Conservatives’ knowledge of Obamacare isn’t

440 thoughts on “Conservatives’ knowledge of Obamacare isn’t”

1. I don’t think the New York Times or Washington Post are leftist, but I’m not in a big fuss about it.
   To me, the real problem isn’t just that there is a rightwing noise machine that confabulates lies. The real problem is that so many of the people who believe the lies slam the door on their capacity for rational thought by claiming that all other sources are invalid. So believe Glenn Beck, don’t believe Paul Krugman.
   I’m not saying that a person should agree with Krugman, but he’s educated, has expertise, and has no history of just making stuff up. Compare that to almost any rightwing pundit or politician or political “entertainer”.

2. This is from Mahablog:
   “Indeed, there is a whole class of grifters on the Right whose incomes depend on keeping the crazy well fed. I’m thinking of Ann Coulter, Rush Limbaugh, Glenn Beck, Sarah Palin, Fox News et al. No doubt Michele Bachmann will become a full-time gifter as soon as she’s out of the House. But there are tons of second- and third-tier gifters, all cashing in nicely.
   And why not? If bank robbers rob banks because that’s where the money is, grifters infest the Right because that’s where the gullibility is. People who can be made to believe in death panels can also be sold on dubious investment schemes, survivalist kits and quack arthritis cures. It’s too easy. See especially Rick Perlstein, “The Long Con.”
   There are also subcategories of specialized grifters such as the NRA/firearm industry and climate change denialists/petroleum industry. But it’s all of a piece, really.
   I wrote recently that the only substantive difference between the “extremists” and the “moderates/establishment” in the Republican Party is that “the ‘moderates’ realize elections have to be won, and the ‘extremists’ don’t know that, or don’t care.” When you look at someone like Ted Cruz, who unlike many others may not be crazy or stupid, one suspects his long game isn’t winning the White House. The long game is making a ton of money. In this country, once you become a reliable supplier of red meat for the Right, you are set for life. Whether you ever actually accomplish anything that’s good for anyone is irrelevant.
   The Republican Party set itself up for this, of course, by being willing to sell out anything that might be an actual principle in order to win elections on the cheap (and dirty).”
   I know this thread is about resources, information, and the comparison thereof, so my comments thus far are kind of tangential. But not completely; the reason there is so much misinformation on the right about Obamacare is that so much of the information is ginned up by grifters as part of the con and there is no left wing equivalent of this. Or, at least, there isn’t enough of one to register. The closest equivalent that I can think of is some of the chronically hysterical and over stated diaries on Kos, but they are not fundraising for themselves, Kos, the Democratic party or anyone. When Kos or Balloon Juice does fund raise the link is to Act Blue for specific candidates, not money for some organization that supposedly is pushing for a political agenda but in reality is supporting a host of grifters.
   As Maha notes, there’s money in lying to the rightwing base, lots of it. So there’s lots of lies from lots of grifters. Hence, Hall of Mirrors.

3. I just got a robocall claiming that
   Obama will be hiring 26000 IRS agents, creating over one hundred new federal agencies and instituting I don remember how many new taxes and t is really important that the states refuse to administer Obamacare because that’s the only way to save America.

4. Laura:
   The real problem is that so many of the people who believe the lies slam the door on their capacity for rational thought by claiming that all other sources are invalid.
   I think you’re not blaming the correct party, here. For Fox News, in particular, emphasizes over and over that “we tell you what the rest of the media is afraid to”, that *only* Fox News (etc.) can be trusted. In this particular Hannity segment, for instance, he says “These are the stories that the media refuses to cover”.
   The message viewers keep getting, over and over, is that *we* are different, *we* aren’t “the media”, we’re on your side, we understand and agree with *you*. Their viewers don’t seal themselves off of their own volition, but because the RWM devotes a lot of effort to getting them to do it.
   And they’re not “gullible” as a character trait, they’re *loyal*. But being loyal to leaders and to their ingroup means they’re much more vulnerable to affinity fraud.

5. I’m curious as to why you stick the BeeB in the center and put AJA on the left? Given that AJA is more or less BeeB and NBC expats…Also, I know our local papers are fairly not center. Last question: CNN?

6. AJA is considered radical-untouchable by most people on the American right. Local papers in my observation have more reporting and less ideology than your true RWM.
   CNN probably belongs in the center, but personally I consider it just embarrassing.

7. if the NY Times, Wash Post are considered Left, wow, i am so far out in left field, then. lol.
   The Times/Izvestia on the Hudson and WaPo/Pravda on the Potomac. such right wing mouth pieces for the Elites. lol
   what a trip to find this list. if these media are considered “left”. i guess thinking is a left wing activity. lol

8. I think this could be a very interesting experiment; most on both sides do tend to favor only “their” sources – and naturally, consider what they read to be centrist. Accepting that your sources have a bias suggests that you yourself are biased, which is very uncomfortable.
   While I am not completely in agreement with where you place everything, I think it is a very reasonable separation. Ultimately, the effect will be to force people away from their preferred sources, if they follow through.
   Is this suggestion for comments on this post alone? A suggestion for all posts and comments on the blog for a time? it would be fascinating to see everyone have to read the shunned sources and attempt to make their cases from them.
   What about the major TV channels: NBC, ABC, and CBS? Are those to be excluded as sources?

