4 ms·

Thank you for your detailed response, I'll try to honor it. > Ethical disagreements exist. You may not think that this is an urgent ethical issue, but I do. I'

Thank you for your detailed response, I'll try to honor it. > Ethical disagreements exist. You may not think that this is an urgent ethical issue, but I do. I'm not going to say that your position is ethically acceptable just because it would make you feel better - sorry. Yes, we do disagree. But, we have to go forward together by dealing with each other honorably and not operating from the default assumption that the other is below reproach or sub-human in their thinking. We need to hammer home that the perfect should not be the enemy of the good (myself included.) We have to make deals and compromise to implement any policies that will be durable and maintain their original spirit. Think Medicare and SS as examples of big compromise bills that lasted, and the ACA as a contra-example. If you don't believe in your bones that we need to compromise on the big stuff, then life will be full of disappointments. > superior both in terms of outcomes and in terms of basic decency What about our obesity epidemic, isn't that a factor contributing to our outcomes? Do all countries use the same measure when tallying outcomes? What are our comparative outcomes for health care at the extremes? Like, when your twins are born 2'10" and 2'11" respectively and still live and are healthy after 7 years? I'm sorry, but respectfully, that talking point is so cherry-picked, and ignores so many factors, that it is meaningless. It is only intended to shock and to shame. Reality is more complicated than just "outcomes are worse." Do not insult my intelligence. > I believe there will come a time when the right to healthcare ... Medicare turns people away all the time, it's actually hard to get them to pay a claim. A right is a only truly a right when it can't be denied. Just start asking simple questions, and the 'HC as a right' concept falls apart. Like, which health care procedures are a right and which are elective? Sex reassignment isn't a right ... this year ... maybe next year ... until the Republicans take power again ... see what I mean? A service like health care isn't so simple, nor black and white, as you paint it. I do not believe you can make your "100% covered" math work AND pay doctors and hospitals such that they will continue to work for you such that you don't wind up with a doctor shortage and induce rationing. I do believe that my "maximum possible" can reach an effective "100% covered". Think of how cheap technology and process changes can make things over time. The world is not a static system, it's dynamic and fluid! For example, Amazon.com, a recent phenomena, is being described as an anti-inflationary force across the entire economy because they are so effective at driving down costs and haggling on prices! > pie in the sky market-based schemes Come now... Consider there is no rationing of food. Food on store shelves regularly goes bad and we have to throw it out, we produce such an abundance. Consider the US manufactures 8x the amount of clothes that actually gets sold. If it weren't for Africa taking, basically for free, all of our excess clothes, we would be incinerating the excess at the end of each fashion season. Consider veterinary services and how much affordable they are relative to comparable human health care. Like, vet services paid out-of-pocket, no insurance at all affordable. Why? How?! Consider health care and student loans - both seeing spiraling cost increases. What's the connection? Heavy government involvement and crony influence. What I'm saying is ... Market forces perform! Pay people up to what the market will bear, and you'll never have a shortage of workers to provide a service. Then, encourage competition and allow people to shop based on price and quality. Next, the market will control for excess and will find a stable value for each service that will be as optimal as it can get. Finally, if you can ease up on regulations, then the cost of providing a service goes down further and businesses will reinvest in themselves, which can further lower the costs. It's economics. The model for how to unleash market forces and make services cheap and accessible exists in standard textbooks. The fact that health care is currently expensive and people's lives hang in the balance makes this discussion more than just economics. I think that's mainly what you are driving at. And I respect your passion in that regard. Honestly, I get you on that! Your whole paragraph there is full of bitterness for me, but why can't you get me, friend? I'm passionate too AND I don't want anyone to suffer! Like, no one normal wants other people to suffer. You know that, right? Finally, if it is true that I actually want to alleviate suffering just like you ...

