Jon Stewart rakes GOP over government shutdown.

This is beautiful.

For so many of the GOP’s talking points on the shutdown (that the ACA is a bill rather than a law, that it’s unconstitutional even after the SCOTUS upheld it) I can only quote Sam Harris: saying it louder and relentlessly will not make it true.

About JT Eberhard

When not defending the planet from inevitable apocalypse at the rotting hands of the undead, JT is a writer and public speaker about atheism, gay rights, and more. He spent two and a half years with the Secular Student Alliance as their first high school organizer. During that time he built the SSA’s high school program and oversaw the development of groups nationwide. JT is also the co-founder of the popular Skepticon conference and served as the events lead organizer during its first three years.

  • Art_Vandelay

    Last night he called them “Self-Righteous Orwellian Zebra Queefs.” I don’t even know what it means but it was awesome.

  • baal

    The montage cannon of the (R) saying the (D) need to compromise is revolting. They know that is entirely misleading to say that there is a compromise to be had.

    Also, I know TDS does a great job normally but they just killed the mainstream (corporate) media on journalistic ethics.

  • JohnH2

    They lost in terms of making it law; but they have the power of the purse meaning that if the president wants to have things funded then he needs to negotiate with the people that control the funding.

    • DavidMHart

      Technically true, but still appalling that the people who currently have the power of the purse strings are willing to hold the government to ransom over a law that was passed, and that had already been declared constitutional by the Supreme Court, just because they don’t happen to like it. It wasn’t entirely clear from your comment, but please reassure me that you don’t actually believe both sides are being equally unreasonable here.

      • JohnH2

        The Tea Party was elected to stop Obamacare and to not compromise; They are doing exactly what they were elected to do, and they have the money and the power in the primaries to force a bunch of the more moderate republicans along to their view. Primaries are coming up really quickly as midterms are next year. If a clean CR gets passed the Tea Party members have figured they well be able to primary and win a bunch of the moderate seats as well as capture the already weakened Republican house leadership. Democrats are utter morons if they think that a person the Tea Party puts up is going to work with them or even try to work with them.

        Perhaps the Democrats are playing this game under the assumption that they may be able to win the house because of it. However, if they do win the house many of the D’s that do it will be in largely R districts and will have to be considered as being closer to moderate R’s rather then D’s; such as the Democratic representative from Utah, for instance. Any margin will be slim and the Tea Party could potentially come out stronger then it now is. It is very short sighted for the Democrats to strengthen the Tea Party.

        If however, the democrats were to sit down and hammer out an agreement with the Speaker that the more moderate members can stand behind in the upcoming primaries, and especially if they can get such an agreement through without the Tea Party members help, then I think it ends up a win for the Democrats all over the place. The moderates will be able to say that they were able to improve the ACA and govern while the Tea Party tactic failed, and the Democrats can still attack the Republicans in the general election as not fit to govern.

        By refusing to negotiate the Democrats are providing clips that can be presented as ‘Democrats are willing to provide breaks to their big donors but don’t care about the pain of individuals that are losing insurance plans they like, not having their spouses covered, and forced to spend hundreds more on insurance’, which doesn’t seem a smart political move on their part.

        Not realizing that the house leadership standing behind the Tea Party position of repeal Obamacare is a negotiating and face saving position and that by providing some minor changes the Democrats can win, and probably improve the likeability of the ACA (which would also be a win), then they have miscalculated their position, I believe.

        • DavidMHart

          This may all be true, but you still don’t seem to be able to commit to saying that the Tea Party are the ones being unreasonable here. Sure, they were elected by unreasonable voters, and given a mandate to overturn a law that was validly passed and had already been declared constitutional, by any means they could, but that doesn’t mean that the Democrats, who had already had to make deep compromises when the law was being drafted in the first place, should have to compromise again to placate a few ideological anti-government (i.e. anti-the-very-idea-of-government) extremists who are willing to hold the country to ransom in an attempt to achieve what they could not achieve by the normal legislative process, and whose demands basically amount to “give us everything we want or we’ll shut down the government”.

          Are you willing to call them on that or not?

          • JohnH2

            I wouldn’t call voters unreasonable, we are a representative republic here and there is nothing at all unreasonable in voters choosing whom they will and nothing at all unreasonable in representatives actually representing the wishes of the voters. The Democrats failed to obtain the house of representatives, largely because they have failed at the state level, and they must live with the consequences of that failure. The house controlling the purse is the normal legislative process and the system is functioning as it is designed to function.

            That said, the absolute ideological purity demanded by the Tea Party is idiotic in terms of success. Their vetting process has had lots of failures because of that and challenging those that agree with your position 90% of the time but still want to govern is dumb. Attempting to form a third party within the Republican party is a decently good idea, but doing so at the expense of the larger party isn’t. I don’t know how much they have attempted to negotiate with the Democrats prior to this point, given the ideological purity I would imagine not much, that is a problem. It is fine to have members of the Tea Party who are wholly ideologically pure and will not compromise, but to be an effective movement they need to have members that are willing to negotiate, are willing to accept less than 100%, and are able to articulate what they want in its place, how that would work, how to get from here to there, and have it be reasonable to the other side.

