Political opinion thread

As I stated in the thread about primaries, I thought we were getting off topic on too many posts. So I'm starting this thread in hopes we can put the opinions on the various issues here and keep the discussion there on the topic of the ongoing contests for the presidential nominations.

 

Let me answer an important question from BurnPyro. "but do you not think it would be for the better of society of certain risk groups are forced to insure themselves against said risk (among others)?"

No. Certainly not at the federal government level when there is no authority to do that. I think there are batter ways to deal with the high risk groups you're talking about than forcing them to buy something they do not want or cannot afford without a subsidy. I would prefer the insurer of last resort concept that works to compliment private and state systems (if it must be a federal program) that has incentives for people to have insurance. (I do have an idea in mind that I discussed with a liberal co-worker who liked the concept. I don't have the time to go into that now.)

 

Then how would you go about it if not for a "medicare for all" type of deal? Before Obamacare, (and I feel like I mention this at least once a day, grmpf), there were 44 000 deaths due to people not having a healtcare insurance.

There is clearly a need for something. If not Obamacare, then what? Because I'm assuming any sort of welfare program would be labelled bad because big govt spending.

 

In that same thread Astamir replied "Do you see me telling you how to think and what's real and not on matters of climate and weather? No. Because I'm not an expert in those things. You're lucky enough to have me on this forums to provide you with insight on things related to economics and development. Maybe you'd do better if you realized that we're not on equal footing here."

Park you brains people! Let the liberal elite economists do you thinking for you!.. Never mind there is a contrasting view of economics espoused by people with sound credentials available to consider.

I'm not going to dispute things like economic definitions, but I'm not going to automatically accept your conclusions when I've seen contradictory conclusions by other creditable economists.

 

Yeah that's nice and dandy and all, but I care more about my own question about your belief that Obamacare is bad but there are downsides (people dying, costing more (obamacare saving millions overall)) that you might want to deal with. Not to be rude or whatever, but take this little feud thing to PM or whatever.

I'd like to know what you'd do if you would cut Obamacare. Do nothing? Something else?

 

Thanks for moving to this thread. I was prepping an answer when you posted.

First I'm not sure where you're getting this 44,000 deaths due to not having healthcare insurance from. I now no one can legally be denied emergency care for lack of finances. You don't time to worry about at that point. Also I don't ever recall seeing the cause of death listed on the death certificate as 'lack of insurance'. For dad it was listed as 'metastatic colon cancer 'and I don't remember what it was specifically for mom. People in every country die waiting for treatment. People die in every country as a result of triage principles; someone else perceived to be savable gets the treatment while the other is not viewed as savable or not life threatening (and it was; honest mistakes do happen).

You claim there is a need for something. First does it have to be at the federal government level? Does it even need to be a government program? Can the end be best served by changing policies to encourage the private sector and charities? Or some hybrid of the two? With 50 different states each taking different approaches we can see what seems to work better and what doesn't work as well. Just as in Europe you have all those different countries each doing things a bit differently and you can see how each approach works or doesn't. Different demographics in the different countries has to be considered just as the different demographics in our states. To me it makes no sense to try to impose something at the federal level on all the states.

I don't know what the optimal solution here is. I know I don't want the 'solution' to include losing power and authority over decisions that are rightfully mine.

 

http://news.harvard.edu/gazette/sto...s-annually-linked-to-lack-of-health-coverage/

Harvard study.

I don't know if it has to be fed level. I don't know the intricacies of the US. I don't know what/how/who. I'm asking specifically, what would you do, if not for Obamacare, to combat these 44000 deaths per year? I'd like to note that I doubt that giving the states the free reign over this issue would most likely result in most of them doing... not much, if anything at all.

To be fair, from what I know, most northern European countries have more or less the same programs, where you are 'forced' to get health insurance (just like you need to have car insurance or house insurance or whatever), the differences are the level of commitment to said insurance (if that makes sense, how far the insurance goes and what it covers) and what the costs are (what you pay and what the govt pays for you).

For example, if I'm feeling ill, I go to the doctor. He charges me around 20-25 euros (depending on what he actually does and if he draws blood or whatever), I get two papers, one is a sick note for work/school where I can take paid holiday off, the other is for my insurance, where I get back a pretty decent portion (I end up paying around 6 euro effectively from that 20 something, iirc). Note, I payed 81 euro if I recall correctly for my complete health coverage for this year.

 

SOB I may have to buy a new computer. Every time I open more than a few internet windows it locks up tighter than a drum. 3-fingered salute (control-alt-delete) doesn't break things loose. This is an old computer since I got it as a birthday present to myself in 2011 or 2012.

Anyway I was checking out a couple articles (one claiming 17 million had found coverage under Obamacare and another claiming 25 million had lost it) when it locked again for about the 'dozenth' time this week. I expect both claims to be fairly true. Millions lost their coverage because their existing coverage did not meet the requirements under the law. Millions ultimately did find coverage in the exchanges. I did see articles discussing the fact that many of those actually got covered under programs that existed previous to Obamacare such as Medicare or Medicaid.

