US Health Care Reform Vote

Politics International Politics
81

I have two main issues with this.

Firstly, it assumes that rights are granted from an authority, rather than exist independent of that authority.

Secondly, it assumes that the majority should be able to dictate the rights of the minority simply by being more numerous.

While the system is working, that’s all well and good, but it seems open to abuse, don’t you think? Wasn’t the U.S. founded as it was precisely so that such abuses couldn’t occur (or at least were far less likely than under other alternatives)?

As for the government backing your money, that is problematic again if for no other reason than that the government can literally turn on the printing presses and inflate your wealth away much faster and much more insidiously than it would if it tried to increase your taxes instead.

82

[quote=“TwoTongues”]All that sounds ideal but the fact is, you can not be sure you will always have your job and your house and whatever else. What you say sounds great to you now, but that could change in the blink of an eye for you, and then you’re screwed. Or else you’re sufficiently wealthy to be able to afford losing a house and a high paying job and going into debt from an illness or car accident, at which point you owe society and government even more for setting up a system that allowed you to accumulate that wealth.

The US government provides an environment for business that allows them to fairly easily lay people off when the company is not doing well, or even when it is making a profit but not enough for their appetite and shareholders. This environment is not friendly at all to retraining, as there is very little social safety net for the 6 months to 1+ years of retraining and additional education needed if your job falls through and there’s nothing else to do in your area. We haven’t even talked about what happens to your kids, their schooling, and so on.

If the government is going to allow such an environment for business, then it has a social obligation to provide the basics to survive to those individuals who are negatively affected by the ups and downs of the business cycle and the bottom line, and also to those who are in the educational system or are retraining.

That obligation must include basic shelter, food, transportation, health insurance or actual health care, and subsidizing or at least loaning money for the education/retraining effort. Many many great things have come from business and the fairly-free business environment of the US, but businesses and the government are here to serve society, society and government are not here to serve business, and the business world is not the top priority or the end goal here, it’s ensuring a safe and stable society for the maximal amount of citizens.

To say that “US Social Security. I don’t need it” and “Medicare. Won’t ever need it.” and “Provide these people with education and with their willingness to learn, they could provide for themselves.” is not only selfish but ignorant and potentially untrue - unless you are already wealthy or waiting on a huge inheritance, you don’t know what situation you’ll be in in even 1 year nevermind 5 to 10 years, and just because things are working out nicely for you now does not mean at all they will continue to work out that way. What are you gonna do if you find you have a huge cancer inside that’s not covered by your medical insurance, or worse, that you lose your insurance with your job and then find out about the cancer? What happens if a hit and run driver leaves you missing a body part and they never find the guy to pay? What happens if your nest egg of retirement savings goes fwwwwwwwp like many people in 2001 and again in 2008, and you find yourself really needing those social security payments? A lot of people do, man, and they are not lazy at all.

As for “Provide these people with education and with their willingness to learn, they could provide for themselves.”, that’s also entirely untrue - how about all the people that got laid off recently (the 10% unemployment rate only includes people looking for work, not chronic welfare-type cases) - you think they don’t have a degree and aren’t looking for a job? It just isn’t that easy for a lot of people, and people often can’t just pick up and move around the country or the world to find a new job.[/quote]Excellent! Excellent points! Very compelling. I really like debating with you. Respect.

I was thinking of a comback, but alas, I’ve got nothing at the moment.

If I ever get a serious disease or get seriously injured and can’t afford the cost myself, I’ll just jump on the plane and head to Naval Hospital, Guam. There all my medical needs will be taken care of until the day I die. In fact, I can even get the US government to pickup the cost of my burial, too. Until then, I will enjoy my hard earned pension provided by the US government. If I lose that, we are all going to be in a world of shit anyway.

83

Please do not let that stop you. :smiley:

84

Northcoast Surfer: I think the question you need to be asking is how anyone is going to fund all of this. It’s all very well to talk about providing for everyone, but countries with highly socialised systems are going to find themselves in serious financial difficulty in the next few decades, especially with ageing populations. At some point, the money getting paid out vastly outweighs the money getting paid in. The benefits of today are being paid for by future generations who will not enjoy the same benefits, despite having paid in even more than current generations. That’s the gaping hole in TwoTongues’ argument.