foldr 7y ago
A market system means that you get what you pay for. Poor people get crap healthcare while rich people get great healthcare - for as long as their money lasts. Unless you think that MRIs are going to become as cheap as paperclips, there's no market mechanism that will level the playing field in that respect. You may respond that poor people would still be covered by Medicare. But your skepticism of the efficiency of the government should extend to its ability to reliably identify the people who need assistance. And if you are ok with the government paying for some people's healthcare, it seems to me that you've given up the main principle. Why not just have a public option open to anyone, and let "the market" compete with that? If the government is as useless as you say, insurance companies should have nothing to fear. The problem with student loans in the US is arguably a lack of government regulation. In the UK, for example, there are very strict regulations on interest rates and the repayment schedule. Although student loan debt is still a drag on the younger generation, it doesn't bankrupt anyone.
- foldr 7y ago
  s/medicare/medicaid
- EdSharkey 7y ago
  > you've given up the main principle If you are still looking for inconsistencies in my position, then you haven't yet accepted that I want to find compromise solutions. I am ok with not getting everything I want. We're all walking inconsistencies anyway. That said, you are right to call me out on that and student loans because I slipped into talking points mode, which was a futile attempt at one-upsmanship. I'm never going to convince you my opinion is the right one, and vice-versa. All that matters is we both have an accurate understanding of the other's worldview so we can discover where the give and take can happen. > Why not just have a public option open to anyone, and let "the market" compete with that? My answer is just another weak talking point regarding US states that have tried that and failed. The private market in those states predictably collapsed because employers took the opportunity to dump employees onto the state run plan. Which was, of course, the goal and no one is fooled. The story ends sadly however, the state tax base couldn't support everyone dumped on the public option and virtually no one remained on the private plans to subsidize the public ones. So, the public options got scrapped. States can't run a debt like the Federal government can, so their plans have to square financially or the whole apple cart gets upturned. There's the harsh reality for ya! <mic drop> And that was the most pathetic, cherry picked story with zero details that didn't include counter-stats about the thousands of mothers and children getting health care for the first time in those states, etc etc. You sank my battleship! Did I just change your mind about single payer? Of course not, and that's fine by me. I just hope you are softening to the idea that someone who disagrees with you is not automatically an ogre, and can be well-meaning. There is far too much distrust driving factions in our society, when it is easy to find so much common ground if we just talk. My position is: the market left to do its thing produces goods/services that are cheap and plentiful. Yours is, I think: the market has no soul and there is corporate greed/corruption and the market will always have losers, so we need to intercede and level the playing field for people. Please correct me if I got you wrong. See, we both have solid points that the other must certainly agree with - the evidence is clear on both sides. What is not obvious is that one position does not negate the other. There is a right balance to be found between the two. Here's how we balance as I see it: we don't dare make policy that wrecks the market so we keep the bounty -and- we don't dare leave people to suffer and die when we have all this bounty. BOTH! Not one at the expense of the other. Cautious, tuned, scientific, numbers based, avoid failures from history, and give ourselves grace that we're doing our best and we'll never reach Utopia. > Poor people get crap healthcare while rich people get great healthcare The world is not static. Today's crap healthcare and over the counter meds are impossible, miraculous health care if you compare with what people experienced historically. Caesar lived less healthfully than the American lower class. How can we get more good stuff into more people's hands more efficiently? MRI's won't ever be as cheap as paper clips, but in twenty years TCFT hand scanner technology will make MRI's a blip in history and you will even be able to buy a consumer-grade scanner for a few hundred bucks at Walgreen's. Ok, I made that up, but hopefully you get the point that greater things are coming than the things we have now.

foldr 7y ago

A market system means that you get what you pay for. Poor people get crap healthcare while rich people get great healthcare - for as long as their money lasts. Unless you think that MRIs are going to become as cheap as paperclips, there's no market mechanism that will level the playing field in that respect. You may respond that poor people would still be covered by Medicare. But your skepticism of the efficiency of the government should extend to its ability to reliably identify the people who need assistance. And if you are ok with the government paying for some people's healthcare, it seems to me that you've given up the main principle. Why not just have a public option open to anyone, and let "the market" compete with that? If the government is as useless as you say, insurance companies should have nothing to fear. The problem with student loans in the US is arguably a lack of government regulation. In the UK, for example, there are very strict regulations on interest rates and the repayment schedule. Although student loan debt is still a drag on the younger generation, it doesn't bankrupt anyone.

foldr 7y ago
s/medicare/medicaid
EdSharkey 7y ago
> you've given up the main principle If you are still looking for inconsistencies in my position, then you haven't yet accepted that I want to find compromise solutions. I am ok with not getting everything I want. We're all walking inconsistencies anyway. That said, you are right to call me out on that and student loans because I slipped into talking points mode, which was a futile attempt at one-upsmanship. I'm never going to convince you my opinion is the right one, and vice-versa. All that matters is we both have an accurate understanding of the other's worldview so we can discover where the give and take can happen. > Why not just have a public option open to anyone, and let "the market" compete with that? My answer is just another weak talking point regarding US states that have tried that and failed. The private market in those states predictably collapsed because employers took the opportunity to dump employees onto the state run plan. Which was, of course, the goal and no one is fooled. The story ends sadly however, the state tax base couldn't support everyone dumped on the public option and virtually no one remained on the private plans to subsidize the public ones. So, the public options got scrapped. States can't run a debt like the Federal government can, so their plans have to square financially or the whole apple cart gets upturned. There's the harsh reality for ya! <mic drop> And that was the most pathetic, cherry picked story with zero details that didn't include counter-stats about the thousands of mothers and children getting health care for the first time in those states, etc etc. You sank my battleship! Did I just change your mind about single payer? Of course not, and that's fine by me. I just hope you are softening to the idea that someone who disagrees with you is not automatically an ogre, and can be well-meaning. There is far too much distrust driving factions in our society, when it is easy to find so much common ground if we just talk. My position is: the market left to do its thing produces goods/services that are cheap and plentiful. Yours is, I think: the market has no soul and there is corporate greed/corruption and the market will always have losers, so we need to intercede and level the playing field for people. Please correct me if I got you wrong. See, we both have solid points that the other must certainly agree with - the evidence is clear on both sides. What is not obvious is that one position does not negate the other. There is a right balance to be found between the two. Here's how we balance as I see it: we don't dare make policy that wrecks the market so we keep the bounty -and- we don't dare leave people to suffer and die when we have all this bounty. BOTH! Not one at the expense of the other. Cautious, tuned, scientific, numbers based, avoid failures from history, and give ourselves grace that we're doing our best and we'll never reach Utopia. > Poor people get crap healthcare while rich people get great healthcare The world is not static. Today's crap healthcare and over the counter meds are impossible, miraculous health care if you compare with what people experienced historically. Caesar lived less healthfully than the American lower class. How can we get more good stuff into more people's hands more efficiently? MRI's won't ever be as cheap as paper clips, but in twenty years TCFT hand scanner technology will make MRI's a blip in history and you will even be able to buy a consumer-grade scanner for a few hundred bucks at Walgreen's. Ok, I made that up, but hopefully you get the point that greater things are coming than the things we have now.