You'll be sorry when you don't get to use Dr. Mrs. Dr. Ol' Professer's revolutionary new perpetual motion machine. Nor will she let you hear her symphony (and trust me, it's good!).
Kill yourself and hide your estate from estate taxes.
Give me your job, Dr. Mrs. Dr. Ol' Professer. I know you work really really hard, and it's just not fair. You just relax, and I'll say idiotic things on the internet.
Well, if I were a forensic psychologist I'd be in a real bind here, because I'd already be a leech on government doing no productive work at all. I suggest that she get a real job first before she goes on strike.
The same would go for Instacracker at his state university law professor job. I'm not aware that anyone in the world would notice a law professor strike. They could just rubberstamp the students as lawyers and send them out into the world to sink and swim.
But these guys are libertarians, so they already know that. They've been on production strike all their lives.
production strike
There's another kind of strike?
Still, let me make a suggestion. Why don't they just stop giving away their perfect objectivist ideas on the Internet? That'll show me!
Perhaps I could give them tips on how far to shove Atlas Shrugged up their arse?
The important thing is for all the members of the "productive" class to go some place isolated where they are the only people to benefit from their very important skills.
Lately I've been going John Galt on unfogged, withholding my comments in protest of the Mineshaft's socialistic policy of taking teh funny from the most productive commenters and, uh, redistributing it to, uh, the lazy people who slack off at work by reading unfogged. Sure, that's the reason.
Or maybe it's just that I've been real busy, or that my employer recently put it's "no fukkin' around on the internets, ya lazy bastards" policy in writing.
For those of you who have never read Ayn Rand's Atlas Shrugged
Save brain cells, avoid shrugging!
against the "looters" (the exploiters, backed by the government).
And those looters would be... Hank Paulson and the Bernanke Sisters! C'mon down!
and rewarding those who overspend, underwork, or are just plain unproductive.
Those would be the Republicans.
My question to readers is, what are some ways to "go John Galt"
Move! Move to Siberia! No, Antarctica. The Siberians didn't do nothin' to me that would call for that.
is there some other way of making a statement?
Please to explain to me why I don't understand economics.
max
['Please also to explain to me how not winning the war is winning the war.']
She does realize it was a work of fiction, I hope. Because of course what we need is the conclusion that during a possible downturn that what we need is businesses doing poorly. (Perhaps she thinks that what we decide to do is make 80% less profit, and boom, businesses just do that. The 25% unemployment during the Great Depression was just smart businessmen withholding the means of production.)
The other thing is, of course, if she quit her job, who the hell would notice? She doesn't own any means of production.
go John Galt
The thing we're missing here, smug in our effete leftist elitism, is that if all the 19-year-olds in the world went on strike - c'mon, everyone who's obsessed with Rand is 19, aren't they? - then there would be no one to make our lattes or prep the refrigerator cases from which we harvest a rich bounty of exotic Whole Foods cheeses. We'd have to work our own drive-through windows and skip our own mid-term exams on the grounds our history prof is "totally Bolshevik" and then where would we be?
Oh, that's right, we'd be without pearl-clutching Objectivists. Actually, yeah, I can get behind this.
My god, is Emerson's point in 4 absolutely right. There is surely no less productive, less important, or cushier state-funded job in the world than being a law professor at a mid-ranked state university.
This reminds me of one of my favorite Unfogged post of all time (from my lurker days), where FL asked if anyone had come out looking worse from the growth of the internet than law professors. The answer, of course, is "no."
This reminds me of Roy's take on Rod Dreher: when it comes down to it, people would rather live prosperous suburban lives while getting nostalgic/indignant over our lost values than to live on a commune in the woods enjoying the values without the material perks. But I would love for the Reynolds clan to prove me wrong.
You saw the look on the dude's face with his giant deep-fried turkey and photoshopped trees. He'd last a week before being eaten by a marmot.
The other thing is that we'd supposed to be....what, begging them to come back to work? Please, state employees, come back to work!! We need ur taxes!! There isn't anyone else who could fill Reynolds' job currently at the bottom of Yale Law, no sir!
The comments are great. Apparently, self-sacrifice here means "I will not buy that new plasma screen TV! That will show them!"
No, I'm not cutting back on spending because the economy is bad, I'm going John Galt.
Is my 401k "going John Galt" on me?
QUated without comment:
"If you need further proof of Zen look at the world TODAY. We are living through the ultimate Zen moment: ideological forces unleashed over past hundred years are coming to their final, epochal battle. And we get to be part of it!" (Marx-Lenin-Gramsci-Alinsy-Ayers-"Cloward-Piven"-ACORN-Obama.)
Wow, one hand fwapping. I see everything so clearly now.
"Baby, we don't need a condom, I'll just go John Galt and withdraw from productive endeavors, I promise."
17 is brilliant. Had Carter only advised people to put on the sweater of John Galt.
"Baby, we don't need a condom, I'll just go John Galt and withdraw from productive endeavors, I promise."
Future pornography will involve men with very small penises screwing women with very small breasts.
max
['The old stars have gone John Galt.']
there would be no one to make our lattes or prep the refrigerator cases
Pfff. We just replace all the alienated 19-year-old Atlas Shruggers with Mexican immigrants. They're entirely more pleasant anyhow.
I have come to suspect that my favorite coffee shop is run by edgy Christian types. Phew, they have to remain engaged in the world to evangelize me through espresso.
27: These beans are freshly roasted every morning. JUST AS YOU WILL BE IN HELL.
26: And we can sell them houses! Profit!
"Baby, we don't need a condom, I'll just go John Galt and withdraw from productive endeavors, I promise."
29: me too. "you know what else is rich, flavorful, and energizing? You betcha-- the blood of the Lamb!"
This is terrible Rand scholarship. I suspect that she hasn't read the book either. The whole point of the Galt's Gulch community was that they weren't just "going on strike" to demonstrate how valuable they were. It was part of a well-planned military strategy based round their possession of a superweapon (the Organ of Death, powered by the Galt free-energy machine). If they hadn't had the Galt engine, they would never have done this, because it would have been fucking stupid.
I can't believe I know this, but the Shruggers (Shruggies?) didn't have the Organ Of Death. Some government agency built it based on the corrupt scientist's work, and then it was destroyed in a struggle between the corrupt scientist and the union boss (might not have been the union boss; could have been some other random thug character).
A group of objectivists going John Galt would have almost exactly the same chance of success as a commune started by back-to-the-land hippies. Both groups would be drawn from the same socioeconomic class, and therefore share the same low odds of having the requisite farming skills. Both groups would be made up of people who are dissatisfied with their immediate lives and would probably share the same low odds of having the interpersonal skills you need to make a group endeavor with few precedents work. (I assume that people who are good with people tend to find ways to make their given circumstances livable.)
I find this all very ironic.
35: you are right of course - but I do seem to remember the Galties had some sort of military plan.
This has all been an elaborate trap to see who remembers that goddamned book. Good points, rob.
Look, Rob, if you're not man enough to man up and join the real men on Ice Station Asshole, then we can sure as hell do without you.
Color me skeptical that "interpersonal skills" and being "good with people" trump actual skills and being good with doing things.
Next time I see you, Rob, I'm going to rape you until you're my pal, then we can build superefficient apartment buildings. gaaaaahhh it's all coming back to me and it hurts. I know, I know, that's the fountainhead, but I wisely stopped there instead of continuing on to Atlas Shrugged.
My John Galt plan is already in place. I comment on Unfogged to keep my productivity at a bare minimum. Lower government interference, and I will become so productive that I will have no time left to comment. The choice is yours.