85

[quote=“GuyInTaiwan”]Northcoast Surfer: I think the question you need to be asking is how anyone is going to fund all of this. It’s all very well to talk about providing for everyone, but countries with highly socialised systems are going to find themselves in serious financial difficulty in the next few decades, especially with ageing populations. At some point, the money getting paid out vastly outweighs the money getting paid in. The benefits of today are being paid for by future generations who will not enjoy the same benefits, despite having paid in even more than current generations. That’s the gaping hole in TwoTongues’ argument.[/quote]Thank you. Yes. Social Security comes to mind. Ageing populations with longer lifespans and falling birthrates. Where is the $$ supposed to come from? The labor of the newborns that aren’t being born in the numbers necessary to support this?

86

If they could simultaneously pay military personnel more and then provide the medical, family, educational, and pension services of the military to civilians, we’d all be in a better place (not to say that VA hospitals don’t have serious problems - I’m referring to the government-paid health insurance coverage for military personnel, not the quality of service of some of the poorer health care facilities).

87

Easy to complain, but what is the solution (to financial solvency of social services)?

And to say “every man for themselves” is not a solution. Societies need to take care of their elderly, handicapped and underprivileged. Specifically, it’s not realistic to propose everyone pay for their own medical care or just not get it. You can’t seriously be suggesting a hospital assure payment before admitting someone into the emergency room.

EDIT: And if you are going to propose the every man for themselves solution, let’s apply the same thing to fire and police protection. Why should a non-homeowner pay for a homeowner’s fire protection? How about when you call the fire department, you need to provide a credit card for payment.

88

Good points…the US is structured so that certain elements benefit more than others. For example Surfer dude has an excellent healthcare and pension due to his contribution to military/empire building. These people don’t see the benefit for ‘them’ so they don’t want to change the system… However in my opinion it shows a lack of real patriotism to not really care about your fellow citizens.

Not only the US but every country has their privileged elements, in Taiwan that would be teachers, civil servants and the military aswell as business class.
The haves should always be careful to not be too greedy as they would create a large underclass which threatens the system that benefits them.

Americans generally still believe in ‘anyone can be rich’ but if you look at the corporate structure you will see that is very far from the case. In the olden days manual workers could still do very well with America’s industrial might and resources but now that crutch has been removed when they shipped the jobs off to Asia, America is in danger of creating a large expanded underclass unless it gets its act together.

Strange country America…don’t even pretend to understand it :doh:

89

Well, what happens is that a country has to tax or borrow ever more money to maintain the funding of those benefits. At some point, there’s only so much you can tax people or businesses, even assuming they don’t flee the country in search of greater prosperity elsewhere. In terms of borrowing, historically, it’s been quite calamitous for a country to do so and has led to either hyper-inflation or defaulting on loans, both of which have serious implications for the economy and social stability anyway.

90

[quote=“headhonchoII”]Good points…the US is structured so that certain elements benefit more than others. For example Surfer dude has an excellent healthcare and pension due to his contribution to military/empire building. These people don’t see the benefit for ‘them’ so they don’t want to change the system. However in my opinion it shows a lack of real patriotism to not really care about your fellow citizens.[/quote]I like your opinion. But, it also requires the ussumption that people who serve the military do it primarily for patriotic reasons and not simply as another kind of career for personal or financial gains, or just stability for their future.

91

It’s a gaping hole though an intentional hole - more like a donut hole actually, I wasn’t avoiding the question of cost, I just didn’t bring it up.

Firstly, government-run health insurance has far less overhead than private health insurance, and there is no profit motive, though I would argue that forcing a state-owned company to pay for itself is generally a good thing (though it doesn’t work for some services - another thread…). Secondly, there is a point where the social obligation to provide a service trumps the discussion of cost. What I mean is, this is something that MUST be done, how it’s paid for - additional taxes, higher taxes on certain income levels, cutting other costs e.g. military, debt, and so on - is something that has a lot of possible answers, but whatever they are, they MUST happen under our social contract. I personally vote for a small increase in overall income tax across the board, coupled with a higher upper level income tax, and some cost cutting on some other discretionary items - and force the pharma industry to cut prices for god sake.

And about social security - I think there’s a fundamental misunderstanding about social security in the US. That is, the SS fund was funded for a lot more than is there right now, but what happened was the politicians in their eternal wisdom (read sneaky-bastardness) “borrowed” the money for SS in the general fund and then spent it; now they can’t afford to pay it back, so it looks like the fund is way lower than it should be. That’s not the “fault” of the SS system, it’s the fault of the fuckers who took it to make it look like budgetary ends were meeting. Yes SS is an issue when you have more and more older people and fewer payers in, but that problem does not mean that you should eliminate the system or privatize the system, it means you have to fund the system in such a way that for those decades where there are more payouts, the savings from earlier “profitable” years (hahaha, I know) is fed back in, and if necessary, supported from the general fund. Privatization is not the answer because it’s sort of like Russian Roulette - when it’s time for you to need it, you may have a 1 in 6 chance that the market got hammered and now you’re screwed - and the point of SS is not to maximize profit or RoI but to try to ensure a stable income level of a certain amount - you can do your market-gambling with your discretionary income.

