7 ms·

He says he is a democrat, but a reasonable interpretation of the article points towards the republican solution of taxing health care benefits. The problem is

He says he is a democrat, but a reasonable interpretation of the article points towards the republican solution of taxing health care benefits. The problem is that both the industry and consumers are very insulated from price sensitivity, so costs shoot out of control and providers have little incentive to improve quality. People need to be paying for far more of their care out of pocket with cash. We need price wars between hospitals.

run4yourlives 17y ago
Why is it that you Americans are so two dimensional? Every possible idea for social reform must either be the republican or democrat position. If it can't be pigeon-holed into one of those viewpoints, it's not worth discussion. If it can, it quickly devolves into some form of partisan debate. Your two party system is killing you in every area, and you don't even know it.
- pixcavator 17y ago
  Do you mean "one dimensional"?
  - run4yourlives 17y ago
    hehe, yes I suppose. I was thinking two dimensional with the understanding that the number of dimensions to an argument (dimension == viewpoint) was infinite. The argument itself though is very one dimensional. :)
- kingkongrevenge 17y ago
  > social reform must either be the republican or democrat position Uhh, no. It just so happens that in this case some Republicans are the only people putting forward the idea of taxing medical benefits as ordinary income, to reduce the role of insurance in the system. I don't even vote, let alone think in terms of democrat vs republican.
- grandalf 17y ago
  I'm an American and I think the one dimensional political spectrum idea is nonsense. I have also never voted for a mainstream party.
- Xichekolas 17y ago
  Yeah, I don't understand why people accept/reject an argument based on which political party supports it, and why one party has to define itself in opposition to the other on every topic. Shouldn't we be looking for good solutions? Not just good solutions endorsed by our party of choice, but overall good solutions...
mrkurt 17y ago
A market based fix for health care isn't really a "Republican solution". If, for instance, we had an "everyone pays for their own care out of pocket" system, and we had state or federal subsidies for those that couldn't afford their care, we'd have a market backed by government aid. Like food stamps.
- philwelch 17y ago
  Or school vouchers (wait--that's another "Republican solution").
  - davidw 17y ago
    School vouchers to promote competition in schools is, IMO, a "libertarian solution", and one worth thinking about. School vouchers to get kids out of studying evolution and into bible classes is a much murkier idea, but one that I fear is the reason behind a significant portion of Republican backers of similar initiatives.
    - likpok 17y ago
      Which is of course the big problem with school vouchers. Much of the initial usage would be to subsidize religious education (since almost all private schools are religious here).
      - Dove 17y ago
        So long as the kids learn their three Rs, why is it anyone's business but theirs and their parents' what else they learn? Or how they get it done? Seems to me designing laws allowing some to discourage access to theological/scientific/ideological education that others may desire is the unjust approach.
        Dove 17y ago
        To expand: The goal of the establishment clause, of freedom of assembly, speech, and press, is to protect individual ideological freedom from government interference, is it not? What danger is there to religious or ideological liberty in allowing vouchers to be used at Catholic schools or Muslim schools or schools with Young Democrats cirriculum or schools with an atheist/skeptic focus? That the government would appear to be funding religious or ideological education? It is a danger to appearances only. The government is not paying more for the extra lessons, and the parents have freely chosen the school. What danger is there to religious or ideological liberty in requiring--through legal or economic means--that children be educated in a school with only politically approved cirriculum? Two dangers: that the unconscious political or religious mores of a powerful majority will find their way into the approved cirriculum and that it fundamentally denies anyone with a minority view the ability to educate their children within their traditions. It seems to me that the second case is far more destructive to our goal. The idea that we would like to economically prevent most Muslims from educating their children as Muslims ought to be repulsive to a society theoretically committed to religious freedom. Nor is there safety in sticking to a 'neutral' cirriculum; poli sci and civics have to be taught, American History has to be taught, and science has to deal with the evolution/intelligent design thing at some point. Defining neutrality on popularly divisive topics isn't easy -- and supposing the group that agrees with you will retain political control in the long run is foolishly optimistic. There is the danger--nay, the certainty--that parents given the freedom to educate their children according to their whims will teach them destructive and false ideas. But this is simply an instance of the highest cost of maintaining a free society: tolerating certain evils because the associated liberty is worth it. It is not the job of the government to serve as a dogmatic gatekeeper, rather it is the job of free citizens to persuade one another in the public forums. It is my opinion that allowing parents to educate their children any how or way they please, without bias for or against any institution except on the basis of its meeting a minimal functional standard, poses no danger to personal liberty and is in fact a great boon.
nradov 17y ago
People need to be paying far less for preventative care out of pocket. When they have to pay for preventative care, a lot of them (especially low income) just skip it. And then small problems turn into big, expensive problems. We want diabetics to come in for periodic foot exams so they don't have to get their feet amputated later.