            Senator Cruz and the representatives that listen to him are power hungry idiots, perhaps useful idiots currently for the larger party, but still idiots. Especially Cruz’s non-filibuster filibuster: since it wasn’t actually a filibuster then it was just a stunt, one that makes him look like a fool and speaks poorly to his long term political effectiveness. Rand Paul did much better (and actually accomplished something).

          • Feminerd

            Really? I’ve met them. I would call them unreasonable. They want government out of everything, except the programs that help them, but those programs should be cut for those other people who are totally moochers and don’t deserve it. They’re just temporarily in a bad place, though, they aren’t moochers. Those signs that said “Get your government out of my Medicare”? Those were real.

            They want government so small it doesn’t regulate businesses at all, but they complain about how it’s impossible to get by on minimum wage (it is, but the answer is to raise the minimum wage, which is *gasp* government action). They want government out of your private life entirely, unless a woman wants reproductive health services, in which case they support government-mandated unnecessary medical procedures at the woman’s expense that many have likened to (a second) rape. They have an incoherent political ideology that they will hold to in the face of evidence that their preferred policies not only don’t work, but hurt their interests. They support subverting democracy to get their way, which is, at the very least, counterproductive and at the worst treasonous.

            You’ve heard about loyal and disloyal oppositions, I hope? Loyal opposition is a minority party that works within the system- maybe to change it somewhat, but doesn’t wish to overthrow it. Loyal opposition party(ies) are absolutely critical for a democracy to work. Disloyal opposition will work within the system as long as it suits them, then will try to break, subvert, or overthrow the system as soon as they stop being powerful. Disloyal opposition parties destroy democracies. The Tea Party is disloyal opposition, and they are terrifying because of it. The absolute worst thing we could do is give in to their extortion (again).

          • JohnH2

            The Tea Party has at its core a libertarian/fiscal conservative element but also contains other parts bolted on. Because of that we get the incoherence and inconsistencies.

            They are in many ways less beholden to big business (but they do have powerful donors that they want to please, some of whom are in business), so they don’t have to worry as much about upsetting the status quo. They have been wildly successful at getting done what they want to get done, even if it hurts Republicans (or is stupid).

            They have brought in a lot of people at the local and state level, much more so than the national level, meaning their libertarian and fiscal conservative ideology is the future of the republican party, regardless of the continued existence of a “Tea Party” itself.

            I imagine that because they have captured so much state and local level (often in very disruptive ways) that future candidates will be better vetted, have more experience, and understand more how to govern while still getting what one wants. I imagine that while right now they are willing to subvert and defy the greater Republican party, as they become more of the party things will settle down, somewhat.

            Given the Tea Parties obsession with the founding fathers and the Constitution then I am pretty sure that they don’t want to destroy the country. They are disloyal to the current way of operating government but I doubt they want to destroy all government.

          • Spuddie

            Bullshit. The libertarian/fiscal conservative part is just what they say in public. Once elected they go whole hog on fiscally irresponsible social conservative platforms.

            Plus they have engaged in some of the most blatant pocket-lining corruption seen in American politics since Warren Harding. The tactics seem to be to hobble government as much as possible from performing its job, complain about the failure of big government and then carve it up for privatizing efforts to fill their coffers and those of their cronies.

            This is why my state nixed an effort to create thousands of jobs, improve the environment and commute to funnel money towards a ghost mall, casino and to choke the roads as often as possible with traffic. The TP can kiss my shiny red behind for wasting my money, thank you..

            They are ENTIRELY beholden to big business. Their libertarian streak only seems to apply to not regulating their actions. Somehow respect for personal liberties always seems to fall short of the 14th Amendment and notions of equal protection under the law.

            The whole point of the TP seems to be “I’ve got mine, fuck the rest of you”. I am sure that has appeal to many, but it is a shit way to run a government.

          • JohnH2
          • Spuddie

            Actually it doesn’t address a thing I said. My gripes about the TP go back much further than the current nonsense.

          • baal

            Politico should be ashamed of itself. It recites inside the beltway insidery bullshit lies that politicians tell themselves and us. Its good for that purpose only. It’s otherwise a fake parallel reality that doesn’t have a clue how real people are living their lives.

          • smrnda

            A problem I have is that many ‘tea party’ types are horribly misinformed about enough that I can’t really consider the reasonable. We don’t have a very well-informed electorate.

            Most Tea Party types I talk to are angry, but don’t exactly have well-informed positions on issues and can’t really make a case for what they believe in that goes beyond a ‘government == icky’ philosophy. Opposing regulations on business as a matter of principle, rather than pragmatics, isn’t really a well-thought out position, particularly when we have the 19th century to show us how great deregulation was.

          • Paula M Smolik

            I stole your reply to put on fb. No name, though.

          • Feminerd

            Works for me! Glad you liked it.

          • baal

            “The Democrats failed to obtain the house of representatives, largely because they have failed at the state level,”

            Bull shit.
            The Democrats won 1.7 million more votes than the republicans and the entire discrepancy can be tied to places like the 6th district in LA. It’s 74% republican so the 26% of the population of democrats there are disenfranchised. The electoral maps are so bad that the House republicans have more seats than the popular vote suggests they should.