9. I posted this on the “A Conservative Healthcare Market” thread as well.
   I find debate with most of the conservatives at OBWI to be a far superior experience to debating the “conservative” memes (nice words for lying horsesh*t) wurlitzered by the right-wing media.
   By which I mean nearly all of the conservatives here argue in pretty good faith, even if I do disagree with them in every detail for the most part, though their opinions of the way I present here may differ (I’m an acquired taste).
   So, we are stuck with conservative opinions about what conservative healthcare marketplace might look like and real world examples of the conservative healthcare marketplace in action in our faces.
   I give you Texas, which I’m using as the worst and most vocal example of a state run by conservatives who I gather aren’t particularly viewed in a favorable light by the Texas conservatives who comment here.
   You see the disconnect. It’s one thing to consider decent conservatives’ opinions about health insurance coverage and yet another to actually live with the crap that the “conservatives” who have taken over the Republican party in these latter days of the Republic provide on the ground.
   What the Texas State Republican Party has wrought (with no little help from the Texas State Democratic Party):
   http://www.window.state.tx.us/specialrpt/tif/healthcare.html
   But look:
   http://www.wfaa.com/news/health/Thousands-line-up-in-Dallas-for-health-insurance-info-229408491.html

10. What we have today is the result of decades of decisions at all levels. I doubt that there is any reason to believe that if “true conservatives” (whatever that might mean) were able to design the system they want, that this is what we would have.
    The fact that we use health insurance to pay for just about all medical care is itself a large part of the problem. It forces doctors’ offices to deal with both paperwork for reimbursement, as well as incentivizing them to comply with the insurance companies classifications of care. The lack of direct pay means that both patients and doctors are a lot less concerned with costs than before this became widespread.
    I think (still trying to confirm this) that we got here because of the HMOs, which promised to reduce costs via increasing preventative care. It sounded plausible, but in hindsight it appears to have been an error. Of course, the insurance companies devised PPOs to compete.

11. FuzzyFace:
    I’m already violating my own rule, but here’s what I found:

    Out-of-control U.S. health care costs, compared to other countries, started shortly after the U.S. started an increased focus on private health insurance companies via “managed care” and health maintenance organizations (HMO’s), while maintaining the private health insurance companies. That activity in the United States occurred shortly after the 1883-1972 period during which the majority of other free-market countries had completed their implementations of their health care for all systems, which allow them to have health care costs much more “in control” than the United States.

    There’s also a informative graph; many comparable ones are available online.
    Now I wonder if the WSJ has covered this …

12. re FuzzyFaces’ 10:21 am:
    For the print media sources mentioned, are we judging their political biases based on the editorial pages or on the news content?
    For the record, I read on a regular basis Investor’s Business Daily, Barron’s Weekly, the New Yorker, the Sunday New York Times, the Wall Street Journal when I get the chance, MSN Money, and a fairly eclectic set of internet political and business sites, the former mostly skewed Left but by no means exclusively.
    I haven’t had a television in five years. I use Netflix and YouTube. I catch John Stewart on Hulu.
    NPR is on a lot, but mostly as background.
    I find all other broadcast news venues, left and right, traditional and cable, to be shite.
    Let’s take Investor’s Business Daily as an example of how a raging Commie like myself picks through the ruin.
    I peruse the editorial page and then check to see if I need to save it or go to the grocery for toilet tissue, though I throw away the ones featuring Ann Coulter, Mark Steyn and company because my nether regions pucker at the mere thought of abrasiveness.
    I read the technical and fundamental analysis, which definitely have bias, but one I find useful in my stock market pursuits.
    I get a kick out of reading short articles about XYC Biotech’s earnings shooting skyward because of a new product, and then doing a little independent research and learning that the R&D was supported by NIH grants, or based on very early baseline research by gummint scientists along the way, and gummint-orphan drug exceptions, and then turning to the editorial page to learn that all government intervention and spending is Stalinist/Muslim/Obama John Maynard GayKenyaism.
    The New Yorker, the New York Times, and NPR, among the other pleasures they provide, give me in-depth reporting and stories that I can’t find anywhere else, with the exception of a few journals.
    The reporting in most conservative print media that I frequent seems to be short on fact content and long on snark, and I should know snark when I read it.
    I listen to NPR’s BBC broadcasts sometimes late at night if only for this type of thing: a report that a fiance soon to be groom has been arrested for calling in a bomb threat to the venue where his wedding reception was to be held the very next day, because he had forgotten, despite months of lead time, to make the bloody reservations and was embarrassed when he remembered the night before that this important task has slipped his mind.
    The report ended with the female British (I’m a sucker for those two descriptives combined in one voice) newsreader noting dryly that “the couple is reported to still be together.”
    There will always be an England.

13. And here that graph is at the WSJ. But that brief article doesn’t say anything at all about the *reasons* for the divergence.

14. God help us, two of my recent captchas have been some combination of Cyrillic script and Chinese ideograms.

15. i assume that’s to make forum spammers feels more welcome.

16. To me, the difference between “news” in the National Review or Faux and “news” on some wacky rightwing blog is a matter of style, not content. I see those venues as not being much different in levels of professionalism from some hyper-partisan exaggerated Kos diary that didn’t make the rec list.
    The Post and NYT don’t strike me as particularly left. They strike me as being substantively different from the National Review and Faux in the same way that a zebra is substantively different from an Appaloosa. The Post and the NYT are responsible news sources. Like everything else, they should be read as part of one’s due diligence at information gathering, not as a sole source and not read with total credulity, either. But Faux and the National Review aren’t trustworthy at all.

17. Ultimately, the effect will be to force people away from their preferred sources, if they follow through.
    There is an acute shortage of “righties” in the comments already, and this requirement would render them extinct.

18. But that brief article doesn’t say anything at all about the *reasons* for the divergence.
    Presumably, one could argue about the reason, but I think the emergence of HMOs is a very plausible reason – and I don’t think anybody predicted it. My 20-20 hindsight can explain it, though 🙂
    There is an acute shortage of “righties” in the comments already, and this requirement would render them extinct.
    Well, that would be part of the experiment 🙂

19. “Extinction” — the new “conservative”.

