FeatherFall
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Posts posted by FeatherFall
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It begins. While this may be a little off topic, calls for doctors to be forced to take medicare/medicaid were foreseen by Paul Hsieh and others.
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I guess that's what I'm trying to understand. The two alternatives you present seem to represent significantly different moral categories and don't necessarily exhaust the possibilities.
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A system that enables and emboldens moochers is not moral. A system filled with (mostly?) moochers is the very definition of a cleptocracy.
It's not practical either. Thousands of years of human behavior shows us that in such a system, virtually nobody would pay, making the costs for the few that do pay untenable.
Enables and emboldens moochers to do what, specifically?
I am talking about externalities. For instance, if you pay the government to prosecute criminals, criminality becomes less rewarding... So "moochers" benefit. You fund a war of defense against an aggressor nation, "moochers" benefit. Never mind that they are probably engaged in some economic activity for which there are positive externalities for you. They haven't taken anything from you, they haven't violated your rights. They simply benefit from an externality caused by the payments you are willing and able to make. What exactly do you see as mooching?
Regarding practicality: History shows us no such thing, as far as I can tell. It's best to talk about specific governments you think confirm your position, rather than the vague generalities implied by "history." You may be referring to the government established under the articles of confederation... If you think that's a poignant example I can tell you why I don't think so. Let's hear specifics.
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A volunteer system means that some can--and inevitably will--mooch off of others.
The alternative is that we tax people based on the services we democratically agree that we want and pay for those services insofar as we use them (viz. property value tax since more property = more protection; contract tax based on the value of the contract being protected; etc. etc.).
Both of these scenarios involve people being compelled to pay for something they do not necessarily want.
A volunteer system may indeed involve many people who don't pay for it. I'd even say I expect it to be "progressive" in the sense that poorer people will pay smaller proportions of total revenues. But so what? If the choice is between a moral system with moochers and a cleptocracy (presumably without moochers? If so, how?) then I'll take the moral system. Insurance companies would have a great deal of interest in promoting law and order, and anyone with assets worth protecting deals with insurance companies. Do you think such people and companies would rather cry about moochers or get on with their lives?
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Railroad Man, if your real point was to establish a conversation I'd suggest not being a jerk to people who are trying to help you do that.
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Adelson's comments are worthy of criticism, but I don't think much of the criticisms Mmmcanibalism and Crow offered. I don't think they even understand his point, which is that negotiations with Iran, as they are popularly understood, are meaningless. To see what I mean, check out the JPost article. Rabbi Shmooley Boteach asks Addleson, "So a tremendous demonstration of American strength? So that they would get the message?" Addleson replies in the affirmative.
In other words, he is basically saying that Iran ain't listening. They deal in violence and the threat of violence. If you want to negotiate with them, you need to do so with a credible threat of force. Blasting a glass crater into uninhabited desert is one such credible threat. At least that is my analysis. Boteach offers another: "When I heard Sheldon make his remark, my initial thought was that his purpose was to goad his more liberal critics into attacking the policy so that their double standards on nuclear threats against Israel could be exposed."
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Essentially what Adelson suggests is to threaten to use force in a way that cannot be ignored and in a way that suggests no path to victory for Iran and no casualties for Americans. Not that I necessarily agree with Adelson, but this is anything but casual.
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In other words, outflows would need to be cut by %50. That would spell disaster for the leadership of both parties due to the abrupt hardship of constituencies on both sides of the aisle. I agree that it has nearly no chance of happening. But if neither side comes to an agreement, they'd be left with a choice. Which is politically more workable at that point, paying debts or finding creative solutions to sell assets/cut services? Lets pretend there were enough Ted Cruz clones. Who makes the decision on what to pay for and what do they decide?
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So, is everyone on the same page that if we bump up against the debt limit, we retain the ability to service the debt?
I don't want to sound like I think what gets cut is unimportant; on the contrary, SoftwareNerd is absolutely right about the need for prioritizing the cuts. But I wonder if Republicans haven't had some of these discussions behind closed doors. It would seem that running into a budget crunch is the kind of cover a morally uncertain politician would look for. "We didn't want to cut these entitlements, but the constitution makes me pay the debt first and foremost. My hands were tied!"
