A vote for Mitt Romney is a vote to deny care to the sick

A vote for Mitt Romney is a vote to deny care to the sick October 27, 2012

When you vote for Mitt Romney, you vote to deny health care to sick people.

This is not theoretical, this is not hypothetical and this is not rhetorical: When you vote for Mitt Romney, you vote to deny health care to sick people.

That’s Violet McManus on the right. If you vote for Mitt Romney, you are — unambiguously and undeniably — voting to repeal her health care. She is a real person and what really happens to real people really matters. Elections are not a game.

This is an actual thing that will actually happen to millions of individuals and families. This is a real and significant thing that you will be doing to them. It is a real harm in which you will be an active participant. It is a real harm that you will be helping to inflict.

What really happens to real people really matters.

This is not theoretical, this is not hypothetical and this is not rhetorical: These are actual, flesh-and-blood real people with names and faces.

Eric Richter.

Wendy Parris.

Robin Layman.

Daniel Menges.

Violet McManus.

Declan McNulty.

Shavon Walker.

Ben Trockman and Caroline Long.

Carolyn Cunningham.

Jennifer Lee.

If you plan to vote for Mitt Romney, you should look at their faces and learn their names. Maybe you can recite them to yourself as a reminder of how “pro-life” you are.

When you cast your vote for Mitt Romney and Paul Ryan and for their promise to repeal the law that eases the pain or saves the lives of all these people, at least have the decency to own up to it.

Say it. Say it out loud. Say it defiantly. It’s what you’re doing, so at least have the stones to say it.

Say, “I don’t give a damn about Eric Richter.”

Say, “Screw you, Wendy Parris.”

Say, “Sucks to be you Robin Layman and Daniel Menges.”

Say, “Violet McManus, your pain means absolutely nothing to me.”

Say, “Declan McNulty, I do not care at all about your life.”

Say, “I’m not looking out for you, Shavon Walker, Ben Trackman or Caroline Long, I have more important concerns.”

Say, “Carolyn Cunningham can suffer and die, for all I care.”

Say, “Jennifer Lee means nothing to me.”

Whether you say it out loud or not, you’re saying it. You’re choosing it.

You’re doing it. To them. To real people with names and faces. Millions of them.

Congratulations.


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  • chessa

    In what country do you live?

  • Asimov once quipped that all the people who fantasize about the Middle Ages and virtuously proclain the benefits of an artisan class tend to forget about the fact that 90%+ of the population worked the land or otherwise made a very menial existence.

  • Ah, but you forget the entrepreneurial spirit that makes America great.  Chessa, for example, would be able to make so much magical corn that she could live in luxury, finance roads, schools, libraries, police and military, and still have enough left over to give charitable corn to cancer patients!

  • *helplessly sputtering with laughter now* XD

  • I know when my grandparents had cancer, or when I needed orthopedic surgery, the one vital thing missing from our treatment plans…was corn.

  • P J Evans

    I mean, geez, what have teachers ever done for Mitt Romney?

    They sure couldn’t get him to learn much about everyone else.

  • Joshua

    New Zealand.

    Not that it matters, much of the developed world can say the same.

    We also have plenty of corn.

  • chessa

    Thanks for the spirited conversation, but it’s time for me to go.  I’ve got a huge project due in two days and I’m self employed.

    I appreciate the answers from those of you who were thoughtful and were truly arguing your point with reason.  As for the mean-spirited comments, I just simply ignored the meanness and looked for any remaining value.

    Here are some things you may or may not care to know about me:

    1) I’m a guy.  I used one of my wife’s favorite monikers, “chessa9”, that she uses for online chess, but mistyped it and then decided to stick with just “chessa”.

    2) (You are going to love this one ;)  I was a millionaire because of a software invention.  I used that money to purchase land, build a building, and start a health science and fitness center for high school and college students.  We employed the latest in exercise science for sports and physical therapy.  Just as we started to sustain a profit, the economy turned downward.

    3) The bad economy led to two foreclosures (home and business) and I lost all my savings.  This happened because I financed half of the commercial building and invested the other half.  When the economy went south, I couldn’t sell any real estate for two years.  I held on as long as I could.  The bank wouldn’t release me as long as I had assets to liquidate and pay towards the note — investments that were being liquidated at pennies on the dollar.