          • JohnH2

            This is because the electoral maps are designed at the state level and at the state level Democrats have largely failed to win the legislature and governorships. There are states which vote solidly Democrat for president and Senate but who are controlled completely by Republicans, who then control the process of setting up representative boundaries.

            As I said, the Democrats have failed at the state level.

          • DavidMHart

            So, because the Democrats failed to win at the state level at some point in the past, and the Republicans then gerrymandered the hell out of the state, the democrats’ failure to win enough of a supermajority to overcome that sort of gerrymandering is the fault of the Democrats, not the fault of the gerrymanderers? I’m pretty sure the blame here falls on

            a) the people who do the gerrymandering, and
            b) the people who fail to reform the system so that the ability to redraw district boundaries is non-partisan and transparent.

          • JohnH2

            Both sides gerrymander fairly equally, I suppose that is at fault. Personally, I think the fault more lies in the subtle changes in the first proposed amendment to the Constitution which make it unclear as to the meaning and have prevented it from getting ratified, I think it would be harder to effectively gerrymander if each representative were representing 50 to 100 thousand people.

          • Feminerd

            Really? Both sides gerrymander equally? You are completely incorrect. Tom Craddick (then Texas House Speaker) actually told us, in a talk at my university, that Texas voted about 60/40 Republican/Democrat. Then he boasted that the new maps he’d drawn up made the split of people sent to the US House about 75/25. When I asked how that was at all representative or fair, he talked around the question by talking about the need to get more conservatives in Congress, even though that’s not what many Texans want. He was proud of his ability to undermine representative democracy! If both sides gerrymandered equally, the fact that Democrats earned 1.7 million more votes would mean they had a majority in the House. In fact, it’s the Republican strategy for remaining in power- cheat.

            From :

            “The rationale was straightforward,” reads the memo. “Controlling the redistricting process in these states would have the greatest impact on determining how both state legislative and congressional district boundaries would be drawn. Drawing new district lines in states with the most redistricting activity presented the opportunity to solidify conservative policymaking at the state level and maintain a Republican stronghold in the U.S. House of Representatives for the next decade.”

            This is not to say Democrats never gerrymander (they do), but it’s not nearly so egregious nor widespread. This is not a “both sides do it so oh wells” situation, this is a direct assault on the idea of representational democracy from one disloyal party.

          • JohnH2

            Failing to effectively capture state legislatures doesn’t at all imply that Democrats are not equal gerrymanders when they do have control of the state legislature. Giving an example of a Republican gerrymandering doesn’t imply anything about what Democrats do in similar situations.

            You have talked only about the Republican strategy, not whether the Democrats have their own strategy. A difference in representation in congress that is explained by the capture at the state level by Republicans doesn’t tell us anything about whether Democrats are just as egregious gerrymanders, just that their state strategy has failed to provide them with the same opportunities to gerrymander.

          • baal

            ” Republicans doesn’t tell us anything about whether Democrats are just as egregious gerrymanders”

            Actually it does. If the democrats gerrymandered to the same degree as republicans, we’d see seats proportional to popular vote. If the democrats gerrymandered more than the (R), we’d see them have an edge in seats dispite popular vote. We don’t have those 2 cases, we have republicans with more seats than votes. Ergo, qed, the (R) are abusing the voting system more.

            I agree that the democrats also have ‘safe’ seats but its a much lesser problem since they don’t have a left wing TP parallel nor do they have disproportionate seat counts.

          • JohnH2

            Ba’al, that would only be true if there were an equal distribution of states that were governed by the various parties; As I have been saying, that isn’t the case, the Democrats have failed to gain governorships and state legislators meaning that an advantage towards Republicans could be anything from Republicans being better at gerrymandering to Democrats being better at gerrymandering, just being able to do it less.

          • baal

            Nope, I’d proffer the 2010 census and Texas redistricting wars that followed as an example of (R) redistricting ‘off season’. Just like the federal level, the various state governments are also highly gerrymandered – but more effectivley by (R). Maddow had a series on it within the last year.

          • JohnH2

            I still think you are only looking at one side while ignoring the other. It seems believable that (R) are more effective at it given their control of states which are otherwise strongly (D). Though saying Maddow said is pretty similar to me to saying Glen Beck said; there might be something true in what is said but truth isn’t the primary purpose of saying something and very likely it has been spun and distorted beyond all recognition.

          • baal

            Glen’s flatly looney. With Maddow, you can at least use the source materials even if you don’t buy her spin.

          • DavidMHart

            Both sides gerrymander fairly equally

            Evidence please? As far as I’ve been informed, the Republicans do it far more.

          • baal

            So if some asshole uses power (say a knife of gun) to rob you, you (the victim) have failed? The oligarchs (cf Koch bros.) are handing out buckets of cash to buy control. In some cases I watched last year, the Koch candidates literally bought up nearly every advertising opportunity in targeted fashions so that the non-gerrymandered races weren’t fair free and open. That ability to strangle the democrats message (or even any republican who isn’t bat shit insane) is the gun or knife in my example.