My sister-in-law's brother just bought a house for $2,000. It's a fixer-upper, though -- when you buy one of those cheapo houses, you know it's going to have some things wrong with it. You're better off going up to $6,000-$8,000 and paying full price.
My answer to anyone, including libertarians, who are sick of being exploited and want to go on strike is this: be my guest!
Seriously. Last time I looked this was still mostly a free country and if you want to stop working or being productive then by all means, stop your whining and do it. DO IT!!
The thing is that behind the adolescent wet dream of libertarianism is the feeling that one is not appreciated enough and specifically one should be paid more, or in the case of the men libertarians, get a hot babe.
"Because it is NOT FAIR dammit and maybe I should just quit playing the game and then you'll all be sorry. Oh yes, you'll all be sorry then!"
So stop the whining already and do something you idiots! Go ahead. Make me sorry. You won't do it because it is always easier to whine about how the whole world should change while refusing to change the one thing you actually control - yourself.
The funny thing is that the last time I heard similar sentiments it was from Hippies, who glibitarians claim to despise, probably because they are so similar in nature.
Tune in, turn on, and drop out you whiners!
"No, I'm not going to just hand you that orange chocolate biscotti. You have to kneel down and then I'll put it on your tongue."
44
This sort of thing makes me so happy. Any productive citizens out there thinking of withdrawing their productive power from our sadly socialistic society, stop by in the comments and we'll give you some tips on frugal, low impact living.
Well since you bring the subject up, if and when I quit my job to devote all my time to surfing the web will I be covered by Obama's health plan?
44. You'll be covered by plain old medicaid, just like you would be now.
Wait, is this true? That the Obama plan still ties insurance to employer, or anyway to being employed?
Fuck that!
Yeah, don't you remember everyone bitching about it in the primaries? It's not great -- better than McCain's, which is actively harmful, but not great.
James,
You'll be covered by emergency room care, just like today. They can't let you die on their doorstep.
But if you get cancer, for example, they won't treat you for that, and if you come in actually dying they will probably get you a chair in the lobby. Maybe even some tranqs to keep you quiet.
I hope you approve of that. Or do you think they should keep you in the gutter because even the most minimal amount of common decency is beyond you?
It is hard to tell where you draw the line.
42 was awesome. The next time I run into some adolescent libertarians, I'm sending them Tripp's way.
Hold up. I've never bothered to read Atlas Shrugged, for obvious reasons. Are you seriously telling me that this novel which inspired the ideology of hundreds of thousands of glibertarian nerds is premised on the existence of a fucking free energy machine? You couldn't ask for a more perfect metaphor for their dickish utopian idiocy.
50: afraid so. It runs by "extracting static electricity from the atmosphere". To be honest, the book would probably have worked as well without it...
50. But it's a free energy machine that could only be invented by a pure objectivist.
51: It wouldn't have had the same crackling suspense.
47
... It's not great -- better than McCain's, which is actively harmful, but not great.
But isn't McCain going to give us a $5000 tax credit independent of employment? Or do I have that wrong? Anyway you say Obama has nothing to offer the idle, not even some subsidized community rated insurance for us to buy?
It runs by "extracting static electricity from the atmosphere"
Maybe Obama could win libertarian votes by specifying that he supports renewable energy sources including solar, wind, and people shuffling across the carpet while rubbing balloons on their hair.
47: no, I don't, I only remember my dad bitching about Obama's plan's being inadequate a few days ago, but we didn't get into specifics.
(My dad favors giving health care to everyone, but if you're 70 and want a new liver, or you want a fifth coronary artery bypass graft, TOUGH LUCK. He needs to work on his pitch, I think.)
But isn't McCain going to give us a $5000 tax credit independent of employment?
I thought you got the $5000 credit for opting out of your employer insurance.
Also, what kind of unemployed person has any use for a $5000 tax credit? If your trust fund is that big you should just buy your own insurance or hire your own doctor.
(is it a tax credit, or a tax deduction?)
54: If you're indigent and can negotiate the applications process, you'll have Medicaid, just like now, as rob said in 45. For the not-quite-indigent, there will be tax credits for purchasing your own insurance.
The actively harmful bit of the McCain plan is killing the deductibility to the employer of health care premiums for employees. While making health insurance contingent on employment was a bad way of setting up the system we have now, that is the system we've got now, and McCain is pulling out a huge subsidy that keeps the employer/health insurance connection working without replacing it with a differently workable system. The tax credit he offers isn't big enough to compensate for the loss of employer-based health care that's going to happen in the absence of deductibility.
58: Refundable tax credit, isn't it? They take it off your taxes, and if it's bigger than your taxes they send you a check for the balance.
57: You don't have to opt out of your employer based insurance to get it. But McCain's new tax will encourage your employer to drop your coverage, so it all works out the same.
Last time I looked this was still mostly a free country and if you want to stop working or being productive then by all means, stop your whining and do it. DO IT!!
"Why the long face, Galt-brother?"
"I sat on the internet and did nothing all day in protest of the redistribution of wealth and then it struck me: I'd done so much nothing I'd nearly done something and am a failure."
It just struck me that if the "Masters of the Universe" had been on a Galt-strike instead of fucking with the mortgage market we would all be better off. Can we make it mandatory?
There is surely no less productive, less important, or cushier state-funded job in the world than being a law professor at a mid-ranked state university.
This, alas, turns out not to be true, but it's up there.
Mostly, on Obama's health plan, I'm hoping Congress gets the bit in its teeth and goes single payer without stopping at his plan. I lead a rich, full, fantasy life.
should productive people cut back on what they need, make less money, and take it easy so that the government is starved for funds
My brother's ex-wife's divorce attorney accused him of slacking for the three years prior to the divorce with the dastardly motive of making sure she would get less alimony. The market, of course had nothing to do with it. Premeditated slacking was the only possible answer.
58
Also, what kind of unemployed person has any use for a $5000 tax credit? If your trust fund is that big you should just buy your own insurance or hire your own doctor. ...
Someone considering early retirement. An extra $5000 a year doesn't hurt.
To be honest, the book would probably have worked as well without it...
Which isn't saying a whole hell of a lot. She was a much better novelist than philosopher, but she wasn't a great novelist by any stretch.
Early retirement is un-american, James.
In one of Saul Bellow's novels the opposing divorce attorney succeeds on pegging the novelist protagonist's divorce settlement on the assumption that he'll write a new book immediately and that it will be as successful as the previous book.
Roth, Bellow, and Mailer seemed to finance each divorce by a novel about the marriage in question. There has to be some economic analysis of that. It would seem that such a novelist could deduct the entire expense of his marriage as a business expense: "Research".
Gosh, I don't know whatever the world would do if Rush decided to put out fewer albums!
But we had to wait five whole years between Rush albums.
70: I am semi-inspired by my divorce from a woman who left me for her novel to write a novel about a man who writes a novel in order to show his ex-wife that he can write a better novel than her.
Your wife left you for her novel?
74: There's a longer-winded way to say it, but she figured out that she couldn't be an artist and a partner at the same time, and her desire for non-monogamy was pretty bound up in feeling too much of my presence to function creatively.
I'm not saying that that's sane or healthy, but it's one of the more generous ways I've found of looking at what happened.
There were times that I was sexually jealous of plot points in her novel, so the boundary issues go both ways.
Someone considering early retirement. An extra $5000 a year doesn't hurt.
Except that it's an either an extra $5000 to love and enjoy or health care, and call me crazy, but retirees probably want health care.
