“Coming down to it, I believe our fundamental disagreement to be this: that I trust disinterested and probably more incompetent government who have no profit motive more than I trust private corporations and conglomerates.”
-Chuckles
I can respect Chuckles’ ability to distill what is probably the essence behind most of the current health care debate. I can also agree that private/public corporations and conglomerates with their “evil” profit motives will do some things that a lot of people will find reprehensible.
However, the power of private/public corporations and conglomerates to do these reprehensible things is severely limited by the very profit motive that makes them so “evil.” Their evilness can only be prolonged as long as they are able to make a profit. Ultimately, their growth, power, and influence is going to be determined by whether they can create value for society or not.
Governments, on the other hand, operate by a different set of rules. For a good example of the complete failure that government’s disinterested incompetence can lead to, we can look at the usual suspect: California.
This week lawmakers in California authorized the government to withhold 10% of everyone’s paychecks to cover their budget shortfall. As evil as they are, private insurance companies cannot perform acts such as this. This is only the fourth or fifth time in the last year that lawmakers in California have raised taxes to close their budget shortfalls, and this will only be the fourth or fifth time that recent tax increases have resulted in lower than expected tax revenues. They keep raising taxes, and the amount of tax dollars coming in keeps shrinking. Democrats and liberals will try suggest that the era of Reagan is over, and it is time to remake the economy. The problem with this thinking is that economic laws can’t be changed by legislative will, e.g. you can’t legislate away the scarcity of an economy’s resources. There seems to be enough historical examples, of which California is just the latest, where increasing taxes during a recession only accelerates the downward spiral of decreasing overall tax revenues. The most recent Californian tax increase is absolutely criminal, and I guess I can’t understand why the same people that are livid about an insurance company making a profit will give disinterested, incompetent governments a free pass.
Given the current abuse Californians are receiving from their disinterested, incompetent government my objections to Obama’s current health care plan boil down to the fact that I don’t believe that Obama’s supporters can adequately answer the following questions:
- What evidence do you have that democrats’ health plan will be successful? Please! Point me to the government model of success that I can look at and say, if they run this the same way, we’ll be fine.
- What is the exit strategy for the possibility that things get worse? Let’s say Obamacare passes, and health costs don’t go down, joblessness increases, private insurers do go out of business, people stop wanting to go into the field of medicine, etc. I am not saying that I think all of these things will happen, but I do believe that the likelihood of a variety of negative consequences resulting from this bill is very high. In fact, the potential for these “reforms” to cause a lot of damage is a lot more likely in my opinion than that the earth will be destroyed by Carbon Dioxide. Once again, I am not saying that I have fallen off the fearmongering cliff, but I am asking for an exit strategy.
- Disinterested incompetence? Really? This is the impetus behind your hope and change? This is what you think will solve problems?
- Why try to do this all at once? The whole health-care reform issue comes across as a big, expensive power grab to me rather than a sincere desire to solve legitimate problems. If there is a a couple hundred billion dollars worth of waste and fraud in Medicare, let’s go fix that. Once it is fixed, and we can see that one of the government’s largest entitlement program isn’t careening towards bankruptcy, then let’s talk about how we can use some of the same intelligence and expertise that fixed that problem to help those who are currently uninsured.
on 
on 
All I know is that overnight a 1,000+ page bill “appeared.” obviously written long ago and simply added to by pork-hungry lawmakers.
To look at alternative fuel incentives and the paper industry one can see how something very simple quickly gets changed round so fast that the “result” no longer resembles the “intention.”
And so it is with every government program. Using a government to dispense money and allocate resources is the most inefficient way of getting things done. This will never change.
Good luck on getting a response to your questions without the usual rhetorical gobblygook or severe oversimplifications.
There is no “exit strategy” for a government program that fares poorly. I’ll give you one recent example. Everybody, even many environmentalists now, agrees that ethanol is simply a wealth transfer scheme for ethanol producers. It doesn’t really do much to lessen CO2 concentration and it’s a lot more expensive to produce and bring to market than previously thought. Now, knowing this, the question is how long before this money pit of a federal program gets axed? I estimate that it will be at least a decade before something-anything-gets done about it. These programs have an inertia that is impossible to stop. With ObamaCare–we are likely to live with it till it wrecks the Republic.
