).
Now quite honestly I took a look at your comment and it would grade it an F because it didn't answer the question. It isn't asking about comparison shopping between various systems or just how terrific the OZ system works. I'm asking you to explain how the price signal would fail to work, why a demand curve wouldn't slope downward (Giffen goods, Ian....I know about them) and why we wouldn't experience all the factors that impact markets. It's about service delivery and the cost of such delivery.
I think your post was disagreeing with me, so it must be wrong. I transparently didn't bother to read it beyond the bit quoted by SG, and I sure as hell won't try to deal with the issue. I also won't read the rest of the post, just in case it answered the question I need to say wasn't answered.
Forgive my naivety but I was always lead to believe that market based outcomes were always superior to the soviet model of command and control.
Insert staggeringly stupid, unsupported assertion here. Make sure it also contains a laughably feeble straw man.
The most obvious place you would see competition is through insurance providers. Arguing there would not be any competition is like suggesting the sun won't rise tomorrow. Even Ian recognized that but suggested we don't need it because ours works just fine while the US needs a change to a competitive model. How slick!
Complete misrepresentation of Ian's argument here, just in case people didn't already think I was an idiot.
Sorry about scoring your comment so low but SG forced me to as he thought it relieved him from having to present his thesis as to why a socialist system is superior. Funny isn't it: that's what he believes in but can't articulate why.
Wait, this is a hard one. I suspect this paragraph was machine translated a couple of times. No literate human could have written it as is...
...um, I think it says: your points are incorrect because another poster quoted you and he is yet to answer my question enough times for me to notice. I am smugly confident of my own superiority because I'm just too stupid to realise my feeble arguments have repeatedly been smashed in this thread. Willful ignorance is the one unassailable defence, and I'm going to stick to it.
Why is that SG?
I forgot who I was replying to. Wait, who am I? What's going on? Where are my pants?
...was that too mean?
I guess I'm still not convinced. JC or SG may or may not be a poo poo head. But someone proposed the US government spending $1500-$2000/person/year to cover $5000/person/year worth of expenses. The fact that the US population is about to get really old, really fast leads me to think that costs/person/year will probably go up. I'm not sure what I am being accused of thinking about that fact, though. But I believe it will probably go up because of that fact. I'm not sure where the shortfall in costs/person/year will be made up.
I believe that costs will probably come down if we can get the poorest in our society to take a little better care of themselves, and not use emergency rooms so much.
I do not believe that putting the US government in charge of another ~$600B/year will cause that money to be spent more efficiently. Here in the US, no government body has ever done anything efficiently. Many government bodies have done good things, but never efficiently (please see Department of Defense, any US Public Schools, Department of Agriculture, Dept. of Homeland Security etc. etc). The next incompetent boob fired by our government for being an incompetent boob will be the first.
And so, it doesn't really matter how we got to where we are. We are here. Any proposed solution must be based on where we are. The US population is about to get older, and need more expensive medical care then needed in the past. I don't see how the US government controlling prices by law will help things. We have tried similar things in the past, and they didn't work. Why will it work this time?
I found an interesting statistic. This was my source: http://www.abc.net.au/news/stories/2006/04/24/1622228.htm
I'm not sure if the news is the best source of facts or not, though... Anyway, the statistic is that the number of obese people in Southern Australia has almost doubled in the past 18 years.
Now, with only casual consideration of the situation, I would guess that to continue to provide these overweight people with proper healthcare, the healthcare spending would have to increase proportionatly. Or, the Australian healthcare system has found a cost free way to care for the ailments that go along with obesity (heart disease, diabetes, high blood pressure). My guess is that the latter did not occur.
I would view this as an opportunity to vindicate the Australian healthcare system. Someone like JC would assert that Australian healthcare is not in a position to provide adequate healthcare to these people. As such, there would be no increase in spending. Someone like SG would assert that the system is capable of caring for these people, and so expenditures would naturally rise to account for the added cost these people.
(As an aside, I would think that a statistic like this would go a long way to proving that obesity is related to lifestyle and not genetics. Unless there is some rampant gene splicing going on down under that we haven't heard about)
So, my (admitedly casual) research has not revealed these numbers to me. Does anyone care to chime in on my hypothesis? Or help me out by providing some numbers?
"I believe the old soviet model of command and control cannot work and ends up with a worse outcome than if the market was allowed to figure it out. So stop being a dinosaur."
You also apparently believe in a binary choice between totally unconstrained market forces and soviet-style communism.
"What i find hilarious is that you would allow a sort of voucher type system to work in the US (sort of), but you seem to think we are unable to have one here. Now that's racism: a form of inbuilt low expetations."
what I find hilarious is that you can;t get it through your head that the current US system is vastly different to the Australian system and I'm proposing a voucher-based system there because it fits better with their current model meaning transitional costs would be lower.
"The LDP policy would offer superior outcomes because it is market based, responsive to conusmer wants and it would allow specialization and segmentation: two elements that create efficiences."
I love how you can read a lengthy detailed analysis of the policy's faults and respond simply be repatign the party mantra.
"Ian, you need to get it out of your head that our Healthcare is cheap. It isn't cheap and it isn't that fantastic. Just because a great deal of the funding comes from general appropriations doesn't mean it's free. "
The simple fact which I have pointed out repeatedly is that the total cost of the Australian health system is less than 2/3s that of the US system. Whether the money comes from the medicare levy, general tax receipts of private spending that fact remains.
"So, the proposal on the table is to create a new government branch responsible for doling out $450-$600B annually (the $1500-$2000/person number). Of course, we spend $5000/person annually, so that puts us at a $3000/person annual shortfall. I can imagine that maybe we don't need all the insurance companies we have, but I can't imagine how many choices I will have left once the CFO's start to do the math. Of course, the government agency responsible not only for doling out the cash but verifying that every policy meets the government standards will not become a big beaurocracy.
There is a lot of hand waving about why costs will go down. I agree that once we get a certain segment of the population to stop going to the emergency room when they have a cold, costs will decrease. But, from reading here, I was under the impression that are costs are due to equipment and number of staff."
The figure of $15-2000 would not cover the total cost of health care. It would cover basic insurance for the current uninsured and subsidise the cost of insurance for others.
Forcing insurers to compete on cost would reduce excessive capital investment over time.
You aren't going to sort this mess out overnight.
But you better start sorting it out soon or its going to bankrupt your government and large sectors of the private economy.
"You would find that the party supports a negative tax up to the tax free threshold of Aprrox. $30,000."
So a "negative income tax" = "healthcare voucher"
"Some times Winston 2+2=4. Sometimes it equals "3" or "5". It depends on what the Party chooses.'
JC"Violence- more deadly violence than other nations"
You know I overlooked this one earlier - there's only so much stupid I can deal with at a time.
Let's see, the excess of US healthcare costs over the OECD average is roughly $3,000/capita or ca. $900 billion per year.
There are approximately 10,000 homicides per year in the US.
Let's assume every single one of them costs the health care system $1,000.000. That's $10 billion a year or around 1% of the additional cost.
That's based on a hugely inflated cost of medical care per case AND an assumption of a zero homicide rate in the rest of the OECD.
SG: "Jc, I have been trying to argue with you in good faith. Not the good faith that you actually care about exchanging ideas, or even earnestly responding to a point. But the good faith that you can read. Yet here you are interpreting my response to your last point as serious."
SG, JC is,I fear, a lost cause.
But I am assuming that there are other people more amenable to reason also reading this.
"Forgive my naivety but I was always lead to believe that market based outcomes were always superior to the soviet model of command and control. The most obvious place you would see competition is through insurance providers. Arguing there would not be any competition is like suggesting the sun won't rise tomorrow. Even Ian recognized that but suggested we don't need it because ours works just fine while the US needs a change to a competitive model. How slick!"
No, I suggested that competition in the Australian health insurance industry DOES work to reduce costs - largely because there's an 800-pound gorilla called the Australian government breathing down their necks.
In the US on the other hand, competition between insurers obviously isn't working to reduce costs. Which is why I suggested that US government, as the world's largest purchaser of health care services, force the insurers to compete.
Tell me, JC, are you familiar with the quote from Adam Smith about what happens when people in the same line of trade get together?
"Forgive me for saying this but spending $us trillions of dollars over this century through a socialist plan such as Kyoto to achieve a tiny fall in temps isn't going to cut it."
Hos is "establish property rights over the right to pollute the atmosphere and let people trade in those rights to produce the lowest cost emission reductions" a socialist plan?
You gotta stop reading those Republican talking points JC, even if they ARE reposted on the LDP's website.
"there has been a free market in healtcare from a histoical perspective longer than the current soviet style command and control system people like SG slavishly adhere to."
And it was a catastrophic failure. Which is why when governments got involved life expectancy increased and economic growth increased.
But those are just more of those nasty old facts. Just call me a "socialist dinosaur" again.
"I do not believe that putting the US government in charge of another ~$600B/year will cause that money to be spent more efficiently."
I'll assume you missed the bit where I said that that money would come from removing people from currentpublic programs such as Medicare and giving them private insurance instead.
In case anyone is taken in by JC's whining about how everyone's being mean to him, go back to comment 13 where he first enters the thread describing me as "woeful" and commenting that he "shouldn't expect anything else"
Then at 18 "This is a silly straw man argument."
That's the problem with the internet, you can't hide from your past.
oconnellc (post 195), healthcare costs always increase in every system (at least every system that cares), and they will increase faster as populations age. The task is to find a way to contain that cost growth as much as possible, so that people get the best quality care at the lowest price. Healthcare costs increase more slowly in Australia than in the US, and from a lower base, so we are in a better position to manage these lifestyle-induced health costs.