76
Except that it's an either an extra $5000 to love and enjoy or health care, and call me crazy, but retirees probably want health care.
You can use the $5000 to buy coverage, either way you are $5000 ahead of Obama's plan.
You can use the $5000 to buy coverage, either way you are $5000 ahead of Obama's plan.
If the average cost of a health care plan is $12,000, and the early retiree is over 50, then I think that leaves them $7000 in the hole. I don't know what Obama's coverage costs, though.
77
If McCain's plan is the same as the Obama plan except that it gives every taxpayer $5,000, I would be suspicious of the deficitatory implications.
the $5000 tax credit under the McCain health insurance plan is not a tax cut at all, it's just a shift of the health insurance tax benefit from the employer to the individual. Your employer will respond to losing his tax benefit by either cutting your salary or taking away your health insurance.
The good thing about the tax benefit being with the employer is that the employer is a pooling mechanism, while without the employer group you are just a little minnow alone with your health status and no pool to swim around in.
she figured out that she couldn't be an artist and a partner at the same time
You can use the $5000 to buy coverage, either way you are $5000 ahead of Obama's plan.
Obama's plan includes means tested tax credits. You may be right that non-poor, non-working, non-elderly adults do better under McCain's plan than Obama's, but (a) that's a pretty small group, and (b) benefits to the well-off idle in their working years seem like more of a bug than a feature.
83: benefits to the well-off idle in their working years seem like more of a bug than a feature.
Why do you hate the American Dream?
The really sad thing is that when I was an idiot teenager in a Republican family, Rand's books took a little digging to find. Now the fucking things are everywhere. Sometimes even in the "Classics" section.
I think I've told before the story of sitting up late reading Atlas Shrugged, thinking it was time to turn out the light and go to sleep, and decide I'd just read to the end of this speech that John Galt is giving.
You may be right that non-poor, non-working, non-elderly adults do better under McCain's plan than Obama's, ...
fixed.
I just got off the bus where some young woman, not obviously defective, was reading Atlas Shrugged. I was thinking that it would be nice, in this situation, to have some kind of pamphlet to give to these benighted souls, with a title like "Listen, Objectivist!" If they seemed confused or unwary, you could start right in witnessing for collectivism and invite them to the next vegan potluck. (Can you imagine going to an Objectivist potluck? There'd be blood spilled within 5 minutes of the first two guests arriving.)
83
... benefits to the well-off idle in their working years seem like more of a bug than a feature.
So the complaint in 46 is misguided?
[Because.]
We just replace all the alienated 19-year-old Atlas Shruggers with Mexican immigrants. They're entirely more pleasant anyhow.
Until they get assimilated whereupon listening to Rush leads them to reading Ayn Rand, and we wind up with, 'Who is John Galt, vato?'
It was part of a well-planned military strategy based round their possession of a superweapon (the Organ of Death, powered by the Galt free-energy machine).
I already have an Organ of Death.
If they hadn't had the Galt engine, they would never have done this, because it would have been fucking stupid.
This is in line with an excerpt from a 1964 interview with Playboy magazine in which Rand states "What we have today is not a capitalist society, but a mixed economy - that is, a mixture of freedom and controls, which, by the presently dominant trend, is moving toward dictatorship. The action in Atlas Shrugged takes place at a time when society has reached the stage of dictatorship. When and if this happens, that will be the time to go on strike, but not until then," thus implying that her novel takes place at some point in the future.
<Judy Tenuta>Bosco! You were supposed to go on strike when Bush was elected, not when he's leavin'!</Judy Tenuta>
I can't believe I know this, but the Shruggers (Shruggies?) didn't have the Organ Of Death.
Shruggies! They're just like Huggies but they come from factory already full of shit!
Color me skeptical that "interpersonal skills" and being "good with people" trump actual skills and being good with doing things.
First, of course, you have be good at doing something. D'oh!
The funny thing is that the last time I heard similar sentiments it was from Hippies, who glibitarians claim to despise, probably because they are so similar in nature.
It should be Gleebertarians now. 'Dude! The school canceled out end-of-the-school-year toga party because of budget cuts. Let's drop out! That'll show them! Watch them try to get along without the popular people.'
max
['Ayntlan!']
I'm sorry, I was insufficiently explicit.
... benefits directed solely to the well-off idle in their working years at the expense of everyone else seem like more of a bug than a feature.
It's not that I don't want the unemployed to have health coverage. I do! I want single payer, covering everyone, employed or not, with the employers out of the picture. But I do think that when you look at a plan, and realize that it hurts everyone except well-off idlers, the benefits to the well-off idlers aren't really a plus for the plan.
Wait, is this true? That the Obama plan still ties insurance to employer,
yes.
I lead a rich, full, fantasy life.
Good approach in a country where really fixing health care doesn't seem to be on the table. (yet? we can hope for yet, right?)
If the average cost of a health care plan is $12,000, and the early retiree is over 50, then I think that leaves them $7000 in the hole
The early retiree likely won't qualify for coverage. It won't be the nice kind where you get to go to the doctor and pay your copay, at any rate.
93 is true.
also, there is no reason at all to assume you'll be able to buy comparable insurance at a comparable rate to what you may have got through your employer.
93: Come to think of it, Obama proposes a regulatory fix for that problem, and McCain doesn't. All right, no one's better off under McCain's plan except perfectly healthy well-off young idlers.
So LB is saying that the unfoggedetariat is McCains target group for this policy, right?
I don't have an employer!!! Aaarrgghh! (Run around in circles. My individually-purchased health insurance costs almost as much per month as my rent (which is admittedly low, because I can't afford more)! They've got me by the figurative balls due to a preexisting condition, such that I am warned repeatedly by my health insurance broker not to mess around with alternative plans, danger, danger.)
So, yes, single payer (payor?), etc. would be great. Oh well.
95
Come to think of it, Obama proposes a regulatory fix for that problem, and McCain doesn't. All right, no one's better off under McCain's plan except perfectly healthy well-off young idlers.
So Obama does have something for me? Details please.
parsimon: this is something like the situation McCain envisions for most people who currently have coverage.
See his website. Navigating it shouldn't be too tough, but if you need someone to help you find the Healthcare page, come back and ask for a link.
But it's all just lies, innit.
Of course, the Repugs would like to pass some kind of hideous tort reform that would make it impossible for individuals to sue corporations. But health insurance portability? Tell me another one.
My nightmares generally involve "negotiating" incomprehensible agreements with people who negotiate incomprehensible agreements for a living, and me being someone who does it once every five or ten years. It's bad enough having to do that for a house or a car, where your meager bargaining power depends basically on how many hours/days/weeks you want to spend on researching the possible options. It sounds completely reprehensible to have to "negotiate" in a situation where my "bargaining power" depends entirely on what physical conditions I was born with. And I don't even have any preexisting conditions! I'd probably presume that I was expected to lie in my answers to all the questions, like you do when signing up for a research study that only wants people who have never had self-destructive thoughts, have never taken any medication in the last 5 years, and have never had more than a cold in the last 5 years. Except that doing so in this instance would presumably mean that after I rack up charges for something my lying would be investigated and then I would be in debt forever.
So, I hope I don't have to devote my life to trying to move to a different country in a few years.
99: I know. I wouldn't wish it on people.
Of course, the Repugs would like to pass some kind of hideous tort reform that would make it impossible for individuals to sue corporations.
It seems that their last goal is to do that without passing any laws or telling anybody, by using some sort of special high-priority procedure that can't be reversed in less than a decade.
100
Ok, the key point seems to be that Obama will offer some sort of public insurance plan:
Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.