20. the female British (I’m a sucker for those two descriptives combined in one voice) newsreader…
    Sadly not quite the same since the retirement of Charlotte Green and Harriet Cass earlier this year (though the latter has now become the voice of the classified football results).
    Charlotte Green on youtube (thanks to a fit of corpsing):
    http://www.youtube.com/watch?v=kKBWsy5A2bA
    Good post by Sullivan on a related topic:
    http://dish.andrewsullivan.com/2013/10/28/keller-vs-greenwald-why-not-both/
    And the debate which sparked it:
    http://www.nytimes.com/2013/10/28/opinion/a-conversation-in-lieu-of-a-column.html?pagewanted=all&_r=0

21. FWIW, I tend to lean towards Greenwald’s arguments, too (even if I don’t share his uncompromising politics).
    After all, even the BBC, which has in its very charter a requirement of impartiality, in reality practices nothing of the sort.
    While it makes a laudable attempt at ‘unbiased’ reporting, its institutional assumptions are pretty blatant.

22. I think pushing people out of their comfort zone is a good thing. Where do government reports (e.g. CBO/CMS/CDC etc) fall?
    Nigel: I also like Greenwald, although sometimes he’s hard to read because he’s so angry. But he always has interesting and under-reported facts, even if I don’t agree with his interpretation.

23. i liked how Keller ignored Greenwald’s complaint about “he said she said” journalism.

24. http://www.businessinsider.com/wall-street-journal-enlists-noted-health-policy-expert-suzanne-somers-to-critique-obamacare-2013-10
    The Wall Street Journal decided to feature an article by guest expert Suzanne Somers on Obamacare.

25. Dean Baker points out ceaselessly examples of the WaPo’s editorial jihad against ‘entitlements’ influencing their their news coverage. On these issues, the Post is no member of the “left-wing” media. Please move them to the right.

26. Well, that would be part of the experiment 🙂
    If you want to experiment on us that way, I’d rather we took their guns away and gave them to us. Now there would be an experiment!

27. I just read the Greenwald/Keller debate and the Andrew Sullivan comment that Nigel linked above. I mostly sided with Greenwald, but also agree with Sullivan that there’s no reason why one can’t have both. That is, reporters with an openly declared agenda or bias (like Greenwald or Scahill) and reporters who ostensibly objective. I want both because it’s good to see if people with different approaches come to the same conclusion–Greenwald also says he wants conservative journalists too, which is fine with me. I respect some self-described conservatives (though people like Andrew Bacevich don’t seem to have much in common with what passes for conservatism in Congress) more than most liberals.
    The problem with “objective” journalism is that it’s been something of a pretense all along. There are always biases, sometimes hidden, sometimes not. Glenn didn’t know that John Burns was pro-Iraq War, someone who saw the US military as ministering angels, but I think he must have been asleep–when I read a Burns story in the NYT back in 2002-2003 it was obvious he was pro-war. But Burns was “objective”. And of course the NYT disgraced itself in its prewar coverage of the WMD issue. So the ideal of objective journalism is a good one, but I wonder how often, if ever, the ideal has been made real.

28. Hmm.. that WSJ feature includes Pat Sajak as an “expert” as well, along with Bob Kerry, Amy Tan…
    http://blogs.wsj.com/experts/category/retirement/
    I guess, “expert” for this page means, “somebody who likes to write and publish their opinion.”

29. Glenn didn’t know that John Burns was pro-Iraq War, someone who saw the US military as ministering angels, but I think he must have been asleep–when I read a Burns story in the NYT back in 2002-2003 it was obvious he was pro-war.
    Ummm, yes, obvious to the sentient.
    This gets to the issue of EDITORS.
    I put that word in caps as a heading to my main comment. The fact is that anyone looking at the editorial slant of most traditional newspapers or magazines realizes that:
    1. The goal of reporters/journalists is to be objective.
    2. Editors perceive bias because they read multiple reporters/journalists and recogize slant.
    3. Editors call out bias and prejudice, and perhaps (as in an opinion journal) embrace a particular view, which is recognized as a hallmark of the publication.
    4. But good editors won’t allow yellow journalism, cherrypicking facts, as in Greenwald, the hack. The fact that this unaccomplished lawyer, wrongheaded apathetic character, then libertarian polemicist/traitor/liar, has a following among thoughtful people never ceases to make me vomit. What the hell are you people smoking?

30. Editors perceive bias because they read multiple reporters/journalists and recogize slant.
    Only if they have a range of biases among their reporters. If all of them are pretty much of the same bias, and it happens to match the bias of the editors, they are not likely to notice it.
    Reporters are fallible; it is not uncommon that they make mistakes, and some papers make a point of noting the errors in subsequent papers (although rarely with the prominence of the original). But when a paper consistently makes mistakes in a particular direction, it’s a pretty good indication that there is bias operating – the editors are not noticing certain types of errors, and maybe excusing them.

31. No kidding FuzzyFace, but the antidote is not to hire or subscribe to obvious hacks.

32. And, by the way, Greenwald the gullible didn’t oppose the Iraq war when it would have mattered.

33. But Oh, Oh, Oh, he is into disappointment.

34. and Outrage!

35. Ted Cruz, Joe McCarthy, Glenn Greenwald. All excellent examples of something really wrong.

36. But good editors won’t allow yellow journalism, cherrypicking facts, as in Greenwald, the hack. The fact that this unaccomplished lawyer, wrongheaded apathetic character, then libertarian polemicist/traitor/liar, has a following among thoughtful people never ceases to make me vomit.
    No biases exposed in that comment, wot?
    What the hell are you people smoking?
    Obviously much better stuff than you are.
    I would not call Greenwald a reporter. He’s more like a left wing Robert Novak with fewer sources.
    Now Izzy Stone and Seymour Hersh…those two are reporters.
    I remember when I got all my political information from Ramparts and Rolling Stone. Yes, I read stuff by David Horowitz and thought it was good!