    4) My wife has sarcoidosis.  It developed while I was unemployed and on COBRA (bridged health care).  It was terribly expensive, and we had to scratch and claw for every penny that it cost me.  We’ve been married for 24 years.

    5) I have two kids in college.  They work part time and my wife works part time when she is able.  It takes family effort to make the tuition work (they attend school part time as well).

    6) I am more happy now than when I was losing my business.  I truly worried about my employees.  It actually put me in the hospital.

    7) I’ve started a new business with 3 life-long business associates.  We’ve hired two employees and will soon hire more.

    8) I’ve always driven a pickup truck and don’t need “things” to make me happy. I have a philosophy that life is about “doing” and not “having”.  That’s why I invested my fortune in a health and sports science business.

    9) I blame the economic disaster on everyone up and down the economic food chain.  I blame Congress for greasing the skids and helping everyone “own” a house, when the truth is that people were buying *debt*, not homes.  I blame the banks for being greedy to profit on the lending turnover.  I blame the investors for bundling all those fragile loans.  And last, but not least, I blame all the people who just had to buy a bigger and bigger home when they didn’t need it and couldn’t afford it.  And don’t try to tell me they were helpless victims, I knew many of them.

    10) I have a fascination with electric automobiles.  Did you know that the majority of electric automobiles on the road in the U.S.A. are home conversions?  I plan to do my own conversion next Spring. I believe we all have a responsibility to take care of our environment.  I’m not a fanatic, but I constantly try to make a difference.

    11) I’m thirty pounds overweight.  I find it VERY difficult to stay away from sugar and starches, but when I do, I feel so much better.  I have to work really hard to keep my blood pressure down and my cholesterol ratio in check.  I go through fitness binges.  Mountain biking is my choice of exercise, and my bike is the most exotic item that I own.

    12) By and large, I do not like large corporations.  It’s not because they are inherently bad, it’s because they are inherently inefficient.  I like big government even less, and for the same reasons, but magnified because the representatives in government are largely unqualified — they are usually elected for reasons that have nothing to do with their job responsibilities.

    13) With all that being said, I still think I live in the best country in the world.

    14) I hope to be wealthy again so I can fund another entrepreneurial venture.  I have a vision of using social networking techniques for organizing charity at the community level.  You see, there’s a basic principle called “the principle of locality”.  We should try to deliver help at the need.  The further you get from a problem, the less efficient the solution.

    I truly wish you all the best.

  • EllieMurasaki

    I blame all the people who just had to buy a bigger and bigger home when they didn’t need it and couldn’t afford it. And don’t try to tell me they were helpless victims, I knew many of them.

    The people you knew–were they all real estate professionals with experience in determining how much house one can afford on a given income? Because I assure you that hardly any of the people who have been foreclosed on or who are underwater after buying more house than they could afford are or were real estate professionals with such experience. And I really do not think it is fair to blame anyone for listening to the fucking experts.

  • Joshua

    As for the mean-spirited comments, I just simply ignored the meanness and looked for any remaining value.

    Shame, really. My comments were intended to show how alien this guy is from all I hold good and holy. If his takeaway is some anecdotes about the NZ health system, that’s sadly peripheral.

    I was a millionaire because of a software invention.

    Computer people. Never trust ’em.

  • Lori

     

    Most entrepreneurs risk their money in order to produce goods and services.   

    The policies that you’re pushing aren’t designed to help entrepreneurs who are risking their own money. They’re designed to help CEOs and hedge fund investors and who risk nothing. The hedge fund guys are playing with other people’s money. The CEOs have golden parachutes, sweetheart contracts approved by board members who scratch each others’ backs and no real fear of failure because even if they do run a business the chances are their employees will be the only ones paying the price (see above re: golden parachutes). If they actually manage to get so fired or forced to resign some other company is always willing to give them another shot, with another contract that assures their continued wealth and comfort, regardless of performance.

  • Lori

     

    I’ve put more than 25 years into helping people solve problems.  I’m a
    scientist and engineer by trade.  See my response to EllieMurasaki in
    regards to what my ventures have cost me.   

