Should broke people receive health care?

[vern_humphrey]

The finitude of resources is not something we can cope with. Maybe it is an ethical reason to promote population control agendas, but I do not know. I simply want less suffering in this world.

Population control agendas have proven pretty much of a failure – they cause more problems than they solve.

 

[SoCalRC]

Not true MSAs – which allow you to save pre-tax (California can’t change federal tax laws!) and to roll over any saved money into your IRA.

Better do a little research, I first contributed to a medical savings account in 1996. It doesn’t get talked about much in conservative circles because, like pilot school voucher programs, reality pretty much dispells myth.

But more than half health care costs are in insurance paperwork. MSAs eliminate the paperwork.

MSAs pay for healthcare out of current income, not out of investments.

Again, I find it surprising that even the most basic aspects of economics seemed to get missed in the rush to redistribute weath.

First of all, it creates more paperwork, not less. Since, like a 401K it involves an alternate status for income.

Second, you cannot plan for when you will get sick. Savings accumulates over time, but you can still rack up massive health bills for, say, an accident or sick child.

Insurance handles this by creating a risk pool. If you are not in a risk pool, someone gets hosed - either way, there are systemic costs to be absorbed. If you talk about ‘helping those’ whose accounts can’t cover their costs, you end up with a risk pool - rather it is a national charity or private insurance. Once you have a risk pool, you need mechanisms to avoid corruption, which turns back into paperwork.

Third, the accounts have to be invested to keep pace with inflation. And, of course, that still does not keep pace with medical costs. So yes, you would be paying medical bills out of investments.

Actually, I’m surprised that anyone with basic arithmetic skills would propose that MSA’s are anything other than another middle/upper middle class handout. That is the reason they are so popular in circles which look heavily to private insurance and investment firms for political funding.

 

[SoCalRC]

Population control agendas have proven pretty much of a failure – they cause more problems than they solve.

Is that why the low population growth countries are so much wealthier (and live longer) on average?

 

[a_priori]

The finitude of resources is not something we can cope with. Maybe it is an ethical reason to promote population control agendas, but I do not know. I simply want less suffering in this world.

We all want less suffering in the world. I think it has less to do with total available resources than it does with people being God’s instruments on earth and being willing to share more of what they have. Government obviously has a role. But this problem cannot ultimately be legislated away.

 

[ribozyme]

We all want less suffering in the world. I think it has less to do with total available resources than it does with people being God’s instruments on earth and being willing to share more of what they have. Government obviously has a role. But this problem cannot ultimately be legislated away.

Sigh… does this mean we have to rely on charity? I find that unpalatable. Humans are vain, status-seeking creatures who are programmed only to propagate their genes.

We are not extremely altruistic in nature; I do not trust charity because I do not trust humanity. Humans are capable of inflicting enormous suffering without remorse. For example, the working conditions of the Gilded Age and the Nazi death camps. Governments should function to protect people from themselves and the ignoble actions of humanity, but the people controlling the government needs to be kept in check too.

 

[vern_humphrey]

Sigh… does this mean we have to rely on charity? I find that unpalatable. Humans are vain, status seeking creatures who are programmed only to propagate their on genes.

We all have only two choices – rely on charity, or pay our own way.

The only difference in a tax-payer supported system is that the charity is not freely given, but extorted from the wage earner by threat of force.

I beg your pardon – I mis-spoke. There is another difference. In a tax-payer supported system, the bureaucracy eats more of the money, and the bureaucrats are less compassionate.

We are not extremely altruistic in nature; I do not trust charity because I do not trust humanity.

Will a government system not be run by those same humans?

Humans are capable of inflicting enormous suffering without remorse. For example, the working conditions of the Gilded Age and the Nazi death camps. Governments should function to protect people from themselves and the ignoble actions of humanity, but the people controlling the government needs to be kept in check too.

Then we should definitely not put our fate in the hands of government!

We have already seen how a Canadian, disparing of getting treatment in the Canadian system, came to the US, found he could neither pay for treatment nor would his own government pay it, returned to Canada and for punishment was sent to the bottom of the list and died without treatment.

 

[a_priori]

Sigh… does this mean we have to rely on charity? I find that unpalatable. Humans are vain, status seeking creatures who are programmed only to propagate their on genes.

We are not extremely altruistic in nature; I do not trust charity because I do not trust humanity.