And yes, you are right in concluding that this obesity issue is lifestyle-based, and yes indeed we have experienced very similar changes in this disease to the US.
This paper (it's a pdf) from Health Affairs gives some background information on changes in health costs, their causes and the parameters of the debate, if you are really interested:
http://content.healthaffairs.org/cgi/reprint/16/6/163
Note in "exhibit 6", Australia's change in infant mortality from 1990 to 1995, vs. the US. There is something seriously wrong with US health care when Australia's infant mortality rate can drop by almost 3 times as much (in relative terms), from a lower base... while in that time American spending increased faster.
OconnellC,
Obesity rates are going up throughout the developed world. Australia is just behind the US in our total obesity levels.
This and other factors, such as the ageing of the population and new drugs, are pushing up our health care costs.
But not only are our costs lower than the US they're rising slower than those in the US despite those factors.
"You also apparently believe in a binary choice between totally unconstrained market forces and soviet-style communism."
Says the Ian, the guy who told another commenter that we in Australia have free vaccination for young girls. This is a startling comment to make for someone who tells people he is an economist. Ian, can you spin this like the other comments?
This is also the guy who thinks it wouldn't be a good thing to allow market forces to work here but would be fine and dandy in the US. Talk about low expectations. Talk about inconsistent reasoning.
----------------------------------------
"what I find hilarious is that you can;t get it through your head that the current US system is vastly different to the Australian system and I'm proposing a voucher-based system there because it fits better with their current model meaning transitional costs would be lower."
Ian, this is truly remarkable. You actually agree with the US libertarian position for US healthcare. Good for you. But when it comes to OZ you think it wouldn't be a good idea because transitional costs would be too high. He didn't explain this howler because he couldn't, as it is so silly I think he even shied away from it hoping I wouldn't notice. We have numerous healthcare firms that offer complimentary insurance that would be chomping at the bit to off comprehensive insurance. Dogs bollicks transitional cost would be too high. In fact I would argue they would he higher in the US.
"I love how you can read a lengthy detailed analysis of the policy's faults and respond simply be repatign the party mantra."
Ian you're a socialist. Everything you say is based on some sort of tribal loyalty. All I am doing is trying to find the best outcome which is a market based system fully reacting to the price signal. You're the dinosaur around here along with trooper SG
------------------------------------------
"The simple fact which I have pointed out repeatedly is that the total cost of the Australian health system is less than 2/3s that of the US system. Whether the money comes from the medicare levy, general tax receipts of private spending that fact remains."
"The simple fact ......", as well as being confused or totally dishonest. Take your pick. At one stage you were comparing per cap costs and then another time you were telling people that a persons cost in Australia is the Income Medicare levy and the private insurance supplement ignoring the huge wads of cash the government forks out from general revenue to run the creaky ship.
--------------------------------------------
.
"But you better start sorting it out soon or its going to bankrupt your government and large sectors of the private economy."
Soon as in what 2025 or do you have more " accurate suggestions that aren't clouded by you bias?
----------------------------------------
So a "negative income tax" = "healthcare voucher"
No, but the voucher system is something the party wouldn't disagree with as an interim measure.
"Some times Winston 2+2=4. Sometimes it equals "3" or "5". It depends on what the Party chooses.'"
Yea, that's right Ian. And just because the government offers free vaccinations it is truly insane for you to suggest it's free. If you don't have a grip of this most basic concept what do you have a grip on?
I had late night but I get back to the other stuff later.
Seeya Ian
Oh SG I'm still waiting for that answer you promised..
Note to self: don't hold your breath.
Oh SG I'm still waiting for that answer you promised..
My god, it's full of stupid...
either that, or it comes from some strange parallel universe where the ability to quote someone else's argument and say "This person has provided the argument", or cite other authorities, somehow weakens the argument.
Kudos to your perseverance, Ian and SG.
"You actually agree with the US libertarian position for US healthcare. Good for you. "
...
"Ian you're a socialist"
How many people think JC is actually not a libertarian and is out to make libertarians look foolish?
At this point it seems to be the most likely explanation.
Slightly peeed says:
"My God its full of stupid."
That just not right pee, your stupid abuse is.
If you're going to act indginant make sure it's backed up with evidence or an argument. Swill doesn't cut it.
Ian:
Nice word tricks, Ian. You always score a high distinction in spin.
That policy you were supporting was similar but not identical to the policy held by libertarians. It made your earlier criticisms of libertarians look silly under the circumstances, which is why I pointed it out to you. (Recall? libertarians are like Stalinists?). I mentioned it sarcastically as another example of how silly your arguments are now becoming. Now your trying to turn that against me. How cute is that? You get an A for spin.
Truth is you're all over the place, flailing about looking for any old branch to hang on to. Tell us, Ian, which site did you heist that idea from? You know the one; where you suggested the US should have a market determined model of sorts.
We also have the spectcale of you supporting the current government command and control system, another astonishing attempt at stretching reasoning to its limits by an economist. So you really do think Americans are superior? Or is it an inbuilt acceptance of low expectations for Australians?
But I leave the best for last. You actually think the national vaccination of young gals through government funding was free.
Dont't be scared Ian, the big bad market won't bight you. Leave that socialist Jurasic park behind and join the better team. I know you can do it.
"You actually think the national vaccination of young gals through government funding was free."
No I didn't and no-one but you was foolish enough to interpret my comment that way.
You know this intellectual version of engaging in an arse-kicking contest with a one-legged man has been amusing but it's simply becoming pathetic.
Don't you think you should stop humiliating yourself?
Ian
Do you know how much does that vaccination costs per gal in oz?
Be a little expansive here and let's use that word " cost" loosely to mean "free".
If you don't understrand the way i have put the question I'm always there to help. You know that...
Now don't go round digging the budget numbers and give us a total. I would like the charge per unit please, fully administered.
I guess I made a mistake. Between medicare and medicaid, the US (states and fed) spend about $600B/year. However, they spend that much on old people and poor people. The proposal is now to spend that much on EVERYONE. I think the poor people and old people are going to need a little help. Also, the medicaid program is actually administered by the states, so we are going to end up pushing a little money to the feds. But here in Illinois, I consider any money put into the hands of the state government as good as stolen, so maybe that isn't horrible.
But, I'm not sure how this will result in something other than another inefficient bureacracy. I'm not terribly concerned about the efficiency of the Oz beaurocrats, since that has little relevance on the incompetance we face here. We are going to take $600B in government spending and turn it into $600B in government spending. Why is that more efficient? Also, since the government chunk is only about 40% of the total we will have to spend, I'm wondering where all the other efficiencies will come from. I for example, will not take my $2k and spend it on insurance. Insurance for a single person costs WAY more that that per year, so I will have no choice but to let my employer take that cash and put that towards my employer insurance. Lets say I do decide to take my $2k. First, that isn't enough to buy insurance. So, I have to hope my employer decides to give me a raise (he has all that extra cash laying around now). Well, if he gives me $200/month raise, I only end up seeing around $140 of it because of taxes. And, on top of the $200/month, as long as I make less than $95k/year, my employer is now responsible for a bigger tax bill on my pay. So, most people will still stay with the employer purchased insurance (I probably will anyway).
I guess I still don't see how this is going to help things. In the meantime, the US population is about to get really old, really fast and costs are probably going to increase faster in the next 25 years than they have in the past 25.
"I would like the charge per unit please, fully administered."
I would like you learn some manners and the basic rules of civilised debate.
We don't always get what we want.
"I guess I made a mistake. Between medicare and medicaid, the US (states and fed) spend about $600B/year. However, they spend that much on old people and poor people. The proposal is now to spend that much on EVERYONE. I think the poor people and old people are going to need a little help."
The US government currently spends considerably more than that.
The idea is to by at least basic cover for the currently uninsured population and use the government's buying power to force the cost down.
"We are going to take $600B in government spending and turn it into $600B in government spending. Why is that more efficient?"
Currently the US government pays that money primarily to private insurers and hospitals. They make huge profits off of it - in large part because of laws such as the ones that prevent Medicare negotiating lower prices for drugs.
--
The US government currently spends considerably more than that.
--
Could you show me where? I've been looking here: http://www.whitehouse.gov/omb/
trying to find parts of the budget that will go away when we replace medicare and medicaid with the new health branch. If you could point me at some specific stuff, that would be great.
I think it is telling that if you look here: http://www.whitehouse.gov/omb/budget/fy2008/hhs.html
you can see that we plan to start auditing how we spend these tens of billions of discretionary spending sometime next year. Seems hard to believe that a government agency wouldn't think of stopping fraud and waste right from the start, doesn't it?
--
Currently the US government pays that money primarily to private insurers and hospitals.
--
I thought the plan was to give everyone $1500-$2000 year so they could use it to buy private insurance or surrender it to their employer, so that the employer could buy it on their behalf?
--
1.Convert a stack of existing funding into a credit for every American worth about $1500-2000.
2.People with existing private insurance could use that money to go towards paying for their coverage. People in corporate schemes could either opt out and get private cover or surrender the credit to their employer.
3.Private insurers would tender for the right to provide basic health cover to people currently uninsured. There'd be competitive bidding, minimum service standards and the total premium couldn't exceed the credit.
--
I've been prodded into understanding that the existing funding was medicare and medicaid. About $600B.
Right now there are about 50 million uninsured. That is about 1/6 of the population. Aren't we still talking about [250million * $2000 = $500B] of government money still getting spent on private insurance? And the other $100B will be spent by those currently uninsured on those insurance companies that are willing to accept $2000 in premiums to cover an average expenditure of $5000/person.
