Message 373 of 440 (612902) 04-19-2011 10:31 PM

Reply to: Message 368 by marc9000 04-19-2011 9:03 PM

So you're saying that if it's a state program, then you'd object to federal officials trying to shut it down? That would be a consistent states rights position, anyway. I suspect, however, that this is a case of state legislative action.

State legislatures are notorious breeding grounds for nut-job legislation, primarily coming from conservatives. Witness Arizona's Republican-dominated state legislature, which when given the choice would much rather ignore their budget crisis and instead spend their time passing laws about 10 Commandments monuments and requiring Presidential candidates to provide long form birth certificates in order to get on the ballot.

Conservatives should actually favor a federally managed heath-care program. If nothing else, it would give them a golden opportunity to effectively overturn Roe v. Wade by making abortion a non-covered procedure.

Reality has a well-known liberal bias.
-Steven Colbert

I never meant to say that the Conservatives are generally stupid. I meant to say that stupid people are generally Conservative. I believe that is so obviously and universally admitted a principle that I hardly think any gentleman will deny it.
- John Stuart Mill

Message 379 of 440 (612941) 04-20-2011 12:15 PM

Reply to: Message 376 by Dr Adequate 04-20-2011 3:37 AM

Edited by ZenMonkey, : No reason given.

Edited by ZenMonkey, : Grammar. And clarity.

Reality has a well-known liberal bias.
-Steven Colbert

I never meant to say that the Conservatives are generally stupid. I meant to say that stupid people are generally Conservative. I believe that is so obviously and universally admitted a principle that I hardly think any gentleman will deny it.
- John Stuart Mill

Message 380 of 440 (612949) 04-20-2011 12:35 PM

Reply to: Message 378 by hooah212002 04-20-2011 10:50 AM

Somehow it never gets pointed out that every time you cut sometihng in a state or federal budget, what that generally means is that, either directly or indirectly, someone is losing a job, and it's sure not Donald Trump. How this is supposed to help the middle class, I'm not quite sure.

Reality has a well-known liberal bias.
-Steven Colbert

I never meant to say that the Conservatives are generally stupid. I meant to say that stupid people are generally Conservative. I believe that is so obviously and universally admitted a principle that I hardly think any gentleman will deny it.
- John Stuart Mill

Message 390 of 440 (613002) 04-21-2011 12:10 AM

Reply to: Message 384 by marc9000 04-20-2011 8:31 PM

What does this even mean?

I can't speak for the good Dr, so I can't say what he would or wouldn't agree with. What I can say is that he knows more about the US Constitution and its history than you do. I can also point out that he has made a powerful and articulate rebuttal to your faulty "foundings" argument. Do you have anything of substance to say about that?

Edited by ZenMonkey, : No reason given.

Reality has a well-known liberal bias.
-Steven Colbert

I never meant to say that the Conservatives are generally stupid. I meant to say that stupid people are generally Conservative. I believe that is so obviously and universally admitted a principle that I hardly think any gentleman will deny it.
- John Stuart Mill

Message 395 of 440 (613133) 04-21-2011 9:30 PM

Reply to: Message 364 by marc9000 04-19-2011 8:46 PM

I honestly can't believe that you said that.

Yes, people get sick, can't afford health care, and get left out in the free market system. And you believe that trying to address this evil by making a basic level of health care available to every citizen - just like they do successfully in every other first world country - is tantamount to demanding that government somehow provide everyone with every imaginable luxury. That's ridiculous on the face of it. The two aren't the same at all, and it shows either willful ignorance or utter calculated heartlessness to claim that they are.

So if government can't afford to provide everyone with a brand new BMW, we should stop offering discounted bus passes to the elderly?

So the US has high cancer survival rates. I assume that that's for people who can afford to be treated in the first place. Does that include all the people who go undiagnosed because they can't afford regular check-ups? It's also true that we have a lot of expensive medical equipment in this country. How many people actually have access to it?

The fact remains, in comparison to other industrialized countries, the US spends the most for health care and gets the least for it. We're below just about everyone else in terms of life expectancy and infant mortality, to name two actual indicators of how we're doing in taking care of our citizens.

Not free. Affordable. There is a difference. And what was affordable for a middle class family 40 years ago can be well out of reach for an equivalent middle class family today. Take a look at the following chart, showing the growth in health care costs since 1960.