If you live in a strictly mechanical universe where energy, time, matter and chance alone have produced the world as we know it including ourselves, then stark social Darwinism rules the day as we eat, drink and spread our genes to the extent that our economic status allows us to.

I believe in a different world where God created us (I’m a Big Bang/evolution guy too) all and He expects us to use all means at our disposal including the political process as well as our own material possessions to alleviate the suffering of others to the extent we can based on what we have been given. I’m merely saying that the political process cannot, by its very nature, be relied upon to redistribute wealth fairly. The concept of “fair distribution of wealth” is highly subjective.

Economic systems, like meandering elephants, will do what they do and when you attempt to tweak them, you often get a result you didn’t expect.

 

[SoCalRC]

It seems to me that the division of opinons on this thread is not between those who want health care for the poor and those who don’t – we all want health care for the poor – but between those who believe there is such a thing as a free lunch, and all you have to do is wave a magic wand to get it, and those who know that’s not true and are seeking economically sound ways to finance health care for the poor.

That is an amazingly silly statement. The problem is that health care is massively expensive and largely not optional. That is, it often comes down to ‘get treatment or die’.

So no matter what system you use, some folks are going to get a ‘free ride’. I’d have to look to get exact figures, but let’s say I pay $10,000 a year for an employee’s family medical coverage. After three years with me, mom and the kids are in a terrible traffic accident and wrack up $1.7M in medical bills. All of a sudden, poor me is paying significantly more for every member of the group. Does that make the family in question free loaders? Are the rest of us in the group plan victims?

Most folks with any semblence of a brain and concience would say no, we understand that we are sharing risk as a group and any of us could be the ones with a family fighting for its life.

This argument boils down to idolatry of a fiscal system to the point of blind faith, or acceptance of earthly reality. No matter how many times a conservative pundit thumps his chest, we already have clear evidence.

Right now, we have nationalized health care for the most expensive class of citizens (who also now are the wealthiest). And, for many decades it has outperformed private heath insurance in cost management and overhead. The only reason that it does not outperform today is that it is precluded, by law, from bargaining on drug costs, the highest source of inflation in medical care (for some reason that GOP did not believe in the free market that time). But, based on VA history, we know that group bargaining on drugs also works.

But, even with a collecitve bailout for the most expensive patients, our current private based insurance risk management system is the worst performing among industrialized nations. That is, we pay the most ($0.05 of every GDP dollar goes to administration in private insurance companies), and privide less care to fewer people.

This seriously effects us in many ways. We are less competitive in world markets and we have massive costs in leaving 40,000,000 off, or nearly off the system. Now, what makes the fiscal policies of the countries that pay less and get more (35-39 of them depending on whose numbers you use) irresponsible or impractical?

They demonstrably work. In terms of outperforming the private sector, our own nationalized health care system components actually work (remember, the medicare pool is the highest risk, most costly group in the nation).

So, “responsible”, in terms of spending less and getting more is clear. So the argument is ideological - policies that work, or blind devotion to the alter of selfishness and greed.

 

[rlg94086]

Sigh… does this mean we have to rely on charity? I find that unpalatable. Humans are vain, status-seeking creatures who are programmed only to propagate their genes.

We are not extremely altruistic in nature; I do not trust charity because I do not trust humanity. Humans are capable of inflicting enormous suffering without remorse. For example, the working conditions of the Gilded Age and the Nazi death camps. Governments should function to protect people from themselves and the ignoble actions of humanity, but the people controlling the government needs to be kept in check too.

Hmm…you seem to have quite a conundrum. You don’t believe in and therefore can’t rely on God. You don’t trust humanity. What to do?

I pray that you will realize some day that love for fellow man comes from God. This is why charity can work…God’s love is infinite. When men (and I mean this in the gender-inclusive sense) start listening to their God-given conscience, they open their hearts and charity flows. This is why the communist experiments failed.

I determined (when I was slightly younger than you) that political constructs and programs won’t change the human condition. A change of hearts is the only thing that will work. A purely scientific approach, which you seem to favor, will only put greater capability for evil in the hands of dark-hearted humans.

 

[SoCalRC]

Economic systems, like meandering elephants, will do what they do and when you attempt to tweak them, you often get a result you didn’t expect.

But we tweak ours constantly. Rather it is tax cuts and bailout money, to fiscal policy.

All the lasse faire neo-conservatives would scream bloody murder if I suggested that we pay for national security in private military accounts. They see intuitively that you cannot have a massive standing army without a massive federal pool and coordinated effort. And they see military might as a common interest.