    Whatever your background it clearly isn’t in biology or psychology because if it was you’d have less ignorant opinions about the value of fat shaming.

     

    In regards to my envy comment, I’m just making an observation.  

    No chessa, you weren’t. You were making a judgement, and a false one at that.

  • chessa

    ELLIE MURASAKI SAID: The people you knew–were they all real estate professionals with experience in determining how much house one can afford on a given income?  …And I really do not think it is fair to blame anyone for listening to the fucking experts.

    Everyone was sipping the same kool-aid.  We all thought our house (or building) was an “appreciating asset”.  There’s plenty of blame to go around on this one.  It was a common saying among colleagues and family, “Buy as much house as you can afford, you’ll grow into it.”  Which was basically saying that you need to finance your self to the limit, take a chance, you’ll be fine (probably).  Guess what, that’s why they call it a “chance”.  Sometimes it doesn’t work out in your favor.

  • Lori

     

    If the stock market is so easy to “play”, as you call it above, then
    anyone can build a fortune.  The stock market is for everyone, so pick
    your winners and go make some money.  The problem, however, is that the
    stock market is NOT easy to play.   

    Seriously chessa? The stock market works pretty well for people who have inherited enough money to start with a great big old pile. If they make a mistake they just try again. The same is not true for those who start with a much, much smaller pile. The “winners” aren’t necessarily winners because they were just that much smarter or harder working than other people.

     

    The American economy needs to be stimulated by innovation.  We need to
    encourage the risk takers.  This will benefit us all, which will in turn
    ease the burden of social needs like healthcare.   

    You have the connection between innovation and healthcare absolutely backwards. If we want people to take risks and innovate we need to free them from being forced to chose their work based on where they can get health insurance. Healthcare is not a “social” need. It’s part and parcel of a well-functioning economy. Sick people can’t work. People who are slaves to the ability to get insurance can’t launch out on their own and do the innovation you claim to value.

     

    Please take note that I am not talking about large corporations.  They
    are really not the issue here, so don’t use them as a smoke screen to
    mask the subject matter.  Big payouts to CEO’s and the few bad apples
    that commit corporate fraud are a drop in the bucket.  There are bad
    apple examples in every sector.  

    The people who ran the gobal economy aground, dodged all responsibility for their actions, and are now doing the same things all over again and worse, are not a “smokescreen” and they’re also not some tiny little group of bad apples. 

  • EllieMurasaki

    Everyone thought they’d be fine BECAUSE THE EXPERTS TOLD THEM THEY WOULD BE FINE.

    It is not the fault of the people who trusted the experts that the experts were either lying or wrong.

  • Lori

     

    Exactly, the world *runs* on the production of goods and services.

    You should read Ruby’s post again because you seem to have managed to totally miss the point.

     

    This scenario is a threat in other countries right now.   

    Would those be real countries with some type of single payer, virtually all of which spend less per capita on healthcare and get better outcomes than the US or would that be somewhere like FantasyCanada where sick people wait months for service and everyone who can makes a run for the border to use the US system?

  • Lori

    They also tend to forget that life for most of those folks didn’t improve markedly until the plague killed off so much of the population that income for those who remained rose considerably.

    Personally I’m not in favor of leaving large numbers of people with no real chance to improve their lives unless we get a return of the plague.

  • P J Evans

     Probably a ‘paper millionaire’. There are a lot of them: the million exists only on paper; in reality they’re not that rich.

  • P J Evans

     I’m a scientist and engineer by trade.

    Probably not very good at it, since there doesn’t seem to be a lot of thought going on in that head. I knew people who got called ‘engineer’ because they’d been working as technicians for X years, not because they actually knew anything about it.

  • P J Evans

    I know people who lost the house that they’d been paying on for 20 years – not because they overbought,  but because they lost jobs in the Bush41 recession and the Bush43 recession. You can’t afford a house when your income disappears. And the GOP won’t admit that their economic policies caused both of those recessions.

  • P J Evans

     That’s a really crappy flounce. Doesn’t even make 2.0 on style.