But it is not clear to me why my premiums under that plan should be expected to be less than they would be under current private insurance (much less the $5000/year less they would have to be for me to come out ahead compared to McCain's plan).
I don't see why they can't all be overturned by an act of Congress.
Did you see Obama claiming support for tort reform as evidence of bipartisanship last night? GRRRR.
My nightmares generally involve "negotiating" incomprehensible agreements with people who negotiate incomprehensible agreements for a living, and me being someone who does it once every five or ten years.
I attended an information session put on by a segment of the insurance industry today. One guy talking about the individual market and how it gave us all so much more choice, etc. Then a large group insurance broker talked about the large group market and said that a key service he provides to major corporations is "contract review", reading through proposed contracts from insurance companies to find "obscure clauses" that can cost the insured corporations "hundreds of thousands or sometimes millions of dollars in reimbursements". He said it was important to have an insurance broker do that because ordinary corporate legal staffs weren't up on all the complexities.
much less the $5000/year less they would have to be for me to come out ahead compared to McCain's plan
are you self-employed but insured, or do you pay for your own insurance? That's the only way you *might* come out ahead under the McCain plan. Even then, maybe not, because McCain will effectively deregulate your insurance company, allowing them to play lots of tricks that might cost you $.
Because as an individual with any thing that could identify you as having deviated from perfect health in the past (BMI in the overweight category? Over 50? Ever diagnosed with anything?) your premiums for individual coverage skyrocket, or you can't get coverage at all. If you can buy into a group plan that treats you as part of a risk pool, your rates should be lower. If you want to say "That's not insurance" sure. It's schminsurance, or social insurance. And it's a stupid way of doing it compared to putting everyone in the same risk pool, but it is easier on unemployed individuals than McCain's; the stupidity is what makes it not a great plan, just less destructive than McCain's. (And don't forget the means tested tax credits for poor people -- McCain's $5K advantage only applies to unemployed people with enough money not to qualify for aid under Obama's plan.)
But admittedly, if you're non-poor, un or self employed, and sparklingly, perfectly healthy in all regards, you might do better under McCain's plan.
I would like to sign up for the free health care. Is there a form, or something?
Since we're giving away money to the financials, let's go whole hog and fuck the health insurers. I mean it. Poof, you're done. Single payer, lifetime cap. (I don't know how the other G7s do cost control, but I think there is a lot of age restrictions on procedures.)
110
But admittedly, if you're non-poor, un or self employed, and sparklingly, perfectly healthy in all regards, you might do better under McCain's plan.
I don't see why I have to be perfectly healthy to come out ahead. According to Obama:
... In fact, the most recent data available reveals that the top five percent of people with the greatest health care expenses in the U.S. account for 49 percent of the overall health care dollar.35 ...
So half the cost is servicing the sickest 5%. So if you have median health it would appear likely you would come out ahead with risk based pricing.
Shearer, the cost to you isn't the cost of providing your health care, it's your premiums. Your health care can be median, and the cost to you can still be prohibitive.
But it is not clear to me why my premiums under that [public] plan should be expected to be less than they would be under current private insurance.
Compared to private insurance, the public plan would have a much bigger risk pool, enhanced bargaining power with drug companies, and economies of scale. Plus as a public institution, it would presumably blow a smaller percentage of your health care dollar on marketing and executive salaries.
So I could see how it would be marginally less expensive.
114
Compared to private insurance, the public plan would have a much bigger risk pool, enhanced bargaining power with drug companies, and economies of scale. Plus as a public institution, it would presumably blow a smaller percentage of your health care dollar on marketing and executive salaries.
But that bigger risk pool is going to include the sickest 5% (accounting for half the costs) that private insurance will exclude or charge a penalty rate. And since it won't be mandatory you are going to have a big adverse selection problem. I don't see a big saving unless you are in bad health.
I haven't looked at your source for 'sickest 5% accounts for half the costs', but taking it at face value, remember that everyone over 65 is on Medicare, rather than in private insurance or the new public pool, and that's got to be a large proportion of the sickest 5%. On top of that, people aren't going to sort neatly into sick/healthy private/public -- sick or high risk people with employer insurance will still be in the private system. Any sorting effect will be only among the unemployed/self employed.
At that point, I don't see any reason to believe that the public plan's costs are going to be wildly higher than a comparable private plan.
On top of that, people aren't going to sort neatly into sick/healthy private/public
True, at first, you're right.
But the one thing that private insurers are really good at is cost shifting. I'd bet that they'll put lots of money into figuring out how to move the high cost insureds into the public pool. It may be as simple as saying to employers "because of the high costs associated with your group we have to raise your premiums. Here are the names of the most costly 5% of your employees. How much longer do you expect them to be in your pool?". My impression is that Wal-Mart was already doing something like this.
I'd also guess that the unemployed and the unemployable, even if they have too much money for medicaid, have higher health care costs. The factors which affect a person's employability are likely to affect health, too, I'd guess.
We need single payor.
117
The source is Obama's health plan (pdf file, p 5). The context is:
(4) REDUCE COSTS OF CATASTROPHIC ILLNESSES FOR EMPLOYERS AND THEIR EMPLOYEES. Catastrophic health expenditures account for a high percentage of medical expenses for private insurers.34 In fact, the most recent data available reveals that the top five percent of people with the greatest health care expenses in the U.S. account for 49 percent of the overall health care dollar.35 For small businesses, having a single employee with catastrophic expenditures can make insurance unaffordable to all of the workers in the firm. The Obama-Biden plan would reimburse employer health plans for a portion of the catastrophic costs they incur above a threshold if they guarantee such savings are used to reduce the cost of workers' premiums. Offsetting some of the catastrophic costs would make health care more affordable for employers, workers and their families.
So if the sickest 5% are all on Medicare your man is misleading us.
Since we're giving away money to the financials, let's go whole hog and fuck the health insurers. I mean it.
It's not really a horrible idea. They've been fucking everybody for a couple decades now.
Besides, if private health insurance companies are cream-skimming the healthy folks, you got to jack them with penalties to subsidize that sickest 5%.
Wow, man, way to invent bizarre standards for 'misleading'. And fascinating substitution of 'all' for my 'a large proportion'.
Now, 118 is right -- in the absence of well-crafted regulation that's exactly what's going to happen, eventually, which is what makes Obama's plan wildly inferior to single payer. But it'll still be easier to live under than McCain's.
It's worth remembering that the 5% group is not fixed, people will move into and out of that group. Have a heart attack or get a cancer diagnosis and all of a sudden you'll be incurring very high medical costs. But if you survive you may move back into the 95% group after your bypass or chemotherapy or whatever. Your risks will be increased, but your actual medical expenses may return to a minimal level until the next big unpleasant surprise.
I know we've had this UHC conversation here a bunch of times, but it continues to baffle me that the WHO data, for example, indicates that the US pays more per person for health care than any other developed country and gets less bang for its buck.
It's an odd argument to have with someone (and not so much Shearer here; he's on about specifics in the Obama proposals, which do not include UHC), because you have all these data, and the opposing side reacts against "European/Canadian socialism"—a complete punt on arguing.
Is there even a reasonable argument against UHC? Arguments about how to implement, sure, but do people really argue for the status quo (or some slightly modified version of it) who aren't taking paychecks from private health insurers? And if so, what are the arguments?
TLL gestured at one above -- scary 'cost controls' that will leave you dying of illnesses that are easily curable in America, but that socialist bureaucrats have decided aren't cost-effective. This doesn't seem to actually happen as such, but it's the talking point.