- hnal943 17y ago
  ...and under what circumstances do people pay increasingly less for an increasingly improved product? The free market! I agree that there needs to be more direct competition for health care dollars.
- anamax 17y ago
  > People need to be paying far less for preventative care out of pocket. When they have to pay for preventative care, a lot of them (especially low income) just skip it. We've posted the links repeatedly - preventative care improves quality of life but doesn't reduce cost. And, pre-natal care is FREE in the US, yet many poor folks don't bother. In other words, both assumptions for your argument are false.
  - sho 17y ago
    "preventative care improves quality of life but doesn't reduce cost" That strikes me as a very questionable assertion. Health problems always get worse with time, becoming more complex and expensive to fix the longer you leave them. How could prevention possibly not reduce costs?
    - kingkongrevenge 17y ago
      Because preventive medical intervention and testing doesn't work. Lifestyle changes work, but getting a bunch of fat cola guzzlers into doctors' offices more often has no impact on the care they will later require.
    - anamax 17y ago
      > That strikes me as a very questionable assertion. Health problems always get worse with time, becoming more complex and expensive to fix the longer you leave them. How could prevention possibly not reduce costs? (1) Folks who live longer consume more medical resources, not less. (Dying is always expensive but living also has costs, so shorter lived people cost less.) (2) Preventative care doesn't always work. In fact, it usually doesn't. If it's cheap enough, that can be okay, but if it isn't.... (3) Saving someone from one or even a couple of causes of death is rarely enough. (That's why it often makes sense to ignore prostate cancer. Yes, it may get worse if left untreated, but old men die of lots of things.) The numbers always matter. Health care is hellishly complicated.
anigbrowl 17y ago
Oh yeah, when I'm sick I really want my care to wait on the outcome of a bidding war between hospitals. How about a reverse eBay, where I post my life-threatening condition and hospitals bid on it in a dutch auction until the price gets low enough for my insurance company to click 'buy it now'. And if nobody bids, I just pay the auction listing fee, and die relatively economically. I mean, what could go wrong! OK, I am not being entirely serious here. but I think market solutions don't work that well when it comes to healthcare because patients can neither be fully informed consumers (without a medical degree) nor can they exercise a free choice about when they plan to fall ill. Consider: having your house burn down is also a bit unpredictable, so you buy insurance for that. And indeed, the costs of a home fire can run into the hundreds of thousands, not incomparable to the cost of health problems. And yet, fire insurance is way, way cheaper than health insurance. Why? Hint: it's not due to competing fire departments. We used to have those, but we got rid of them for a reason.
- aardvarkious 17y ago
  EVERYBODY will have health problems and use their health insurance. Very few people will have their house burn down and use their fire insurance. Therefore, there is a massive difference in price.
  - anigbrowl 17y ago
    Yes, but most people's health problems are not as severe as to cost hundreds of thousands of dollars. Your argument assumes everyone will become so ill as to require massively expensive treatment at some point, but they don't. My point, though, is that multiple competing private health care providers create administrative overhead without delivering the benefits of competition because sick people are a captive market, and thus normal market forces are unable to operate properly. If you look into the history of private fire companies you'll see problems which are echoed in today's health care system.
  - Xichekolas 17y ago
    That is because everybody uses health insurance for things that really shouldn't be insured. My Dad was recently complaining that his prescription coverage was cut, so he was now paying about $100/mo for his prescriptions. I asked how much the pills would cost with no coverage, and he dug out the bills and determined they would cost about $600/mo. This sounds outrageous I suppose, until you realize that he pays about $1100/mo for insurance. Granted, that is for more than just drugs, but if insurance was really for unaffordable things, it wouldn't cost that much. My dad is still paying for his monthly prescriptions... just in a roundabout way. Anecdotes aside, the article points this out too. Would you expect your fire insurance to cover the cost of batteries for a smoke detector? Of course not. But if it did, the batteries would most likely cost more, since instead of having to sell to millions of battery buyers in Wal-mart, battery makers would be selling to mere dozens of fire insurance companies, who would pass on the costs to those buying the insurance, and hence have no incentive to control battery costs. Even worse, the administrative costs of having people constantly file battery-replacement claims would dwarf the cost of the battery itself. So people would suddenly be paying $25 more a month to avoid buying $2 worth of batteries. Sounds absurd I'm sure, but that is exactly how our comprehensive health insurance works today. If people actually used health insurance for things that are equivalent to a house burning down, it would function more like other insurance, and get cheaper. I'm 26, and my most expensive health expense to date was my birth. The next closest thing was probably when I had my adenoids out when I was 7. After that, when I broke my big toe ($900). None of those are akin to having a house burn down or getting in a car wreck. The first two were predictable and all three could be payable with credit or HSAs. It makes no sense to pay thousands of dollars a month so you can go to the doctor for free when it would only cost $150 anyway.