Now take a look at the following graph illustrating the change in median real income since 1947.

Now, I'm far from being a mathematical genius, but even I can draw a pretty obvious conclusion when I compare the two graphs. Can you?

Take a closer look at the second graph, and you'll see something that bears directly on the larger topic of this thread. Starting in the 70's and accellerating in the 1980's, productivity has outstripped income in the US. Hmm, a coincidence that this coincides with the start of "trickle down economics?" For 30 years now, people have been working harder and getting less for it in real terms.

So who's benefiting from all that productivity, if the middle class isn't? 58% of real income growth in the US since 1976 has gone to the top 1% of households. What does that tell you about the middle classes ability to get ahead or even keep even in this country?

I believe that Dr Adequate has done an excellent job of addressing this particular claim in Message 376. Have you come up with any substantial answer to his evisceration of your assertions? Thought not.

Sez who? Have any states stepped forward yet to provide universal health care to its citizens? Thought not.

Universal health care falls well within the purview of the federal government. Which do you think would be easier to administer, one central program, or a conglomeration of 50 different programs? Nor do states have the same resources that the federal government does to implement such a program.

No, I haven't had that particular experience. 14 year-olds don't always get what they want, no matter how shrill their voices. Did she? And don't you think that it might be better and cheaper to make contraceptives available to a sexually active teenager, rather than see her get pregnant? Oh, I forgot, the majority of conservatives oppose contraception as well as abortion. Not quite logical, but there you go.

By the way, the availability of universal health care does not preclude anyone who wants from buy as much additional insurance as they like, or paying whatever they want for additional care.

Have you heard of a concept called medical necessity? I have. I'm a medical massage therapist in private practice, and in my line of work I have to document medical necessity all the time. If I can't, then insurance won't pay for it, and my patient has to pay out of pocket. A government-run health care program would work the same way.

Some "boob jobs" are actually medically necessary, reconstructive surgery after a mastectomy, for example. Some aren't. In the real world, insurance companies have gotten quite good at denying medical necessity, even in cases where there's an obvious need. I'm reminded of the case I read about recently in which a woman shattered her jaw in a cycling accident. Her medical insurance wouldn't pay for reconstructive surgery, because they claimed it was a dental matter, and her dental coverage wouldn't cover it because, well, you can guess why. She ended up going into something like $30,000 in debt because she had to pay out of pocket to be able to chew again. One of the things that universal health care would benefit us would be reining in that sort of abuse.

Your slippery slope argument doesn't work.

Really? Really? Have you tried to get health care without insurance? Unless you're at least in the top 25th income percentile in this country, you're not going to get very much of it. The way the system is rigged, insurance companies have a stranglehold on the health care market. It's either their way or the highway. They prosper when they prevent people from getting health care. And there's no need for it to be that way.

It works for the insurance companies, I'll give you that. Not for anyone else.

So rates fell in 2004/2005? How far, in comparison to how much they'd gone up before? And how much have they gone up in the last 5 years?

I believe that that are in fact already at least two or three companies competing in the mail delivery market. I don't see competition driving prices down to 50 cents a letter. Seems to me that you've actually made a case for government succeeding in making a service much more affordable than it would otherwise be. And no one is forcing you to use them if you'd rather use FedEx instead.

So you looked out the window, sniffed, and determined that the air quality in Cincinnati was pristine? Do you think that maybe the EPA and NOAA had more accurate means of determining air quality than you did? Do you think perhaps the whole point was to keep the air in Cincinnati clean? Or do you think that we really ought to be choking on exhaust before someone takes action?

Your attempt to equate air quality inspections with warrantless searches is absurd on the face of it. If you want to get worked up about oppressive and abusive search and seizure operations, then spend some time looking into the number of fatal shootings of innocent people have resulted from police "no knock" raids on supposed drug dealers.

How much has the free market actually done to regulate pollution? Exactly nothing. A company will dump as much toxic waste, open up as many strip mines, and deforest as much acreage as it can get away with. Witness what was going on in this country before we started getting some environmental regulation. Witness what China looks like without any environmental regulation.

