Health Care Discussion

Sep 2017
4,884
5,805
Massachusetts
They usually aren't, at least in this case, because their apparent purpose is merely to excite partisan voters, not be an actually workable policy.
True. And that's usual for this stage in pitching an idea. When, for example, a politician makes a pitch for high-speed rail, he doesn't generally present a detailed route map with all the switching yards and stations mapped out. He or she proposes it as a concept. The concept of single-payer healthcare is rock-solid. It's already been implemented successfully in a number of wealthy nations.... including the US, itself, when it comes to the elderly and certain other subgroups. The details need to be worked out, but it's completely legitimate to get people excited about the big-picture idea while leaving those details to the legislative process. There are a lot of authoritarian types who simply announce that the idea is "unworkable," because they want to encourage defeatism. But out here in the real world, there's no reason to think it's unworkable. It has worked again and again around the world, and can work here as well, if that's the path we choose.

People are starting to catch on to the B.S. If anything resembling single payer is going to succeed, it's time to start sweating the details instead of lofting up silly fantasy promises to appeal to morons.
I think you're dead wrong. Sweating the details is not a way to pitch an idea.... and yes, appealing to morons is an absolute key to success. When Trump pitched his wall idea, he didn't have the details. In fact, he based the whole thing on the utterly absurd notion that Mexico would pay for it. Did people "catch on to the B.S."? Well, certainly some of us did, right from the start. But the kinds of people Trump relies on (which is to say, complete morons) never did, and the idea helped to propel him into office. Would he have done better if he'd gone into detail about how he'd actually try to make it happen (declaring a fictional emergency to empower him to steal money from the military to build the project)? I don't think so.

I'm not advocating that Democrats dumb down their notions to the level of the imbeciles who vote Republican. That wouldn't work, since the Democratic base isn't nearly THAT stupid. Nor should they lie through their teeth like Trump did. But their job right now isn't to convince policy wonks who are sticklers for all the details. It's to get the liberal masses enthused, and that isn't done by putting people to sleep with details. It's done by building excitement for the big-picture idea.

You might be able to patch together some plausible deniability, nonetheless the perception that he lied on that point was a successful mountain made out of a molehill.....
Yes, and morally we're compelled to take away the bullshit and return it to its proper size, rather than play along and pretend it's a mountain.

can you imagine how damaging it would be if a policy was passed on a premise of no more cost-sharing and no more insurance companies and then the actual law that was passed required both of those things?
Yet the Obama example shows exactly why we shouldn't care. Even when you sell your policy honestly, like Obama mostly did, the Republicans will simply call honest claims lies and the idiots will believe them and parrot it. No matter how single-payer gets sold, if it passes, the Republicans will insist it was sold on the basis of lies. Better just to tune them out. Democrats never lose so much time as when they deign to make concessions to GOP tactics.

The notion that people living in rural areas are treated as an "aristocratic class" is just absurd....
Why? They get great net federal assistance and also tend to have much more voting power per capita (both given the official greater voting power of small states, and the unofficial greater voting power from urban people being packed into fewer districts where they have inefficient supermajorities that squander their votes). When a class of people are treated as an elite politically, and also entitled to more expensive government services relative to what they're expected to pay, doesn't that make them a kind of aristocratic class? You merely need to see the presidential candidate courting the people of Iowa and New Hampshire, while effectively ignoring big cities like NYC and LA, to see how it works.

Rural America is an absolute mess in this country....
It is, despite those people being treated as aristocrats by our government. And that's because of the failed policy idea of propping up their economically, socially, and environmentally inefficient lifestyles, rather than helping them transition to something better. We should phase out that failed policy idea.

It's disingenuous to suggest that money for rural health care should be cut off but then say there's no intention to create access problems.
I have never said money for rural health care should be cut off. I've advocated going to more equal treatment of people in terms of how much money is going to their healthcare, rather than treating rural people as super-citizens deserving of extra benefits financed by the people of the cities. And, again, the intention isn't to create access problems. The intention is to end a subsidization pattern that is worse for people in the long run. We can eliminate access problems more cheaply, long term, by helping to facilitate a move towards urbanization, rather than fighting that tide by throwing good money after bad.
 
Feb 2011
16,343
5,684
Boise, ID
True. And that's usual for this stage in pitching an idea. When, for example, a politician makes a pitch for high-speed rail, he doesn't generally present a detailed route map with all the switching yards and stations mapped out. He or she proposes it as a concept. The concept of single-payer healthcare is rock-solid. It's already been implemented successfully in a number of wealthy nations.... including the US, itself, when it comes to the elderly and certain other subgroups. The details need to be worked out, but it's completely legitimate to get people excited about the big-picture idea while leaving those details to the legislative process. There are a lot of authoritarian types who simply announce that the idea is "unworkable," because they want to encourage defeatism. But out here in the real world, there's no reason to think it's unworkable. It has worked again and again around the world, and can work here as well, if that's the path we choose.