37. No biases exposed in that comment, wot?
    Didn’t realize I was applying for the job of the editor of the NYTimes.
    That said, Greenwald is a cherrypicker and liar. If anyone knows any facts (and there are such things, bobbyp, and Ken Cuccinelli), they will know that reporting does involve attempting to load an article with facts, not “analysis”.

38. By the way, how’s that Miranda court case going? This is the last I read: http://www.businessinsider.com/david-miranda-glenn-greenwald-documents-national-security-2013-8

39. and I wonder whether there is any such thing as hack reporters not defending hack exposers of private documents. Because you know the NSA is bad, but wikileaks is good!

40. Oh, and speaking of outrage, let’s be outraged that Obama has targeted and killed Ibrahim Ali. Because, as we all know, he would have been apprehended and read his rights by the Somalian Court of Justice!
    Let’s be outraged!

41. On second thought, I’m not sure I’d call Greenwald a reporter either. A polemicist/pundit with sources.
    And sapient, you seem a tad upset. Possibly over the fact that the traitor now has someone with deep pockets funding him. I’m wondering if he and Scahill and the rest will have to worry about ticking off their benefactor. But if all goes well, it’ll be good having someone with such “traitorous” impulses reporting the news from a perspective different from the US pseudo-liberal mainstream.

42. And sapient, you seem a tad upset.
    A tad you say? You must be one of those damned liberals, Donald. 😉 I am outraged!
    But let’s get back on track here. Is Business Insider a left wing, right wing or centrist publication?

43. The open thread is the other one, sapient–I linked to some Human Rights Watch and Amnesty International reports on the drone campaign there if you want to continue our mutual rant session on that subject. Not that I wanted to do more than point out the existence of these traitorous documents compiled by lying scum who must be smoking something.

44. it’ll be good having someone with such “traitorous” impulses reporting the news from a perspective different from the US pseudo-liberal mainstream
    Would definitely by nice to have the al Qaidistt point of view represented. I’m outraged that the car bombists aren’t being fully given a voice.
    And bobbyp, what have you heard? Maybe the media protectionists are too “concerned” to report that maybe it was a bad idea for Miranda to be spilling secrets to the fascist Russians. But go, be with them – that’s who you prefer, apparently. (By the way, Izzy Stone loved Roosevelt – he wasn’t a “libertarian” b.s. artist.)

45. On Doctor Science’s rating system, I think the NYT is center-left on domestic policy– I’m guessing that having Krugman as one of their columnists and not just pseudo-liberal (let’s get those damned seniors eating catfood) Tom Friedman, it probably helps keep them somewhat honest. Their reporting on Western European economies is almost always about how sclerotic and rigid they are–too many vacations, too much protection for the workers, things have to be cut before disaster occurs. It sounds like the Wall Street Journal editorial page. They’ve been writing that story forever. Dean Baker (another one of those actual liberals) complains about it sometimes. I can’t tell where the truth lies, because they never bother to get into facts and present detailed competing views–it’s all just a mass of cliches of the sort I just mentioned, with chosen experts presenting little snippets to “prove” the case being made. When the NYT has a piece called “news analysis”, I usually brace for an editorial.

46. Seeing how Roosevelt was an Executive power-grabber, I’m pretty sure that Greenwald would have been outraged.

47. I can’t tell where the truth lies, because they never bother to get into facts and present detailed competing views–it’s all just a mass of cliches of the sort I just mentioned, with chosen experts presenting little snippets to “prove” the case being made. When the NYT has a piece called “news analysis”, I usually brace for an editorial.
    So you turn to Greenwald, snippeteer par excellence. Ha ha.

48. Almost Godwinesque to mention I. F. Stone, no? Thought we were all past that? Oh, right, he didn’t time in time not to be mentioned.

49. meant “die in time not to be mentioned”

50. He probably would have been outraged by the imprisonment of the Japanese Americans. Just guessing.

51. Sapient, if you want to engage in random silly insults linking my view of the NYT coverage of economic issues with my admiration for Glenn’s coverage of human and civil rights issues, that’s your right. But to me you sound like you’re drunk. No spelling mistakes though.
    Anyway, good night.

52. oh. we all seem to have our biases. if you can support your bias with facts, then i will listen and evaluate what you “profess.”
    just defending your version of honor isn’t good enough. that’s why i think it’s important to follow through and scrutinize what these supposed “news” organs say.
    otherwise, we are just discussing more Faux noise channels. Facts, not persuasive “opinions,” are what make a newspaper left or right. and we all know how we have been lied to or just not told anything the media refuses to say/report. but we only find out these things, at times, after the fact, if we find out at all. The NYTimes has such a checkered past in the most recent history.
    full of sound and fury. signifying BS is what most of the Media is now adays. especially when you consider the media are in it to make money. as William Randolph Hearst proved many years ago. 6 major Corporations own the Media. so tell me how Business/Media is “liberal” once again!
    prove to me or others these “organs” are not just beholden to the owners’ moneymaking desires. Real news is when facts are allowed to be reported or obfuscated. Biases are easy to see, facts too, but rarely are we allowed to read the facts. that is.
    any organ that publishes drivel and slime like Tom Friedman, David Brooks, Ignatius, or similar WaPo Broder type propaganda is definitely not “fact” based. or left of center, unless left is so far to the right of the universe, as it does appear to be nowadays.
    as Sgt. Joe Friday said, “Just the facts, Ma’am.” just the facts. Right wingers don’t like facts and don’t allow them to be printed or allow questioning of their “holy Grail” opinions.
    One of my “favorite” Right wing Media s is NPR, aka Nice Polite Republicans. lol they couldn’t or wouldn’t dare say the word torture during the Iraq War. what with their “embedded” liars, it was “enhanced interrogative techniques”! some left wing organ? lol
    Left wing media, oh please. show me!