I'm hoping that the public entity in Obama's plan is the camels nose in the tent toward getting us to single payer.
125: Yeah, that's not a really good argument but it is at least addressing the question, not punting.
Compared to private insurance, the public plan would have a much bigger risk pool, enhanced bargaining power with drug companies, and economies of scale. Plus as a public institution, it would presumably blow a smaller percentage of your health care dollar on marketing and executive salaries.
Plus they're not trying to turn as big a profit as possible by providing as little coverage as possible for as much money as possible.
Is there even a reasonable argument against UHC?
If God wanted everybody to have medical coverage, he wouldn't have made some people poor.
scary 'cost controls' that will leave you dying of illnesses that are easily curable in America, but that socialist bureaucrats have decided aren't cost-effective. This doesn't seem to actually happen as such, but it's the talking point.
Actually it happens all the time in the current system, except the bureaucrats are capitalists, not socialists.
130 is part of the reason it isn't a good argument against.
Dammit, I should know better than to put my faith in Tampa Bay.
fuck the health insurers
You can have 'em. If there's fucking to be done, the drug reps look like better targets.
But that bigger risk pool is going to include the sickest 5% (accounting for half the costs) that private insurance will exclude or charge a penalty rate.
The bigger risk pool also includes healthy young people for whom insurance isn't really a necessity except in emergencies. The sort of people who don't bother with annual checkups because they're in perfect health, and aren't all that concerned about having health insurance.
Private insurance excludes a lot more than the sickest group, which any one who has ever had to purchase insurance on their own knows. Being over 50 in perfect health. Being 28 and having once been treated for depression. Those people aren't, by and large, running up most of the costs, but the private market isn't providing them affordable insurance.
shiv is self-insured. We have the absolute minimum plan we can for him (because he is in great health), and he got hit with a 25% penalty because his BMI is 28. This is a 32-year-old guy. How do you think the rest of you fare? On any meds?
TLL gestured at one above -- scary 'cost controls' that will leave you dying of illnesses that are easily curable in America, but that socialist bureaucrats have decided aren't cost-effective.
More seriously -- newer drugs for conditions which already have drugs are sometimes slower to get approved. I'm only familiar with the Canadian system, but there there aren't really scary cost controls; delays on things like knee replacements are due to another problem, which is retaining doctors. There's not a quota. (And I love having this conversation with the presumption that the average American who needs a knee replacement calls up on Tuesday and has it done Thursday. )
135: right, which is partially a training problem (the med schools have a big lag, and underestimated) and partially a retention problem. The latter is largely due to how distorted the US system is, relative to anyone elses.
Are you suggesting that, God forbid, physicians need to make less money?
The latter part of this thread indicates part of the reason a Galt's Gulch effort would be so funny: a lot of the most enthusiastic boosters are absolutely terrible at basic probability. They are, in all likelihood, as a group worse off than any other demographic except repeat felons (who are often there in part through bad risk evaluation) and really hard-core gambling addicts. And since they think arguments set reality, they'd be arguing the same stuff again and again and again, coming to wrong conclusions every time, and finally starving while the rest of us go on to lead improved lives because we're not wasting time on them.
I'll help pack their bags.
Make that "basic probability and statistics", to cover the refusal to accept thoroughly verified data.
TLL gestured at one above -- scary 'cost controls' that will leave you dying of illnesses that are easily curable in America, but that socialist bureaucrats have decided aren't cost-effective
I know that European style UHC plans include an endless pot of money so things like cost controls don't exist.
It won't matter that instead of a insurance company clerk denying coverage it will be a government clerk.
The only difference is who is making the policy, politicians (always reliable, knowledgeable and incorruptible) or greedy insurance company executives (whose motives are always pure, and in the best interests of the patient).
I predict that when UHC comes to the US there will be more NPs and GPs, but that these will be "pink collar" jobs. Specialists will still rule the profession.
I know that European style UHC plans include an endless pot of money so things like cost controls don't exist.
Well, no. But they aren't implemented the way you suggest.
I predict that when UHC comes to the US there will be more NPs and GPs, but that these will be "pink collar" jobs.
Mostly they'll be staffed by NPCs, though.
The only difference is who is making the policy, politicians (always reliable, knowledgeable and incorruptible) or greedy insurance company executives (whose motives are always pure, and in the best interests of the patient).
The other difference is that at least one has the opportunity to have a policy. We should be careful not to compare the best health care the U.S. has with the horror-stories of UHC. Besides, most medical care isn't in the realm of 'back in the US I could pay for this experimental cancer treatment but here it is unavailable. An bureaucrat might deny the experimental surgery, but he probably won't deny basic checkups for the kids or antibiotics for strep.
142: Treatments will consists of Troll Unguent.
Fuck you, TLL. Just shut up.
Every country in the goddamn developed world does a better job of this than the US, but anyone who knows that and tries to say so has to fight their way through a killing zone of bullshit arguments like yours. I have no interest in participating, and I have no interest in observing either.
What 114 said.
All of these countries with 'nightmarish' UHC have better health outcomes than the US for less money. So fuck that argument in the ear.
Emerson, you are making a value judgement that I am not making. I think single payor is the way to go, but that there are trade offs. So you can fuck off, respectfully. Every single time I read about UHC there is some sob sister telling the story of what some dastardly insurance company did. Well, it will be similar under a UHC plan. There is a better way to do it, but there is no free lunch.
I think single payor is the way to go, but that there are trade offs.
So why do your characterizations have nothing to do with the likely tradeoffs, as visible in actual systems actually at work ?
Your contributions so far to this end have looked closer to a round up of bad faith talking points than any real engagement.
Excuse me, soup, but all I said was that there would be cost controls in any UHC arrangement. If this is not true, please inform.
LB made the characterization that these would be "scary", and Emerson told me to fuck off. Where is the bad faith?
147: But by bringing up 'cost controls', you haven't described a tradeoff. There are cost controls now, from private insurers. It's not that there won't be cost controls in a UHC system, but (a) that's not a special characteristic of a UHC system, that's a characteristic of any system and (b) comparisons with countries with actual UHC systems suggest that the cost controls they deal with are less onerous than the ones we have to deal with.
Presenting 'cost controls' as a negative feature of UHC only is confused and misleading.
but all I said was that there would be cost controls in any UHC arrangement
No, TLL, that's not all that you said.
You said there would be cost controls (true) and they would take the form of:
...that will leave you dying of illnesses that are easily curable in America, but that socialist bureaucrats have decided aren't cost-effective
which is not only not true, it's ridiculous.
Which wouldn't matter if it was just you being silly, but surely you realize that you are echoing false statements made knowingly and in bad-faith by people who oppose health care reform?
Single payer, lifetime cap. (I don't know how the other G7s do cost control, but I think there is a lot of age restrictions on procedures.)
This is what I said. If you find it negative, so be it.
151: Um, soup, you quoted my tendentious rewording of TLL's statement as if he'd said it that way. That was me, not him.
152: Lifetime cap is nuts. No one on the planet is going to withhold necessary medical care from one 50 year old and give it to another because the first had an expensive bout of childhood cancer and used up their lifetime benefit. Or am I misunderstanding "lifetime cap"?
lifetime cap probably isn't the way to go, but that's a separate issue.
153 to 154!
Not sure how I got that all turned around...
151. That wasn't me- that was LB channeling me. Putting bad faith in my mouth, as it were.
Back in the day I was on the board of a health insurance mutual, even serving as president for a while. We did focus on cost control, but in administrative overhead, not denial of service. We used our good, fast payout as a bargaining tool with both the providers and the employees. The goal was to do better with our investments so we could keep premiums low for our clients, the local employers (in fact, us).