I had just checked an article that was discussing the oncoming employer mandate that was originally supposed to go into effect in 2014. Businesses through enough of a fit that Obama unilaterally decided to delay the requirement even though Congress well at least the House was willing to pass a law to delay it. Anyway the mandate requires businesses that have 50 or more full time equivalent employees to provide an increasing percentage to ultimately all employees insurance coverage. Companies are concerned about being able to afford it. For them it may be cheaper to pay the tax than provide the coverage. Depending on how many decide to pay the tax, millions more people could lose what they have now and be forced to scramble to find coverage.

SO WRT the question about the 44,000, first I find it hard to believe these people weren't covered under an existing program unless they were too poor to afford insurance but not poor enough to be covered in an existing program. Be that as it may, one thing I would do to encourage coverage is not to mandate such a full coverage. Clearly some insurance is better than none. Then forcing these people to pay a tax (really a penalty) that denies them those funds in case they do need medical care is brain-dead stupidity to me.

If one is going to live in a free country, one is responsible for one's actions. Everything has a price and the cheapest you can pay is attention. The most expensive is your life. I think the best way to deal with it is at the state and local level under authorities delegated to them. You can offer various programs, but you can't force people to take advantage of them. That is reality in a free country (or at least what is supposed to be a free country).

If you want I can go into more detail about the idea I have in a different post.

 

SSDs? File not found. It does offer a free upgrade to Windows 10. I don't know if that would help or if this computer has the power to handle it and it was built for Windows 7.I'm hoping that since it started recently, the next set of updates will clear it. Until then I'll have to limit the number of internet windows or tabs I have open to 3.


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I didn’t mean to ignore you, but as I pointed out to BurnPyro, my computer problems are precluding me from doing the checking and gathering the info I’d like to do. I didn’t have saved link a nice chart.


It dons on me my primary point is really economic freedom is key to affluence. Tax rates are only one piece in the economy puzzle. You know that as well as I. It’s very visible because the more you’re taxed the less of your own income you have to spend on your own needs and wants. Yes, that hinders your economic freedom.


http://www.heritage.org/index/ranking


The above is a link to the Heritage Foundation’s index of economic freedom. They consider 10 categories and various things in each category. Is it the best way to come up with a number? I don’t know, but it gives a good indication. You can see what the ranking is for this year. I didn’t see an easy way to get to past years, but I know they’ve been doing this for some time. The US used to be well in the top ten. As an American it’s quite discouraging to see the US has fallen below several countries including Canada (which it did about 5 years ago) and UK this year. OK both are pretty good countries so it could be worse. Many Western European countries do very well in the list and have done so for a long time. They do very well despite their high tax rates because they do well in other areas.


http://www.nationmaster.com/country-info/stats/Economy/GDP-per-capita

The above is a link that you can get lists where countries stand on a lot of things. Some are dated and even the per capita GDP is 2012.


If you compare the two lists you will see that by and large the countries that are free or mostly free are high in the per capita list. Actually per capita GDP results from decades if not a couple of centuries of policies. So even though some Eastern European countries (like Lithuania and Estonia) score very well in the economic freedom index, they aren’t as high in the per capita GDP simply because they’ve suffered decades of communist rule. It takes time to undo the damage of bad economic policies.

 

You guessed right. My laptop computer is a Samsung. I'll still probably go with the new computer route since my big limitation is the size of the video card. It's a 256mb and so many strategic games I like to play are requiring 512mb or higher.

 

Now we're getting somewhere. As I mentioned before I don't know if Heritage's index is the best way and it probably isn't. The one thing that I'm satisfied with and history proves to me conclusively is that economic freedom combined with sound rule of law that protects peoples rights (certainly of life and property) is related positively to economic growth, affluence and economic mobility. Just look at the US. In about a century we went from being a 3rd-rate backwater country to being the world's number 1 economic power while suffering a major civil war in the period. Meanwhile Europe had a relative period of peace (between Napoleon and WW1). Later the USSR simply could not compete with it's hard-core central controlled economy.

Milton Friedman in the book 'Free to Choose' compared South Korea and India after each country's independence. India prided itself on being the largest democracy, but remained way behind in economics. Meanwhile South Korea was a dictatorship, but was much economically freer and grew faster in per capita GDP. Granted South Korea is considerably smaller than India, but it did not have the previous influence of the West like India had (having been a colony of UK). Compare East to West Germany, North to South Korea. A freer economy beats a centrally controlled economy hands down. Particularly when that freer economy is complemented with a sounder rule of law.

 

You know, it's probable that I don't fully understand everything about the intricacies involved in the American health care system (and neither do any of y'all I would guess), but the way I see it is as follows:

Currently, the number one cause of bankruptcy in America is medical expenses. Even putting aside the humanity argument that everybody likes to bring up, being one major illness away from financial ruin is a pretty horrible and stressful thing. I'm pretty gosh darn republican, but even I'm in favor of some form of reform or a single-payer system if it means mitigating this fact.