run4yourlives 17y ago

Why is it that you Americans are so two dimensional? Every possible idea for social reform must either be the republican or democrat position. If it can't be pigeon-holed into one of those viewpoints, it's not worth discussion. If it can, it quickly devolves into some form of partisan debate. Your two party system is killing you in every area, and you don't even know it.

pixcavator 17y ago
Do you mean "one dimensional"?
- run4yourlives 17y ago
  hehe, yes I suppose. I was thinking two dimensional with the understanding that the number of dimensions to an argument (dimension == viewpoint) was infinite. The argument itself though is very one dimensional. :)
kingkongrevenge 17y ago
> social reform must either be the republican or democrat position Uhh, no. It just so happens that in this case some Republicans are the only people putting forward the idea of taxing medical benefits as ordinary income, to reduce the role of insurance in the system. I don't even vote, let alone think in terms of democrat vs republican.
grandalf 17y ago
I'm an American and I think the one dimensional political spectrum idea is nonsense. I have also never voted for a mainstream party.
Xichekolas 17y ago
Yeah, I don't understand why people accept/reject an argument based on which political party supports it, and why one party has to define itself in opposition to the other on every topic. Shouldn't we be looking for good solutions? Not just good solutions endorsed by our party of choice, but overall good solutions...

mrkurt 17y ago

A market based fix for health care isn't really a "Republican solution". If, for instance, we had an "everyone pays for their own care out of pocket" system, and we had state or federal subsidies for those that couldn't afford their care, we'd have a market backed by government aid. Like food stamps.

philwelch 17y ago
Or school vouchers (wait--that's another "Republican solution").
- davidw 17y ago
  School vouchers to promote competition in schools is, IMO, a "libertarian solution", and one worth thinking about. School vouchers to get kids out of studying evolution and into bible classes is a much murkier idea, but one that I fear is the reason behind a significant portion of Republican backers of similar initiatives.
  - likpok 17y ago
    Which is of course the big problem with school vouchers. Much of the initial usage would be to subsidize religious education (since almost all private schools are religious here).
    - Dove 17y ago
      So long as the kids learn their three Rs, why is it anyone's business but theirs and their parents' what else they learn? Or how they get it done? Seems to me designing laws allowing some to discourage access to theological/scientific/ideological education that others may desire is the unjust approach.
      - Dove 17y ago
        To expand: The goal of the establishment clause, of freedom of assembly, speech, and press, is to protect individual ideological freedom from government interference, is it not? What danger is there to religious or ideological liberty in allowing vouchers to be used at Catholic schools or Muslim schools or schools with Young Democrats cirriculum or schools with an atheist/skeptic focus? That the government would appear to be funding religious or ideological education? It is a danger to appearances only. The government is not paying more for the extra lessons, and the parents have freely chosen the school. What danger is there to religious or ideological liberty in requiring--through legal or economic means--that children be educated in a school with only politically approved cirriculum? Two dangers: that the unconscious political or religious mores of a powerful majority will find their way into the approved cirriculum and that it fundamentally denies anyone with a minority view the ability to educate their children within their traditions. It seems to me that the second case is far more destructive to our goal. The idea that we would like to economically prevent most Muslims from educating their children as Muslims ought to be repulsive to a society theoretically committed to religious freedom. Nor is there safety in sticking to a 'neutral' cirriculum; poli sci and civics have to be taught, American History has to be taught, and science has to deal with the evolution/intelligent design thing at some point. Defining neutrality on popularly divisive topics isn't easy -- and supposing the group that agrees with you will retain political control in the long run is foolishly optimistic. There is the danger--nay, the certainty--that parents given the freedom to educate their children according to their whims will teach them destructive and false ideas. But this is simply an instance of the highest cost of maintaining a free society: tolerating certain evils because the associated liberty is worth it. It is not the job of the government to serve as a dogmatic gatekeeper, rather it is the job of free citizens to persuade one another in the public forums. It is my opinion that allowing parents to educate their children any how or way they please, without bias for or against any institution except on the basis of its meeting a minimal functional standard, poses no danger to personal liberty and is in fact a great boon.

nradov 17y ago

People need to be paying far less for preventative care out of pocket. When they have to pay for preventative care, a lot of them (especially low income) just skip it. And then small problems turn into big, expensive problems. We want diabetics to come in for periodic foot exams so they don't have to get their feet amputated later.