  • chessa

    Ellie, you said “Everyone” that was foreclosed on was lied to by experts.  That’s impossible, because I know people who were NOT lied to by agents.  I’m one of them.  I took chances, and got snake eyes.  There are no guarantees in life.  You can’t always blame someone else.  Frankly, I’ve lived in my town for a long time and saw many of my friends become “mortgage brokers”.  They hardly knew what they were doing, they just pushed it through.  There were so many ignorant people running around giving loans, getting loans, and refinancing.  I look back on it as a financing frenzy.  It was simply out of control.  My mortgage broker friends now do something else (thank God).

    I’m sure there were many people lied to by processors and banks, but there were also many people who were told the truth.  I saw a “gold rush” look in peoples eyes.  They thought that they had to upgrade to their dream house now, or in a few years it would be out of reach.  Whether those people were lied to or not, many of them were going to take a chance, period.

  • Amaryllis

     the world *runs* on the production of goods and services.

    Belatedly skimming the thread, and that caught my eye.

    Because the world only partly runs on the exchange of goods and services for money. The world also runs on personal relationships, between family members, friends, neighbors, colleagues. And it also runs on the relationships between citizens and their government; which, in a democracy, is to say the world runs on the arrangements that citizens have made to  take care of things that are considered collective responsibilities.

    The market model isn’t the appropriate way in which to think about absolutely everything.

    Also, anthropologically speaking, I don’t think it’s accurate to talk of “being thrown back to a barter system.” I don’t believe that a pure-barter economy– a bushel of corn for bottle of medicine, every transaction an exchange of goods or services somehow deemed to be of equivalent value, between exchangers each of whom has something the other needs– has ever been documented anywhere.

    As for healthcare, here’s a hospital nurse’s opinion of that dreadful “skin in the game” phrase, Saving Your Own Skin.

    The visceral phrase “skin in the game” keeps popping up in discussions
    of American health care policy. It’s the idea that if patients spend
    their own money on care, they will spend it more carefully, and health
    care costs will go down. Conservatives worry that as the government
    becomes more involved with health care, patients will become less
    responsible about costs because the money being spent — their “skin” —
    is not their own.


    Health care choices made by patients only rarely resemble a penny-wise
    buyer who, say, needs a car and must choose between a used Buick, a new
    Hyundai or a shiny new Mercedes….

    When these patients think about their personal health care costs,
    they all have skin in the game: their own skin. Or their own bones,
    their own heart muscle, brain cells, lung tissue, spinal cords, blood.

    In
    dire situations of illness and injury, there isn’t an old Buick
    alternative. There’s care that can fix what’s wrong, and anything less
    is about the same as doing nothing.

  • EllieMurasaki

    What did your real estate agent say to you regarding how much house you could afford? Because if it was anything other than ‘this house you want to buy [and subsequently bought] is too expensive for you given your stated household income’, then I’m counting you among the people who got lied to by the people who should have known better or who were trying to make money off you and didn’t care if if fucked you over.

  • Lori

    Chessa, your list looks like a lot of very good reasons for your political and economic opinions to be quite different than they are. Don’t you ever get exhausted tugging on your bootstraps with one hand and waving the flag with the other?

    I bow to no one on the issue of love of my home, so playing the patriatism card really doesn’t work on me. My love of my home is one of the reasons that I want to see it get better, rather than watch it slide further into the second Gilded Age. We’re better when we stand together and help each other than we are when it’s dog eat dog and every man for himself.

    The old saying that what doesn’t kill you makes you stronger is oft-repeated, but frequently not true. Often what doesn’t kill you just wears you down so that the next thing that comes along, which should have been no big deal, kills you. There’s no reason for us to waste people’s lives and energies and talents that way when being just a little kinder and a little less in love with Right wing ideology could help so many of us.

    I support Obamacare for the same reasons I support FEMA: We must take care of each other by Harold Pollack

    Nytimes.com features dozens of fabulous pictures today. I
    especially like the one by Michael Kirby showing several police
    officers rescuing three-year-old Haley Rombi from dangerous flood
    waters. When natural disaster strikes, we need people to have our backs.
    As individuals, each of us is utterly vulnerable to many forces larger
    than ourselves. Acting together, we can protect each other against many
    of life’s scariest risks. Hurricane Sandy has battered the northeast.
    Watching the pictures, we glimpse the magnitude of destruction. Only we
    really can’t grasp it. One cubic meter of water weighs one metric ton,
    as much as my car. The energy contained within a storm surge raging
    towards us is literally unfathomable, out of human scale.