Some kind of political master stroke is out of the question, of course. They only control the house, they don't have unified leadership, and Democrats have a lot of leverage in proposing their own painful cuts. However, a real reduction in short-term spending seems possible. -
Moreover, while many people may not like this new law, many of them would not agree that repealing it is worth blowing our government to bits in order to repeal the law.
Holy crap, I didn't realize the government was going to blow up... Does the Democratic agitprop apparatchik who found out about this plot have any tips for law enforcement, so we can catch these terrorists?
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Kate, nothing in exchange for nothing would be exactly what we have now... Spending bills must be proposed and passed to avoid shutdown or collision with the debt limit. All such bills must originate in the house. So factually speaking, your description of the process is incorrect. But again, the point I was trying to make earlier is that a normative conclusion based on a critique of procedure is an exercise in rationalism ("sports-fan politics"). How you feel about the procedure is completely dependent on your evaluation of the law, so don't try to reverse the process and pretend the procedure is what is at issue here.
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If the Republicans didn't know this, whose fault is that? Its the most obvious thing in the world that the Dems are not going to give up the ACA in return for the Republicans not destroying the economy.
You'd have to be a moron to agree to that, and a double moron to think your opponent would agree to it. If you disagree with me, then tell me what the Republicans were offering in return for not funding the ACA? The fact is that they are offering to not destroy the economy. Which is the dumbest offer I ever heard.
Please reply with what you think the Republicans are offering.
I don't think they are offering anything, nor do I think they should. That premise is flawed. What were the Democrats offering when this started? Please reply with that.
Edit: The reality here is that the Democrats know their healthcare law is so unpopular that they had one and only one chance to pass it, back when they controlled all branches of government. Because they know they'll never get another crack at something this hated, they refuse to negotiate. The Republicans knew this bill was hated, and despite that they flinched. They are now negotiating. I predict that once the spotlight is turned away from who "wins or loses" this negotiation, the Democrats will agree to a few very minor tweaks to the law to fix some things that are bad for everybody in exchange for tweaking it a little in favor of their political allies (see SoftwareNerd's above post). The Democrats will claim victory in having convinced abusive Republicans not to "blow up the world economy" (As if!) and the Republicans will claim victory in "repealing part of the healthcare law."
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Yes they did. As soon as they tied passing a budget to defunding of the ACA.
This relies on the assumption that Republicans knew the Democrats wouldn't fund the rest of the government if there was no funding for the ACA. How many times will we navigate this circle?
Both sides appear willing to shut down the government over this. To lay the blame entirely on one side is sports-fan politics. How a given person feels about this issue seems to depend entirely on his or her view of the healthcare law. But have no fear; I think I've found a solution to these debt limit/government funding antics: Don't pass laws on slim majorities that are likely to be so hated that they will not be funded 2 years later.
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I had pretty good success by looking at which ones blended colors, and which ones simply mushed unlike colors together with no regard to what shade of brown they'd create. Using that method, I would have said all five of your latest images were produced by adults.
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Valid criticism. Advice on cultivating confidence would have been helpful. I can get behind that.
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I actually thought this was one of his better posts. It doesn't reference any flawed underlying premises and seems to give good advice: make eye contact and don't be a confrontational braggart.
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If these are truly essential services, why would we allow employers to offer plans that don't cover them?
I think that's the purpose of the employer mandate/subsidy set up. The subsidies are supposed to make these plans look attractive to employees, who are supposed to "choose of their own free will" to sign up... Which brings me to something I was too tired to remember last night: the reason for the 1-year (I'm not sure, but extralegal?) delay in the employer mandate. I can think of only a few possible and realistic reasons.
1) Obama caved to some backer of his. It seems that his backers know by now that he's got them all by the balls, so this doesn't seem as likely to me. But it isn't outside the realm of possibility.
2) The economic damage this will do will be too embarrassing, so he's willing to give up or rework the mandate as a "concession" to Republicans.