Yes, government is in fact the only thing with enough authority to prevent at least a few of corporate America's abuses of the environment. As it stands, corporate America has such a grip on government that we don't even have sufficient regulation to stop the severe environmental damage that still goes on every day. BP got away with ignoring a multitude of regulations in its offshore drilling operations before last year's huge oil spill. And you think that the answer is less regulation?

And what is it with this "foundings" thing? Pick either "founders" or "foundations", please.

Reality has a well-known liberal bias.
-Steven Colbert

I never meant to say that the Conservatives are generally stupid. I meant to say that stupid people are generally Conservative. I believe that is so obviously and universally admitted a principle that I hardly think any gentleman will deny it.
- John Stuart Mill

Message 405 of 440 (613178) 04-22-2011 11:17 AM

Reply to: Message 404 by Catholic Scientist 04-22-2011 10:04 AM

Of course they do.

I live in Oregon, which differs from many states in that some insurers actually offer coverage for massage here. Many don't. For a typical plan, the patient pays a $25 copay and the insurance company pays me $25, and I have to submit documentation establishing medical necessity about every 5th visit or so. These plans commonly put something like a $1500 annual combined limit on all "alternative care" benefits. There are also plans that pay the same, but for which I don't have to submit such documentation. These typically limit patients to 12 visits a year.

For an hour session paid out of pocket, on the other hand, I charge $75. Make of those figures what you will.

Reality has a well-known liberal bias.
-Steven Colbert

I never meant to say that the Conservatives are generally stupid. I meant to say that stupid people are generally Conservative. I believe that is so obviously and universally admitted a principle that I hardly think any gentleman will deny it.
- John Stuart Mill

Message 409 of 440 (613190) 04-22-2011 12:29 PM

Reply to: Message 406 by Catholic Scientist 04-22-2011 11:38 AM

Ah, I see. Here's how it works. I have a fee schedule, which says that I charge $40 per 15 minute unit for massage therapy. On the other hand, my published out of pocket fees are as I described: $50 for a half hour, $75 for an hour, $100 for 90 minutes, etc., with a disclaimer saying that prices reflect a discount for payment at time of service, i.e. I'm not billing insurance. When I bill insurance, I bill them $40 per 15 minute unit, just like my fee schedule says. Why am I billing them that much? For the most part, it doesn't matter in the least what I bill the insurance company; they're going to pay me a set rate whether I bill $50 or $5000. They've determined that an hour of my time is worth $25 from them and $25 from the patient and that's that. However, other plans, notably those for federal employees, pay at a higher rate. Motor Vehichle Accicent cases, which are paid for out of automobile insurance in Oregon and not private insurance, do pay out at that maximum rate. (They also require a doctor's prescription and a hellish amount of documentation.) So I bill the maximum allowable under any given plan no matter what they'll pay in order to be uniform in my pricing, and in order to get the maximum compensation allowable. (Good old free market.) In the end, sometimes that's $50 for an hour of my time, sometimes (much, much more rarely) that can come out to $80 for half an hour. Mostly I do make more when the patient is paying out of pocket.

It took much pain and suffering and many frustrating phone calls for me to even start to learn how to work this system. Do I wish that I didn't have to take insurance patients at all? You bet. Considering the time I spend filing claims, calling to verify elligiblity, and refiling denied claims, it really doesn't pay that well. Can I stop taking insurance? Not so long as that's the only way that most of my patients can afford to see me. But I would gladly work with a single-payer system that offered reasonable compenstation to me and reasonable co-pays for my patients.

Reality has a well-known liberal bias.
-Steven Colbert

I never meant to say that the Conservatives are generally stupid. I meant to say that stupid people are generally Conservative. I believe that is so obviously and universally admitted a principle that I hardly think any gentleman will deny it.
- John Stuart Mill

Message 411 of 440 (613211) 04-22-2011 7:03 PM

Sullivan also links to this blog post by an ER physician, who I think we can all agree should know what he's talking about.

First, here's the graph illustrating the data to which he's refering:

He says:

I also see that over one fifth of health care costs in the US is accounted for by only 1% of the population. Also, half of the people in the US are paying less than $724 a year on health care. That means that those who claim that providing access to a basic level of health care to all Americans will lead to a huge wave of people demanding every expensive procedure known to medical science are misguided to say the least. Yes, under universal health care system there would have to be some money spent for those who haven't been able to afford any health care at all. But most people simply don't need or use that much health care.

