The uninsured are uninsured, regardless of whether they could be insured. For example, I have enough money to buy flood insurance. That doesn't magically make me insured if I happen to lose property to rushing waters. None of those 47 million has a plan that covers preventive care.

9/17/2008 12:16:31 AM

and 50% of them don't care enough to do anything about it. If they don't care, then why the fuck should I? Then, another 10 or 12 million are illegal immigrants, who, well, let's face it, have no business getting anything off the public dime.

And, again, if we reigned in the cost of healthcare that is rising due to government meddling, then maybe, just maybe, they wouldn't need insurance anyway, now would they?

9/17/2008 12:29:08 AM

Quote :

"and 50% of them don't care enough to do anything about it."

Conjecture. They might not care, they might not know, they might have different ideas about their ability to afford insurance from folks doing the studies.

Quote :

"Then, another 10 or 12 million are illegal immigrants, who, well, let's face it, have no business getting anything off the public dime."

Many pay taxes like anybody else.

Quote :

"And, again, if we reigned in the cost of healthcare that is rising due to government meddling, then maybe, just maybe, they wouldn't need insurance anyway, now would they?"

How about we open up the market to foreign professionals?

9/17/2008 1:07:10 AM

if those foreign professionals are truly qualified and can get certified, then sure, assuming that no other Americans are qualified. Of course, that would require the gov't to stop limiting the number of doctors in the first place *cough*meddling*cough*.

9/17/2008 1:16:14 AM

Quote :

"if those foreign professionals are truly qualified and can get certified, then sure, assuming that no other Americans are qualified."

That, my friend, is protectionism.

9/17/2008 1:22:47 AM

your point being? Why import in labour if it isn't necessary?

9/17/2008 1:24:46 AM

Because foreign professionals would work for less, thus lowering prices. This would benefit all consumers. Such savings are the supposed point of free trade.

9/17/2008 2:18:22 PM

can we please embrace some Darwinism here and say fuck'em.

There's to many people on the planet as it is.

Seriously though, lack of health insurance personal problem, no matter how many people have it. You want health insurance, get a job that offers it. There a plenty of hard, shit, awful jobs out there that come with okay enough health coverage. And most of them are always hiring, why, because the jobs suck.

9/17/2008 5:45:02 PM

Quote :

"Conjecture. They might not care, they might not know, they might have different ideas about their ability to afford insurance from folks doing the studies."

Regardless, failure to evaluate their situation and properly prioritize their expenditures does not make for a national crisis that only Uncle Sam can solve by making everyone else pay for it.

If they don't care, then it doesn't matter if they have insurance or not, they clearly don't view the risk as worth insuring against.

If they don't know, they're not looking hard enough and therefore probably don't care. I know that there are myriads of options and it can be confusing, but access to information is hardly a problem in this day an age.

And if they have different opinions about their ability to afford, it's a matter of prioritizing your costs, if you view X as more important than health insurance, then it's a choice you are making.

Again, what would be nice to have is a real number of how many people really and truly can't afford health care.

9/17/2008 9:32:23 PM

Quote :

"If they don't care, then it doesn't matter if they have insurance or not, they clearly don't view the risk as worth insuring against."

Which can turn out badly when they get injured or become sick.

Quote :

"I know that there are myriads of options and it can be confusing, but access to information is hardly a problem in this day an age."

It confuses the hell out of me and I'm college-educated. If eligible people aren't enrolling in Medicaid, something's probably wrong.

Quote :

"Again, what would be nice to have is a real number of how many people really and truly can't afford health care."

Based on the data, around twenty-three million.

9/17/2008 10:02:11 PM

Quote :

"Which can turn out badly when they get injured or become sick. "

Not society's problem. If you have the option to insure yourself against a risk, any risk, it isn't society's responsibility to take care of you if you don't. No one gives a crap if the guy that drives a Ferrari doesn't get comp coverage and hits a light post, so why should we care if you choose not to cover yourself and have to pay for your broken leg out of pocket.