    So it’s pretty damn inspiring to watch doctors, nurses, EMTs, police
    officers, fire fighters, utility workers, air traffic controllers,
    meteorologists, construction workers. members of the armed forces,
    electricians, plumbers, engineers, public health officials, politicians,
    and ordinary people helping each other when such a storm strikes.

    I feel the same way about some other things. I remember when Vincent
    moved into our home. Bewildering forms began arriving at our house, many
    from hospitals sporting impressive dollar figures, alongside the
    notation: “this is not a bill.”  The totals quickly accumulated: tens of
    thousands, then hundreds of thousands of dollars.  As I’ve said many
    times before, our family would have been whiped out if it weren’t for
    Medicare and Medicaid. These programs had our back when we needed them.
    most.

    Writing in this morning’s Times, David Brooks worried that
    a second Obama term would ”be about reasonably small things.” The words
    “implementing Obamacare” were included within a list supposedly
    illustrating this point. That’s not a small thing. Quite the opposite.
    Until the Affordable Care Act is securely implemented, tens of millions
    of people will lack the protections our family received. So many
    people are one car accident, one serious illness away from medical
    bankruptcy. We finally have the opportunity to remedy this scandalous
    situation.

    As Americans, we need to protect each other against these risks, too.
    One person loses her house to a tidal wave of rushing water.
    Another loses her houses to a tidal wave of daunting medical bills. Both
    people need help.  As our glorious first responders struggle to address
    the carnage of Sandy, today is a good day to remember this simple
    point.

    http://www.samefacts.com/2012/10/disasters/i-support-obamacare-for-the-same-reasons-i-support-fema-we-must-take-care-of-each-other/

    (Note: Vincent is his mentally handicapped BIL, who moved in with them after his MIL passed away suddenly.)

  • To be fair, there are analogies between the house-buying boom of the 2000s and the stock market buying frezny in the 1920s.

    One of them is that the people who already had substantial amounts of money in either market were looking for ways to keep the balloon inflated and counted on the herd behavior of human beings (chessa even admits this in a way as one of his motives for buying a very expensive house) to bring in money from people who otherwise would never dare commit such sums for what amounted to risky bets.

    In both cases they also counted on consumer ignorance. Taxi drivers buying stock and treating it not as a long-term investment but as a lottery ticket are not making anything like economically rational decisions. Nor are people who don’t fit “standard” lending criteria being offered attractive loan terms and seeing everybody else going along with a home-buying momentum, thus deciding to go in on it as well.

    People really underestimate how much of their decision-making is actually group-social rather than individual in origin.

  • chessa

    FOR ELLIE

    Ellie, that’s my point.  I was easily able to afford my house, but ultimately suffered a foreclosure because of economic consequences (side effects).  And not because I was lied to.
    When I bought my house, building, and capital equipment, I could have paid cash for all of it.  I was advised by many people to borrow on the real property, and then invest my money elsewhere.  When the stock market crashed, which was an event that took place over months, I was no longer solvent.  I don’t blame them for the advice.  In most circumstances it would have been good advice — it’s called leverage.  However, I was taking a chance and it failed.  I was *over leveraged*.

    AMARYLLIS

    I’m not that shallow.  I understand there is more to life than goods and services.

    FOR P J EVANS

    I hope for your sake that I’m a good engineer.  There’s a strong possibility that if you drive an automobile, then its manufacturing was controlled and managed with code that I wrote.

  • EllieMurasaki

    So you trusted the experts and it backfired…and that’s somehow your fault?
    I’m not saying, in this case, that it is their fault. In many similar cases it was, but I’ll take your word for it that this time it wasn’t. But it is certainly not your fault, nor the fault of anyone else who trusted the advice they were given from people who had a lot more experience in the field, and you need to stop with the victim-blaming right the fuck now.