Driving out to a favourite restaurant out in Nowheresville Virginia yesterday (Lighthouse Tofu, if you get a chance, is worth any drive…), I listened to C-SPAN debate between those for and against the bill. My girlfriend had the idea that these hard-core believers in the free market should get their wish. They should be able to live in a world where government did nothing for its citizens, and the free market cared for everything. The results would be positively medieval. Feudal lords (capitalist landlords) would replace whatever flawed system we have now, as the powerful would continue taking what we have without the right for redress, and guilds would stifle competition b/c the worst thing in the world would be for advancements to come to people who are not in power. … Think how much Bush hated all media except Foxnews, and how much Obama hates Fox… if either of them had the power, you could see them passing serious restrictions. But they don’t. This wouldn’t happen under the system so many of these market fundamentalists imagine. The advances and gains of the late 19th and all of the 20th century had to do with the collectivsation of good ideas. I’m no communist. I’m an ardent capitalist! But I’m smart enough a capitalist to know that the world cant run on capitalistm exclusively. I just have a different sense of what makes sense as public utilities and what makes sense in private hands.
Now, to your comments:
*****Ultimately, their growth, power, and influence is going to be determined by whether they can create value for society or not.*****
Not when you hold a monopoly over an essential commodity. You can stand before a man dying of thirst with a bottle of water and try to extract from him everything his family has ever owned and his labour for the next however many years. The man will pay. He has no choice. The commodity is scarce, and you own a monopoly and control the price. There is no ‘value’ you can place on retaining your possessions if your life will be gone.
*****Governments, on the other hand, operate by a different set of rules. For a good example of the complete failure that government’s disinterested incompetence can lead to, we can look at the usual suspect: California.*****
I don’t accept your California example, b/c it is an absolute anomaly in American politics. Having taken History of SF with you, I know you know at least some of California’s history. But history is important here. The ballot initiative system is what is crippling CA by not allowing for raising property taxes without a 2/3 vote. California was a wholly owned subsidiary of the Union-Pacific RailRoad company until the ballot system came into being. So it was a positive step at the turn of the century, but now it’s a fantastic mess.
http://www.newyorker.com/talk/comment/2009/08/24/090824taco_talk_hertzberg
*****What evidence do you have that democrats’ health plan will be successful? Please! Point me to the government model of success that I can look at and say, if they run this the same way, we’ll be fine.*****
Well, allow me to hide behind the camouflaged jackets of our fine men and women in the military. National defense, transportation, security nets of Medicaid. Allow me to preempt your objections: “Waste! Fraud! Corruption!” To which I’d respond that any company working on a large scale will have instances of these. If we think for 2 seconds that Wellpoint doesn’t have waste, fraud and corruption, in addition to a profit motive, we’d be fooling ourselves.
*****What is the exit strategy for the possibility that things get worse? Let’s say Obamacare passes, and health costs don’t go down, joblessness increases, private insurers do go out of business, people stop wanting to go into the field of medicine, etc.*****
The exit strategy is the same for any program the government passes. Legislators could ‘un’legislate it. Sunset it out, or just vote things back to the way they were.
*****Disinterested incompetence? Really? This is the impetus behind your hope and change? This is what you think will solve problems?*****
No, I certainly don’t think it the norm. I personally know hundreds of civil servants who are remarkably dedicated to the jobs they have. Intelligent and well-educated, who use their off-hours to discuss policy chances and adverse effects of proposed changes. Having worked in NGOs and the private sector, I found as much if not more incompetence in people with jobs in the private sector. And quite a bit more disinterest. I personally don’t fall into the trap of believing that people in government are sloven, bumbling fools while people working for private companies are sharp and together, but I do not believe it. It’s a horrible false assumption. I was just stipulating to a common conservative belief—pandering to your inner Ronald Reagan. I was saying, “even if this were true…” and arguing from a place of artificial weakness, because I believe I can win on that point too. But coming down to it, is my hope pinned on that? No, absolutley not.
*****Why try to do this all at once?*****
That’s an easy one. The more time you spend doing it, the more time you allow the opposing forces to marshal their side, and the less likely anything is to pass. It shouldn’t come across as insincere. It would seem insincere to me to allow those who hate it to destroy it.
***** If there is a a couple hundred billion dollars worth of waste and fraud in Medicare, let’s go fix that. Once it is fixed, and we can see that one of the government’s largest entitlement program isn’t careening towards bankruptcy, then let’s talk about how we can use some of the same intelligence and expertise that fixed that problem to help those who are currently uninsured.*****
I don’t doubt your sincerity, but I might point out that that’s EXACTLY what somebody would say if they never wanted to solve this particular problem in the first place. I don’t believe that there are hundreds of billions to wring out of Medicare. You have to find the tipping-point: how much will it cost to effectively identify all of the waste, and change everything required. Because that by itself in a system this large could cost billions of dollars. How much would there be in savings? Estimates vary widely, but I’ve never seen any that come close to the figure necessary to insure America’s uninsured.