The question becomes, is the system maintainable. At 10-18% inflation, the system is going to explode. We waste time yacking about social security, when we have to project anemic economic growth, literally, forever to even make the system look modestly insolvent, while quality of care plummets, extension of coverage shrinks, and percentage of GDP soars.

Personally, I think it is in our national interest to not be in a health care crisis. And, it doesn’t bother me if, God forbid, someone gets medical treatment even if they have a slacker attitude.

 

[SoCalRC]

Hmm…you seem to have quite a conundrum. You don’t believe in and therefore can’t rely on God. You don’t trust humanity. What to do?

I pray that you will realize some day that love for fellow man comes from God. This is why charity can work…God’s love is infinite. When men (and I mean this in the gender-inclusive sense) start listening to their God-given conscience, they open their hearts and charity flows. This is why the communist experiments failed.

I determined (when I was slightly younger than you) that political constructs and programs won’t change the human condition. A change of hearts is the only thing that will work. A purely scientific approach, which you seem to favor, will only put greater capability for evil in the hands of dark-hearted humans.

I would be careful in passing judgement. We all fail Jesus in this way. At some point we all put more faith in earthly constructs than the Lord. Sure, turn the cheek sounds nice, but it is impractical…

And really, isn’t that what is happening here? We already have socialized structures in our society. Our most massive mechanism is one of war. We spend more on military than most other industrialized nations combined. Yet, early Christians faced the Roman empire with no armed resistance at all.

All that we have comes from God. Nearly 40 other nations spend dramatically less for better health care for a greater number of their citizens than us. That result is by the grace of God. So when we reject something that demonstrably works, all for the sake of remaining true to a human ideology that demonstrably works contrary to the teachings of Jesus - what does that say about what we truly worship and believe?

 

[rlg94086]

I would be careful in passing judgement. We all fail Jesus in this way. At some point we all put more faith in earthly constructs than the Lord. Sure, turn the cheek sounds nice, but it is impractical…

Who was I passing judgment on?

SoCalRC:

And really, isn’t that what is happening here? We already have socialized structures in our society. Our most massive mechanism is one of war. We spend more on military than most other industrialized nations combined. Yet, early Christians faced the Roman empire with no armed resistance at all.

All that we have comes from God. Nearly 40 other nations spend dramatically less for better health care for a greater number of their citizens than us. That result is by the grace of God. So when we reject something that demonstrably works, all for the sake of remaining true to a human ideology that demonstrably works contrary to the teachings of Jesus - what does that say about what we truly worship and believe?

I made a comment on humanity and charity. What do these two paragraphs have to do with my post? What did I reject in my post “that demonstrably works?” Are you taking issue with my statements regarding God and charity? I don’t understand your post in relation to mine.

 

[vern_humphrey]

That is an amazingly silly statement. The problem is that health care is massively expensive and largely not optional. That is, it often comes down to ‘get treatment or die’.

There are two problems – one is that the cost of paperwork exceeds the cost of health care. So one way to get healthcare costs down is to cut paperwork – and that’s what MSAs do.

The second is, someone must pay. Hospitals won’t grow out of the ground, doctors won’t work for free, drug companies won’t develop and sell drugs at a loss.

Therefore we need a system where those who can pay, do pay, and those who can pay something pay what they can. And we help those who truly cannot pay.

So no matter what system you use, some folks are going to get a ‘free ride’. I’d have to look to get exact figures, but let’s say I pay $10,000 a year for an employee’s family medical coverage. After three years with me, mom and the kids are in a terrible traffic accident and wrack up $1.7M in medical bills. All of a sudden, poor me is paying significantly more for every member of the group. Does that make the family in question free loaders? Are the rest of us in the group plan victims?

When did this happen? Or is this another fantasy?

If you had an MSA you would be liable only for the amount you saved each year, and your catestrophic coverage would take care of the rest.

Most folks with any semblence of a brain and concience would say no, we understand that we are sharing risk as a group and any of us could be the ones with a family fighting for its life.

And the best way to do that is through an MSA, not through a bureaucrat-ridden single-payer system.

This argument boils down to idolatry of a fiscal system to the point of blind faith, or acceptance of earthly reality. No matter how many times a conservative pundit thumps his chest, we already have clear evidence.