          • DavidMHart

            I wouldn’t call voters unreasonable

            I didn’t mean all voters were unreasonable; just ones that vote for Tea Party candidates (and I don’t mean that it is unreasonable to vote for a candidate who supports your aims; rather that the aims of those who support the tea party are unreasonable aims, since the policies they support either support theocracy, which is bad for pretty much everyone except those at the top echelon of whichever denomination finds itself in charge, or plutocracy, which is bad for everyone except the super-rich (and, eventually, very bad even for them if enough of the very poor decide they have nothing to lose from violent revolution).

            Are you at least willing to accept that the tea party’s aims – preventing people from having adequate healthcare unless they are wealthy, preventing women from having any reproductive rights, preventing the Government from providing any sort of security net for those who fall on hard times, preventing any kinds of limit on corporate power, and deliberately entangling government and religion – are unreasonable things for most people to want?

          • JohnH2

            I don’t think that is what the Tea Party stands for. Certainly there are parts of it that are for those things, but I think over all it is a fiscal conservative/libertarian movement within the Republican party.

            I think the religious aspect is piggy backing on the libertarian aspect of it, at least I hope that is the case. The reproductive rights may be tied to the religious aspect, but it is certainly tied to a different set of assumptions about the rights of an unborn child and whether the unborn do have rights.

            The libertarian aspect is not about preventing people from having health care but about allowing the market to create solutions to the problems. My family has gotten by on 55 dollar clinics and birthing centers with midwifes, we have been lucky that way; I very much wish there were more of that thing and that insurance wasn’t tied to a job and didn’t get tax breaks from the employers perspective; that I believe would help drive down the cost of health care and of insurance. That certainly doesn’t solve the whole problem and, to me, it seems there is a role for government in health care, but I am fine if that role happens at the state and not the federal level. (In case it wasn’t obvious I lean heavily libertarian).

            So no, to me, it doesn’t seem unreasonable to not want the Federal Government to provide health care, to not want it to provide a social safety net, to want to change the regulatory structure and the scope and depth of what regulations can do (like preventing people from drinking raw milk, or eating wheat they grew themselves on their own farm, for examples).

            They are looking at the same problems and thinking of how to solve them, just with different assumptions and models of the world and that is not unreasonable. It is very unreasonable to take it too far, just as it is very unreasonable to take social programs too far. It is also unreasonable to ascribe unreasonableness to others, just because they have different models of the world then you.

          • smrnda

            Given that no other nations are bothering with ‘market solutions’ to health care but are getting results, why should we experiment with something unproven when other nations get results with national health care? Nations with national health care spend less on health care than we do with a more market based approach, and I’m supposed to take the idea that ‘the market will drive down costs’ seriously when the evidence suggests the opposite?

            To me, libertarianism is just feudalism ; the governments exists to protect the rights of the properties class, and then you decide where you want to be a serf. That’s been tried before, with the whole ‘company town’ model, and I’d like civilization to move ahead and not backwards. I don’t think people who think this way are unreasonable, they just would rather that people without money get pissed and shat on, or have to go begging for some half-assed ‘charity’ from someone who is totally willing to use inefficient and ineffective private means of meeting human needs rather than more efficient government level ones?

            On health care, as a person who is disabled, with a few chronic health conditions, ‘market based solution’ means *I DIE.* Libertarians just think a tax cut is worth me dying, and any nonsense that ‘we’d be willing to help through private means’ – isn’t going to work. I can’t get by on 55 dollar clinics, and if you want to use primitive means of health care, I sure don’t. Civilization requires lots of infrastructure and cooperation, and medicine is going to be kind of costly since we expect it to work, to improve, and we need it to be administered by trained experts.

            Aversion to government run health care isn’t irrational, since it’s okay to say “It’s okay that poor people die since I think small government is intrinsically valuable and I don’t want to pay taxes” or “I think most people should accept a decreased standard of living because government regulations are icky” but it’s unreasonable to pretend that national health care doesn’t work, or that market based solutions will.

          • baal

            For me, health care is something everyone needs and in order to have a civilization, you need government to provide the infrastructure. I see having a healthy and less stressed workforce (along with education and roads to get to work) as being more fit than a stressed out sick workforce.

            Aside from the healthcare as infrastructure arguement, if your society can’t provide health care (by what ever mechanism) to tens of millions of people, then the society is doing it wrong.

          • JohnH2

            “I’m supposed to take the idea that ‘the market will drive down costs’ seriously when the evidence suggests the opposite?”

            The cases in medicine (like Lasik) where insurance does not cover things and market forces are the primary driver show that costs drop sharply, just as they have done with all else that has been subject to market forces, like computers or cars.

            Midwives are not primitive; in other countries they are THE way to have children and until the second half of last century both baby and mother were absolutely safer going to a midwife then a doctor; and now doctors are only about as safe as midwives; with unnecessary C-sections pushing it slightly in midwives favor.

            I thought I had made it abundantly clear that I am not in a position of having money; making your statements about feudalism a clear straw-man of where I am standing. Same with my non-existent taxes to be cut.