Quote :

"It confuses the hell out of me and I'm college-educated. If eligible people aren't enrolling in Medicaid, something's probably wrong. "

Well yeah. Number one, you have a government program, which by default means it will be confusing, arbitrary and poorly marketed and have horrible costs compared to benefits. But at the same time, you also have people who are not taking advantage of the multiple groups out there who volunteer to assist with this stuff, or even just going to their local social services department as asking some questions.

9/17/2008 10:10:35 PM

Quote :

"Not society's problem."

I disagree completely, as you know. But I doubt we'll get anywhere in that debate.

Quote :

"No one gives a crap if the guy that drives a Ferrari doesn't get comp coverage and hits a light post, so why should we care if you choose not to cover yourself and have to pay for your broken leg out of pocket."

What if you can't pay for it or if the cost reduces you to debt and poverty? Or, as in the classic Sicko case, can't get your fingers reattached because of the price. I feel far more empathy for folks without fingers than I do for dudes without Ferraris.

Quote :

"Number one, you have a government program, which by default means it will be confusing, arbitrary and poorly marketed and have horrible costs compared to benefits."

The single-payer system seems rather straightforward. You need care, you get it.

9/17/2008 10:20:53 PM

Quote :

"You need care, you get it."

And who provides it? The computer people?

9/17/2008 10:26:11 PM

Young doctors with sweet rides, sprawling homes, and beautiful wives.

According to Michael Moore, anyway.

9/17/2008 10:32:01 PM

Quote :

"The single-payer system seems rather straightforward. You need care, you get it."

That is not straightforward at all. Which care? Who decides what you need?

It is the classic anti-sicko case of the Canadian dying on a waiting list or the British women refused surgery to save her eye because she still had a spare.

[Edited on September 17, 2008 at 10:36 PM. Reason : .,.]

9/17/2008 10:35:53 PM

Quote :

"That is not straightforward at all."

From the point of view of a Joe Tofu like me it is. Compared with the nightmare of health insurance and Medicaid, anyway.

Quote :

"It is the classic anti-sicko case of the Canadian dying on a waiting list or the British women refused surgery to save her eye because she still had a spare."

Yeah, I'm sure there are many similar horror stores. But the evidence suggests such systems produce better health results overall.

9/17/2008 10:40:34 PM

Quote :

"What if you can't pay for it or if the cost reduces you to debt and poverty?"

Tough shit, that's what insurance is for. You chose not to get it, you pay the price.

Quote :

"I feel far more empathy for folks without fingers than I do for dudes without Ferraris. "

And I feel far more empathy for people that try to mitigate their losses rather than those that choose to take risks and expect society to pay the costs. Bailouts for any reason is not a business the government should be in.

Incidentally, if you were damaged by someone and they were legally responsible, you still have an obligation to mitigate your damages. For example, if you rent an apartment to someone for a two year lease and they bail on you in 3 months, you can't let the apartment sit empty for two years and sue them for the full value of the lease. You are obligated to attempt to mitigate your damages. I don't see why the same principle shouldn't apply here. You have a responsibility to take care of yourself before anyone else takes care of you.

Quote :

"The single-payer system seems rather straightforward. You need care, you get it."

So why is medicare/medicaid so difficult? Tell you what, you get medicaid to be simple, and then we'll discuss medical care for the rest of the country.

Quote :

"Compared with the nightmare of health insurance and Medicaid, anyway."

I don't know about you, but my insurance is real simple. I go to the doctor, pay my share, and the insurance company pays theirs. Hell I hardly have to think about it.

Quote :

"But the evidence suggests such systems produce better health results overall."

No, the evidence shows two things:

1) Health care spending in such countries is lower overall. This doesn't account for types of procedures paid for, types of treatments needed and other variables. It's real easy to keep your health care expenditures down, if you deny the expensive treatments. Now to be fair, this is only what I've seen from the things I've read. If you have a study that breaks down overall costs by treatment, or ailment, by all means I would love to see it.