**Your **argument may boil down to idolatry of a fiscal system to the point of blind faith, but mine doesn’t.

Right now, we have nationalized health care for the most expensive class of citizens (who also now are the wealthiest). And, for many decades it has outperformed private heath insurance in cost management and overhead. The only reason that it does not outperform today is that it is precluded, by law, from bargaining on drug costs, the highest source of inflation in medical care (for some reason that GOP did not believe in the free market that time). But, based on VA history, we know that group bargaining on drugs also works.

First of all, I invite you to visit the nursing home where my wife works and see how well it “works.”

Secondly, I invite you to visit a VA hospital and see how they “work.”

But, even with a collecitve bailout for the most expensive patients, our current private based insurance risk management system is the worst performing among industrialized nations. That is, we pay the most ($0.05 of every GDP dollar goes to administration in private insurance companies), and privide less care to fewer people.

Because we pay about $0.60 of every dollar spent on paperwork. And believe me, a government system will not have less paperwork – nor less fraud. I cite Medicare as an example.

MSAs, however, cut the paperwork dramatically.

This seriously effects us in many ways. We are less competitive in world markets and we have massive costs in leaving 40,000,000 off, or nearly off the system. Now, what makes the fiscal policies of the countries that pay less and get more (35-39 of them depending on whose numbers you use) irresponsible or impractical?

You’ve made that claim, now support it. Prove that we are less competitive, and show that is somehow linked to healthcare.

They demonstrably work. In terms of outperforming the private sector, our own nationalized health care system components actually work (remember, the medicare pool is the highest risk, most costly group in the nation).

Again, I invite you to visit the nursing home where my wife works.

So, “responsible”, in terms of spending less and getting more is clear. So the argument is ideological - policies that work, or blind devotion to the alter of selfishness and greed.

Policies that work recognize that someone must pay and that bureaucracies are like kudzu – they grow.

 

[a_priori]

But we tweak ours constantly. Rather it is tax cuts and bailout money, to fiscal policy.

I agree. We certainly do tweak it constantly, and we must. But it is reductionist for some people to suggest that there is a linear, direct cause-and-effect relationship between the needs of society and our ability to set the dials on the monetary and fiscal policy machines in order to make it happen. It is incredibly more complicated than that. That’s my point.

 

[a_priori]

But we tweak ours constantly. Rather it is tax cuts and bailout money, to fiscal policy.

All the lasse faire neo-conservatives would scream bloody murder if I suggested that we pay for national security in private military accounts. They see intuitively that you cannot have a massive standing army without a massive federal pool and coordinated effort. And they see military might as a common interest.

The question becomes, is the system maintainable. At 10-18% inflation, the system is going to explode. We waste time yacking about social security, when we have to project anemic economic growth, literally, forever to even make the system look modestly insolvent, while quality of care plummets, extension of coverage shrinks, and percentage of GDP soars.

Personally, I think it is in our national interest to not be in a health care crisis. And, it doesn’t bother me if, God forbid, someone gets medical treatment even if they have a slacker attitude.

The system is now like that old cliche about riding on your horse across the desert to get away from the pursuing bad guys. They are gaining but your horse is tired and must be allowed to rest. But you can’t stop. Eventually the horse will stop and the bad guys will catch up. At that point there will be a recalibration in your relationship with the bad guys.

The economy will begin to shudder more and more under all of the demands placed on it and will one day, like the horse, stop to rest. Then life will change. The basic concepts of economics are value-neutral. They are no respecter of persons.

 

[ribozyme]

And really, isn’t that what is happening here? We already have socialized structures in our society. Our most massive mechanism is one of war. We spend more on military than most other industrialized nations combined. Yet, early Christians faced the Roman empire with no armed resistance at all.

?

Want to know why? Libertarians have a fetish with property rights and they acknowledge a military is necessary to preserve that.

 

[vern_humphrey]

The system is now like that old cliche about riding on your horse across the desert to get away from the pursuing bad guys. They are gaining but your horse is tired and must be allowed to rest. But you can’t stop. Eventually the horse will stop and the bad guys will catch up. At that point there will be a recalibration in your relationship with the bad guys.

The economy will begin to shudder more and more under all of the demands placed on it and will one day, like the horse, stop to rest. Then life will change. The basic concepts of economics are value-neutral. They are no respecter of persons.

During the First Congress, they were debating going into debt to finance government. Edmund Ruffin of Roanoke stood up and said, “Mister Speaker! Mister Speaker! I have discovered the Philosopher’s Stone! It is pay as you go, Sir, pay as you go.”