  • chessa

    LORI SAID:  Chessa, your list looks like a lot of very good reasons for your political and economic opinions to be quite different than they are. Don’t you ever get exhausted tugging on your bootstraps with one hand and waving the flag with the other?

    I march to the beat of my own drum.  I have to be able to reason my way through it.

    Economically, I believe in small business agility and efficiency.  Modern technology allows us to work together that makes the large company model obsolete.

    I think healthcare problems haven’t been addressed appropriately by either side — liberal or conservative.  It’s too extreme in either case.  The reason you all jump all over me is because I lean towards private sector solutions.

  • 4) My wife has sarcoidosis.  It developed while I was unemployed and on COBRA (bridged health care).  It was terribly expensive, and we had to scratch and claw for every penny that it cost me.  We’ve been married for 24 years.

    My many sympathies.

    That being said, do you understand that under the Canadian system, a lot of the financial hardship you would have incurred would not have happened? Your tax rates might well have been somewhat higher, but believe me, they aren’t as onerous as the Scandinavian rates would have been.

    I make very little money compared to you in the boom era, but regardless, my “health plan” is the same as anyone else’s. I can choose my own doctor. I can go to the emergency at hospital any time I should need it. And so on.

    6) I am more happy now than when I was losing my business.  I truly worried about my employees.  It actually put me in the hospital.

    I am sorry to hear that. However not everyone who meets a payroll cares about their employees and you shouldn’t universalize your experience as a business owner. There are countless horror stories, particularly in the restaurant sector, of owners treating their employees poorly, even to the point of demanding bribes and sexual favors for people to get put on high-tips shifts.

    This doesn’t even touch the large-corporate dead-peasants-insurance schemes companies like Wal-Mart have used to extract millions from their employees (keep in mind that undisclosed policies would have the effect of ‘overinsuring’ them and causing future policies to be declined) over and above the way their low-wage structure forces the government to subsidize them to the tune of lots of food stamps and/or rental payment assistance.

    8) I’ve always driven a pickup truck and don’t need “things” to make me happy. I have a philosophy that life is about “doing” and not “having”.  That’s why I invested my fortune in a health and sports science business.

    It is good that unlike some business owners, you have a more balanced philosophy of life.

    But Western society (especially US) has so gravitated towards the acquisitive type mentality, that for far too many people the mouse-wheel we are in is a Red Queen’s Race to hang onto as much money as possible, and for a fortunate few, to haul down princely sums and live an ever-increasingly lavish lifestyle of the kind last seen before World War I or perhaps in the late 1920s.

    12) By and large, I do not like large corporations.  It’s not because they are inherently bad, it’s because they are inherently inefficient.  I like big government even less, and for the same reasons, but magnified because the representatives in government are largely unqualified — they are usually elected for reasons that have nothing to do with their job responsibilities.

    The key word here is “elected”. You can always vote for the ones you feel are qualified.

    You can’t even vote for the CEO of the company you like buying from.

    The ‘big is inefficient’ motif has been around since probably the 1970s, but the fact that so many multinational corporations have done so well, especially since the 1990s, is proof positive that when not actively opposed (as in the ideological war with the Soviet Union), and unhampered by military expenditures, and in fact given favored succour and support —

    Extremely large, far-flung, centrally planned economies actually do very well.

    (Economists have long recognized the paradox that the firm represents, in microcosm, a centrally planned economy within a market system. The Soviet mistake was to scale this up and put the entire apparatus in the hands of a comparative few in an era where it simply wasn’t possible to make it work. In today’s era of computers, it would be a massively different story.)

    So big isn’t necessarily inefficient.

    In fact, what makes inefficient operations inefficient is usually when the people in charge don’t care – either because they don’t want to, or because they’re distracted from keeping their eye on the ball.

    The latter did in Ken Lay of Enron, when he took his eye off the ball – being more interested in gaining political support for ventures of dubious usefulness to the general population, and not paying attention to the risk culture he was encouraging.

    The former characterizes the Republican party at all levels.

    Many Republican politicians actively do not want government to succeed and do well. To do so would defeat the raison d’etre they put forth as the basis for why they so constantly complain that government sucks (yet they eagerly seek re-election to get a taxpayer-funded paycheck – funny how that works).