53. I go to watch football for a few hours and now…I can’t even tell what’s going on. I mean, literally, I can’t follow the discussion from the past few hours. I guess it’s time for bed…

54. Also, fairly creepy. The captcha was 2 digits off of my phone number. Definitely time for bed…

55. I’m a bit late here, and everyone is probably in deep REM right now, but when you wake up and turn on your computer, let’s tone it down just a bit. Thanks

56. Almost Godwinesque to mention I. F. Stone, no?
    Well, Dr. Science DID call “right-wing media” the “the Limbaugh-Fox News-Drudge axis.” I think we were technically there before we started.

57. Just curious if anyone else has come across the “Michelle Obama’s college pal in charge of healthcare.gov based on no-bid contract” thing. This seems to be another bit of conservative knowledge of Obamacare.

58. I got it from a sibling (of the right-wing-yet-proudly-“politically-disengaged”, pox-on-all-houses-equally(-but-yours-more-than-mine) variety) Sunday afternoon. I didn’t feel strongly enough to get into a political argument with family IOT find out the basis for their very firm convictions on this subject, though.

59. the resident fools at Kevin Drum’s site have been yammering about that for a couple of days.
    it was interesting to learn that the First Lady has control over awarding contracts.

60. This is funny:
    Townes-Whitley and her Princeton classmate Michelle Obama are both members of the Association of Black Princeton Alumni…
    And the curious connections don’t end there.
    OMG!!!

61. Trying to assemble an argument for X based on the writing of people who don’t like X seems kinda arbitrary, like trying to assemble a highlight reel for Tim Duncan based on times other people scored on him or times he shot and missed. Maybe composed entirely of scraps of other players’ (from other teams) regular highlight reels.
    I mean, I guess if you could do that you’d say “goddamn Tim Duncan is so great he looks awesome in *other people’s* highlights. Tim getting *posterized* is playing better D than Boogie Cousins has played in his life.”
    I think pushing people out of their comfort zone is a good thing. Where do government reports (e.g. CBO/CMS/CDC etc) fall?
    Another reason why this is a tricky thing to try to do. It’d be easy to say that eg the CBO is relatively unbiased, but then the CBO produces reports according to the requirements of Congresspeople, who can then give it insane assumptions for propaganda purposes and then tout the results as CBO-sanctioned and therefore accurate. (propaganda laundering?)
    Now, we can get to the bottom of this sort of thing by reading carefully and debating the facts- but at that point we’re reading carefully and debating the facts, which makes the exercise of deciding which news sources are inherently reliable kinda pointless.
    I mean, I get the impetus- so many of my abortive online debates fall apart at the initial “can we agree on the &$&#ing facts here?” stage, before we can even get to policy. It drives me nuts, because while I can completely countenance disagreements about political philosophy or principles, I can’t countenance playing loose with the facts.

62. Carlton: “I mean, I get the impetus- so many of my abortive online debates fall apart at the initial “can we agree on the &$&#ing facts here?” stage, before we can even get to policy.”
    I think its far harder than that. There are some facts that are easy to ascertain. Frex: America spent $X on Medicare. Some are harder to ascertain and typically involve approximations, assumptions, models, and the most heinous lying of all, statistics. Frex: Waste, fraud and abuse leads to $Y in medicare costs, impossible to track exactly, but you can estimate it. And than policy: Should we spend $Z on a program to combat it? $2Z? $0.5Z?
    I think what can happen is people get stuck in that middle step…things we know but don’t really know rigorously. Things that involved experts, and models, and assumptions. Sometimes it makes sense to discard that data (frex your link).
    And since every study/model like that will have a few holes in it, it can make it easy for an otherwise reasonable person to discard pretty good data (It’s currently cold outside! I guess AGW is just a model after all!).
    And I think those models/studies/approximations are often presented as facts in the echo chambers/halls of mirrors (frex: the Heritage Institute study showed that decreasing the top marginal tax rate to X% will lead to increased growth).
    I think the interesting part of the experiment, to me, anyway, is if there is something YOU KNOW to be unequivocally true, there has to be a source somewhere on the other side that at least grudgingly admits it, even if it’s part of a “yeah, but…” But it might lead you to find things you know to be true are based on assumptions that, even if you agree with, didn’t think of as assumptions. If nothing else you get to see how different the world looks in a different hall of mirrors.
    NB – I want to say that the examples are made up off the top of my head, not trying to make any claims about anything real.

63. magic unicorn doctors and propaganda laundering…I really like your turns of phrase.

64. Some liberals are criticizing some aspects of Obamacare–I’m in no position to say if this is accurate or not–
    digby
    I first heard a similar criticism from a far left blogger a couple weeks ago, but since he also used a ridiculous Hitler analogy I wasn’t sure how seriously to take it. The claim is that for some middle class people living in high cost of living areas like San Francisco, even the bronze plans are too expensive (more than what they currently have) and supposedly these folks aren’t eligible for subsidies.
    “I mean, literally, I can’t follow the discussion from the past few hours”
    I saw this comment this morning and was going to explain tonight, but the thread seems to have gotten off its tangent and returned to what the topic is supposed to be, so I won’t. The argument you didn’t follow will come up again soon enough, I’m pretty sure.

65. Donald:
    Thanks, and should it come up again, I’d love to learn more. I meant the comment more in terms of an ocean of names and references that I just wasn’t up on, not that the conversation was particularly incoherent. My problem, not yours, in other words. I certainly didn’t mean it as a criticism.
    I think the digby link you have is a much better demonstration of what I was trying to get at above: both hostile and supportive discussions agree some rates are going up, but the whys diverge substantially. If you wanted to talk about the rates going up, you really could turn to either the “left media” or the “right media” as a source for that fact. The surrounding story will be quite different, however.