3) He wants to get as many people as possible to "choose of their own free will" to go onto the exchanges, triggering more subsidies when the employer mandate goes into effect.
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Current law is Obamacare. I understand if there is some confusion on this, since it is still being phased in piece by piece. I'll also lay off of you on the Ted Cruz thing, because I think the Objective Standard's article about it was poorly thought out after learning more about it. It was a mistake, but I wouldn't call it totally retarded.
How exactly does OC interfere with the choices people make? As I understand it, you still get to pick from the same insurance companies (and plans) you do now, right?
Not quite. Obamacare hasn't outlawed specific plans or anything, but they have saddled the most sensible plans with two kinds of penalties. They use tax and fine sticks to beat people into a group of plans that cover a wide variety of highly personal risks (counseling, rehab, etc.) or conditions that aren't properly considered insurable risks (prenatal care, for instance). The first penalty, the individual mandate, is a "tax" that is incurred if you lack a plan that meets minimum coverage requirements (rehab, prenatal, etc.). This penalty incents the individual to insure for things he normally wouldn't, and therefore use healthcare he normally wouldn't, because doing so is now just as expensive as what I call a "sensible plan." Sensible plans insure an individual against risks for which he thinks he needs insurance. The other plans insure him for more. Specifically, the penalty looks like this:
Under the new rules, individuals choosing not to carry insurance are subject to a penalty of $95 per person each year, or 1% of household income, whichever is greater, beginning in 2014. Over time, the penalty increases, so that by 2016 the penalty is $695 per person, or 2.5% of household income. Subsequent years will be calculated based on a cost-of-living formula.Please note that the article wrongly describes the event that triggers the penalty; penalties are not incurred for being uninsured, but rather for not having a state-approved insurance plan. So yes, you can keep your plan. But they'll tax you. The second penalty, called the employer mandate, more directly speaks to people losing their plans. As far as I know, the SCOTUS saw no problem with leveling a penalty against business, so there is no pretense that this is a tax. It may still be administered by the IRS. I could be wrong. What we call it is really irrelevant, but I digress.
The employer mandate penalizes businesses like so. Let's pretend you are a business owner (maybe you really are, I don't know). Your business employs 50 people, and one of them makes 399% of the poverty level. That employee chooses not to incur a "tax" penalty, so he decides to insure himself against things he otherwise wouldn't, and he calls up the state (or extra-legal federal) exchange. The exchange navigator asks him to provide all of his employment info and, lo and behold, it turns out that he is eligible for a subsidy because his family income is less than 400% of whatever the hell the bureaucrats who decide things decide to call the poverty level that year. The employee says, "Sweet, now I won't have to pay for all of that new medical care I didn't need! I'll take it!"
*Poof* Your business now owes the state $40,000 because he got a few grand in subsidies. Magic is fun.
So, being a business owner, you have lots of extra hours of time to devote to sorting through new government laws (or maybe you have a crystal ball), and you foresee your single employee costing you $40,000. So you change your plan, insuring him for more than he'd prefer, and take it out of his paycheck. Maybe you'll get lucky and he'll choose not to take the plan and pay a "tax" penalty (fat chance). Or maybe you just say, "Screw it. $40,000 is less than I'm paying now for insurance. I'm dropping everyone, they can go get their subsidies on." Well, Mr. Business owner, I'm with you. To hell with letting them keep their plans!
Now consider the fact that the employer mandate refers to family income. That's something an employer couldn't possibly know without invasive (possibly illegal?) questions... So how the hell are they supposed to make sound business decisions? More magic, I guess. The ACA fucks with your choices via "monetary incentives" and then makes an informed decision impossible. But have no fear. Not to have bureaucracy outdone by the SCOTUS (what the hell is constitutional authority, anyway?), the IRS has saved the day with another extralegal change to the law.
I'd love to be able to go on and examine every iteration of the employer mandate, but my head is spinning. You get my point, though. We aren't making decisions like we used to.
How exactly does it interfere with a doctor's decision to run his own practice?.