To me the lesson is obvious. The idea that there is a "free market" solution to health care costs is wrong. It doesn't work. The only people who are being served by the present system are insurance company shareholders.

Reality has a well-known liberal bias.
-Steven Colbert

I never meant to say that the Conservatives are generally stupid. I meant to say that stupid people are generally Conservative. I believe that is so obviously and universally admitted a principle that I hardly think any gentleman will deny it.
- John Stuart Mill

Message 418 of 440 (613826) 04-27-2011 4:25 PM

Reply to: Message 412 by marc9000 04-26-2011 9:28 PM

You mean the guy who just turned down the opportunity to receive a heart transplant?

quote:

---

Transplant centers have the right to turn patients away, but physicians are required to care for every patient they see, according to Arthur Caplan, director of the Center for Bioethics and the Sydney D. Caplan professor of bioethics at the University of Pennsylvania.

In 1976, the U.S. Supreme Court ruled that prisoners were entitled to the same medical and dental treatment as everyone else in their communitities. Prisons that withhold necessary care from inmates can be held liable for violating constitutional bans against cruel and unusual punishment.

Prison facilities often pay a negotiated reduced fee with contracted hospitals across the state, according to Peter Cutler, spokesman for the New York State Department of Corrections and Community Supervision. But Strong Memorial Hospital in Rochester, where Pike is reported to have been transferred, is not one of them.

"We are constitutionally obligated to provide health care services to any inmate," said Cutler, citing the Eighth Amendment of the Constutition. "We're a state agency doing our job."

---

Your point is irrelevant. You have a single case of one inmate who could have received an relatively expensive procedure, but won't. This is hardly evidence of a widespread demand for expensive medical procedures among the US inmate population as a whole. Inmates actually have a Constitutional right to health care. How many of the 2.3 million other people in prison in the US are demanding $800,000 operations? How many are actually getting them?

You're wrong, and if you actually looked at the documentation I provided in Message 411, you'd see that it's not my opinion, it's a fact. The free market offers no solution to the cost of health care. Americans spend more than anyone else on health care, and get less actual care for their money. When fully half of all health care costs in the US come from just 5% of the population, and 80% of those costs come from just the top 20%, there's very little that "consumer choice" can do to drive down costs.

Considering that you have nothing to counter these facts other than the bare assertion that government is to blame, I can see why you now have nothing left to say.

Also, exactly who do you mean when you refer to the people who costly medical technologies developed by and for? Do you somehow think that medical researchers are saying, "Well, we don't want this new antibiotic to go to those sorts of people. It's only for our sort of people."? Do you know anything about medical ethics at all?

Dr Adequate was using citations from the Constitution itself, as well as a pertinent statement from Alexander Hamilton, and a clear factual analysis of the subsequent history of the interpretation of the General Welfare clause. Exactly what part of that is "far left talking points from the internet?" Do you have a particular site in mind that you think he plagiarized from?

You seem to have an inability to think in anything other than extremes. To a rational mind, there is an significant difference between Congress being responsible for expenditures for the General Welfare, and doing "absolutely anything it wanted." When someone invites you into their house and says, "Make yourself at home," do you then eat all of his food, spray paint the walls, wreck his car, and set fire to the kitchen?

First, Tytler never said that; you're simply passing on yet another Made-up Quote for Conservatives. Second, considering that Tytler most significant book was on how best to translate Greek and Latin, that doesn't necessarily lend him a tremendous amount of authority in matters of political analysis. Third, if he did have something significant to say about democratic forms of government, it's not likely that Hamilton or anyone else would have known about it, as the book that Tytler did write on history was apparently published posthumously in 1850.

Again, you're presenting an argument ad absurdum. Way absurdum.

Any documentation to show how much of that debt can be attributed to inmate heart transplants and EPA regulations? Perhaps a $689 billion annual defence budget might have a little more to do with it? A $700 billion bank bailout in 2008?