The point is that the fault lines will be different in a government run plan. I don't need to focus on horror stories, they are well known. But he who pays the piper calls the tune in any scenario. Washington is along way away to be heard.
So's wherever the hell my insurance company is. There's just no a priori reason to think a UHC system will be less responsive than our current system.
The point is that the fault lines will be different in a government run plan.
Of course. These points are trivial, TLL, and nobody has argued them.
The real issue is that there is every reason to believe that in all likelyhood, UHC will be a significant improvement. Including cost-cutting measures.
Your mutual sounds pretty good, but either this experience was quite a long time ago, or it's practice is seriously divergent from most of the industry. Denial of service is one of the go-to tools these days.
oh, and 153 to 157 as well as 154 I guess.
159
The real issue is that there is every reason to believe that in all likelyhood, UHC will be a significant improvement. Including cost-cutting measures.
I don't believe UHC in the United States would reduce the fraction of gdp spent on health care.
I don't believe UHC in the United States would reduce the fraction of gdp spent on health care.
This is possible. In fact, I believe it's quite plausible that UHC in the US would `merely' improve the outcomes for about the same amount of money.
But this is part of the point. Not the magical UHC ponies will come and give everyone a shiny new cadillac, but that if you look at the plausible outcomes improvement is most likely, followed by not worse than current.
Spending the same amount of money and getting quite a bit more for it is hardly a fatal flaw, if it comes to that.
What's in question:
1. Will we get anything at all?
2. If we do, will it be a good plan, better than the present situation?
3. If it's better than the present, will it be seriousy disappointing nonetheless?
3. In the best case, will it be perfect and make everyone happy?
The answers are "maybe", "almost certainly", "probably", and "no".
TLL and James were apparently speaking to #4, whereas the questions on the table are #1, #2, and #3.
this experience was quite a long time ago, or it's practice is seriously divergent from most of the industry
A little of both, I'm sure. We only instituted the health plan to keep UFW out, but after that our health plan kicked their ass six ways from Sunday, and we got a lot of business. Doing well by doing good.
No, JE, I'm speaking to #3. quit putting words in my mouth and motivations to my thoughts that don't exist. Get out of my brain, Old Scout!
I will always put the worst interpretation on what you say, I'm afraid, because your center of gravity is so far in that direction.
I lean so far to the right, I can't help but fall over and be trampled by the sans culottes. What a world, what a world.
122: in the absence of well-crafted regulation that's exactly what's going to happen ...
I have lost my faith in the power of well-crafted regulation. For most of my adult life (since Reagan's first, 28 years ago) regulations have been under successful attack. The EPA, the NLRB, the SEC, the FEC, the CPSC, all have been captured by the entities they were supposed to regulate. If we let the private insurors live they will mount an incessant and well-funded political attack, using advertising and campaign contributions, until those well-crafted regulations are as dust.
157: Putting bad faith in my mouth, as it were.
How many times do I have to tell you, don't let people put LB's bad faith into your mouth. You don't know where it's been.
168.1 My God, Michael, you sound positively Libertarian. You can't possibly mean that the rentiers would find a way to gain access to health care dollars? Only the pure of heart go into the healing arts.
The rentiers control health car now, TLL. Michael seems to be recommending that they be expropriated without compensation. If he's not, I am. "How ya like THESE takings, motherfucker?"
Michael seems to be recommending that they be expropriated without compensation
I think the Founders would not have a problem with telling the rentiers seeking health care dollars to stuff it. I'm sure there is a joke in there somewhere, but I have just returned from the proverbial three martini lunch, and can't quite make it work.
What taking? We're just determining that for the public health, welfare and safety certain business enterprises should be disallowed. It's like sewer systems. In cities everyone must be hooked up to the public sewer system. Privies are disallowed.
Similarly, private health insurance is like gambling, bad for the public morals, and allowable only on Indian lands. Everyone must be hooked up to the public health care system.
I will now exhibit the bad faith I have previously been accused of:
1. While I am in favor of attracting the best and brightest to the health care field, with commensurate compensation, our current model favors the most competitive over those with a possibly higher aptitude for empathy. But tamper with that model at thy peril, for one of the tenets of a profession is self regulation, so I'm not sure how one gets more doctors without lowering quality. This is why I think we will lower "quality" of front line providers, i.e. more Nurse Practitioners and General Practice MDs, and that these will come to be seen as pink collar.
2. My worry (concern troll alert) is not with UHC, but how it will be implemented in the good ole USA, where Congressman Schmotz (I. ME 1st) can be bought for a $10,000 campaign contribution. Regulatory capture is but a small part of the potential problem. There will be a scramble for pork in the R&D area (nothing new) as well as every other type of procurement in what is now a competitive bid situation. If you think defense spending is a boondogle, wait until you see health care "for the children".
3. Contrast that with what we have done to public schools. It would not surprise my cynical self in the least that the current problems of different school districts go exponential when hospital districts become the norm. Local control, don't you know. Out of district has a different line. Won't affect ERs, but other procedures.
4. At roughly 10% of the GDP health care is too important to be left to the politicians, to paraphrase. But the bass-ackward way we approach paying for health care now is not certainly not optimal. It has become the Hydra, and UHC is probably the only way to kill the beast. If we only cut off one head, others will grow.
TLL, how come we don't have those problems now, given the significance of Medicare in the healthcare marketplace?
This is why I think we will lower "quality" of front line providers, i.e. more Nurse Practitioners and General Practice MDs, and that these will come to be seen as pink collar.
`Pink collar' or not, doing this would in all probability improve the quality of front line care, not lower it.
I understand the concerns about the US's ability to fuck up on the implementation of UHC. But things as bad as they are now are only going to get worse if something fundamental doesn' shift. And as far as I can see, even a screwed up implementation of UHC, even twisting in knots to avoid the single payer approaches, even with every tin-pot local politician sticking their fingers in a mucking it up ... and it will still in all likelihood be better than the current system.
Who has suggested local control for hospitals? People worried about Socialized Medicine always seem to be worried about Big Government controlling everything from DC.
I am not completely unsympathetic to the idea that the US is too fucked up to ever do anything right, but that's not the main objection most people make. Usually you just hear what a hellhole France is. (Of course, the people saying that are the same ones who will make sure to fuck things up once UHC becomes inevitable. They've got a good 1-2 punch.)
174. We do have those problems. Of course this is anecdotal, but an MD who specialized in cataract surgery had his reimbursement cut in half because some pol saw how much he had received in payments from the government. Now, perhaps the reimbursement was too high to begin with, but this particular guy was helping old folks see better. It offended the sensibilities of some pol that he made that much money providing the service. The funny thing, but by cutting the reimbursement level his competition was wiped out, leaving him the only game in town, which he was able to do because of economies of scale.
On review, that is probably a good thing. I need another martini.
The status and income of MDs have already fallen, and the new ones know it. I don't think it will me a decline in care. Nurse-practitioners and Certified Medical Assistants are already taking over a lot of stuff. My experience with them has been good, especially the cute one who fingered me.
175.1 That's why I put quality in scare quotes. I remember reading that on a typical visit the medical professional needs to be an MD about 15% of the time, or that the typical MD only used that "extra" knowledge 15% of the time. Where the hell is that martini?!!
177: Can you explain the mechanism whereby the competition was wiped out? We get a lot of gripes locally because the local Blue has 70% or so of the market and the docs don't like their reimbursement rates, but docs who are really unhappy can leave the state. If we're talking about reimbursement rates set by the feds, where do the docs go? Maybe you're talking about people moving to an area where they can get a more favorable payer mix, but that would stop working with only one payer.
