7 ms·

No. Of course not. We have one person here per capita, just like the UK. If anything we'd get more economies of scale. But it would be socialism, and theref

by Vivtek 13y ago

No. Of course not. We have one person here per capita, just like the UK. If anything we'd get more economies of scale. But it would be socialism, and therefore inherently antithetical to the desires of every right-thinking American.

protomyth 13y ago
Since we cannot even fund IHS for a full year at a time with significantly less people than the entire US population, I think you might want to look at what the actual funding versus cost would be. http://richheape.com/american-indian-healthcare.htm http://richheape.com/american-indian-healthcare.htm
- knowtheory 13y ago
  Seems like a non-sequitur? The problem with the way that Native Americans are treated in the US is a lack of political will and the totally fucked power dynamic between the political institutions that have (or have not really) developed in the shadow of Western dominance of the continent. Canada has universal healthcare and health outcomes for the First Nations are poorer there too. It's really not an apples to apples comparison, since there's so much other fraught bullshit involved.
  - protomyth 13y ago
    So, who exactly is going to protect the small business owner or the poor soul who now has to work two jobs each under 20 hours? The point stands, if we in the USA cannot get it right for IHS or VA, then we won't get it right for the majority. If you cannot do the little things, don't expect to do the big things. The act (which I am sure the author has not read) has already cost people insurance and failed at reducing costs for everyone else. It cut medicare money (read the act), and reduced the effectiveness of the non-employer health saving funds. We are more dependent on employers, not less. It bungled the wording of the exchanges to screw up the tax benefits (perhaps public review would have helped this point). I await the report that the fraud prevention in the act hasn't resulted in the required savings.
    - knowtheory 13y ago
      Uh? Maybe you didn't read what i said? The IHS nor the VA are representative of the US population, nor are the politics around Indian or veteran affairs representative of how politicians deal w/ the general public. Nor is there necessarily a connection between small and large projects. What's the political will to get these small things done? What are the consequences when they fuck up? Does it threaten a politician's chances at getting reelected? Is it likely to hurt industry's bottom line? Is it going to generate a significant amount of negative press? Small projects are not necessarily representative of the governments ability to get things done, and the IHS as i've pointed out is definitely not representative for a whole pile of reasons. I also don't get why people are so concerned that it cut medicare money. Isn't the point to reduce how much medicare costs?
      - protomyth 13y ago
        Yes, I read what you wrote and disagree with it. I have seen no evidence that the USA can execute on massive projects when it has shown no ability to do it in pilot programs. If the VA and IHS don't represent the pilots for this bill then what does? That is one reason there is a fair history in the USA of pilot programs. In the US, small projects are fair predictor of larger success because of a pilot first culture. No, the cut in Medicare is justified by the saving from fraud detection. Perhaps you are thinking Medicaid?
        knowtheory 13y ago
        That is a different argument from your initial assertion. The IHS's failure is not an indication that the us government can't execute on healthcare. Additionally there are plenty of regulatory agencies in the US that do a phenomenal job at what they do even in the face of dire circumstances, the FDIC being a really good example. Literally hundreds of banks went out of business between 2008 and 2010 (see: http://www.fdic.gov/bank/individual/failed/banklist.html http://www.fdic.gov/bank/individual/failed/banklist.html ), and the FDIC unrolled those institutions, found other banks to take over depositor accounts, without any substantial problems. The government can and does work, even if it doesn't always. The question is how can we ensure that government's interface with the healthcare system is one of the systems that does work.
laumars 13y ago
I really don't get this attitude some Americans have that any kind of public service designed to make the lives of your less fortunate peers just that little bit easier is some how a bad thing. It's as if 70 years of brainwashing that all "commies" are evil has irreparably warped their brains and now any piece of legislation that doesn't propose proverbially kicking struggling families in the "nuts" is seen as socialism and, by extension, wrong. Capitalism is all well and good so long as peoples lives are not put in danger; and I'm not talking about luxuries here, I'm talking about whether people live or die. But what we have happening instead is a closed market dominated by a small number of monopolistic drug companies who abuse patent systems and extort their customers just because they can. Surely at some point, even the right-wings have to appreciate that neither closed markets nor putting peoples lives put in danger because of the greed of the few is neither in the spirit of capitalism nor the Christian thing to do (and I only reference the last part because of the emphasis that many right-wings place on religion).
- TheCowboy 13y ago
  One 'good' thing about the Cold War was that it 'put the fear of Communism' in the heart of every Commie-fearing capitalist. We had a moral obligation to be seen as and actually provide a better life than that experienced by those behind the Iron Curtain. We had to pay attention to the negative aspects of market-based economics and at least attempt to mitigate these problems. It also showed people what 'real' communism looked like. It's big joke that people think we're measurably closer to anything resembling socialism. The idea that capitalism itself is a moral end to achieve in and of itself, regardless of the reality, seems to have taken root. People who are left worse off are dismissed as stupid and lazy. As someone with an economics background I'm strongly in favor of markets and capitalism, but it's worrying when people forget that the strength of this way is based upon the health of the economic institutions that enable it to function.
  - sageikosa 13y ago
    > it's worrying when people forget that the strength of this way is based upon the health of the economic institutions that enable it to function. ...which would be markets, correct? There is no free market for welfare.
glenra 13y ago
> If anything we'd get more economies of scale. No, because there are also diseconomies of scale. Some services are best provided by smaller-scale organizations than an entire nation, much less one the size of the US. It is perfectly plausible that a service that worked well for the UK might not work at the scale of the US. Making an organization bigger means adding more layers of bureaucracy, which puts the ultimate decision makers farther away from the problems they are trying to solve. It also creates more room for resources to be absorbed by political infighting within the organization.
- cecilpl 13y ago
  Which is why here in Canada the health care is provided by a province-level organization, which is partially funded by the federal government.
- deleted 13y ago
  [deleted]
- auctiontheory 13y ago
  Then maybe the organization shouldn't be national. The law does need to be national, or Texas and Alabama will send all their sick people to states that provide free care, much as Nevada now buses out its mentally ill.