I found some budget information here:
http://www.whitehouse.gov/omb/budget/fy2008/summarytables.html
Non-security discretionary funding is ~$450B
I'm trying to figure out where that "considerably more" that the US Government is spending on health comes from. That $450B has to cover NASA, Transportation, HUD, Agriculture, Congressional Salaries, etc. etc. Tell me how much that "considerably more" is so we can talk apples to apples.
Ian smuggly says:
"I would like you learn some manners and the basic rules of civilised debate.
We don't always get what we want."
You mean I should lie there and think of england while the abuse directed my way rages on. Pity you don't show the same scorn towards your socialist brothers in arms Ian. That way people would think you're being honest.
I took a quick stab at the numbers and figured out the cost will be around $300 dollars per head. Sure looks like your FREE vaccines are cheap, Ian. $300 bucks is now less than $us 140.
The way i figured it out:
230,000 are going to be given the shot. The total cost is going to be $537,000.000 over 5 years.
230,000 gals represents the 0 to 14 age group in NSW.
They will then do the 15 to 26 year old age group.
I estimate there will be 100,000 kids entering the age group over he next 5 years based on even distribtution. Also estimate 230,000 gals in the 15 to 26 age group. There should be a little les But I'll let that go.
230,000+230.000+ 100,000 = 560,000 gals get the needle over the next 5 years.
NSW is carries 32% of the nations population.
so $537 million *32% = $172 million/560,000 = $306.
let me know if you don't agree thanks.
Jc, the cost in the US is $360 US, or about $500 Australian. Ian was wrong before, maybe he had $140 for the first shot (it`s a 3-shot course). In case you now think your calculations are wrong, when the PBAC originally refused to license Gardasil it had an asking price in Oz of $335 US. They thought it was too expensive, and refused to list it. Since then the government must have used its market power to negotiate a lower price, since the $306 you quote includes the administration cost.
(I think your figures are wrong though, because you have calculated the number of girls in the 0 to 14 age group and they are only giving it to 12 year and up girls. Also, the program is estimated at $486 million over 5 years - look it up on the federal dept of health website if you aren`t sure. So taking that into account I`d say the cost per person of administering the vaccine in schools and to women aged up to 26, including the cost of the vaccine itself, is probably more towards $500 each).
So there you go, cost control in action at every stage of the health process. THe government negotiates a lower price for the drug than you and I can individually, then uses its tax revenue to protect all kiddies from HPV, which is a very expensive disease. This could eradicate dangerous forms of HPV in Australia in the long-term, eliminating the need for regular pap smears, which is good for everybody.
SG
Well and good. We can continue to screw them to the bone, but as long as the US consumer ( Healtcare system) is prepared to be the price taker. In a perverse why it may actually work our way because we're a small consumer of pharma in terms of world rankings (just speculation here).
However there is a problem if we all screwed pharma to the bone. They just won't make the medicines we need as happened in the US over the issue of vaccine production. They stopped making some and it went to the UK.
Pharma is a business and every business must return profits to its shareholders and for re-investment into new meds R&D. If you try to mess with that virtuous circle you end up with the way European Pharma has gone since the governments there began to meddle in the market. They stopped being the lead producers and R&D specialists with that title going to the US. Germany, Switzerland Holland were once world leaders.... and now?
I'm not telling you to love big pharma, but don't hate them so much that you want to destroy them. They have given us what we want in spades. You want these guys to make fat protis becasue it will attract other participants.
Some time ago Eli asked the question "Someone want to post outcomes where the US scores better than other industrialized countries on health related issues?"
There has been a deafening silence.
Oh yeah, it is a hell of a lot less expensive to vaccinate than treat and that goes for ovarian cancer too.
A major point about pharma, the big drug development expense is phase 3 trials, everything before that is peanuts. It is essentially at the point that a startup or small company must sell the drug out to a large one at the point where the drug is ready for phase 3 testing (large trial, lots of people, lots of hospitals/physicians, lots of data generated). The big research and development expense is marketing.
And it's a hell of a lot cheaper to excerise and not get fat, Eli. It's even cheaper and you live longer on a near starvation diet. It's cheaper not to get out of bed in the morning too. What exactly is your point. That pharma gives away the vaccines?
It's even easier for the government to put a gun at the head of the Pharma heads and demand we get our meds free of charge. But don't rely on them being around for long or hope we get terrific new drugs that will make our lives better when we turn sick unless they make a profit. Good luck.
It's not that easy to come up with such a matrix because it's an extremely complex issue. It's not as easy as AGW :-)
"The big research and development expense is marketing."
What Eli means by marketing is that a proportion of costs associated with the massive requirments of having to go through so many health agencies around the world that would make it next to impossible for any small firm to navigate. That is a huge expense alone which is part of the marketing budget for any new drug.
"Non-security discretionary funding is ~$450B"
Most US government spending is "nondiscretionary" i.e. it is required by various laws.
Think about it, $450 billion is around 3% of US GDP, do you think that's all the US government spends on items other than defence?
"Ian was wrong before, maybe he had $140 for the first shot"
Precisely - and the US cost is for the vaccine only.
The Australian cost ($460 for people who don't want to wait for the subsidised vaccination or who aren't eligible because they aren't citizens or permanent residents) includes the actual innoculation.
"when the PBAC originally refused to license Gardasil it had an asking price in Oz of $335 US."
The US pharmaceutical industry lobbied heavily (and unsuccessfully) during our free trade negotiations for the abolition of the PBAC. Presumably they feel it's forcing down the cost of drugs in this country and their profit margins.
Funny how the US is pretty much the only developed country without an equivalent body.
Apologies for the interruption but comments are not working for me on the other thread, and I wanted to test my ability to comment here.
++
Think about it, $450 billion is around 3% of US GDP, do you think that's all the US government spends on items other than defence?
++
Oh my goodness, no. I was trying to point out that the great majority of US spending is already spoken for. Things like Social Security, medicare and medicaid take up most of the budget. I don't have it open here, but you can see what those other items are if you look. There is about $900B left that members of congress get to argue about. The president wins and spends about $450B of that on defense. That leaves about $450B that can get spent on 'whatever'. A lot of stuff has to fight for that 'whatever'.
I stated that based on the budget, the US Gov looks like it is spending about $600B on our health and insurance. You stated that it is spending considerably more than that. I said fine, I'm not sure where in the budget that is coming from, but I included a reference to the budget so you could maybe show me some of the items in there that I missed that are related to our insurance. Of course there are things like programs to help people get over drug addiction, or wellness programs. But those won't go away in any case (as we can see from watching Oz, lots of people still get addicted to heroin and the obesity rate is shooting up), so it isn't fair to count those numbers.
Since I couldn't find anything that obviously looked like government spending on insurance or health that would go away under the new system, I pointed out that the discretionary spending, which is where I figured the rest of that insurance/health spending would come from, was only about $450B. I figured that would be the pile that the rest of that 'considerably more' would come from.
I hope I'm more clear now. Sorry about the confusion.
Jc, an amusing rant at #221, but it seems a little unfair. If you find that the drug costs more here than in America, it's our bad system ripping off Australian consumers. If we point out to you that the drug costs more in the US than here, it's our bad system ripping off American consumers. I think the term for that is "biassed".
The one tiny flaw in your little rant though, is that Gardasil was invented by CSL, and is licensed to Merck. So the profit-taking is being done by the Australian company according to free market principles. And CSL was actually criticised in Australia for trying to sell the drug at $335 US because it was seen as recouping its license profits twice (by setting an Australian price near the american one, when the Australian arm doesn't have to pay a licensing fee). So who is profit-taking at the expense of who, Jc?
"Funny how the US is pretty much the only developed country without an equivalent body."
Maybe it's because the US doesn't have as many brain dead socialist dolts who think screwing pharma is the long terms solution. They may actaully believe it presents us with other problems in the future like , err, falling investment in this most important sector.
The government would have monopoly status dictating the price at which drugs could be sold. It would more or less be the same socialist models the Nazis and fascists were running where they allowed firms to exist but only on their strict terms and conditions. Terrific!
Good one, Ian. Now your calling for defactor socialization of drugs.
Any other bright ideas this morning?
SG
It was Ian who brought up this vaccine caper and I don't have all the time to look into it who owned it and who is distributing it. So what? It's a stawman anyway meant to catch me out on some point and ended up exploding in his face.
Ian recently alluded that he somehow thought it was a good idea to keep down the wages of medical staff because, you know, it keeps down the cost of medicine as a % of GDP, so we don't end up looking like Americans.
Good one Ian. So doctors wages and salaries should be controlled because of your pathetic personal preferences. You sure are a supporter of persoanl freedoms and the right to enjoy the fruits of your own labor without a meat clever going through your wages.
These controls of course only apply to other people. If they applied to Ian he would be squealing like a stuck pig.
People like Ian would be the first to cry blue murder over free labor markets in case it meant labor rates truly reflected market conditions particularly in the Union movement, but think it's just fine and dandy to place a ceiling on the wages of doctors.
This is a great example of the socialist menace at work..... About as intellectaully bankrupt as anything could possibly be.
Jc, I have no idea what you're talking about. Did you just admit that you were wrong about the vaccine, or did you just explode in a cloud of piss and vinegar? I can't tell.
I'm sorry, sg. i should be a little more gentle with you. I ought to realize when it gets past 3rd grade equivalence it can get pretty tough for disabled people like you. I'll slow down in future a let you catch up with the rest of us. That's the nice person i am.