66. Some liberals are criticizing some aspects of Obamacare
    Gets a little bit tricky just dividing into left-right groups- plenty on the left don’t like the ACA, and are therefore predisposed to bias against it. On the one hand, if half of Dems are for something and half are against it, I would hypothesize the factual debate to be at a higher level (not bc of the left, but bc these are groups with higher trust toward each other) than one that fractured along the normal left-right fault lines.
    Otoh, there’s something to be said for dividing into pro- and anti-ACA groups for these purposes, rather than straight left-right. eg if we were debating Israel-Palestine, it wouldn’t seem right to quote some paleo and say “see, even the right accepts X as a fact”.

67. I think its far harder than that. There are some facts that are easy to ascertain. Frex: America spent $X on Medicare. Some are harder to ascertain and typically involve approximations, assumptions, models, and the most heinous lying of all, statistics…I think what can happen is people get stuck in that middle step…things we know but don’t really know rigorously.
    I would *love* to get stuck in that middle step. I would *pay cash money* to get stuck in that middle step. That’s like my fantasy of a political discussion on the internet, agreeing about all of the basic facts and getting to a point of recognizing our diverging assumptions etc. This is like telling a starving man that he can have a pizza, but maybe it doesn’t have pepperoni.
    I had countless discussions about the shutdown on the net. I can’t remember one where I engaged a conservative who thought that shutting down the government was a reasonable thing to do- every single one, to my recollection, was about how Obama was the real shutter-downer and how he was turning the screws to make the shutdown more painful when it shouldnt be because government is a cancer anyway so shutting it down should be good but he’s doing it wrong intentionally. All I wanted to do was find someone who could articulate “yes, I suport the TP in Washington and here’s why, and here’s how I expect this to work out, and here’s how I see someone whose principles differ from mine working with my plan”.
    I think the interesting part of the experiment, to me, anyway, is if there is something YOU KNOW to be unequivocally true, there has to be a source somewhere on the other side that at least grudgingly admits it, even if it’s part of a “yeah, but…”
    That’s still tricky because in my experience when people on one side cross the boundary into even tentative support for the other side’s memes, they are considered beyond the pale. Because, unfortunately, way too many people think of politics like sports, and find it hard to accept their star player occasionally suiting up for the other team ‘because I thought it was the right thing to do’.
    I mean, I can find the likes of Norm Ornstein or Bruce Bartlett to support positions ‘from the right’, but that would just lead to (not unreasonable) accusations that those two are no longer ‘on the right’- based on their ‘support’ for ‘left’ positions.
    Or, from the left, Im going to ask- is this from a conservative Dem (or a radically liberal Dem) who doesn’t really share my policy preferences and is actually biased against them? Is this from a ‘contrarian’ Dem who is more interested in the spotlight of being a maverick? Is it from a ‘genuine fake’ Dem who is actually conservative but claims to be a Dem in order to show how Dems suck?
    Those are, I think, actually reasonable fears from either side. That I can find self-proclaimed conservatives who think climate change ought to be a serious policy issue is about as persuasive to conservatives as them finding a liberal creationist is to me.
    In the end, there will be the great noise machines of the various political factions and causes. I think some are closer to the truth than others. But we’ll just be scurrying around at the base of the machines, in the shadows, trying to determine what’s true and what’s best- by ourselves or talking with others- even though we know we can’t raise our voices to match the volume of the machines. Because as much as seeing wrong things happen makes us crazy, it makes us even crazier to not know when things are wrong, I guess. Im not really sure why I do what I do.

68. Digby isn’t a kneejerk lefty Obama opponent, I don’t think. I know the sort you are talking about, but I don’t think she belongs in that camp. (Sapient seems to think I belong in that camp, but I dislike Obama on some things, support him on others, and am not sure what to think on some issues.)

69. Anyway, the issue digby discusses in my link seems like a straightforward factual sort of thing, something that could be supported or refuted without reference to one’s political prejudices. Are there going to be middle class people whose health insurance costs will skyrocket and who aren’t eligible for subsidies? A friend of mine in real life was furiously bashing Obamacare some months back when she visited us–I didn’t know what to make of her complaint, but she said she’d have to pay a fortune when the bill went into effect. I don’t think she’s the sort who would be stupid about money, subsidies, etc…
    I know Faux News dredges up imaginary complaints from people who don’t know any better or who are lying (I’ve seen the story about Sean Hannity a few times now), but are there real complaints of this sort that are valid?

70. Digby isn’t a kneejerk lefty Obama opponent, I don’t think. I know the sort you are talking about, but I don’t think she belongs in that camp.
    That’s reasonable, but at that point Im not just evaluating sources based on their politics, but on whether I think they’re trustworthy (or other people I trust vouch for them as trustworthy). Which again, kinda shoots down the idea that I can get at the truth by finding things agreed on by both left and right- if I need to analyze source by source, I might as well forget about their political affiliation and just judge them on merit alone.
    I just realized as well that this method also privileges the majority left and majority right, leaving out the genuine socialists, neonazis, etc. At best, I guess we could arrive at some broad consensus of ‘what the American public/wurlitzers believe is true’, but if anyone did come up with that list there would probably be ‘facts’ on there that I would dispute the truth of.
    I know that’s kind of meta from your point about what Digby is actually saying, sorry about that. I question the method,

71. It doesn’t really matter who says it–my point is, there ought to be some way to evaluate the claims. What does the law say, what are the subsidies, how much do bronze plans cost, etc… In this case I do agree with Bill Keller–there ought to be something, let’s call it a newspaper, which would look into all of this, bring in trustworthy people capable of doing statistics (so we’d know how common this alleged problem might be if it exists), and quote their expert opinions alongside whatever data this hypothetical thing called a newspaper was able to gather.
    For that matter, a slanted outlet with a distinct point of view could also take some pride in being honest about whatever the facts are here. I don’t really think people have to be prisoners of their ideology when evaluating facts. It often works out that way, but it doesn’t have to.