by Vivtek 13y ago

protomyth 13y ago

Since we cannot even fund IHS for a full year at a time with significantly less people than the entire US population, I think you might want to look at what the actual funding versus cost would be. http://richheape.com/american-indian-healthcare.htm http://richheape.com/american-indian-healthcare.htm

knowtheory 13y ago
Seems like a non-sequitur? The problem with the way that Native Americans are treated in the US is a lack of political will and the totally fucked power dynamic between the political institutions that have (or have not really) developed in the shadow of Western dominance of the continent. Canada has universal healthcare and health outcomes for the First Nations are poorer there too. It's really not an apples to apples comparison, since there's so much other fraught bullshit involved.
- protomyth 13y ago
  So, who exactly is going to protect the small business owner or the poor soul who now has to work two jobs each under 20 hours? The point stands, if we in the USA cannot get it right for IHS or VA, then we won't get it right for the majority. If you cannot do the little things, don't expect to do the big things. The act (which I am sure the author has not read) has already cost people insurance and failed at reducing costs for everyone else. It cut medicare money (read the act), and reduced the effectiveness of the non-employer health saving funds. We are more dependent on employers, not less. It bungled the wording of the exchanges to screw up the tax benefits (perhaps public review would have helped this point). I await the report that the fraud prevention in the act hasn't resulted in the required savings.
  - knowtheory 13y ago
    Uh? Maybe you didn't read what i said? The IHS nor the VA are representative of the US population, nor are the politics around Indian or veteran affairs representative of how politicians deal w/ the general public. Nor is there necessarily a connection between small and large projects. What's the political will to get these small things done? What are the consequences when they fuck up? Does it threaten a politician's chances at getting reelected? Is it likely to hurt industry's bottom line? Is it going to generate a significant amount of negative press? Small projects are not necessarily representative of the governments ability to get things done, and the IHS as i've pointed out is definitely not representative for a whole pile of reasons. I also don't get why people are so concerned that it cut medicare money. Isn't the point to reduce how much medicare costs?
    - protomyth 13y ago
      Yes, I read what you wrote and disagree with it. I have seen no evidence that the USA can execute on massive projects when it has shown no ability to do it in pilot programs. If the VA and IHS don't represent the pilots for this bill then what does? That is one reason there is a fair history in the USA of pilot programs. In the US, small projects are fair predictor of larger success because of a pilot first culture. No, the cut in Medicare is justified by the saving from fraud detection. Perhaps you are thinking Medicaid?
      - knowtheory 13y ago
        That is a different argument from your initial assertion. The IHS's failure is not an indication that the us government can't execute on healthcare. Additionally there are plenty of regulatory agencies in the US that do a phenomenal job at what they do even in the face of dire circumstances, the FDIC being a really good example. Literally hundreds of banks went out of business between 2008 and 2010 (see: http://www.fdic.gov/bank/individual/failed/banklist.html http://www.fdic.gov/bank/individual/failed/banklist.html ), and the FDIC unrolled those institutions, found other banks to take over depositor accounts, without any substantial problems. The government can and does work, even if it doesn't always. The question is how can we ensure that government's interface with the healthcare system is one of the systems that does work.