Can I just thank JC at this point for giving such a marvelous and extended demonstration of why I hold most libertarians in such profound contempt.
I note that not even Nanny is jumping in to support such gems as "what's the big deal about torture anyway?"
"Things like Social Security, medicare and medicaid take up most of the budget."
Yes but if you subsidise private insurance soem of the people currently reliant on those programs will shift over to private insurance.
Similarly, some currently uninsured people will get insurance meaning that they no longer wait until they're so sick they need to go to emergency wards for treatment, which will leave the state governments money which in turn will reduce the amount the federal government gives them to subsidise those services.
At the same time, converting the current tax deductibility of employee health insurance to an upfront grant will make it easier for small businesses and the sefl-employed to afford insurance.
I note that not even Nanny is jumping in to support such gems as "what's the big deal about torture anyway?"
Nanny is away Ian or he saw the beating you're getting and didn't want to make it any worse. He has manners after all.
Torture?
Ian? Wrong thread. This is socialized medicine thread. The torture thread is somewhere else....possibly another site maybe?
"Can I just thank JC at this point for giving such a marvelous and extended demonstration of why I hold most libertarians in such profound contempt."
Oh schucks and me thought you like me!
Ian let me tell ya kiddo. The level of contempt you hold libertarian types pales comparison to the contempt I hold socialists. It doesn't even come close. However I hold even more contempt for those who ought to know better. Ya know, people that went to uni and still hold those views. That's detestable contempt for who I hope a special place is reserve for them in Dante's hell.
Jc, a little hint for you: when expressing contempt, try to do so in a way which can be understood by, ah, well, um, anyone. Because if instead you write a sentence of complete gibberish, it kind of ruins your grand position.
Ian, I never disputed that people without insurance will have insurance under the new plan. I also said that we would see some costs go down as people stopped using the emergency room when they get a cold.
So, you said that the US Government spends considerably more than $600B. I asked if you could show me. I'm still asserting that the US is going to go from spending $600B on poor and old people to spending $600B on everyone. The poor and old are going to need some more help. And I'm surprised that anyone thinks that insurance companies are going to be fighting to provide insurance at ~$2000/year in premiums when the costs are going to be ~$5000/year. I mean, costs are going to have to drop from ~$5000/year to less than ~$2000/year for anyone to think they can make money providing insurance.
And where will the big cost savings come from? The proposed plan only changes who pays for some of the insurance premiums. But it does keep the government with lots of responsibility tracking all those plans and programs and costs and making sure that everything runs according to law. Why does anyone think that will be efficient?
And, does this plan take into account that as the US population gets really old, really fast, total costs are going to go higher more quickly than they have in the past. $2k/person doesn't seem like nearly enough.
++
converting the current tax deductibility of employee health insurance to an upfront grant will make it easier for small businesses and the sefl-employed to afford insurance.
++
Maybe there is something I am missing, but most businesses and self-employed have people who do their taxes for them. They have to. I have many self-employed friends and I work for a company with 11 employees. Tax laws in this country make it impossible for anyone in any sort of complicated situation to do their own taxes. Those people aren't paying "too much" in taxes and waiting to get their refund. I think it is a good idea, but in general, that won't make much of a difference on the cash flow of those people. They manage their insurance out of monthly cash flow. It seems nice to give them a pile up front, but they really in general want the government out of the way so they can manage their business. Causing them to pay more taxes while they get an upfront grant really isn't going to do anything to help them pay a regular recurring bill. Unless they aren't making enough money to pay for their insurance, in which case they will soon be out of business, regardless.
"Maybe there is something I am missing, but most businesses and self-employed have people who do their taxes for them."
What you're missing is that the current system requires employers to pay the insurance premiums and then get partial reimbursement later from the government.
As a small business-owner who fairly recently had to shift from paying my staff's superannuation (pension)contributions quarterly to paying it monthly I can assure you the cashflow implications are significant. Tax deductibility is also no help to businesses that aren't currently making a profit.
As to public expenditure: http://earthtrends.wri.org/pdf_library/data_tables/pop2_2005.pdf
In 2001, the US government sector (including states and municipalities) was spending $2100 per capita on health care. Adjust that figure for inflation (and subsequent initiatives like the Medicare prescription benefit). Cost increases for the US health sector are running at 10% of more per year so compound 6 years growth onto that $2100 figure.
Oh and when I say "$1-2,000 per person" why do you automatically seize on the upper extreme?
In case anyone confuses JC's comments with reality (which is I suppose theoretically possible:
#74 "What is it with you,lefties and torture? You all seem obsessed with it." -JC
I suppose when you possess the secret to solving all the world's problems and are marked out by the Gods for a special destiny a few facts slip past you here and there.
So let me see here, Ian the socialist is a small business owner, that makes jc the libertarian, what.....he must work in the motor vehicle bureau which I guess IS the ninth circle of Dante's hell.
Gentleman, gentleman, stop sqabbling in the war room.
Eli, when did you latch onto the habit if referring to yourself in the third person? It's, it's so Seinfeldian. You know they did a take on someone always referring to himself like that. Hilarious.
Socialism basically describes someone who prefers lots of government intervention. Yea, Gould's a socialist alright. And no, i work for myself as I would rather have a large brain mass than work for the state.
Ian
What the hell are you one about now. What "proof" have you found by lurking around the far leftiside of the interwebs that somehow proves demand /supply curves and the price signal doesn't work when you have an ingrown toe nail.
Will you please stop roasting that old chest nut about the US healthcare system..... for gawds sake. If anything it doesn't help your cause for more government intervention because the US is truly screwed up with all sort of intervention and mandates. Drop it Danno, it's not helpful.
SG:
SG is now resorting to picking up typo and gram errors. showing that when the heats on SG is certainly there to provide intellectual rigor
Ian, thanks for your questions. First, I guess I chose $2k/person because it seemed the most realistic. You said convert a chunk of current funding, and we spend ~$600B/year on medicare/medicaid and it kind worked out. Does that answer the question of why I picked it? It doesn't seem unreasonable, does it. If you don't like that number, please tell me what part of your range you didn't really mean, and we can limit it to that part of the range.
As far as the $/person, I like the chart. It does provide a couple answers to Eli's question. The US has among the highest number of physicians, among the lowest rates of TB and HIV, among the lowest rates of childhood malnutrition and highest rates of "improved sanitation and water".
Also, I think it helps us get a bit closer to the actual $/person number. If the # was $2100/person in 2001, lets say it is $3000/person in 2007 (I'm just guessing, if you think it is more, thats fine). That is $900B/year, so it is considerably more than that $600B/year. But to compare apples to apples, once again, how much of that will really go away when the federal government starts paying insurance for everyone? For example, money spent on obesity, drug addiction etc. will still have to be spent. I'm guessing a lot of local free clinics, etc, will go away, so money will be saved. How much do you suppose that is? Monies spend on things like the CDC are probably included in that number (but, once again, I could be wrong). In addition, that number included 'extrabudgetary' funds. That term isn't defined very well, but I'm guessing the possibility exists that some of it isn't actually money that comes from the government. Like, lets say a grocery store donates some diapers to a local program that helps poor, single women care for their children. It also includes 'grants'. I'm guessing that might include any federal money spent on cancer research etc. It might also include federal money spent to fight health problems overseas (I don't know how much has actually been distributed, but I know Bush has promised to send billions to Africa to fight HIV, malaria, clean water etc. etc.). I'm not sure how to estimate how much of that is in that $3000/person.
But, I'm still not sure where all the rest of the money will come from. If we increase that $2100 to $3000 in gov money, then the total money figure will probably need to increase from $4800 to, say, $7000/person. If we are in total spending about $7000/person now, and you are proposing that the federal government spend some amount less than $2000/person, where does that differential go? ~$5000/person/year is a lot of money to come up with. And, what is it about the federal government spending money that will make things more efficient?
oconnellc sez
Overhead for Social Security is less than 1% (one percent).
What's the overhead for Prudential?
Thank you for not being as idiotic as that cerebellum-challenged dolt JC.
DoD is a rather special case...do you know of any private defense departments working in the free market that are any more efficient?
This one annoys me for any number of reasons, mostly due to the lack of any data to back up the claim.
Ever worked with a fire crew? Extension agent? Forest Biologist?
I didn't think so.
If you'd like to get out in the world to get some firsthand experience as to how inefficient, say, the USFS or USF&W are, there are many, many volunteer opportunities out there. Many require you to be willing to do some physical work, with some physical discomfort (i.e. living outdoors in a tent in isolation for a few months at at time), and often you need skills before they'll accept you, but there are projects for which training's available.
Do you have any idea how much work is done by volunteers, interns, and the like for projects run by these agencies?
How many companies in the private sector do part of that company's job on a volunteer basis?
Which portion?
Are the coasties inefficient? Details, please.
The Border patrol? Again, details.
These guys don't even have the civil service protections given people outside the Dept of Homeland Security and the military ...
It is almost hard to answer a post like the one written by dhogaza. It is hard to believe it is serious. The assinine tone and the obvious insult that dhogaza took by my statement can only lead me to believe that he is indeed a government employee. In which case I apologize for your offense. But it hardly changes my feelings.
First, public schools. I found a few references, but I will post this one: http://www.homelandstupidity.us/2006/07/18/do-public-and-private-school…
I feel it actually gives public schools the best shake. The best conclusion for public schools I can find is that given twice as much money, public schools provide the same results as private schools. The web site refers to a study in wisconsin that compared voucher kids with public school kids. There was a significant difference in the performance of the voucher kids.
Dept. of Homeland Security etc. etc)
Which portion?