          • Feminerd

            Oh, dear me, you did not just claim midwives were as safe as OBs for childbirth, did you? The data coming in from Oregon and Vermont and the Netherlands and everywhere else we have data collection suggests that childbirth with qualified midwives (CNMs) has a perinatal death rate of ~300% greater and with unqualified midwives (CPMs, CMs) has a perinatal death rate somewhere between 800-1000% greater than hospital birth with qualified OBs. There is also a much greater rate of things such as hypoxic ischemic injury (brain damage from lack of oxygen at birth). Women die at greater rates as well.

            Do keep in that’s comparing only low-risk pregnancies (the only kind midwives are allowed to take) with all births with OBs, which means the OB stats should be worse because they take the high risk cases. That the OB stats are better clearly indicates that midwives are doing something terribly wrong.

          • JohnH2

            References please or you are making an unsubstantiated claim. High risk pregancies then sure:

            But as that one points out and this one confirms for low risk pregnancies the outcomes are the same (no significant difference) or better for the midwives.

          • Feminerd
          • islandbrewer

            I love Amy Tuteur! I had no idea she had her own blog, now!

          • Feminerd

            Oh yeah, she has for quite some time. It’s a lot of fun to read.

          • JohnH2

            Your blog posts are quite a bit different then peer reviewed research to begin with. The write appears to be highly partisan and taking a non-statistically significant difference to make its claim that hospital birth is somehow better.

            As in, Statistics FAIL.

          • Feminerd

            They are analyses of peer-reviewed research by a trained OB who clearly understands statistics quite well. I can’t get at much of the original research because it is behind paywalls, but you obviously didn’t read them (or the many, many other indictments of the BMJ study, or the other studies showing that homebirth in Oregon is not safe at all) if you replied this fast.

            Perhaps instead of just ignoring a blog post (by an expert), you should actually read what she says?

          • JohnH2

            I did read them and ran the numbers, you under estimate my reading ability apparently. It is a blog post by an OB that apparently failed Statistics because the level of significance for the difference in deaths is below any reasonable threshold to say that it is statistically significant. It also requires that the assumption be made that the singular possibly preventable death would actually have been prevented had the person been in a hospital which is just claimed and not proven. There really is nothing in those two blog posts backing up the claim that midwives are more dangerous.

            Also, the blog posts linked don’t actually address either of the studies I linked to which were Scotland and North America, not Netherlands.

            I should also point out that in a graph linked to by one of the blog posts she posts the 95% CI for all countries, except for the one in question showing only the mean. Even with just showing the mean reading it as 6th worst isn’t accurate because it (the mean) lies within the 95% CI of most of the other nations, implying directly that there is no statistically significant difference between the outcomes.

            Also, interestingly enough, the reported fatality rate for home births in the Netherlands is lower than the deaths per 100000 per year for automobiles. Given that generally women only give birth once in a year then giving birth at home in the Netherlands is safer then driving in ones car an average amount that year.

            And the Netherlands fatality rate is half of the US hospital fatality rate; well outside the 95% CI, meaning that it is safer absolutely to give birth in the Netherlands than in the US. + simple statistics.

          • smrnda

            One does not have to have money to support feudalism. I know plenty of poor people eager to become serfs and destroy their own standard of living.

            The difference between health care and other products is that, for the most part, other products are *optional* – people can choose not to buy products that are too expensive and do without, and their makers can then either cater to a luxury market (I don’t see the market driving the cost of either Ferraris or real estate in San Francisco down) or else they can reduce the cost. Lasik isn’t covered by insurance because it is not viewed as medically necessary, and as an optional good, the suppliers can either keep the cost high, or lower it to get more business. I also think Lasik is a bad example, since it’s still pretty expensive, WELL outside the ability of most Americans to pay for it, and that there exists glasses and contacts which are still pretty standard.

            Health care isn’t the same, since it isn’t something a person can just choose to go without, so it’s not subject to the same market forces as things that are optional. I can’t choose to go without treatment. Insurance companies want to make money, and I am not a client they want since I will definitely cost them lots of money. Since I get my health care through an employer (I have one job and then I am somewhat self-employed at present) and am subject to a collective bargaining agreement (as in that I am in a UNION) I get comprehensive health care, and I’m still spending a lot of money out of my own pocket. Lots of plans that are out there pretty much suck, as the goal of an insurance company is to take in $$$ and avoid taking risks. Plans are all about diverting the cost onto the worker or consumer through high deductibles.

            The real reason that system doesn’t work is that the market responds to the demands of people with money, and people’s suffering doesn’t cost anyone anything but themselves and the handful of people who give a shit. If many Americans have declining health, that cost is born by them and their families and their loved ones alone. If the notion is unhealthy people can’t be good workers, there’s lot of unemployment already. People can function well enough to be exploited with bad health, and insecurity is good for the Ownership Caste.

            On what would happen if health care was a pay for use service, I just look at real estate. In any area, housing costs can become drastically inflated by the ability of *some* people to pay far higher rents than others. I live in a college town, where the presence of college students (often from affluent families) drives up the cost of rental housing, since the market is more or less an auction where prices are bid up.