92

[quote=“TwoTongues”][quote=“Northcoast Surfer”]
4. US Social Security. I don’t need it. I will take it. Why? I paid into it, and not by choice. I either want all of the money I paid into it, or I will settle for the monthly benefits when I qualify. If there is anything left to it, that is.

  1. Medicare. Won’t ever need it.

…

  1. I don’t see welfare, food stamps, WIC, and the like as benefiting everyone as a whole and I’m against these programs. Provide these people with education and with their willingness to learn, they could provide for themselves. But, would they want to provide for themselves?
    [/quote]

All that sounds ideal but the fact is, you can not be sure you will always have your job and your house and whatever else. What you say sounds great to you now, but that could change in the blink of an eye for you, and then you’re screwed. Or else you’re sufficiently wealthy to be able to afford losing a house and a high paying job and going into debt from an illness or car accident, at which point you owe society and government even more for setting up a system that allowed you to accumulate that wealth.

The US government provides an environment for business that allows them to fairly easily lay people off when the company is not doing well, or even when it is making a profit but not enough for their appetite and shareholders. This environment is not friendly at all to retraining, as there is very little social safety net for the 6 months to 1+ years of retraining and additional education needed if your job falls through and there’s nothing else to do in your area. We haven’t even talked about what happens to your kids, their schooling, and so on.

If the government is going to allow such an environment for business, then it has a social obligation to provide the basics to survive to those individuals who are negatively affected by the ups and downs of the business cycle and the bottom line, and also to those who are in the educational system or are retraining.

That obligation must include basic shelter, food, transportation, health insurance or actual health care, and subsidizing or at least loaning money for the education/retraining effort. Many many great things have come from business and the fairly-free business environment of the US, but businesses and the government are here to serve society, society and government are not here to serve business, and the business world is not the top priority or the end goal here, it’s ensuring a safe and stable society for the maximal amount of citizens.

To say that “US Social Security. I don’t need it” and “Medicare. Won’t ever need it.” and “Provide these people with education and with their willingness to learn, they could provide for themselves.” is not only selfish but ignorant and potentially untrue - unless you are already wealthy or waiting on a huge inheritance, you don’t know what situation you’ll be in in even 1 year nevermind 5 to 10 years, and just because things are working out nicely for you now does not mean at all they will continue to work out that way. What are you gonna do if you find you have a huge cancer inside that’s not covered by your medical insurance, or worse, that you lose your insurance with your job and then find out about the cancer? What happens if a hit and run driver leaves you missing a body part and they never find the guy to pay? What happens if your nest egg of retirement savings goes fwwwwwwwp like many people in 2001 and again in 2008, and you find yourself really needing those social security payments? A lot of people do, man, and they are not lazy at all.

As for “Provide these people with education and with their willingness to learn, they could provide for themselves.”, that’s also entirely untrue - how about all the people that got laid off recently (the 10% unemployment rate only includes people looking for work, not chronic welfare-type cases) - you think they don’t have a degree and aren’t looking for a job? It just isn’t that easy for a lot of people, and people often can’t just pick up and move around the country or the world to find a new job.[/quote]

Very well said. I’d go further to say that to maintain a healthy and well educated and therefore efficient workforce in a modern, mature economy you need to provide a safety net.

In any case, the US already provides defacto free healthcare through the A&E/Emergency room. This is the most expensive and ineffective means to providing healthcare. Better face this directly and manage this through some kind of system.

93

I honestly don’t know what the solution is. Headhoncho alludes to the difficulties of the average worker in losing his job overseas, but that’s simply because with China and India on the scene, there’s effectively a tripling in competition. Wages (and other benefits) will reach for an equilibrium.

For myself, I’m trying to save and invest my money as best I can whilst living a relatively frugal life compared to many Westerners. I think the lifestyles of the West over the past thirty years have been unsustainable from a whole lot of angles. I’m also trying to keep my employability fairly mobile and I’m prepared to go where the going is good and move my money where necessary. That is in part why I am in Taiwan right now. Patriotism is an outmoded concept. I think those things are all anyone can hope for, really. I’m not particularly optimistic about the next century for most Westerners (although if I were at the other end of the scale, say in India or China, I would be more optimistic about Asians’ futures since I would stand to improve my standard of living). The world is simply going to become a much, much more competitive place and old standards, expectations and entitlements are going to change, whether we want them to or not.