laumars 13y ago

I really don't get this attitude some Americans have that any kind of public service designed to make the lives of your less fortunate peers just that little bit easier is some how a bad thing. It's as if 70 years of brainwashing that all "commies" are evil has irreparably warped their brains and now any piece of legislation that doesn't propose proverbially kicking struggling families in the "nuts" is seen as socialism and, by extension, wrong. Capitalism is all well and good so long as peoples lives are not put in danger; and I'm not talking about luxuries here, I'm talking about whether people live or die. But what we have happening instead is a closed market dominated by a small number of monopolistic drug companies who abuse patent systems and extort their customers just because they can. Surely at some point, even the right-wings have to appreciate that neither closed markets nor putting peoples lives put in danger because of the greed of the few is neither in the spirit of capitalism nor the Christian thing to do (and I only reference the last part because of the emphasis that many right-wings place on religion).

TheCowboy 13y ago
One 'good' thing about the Cold War was that it 'put the fear of Communism' in the heart of every Commie-fearing capitalist. We had a moral obligation to be seen as and actually provide a better life than that experienced by those behind the Iron Curtain. We had to pay attention to the negative aspects of market-based economics and at least attempt to mitigate these problems. It also showed people what 'real' communism looked like. It's big joke that people think we're measurably closer to anything resembling socialism. The idea that capitalism itself is a moral end to achieve in and of itself, regardless of the reality, seems to have taken root. People who are left worse off are dismissed as stupid and lazy. As someone with an economics background I'm strongly in favor of markets and capitalism, but it's worrying when people forget that the strength of this way is based upon the health of the economic institutions that enable it to function.
- sageikosa 13y ago
  > it's worrying when people forget that the strength of this way is based upon the health of the economic institutions that enable it to function. ...which would be markets, correct? There is no free market for welfare.

glenra 13y ago

> If anything we'd get more economies of scale. No, because there are also diseconomies of scale. Some services are best provided by smaller-scale organizations than an entire nation, much less one the size of the US. It is perfectly plausible that a service that worked well for the UK might not work at the scale of the US. Making an organization bigger means adding more layers of bureaucracy, which puts the ultimate decision makers farther away from the problems they are trying to solve. It also creates more room for resources to be absorbed by political infighting within the organization.

cecilpl 13y ago
Which is why here in Canada the health care is provided by a province-level organization, which is partially funded by the federal government.
deleted 13y ago
[deleted]
auctiontheory 13y ago
Then maybe the organization shouldn't be national. The law does need to be national, or Texas and Alabama will send all their sick people to states that provide free care, much as Nevada now buses out its mentally ill.