Well, without spending 30 seconds to look for a reference, I'll ask you to look for yourself how they are managing the task of getting citizens their passports. But here is a report about some of the other things they do: http://www.indystar.com/apps/pbcs.dll/article?AID=/20070729/NATIONWORLD…
it includes quotes about the astonishing efficiency like this: More than 40 state-run operations set up after 9/11 to help uncover terrorist plots are proving to be a costly but largely ineffective weapon against terrorism, according to congressional investigators.
or this: http://www.dlc.org/documents/HomeSecRptCrd_0703.pdf
You can go right to the conlusions to find this: President
Bush has devoted much rhetoric to bringing our
entrepreneurial spirit to other elements of
government, but on homeland security he has
consistently sided with the ponderous,
underfunded status quo over fostering the kinds
of innovations that will help keep our citizens
safe.
Hmmm... Sounds efficient.
Sorry, but my post was too long, so I had to cut it in thirds (turns out that 10 minutes on google finds all the examples of government waste you can fit in a single post)
What about social security? Here is an interesting report from the university of chicago about the impact on households that would come from privatizing social security: http://ice.uchicago.edu/slides_2006/smetters_slide31.pdf
Or, we can examine the expense of social security... they only charge 1% to manage my money. Lets see how Vanguard does: https://flagship.vanguard.com/VGApp/hnw/FundsFeesMinimums?FundId=0085&F…
if you register for online statements etc., you don't pay any account fee and the expense ratio is .19%. Well, only 5X the expenses of Vanguard (who does this to make money, by the way). But, maybe they provide really good returns on my money! Lets see what sort of past returns they have provided: http://www.heritage.org/Research/SocialSecurity/CDA98-01.cfm
Well, that is the Heritage Foundation. We know where their politics lie... Perhaps you could point me to a study of the real rate of return of Social Security by someone who is a bit more left leaning?
Of course, you included this statement, just to make yourself sound like an a**:
Ever worked with a fire crew? Extension agent? Forest Biologist?
I didn't think so.
Actually, I have spent several years with a volunteer fire department and I have close relatives in law enforcement and the military. Does my answer to your question really affect how efficient any of those agencies or some of the massive beaurocracies we have in this country are?
Why, for example, do you quote that much of the services provided by our government are actually provided by private citizens or funded by donations? You must know that that only indicates that the true costs of those services are higher than is indicated by the budget number associated with it. I could help you mow your lawn, but you could still be a schlub who spends twice as much as necessary to get it done.
I also thought it was interesting that you took offense to my claiming the DoA was inefficient when this thread has references to a story about them spending 3% of their budget on dead people for several years.
Sorry, but I'm still waiting for someone to explain why giving any money to the government for it to spend makes things more efficient.
Here is an interesting story in the Boston Globe: http://www.boston.com/news/globe/ideas/articles/2006/04/23/peace_corp/?…
In includes this quote: Private companies would be much, much cheaper. When we compared their costs to most UN operations, we came up with 10 to 20 percent of what the UN would normally charge.
This isn't terribly recent, but do you really want more: http://sfgate.com/cgi-bin/article.cgi?file=/c/a/2003/05/18/MN251738.DTL
"Private companies would be much, much cheaper. When we compared their costs to most UN operations, we came up with 10 to 20 percent of what the UN would normally charge."
Mercenaries (sorry "private military contractors") undercut the costs of the military in a coupel of ways:
Firstly, they recruit veterans, thereby avoiding the need to train their own staff;
Secondly, their pensions, medical insurance and provision for thew families of personnel killed in the line of duty is far less (see the current litigation between Blackwater and the families of the contractors killed in Fallujah);
Thirdly, they leech off the services of the conventional military (I don;t see Blackrock running its own fleet of C5 cargo planes or paying for the R&D on the weapons it uses).
Ian, is that it? Is that your defense of the efficiency of the Department of Defense? If so, I'm guessing we can move on to other items then. Oh, and this is a good website reinforcing your point about the excellent care of military personnel and their families provided by the Department of Defense: http://mfso.org/
Of course, we have the fine work of our intelligence gathering agencies to thank for providing the excellent intel on Iraqi WMD work. I'm starting to wonder if maybe I could pay some extra tax money next year because of all the great things being done with the money they already have.
Also, I'm still curious as to how you have modified your range of how much the US Gov. will spend on insurance.
ian can sniff out a fully paid for government boondoggle from miles away upwind. And he's still never seen one he doesn't like.
By Ian's "reasoning" we should not have private airlines either.... You know the pilots were trained on military jets and all.
OconnellC: firstly I'm less interested in defending the DoD than I am in puncturing the inflated claims of the merc companies.
In that vein, I'll also point out that UN missiuosn are unusually expensive because every single mission has to start from scratch and establish its command structure and support from zero. That's because ever since 1945 the five Security Council permanent members have repeatedly vetoedd the proposal, which is in the UN Charter, for a stnading UN military force.
As far as health care goes, my initial comments were speculative and not based on a fully costed analysis of the current US healthcare system. If you want a fully costed analysis of the current US healthcare system, I can provide one. My consultancy rates are quite reasonable.
Failing that, I will refer you to the system introduced in Massacheusetts by Governor Mitt Romney since it contains many of the elements I think are necessary such as a clearinghouse mechanism to drive down the cost of basic cover.
http://en.wikipedia.org/wiki/Massachusetts_2006_Health_Reform_Statute
It's not that I think the public sector is innately more efficient. Rather, it's screamingly obvious to me that the current public sector health spending in the US is staggeringly inefficient even by public sector standards. Given that, it should be possible to reduce costs AND improve coverage.
Romney appears to have done that.
This is hilarious. It's the first time I've ever seen the claim made that successfully accomplishing organizational goals using volunteers and interns is a sign of inefficiency.
In oconnellc's world, then, every damned NGO on the planet tht makes efficient use of volunteer labor is less efficient than profit-making companies that are fully staffed by paid professionals.
Name a LARGE non-governmental entity that beats Social Security's less than one-percent overhead, then we can talk.
Yes, some government programs are inefficient. This doesn't prove that all are, and there's ample evidence that many are very efficient.
Let me rewrite that statement:
Yes, some for-profit companies are inefficient. That doesn't prove that all are, and there's ample evidence that many are very efficient.
Apparently you agree with the second statement, but not the first, despite clear evidence supporting both.
Why? Your political philosophy.
Which is the problem with modern right-wingers, in general. If the data doesn't fit their political philosophy, throw out the data. AGW must be false, not because of the data, our solid understanding of atmospheric physics, etc but because the truth is inconvenient to those who believe that government has no (or a very small) legitimate role in society. Etc etc etc.
Actually, no. The first half of my professional life was spent running a company based on compiler technology I developed in my early 20s, in the mid to late 1970s.
The latter half of my professional life has been spent as a self-employed software consultant.
However, I've spent up to three months a year as a volunteer for ODF&W, the USF&W, USFS, and BLM, doing fieldwork monitoring sensitive species in remote areas, and helping to organize and run projects doing such work. All as an unpaid volunteer. I've worked closely with agency personnel for a couple of decades now and have a great deal of respect for them.
Regarding the military, I have had the opportunity to compare the logistical support skills of helitack fire crews and national guard blackhawk crews. The latter suck so bad it is an absolute wonder to me that we're winnning the war in Iraq with such ease.
So, no, I don't think all government agencies are efficient. But some are, and broad "government is evil" generalizations are stupid, just as "all companies are evil" is.
I can't think of any government agency that's as inefficient, when viewed broadly, than Microsoft, for instance. The company's incompetence and inability to write software that is as secure as that written forty years ago has cost customers billions of dollars.
JC Superstar sayeth:
Here we have it. JC is obviously smarter than the physicists who ran the Manhattan project, because having a large brain mass is incompatible with state employment.
Oh, wait, Mr. JC-the-brilliant doesn't seem to be aware that brain mass in humans doesn't correlate well with intelligence...
Is there anything else he may be misinformed on? Let me think ... hmmmm ...
Social Security overhead is LESS THAN 1%, for one thing. Also, Social Security does more than simply manage money. If you want to do an apples-to-apples comparison, you need to compare the amount of money Social Security spends to manage its funds to the amount Vanguard does. Since Social Security has very little flexibility in how it does so, my guess is that they spend a very small amount of their budget on that task. My guess is that most of that less than 1% overhead goes to paying for their customer service offices.
The modern airline industry would be nothing like it is today if it weren't for direct government subsidies that paid for the development of modern jet aircraft (KC-135, for instance), and, yes indeed, if training of pilots had not been paid for by the military.
Today's airline industry is self-sustaining, but the "dawn of the jet age" and the rapid maturing and growth of the industry owes a lot to government funding.
And, of course, the various national air traffic control systems, which are government-run entities.
And publicly-funded airports, and government certification programs for aircraft which greatly accelerated the increase in reliability we take for granted today ... there's a lot more to this iceberg, I'm sure, but without thinking much it's clear that the modern airline industry isn't a good example of the success of free-market economics.
Nor is the internet, without which you wouldn't be making a fool of yourself online.
"The modern airline industry would be nothing like it is today if it weren't for direct government subsidies that paid for the development of modern jet aircraft (KC-135, for instance), and, yes indeed, if training of pilots had not been paid for by the military."
Ignore JC, the poor socialist dinosaur obviously thinks that if a service is provided by the government then it's "free".
Ian
Stop strangling yourself with your own ideas. You were the one who somehow morphed that silliness about private security frms and how they leech off the military.
I simply stretched it out to its own pathetic conclusion. Don't blame me, blame yourself for writing silly somments.