2) People in those countries sometimes have higher life expectancies and lower infant mortality rates. This ignores many factors including lifestyle choices that have significant impacts on overall health. The best healthcare money can't buy won't save you if you choose to indulge in a quarter pounder with cheese every hour, or if you decide to get yourself mixed up in a gang and get your dumb ass shot.

9/17/2008 11:48:39 PM

Quote :

"Tough shit, that's what insurance is for."

I only believe in tough shit for rich folks, and only when it doesn't drop them below the median.

Quote :

"And I feel far more empathy for people that try to mitigate their losses rather than those that choose to take risks and expect society to pay the costs."

You care about incentives, earning, deserving, responsibility, and crap like that. I care more about results and equality.

Quote :

"So why is medicare/medicaid so difficult?"

Because it ain't universal.

9/17/2008 11:59:55 PM

Quote :

"I only believe in tough shit for rich folks, and only when it doesn't drop them below the median. "

Because rich people are much less deserving of the things you claim are basic human rights.

Quote :

"You care about incentives, earning, deserving, responsibility, and crap like that. I care more about results and equality. "

Clearly you don't as your own words not more than a sentence ago indicate. I don't even begin to understand the type of mental gymnastics you need to go through to say on the one hand that you believe in equality and on the other hand declare you believe in different rules depending on who you are.

Quote :

"Because it ain't universal."

Doesn't matter. It should be real simple for the government to make medicare easy for you to get on if you're qualified. Similarly, it should be easy for them to spell out who is qualified. Since they fail at both, for a very limited subset, I don't imagine they will have much success for a larger pool. Besides, even universal care isn't universal, or do you think the public should have paid to keep terri schiavo alive indefinitely?

[Edited on September 18, 2008 at 12:09 AM. Reason : asdfakjsdh]

9/18/2008 12:08:44 AM

Quote :

"Because rich people are much less deserving of the things you claim are basic human rights."

They should have the same access to goods and services as anybody else. In other words, they should cease to be rich. That's the path the equality. I'm not impressed by your argument that you can't treat the rich differently because would be unfair. For me and other radicals, equality means annihilating privilege.

To clarify, I'm interested in equality of results first and foremost. I don't care about deserving. I don't believe in it. To you, I imagine, it would be manifestly unequal for the ball-busting businessman and the lethargic pothead to enjoy identical consumption. I'll settle for nothing less. I hope that explains our different use and understanding of the term.

Quote :

"Since they fail at both, for a very limited subset, I don't imagine they will have much success for a larger pool."

Hey, that's entirely possible. As you know, I'm no fan of the state. On the other hand, various other countries have managed to create at least basically functional systems. Including, I'll note, our neighbor to the north. Unless they screw it up completely, universal coverage should at least benefit those at the bottom of the totem poll.

[Edited on September 18, 2008 at 12:50 AM. Reason : clarification]

9/18/2008 12:45:15 AM

Quote :

"On the other hand, various other countries have managed to create at least basically functional systems."

Too bad you ignored his arguments that address why such comparisons are pointless...

9/18/2008 2:11:18 AM

Quote :

"they should cease to be rich. That's the path the equality."

This scheme ignores the fact that the United States got to where it is today due to individuals seeking wealth. Most employees at Google, for instance, have spent thousands on higher education. If we confiscate their earnings in the name of equality, what message would that send to future students? It unequivocally removes any incentive to invest in human capital. Without a return on investment for further education, droves of future graduate students would opt out of graduate programs, leading to a shrinking, rather than expanding, economic pie for the rest of us (including your beloved poor)

This is the fundamental flaw of striving for equality. You end up with a personal-pan-pizza-sized economic pie with equal slices rather than an extra-large-sized pie where even the smallest slice is larger than largest slice of the small pie.

[Edited on September 18, 2008 at 7:37 AM. Reason : .]