I’ve oft commented on how cute I find conservative understanding, and this is another one. Here’s another one: why do we have anti-competitive laws on the books that limit the number of insurers? That seems very “anti-market” to me. Well, the answer for people who look past ideology goes to the nature of the bargaining process when it comes to medical procedures. If you break your foot and you have no insurance, you’ll get it fixed, and the hospital will say, “that will be $5k”, and that’s what you’ll owe. If you’re over 65 and you break your foot, the hospital will tell Medicare that they own $5k. Medicare will say “we will pay you $900, and deal with it.” If you break your foot and belong to an insurance plan that owns >50% of the marketshare, the hospital will say to them “you owe $5k” and they will say, “we will pay you $1750.00, because according to our studies, that is the ‘real’ cost, and if you don’t like it, all of our customers will be ineligible at your facility.” And the hospital will take it. If you belong to an insurance company that has <30% of the marketshare, the will have a $5k bill shoved at them, and they will be told to pay, but their bargaining power is not there. They will have to pay it and raise premiums, or pull out of the market, like Aetna did in many places in the early 2000s.
My point here: people who claim “let the market solve the problem” have no idea what they’re talking about. I realise that’s not your point in the post I’m replying to. Just had to get that off my chest.
Do I love the bill that passed Saturday night? Nope. But I do think it’s a step in the right direction.
Chuckles
Dear VH:
*****Good luck on getting a response to your questions without the usual rhetorical gobblygook or severe oversimplifications.*****
And thank you, VH, for your vague reference to things you clearly do not understand.
*****There is no “exit strategy” for a government program that fares poorly.*****
I did health policy for a living for at least a few years and have worked directly with the government, but, pray tell, what do you mean by this. Because, I’ll be honest, I’m lost.
***** I’ll give you one recent example. Everybody, even many environmentalists now, agrees that ethanol is simply a wealth transfer scheme for ethanol producers. It doesn’t really do much to lessen CO2 concentration and it’s a lot more expensive to produce and bring to market than previously thought. Now, knowing this, the question is how long before this money pit of a federal program gets axed? I estimate that it will be at least a decade before something-anything-gets done about it. These programs have an inertia that is impossible to stop.*****
As an ethanol hater myself, all it takes is the political will. There are lots of loathable programs out there (ethanol has been rolled into the larger body of ag subsidies, and will be tough to eliminate—but I oppose all of them on free market grounds).
With ObamaCare–we are likely to live with it till it wrecks the Republic.*****
Yeah, totally. I’m sure “we will be spending our sunset years telling our grandchildren what it was like to live in a free country”, right? According to Ronald Reagan and when he first prophesied that, America ceased to be free with the passage of Medicare in 1965. So… accoridng to the Prophet of modern America conservatives, we have nothing left to lose. There is no Republic left to wreck. So what are we all complaining about? It’s like taking a demolished car to a demolition derby. What’s the difference if we add a few dings to it?
Chuckles
You are right about monopolies, and I generally don’t have a problem with government interfering. To the extent that health insurers are monopolies, it seems like there are better alternatives for busting up a monopoly rather than initiate a massive new entitlement program.
You’re right. The problems in California are due to ballot initiatives that are preventing them from raising taxes even more. It is entirely impossible that government spending can ever be out of control or inherently destructive. Liberals can be cute too.
To use the success of our military as a justification for entitlement programs, seems like a bit of a stretch, but I’ll give you points for creativity.
How many major pieces of legislation, like this health care law, get un-legislated? You know this is highly unlikely.
I’ll be back later
*****You’re right. The problems in California are due to ballot initiatives that are preventing them from raising taxes even more. It is entirely impossible that government spending can ever be out of control or inherently destructive. Liberals can be cute too.*****
Well, just a logical quibble: “can ever be out of control or inherently destructive?” It would have to “always” be destructive to be ‘inherently destructive’. But yes, of course bad spending is always worse than no spending at all. I’ve seen California roads, and I hear about California public schools, and I see a property tax cap that’s nearly impossible to surmount, and I see a ridiculous recipe for civil society. You just need a recalcitrant minority larger than 1/3 and your budget will never be solved.