            Now, I’m suspecting that you’ll bring up food and ask why food hasn’t been driven through the roof since people need to eat, and I’d respond that supplying people with food is an area where we see lots of market failures. I lived in Chicago, and have a number of friends who live on the south side. Despite the presence of people who want to buy food, affordable grocery stores selling food of real nutritional value haven’t materialized in many of these neighborhoods. (ALDI seems to be the chain that goes against the trend there on occasion.)

            As a person who has lots of health problems, I am naturally risk-averse as a matter of survival. I’d rather put my faith in ‘the government WILL because of a law’ than ‘the market might’ since I’ve seen ‘the market might’ fail large groups of people over and over again. I see no reason why I or anyone else should not use what has worked in other nations but should gamble on something unproven.

          • JohnH2

            I don’t want to become a serf, that’s your assumption. With health care tied to employment as it currently is then losing a job is not only losing income but also losing insurance and health care. This inhibits the taking of risks; starting a company becomes harder and more people are forced to be cogs in the wheels of a large employer instead of being able to form or work at smaller firms. Which is true of a lot of regulations, they favor large firms and inhibit competition, and therefore growth.

            As I already stated, there are already $55 clinics which are pay for use. I see no reason why normal doctor visits should not operate on the same model; instead of charging for each gauze, shot, blood pressure reading and so forth have an upfront set price: you go to the doctor for an standard exam or for an illness this is what it will cost you, regardless of what the doctor actually does. (Medicaid and Medicare are the reason for the current pricing model). Obviously specialists that doesn’t work, but that is what insurance should actually be covering (and the deductibles exist so that insurance isn’t covering normal health costs even though that is part of the plan). This would also reduce the incentive of over testing and over treating that doctors currently face.

            Supply and demand is what rules the market; the marginal willingness to pay is what drives up housing prices. Rent can go up quite a bit and quickly but the space remains largely the same and there is only so much additional space that complexes and skyscrapers can add. This is different from health care where rising prices can, in a functioning market, lead to more people becoming doctors which changes the supply of health care and should lead to lower prices.

            I am not sure why you would think I would turn to food. I will point out that to build a grocery store requires a capital investment from which a rate of return is expected subject to loss of product and rents. Aldi though is a privately owned company and so isn’t subject to many of the same demands that publicly owned or franchised stores have.

            Of note Aldi’s owner is worth 17 billion dollars, which in your dialectic approach to economics makes him the bad guy; though he got that way by providing people with what they want/need so I don’t know how that is bad or how he is exploiting people.

            Marx has been shown to be wrong in every possible setting; I don’t know why you are basing your understanding of economics off him. You might want to checkout Adam Smith’s An Inquiry into the Nature and Causes of the Wealth of Nations sometime for a much better understanding of how the world works. Or even “The Road to Serfdom”.

          • smrnda

            Perhaps I am using too strong of language. I am not a Marxist. I never said markets always fail, just that there are some areas where they do. We don’t leave national defense, police and fire protection or education up to the market, and it’s not too hard to see how the ‘free rider problem’ demonstrates the infeasibility of privately funded roads. I have read Hayek (as well as von Mieses) and I’m familiar enough with Adam Smith to know that most people’s perception of his ideas aren’t accurate. At the same time, I think economic policy should be based on empirical evidence ( I don’t recall the Austrian school being heavy into statistics and von Mieses explicitly stated his premises were not open to empirical falsification, and that seems kind of silly for a field about real world events. There is a lot of data on that available) of what works and what doesn’t more than what *theoreticaly should* (and both libertarians and Marxists and others are ridiculous when it comes to arguing that certain things theoretically work when the evidence isn’t in), and we’ve got pretty much all other first world nations to demonstrate that government funded health care gets results. To learn how the world works, I prefer the concrete to the theoretical -
            finding out how other nations deliver health care and what results they
            get and health outcomes. If supporting government funded health care is Marxist, is Eisenhower a “Marxist” for supporting the interstate system? Is Western Europe offically “Marxist” now (Western European nations had national health care during the cold war, so was the cold war “Marxism against a shittier Marxism?”) Check out the marginal tax rates under Ike and compare him to Obama :-)

            I forgot this in my previous post, but there are reasons why the cost of health care can’t be driven down by market factors the way the cost of a phone can be. Health care is a service that has to be provided by highly trained professionals where we actually live – we can’t export the production of health care to a factory in China, where things are cheap, and we can’t increase the productivity of a doctor the way we can a farmer – there’s only so many patients that can be treated in a day, so cost reduction would have to occur with something else (cheaper meds for example.)

            When people talk about ‘over-testing’ or ‘over-treating’ I’m never really sure what they mean, and if there are any actual meaningful definitions of this or metrics for it that aren’t just a subjective perception of ‘it feels like people go to the doctor too much’ I’d like to know about them. In the US more money is spent on worse health outcomes, but part of this is that low income people get less preventative care so they end up getting ‘treated’ for health concerns that will now be more costly to fix than it would be if they’d been diagnosed sooner, and some lifestye issues, but exactly what is being used to define ‘over-testing’ or ‘over-treating?’ I mean, are doctors competent to deliver care and make judgment calls and diagnosis, but totally unable to decide what tests are necessary or not? Or is it just a demand for people to sacrifice security and superior health to reduce costs, which ends up being a totally subjective assessment on the point where you reach ‘over-testing?’