You mean Federalist #45, in which Madison argues that the Federal government will never be stronger than the respective state governments, since among other reasons, only state legislatures can elect the President, just as only state legislatures can elect US senators? Madison appears to be a bit behind the times. In case you never heard of it, the US fought a civil war sometime in the middle of the 19th century, and one of the issues that that war decided was that the Union was in fact more than an association of independent sovereign states. History is not on your side, nor is it on Madison's. You are correct in saying that Madison was a vital formative force in the shaping of the American form of government. However, on this particular point - the meaning of the General Welfare clause and the subsequent power of Congress to tax and spend - Madison's view did not prevail.

As has already been pointed out, Minnesota's program wasn't universal health care by any means; it apparently only covered individuals who couldn't otherwise get insurance at all. Big difference. Besides, Republicans are trying to destroy that program anyway.

Do you have any data at all to back up any of these assertions? I'd be interested to see it.

Data, please. Anything?

Well, for sane people, the time to dig the well is not when you're dying of thirst. You don't put off funding the fire department until after the house is already burning down. But that's just for sane people, I guess.

Who said the program failed? You?

I never meant to say that the Conservatives are generally stupid. I meant to say that stupid people are generally Conservative. I believe that is so obviously and universally admitted a principle that I hardly think any gentleman will deny it.
- John Stuart Mill

Message 434 of 440 (614114) 05-02-2011 1:10 AM

Reply to: Message 421 by marc9000 04-30-2011 9:30 PM

So it's good if a business owner loses business because consumers won't buy products from a known polluter, but it's bad if he loses business because government regulations restrict his ability to be a polluter? At least it seems that you're agreeing that pollution is not really such a good thing. Or maybe you actually think that smog, toxic waste, and acid rain are good for us.

I'm wondering, how exactly are consumers supposed to find out on their own who's a polluter? Blogs? The National Enquirer? Fox News? Are you personally going to investigate whether or not there's jet fuel in your milk, DDT in your carrots, and PCBs in your drinking water?

It's not historical revisionism to note that industries simply don't regulate themselves for the common good. Meat processing plants didn't voluntarily stop allowing rat droppings, the rats themselves, and workers' fingers from being mixed in with the sausage. Coal mine owners didn't decide on their own to stop sending men and boys down to work 12 hour shifts breathing coal dust. Big agricultural concerns didn't do studies on their own to see what massive use of pesticides was doing to the environment. They didn't do these things until the government, taking seriously its responsibility to the general welfare, got involved.

I will admit that every once in a while, companies do respond to consumer demand that they clean up their act. For example, Nike finally decided, after years of protests about its use of sweatshops in other countries, to stop attacking its critics and start monitoring working conditions abroad. However, they still make almost all of their goods in countries like China, where there is no environmental regulation, no labor laws, and workers make less than $2 a day. The point remains: companies will do whatever they can get away with in order to maximize their profits. Capitalism is founded on the principle that companies should do whatever they can get away with to maximize their profits.

By the way, the case of China illustrates why it takes federal regulation, not state regulation, to restrict harmful practices. Just as the US government is in no position to tell China to not dump toxic waste, if you depended on state regulation, Florida would be powerless to prevent hog farms in Georgia from flushing their waste downstream and across the state line. Environmental regulation is manifestly a federal issue.

To continue, this is from the above linked article on Nike in Business Week, a well known radical socialist propaganda outlet:

quote:

---

None of this means that Nike or any other businesses have come close to solving the sweatshop problem. Far from it. The monitoring systems set up by a Nike and handful of other Western outfits such as Mattel (MAT ) or Adidas have helped to address some of the more egregious problems at some factories, such as locked doors and unsafe chemicals, human rights experts say. But the inspections they do are limited and periodic and can't possibly catch all of even the most egregious problems.

In addition, only a handful of multinationals have serious monitoring efforts like Nike's in the first place. Most others, including retailers such as Wal-Mart (WMT ) and Target (TGT ), which have the most control over consumer prices, do virtually nothing, labor experts say. "What we do is a drop in the ocean out of the 90,000 or so factories that export to the U.S. from around the world," says FLA President Auret Van Heerden.

---

So given the above, can you come up with any companies that have actually gone out of business due to environmental regulation? Names and dates, please.

Seems that the only liberty you seem concerned with is the liberty to make as much money as you can.

I never meant to say that the Conservatives are generally stupid. I meant to say that stupid people are generally Conservative. I believe that is so obviously and universally admitted a principle that I hardly think any gentleman will deny it.
- John Stuart Mill