72. I didn’t skim the thread closely enough to see if anyone already linked to this (or something like this), but the LA Times did do a story about middle class people who might be hurt. The question is, how many? Well, another question would be “why should any be hurt?” Ross Douthat (sp?) has a long blog piece on this that Sullivan linked (I just found it).
    link
    On the related subject of who do you trust from the other side of the spectrum, I generally think Douthat comes a lot closer to my idea of a reasonable conservative than David Brooks. Somebody will probably see this and post a link to something really stupid that Ross D has said, but I’m not trying to endorse everything he says, just that he fits better the niche of token NYT reasonable conservative compared to Brooks. (Alongside the mostly not-worth-reading liberals like Maureen Dowd and Tom Friedman and the actually worth reading Paul Krugman.)

73. And since every study/model like that will have a few holes in it, it can make it easy for an otherwise reasonable person to discard pretty good data
    Which is why you need a common understanding of how to evaluate a model. In hard sciences, for example, it should theoretically be simple: if the model consistently predicts what is subsequently observed, it looks good. The minute it predicts something incorrectly, you have an issue of some kind.
    In the social sciences, it’s never so clear. Our understanding is poor enough that you can make compelling arguments that absolutely contradict each other.
    And in simple reporting? It is incredibly easy to cherry-pick the data. You’d pretty much have to have a group of people coming from different sides agreeing on a collection method and ensuring that it was carried out fairly and openly.

74. My faith has been shattered. Two days of comments, and nobody even mentioned the Economist???
    I would have thought that most of those here would at least be familiar with it. It is, after all, far less tied to particular
    American political positions than most of the options provided.

75. I thought the Economist had a sort of rightwing slant on economic issues, but that’s something I picked up from second or third hand and don’t know. I know it has or had a certain appeal among Americans who said it was better than anything on this side of the pond.

76. The Economist is an excellent magazine, but it costs a lot of money for a subscription, and for people who don’t always read the current issue of The New Yorker (with its incredibly engaging writers and even cartoons), the Economist is a bridge too far. I’ve tried it; I know!
    Besides, being realistic, our choices are pretty limited, so getting the gist of the argument is the most efficient strategy: No ACA? Lots of bankrupt people, and emergency room care for people in crisis – care that is more expensive and that we all pay for. ACA? Folks with pre-existing conditions are covered; people can stay on parents’ health policies until they’re 26; insurance companies have to rebate excessive premiums (not spent on healthcare); people can see what options are available; people aren’t stuck in a job because they can’t get health insurance without it; etc.
    I don’t need to read the Economist to realize that I support the ACA versus the Republican plan: nothing. If someone comes up with a legislative alternative, maybe I’ll need to resubscribe to the Economist.

77. a reasonable conservative
    I like Larison, and that’s pretty much my list. Present company excepted.
    If he didn’t have Pat Buchanan, that bellicose white supremacist former Nixon ratf**ker and generally obnoxious @sshole, on his masthead, I might even spend time on his website.
    Too bad about that.
    For my money, Douthat is professionally reasonable, in sort of the same condescending faux-above-the-fray way as Brooks, except he’s about 1,000 times more lugubrious about it (hard to imagine, I know, but nonetheless so), which makes me want to either dope-slap him, or buy him a couple of drinks, steal his wallet pants and car keys, and abandon him in a roomful of wild girls.
    Maybe all of the above.
    LOOSEN UP, ROSS!!! You too, Brooks.
    Either way, not my cup of meat.
    Peter Viereck seems like an interesting dude to me, but god alone knows where he’d land in the spectrum of current day ‘conservatism’.
    When I think of ‘conservative’, I think of somebody like Wendell Berry.

78. When I think of ‘conservative’, I think of somebody like Wendell Berry.
    Wendell Berry doesn’t trade in the politics of resentment. He believes in community, not “self-sufficiency”. There are actually many Democrats in western counties of Virginia that would agree strongly with Berry’s personal values, and share his lifestyle. Maybe he’s a conservative in the true sense of that word, but not in the political sense.
    (And, just an observation: Berry benefited from an extremely fine liberal arts education. He has an enlightened interpretation of his traditions.)

79. FuzzyFace, your 8:25 is dead on. I would only add emphasis to: it’s only *theoretically* simple in the hard sciences…its actually pretty up in the air in hard science as well. Particle physics may be the last bastion of rigorous application of the experimental method…everything else is just too hairy.
    But everything else, especially once you get to policy, its a mess. There is very little you can know for sure.
    And even if you could reach agreement about the results, values vary greatly. A reasonable compromise to some is a bridge to far for others. The recent chatter about the NSA is a really good example of this in a way that seems to transcend party lines (in that someones position on the NSA isn’t correlated well with their party…not that people aren’t trying to score political points. They are).
    And then on top of all this, you add political point scoring, tribalism, and just the fact that people don’t like being wrong. That’s why I always try (try and freq. fail) to tread very lightly in political conversations and as much as possible ask questions rather than issue challenges. The second you say someone is wrong, you’ve likely lost all hope of a reasonable discussion
    It’s also why I think being inside someone else’s echo chamber is a useful exercise. If you can not choke on your own spit long enough, you can start to see how reasonable people come to a completely opposite conclusion.
    As an aside: The split of reactions on the NSA without regard to party lines is something I found curious…were the revelations to sudden for the respective echo chamber machines to crank out a consistent message?