hnal943 17y ago
...and under what circumstances do people pay increasingly less for an increasingly improved product? The free market! I agree that there needs to be more direct competition for health care dollars.
anamax 17y ago
> People need to be paying far less for preventative care out of pocket. When they have to pay for preventative care, a lot of them (especially low income) just skip it. We've posted the links repeatedly - preventative care improves quality of life but doesn't reduce cost. And, pre-natal care is FREE in the US, yet many poor folks don't bother. In other words, both assumptions for your argument are false.
- sho 17y ago
  "preventative care improves quality of life but doesn't reduce cost" That strikes me as a very questionable assertion. Health problems always get worse with time, becoming more complex and expensive to fix the longer you leave them. How could prevention possibly not reduce costs?
  - kingkongrevenge 17y ago
    Because preventive medical intervention and testing doesn't work. Lifestyle changes work, but getting a bunch of fat cola guzzlers into doctors' offices more often has no impact on the care they will later require.
  - anamax 17y ago
    > That strikes me as a very questionable assertion. Health problems always get worse with time, becoming more complex and expensive to fix the longer you leave them. How could prevention possibly not reduce costs? (1) Folks who live longer consume more medical resources, not less. (Dying is always expensive but living also has costs, so shorter lived people cost less.) (2) Preventative care doesn't always work. In fact, it usually doesn't. If it's cheap enough, that can be okay, but if it isn't.... (3) Saving someone from one or even a couple of causes of death is rarely enough. (That's why it often makes sense to ignore prostate cancer. Yes, it may get worse if left untreated, but old men die of lots of things.) The numbers always matter. Health care is hellishly complicated.

anigbrowl 17y ago

Oh yeah, when I'm sick I really want my care to wait on the outcome of a bidding war between hospitals. How about a reverse eBay, where I post my life-threatening condition and hospitals bid on it in a dutch auction until the price gets low enough for my insurance company to click 'buy it now'. And if nobody bids, I just pay the auction listing fee, and die relatively economically. I mean, what could go wrong! OK, I am not being entirely serious here. but I think market solutions don't work that well when it comes to healthcare because patients can neither be fully informed consumers (without a medical degree) nor can they exercise a free choice about when they plan to fall ill. Consider: having your house burn down is also a bit unpredictable, so you buy insurance for that. And indeed, the costs of a home fire can run into the hundreds of thousands, not incomparable to the cost of health problems. And yet, fire insurance is way, way cheaper than health insurance. Why? Hint: it's not due to competing fire departments. We used to have those, but we got rid of them for a reason.

aardvarkious 17y ago
EVERYBODY will have health problems and use their health insurance. Very few people will have their house burn down and use their fire insurance. Therefore, there is a massive difference in price.
- anigbrowl 17y ago
  Yes, but most people's health problems are not as severe as to cost hundreds of thousands of dollars. Your argument assumes everyone will become so ill as to require massively expensive treatment at some point, but they don't. My point, though, is that multiple competing private health care providers create administrative overhead without delivering the benefits of competition because sick people are a captive market, and thus normal market forces are unable to operate properly. If you look into the history of private fire companies you'll see problems which are echoed in today's health care system.
- Xichekolas 17y ago
  That is because everybody uses health insurance for things that really shouldn't be insured. My Dad was recently complaining that his prescription coverage was cut, so he was now paying about $100/mo for his prescriptions. I asked how much the pills would cost with no coverage, and he dug out the bills and determined they would cost about $600/mo. This sounds outrageous I suppose, until you realize that he pays about $1100/mo for insurance. Granted, that is for more than just drugs, but if insurance was really for unaffordable things, it wouldn't cost that much. My dad is still paying for his monthly prescriptions... just in a roundabout way. Anecdotes aside, the article points this out too. Would you expect your fire insurance to cover the cost of batteries for a smoke detector? Of course not. But if it did, the batteries would most likely cost more, since instead of having to sell to millions of battery buyers in Wal-mart, battery makers would be selling to mere dozens of fire insurance companies, who would pass on the costs to those buying the insurance, and hence have no incentive to control battery costs. Even worse, the administrative costs of having people constantly file battery-replacement claims would dwarf the cost of the battery itself. So people would suddenly be paying $25 more a month to avoid buying $2 worth of batteries. Sounds absurd I'm sure, but that is exactly how our comprehensive health insurance works today. If people actually used health insurance for things that are equivalent to a house burning down, it would function more like other insurance, and get cheaper. I'm 26, and my most expensive health expense to date was my birth. The next closest thing was probably when I had my adenoids out when I was 7. After that, when I broke my big toe ($900). None of those are akin to having a house burn down or getting in a car wreck. The first two were predictable and all three could be payable with credit or HSAs. It makes no sense to pay thousands of dollars a month so you can go to the doctor for free when it would only cost $150 anyway.