            The other issue I have with the whole ‘over-testing over-treating’ rhetoric is that the only solution ever proposed is to divert costs onto the consumer in the form of higher pay per service or higher deductibles. That doesn’t eliminate *EXCESSIVE OR WASTEFUL* testing and treatment at all, since it just rations care based on ability to pay, so instead of decisions being based on any kind of medical concern it’s just ‘some people can go to the doctor to get their bruise checked out, some people might just have to nurse a fracture on their own, because one person has more money.’ My partner was a victim of this type of cost-rationing – once we got together and I put her on my insurance thanks to civil unions becoming legal in our state, she was able to get on meds and have 2 surgeries. She’d known she had problems that needed treatment for at least a year, but meeting the 1500 deductible pretty much guaranteed should couldn’t get it done. I think that, from a moral perspective, that’s disgusting, and I think it’s also nonsense from a medical perspective as we should be discouraging frivolous care, not discouraging people from just seeing doctors, period, by making costs high. People are also not equally healthy for reasons totally beyond their control at times, and the level of non-emergency medical care a person requires can be extremely variable. I also am disgusted by the idea that people might end up in or stay in relationships… for the health care.

            I can understand a feeling that it’s totally unfair that some people are getting nice employer sponsored health care, and others are shit out of luck, but eliminating or reducing the incentives for employer sponsored health care is just going to *lower* the quality of care for some people, not raise it for others. The other thing, if you’re buying health care on the market, your ability to pay is linked to your having a job, so it’s still totally dependent on employment (or earnings if you are self-employed) so there’s really absolutely no gain there for anyone. The other thing is employer based health care often does something right – where I work, premiums are scaled by income for the same coverage because it’s something that we, the workers, negotiated. Individual consumers buying insurance on the market aren’t going to have the capacity to make demands like that; it’s a seller’s market, since (as I said before) health insurance isn’t a good someone can choose not to get.

            My opinions here have a lot to do with the fact that I’ve had serious health problems my entire life; I have never been *young and healthy* ( I have epilepsy, serious psychiatric problems, and vision problems which leave my corrected eyesight at 20/100 in one eye and pretty much blind in the other.) I got health care while young because my parents had money, and I got health care later as earlier privileges put me in a position to make $. If they hadn’t, my life would have totally sucked and I might be dead or have severe brain damage at present, or I might be completely blind, or all of these. I sometimes think that healthy people who will experience no urgent consequences if they lack health care access for a period of time just aren’t the right people to be talking about the issue, since the consequences of health care policy are trivial for them, but pretty serious for people like me. The healthy (to borrow a phrase) “have no skin in the game.” I don’t know for sure what your health is like, it may be terrible so it might not apply to you, but overall, it bothers me when healthy people keep talking and we don’t get perspectives from people for whom a trip to the doctor is actually necessary and for whom ‘routine health care’ is a trip to a specialist every other week and a few different meds every day. (likewise, talk about racism could use fewer perspectives from white people) And keep in mind, there are conservatives and libertarians who have cheered at the prospect of a person who cannot afford health insurance DYING – those people are cheering at the prospect of MY death, so I take the issue very personally. Given that attitude, I also don’t take the ‘private generosity’ angle very seriously.

            A breakdown of my costs (me alone, not my parnter) – I have decent insurance, so between premium, copays for appointments, meds and tests I’m looking at around $500 a month, until I hit my out of pocket maximum of $2500 a year, after which I only pay premiums, which makes my yearly health care bill around $3700, and there’s nothing I can do to lower that cost unless some cheaper meds come on the market, and that would possibly take it down by $40 or so a month. The only expense that I have bigger than health care is housing. I don’t see how any market based solution is going to do anything but increase my costs, since I’m pretty much a customer that there’s no way an insurance company can make a profit from. Right now I get a better deal through an employer, but apparently this is not a good market based solution so instead, I could buy it on the market, get hit with a high deductible and then I can spend 50% to 100% of my first month’s income on health care costs. Imagine a person who didn’t have an education and marketable skills with these problems. If my parnter had been born (rural south, parents with only at most a high school diploma) with my health problems, she could have ended up dead. And I regrettably am not in sound enough health to wait while the market works out a solution.

            So when I hear people whine about what a safety net that might keep me alive would cost them, I doubt they’d really want to trade places. Taxes are rough, but it’s the price we pay for civilization. Life’s imposed a high *bad health tax* on me, but I feel that the best way to survive is to contribute to a reasonable social safety net. That’s civilization, instead of barbarism. I haven’t really done a very good breakdown of my own health care costs (as in what my insurance pays) this year, but even working for decent money, there have been at least 3 years when the total cost of my health care definitely exceeded my entire income. I kind of *lost the genetic lottery* and so the risks of leaving health care up to the market is a huge risk to me, and the ACA is far from good enough, but better than leaving it to chance, and given the health problems I have or the difficulties I’ve seen people struggle with (a woman I know was fired for throwing up on the job – she was pregnant but was told she could not take extra bathroom breaks or drink water at her workstation, for example) so when I hear people tell me about the *horible government regulations* that keep them from drinking unpasteurized milk or burning tires or that forces them to wear a seat belt I just think it’s a load of whining from people who need some real problems. I mean, Milton Friedman went on about how he doesn’t always wear a seat belt in ‘free to choose’ taking on the horrors of excessive government regulation. I guess he’s making a point, but a political philosophy endorsed by a guy who does not do a proper cost benefit analysis when deciding what to do when it comes to putting on a seat belt is based on irrational, emotional factors and not logic. It’s like hearing a life philosophy that comes with an endorsement of occasionally playing Russian roulette.