Remember that Simpsons about the Bear Tax? People in CA DEMAND the services of roads and schools, but they refuse to pay for them. “Are these morons getting dumber or just louder?” “Dumber, sir.”
I hold to my original premise: California’s is it’s own box of fruit loops.
We’re here, We’re clear, We don’t want any more Bear!
Kalifornia voters, like all tax payers, do want some government services. However just because they want them and just because the government takes the money to give them doesn’t mean the voters will get what they want. There are many ways to change a bill around and to pervert its original meaning by the time it is signed into law. There are layers upon layers of bad amendments in the Kalifornia bills. The fact is most voters don’t know what goes on nor do they have the time. Sure, we get the governmnet we deserve but blaming voters for passing various propositions is not the right answer. If anything, those propisitions throw kinks in the path of lawmakers to pass more pork.
Dear Chuckles,
“And thank you, VH, for your vague reference to things you clearly do not understand.”
No, no, thank you for what your oversimplification of things you don’t understand.
“I did health policy for a living for at least a few years and have worked directly with the government, but, pray tell, what do you mean by this. Because, I’ll be honest, I’m lost.”
No doubt you’re lost. You agree on the issue of ethanol but still do not understand why government couldn’t possibly screw up health care. Yup, you are lost.
“Yeah, totally. I’m sure “we will be spending our sunset years telling our grandchildren what it was like to live in a free country”, right? According to Ronald Reagan and when he first prophesied that, America ceased to be free with the passage of Medicare in 1965. So… accoridng to the Prophet of modern America conservatives, we have nothing left to lose. There is no Republic left to wreck. So what are we all complaining about? It’s like taking a demolished car to a demolition derby. What’s the difference if we add a few dings to it?”
And what are you complaining about. If the country isn’t free, as you say, then not having government take another one of our freedoms (in this case, freedom of choice) won’t mean a shred to you. Relax. Take stock in your Messiah, he’s going to bring you all the security that your little heart desires.
Dearest VH:
*****No, no, thank you for what your oversimplification of things you don’t understand.*****
You seem to have a ‘thing’ for “oversimplifications”. You’re kind of the “oversimplifications” guy. The one guy on the sitcom who has a phrase he uses over and over, to greater comedic effect each time. It doesn’t seem to me, based on your two posts in this thread, that YOU bring anything substantive to the debate. You’re all about substance, but you have nothing to offer.
*****No doubt you’re lost. You agree on the issue of ethanol but still do not understand why government couldn’t possibly screw up health care. Yup, you are lost.*****
So allow me to unpack that: because I’ve worked in the policy field being discussed and am currently involved in the healthcare debate here in DC, I’m lost? You realise your argument only requires me to come up with one segment of the economy that the free market has not or cannot solve and we’re on an even footing, and we’ve adequately disqualified them both, making both government and the free market ineligible to handle health care. I’ll go with…energy. The Free Market has not been able to adequately provide energy resources to most/all citizens, and therefore would undoubtedly fail at healthcare.
(Note: for this to be an even comparison, we’d have to pretend private health care hasn’t already failed miserably… and we’d have to pretend that health plans have not been subsidized by taxes since the Truman administration, and we’d have to pretend that VA healthcare and Medicare are not run by the government… both of which have vastly higher-rated medical care and coverage than the quasi-private system we have now… Or am I “oversimplifying” again?)
Speaking of which, why don’t you privatize the VA? Or Medicare? Those are 100% govt run healthcare plans. And people who have those plans, compared to people who have private insurance, LOVE their health care. Say what you will about it, you can’t say the govt can’t do it. It has been doing it for decades.
*****And what are you complaining about. If the country isn’t free, as you say, then not having government take another one of our freedoms (in this case, freedom of choice) won’t mean a shred to you. Relax. Take stock in your Messiah, he’s going to bring you all the security that your little heart desires.*****
You truly have an unbeatable formula: you don’t seem to understand statements which you claim are oversimplified. All I can say is thank heaven the for the intrepid internet company has found its way to your armoured RV in the middle of some desert, so you can beam these delightful soundbites to entertain so many of us. You have to understand that some of your statements, the one above in particular, come off like right-wing fortune cookie slogans pulled randomly from a hat and pasted together without concern for coherence. I don’t really know how to respond. Take stock in my Messiah? I probably should. The gob-mint is going to take away “one of your freedoms, in this case, the freedom of choice” by providing an additional option (perhaps)? — What is on the table right now is a weak public option or a trigger option. Is this crippling your choice? Many argue it’s the road to “single payer”, which I wouldn’t cry over. As costs increase by 10s of percents every few years, what are our options? What limits my choice now are costs that I wouldn’t be able to surmount if I got sick. And I’m not poor. I don’t consider the insurance company the real enemy in this whole mess, but my explanation would go WAY over your head.