180. This was when cataract surgery was relatively new, so there was a lot of competition. This one guy set up a clinic that did nothing but, so when the reimbursement rate went down the other docs just referred to the clinic. This particular MD was bitching at a cocktail party, so if details are muddled please forgive.
I want some love for Congressman Schmotz, Independent from the First Congressional District of Maine (apologies to Tom Allen, Dem. current holder of the seat) Comedy gold! I. ME 1st!
Nurse-practitioners and Certified Medical Assistants are already taking over a lot of stuff.
Yeah. The way my university health care plan is structured, most of the time if I go in for something minor, I'll see an R.N. instead of an M.D. If that's the change we're likely to see from UHC, I say this is not a change anyone really has to fear; the GP M.D. is already a thing of the past.
TLL, maybe your #3 makes sense after three martinis, but sitting here sober it just looks like you think that single-payor health care plans would be funded out of local property taxes as a federal initiative. (Consider the point about 'networks' and 'finding a doctor in network' made obviously.)
There are two basic arguments against universal health care in the US.
One is that it's more moral to leave people to their own devices, no matter what harm may come. Fuck that. Governments are instituted to provide for the needs and wants of the people, and good health is fundamental to a whole lot else.
The other really boils down to the idea that there's something distinctively vile about the American people. Everyone from Canadians to Italians to Taiwanese can manage to supervise a universal system, but we mustn't be allowed to try, because it would go all rotten. If it's true, then it should be part of a general mea culpa and coupled to some effort to identify and deal with the vileness, rather than accepting it as grounds for inaction.
Everything else comes down to either accepting long-debunked false claims for reasons of convenience and/or doctrine, or sheer moral callousness in the refusal to pay attention to what is and isn't working when it comes to attending to people's health.
And like others here, I'm done putting up with it. Anyone who wants to argue that we can't or shouldn't try to have universal health care here has an obligation to identify, precisely, what it is that makes everybody else's solutions obviously not possible here, and to explain why these things cannot be fixed. Otherwise, piss off and take your stupid, willfully self-deceiving selfishness with you and let the grown-ups get to work.
And like others here, I'm done putting up with it. Anyone who wants to argue that we can't or shouldn't try to have universal health care here has an obligation to identify, precisely, what it is that makes everybody else's solutions obviously not possible here, and to explain why these things cannot be fixed. Otherwise, piss off and take your stupid, willfully self-deceiving selfishness with you and let the grown-ups get to work.
Fuck you, too.
Going to UHC involves destroying the health insurance companies by definition. It likely involves breaking the doctor's union (aka AMA). As far as I know, everybody else's solutions didn't have to be implemented over these existing players.
If you can't destroy health insurance companies, then the decision isn't between what we have now and UHC but what we have now and some UHC/Health Insurance Company hybrid. It's automatically clear which is better.
I think that General Practitioners, now called Family Practitioners, will continue, but with more ancillary help. If there's a squeeze it will be on doctor's earnings and on specialists.
I gambled on my good genes and went without insurance 2002-2008. I've one, so far, but I'm crossing my fingers -- I went in for a physical a few days ago and am going to have the colonoscopy next week.
I'm definitely open to the possibility of America's unique vileness. I just don't think that we should give up immediately.
The HMOs have done a job on the AMA and we don't need to worry about that.
Going to UHC involves destroying the health insurance companies by definition. It likely involves breaking the doctor's union (aka AMA). As far as I know, everybody else's solutions didn't have to be implemented over these existing players.
In the UK the initial institution of the NHS involved conflict with the doctor's union. There were also extant private health care insurance schemes. That self-same doctor's union still exists and functions just fine with universal care. There are also still private health insurance schemes and people can pay for them if they want them.
What do you think universal health care involves? Health gulags for doctors and a ban on private care?
the decision isn't between what we have now and UHC but what we have now and some UHC/Health Insurance Company hybrid. It's automatically clear which is better.
Oh really? Automatically clear in what way? And automatically clear to whom? Most (all?*) countries with UHC also have private health care. It's just that, in the UK at least, not many people choose to pay for it, and when they do it's usually for elective procedures. Private dental insurance is more widespread, I think.
Seriously, wtf? It involves fuck all of what you say it does. Do you even know how health care works in other countries?
* I'm not aware of any current states that ban private health care. There may be some, but that's not how it works in those European countries that have a universal system.
Also, in the UK, private health insurance is vastly cheaper than in the US as the heavy lifting [emergency care, serious acute illness, major surgery, long term chronic illness] is handled by the NHS.
So private health insurance customers are arguably better off, not worse. With private health insurance existing as an extra 'luxury' tier for those who want it.
Do you even know how health care works in other countries?
That would be UnAmerican.
UHC involves destroying the health insurance companies by definition
Can't happen quickly enough.
Also, in the UK, private health insurance is vastly cheaper than in the US as the heavy lifting [emergency care, serious acute illness, major surgery, long term chronic illness] is handled by the NHS.
Vastly cheaper is not a good thing from the point of view of the private health insurance company. Private health insurance companies sit astride some very significant fraction of the US GDP today. With UHC, this will no longer be the case. This is going to mean the end of the private health insurance companies, or possibly their shrinking into something unrecognizably different from their current form. I shortened that to "destroyed", but it's pretty much the same thing.
"You don't have to destroy private health insurance companies. The UK still has private health insurance companies! Basically no one uses them, and those that do pay them way less money!"
Can't happen quickly enough.
Agreed. But with how much money is at stake, they're going to fight bitterly (as they did against Clinton), and partially destroying them may be worse than nothing at all.
This is going to mean the end of the private health insurance companies, or possibly their shrinking into something unrecognizably different from their current form.
Right, which is a good thing.
The transition should be handled carefully to avoid unnecessary pain, but some pain is going to come from that regardless. The insurance industry is one of the biggest things broken about the current US system, and it's current form has to go, if you want to make any real progress. You can do it quick and try and cushion the economic blow, or you can drag it out for ever (more damage long term). But it has to be done.
I think for me, the best thing about UHC is that I would not have to listen to stupid fucking stockbrokers whine at me because they're not going to be able to buy a third yacht this year, or whatever it is that's got them so bent out of shape. Seriously, at market open yesterday I was projectile vomiting in the handicapped restroom. Then I cleaned up the toilet, rinsed out my mouth and worked for another seven and a half hours fixing the mess that these idiots have created for themselves. Some piece of shit from a very wealthy area in Southern California had the temerity, a couple hours after the projectile vomiting, to compare me to a Nazi war criminal because I wouldn't let his stupid fucking doctor client (who was no doubt on vacation, at his lake home) make a quarter-million dollar profit without putting up any of his own money. Seriously, consider your average working-class criminal. How many of them ever see a quarter-million go through their hands? These lousy professional pricks are the worst thieves in the world. They immiserate millions with their corrupt schemes and their rip-off loans and I'm stuck here helping them do it, while being whined at for my troubles. I despise you, I despise your laws, your false god, your force-propped authority...HANG ME FOR IT!
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Cutting-edge research unlocks mechanisms of worm grunting
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I can't believe a thread with this much promise devolved into goddamn health-care wonkery.
198: It's a foretaste of what a Democratic presidency will be like. Sobering, really.
There's hardly anything left to say about objectivists that isn't both obvious and futile, Brock. I was amazed that the thread went as far as it did with that theme. Now, adress your intellect to the worm grunting findings.
HANG ME FOR IT!