9/18/2008 7:36:39 AM

A few things:

Part of the rising cost of health care is simply the rising cost of health equipment. I'm a little surprised this hasn't been mentioned. That new MRI isn't going to pay for itself, it has to be used. Couple that with the fear of litigation for failing to perform a thorough examination and the fact that the insurance company and not the individual will bear the cost of a questionably necessary scan and you've got part of the driving force behind the rise in unnecessary health care.

Quote :

"As you know, I'm no fan of the state."

Yet you propose to give the state control over our health and, in doing so, authorize the same government to conduct a massive redistribution of wealth from the young to the old? You need to re-examine your anarchist credentials my friend.

9/18/2008 8:11:58 AM

Quote :

"Too bad you ignored his arguments that address why such comparisons are pointless..."

No, regardless of those differences, Europe's socialized systems at least can't be terrible. Unless you think Europeans would have a life expectancy of 90 or something without them. Again, the government would have to fail epically for universal health care to hurt folks on the bottom of the totem pole. (I guess that's possible.)

Quote :

"Without a return on investment for further education, droves of future graduate students would opt out of graduate programs, leading to a shrinking, rather than expanding, economic pie for the rest of us (including your beloved poor)"

As a soon-to-be graduate student who doesn't expect any return on the investment, you'll understand why I'm less moved than I could be by this argument.

Quote :

"You end up with a personal-pan-pizza-sized economic pie with equal slices rather than an extra-large-sized pie where even the smallest slice is larger than largest slice of the small pie."

According to the price system and economics, sure. I consider that one step above superstitious nonsense. Wealth comes from technology, not markets. Incentives and dollars didn't create the computer I'm typing on. Machines did.

Quote :

"You need to re-examine your anarchist credentials my friend."

You may be confusing anarchism (libertarian socialism) with libertarianism. I oppose both the state and capitalism. This gives me remarkable freedom. I don't like the state, but I'd much rather support coercion for the purpose of health care and redistribution than coercion to drop bombs on other countries. Now, if there were a real chance to the country moving in a libertarian direction, I might support that at the expense of redistribution. I don't see that happening. A Canadian- or European-style socialized health care program seems far more likely to me than deregulation.

Of course, many anarchists would accurately say I care too much about these things, and should focus my energy to building alternatives.

9/18/2008 12:51:18 PM

Quote :

"No, regardless of those differences, Europe's socialized systems at least can't be terrible. Unless you think Europeans would have a life expectancy of 90 or something without them."

They don't have to be terrible, just worse than what we have, or the other alternative changes.

Quote :

"Wealth comes from technology, not markets."

Wrong. Wealth comes form the ability to leverage technology to produce things that other people want. Take your machines and computer to africa and see just how wealthy you really are.

Quote :

" Incentives and dollars didn't create the computer I'm typing on. Machines did. "

But incentives and dollars brought together the labor that created, built and ran those machines, as well as the labor that extracted the raw materials from the earth. Incentives and dollars put that labor and materials and machines towards making your computer and not making bear traps or digital watches. And Incentives and dollars are what made those ships and trucks bring your computer to you instead of someone else.

9/18/2008 1:48:02 PM

Quote :

"They don't have to be terrible, just worse than what we have, or the other alternative changes."

Do think measures such a healthy life expectancy would drop or increase more slowly if the US adopted universal health care?

Quote :

"But incentives and dollars brought together the labor that created, built and ran those machines, as well as the labor that extracted the raw materials from the earth."

Yes, they're an organizing tool. I know capitalists like you believe rewards and incentives are the best way. Not without evidence, either, as more capitalist countries fare better than state socialist ones. However, the physiological research questions the desirability of rewards and competition.

9/18/2008 2:14:26 PM

Quote :

"Do think measures such a healthy life expectancy would drop or increase more slowly if the US adopted universal health care?"