I think you're dead wrong. Sweating the details is not a way to pitch an idea.... and yes, appealing to morons is an absolute key to success.
The details-free appeal-to-morons approach to single payer been proposed repeatedly in this country and failed each time.

Medicare-for-All Isn’t the Solution for Universal Health Care - The health-care debate is moving to the left. But if progressives don’t start sweating the details, we’re going to fail yet again.
I'm not advocating that Democrats dumb down their notions to the level of the imbeciles who vote Republican. That wouldn't work, since the Democratic base isn't nearly THAT stupid.
Those giddy over Sanders' plan, and those assuming a default position of support for it, are pretty close to that stupid.
Nor should they lie through their teeth like Trump did. But their job right now isn't to convince policy wonks who are sticklers for all the details. It's to get the liberal masses enthused, and that isn't done by putting people to sleep with details. It's done by building excitement for the big-picture idea.
There isn't even basic agreement on the core aspects of the big picture here. You balked at the core concepts under Sanders' plan. You can't build excitement for an idea premised on things like eliminating cost-sharing and eradicating insurance companies and then renege on both of those, or you're going to pay a generations-long price for those lies.
Yet the Obama example shows exactly why we shouldn't care. Even when you sell your policy honestly, like Obama mostly did, the Republicans will simply call honest claims lies and the idiots will believe them and parrot it. No matter how single-payer gets sold, if it passes, the Republicans will insist it was sold on the basis of lies.
If a single payer policy is proposed with zero cost-sharing and complete obliteration of insurance companies, and then those aspects are completely reversed in committee, then it was sold on the basis of flies, full stop.
Why? They get great net federal assistance and also tend to have much more voting power per capita (both given the official greater voting power of small states, and the unofficial greater voting power from urban people being packed into fewer districts where they have inefficient supermajorities that squander their votes). When a class of people are treated as an elite politically, and also entitled to more expensive government services relative to what they're expected to pay, doesn't that make them a kind of aristocratic class? You merely need to see the presidential candidate courting the people of Iowa and New Hampshire, while effectively ignoring big cities like NYC and LA, to see how it works.

It is, despite those people being treated as aristocrats by our government. And that's because of the failed policy idea of propping up their economically, socially, and environmentally inefficient lifestyles, rather than helping them transition to something better. We should phase out that failed policy idea.
I'm just going to let all that go, since we've been over it so many times. Your little thought experiment can't be morally justified and has no apparent support from anyone.
I have never said money for rural health care should be cut off.
Then you've been very unclear.
if we cut off the money currently being used to subsidize rural life, that would free up a lot of money that could be used to help transition people.
We should persuade our rural people to move to cities by depriving them without depriving them. We should cut off funding to them without cutting off funding to them. Rural people are treated like aristocrats. These comments are just beyond bizarre. Even people who would probably like to agree with you fall silent because this line of thought is so bonkers
 
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Jan 2014
16,162
6,165
south
The details-free appeal-to-morons approach to single payer been proposed repeatedly in this country and failed each time.

Medicare-for-All Isn’t the Solution for Universal Health Care - The health-care debate is moving to the left. But if progressives don’t start sweating the details, we’re going to fail yet again.


Those giddy over Sanders' plan, and those assuming a default position of support for it, are pretty close to that stupid.


There isn't even basic agreement on the core aspects of the big picture here. You balked at the core concepts under Sanders' plan. You can't build excitement for an idea premised on things like eliminating cost-sharing and eradicating insurance companies and then renege on both of those, or you're going to pay a generations-long price for those lies.

If a single payer policy is proposed with zero cost-sharing and complete obliteration of insurance companies, and then those aspects are completely reversed in committee, then it was sold on the basis of flies, full stop.


I'm just going to let all that go, since we've been over it so many times. Your little thought experiment can't be morally justified and has no apparent support from anyone.

Then you've been very unclear.

We should persuade our rural people to move to cities by depriving them without depriving them. We should cut off funding to them without cutting off funding to them. Rural people are treated like aristocrats. These comments are just beyond bizarre. Even people who would probably like to agree with you fall silent because this line of thought is so bonkers
well, at great risk to body and soul, I will comment on this exchange - which is quite interesting. first is the fact (and you'll have to take my word here) that nobody will give enough incentive to prod the majority of rural folk into moving into a suburban or urban area. they live in the country for good reasons - mainly because property is less expensive as are taxes and insurance. most I know who live there are on the poorer side, so it's a way for them to have their own little piece of dirt to own - and others want to simply escape to an area away from people. I doubt that idea will go far at all. sorry if that's offending to anyone, but having lived in rural areas much of my life, that's how it works.
 