I covered that earlier. Post 60, to be exact. ACOs. But to be fair, a doctor could choose not to accept medicaid... But that would be a choice brought about by the new electronic medical requirements, wouldn't it? If I went back in time to kill this law, I wouldn't have a reason to go back in time, but if I don't go back in time this law will exist, so I'd have to go back...
I think a lack of sleep is getting to me now. Good night. -
Then I guess it's a good thing that Objectivists who have more relevance in the media disagree with him on this.
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Crow, of course the young should pay for their healthcare choices. Under the current law, however, they are paying more in taxes and premiums to fund the healthcare of the elderly and the sick. That was the whole point of the law. I don't care if you care about these people. But if you want to judge this law, you must take into account the rights of others as well as your own. You can't evaluate how this affects others without looking at how it interferes with the choices they make. Despite your dismissals, we know that the law further interferes with the choices people make to provide for their own care, we know that it further interferes with a doctor's decision to run his own practice (not to mention the care decisions of doctors who accept medicare), and we know that in order to implement this law the rule of law itself suffered significant injury (SCOTUS redefining the penalty as a tax, the creation of federal exchanges without legal authority, the regulation of non-activity as commerce). Given all of this, you continue to level base insults at defenders of individual rights because you think this law might provide you tax savings for which you have no evidence.
Speaking of which, those insults serve as an end-around meaningful discussion They amount to cowardly ad hominem, and they aren't even true. For counter examples, see Immigration and Individual Rights, Morality and Sanity Demand an End to Drug Prohibition, Toward a Free Market in Education; School Vouchers or Tax Credits?, and Planned Parenthood and Others Admirably Fight Texas Anti-Abortion Bill. Your opinions on gun rights are flat wrong (they involve a Zeitgeistian appeal to broad statistics while dismissing principles and real-world examples), so it doesn't surprise me that you would resort to more ad hominem on that issue. I'd be willing to accept a single criticism of yours (their support for the gold standard) as valid if you can show that they advocate a return to it for it's own sake, rather than as a meaningful step toward free banking. But even then, it's not like Republican talking points demand a return to the gold standard. Far from just "notable exceptions," these examples are proof positive that those who write for the Objective standard are carving a path toward a society that respects individual rights regardless of Republican talking points.
Anyhow, I suppose as evidence I'd point to The Objective Standard and every anti-OC article written by somebody calling themselves "an Objectivist" in prominent publications.
Every article? Do better, man. You have to know that lazy dismissals like this evidence a broader lack of intellectual rigor.
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In fairness to Peikoff, this format invites more mistakes than a prepared lecture with no back-and-forth discussion. I still don't agree with him. I thought his attitude toward German emigres to Wisconsin was kind of funny, as that sums up pretty much all of my traceable ancestry.
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Interesting. Sounds like this might be a short-term solution. [...] To be sure, the interview you linked talks about primary care physicians doing routine stuff, not (from what I understand) where the meat of the money is spent on health care, which is acute treatment, right?
There's no reason this has to be a short-term solution. That is, unless you've changed your mind about single-payer (or some other totalitarian takeover) being the ultimate goal of Obamacare. The article may have focused on primary care, but I remember Umbehr saying he was able to leverage his practice to negotiate lower costs for specialist referrals. The costs savings for specialists aren't as dramatic as prescription or test savings, but they are still impressive.
Certainly a loss of quality is a big loser, sure. If that's a threat of OC, then I'd be interested in how they'd pull that off. Remember that I don't particularly care about costs personally, and I can just buy whatever I need price-no-object. I care about costs in terms of my taxes, wherein a point or two more is worth a whole lot more than any medical bills I might rack up. Hence I'm concerned about the costs for deadbeats (as in, I want their costs to diminish so I don't have to pay as much for them) but my own bills aren't relevant to me.
And no, I have no idea what an ACO is :-).