            Something which I think is a major factor in the debate on health care in the US (you don’t seem to fit this, so it isn’t about you, more folks like Friedman perhaps)) is that our political culture is dominated by old, grouchy white guys, many of whom are rural, and for this demographic going to a doctor instead of ‘toughing it out’ is seen as a sign of weakness, and you do get nostalgia for the good old days of “Back in my day, if Johnny got hit on the head we just splashed some water on him and told him to get back in the game.” And back in the day we didn’t have evidence that Johnny getting a concussion might have an impact on him decades later. Back in the good old days, I would have been dead! The perspective defies reason since preventative care saves money. Perhaps an issue here is that I’m from a family of fairly recent immigrants and that I’m not really part of the historically dominant culture in the US. Roughing it out on the frontier isn’t part of my cultural heritage, and seems about as appealing as living in the stone age, and I’d have been dead on arrival back then. I like a high standard of living, high levels of security, lots of functioning infrastructure, so seeing countries in Western Europe, Israel, or Japan or S Korea makes me think that we’re simply refusing to see that the uniquely American way is just a cultural preference, and not a rational one, and isolation prevents your average person from understanding what is done elsewhere; I’ve traveled a lot and have lived outside of the US, so to me, the US is just another country with a list of problems that need to be solved, not any place magic or special.

            SOrry that was so long. Just felt that you deserved a proper response.

          • JohnH2

            I would rather leave education up to the market with fully funded vouchers for the median (or mean) cost of education. Adam Smith was okay with government funded roads, and so am I.

            It would be accurate to say that WW2 was primarily a fight amongst National Socialism and International Socialism and that the Cold War was against International Socialism and Corporate Socialism

            More Doctors can be trained; If doctors were the ones primarily benefiting from rising cost of health care then there would be more people wanting to become specialists and doctors.

            I am not qualified to debate over-testing or over-treating. As I understand it there are lots of medically unnecessary procedures which happen in order to drive up profits and cover the health providers in case of lawsuit.

            I disagree with you about the effect of eliminating employer provided health care; Right now your employer has to have a health care plan set up, meaning that if one is small business owner or self-employed or whatever else other than working at a large employer then getting health insurance is difficult, expensive, and crappy. Removing health care from insurance from employment means that all of those people will now be able to purchase health insurance. The insurance market has been set up on the basis of employment; removing that will force the insurers to restructure how they contain and manage risk: meaning that everyone should be able to end up with insurance. I am unclear as to why the ACA didn’t create a national exchange and require everyone to get insurance through the national exchange instead of via employment.

            Even being healthy and younger health insurance is still more expensive than everything excluding housing: which makes not having it seem attractive. Which leads to an argument for catastrophic and long term insurance to be done through the government as not having insurance is equivalent to passing the cost onto society already. I am very familiar with a wide range of health care needs and health insurance situations from within my immediate family.

            Not sure what you have against unpasteurized milk, it is more risky than pasteurized milk but less risky then many other behaviors or products that people regularly use. Disallowing it has more to do with corporate socialism then with health and safety.

            I have rode busses without seat belts quite a lot, there aren’t even the options to wear a seat belt.

            Preventative care is something that is a complete failure already in the Health Care system and I am not aware of any examples of it being done successfully.

      • Pofarmer

        “over a law that was passed, and that had already been declared
        constitutional by the Supreme Court, just because they don’t happen to
        like it.”

        I think the problem is the way it was passed, and that there was pretty large opposition to it. From these things, Republicans and tea partiers, think that they have a mandate to repeal it. The bill was HUGELY unpopular when it was passed, especially in flyover country. The thing was an unknown quantity, and as the regulations are written to go with over 2000 pages of legislation, it isn’t getting any more popular. The initial passing of the thing was just a political boondoggle, and now it won’t quit. I do think the R’s should have left it alone, but, I do think, in at least some cases, the Tea Party folks are acting in good faith, as they think that this bill is going to bust the budget. It’s up to proponents to show why this isn’t so-convincingly.

  • EmpiricalPierce

    In a compromise, two (or more) parties make a disliked concession in order to get something else they want. So let’s look at the compromise: Shut down the ACA in exchange for keeping the government functioning.

    For Democrats, this compromise would mean that while they do not want the ACA to be shut down, they’re willing to do so to keep the government functioning.

    For Republicans, this compromise would mean that while they do not want the government to function, they’re willing to allow it if it shuts down the ACA.

    According to the terms of the so-called compromise, Republicans do not want the government to function.

    • Zinc Avenger

      A beautiful observation.