Sep 2017
4,884
5,805
Massachusetts
The details-free appeal-to-morons approach to single payer been proposed repeatedly in this country and failed each time.
Could you give an example of a failed details-free approach from the past?

Those giddy over Sanders' plan, and those assuming a default position of support for it, are pretty close to that stupid.
I don't think so. I think Medicare-for-all is a fundamentally workable idea. One can support Sanders's plan in general terms, based on the generally solid overall notion underpinning it, without being stupid, while expecting that the details can be worked out in committee, as always happens with any large reform. I'll bet you that when Medicare was first proposed, it didn't spring fully formed and arrayed in all its policy armor from Zeus's head, but instead started as more of a mushy concept that got worked out in detail only after much of the population had been mobilized in support of the concept.

You balked at the core concepts under Sanders' plan. You can't build excitement for an idea premised on things like eliminating cost-sharing and eradicating insurance companies and then renege on both of those, or you're going to pay a generations-long price for those lies.
What's building excitement aren't those up-in-the-air details, but rather the overall concept of the US finally moving beyond our dark-ages approach to healthcare, to a more socialized system that resembles those of nations that have been much more successful than us at achieving good public health results at an affordable price.

Your little thought experiment can't be morally justified and has no apparent support from anyone.
My policy prescription can, in fact, be morally justified. That's how I was able to succeed in morally justifying it. What's less justifiable is the notion of trying to perpetually prop up inefficient settlement patterns that result in lower quality of life, out of some misguided romantic notions about rural living. That's bad for those who subsidize the rural residents and, in the long term, bad for the rural residents as well. Better to use that money to aid them in transitioning to a more efficient pattern, rather than working to keep that wound open and bleeding money for generations to come.

Then you've been very unclear.
No, I've been very clear. If you check post 111, you'll see I specifically countered the notion that I was calling for money for rural health care to be cut off. Instead, of cutting it off, the idea is simply to decrease it to per capita levels comparable to what people get in urban and suburban levels. It's there again, with extreme clarity, in post 118. Again, it's not about cutting off the money, but rather gradually reducing the subsidies until they're on par with other areas. They wouldn't be cut off, but instead made equitable. Earlier, in post 105, I made the same point -- saying that I'm fine with balanced subsidies -- e.g., X net dollars per capita to areas, regardless of whether they're rural or urban. I just didn't want considerably more per capita money being flowed to the rural areas than they're contributing, because that's inefficient. Tolerating those inefficiencies over the short term, for humanitarian reasons, while we work to transition to something better, makes sense, but making them an effectively permanent political and economic policy, thereby slowing a transition to something better, is foolish and destructive.

Also, you know that it doesn't have "no apparent support from anyone," since you've been arguing with someone who plainly supports it.

These comments are just beyond bizarre
Yes, your straw men are, indeed, bizarre. So, why not debate what I really said, rather than fictions of your own invention?
 
Feb 2015
15,962
7,947
sadness
Really? I had a trip to the ER in the Rescue squad my husband was once a part of. I didn’t get a break. $700.

I have enough experienc with health care to feel pretty qualified to know the costs.

I do not need anyone to tell me about costs.

But you are mixing apples and oranges. You seem not to understand why those costs are so high and who benefits from those high charges.

You act as if the drunk in ER creates the cost. Those drunks and people who go to the ER have driven many Hospitals out of business. If many of them had preventive care before theybecome deathly sick we would all w
Better off.

I am not sure where you came up with that $3000 business. You gave no chart to prove it. And we have no details yet.
i think you are sadly lacking in what things in this country really cost. Ill go with that becasue the other option is you are flat out calling me a liar.


the cost of transport

https://www.reddit.com/r/personalfinance/comments/3nr30z
https://www.reddit.com/r/personalfinance/comments/3nr30z
cost of an ED visit

How Much Will I Be Charged at the Emergency Room?

Cost of ER visits increased 31% between 2012-16: 5 findings. Cost of ER visits increased 31% between 2012-16: 5 findings

cost of a single night stay

Cost of ER visits increased 31% between 2012-16: 5 findings. Cost of ER visits increased 31% between 2012-16: 5 findings



yes, i am sure you can do the math.
 
Jan 2014
16,162
6,165
south
just a note here. costs vary quite a bit depending on the region you live. I live in a "cheap" area and such costs would not be incurred here. of course, wages are very low also, so what one person sees where they are may not be your costs replect.
 

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