But I’ll save what else I might have said, as I’m sure I lost you a while back, what with my egregious oversimplifications.
Best,
Chuckles
VH,
Just a follow-up observation: this thread began with a series of questions. I did my best to answer those questions.
You have had no comment on any of the questions or responses. Do you understand what is being discussed? How about a substantive rebuttal?
Chuckles
@ Chuckles:
***The Free Market has not been able to adequately provide energy resources to most/all citizens, and therefore would undoubtedly fail at healthcare.
Those who believe that markets are good at allocating scarce resource usually don’t make the leap that they will adequately provide enough of a resource to most/all that want it or feel entitled to it. Markets will usually allocate the scarce resources more efficiently.
Those who believe that a central planning agency can adequately allocate scarce resource usually do believe they can provide a resource, despite its scarcity, to those who want or feel entitled to it.
Obviously, people on medicare love their health coverage. If Medicare wasn’t on a crash course towards bankruptcy, I would concede the point that government can provide healthcare for people. Just because people like Medicare, doesn’t disguise the fact that it is a fiscal disaster and therefore a failure.
*****Those who believe that markets are good at allocating scarce resource usually don’t make the leap that they will adequately provide enough of a resource to most/all that want it or feel entitled to it. Markets will usually allocate the scarce resources more efficiently.*****
Rubbish. Help me get around the natural monopoly problem. Energy allocation in the free market almost REQUIRES monopoly. Energy is a prime example of that.
Okay, you don’t like Medicare. That’s fine. Go VA Health. What say you about Veteran’s healthcare?
Dearest Chuckles,
How appropriate that your handle is “Chuckles”…you would be a big laugh if you weren’t so boring and predictable. Anybody that really believes that the free-market has failed to provide cheaper and more abundant energy to more people in history over the last 150 years is truly beyond reasoning. Do you even understand what you are saying? No…you don’t.
You see, Chuckles, everything around you that has made our modern standard of living possible is precisely due to the abundance of energy—food, medicine, clothing, longer life spans, computers, etc—and the beauty of low cost brought to us by entrepreneurs, inventors, and free markets. Even the poorest among us has benefited in one way or another. Take a look at North Korea and how dark it is on satellite images at night; aside from a lack of energy you’ll find a lack of free-market there too. Your assertion is a oversimplified joke. Try again.
Chuckles,
I wonder if we are thinking of different things when we refer to “energy”
If you are referring to trading energy commodities, you probably end up in a moderately regulated open market.
If you are referring to power utilities, you end up in a more regulated market, mostly due to the monopoly problem to which you refer. In this case, I would agree, it makes more sense to have one power grid served by one company, which because of the potential for abuse, should be regulated by local governments (the more local the better).
In addition, notice that I said the government’s role in this scenario is to regulate the potentially monopolistic industry – not build the infrastructure, maintain the system, source the raw energy materials, manage environmental impact, etc. These are functions that I would prefer to be run by competent profit seeking capitalists, Warren Buffet comes to mind.
You get the govt. too involved in actually providing the good or service, and you end up with an industry like the health care industry.
I guess I am not making the leap with you that health insurance should be a public utility.
Sigh,
VH, your example is “Everything”? Hard to argue with that. I’ll bow out of this one, your argumentation is overwhelming.
Bloghorn,
There is agreement to be had around Medicare, but that has more to do with medical costs growing up in a void of market AND government corrections. I have discourses that I could write on this, but I’ll save it for another time.
Chuckles
@ Chuckles,
I liked your comment about the bargaining process involved in health care. The interesting point in the scenario that you illustrate is how prices can possibly be determined for medical procedures. With a barrel of oil, eventually the price will get so high, that you would have to be a sucker to buy it. The value you can extract from it is limited. Your foot on the other hand doesn’t have this price ceiling. Markets can allocate scarce resources pretty well in my opinion. It is possible for a government to regulate a market pretty well. However, how should priceless resources (body parts) be allocated.
Rather than compare the healthcare industry to a public utility, I have compared it in the past to something more like public education. Public education in theory is a great idea, and it is hard to argue against it. However, the government’s (especially the federal government’s) execution of the project of public education is pretty dismal in my opinion.