We cannot tax ourselves into prosperity. We cannot cause hospitals to spring up out of the ground, nor compel men to take careers as physicians for inadequate remuneration (as the Canadians have found.) Nor can we force drug companies to operate at a loss (as we found when the government took over distribution of vaccines.)

A pay as you go system – where those who can pay, do, and those who can pay something also pay – and which dramatifcally cuts expensive paperwork, leaves people in control of their own fates, and also allows them to build up savings, only makes sense.

 

[pathia]

Consider a young person, 18 to 20 years old, making $5.50 an hour. Working steadily, he will make $11,440 a year. He currently pays 7.65% in FICA taxes, and the employer pays another 7.65% – which is really the employee’s money. He earns it (if he doesn’t, who does?) So he pays a total of $1750.32 in FICA taxes annunally, or $145.86 a month. None of this goes toward his healthcare – he doesn’t get Medicare at his age.

Let’s suppose this money were invested in his name, in a fair-to-middlin’ mutual fund with a return of 10% annually (that’s below average for long term funds.) After 45 years, he would have about 1.5 million in his account, and could transfer that to money market funds and draw about $75,000 a year and never touch the principal. If his wife also worked (as most wives do nowadays) they would have about twice that – or roughtly 4 times what Social Security will pay.

That works all fine and good if they don’t get sick, and don’t have any conditions that will stay with them the rest of their natural lives.

I pay on average about $18,000 a year for my medical care ‘out of pocket’ now since as we have discussed before, I cannot get worthwhile insurance. That’s my yearly average for keeping myself the bare minimum of healthy. This also started at about the age of 8 for me. $18,000 a year before rent, food, or car payments. That’s about $162,000 so far in ‘health maintenance’ debt. If I don’t have my health, I can’t work to get the reset of those on that list.

There’s alot more I could have done as preventive or increase my quality of life, but of course that’s even more money I don’t have and this of course doesn’t include catastrophic events that also occur completely at random that have so far racked up another $500,000 or so. Explain to me how I’m supposed to have made $662,000 by the age of 24 AND gone to school AND actually made any progress in life?

 

[vern_humphrey]

That works all fine and good if they don’t get sick, and don’t have any conditions that will stay with them the rest of their natural lives.

People who cannot work, or cannot work much should be helped – but as I showed, the money even minimum wage earners pay in FICA taxes would make them millionaires if they work steadily.

And once they were millionaires, they would be much more able to help those who cannot work.

I pay on average about $18,000 a year for my medical care ‘out of pocket’ now since as we have discussed before, I cannot get worthwhile insurance. That’s my yearly average for keeping myself the bare minimum of healthy. This also started at about the age of 8 for me. $18,000 a year before rent, food, or car payments. That’s about $162,000 so far in ‘health maintenance’ debt. If I don’t have my health, I can’t work to get the reset of those on that list.

But not everyone is in your situation. If we stop confiscating the wealth of those who work steadily (and squadering it, as we do the FICA surplus) there would be far more people who could contribute to helping those who cannot work.

There’s alot more I could have done as preventive or increase my quality of life, but of course that’s even more money I don’t have and this of course doesn’t include catastrophic events that also occur completely at random that have so far racked up another $500,000 or so. Explain to me how I’m supposed to have made $662,000 by the age of 24 AND gone to school AND actually made any progress in life?

Explain to me how a person who makes enough (at minimum wage) should be robbed of the fruits of his life work?

Let him save, and he will be able to help you. Continually confiscate and squander his money, and he can’t even help himself.

 

[pathia]

Explain to me how a person who makes enough (at minimum wage) should be robbed of the fruits of his life work?

Let him save, and he will be able to help you. Continually confiscate and squander his money, and he can’t even help himself.

You expect me to rely on the kindness of strangers, the church and society as a whole? I was cast out by my own family. I was cast out of homeless shelters. I was unwelcomed from church.

You expect me to rely on the kindness of these sorts of people? I’m sorry, but I am a very jaded, bitter person. Almost no one has ever willingly helped me with my medical needs, I have had to fight for everything and many basic things are still denied me. I have to constantly switch doctors because of the bills that rack up that I cannot pay.

My medical bills consume everything spending dollar I have. This laptop is something I picked up that someone was throwing away and I fixed it. I use free wireless to write here online. I will not deny that I am something of a leech on society, but society seems hellbent on KEEPING me a leech.