Tonight I got to see a 20th anniversary, crystal-clear print of They Live on a very big screen. I'd forgotten altogether that when Rowdy Roddy Perry looked at money through the special alien-revealing sunglasses it was just paper that read "THIS IS YOUR GOD." I'm currently printing that out to carry around in my wallet.
Private insurers are destroyers of other people's wealth and well-being. They make us all worse off. Fuck 'em. They had a chance to demonstrate some congruence between their profit seeking and everyone else's concerns, decades' worth of chance, and completely blew it. I feel about insurers and UHC very much as I do about the drug cartels and drug law liberalization.
There are practicalities to consider in terms of unemployment and such, but precisely no need to regard the leaders' feelings or anything like that. They ought to know that they are loathed and have brought dissolution upon themselves.
Robust, that's a movie with a darned good heart on it. John Carpenter's got a real streak of sympathy for folks getting hosed, and of contempt for detached authorities.
Tonight I got to see a 20th anniversary, crystal-clear print of They Live on a very big screen.
So, so rad.
Oh, it's an incredibly ambitious anti-authoritarian message with startling relevance to today. The bit skewering the 'Morning in America' speech will never, ever, get old.
Oh, it's an incredibly ambitious anti-authoritarian message with startling relevance to today
And it stars Rowdy Roddy Piper and features the line "I'm here to kick ass and chew bubblegum, and I'm all out of bubblegum".
God, John Carpenter's awesome. He did the music, too, of course.
The story it's based on is quite good, too, if a little more restrained and fifties-y.
What? That's crazy talk. No one person can be that great.
OK, time for bed, peopoe. I've got an election to help make happen tomorrow.
Yes, Carpenter does the music for most of his friends, with his long-time movie-making partner Alan Howarth. He's got talent, and he also knows his limits, so he works productively within them. Side note: the commentary tracks for the DVDs of his movies with Kurt Russell are great fun, and also filled with practical advice for work of any kind where your vision way outpaces your money.
206: I always wondered where that line was from.
He's got talent
I'll say. The soundtrack to Assault on Precinct 13, for one, is just fabulous. Stripped down, eerie, electronic awesomeness. Plus it has a track called "Ice Cream Man In Trouble" which may be my favorite song title ever.
I'm holding John Emerson entirely responsible for Michele Bachman. As of two weeks ago, I never heard of her, then John starts talking about her, and now she's on my TV accusing me of treason. I don't know what kind of show you're trying to put on here, John, but let me tell you, I can at least see who's hand is on the puppet strings.
213: You didn't see the footage of her groping the fake President? That was all over the place. I dunno if Tinklenberg has much of a chance, given how awful that district is politically, but if it's ever gonna happen, this is the year.
Keith Ellison is here for good though, so that's something. Even if I didn't have positive associations with him, the fact that he pisses off all the right people excuses lots of politricks.
I only wish there was some way to end Pawlenty's reign of wickedness.
The guy who wrote the story They Live is based on invented the propeller beanie.
Thanks to this thread, I am about halfway into They Live on Google video and it is Sofa King awesome. The grocery store is a prophetic vision of Whole Foods.
OBEY!
When I say those little faces evertwhere I thought it was riffing on They Live.
http://tantek.com/presentations/2006/03/building-blocks/obey.png
Oh, and Cala, just to be clear, those were not policy recommendations, but crystal ball gazing at how implementation might work in the US.
216: unfogged is a force for good!
Contra TLL, the episode with cataract reimbursement is an example of nationalized health care working exactly as it should--controlling costs and discouraging spending on low-value or superfluous procedures.
Here's the backstory: Cataract surgery used to be a difficult, expensive procedure that involved taking a scalpel to the patient's eyeball and making a large incision in the cornea. Then along came phacoemulsification, which turned cataract surgery into a simple outpatient procedure.
Because the Medicare reimbursement table still treated cataract surgery as an onerous procedure, there were mega profits to be made. Opthamalogists raced to get into the business. They recruited aggressively, going to senior citizens centers and rounding up whole busloads of people to come in for a "free procedure to help you see better" and operating on them in assembly line fasion. Because almost every older person develops at least some degradation of the intraocular lens, virtually every Medicare-eligible was arguably a candidate for the surgery.
Medicare administrators recognized the perversity of the situation, but it was still a struggle to get the adjust the reimbursement rates to a more sensible level, given the influence of newly wealthy practioners and the power of appeals like a kindly grandma figure saying things like "He gave me my sight back. Now I can see my grandchild's face for the first time."
Because the Medicare reimbursement table still treated cataract surgery as an onerous procedure, there were mega profits to be made. Opthamalogists raced to get into the business. They recruited aggressively, going to senior citizens centers and rounding up whole busloads of people to come in for a "free procedure to help you see better" and operating on them in assembly line fasion. Because almost every older person develops at least some degradation of the intraocular lens, virtually every Medicare-eligible was arguably a candidate for the surgery.
I knew a guy that made just an absurd amount of money off of this particular hitch.
Tweety, wtf are you doing up at this hour? Or dare I ask?
This hour might not be the hour you think it is, depending what coast you think I'm on. What the fuck are you doing up?
This hour might not be the hour you think it is, depending what coast you think I'm on.
Ah yes, I hadn't considered that possibility. Does Blume know that you're making a booty call at B.'s house?
What the fuck are you doing up?
The hour might not be the hour you think it is, depending on what hemisphere you think I'm in.
Ah yes, I hadn't considered that possibility. Does Blume know that you're making a booty call at B.'s house?
She even knows the blackmail amount.
The hour might not be the hour you think it is, depending on what hemisphere you think I'm in.
I don't think. I act. And therefore, I am not surprised. Because of... acting. I think. Where am I?
I'm convinced Sifu and KR are holed up in Antarctica together, holding out for global warming. And their faces are all robot-y.
Now what the hell is Stanley doing up, that's the question?
226: A buncha assholes on the internet suggested I watch some weird sci-fi movie with a professional wrestler, except I started in on the internet really late. That's what, chicken butt.
I did note that movie was the source of a quip off Good Riddance's A Comprehensive Guide to Moderne Rebellion, so that was neat. But I probably could've googled it.
214: You're in on it too, minnie? Makes sense. No one could pull off a fraud of that magnitude alone.
I'm always slightly surprised to learn that someone hasn't seen They Live. Meg Foster is one of my favorite actors, actually, for her striking eyes. I am unconvinced that Google Video can show their awesomeness and encourage Netflixing it if possible.
I think that people are slightly mischaracterizing McCain's plan. The actual plan is no less awful than the mischaracterizations. MCCain does not, AFAIK, do anything to affect the deductibility of employer provided health premiums to the employer. (Unless some weird ERISA rule kicks in, but that's not part of the plan.) So, employers would still be able to deduct health care premiums/ spending just as they are now for almost all employee salaries*
The difference is that McCain's plan would treat the value of the health benefit as taxable income to the employee. So your family plan is worth $12,000. That's an additional 12K of reported income with no extra cash to pay the tax.
If you want to buy insurance in the individual market you get a refundable tax credit worth $2500 for an individual and $5,000 for a family. For some people who want to buy high deductible insurance this will be a better deal. Healthy people will drop out of their employer plan, so the per person premium for the employer insurance willl be too high. This will encourage employers to drop the coverage once there's no decent risk pooling going on, but that's not because the deductability has been affected.
*There's an exception for salaries above a certain amount that aren't in some way tied to performance, but it's pretty meaningless.
Rather than health insurance, can't we just deregulate the market in Healthcare Default Swaps?