Ian, government is the road to hell all paved with good intentions.
.......................
Hogaza
You seem angry that I work for myself. Too bad.
Do I think I am smarter than the bomb makers? Course not, Dude. I don't think i am very smart at all. In fact I don't even think or worry about it.
Thanks for your Bio/resume though. It seems very interesting.
"I can't think of any government agency that's as inefficient, when viewed broadly, than Microsoft, for instance. The company's incompetence and inability to write software that is as secure as that written forty years ago has cost customers billions of dollars."
Then off you go dude, go write a great program(s) that people will like and I'm sure you'll be there with Buffet and the geek giving billions away to needy causes in not too long a time.
No one's stopping you and there are plenty of VC firms chomping at the bit to take a pound of flesh off Microsoft's backside getting plenty of satisfaction along the way.
Ian copies the first para and then comments:
"The modern airline industry would be nothing like it is today if it weren't for direct government subsidies that paid for the development of modern jet aircraft (KC-135, for instance), and, yes indeed, if training of pilots had not been paid for by the military."
Ignore JC, the poor socialist dinosaur obviously thinks that if a service is provided by the government then it's "free".
Ian, please stop spinning. I have frequently used the term "socialist dinosaur to describe you and your beliefs. Tell the truth (or I will tickle your cheeks) there isn't one government program you haven't fallen for.
You make me laugh, you do. Here I am crticising almost every aspect of the government's role in the economy while you're there still pretending that it was West Germans who cracked the Berlin Wall trying to make it to the East German side as the reason it came down. You then have the nerve to call me a socislist dinosuar.
You're too funny for words.
By the way I didn't particularly take to your racist comments above, you embarrass yourself.
Perhaps if you had a state job, you'd be eligible for some remedial reading comprehension classes, and wouldn't continuously misspell my handle.
I've worked for myself, or my own company, my entire adult life. I'm annoyed that you're a pompous imbecile, not because you work for yourself (though in your case I have to wonder if it's because your attitude makes you unemployable).
Finally! You've said something I agree with!
MS's success is largely due to a couple of reasons not having anything to do with their technology being great.
1. IBM was too chickenshit to spend the money to lock up DOS themselves, because they really didn't believe in the market they were creating with the PC, and they didn't imagine that anyone would reverse-engineer the PC BIOS. Timing was important, too - today, they'd just patent the BIOS and those reversing-engineering it would be introduced to IBM's legal team. They're quite good, I've had personal experience (though in a friendly way).
2. MS acquired DOS from a garage company in Washington, under contract terms that forbade them from licensing third parties. They did so knowing they'd tweak it and license it to IBM. They later lost a lawsuit that took a tortuously long time to go through the legal system and had to pay the two developers a million or so each for the contract violation. MS's ethics haven't improved over the years.
I wouldn't want money earned this way, to be honest.
Naw, I prefer to remain in the open source community, earning my money the old-fashioned way, by the hour.
Can't help but notice that JC isn't responding to points raised by Ian, myself, or anyone else but is taking a rather, mmmm, more personal approach.
"I'm annoyed that you're a pompous imbecile..."
Quoted for truth.
JC seemed to think this is the socialized health care thread. Actually, it's not - s/he might want to read the starter bit at the top. As for a faux-libertarian take on US health care, try this one from Brad Delong. Bush is trying to veto a lower-cost health insurance expansion for children, in favour of using (much more expensive and inefficient) emergency rooms and catastrophic services.
"And there you have the core of Mr. Bush's philosophy. He wants the public to believe that government is always the problem, never the solution. But it's hard to convince people that government is always bad when they see it doing good things. So his philosophy says that the government must be prevented from solving problems, even if it can. In fact, the more good a proposed government program would do, the more fiercely it must be opposed."
Check how jc's colleagues in spirit are then adding to the misinformation.
http://delong.typepad.com/sdj/2007/07/paul-krugman-on.html#comments
Stewart
I gave reading Brad Delong after the first I wondered over to his site and I'm not about to start now.
I'm really not sure what your point is. Was it an anti-Bush rant? Fair enough there's a lot to dislike about his administration though not from a left leaning perspective. However if your arguing that government funded or regulated health care is superior, save your breath.
hogaza says:
Can't help but notice that JC isn't responding to points raised by Ian, myself, or anyone else but is taking a rather, mmmm, more personal approach.
What points exactly. you left me questions to answer? Can't see them.
Ian please don't get upset like that when your socialist supporting ways make you look like the skinny naked kid who escaped from he bathroom.
Pull youself together.
Splurf ...
Anyone one to speculate on JC's age? Hard to imagine he's much beyond 14 years old.
JC can't spell, that's what I say.
Nor think.
I've never met a libertarian who's not an idiot, ignorant of basic science, economics and history. Having said that, JC makes most of them look brilliant.
"I've never met a libertarian who's not an idiot, ignorant of basic science, economics and history."
I have.
Hell, Larry Niven is a libertarian. Too bad he's also a blatant racist (see The Burning City).
I've never met him, though his right-wing leanings are no surprise, given his writing partnership with Jerry Pournelle.
And Heinlein was no idiot, either, and while I don't know if the handle "libertarian" was invented in time for him to adopt it, "The Moon is a Harsh Mistress" is a veritable libertarian wet dream.
Ian, if you had stated right away that you really weren't interested in talking about your proposal, but rather interested in charging me for consulting, I think you could have saved us both some time. If you thought that Romney's proposal was the correct one, you could have stated that and saved a week of trying to defend yours (before of course, springing that consulting thing on me).
dhogaza, you say so many ridiculous things, it is difficult to comment on all of them.
Regarding Social Security, after I find a large private entity that does almost the same thing as Social Security, and does it at a fraction of the cost, you state: If you want to do an apples-to-apples comparison, you need to compare the amount of money Social Security spends to manage its funds to the amount Vanguard does. Since Social Security has very little flexibility in how it does so, my guess is that they spend a very small amount of their budget on that task. My guess is that most of that less than 1% overhead goes to paying for their customer service offices.
That seems a bit odd. Are you saying that Vanguard doesn't provide any customer service? Can you go to the SS website and check your personal rate of return for the year? Life of the account? Are the phone numbers for SS staffed longer hours or shorter hours than the phone numbers at Vanguard? Also, since we are doing apples to apples, maybe we should subtract the amount that Vanguard has to charge and spend on marketing, since SS has a guaranteed supply of customers and doesn't need to spend any money on that.
Oh, and about that customer service... Maybe you could do some research and tell us how what percent of people who apply for SS disability are refused the first time they apply? Maybe you could also tell us on average how many times people have to apply before they finally qualify? Perhaps you could tell us what percent of applicants have to hire an attorney or outside representative before they qualify?
Oh, and maybe you forgot, but isn't part of the efficiency of a money manager what rate of return they get for your money? Could you check that for us as well?
dhogaza, you wrote (to me):
++Why? Your political philosophy.
Which is the problem with modern right-wingers, in general. If the data doesn't fit their political philosophy, throw out the data. AGW must be false, not because of the data, our solid understanding of atmospheric physics, etc but because the truth is inconvenient to those who believe that government has no (or a very small) legitimate role in society. Etc etc etc.++
Odd, I searched this thread for anything that described my political philosophy. I commented many times about the inefficiencies of beaurocracies. When you stated you couldn't find evidence of this, I found it for you (spending a total of about 10 minutes on google). Is it possible that since I disagree with you on this you decided it might be easier to call me names? Should I turn the tables and say that the problem with all modern left wingers is they like to make up stuff about people who disagree with them?
dhogaza, this was too much... you wrote++This is hilarious. It's the first time I've ever seen the claim made that successfully accomplishing organizational goals using volunteers and interns is a sign of inefficiency.
In oconnellc's world, then, every damned NGO on the planet tht makes efficient use of volunteer labor is less efficient than profit-making companies that are fully staffed by paid professionals.++
Actually, I never said anything of the kind. If I did, please point it out to me. I thought I was pretty clear when I used the example about helping you mow your lawn that the presence/absense of volunteerism actually had nothing to do with efficiency of a government agency. If the Dept. of Education got $100B in government funds to pay teachers, then convinced a bunch of teachers to volunteer $200B worth of time and then used $95B of that $100B to buy bubble gum cards, the Dept. of Education would still be inefficient. That is because they would have spent $100B to accomplish something that they only needed to spend $5B on. Yet it seems that you would still contend that they are efficient because they had volunteers. How could you get it so wrong? And, how could you in good conscience keep ascribing things to me that I never said?
Perhaps this would be easier if you would just come out and tell me what argument/point of view you want to argue against and ask me to just represent that. It would save me the trouble of thinking I could just have a conversation with you.
oconnellc:
A mutual fund does not do "almost the same thing as Social Security".
Apparently you don't know what you're talking about.
Am I surprised? Hmmm ... let me think ... you're a libertarian. No, I'm NOT surprised!
Well, actually ... if giving $95B of bubblegum cards to volunteers is what convinced them to volunteer $200B of teaching time, it wouldn't be inefficient at all ...
This one really burns, so I'll post again on it.
"does almost the same thing" is an *assertion* on your part, not backed by any evidence at all.
You raise some hypotheticals ... "vanguard answers the phone, therefore their service component is equivalent to social security's", etc etc. No data. Just handwaving assertion.
You then move the goalposts, claiming social security is less efficient because it has a lower rate of return than Vanguard, which has nothing to do with operating efficiency.