94

That makes sense to me, too, it’s fairly obvious that you can’t keep living in a high state of debt for decades - both the government and individually. Though I would argue that some amount of debt is perfectly normal, and having a “balanced budget” in any particular year is a silly dream that has no real usefulness of meaning. As we say in the requirements business “it’s a nice-to-have and a feel-good”. Decide on what the social contract and modern technology/medicine allows for, and do it! Not everyone has to agree on every bit, but 60-70% want government covered health insurance, and it is not prevented by the bill of rights (unlike, say, if 60-70% wanted to eject a particular minority from the country), so the fuckfaces in congress who are greased up on corporate and lobbyist dollars ought to be ashamed.

95

It’s fairly safe to assume that the people who want government health care plans don’t expect it to cost nothing. I think the point is that health care shouldn’t be put to the same profit-loss equations as a TV set.

96

TwoTongues: Clearly, costs in America are out of control in healthcare, but even in other countries, such as Taiwan, government is going to find itself falling ever short, and not just with healthcare. I’m actually largely beyond a public vs private debate these days because I think people are just splitting hairs over how quickly they’re going to go to hell in a handbasket, to mix my metaphors. I think virtually all of the developed world has cooked its goose so to speak because people are living vastly unsustainable lifestyles in everything they consume from business’ goods to governments’ services. There’s a massive sense of entitlement. Households, governments and the environment can’t sustain it though and there’s a massive readjustment coming for all three. It’s fucked, but I am not at all optimistic about where things are going to be at by the end of my lifetime based upon current trends. Globally, we’re going to see all sorts of problems and political instability arising from environmental degradation (I’ll leave aside the usual bugbears of global warming and peak oil and just mention arable top soil loss, pollution of water, air and soil, fisheries collapse, etc.), excessive debt/hyper-inflation/default, and all of the secondary issues such as war and huge numbers of refugees that will follow.

Debt is one thing, but excessive debt of the sort that developed nations are heading for is another entirely. It destabilises political processes, especially when outside forces hold the debt, and it drives economies backwards. All of this leads to greater social problems and an increased inability to cover government programmes. It’s actually a real problem. Plenty of empires or wealthy nations have crumbled as a result of fiscal insolvency.

97

CraigTPE: All very well and good, but they still need to be paid for. Debt, and the effects of excessive debt, doesn’t really discriminate based upon what led to the debt.

98

Yes. It needs to be paid for. Best, most efficient way is to spread the risk pool over 100% of the population and charge each person the same premium. Then for those who are at some point below poverty, there will need to be a safety net, paid for, yes, by those with means. That’s how societies work.

The private insurance system is inefficient at spreading the risk, which according to them is their main purpose.

99

Absolutely agree with this part. The government needs to do something about the military, and it needs to make some bold steps in industry, such as nationalization or state-ifization of utilities, put hard limits on profit taking by banks and insurance companies, reduce speculation by requiring holding periods and adding fees to transactions (which would also help pay for enforcement), etc. They also need to put a hard limit on what a person can owe, and on the interest rate a bank/cc company can charge. Yes these are all invasive to the business process, but it’s a long time coming, the business world is way out of control, and unlike with government, the vast majority of us don’t get a vote on what they do or how much they rape society.

But I think the answer to services is probably incremental - add or enhance a service, in return cut some things and add a little tax and make some more things more efficient, then do the next thing - and it takes a long time and it will eventually make-over society. And that’s why, despite how lame-ass it appears at face-value, I think the health care bill is a good thing.

Also, I suggest a moderate amount of increased bacon-ingestion.

100

It’s fairly safe to assume that the people who want government health care plans don’t expect it to cost nothing. I think the point is that health care shouldn’t be put to the same profit-loss equations as a TV set.[/quote]
That is an excellent point. :bravo:

I’ll all for it.

Providing citizens with healthcare, not necessarily “affordable healthcare”, should be a goal of any well-functioning country. The thing is, protecting that system entails…down the line…making the stuff people do that harms their bodies (ie, salt,sugar,transfats) illegal, or in the least, costly. Tobacco has been taxed to death…well, not the tobacco industry, but the people…anyway; let’s see soda and chips and TV dinners taxed. That shit kills millions.

The fact is that people, in general, as citizens of countries, are not punished ENOUGH for the dumb shit they do to themselves and others.