As an aside, I wonder if it will be easier or harder for young people to become rich people when their costs are front-loaded on medical care rather than investments.Earlier you voiced skepticism about cost savings; you seemed to be arguing that this wasn't relevant because it wouldn't be affordable to most people. I'm starting to feel like you're moving the goal posts. But if your purpose here really is to see how this law effects people like you and to hell with everyone else, fine. On to ACOs (that's an accountable care organization, not affordable as I wrote earlier). I'll link to what the state has to say about them first. Here is a short piece by Paul Hsieh. The short argument for why ACOs may affect your care goes like this:
Doctors and small hospitals are incented to join ACOs to create efficiencies of service. The electronic medical records system will track their services, compare them to other ACOs, and medicare will adjust payouts accordingly. ACOs that don't spend as much money will receive higher per-service payouts, ACOs that spend more will receive lower per-service payouts. The danger for you is that your doctor's ACO administrator will lean on him to offer cheaper services rather than better services. You may not even know you need that expensive service you're willing and able to pay for (heck, medicare may even pay for it if your doctor would recommend it). Sure, you can avoid shitty doctors or ACOs by spending more time vetting your doctor or his advice, or spending time searching for a non-ACO provider when your current practitioner joins one, etc. In short, you could spend more of your own time ensuring you get quality care. But you're super rich. Your time is more valuable than the time of others.I think we've proven pretty well that this law represents a huge expansion of state interference in the lives of a significant portion of US residents. I can't fault you for supporting a plan that you know will reduce state interference in your life. But as you've said many times, you don't know how your bills will change. It may even reduce your quality of care or waste your time. In light of that, it's hard for me to understand why you would dismiss the egregious rights violations for others and say something like this:the Objectivists-come-Republican-lap-dogs arguably would have held their hands the whole way, no doubt underscoring what I have underscored in this thread.
I imagine your social circle gives people immense visibility and status for ridiculing conservatives. To me it comes off as petulant. We were having a good discussion until now. You've dropped this trash in another thread, only to disappear when asked for specific names. It's time to put up or shut up. Who are these Republican insurgents that are so influential or numerous to warrant comment?
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Again, unless somebody has a clear reason why this scheme will actually cost us a lot more... I'm all ears...
I assume you consider a loss of quality to be a cost. If that's not right, please tell me. Before I take a stab at this I'd like to know how familiar you are with accountable care organizations (ACOs).
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You mentioned above that I can choose a hospital that doesn't take deadbeats, but clearly they exist in a competitive marketplace and clearly they can and do charge a lot more compared to a system that was totally free, so I'm getting hit that way regardless.
It would have been more accurate of me to say that you can choose a healthcare provider that doesn't take "deadbeats". And no, they are not necessarily more expensive. They work fantastically. Really, it would sound like I'm making shit up if I told you how much some of these practices save their patients. Since you're unfamiliar, please check out Ari Armstrong's interview with concierge practitioner Dr. Josh Umbehr. From that interview:
Our model could potentially save trillions in health costs nationwide. Health care is a $2.8 trillion industry. I believe we can potentially take out more than $1 trillion of that cost. I know that sounds extreme. But, again, if you take a model with family doctors, unlimited visits without co-pays, and wholesale pricing on medications and lab tests, dramatic savings are possible.Bold mine. Like I said, numbers like that sound like this is just made-up feel-good nonsense. But if you take the time to read this interview I think you'll see how cost-savings approaching that magnitude are possible if this became the popular model for patient care. It's really exciting, actually. Earlier in the interview:
Whereas a standard office might charge upwards of $70 for a blood test, we get it for $1.87—and that’s the price our patients pay. Why would you ever pay insurance for that? That would be like paying insurance for windshield wipers or gasoline. Such things are affordable. You just buy them when you need them. That’s not properly an insurable product or an insurable risk.This is the proper solution to the nation's healthcare woes. Empowered doctors serving empowered patients and earning money while lowering costs. Obamacare penalizes this activity. The smart shopper's costs just went up.
Critique of voluntary taxation
in Political Philosophy
Posted · Edited by FeatherFall
Crow, at some point you'll have to ask yourself why people keep constructing these straw men. Perhaps there is something in the way you present your arguments that leads people to misinterpret your intent. In other words, maybe you could ask some probing questions to find out why you were misunderstood.