And which, of course, ignores the fact that by law social security manager's aren't allowed to invest in high-yield instruments. The legal framework in which Social Security or Vanguard operates does not speak to their relative efficiency. The mafia may well be more efficient than Vanguard, for instance, due to working under different legal frameworks. What does this mean? Crime is more efficient than honest labor, so we should scrap business and rob each other instead?
dhogaza, this is getting funny. Since SS can't spend money to do research or get me a good rate of return, that can't be something we compare. Why not? If you were comparing Prudential and Vanguard you would compare them. I mean, maybe it would help if you gave us your meaning of the word efficiency. From the point of view of someone who wants to retire, how much money they are going to charge me and how much money they are going to give me back are pretty important things.
And you accuse me of handwaving! You still only know that the expenses for SS are less than 1%. How about finding out the real number? And how about answering my questions about the great service SS provides? If you assert they are efficient, shouldn't the onus be on you to provide at least SOME evidence of that? I have tried. You disagree. Fine, prove me wrong. To merely assert that I have failed and that I need to try again won't cut it. If they do things that are different than Vanguard, shouldn't you be able to quantify that to some extent? You brought up SS as a specific example in the first place, not me. You want to go way out of your way to make sure that I am fair to SS in comparing the services of Vanguard and SS, but so far you don't seem real concerned that we do the same for Vanguard. If SS provides better service than Vanguard, it should be easy for you to point me at some evidence that leads you to believe this.
dhogaza ++ Am I surprised? Hmmm ... let me think ... you're a libertarian. No, I'm NOT surprised!++
Is that what they call an ad-hom? All I do is point you at websites that back up what I say. Please feel free to do the same.
And, once again, I have never said I am a libertarian. I have only complained about inefficiency. Is that the definition of a libertarian to you? Well, I guess that is the problem with modern day lefties, they all have to make up things about you.
++A mutual fund does not do "almost the same thing as Social Security".++
I'll admit that this is just a surface examination, so it could be wrong
-Register an account with you and assign an account number.
-Track contributions.
-Manage money.
-Provide distributions when the account gets closed
-Provide regular information about the status of your account, balances, rates of return etc.
Oh, well, one of them does this.
-Provide educational information on retirement, savings, etc.
I will give you that SS provides payment to disabled people. If you feel that SS does more, please feel free to list of those things and how much they spend doing that so that we can compare how much money Vanguard spends to how much SS spends. I have already requested that you give us some information on how well they provide some of those other services (like handling disability requests), I'll wait patiently for that.
++What does this mean? Crime is more efficient than honest labor, so we should scrap business and rob each other instead?++
Wow, thats good. Are you having trouble actually addressing things that I say? If you don't want to have an intelligent conversation, I guess you could say so in two ways. One, you could come out and say it. Two, you could make up and ascribe stupid things to me and then mock me for them. I'm beginning to think you are too shy for #1.
I guess that is the problem with modern day lefties, they all have to make up things about you.
Hogaza:
"You then move the goalposts, claiming social security is less efficient because it has a lower rate of return than Vanguard, which has nothing to do with operating efficiency."
Which is really what he meant of course and you now seem want to avoid by smoke and mirrors. He has explained why Vanguard has offered superior returns to investors over multi decades. As an investor that's all you care about. Meanwhile the service is superior too as the information flow is timely and at your finger tips.
I would suggest that you made those assumptions too, ie that SS offered equal services to Vanguard and then see how your precious government service performs.
Where's Ian, that old Socialist dinosaur, to tell us that it would be racist to look at it like this.
So many lies in one post, it's amazing...
No, he hasn't. I did. Vanguard works in a different legal framework than Social Security. The relevant framework is set by Congress in both cases.
Not true at all. Many, perhaps most, financial advisors recommend moving retirement money into fixed return instruments after a certain age because a decade-long downturn in the stockmarket can be very painful if you're at or beyond retirement age.
Again, an assertion not backed up with any data whatsoever.
Bullshit, I've said all along that it's an apples-to-oranges comparison.
But then again, we know you're dishonest, don't we?
Sorry, you're making the assertion, you do the analysis.
The differences between SS and a mutual fund makes a very long list. Take your time.
Not at all. Apples-to-oranges is apples-to-oranges, and using an absurd analogy to make that point clear is perfectly reasonable.
SS, Vanguard and the Mafia all operate under different operating constraints. Comparisons among them are equally [in]valid unless these constraints are meticulously accounted for.
The nice thing about this and other threads where libertarians take part is that they make clear that it is no fluke that libertarians can't even get a friggin' dogcatcher elected in most of the US or Australia.
No wonder.
"libertarians can't even get a friggin' dogcatcher elected in most of the US or Australia.
No wonder."
Not true, Hoggsie. The previous New Mexico Governor was pretty close to being a libertarian. Bill Richardson is too.
(No Ian he/they aren't racist)
Mike? Sanford out of one of the Carolina's is okish that way too . Not perfect, but pretty good. He took a pig under his arm tot he statehouse to demonstrate what he meant by porkbarreling.
We had a closet libertarian PM in OZ by the name of Bob Hawke in the 80's who also came prety close- only thing is he didn't even realize it.
No Ian, Hawke wasn't a racist.
Doesn't everyone get the feeling that Ian is some kind of spam bot which is progrmmmed to post racist accusations whenever a keyword appears. I think so.
Reason Magazine has serious doubts about Richardson's "libertarianism", and the Cato institute only gave him a "C" last go-around, not exactly a stirring endorsement.
(http://reason.com/news/printer/120758.html)
It takes more than cutting some taxes (while increasing others) to make one a libertarian.
Regardless, Richardson's a Democrat, not a Libertarian, and the Libertarian Party nominated a candidate to run against him.
Perhaps you're claiming that the Libertarians got Richardson elected by drawing votes away from the Republican Party?
dhogaza, you are getting worse. Whenever I make an assertion, all you do is say 'Nope, thats wrong too'. Fine, show me how I am wrong. After a while of me getting it wrong, then you have to show me where. I have asked lots of times, with you ignoring me every time, what else does SS do? How much do they spend doing it. Lets get an apples-to-apples comparison.
You know, I thought it was odd that earlier you said that Microsoft was inefficient because of the quality of the code that they produce was bad. In this case, an entity can be judged inefficient because of the product it produces. However, we can only judge SS by its operating efficiency, not the product it produces. So, you are saying that they are efficient because they can minimize the # of paper clips that they use?
If you refuse to have a discussion about this, fine. Please say so. I'm getting tired of wasting my effort pointing you at references and having you just say "no, you are wrong. try again". This is almost comic. Does this ring a bell:
Meanwhile the service is superior too as the information flow is timely and at your finger tips.
Again, an assertion not backed up with any data whatsoever.
How about checking the website. I can go online at Vanguard and get a daily balance, a yearly rate of return, a total rate of return, reports about my contributions, dates of all transactions etc. I get a letter once a year from SS telling me what they think I will get when I retire. Do you really think that there is any comparison between those two? I have asked you a couple times to show me how great the service is for those people who try to apply for SS disability. That would be a great place for you to shut me up. Please stop ignoring that request.
Then there was this:
please feel free to list of those things and how much they spend doing that so that we can compare how much money Vanguard spends to how much SS spends
Sorry, you're making the assertion, you do the analysis.
The differences between SS and a mutual fund makes a very long list. Take your time.
No, actually you made the assertion. I said that they did many things that were similar. I listed things that they did that were similar. Then you said that they did things that were different. That means that you are the one making an assertion and not doing any analysis. It is your turn now. Please list the things that SS does that make it a not apples to apples comparison. Please show the great service results of people applying for disability.
I'm sorry if this frustrates you, but this is how conversations work. At some point you have to list facts that back up the things you say as well. I will even help you. Here is a page on the website that lists Services provided by SS: http://www.ssa.gov/howto.htm
Please list those that are unlike anything done by Vanguard with your estimate of how much they spend doing that so that we can get to an apples to apples comparison.
Also, please provide that data about people applying for disability (% rejected the first time, % that eventually get accepted, % that has to hire a lawyer or representative to get the benefit).
Also, please answer why it is acceptable to judge Microsofts efficiency based on their results, but only acceptable to judge SS efficiency based on how many paper clips they use.
And, please explain why the legal framework matters. Most people define efficiency as some measure of the resources expended compared to the theoretical minimum resources that could be expended to get a particular result. SS is what it is. If it changes, then we can judge it in its new form. The fact that they cannot by law invest in anything that provides a decent return does not make me feel any better when I get that mailer once a year telling me how much money I am going to get. I still wish I could keep my money and invest it in something that will do me some good.
Oh, yeah, I almost forgot. The problem with modern day lefties is that they have to make up things about you.
Hilarious.
By law, SS is not allowed to invest in the stock market, therefore by law SS is not allowed to make the return that mutual funds can make by investing in the stock market.
You're saying that this doesn't matter? The SS could be the most efficiently-run organization in the world and their rate of return would still lag the S&P index.
As far as the rest of your drivel goes - have an ideologically pure and happy day, undisturbed by reality.
Hogssie
I don't give cracker about their poltical affilation as long as they're showing libertarian tendencies. Of course no libertarian will be elected in my life time. But that isn't the point. Richardson is about as best as you can get from the Dems so you gotta take what you can get.
He's the good tale of why the US SHOULD NOT GO with the Canadian health model.
http://www.city-journal.org/html/17_3_canadian_healthcare.html
There is a private clinic per week being estbalished in Canada these days.