    Al Gore’s Reinventing Government was motivated by completely different things; the Democrats have a vested interest in making the government work properly. So the Clinton Administration applied regulations judiciously, hired the right people, and whipped government agencies into shape.

    Even before the much-ballyhooed “IRS Bullying” hearings of the late 1990s, the Clinton Administration had already worked on another org of relevance to us right now:

    FEMA.

    Katrina wasn’t the first time FEMA committed the mother of all fuck-ups.

    In 1992, when Bush I was President, FEMA was a sorry-ass mess. They took three days to respond to a hurricane that hit in 1992, AAMOF.

    In 1993/1994, Clinton got it turned around so well that in the 1990s, people who the FEMA helped in hurricane response complimented them on how well they did!

    What liberals have learned (contrary to the oft-cited claims that conservatives are the only ones with new ideas – actually they are just old ideas in shiny wrapping) is this:

    1. Regulation works best when it sets general objectives, not specific procedures.
    2. It takes money, sometimes, to keep things going well.
    3. Paying attention to what people want from their government is actually a good idea.

    Government isn’t about trying to ape the behavior of businesses. It’s about keeping society together. And believe it or not, but part of that ‘huggy-feely’ involves asking people who have benefitted much from the basics the government has put in place, to contribute much to keep that society going.

  • Lori

    I march to the beat of my own drum.  I have to be able to reason my way through it.  

    Your drum is marching you off a cliff and apparently you aren’t able to reason your way through it.

    The reason you all jump all over me is because I lean towards private sector solutions.  

    We didn’t “jump all over you”, we disagreed with you because the private sector solutions you favor don’t work. I favor having a million dollars and a pony. That is no less a fantasy than your desire for effective healthcare delivered by the private sector.

  • Joshua

    In fairness, I jumped all over him.

  • Carstonio

    Private sector solutions don’t work for health care because the two concepts’ goals are irreconcilable. The goal of for-profit corporations is to produce dividends for shareholders, and the only way a for-profit health insurer can do that is by raising premiums or cutting benefits. Meaning that a private sector approach results in health care being a privilege and not a right. One exception would be if insurers were operated like non-profit membership corporations, with the shareholders being policyholders and each one owning one share. I’m a big supporter of this approach with banking, as in credit unions. Private sector solutions have their place, but treating it as a panacea ignores the principle that economies exist to benefit people and not the other way around.

  • Joshua

    Economists have long recognized the paradox that the firm represents, in microcosm, a centrally planned economy within a market system. The Soviet mistake was to scale this up and put the entire apparatus in the hands of a comparative few in an era where it simply wasn’t possible to make it work. In today’s era of computers, it would be a massively different story.

    I disagree. While that is among their failings, I think their primary failing was based in their understanding of human nature rather than technology. I think if their approach were tried again by an equally large country by people of similar qualities, they would fail again in pretty much the same way, computers or no.

    I think one reason why large companies can be inefficient is that middle managers accurately see their self-interest being served by competing against other middle managers rather than by improving the performance of the company as a whole. Promotion is better than the company bottom line, when your influence on the latter is miniscule. Thus, the group as a whole brings each other down more than it co-operates.

    And the Soviet Union had that fault in spades IMHO.

    But the main faults of the Soviet system were (i) the way the benefit of hard work or innovation was separated from the reward for most of the population, so that there was no point in doing your job properly, and (ii) the naked corruption and hypocracy of leadership running the place for themselves in the name of an ideology they only paid lipservice to. It’s not like the populace didn’t realise this.

    I think the root cause of both of these is that while Marx was great at diagnosing an illness of the capitalist system, he came up with a lousy solution that lacked a way to peacefully get rid of rulers when they go bad. As soon as one does the country is fucked. Which of course happened immediately. Surprising it took so long to actually fall.

    Not that I can claim any particular expertise in political science. I read an book by a defector from the Red Army to England once, for me it was quite eye-opening.

    Anyway, TL;DR is I think not much of that would be fixed by modern information technology.

  • Joshua

    One exception would be if insurers were operated like non-profit membership corporations

    The largest private health insurer in New Zealand (to which I belong, as it happens, although did not use for any of the stuff mentioned in my previous comment) is a non-profit. Does brilliantly well in its niche, IMHO.