I think our life expectancy has much more to do with our lifestyle choices (food, exercise, risk) than the number of people who can't afford chemo so they can live another 6 months. So I think that honestly it would stay the same. How often do you hear stories about poor old Grandma Bessie who died because she couldn't afford her diabeetus supplies from liberty medical? Now how often do you hear about some one's life cut short because they chose to get mixed up in a gang? Or got drunk and uttered the redneck's famous last words? Like I said, the best health care money can provide won't protect you from yourself and your own self destructive habits.

Quote :

"I know capitalists like you believe rewards and incentives are the best way. Not without evidence, either, as more capitalist countries fare better than state socialist ones. However, the physiological research questions the desirability of rewards and competition."

What research?

[Edited on September 18, 2008 at 5:36 PM. Reason : dasflhj]

9/18/2008 5:35:31 PM

^ Alfie Kohn would be the classic source. For example:

http://books.google.com/books?id=bLudHIk3gsMC&pg=PA185&lpg=PA185&dq=harms+of+competition+%2B+intrinsic+motivation&source=web&ots=7FfOWY839n&sig=UCOxmhLmlRCHZDHIIHnRCqslqLg&hl=en&sa=X&oi=book_result&resnum=1&ct=result#PPP1,M1

You can also check on the Anarchist FAQ on the subject:

http://www.geocities.com/CapitolHill/1931/secI4.html#seci411

9/18/2008 6:56:28 PM

That addresses competition, though I'm not convinced.

But what about rewards? Studies of animal psychology show that positive reenforcement (that is, rewards) generates the best results when trying to train an animal or bring out a particular behavior. If I recall, you're one of the people who believes that we're nothing more than machines responding to external inputs in predicable and measurable ways, so why do you think we are significantly different from animals enough to not be effectively motivated by rewards?

9/18/2008 7:13:07 PM

Quote :

"But what about rewards?"

Both Alfie Kohn and the Anarchist FAQ address rewards. In the research, rewards seem to decrease motivation, leading to poorer (though perhaps faster) results, particularly in creative tasks.

Quote :

"Studies of animal psychology show that positive reenforcement (that is, rewards) generates the best results when trying to train an animal or bring out a particular behavior."

Indeed. And the behaviorists, a particular school of psychology, do insist the same holds true for human. We're just like the less complex animals, thoughts are a sham, and so on. They dominated for a while, but now they've been significantly discredited. Human motivation doesn't seem to be nearly as simple as they thought. Needless to say, the subject remains somewhat controversial.

9/18/2008 7:19:35 PM

Quote :

"rewards seem to decrease motivation"

Any tenable empirical evidence?

9/18/2008 9:28:45 PM

Sorry, that should be intrinsic motivation. If you're doing something for a reward, you opinion of the task's innate worth drops. And yes, I linked to some.

[Edited on September 18, 2008 at 9:30 PM. Reason : worth]

9/18/2008 9:29:47 PM

Quote :

"Both Alfie Kohn and the Anarchist FAQ address rewards. In the research, rewards seem to decrease motivation, leading to poorer (though perhaps faster) results, particularly in creative tasks. "

Well of course monetizing creativity leads to poorer results, anyone who's watched the record industry can tell you that. But the problem with this discussions is that anarchists seem to think that the only thing that is a reward is money.

Quote :

"Sorry, that should be intrinsic motivation. If you're doing something for a reward, you opinion of the task's innate worth drops. And yes, I linked to some. "

You linked to one. Your anarchist FAQ simply referenced your first link

9/18/2008 11:22:17 PM

Both Kohn and the FAQ section cite all sorts of psychological studies. Kohn may be the main dude publicizing the data, but the data comes from various researchers. I want to make that clear.

9/18/2008 11:28:39 PM

Is this really a surprise? Have any of you been to an ER? Poor people/people without health insurance are less likely to get checkups and preventative health care, don't have a family doctor to see for minor ailments. Combine that with higher obesity, diabetes, etc. rates among the poor and there are many reasons driving high health care costs. This is why lack of universal health care is sometimes billed as a free rider problem and efficiency issue.

9/19/2008 3:03:34 AM