Oh, and it mentions that research in cancer in Canada equals the amount spent by ONE research center in Texas. Way to go canadians.
http://www.city-journal.org/html/17_3_canadian_healthcare.html
It's a pretty fair minded piece as it reminds people that the US system is quite expensive. But hey, you can at least get the proper drug for cancer treatment in the US.
dhogaza, what is ideological about my discussion of SS? First, if SS can't invest in anything other than t-bills, fine. I tried to at least answer your questions. Efficiency is based on actual expenditures to achieve a outcome vs a theoretical minimum to achieve a outcome.
So, if the rate of return lags the S&P, fine. You assert that they need to spend ~1% of their budget doing something. I just wondered if you could explain that. What is ideological about that? You have taken every opportunity to accuse me of things I never said and dismiss questions because they are 'ideological'. Well, if all SS can do is take money, buy t-bills and then return it when you retire or need disability, why do they need so much money. I pointed at Vanguard and I said that Vanguard does roughly the same thing, only better (even ignoring rate of return, if you like) for less money. You said, well, SS does more. Ok, fine. What else do they do and how much does it cost?
If you are going to repeatedly ignore my questions and attempt to have a discussion, why do you even bother to reply? What does ideology have to do with the fact that I can get information daily from Vanguard on the internet, and SS will only send me information once a year via mail. If I request it, then it will take 2-4 weeks to get to me and that becomes my yearly mailing and I don't get another for another year. You know, people from all political parties put their money in Vanguard accounts, I'm not sure how showing they are better at the same job than SS is has anything to do with ideology.
Oh, and by the way, that is the problem with all modern day lefties. They have to make up stuff about you.
++The SS could be the most efficiently-run organization in the world and their rate of return would still lag the S&P index.
++
Fine. Since they don't have to spend any money doing analysis of the market, that is cost that they don't have. If their returns are lower than someone that invests in the market, then shouldn't their costs be lower as well? And if they were compared against another group that didn't do market analysis, but instead just bought the same old thing, then shouldn't their costs at least be the same? Isn't that your definition of operational efficiency?
The Vanguard index purchases only the S&P500 index. They don't spend money doing analysis. They charge .19%. They also have to spend money on marketing, which SS does not. So, to compare apples-to-apples, we should really assume a number less than .19%, right? This is operational efficiency, right? Also, since they are a for profit company, we actually should not count the money they charge that becomes profits, since that has nothing to do with operational efficiency either, right? We are only comparing operational efficiency, right? So now the number is even further below .19%!
I've also given an example of how equivalent services are astronomically worse for SS.
I've asked you to give us some information on some of the other services. Very simple. What percent of people who apply for disability are refused by SS the first time they apply? What percent of those people eventually end up getting approved? What percent of those people have to hire an attorney to eventually get their disability?
Now, could someone please explain the ideology I have demonstrated in this post?
Now, this is just something to think about. Please do not attempt to answer this question until you have addressed the above. If you had $100/month to invest in a retirement plan for the rest of your working life, would you invest it in A) a plan that was really, really operationally efficient? Or would you invest it in B) the one that would give you the best returns, best information, best service and most flexibility? Now, which kind should we as a society set up A) or B)?
B.
Now, let's talk dates.
Let's say you're 55 years old, it's 1928, and you're planning to retire in 1933.
What's the rate of return you'd expect from the S&P 500 (assuming its existence) in that timeframe?
Would you consider that a good investment, or a poor one?
Was the stock market return in that time frame the best possible investment, fulfilling your first criteria for "B"?
How about that period of time known as the "dotbomb", followed by the post 9/11 sag? Made me quite happy not to be retiring 'cause my 401K, which I had little control over at the time (I've left it and bailed into an IRA since), was in a fund which tracked the stock market very closely.
An S&P 500 fund certainly didn't fit your criteria "B" for that timeframe.
Regardless, the original claim was that government agencies are operationally inefficient.
You've moved the goalposts on that one more times than I care to count.
Again, have a reality-free happy life basking in your simplistic black-and-white fantasy world where "right" and "wrong" can always be determined by one's political ideology, facts be damned.
Let's see, I said something like "libertarians can't even elect a dogcatcher".
JC says "no, no you're wrong!". After being called on it, he says:
Interesting.
True, my point was more immediate, for all I know they may manage to elect a dogcatcher somewhere. So, yes, you're right, I'm wrong, because I'm far too optimistic about the future of your party, apparently.
hogssie says:
"Let's say you're 55 years old, it's 1928, and you're planning to retire in 1933."
Why look at the long term, hogssie. That period is far too long. I would suggest we look at a two day investment horizen period.
You know I had left this thread in the hope that it owuld be a natural death.
This was obviously my error since I missed the classic humor of JC embracing Bill Richardson and Bob Hawke as libertarian fellow-travellers.
Hawke is, of course, one of the principal architects of the Australian medical insurance system he so detests.
I don;t know much about Richardson's policy positions but I'm fairly certain he supports both universal health care and government regulation of carbon dioxide emissions.
It's been an interesting, data-free discussion.
So: What does the data say about health care plans and costs? Has Jc's model been implemented anywhere? What were the consequences? How does this compare against other mixed models? (And they all are mixed, with the possible expection of Cuba and North Korea, but there is no data on the latter, anyway). Please let us know about overall costs, out of pocket and catastrophic costs, degree of coverage, and outcomes (QALY is probably best, but childhood mortality and life expectancy are also reasonable).
Otherwise, this bantering of hypotheticals and bringing in all sorts of 'protolibertarians' (and you forgot to mention Blair, if you want to bring in Hawke) is a bit too reminiscent of the marxist-leninist lunchroom crowd. I know you're a true believer. I need is some data to make me believe, but words won't do it.
dhogaza, first, I'm not sure where I made the claim that they had to be "operationally" inefficient. You were the one that made that distinction. I'll admit to using a bit of hyperbole when I made my original statement. But fine, you got all lathered up and asked for specifics about some of the departments that I mentioned. I gave them to you. Then you, not me, started to argue about operational efficiency. Personally, I would think that there are more appropriate types, but I'm willing to work with you.
So, lets address your post. First, you pick a couple interesting time periods. Yes, there are certainly times when the stock market has had poor performance. Couple things... first, I will concede that in the 30's the average person didn't invest much and may well have made the mistake of having most of their investments in stocks just a few years before retirement. However, by the 90's, anyone who was doing that was doing so against all common sense and against any type of advice from anyone trustworthy. Actually, if you go to the Vanguard website, you can see that they have a free little online asset planner. You answer a bunch of questions about age, risk tolerance etc. and they give you an asset allocation to shoot for. You know, the older you are, the less you should have in stocks, etc. You should play with it. Although I'm only in my 30's and years away from retiring, I have already started to put a % of my retirement in bonds and cash equivalents.
So, your argument seemed to be that if you do something stupid with your money, it can hurt you. No disagreement here. I'm not sure what that has to do with your assertion about B). I mean, if you spend 8 seconds on the Vanguard website, you can see that you can also invest in bonds, money markets, REIT's, whatever. What does that have to do with operational efficiency? Remember, the term operational efficiency actually started with you. I checked and the first time we see it is post 279 when you bring it up, state that I'm not limiting myself to operational efficiency and claim I'm moving the goalposts.
I would have assumed that anyone reading my post would understand that I was intentionally not limiting myself to operational efficiency. After all, the DoA might have been very good about how efficient they were in cutting those checks to those dead people. But they still sent checks to dead people, and in the long run, it is that bigger picture that we are probably concerned about.
The second point you seemed to make is that for older people, investing in the market can be bad. Would you care to continue with your reasoning? Why not pick a large number of 20 year periods and see what would happen to young people who invest in equities during those periods? I'm not sure what that has to do with operational efficiency, but it seems like you see some correlation, so please continue.
So, I have tried to compare SS to an organization that I claimed was similar to SS. I gave similarities, talked about costs, services, outcomes... I have then asked you very specific questions several times to try to get some information from you. You have ignored almost all of them. You have referred to my ideology and my ignorance multiple times. Isn't it a bit incongruent that in this very same thread you wrote about someone else:++Can't help but notice that JC isn't responding to points raised by Ian, myself, or anyone else but is taking a rather, mmmm, more personal approach.++
Please, we have now noticed that you are doing the same. If you want to talk about the operational efficiency of SS, lets do so. Present some fact or assertion about their operations. I have asked lots of questions that might give you some direction on where to start. But at this point, save yourself the effort of referring to my ideology.
Gould
Can you understand nunace? Seriously, is everything a word game with you.....always playing gotcha with a blind cat and then declaring yourself the winner.
Hawke has been as close to a libertarian as we can have in this socialist paradise of yours. I never suggested he was a member of the LDP, but he seemed to display strong libertarian instincts, certainly more so than any conservative.
I mentioned Rishardson along similar lines.
I didn't say that they were libertarians, just that they showed strong leanings. Got it now. Ponder that for a few days and come back.
Is it all emissions with you,oh gaseous one?
"Can you understand nunace?"
I swear, you couldn;t make this shit up.
Ian
The trouble with you is that you never leave an argument that you have clearly lost without going troppo on us. That's why you are left resorting to silly word games.
The last thing a loser resorts to is correcting typos.
Lol. Sleep it off you old socialist cave man. The wall did come down from east to west, not the other way round.
IT really is pathetic isn't it.
That smelly homeless guy in the urine-stained pants and the vomit-covered t-shirt who follows you around screaming about how he knows you've been beaming microwave messages to his teeth screams at you as you finally walk away in disgust "You lost the debate."
Gouldie
Talking about vomit....are you playing the part of the dog in this thread... who returns to his vomit after a few days?
Don't worry, at least you learned a few things about economics and no one, i promise you, is gonna read 300 comments. How lousy you are just stays with us , ok?