    Of course it has to, it’s competing with free.

    Totally private health care is a market failure because a rational economic actor will pay anything rather than die. This is not a strong bargaining position: assuming the doctors are also rational economic actors (which I pray they aren’t, but people are a mixed bag) the price will rise to the point that the patients literally cannot pay any more, but that the doctor’s time is still fully utilised. Anyone poorer than that point drops dead.

    I think a mix of public and private health care is ideal: public in the main, because as you say, a for-profit motive militates against insurers actually providing health care. But private health care is a good way to keep the public system honest – if it sees a dollar in providing something the public system does not, by moving faster it can demonstrate flaws in the public system. In the short term the private care fixes those flaws for its paying customers, but in the long term by making the flaws visible it shows up public providers and creates pressure to improve them.

  • Carstonio

    Totally private health care is a market failure because a rational economic actor will pay anything rather than die.

    Yes. It doesn’t work like other markets because participation is effectively not optional. I like your idea of a mix of public and private, as long as the latter are membership corporations. Insurance of any kind is not supposed to be about making a profit.

  • Carstonio

     

    Government isn’t about trying to ape the behavior of businesses. It’s
    about keeping society together. And believe it or not, but part of that
    ‘huggy-feely’ involves asking people who have benefitted much from the
    basics the government has put in place, to contribute much to keep that
    society going.

    And I suspect that’s deeply offensive to many wealthy people who have long rationalized their fortunes by believing that they deserve it. One unstated principle of government is that the universe is not just and that government exists to societies can get things that individuals cannot get for themselves alone. If this type of wealthy person were to acknowledge that zie has benefited from the basics that government has in place, it would be ultimately admitting that hir fortune depended heavily on circumstance and zie is not as good and righteous as zie thought. It may be not much different from a woman on a jury blaming a rape victim instead of recognizing that she herself is vulnerable.

  • AnonymousSam

    “I was a millionaire and now I’m poor, but still talking down to you as part of the society who makes such terrible choices and that’s why you all have nothing” doesn’t reassure me that your definition of “poor” is markedly different from my own.

  • As I once said it’s like owning a business becomes some kind of Magic Debate Bullet that makes everything a person says the final word on anything. (>_<)

  • Joshua

    Well, I like the non-profit approach to insurance too. But my impression of our health system is that it’s a really hard environment for an insurer to be an asshole in.

    The largest health provider by far is the public system, the second largest is a non-profit insurer, it would be very easy for a third for-profit player to lose customers if they behave like assholes, and the impression I get is that they therefore don’t.

    I have a colleague who seemed happy with his for-profit health insurer, so there’s a vast body of anecdotal evidence.

  • Still, he hit most of the items on the standard flounce checklist:

    1.  I’m not what you assumed I am.  I’m a man instead of a woman, but instead of informing you of that when the mistake was first made, I choose to do so during my flounce.

    2.  I use all the standard lines about “personal responsibility” and (of course) used obesity as my example.  But surprise!  I am very slightly overweight and like cheesecake, which qualifies me to judge all overweight people as lazy slobs.

    3.  You should be thanking me!  I’ve done nice things.

    4.  You should be thanking me!  I have values.

    5.  You should be thanking me!  I owned a business.

    6.  You should be thanking me!  I’ve made everyone’s lives better with my invention/idea.

    Given how many times I’ve seen these before, hopefully everyone will forgive me if I take such assertions with a very large grain of salt.

  • Carstonio

    Talk to some providers – the squeezing affects them as well. A relative who deals with the companies on a professional basis fumes that an insurer’s authorization of a given treatment doesn’t constitute a promise to cover the treatment.

  • Joshua

    Like I said, as far as I can tell that’s not a problem with the for-profit insurers in NZ. They couldn’t keep customers if they jerk people around, since they are competing with a free public system and a primarily non-profit private system.

    Very different beast to your for-profit insurers.

  • As I understand it Switzerland also imposes stringent regulations on insurers, so that even though everybody in Switzerland is mandated to get health insurance almost nobody is put to considerable hardship in purchasing it.

    http://en.wikipedia.org/wiki/Health_care_in_Switzerland