But I'd ask y'all to truly consider what that means, like I have. Right now, pharmaceutical companies are the ones driving innovation and the research for cures or treatments for previously untreatable diseases. This research is pretty freakin costly and doesn't always yield a cure, which means the companies eat huge losses. Now, why do they do this? Because they know that if they find a cure, they can recoup their losses and then some. This means that they charge big prices when they invent a cure, because they have to cover all the expenses they had to eat that no one really sees (plus they want to make profit, but hey, they aren't a charity). Seriously, if you haven't watched martin Shkreli's vice interview, his radio interview, or his home streaming videos I would highly recommend doing so. I love that dude now after hearing his side of the whole thing.

Hospitals are also included in this equation. They have to haggle with the insurance companies over prices. This means that hospitals set outrageous prices for ordinary things like administering advil, putting in an IV, etc. because that's their starting position. It gets haggled down by the insurance companies when they go to settle the bill. This means, unfortunately, that those without insurance can get absolutely shafted in the process. Now, this system is pretty obviously fukced up. I don't want my freaking hospitals and doctors having to haggle with the damn insurance companies just to get down to a reasonable price for their services.

Now, what does this mean? This means that a single-payer system (the government) would be setting the prices. This means that doctors, surgeons, etc. would probably be paid lower amounts for their services. This means that everybody would get healthcare. This means that pharmaceutical companies would no longer be able to charge whatever they wanted (which is great in some ways and really bad in others).

One of the interesting things that people don't often bring up is the balance between cost and availability. People traveling to places outside of the U.S. to get an operation done because it will be cheaper is fairly common. However, on the flip side, people traveling to the U.S. to get operations done is also not uncommon. The republicans like to bring up the "Death Panels" as a scare tactic (which is exaggerated), but it holds a kernel of truth. Single-payer systems are great for the young and less-so for the old.

Basically, even considering the probable slowing of innovation/research and the other areas it might negatively impact, at this point in time I think I'm in favor of a single-payer healthcare system if just for the fact that I want people to stop having their lives and their families lives financially ruined for something so far obviously out of their control. I would vastly prefer trying some form of healthcare overhaul before we make the decision to slip into a single-payer system (Obamacare is currently awful so please don't bring it up)

Anyways, these were just some of my thoughts. I'm on Vyvanse right now and studying for a test, so sorry if it's disjointed and skips over some stuff (or maybe even just wrong I don't know)

 

Really nice to hear a view which isn't based on ideology for a change.

Coming from the country with (i think) the most completely socialised health service, I don't think there are many here who would give it up (excepting right wing politicians) as it provides efficient and effective medical care for every single citizen at a lower price than other countries manage. At the risk of turning into sok, here is a graph:



But I have also wondered if the system doesn't discourage medical research, if you look at where drugs are developed:



You see the US as by far the biggest producer, it also has a more healthy mix of smaller and larger companies as well as types of company (phama/biotech), though this isn't adjusted to reflect that the US has a much bigger population than individual European countries - if this was adjusted for the results would be less dramatic. Europe as a whole produces 98.3 to the US's 117.6. It's also worth noting that the UK where drugs are cheap, is making more of them than the US if you adjust for population.

Another factor, is that this may not be entirely due to potential profits of private enterprise since the US government puts a greater percentage of GDP into grants for research and development than the EU average.

Though of course, in a globalised world, where things are researched and produced isn't necessarily the same place as the profits are generated.

So I don't know.

You could argue that from a pharmaceutical companies point of view, if more Americans where given access to health care then consumption of drugs would go up, and would mitigate any lowing in per unit profit.

 

It doesn't help when we are the primary ones paying for the cost of researching new drugs.

http://www.xconomy.com/seattle/2014...-excel-in-creating-new-drugs-its-complicated/

http://www.forbes.com/sites/paulrod...free-ride-unless-china-steps-in/#2701e6404717

http://www.wsj.com/articles/why-the-u-s-pays-more-than-other-countries-for-drugs-1448939481

They'll all opinion pieces, but each point to facts. The first has a chart that shows the headquarters of the company that invented the new drug. Notice that the overall number is going down and the percentages are tilting towards the US. Granted that doesn't mean the actual research has to be done in the US, but based on the other 2 articles we're paying for it. The cost in other countries are based on the cost to produce the drug plus a very modest profit. Companies are essentially precluded from passing the research costs to the customers.

So if the other countries allowed the companies to balance out those costs the prices would go up there while ours would go down. I don't see that happening.

The Forbes article has a grim prediction if things don't change.

 

Malpractice is another major player and other countries deal with it better the US does and is a result are able to hold those costs down. You can Google malpractice and get plenty of articles discussing it.

http://www.wsj.com/articles/SB124631652544770707

The article above mentions the cost of defensive medicine adding 10% to the total cost. That's low in comparison with other articles I've seen in the past that had the estimates of medically unnecessary procedures done to protect the doctor in case of malpractice case as high as 30-50% of the procedures. Clearly there's potential for BIG savings here.

You factor a more equitable sharing of drug research costs and a better malpractice policy and our costs would come down considerably in comparison to other countries.

The other factor of our higher cost is simply we pay more because we afford more. Also you will find Americans will go to greater lengths to get cured than others (again perhaps because we are willing to pay for it).