80. There are actually many Democrats in western counties of Virginia that would agree strongly with Berry’s personal values, and share his lifestyle.
    I imagine that there are lots of Democrats in western Virginia who are conservative, by any reasonable definition of that word.
    Maybe he’s a conservative in the true sense of that word, but not in the political sense.
    And so, the penny drops.
    Folks can hijack words for any purpose they like. Doesn’t mean I have to play along.
    On the whole Obamacare thing, it’s going to be good for some people, and not good for others. Like each and every item of public policy that has ever existed, including the option of ‘do nothing’.
    The selling point of the ACA is that it would make coverage available to a lot of people who cannot afford it, or obtain it at all, now. And, it should lower the cost of insurance *in the aggregate*.
    IMO it was not wise for Obama to claim, as apparently he did, that if you liked the coverage you had you could keep it. Perhaps that comment has been quoted in a way that distorts its intended meaning, but basically as stated it’s false, and it is now undermining confidence in the value of the program.
    It shouldn’t matter if you support Obama or not, unless I’m thoroughly mistaken on the salient points the above is just a simple statement of the obvious. There is NO VALUE in trying to ignore it, deny it, or obscure it.

81. and as an aside, and maybe to balance some of the ‘greenwald delendo est’ atmosphere, allow me to say:
    i haven’t read greenwald in years, not for any particular reason other than he just hasn’t bubbled up onto my must-read list for a while. he does have a very strident style, which can be tiresome to wade through, i’m sure that’s a factor.
    however.
    greenwald took a clear, public, and uncompromising stand against the torture regime, at a time when that was NOT POPULAR, and actually took some spine. so, i did, do now, and always will give the man his propers for that.
    our very own and much-missed sebastian holsclaw, ditto.
    so, partisan, shrill, overwrought (as if none of us ever cross any of those lines!), be all of that as it may. greenwald’s made a contribution.

82. I’ve seen some recent stuff that brings together an interesting meme encompassing the ACA, the Tea Party, Ross Douthat, and the left wingy blogosphere. To wit: Think of 3 boxes labelled as follows:
    1. What we had.
    2. What we shall have under the ACA
    3. Single payer, or ‘Medicare for all”.
    Consider that the ACA seeks to move those not currently covered by insurance (private or public)from box 1 to box 2. Those in 3 stay there.
    Many, if not most, lefties want to move everybody from boxes 1 and 2 into box 3, but certainly getting folks from 1 to 2 is an admirable social goal.
    Current GOP plans, as Douthat points out, seeks to move everybody from boxes 1 & 3 to box 2.
    The political ramifications are indeed fascinating.

83. Folks can hijack words for any purpose they like. Doesn’t mean I have to play along.
    Well, just so you’re aware, I wasn’t particularly disagreeing with you regarding Wendell Berry, and I don’t disagree with your use of the term “conservative” in the generic sense. As to the above comment, I do disagree: language is dynamic because “folks hijack words” and then everybody who wants to be understood either has to play along, or explain their usage in every sentence. As political terms “conservative,” “liberal,” “left,” “right,” are only so useful anymore because the operative definition needs to be explained. Once we all agree in any particular conversation what we’re talking about, then they can be used as shorthand.

84. As to Glenn Greenwald’s supposedly courageous stand against torture, I dispute the fact that he was in any way, shape, or form alone, or that it was ever unpopular for anyone to complain about the Bush administration’s embrace of torture. The fact that so many politicians (not citizens) seemed complacent about it is, of course, a sad fact, but I certainly didn’t know any private citizen who was afraid to object to it.
    The fact that Greenwald created false equivalencies between the administration that made torture an official policy, and the administration that ended it, is an argument against his valor, IMO.

85. On the know-nothing conservatives, there is the bit about what people were told about keeping their insurance if the liked it and the present reality. This sums up the integrity of the process nicely:
    The text of the Affordable Care Act said that none of its language “shall be construed to require that an individual terminate coverage” that existed as of March 23, 2010, or the date the law was enacted. But as early as June 2010 HHS published a regulation reinterpreting this “Preservation of Right to Maintain Existing Coverage” to obviate that promise.
    What kind of law says one thing, but allows unelected officials to rewrite that law? What kind of law allows the executive to pick and choose to whom the law applies? What kind of law can be suspended in whole or in part by the executive?
    I know, silly conservatives, they think they know about this law, but they really don’t.

86. I know, silly conservatives, they think they know about this law, but they really don’t.
    they don’t. they’re learning bits and pieces as they go, as they explore new ways to complain about it.

87. McKinney, I’m curious where you got that quote from. My understanding was that existing insurance coverage that didn’t comply with the ACA would be grandfathered, but that significant changes made to said coverage would invalidate the grandfathering. But, also, that Obama knew or should have known that a lot of people would lose their coverage as a result the ACA because significant changes were going to be made to a large number of people’s policies (because that’s just what happens, I guess).
    So you might say that what Obama said was technically true, assuming that “existing coverage” meant “existing coverage not subject to future, significant changes,” but that he was not being forthright about the practical application of the law, since lots of people’s policies were very predictably subject to changes that would invalidate their grandfathered status.
    All of which is to say that I’d like to read the whole thing.

88. The text of the Affordable Care Act said that none of its language “shall be construed to require that an individual terminate coverage” that existed as of March 23, 2010, or the date the law was enacted.
    Not looking to take Obama off the hook on this, because IMO there is a real problem here, both with the practical result of the law and with Obama’s statements about folks being able to retain their coverage.
    But as a point of fact, what the text of the law says is:

    Nothing in this Act (or an amendment made by this Act) shall be construed to require that an individual terminate coverage under a group health plan or health insurance coverage in which such individual was enrolled on March 23, 2010.

    My bolds.
    My understanding is that the discontinued policies are almost all in the individual market. So, not group plans.
    If I’m misunderstanding the issue, I’ll thank anyone with the correct understanding to set me right.
    I haven’t had a chance to wade through it yet, but the analysis here seems potentially relevant.

89. I’m guessing you got that here, McK.

90. The WSJ article isn’t altogether honest. It states that Americans “are losing their coverage”. That’s not what is happening.
    Americans are experiencing coverage changes which are resulting in cost increases in some situations.
    Obama wasn’t being altogether honest either when (if?) he said that people who like their insurance can keep it. IT’s true that if you like your insurance carrier, you can keep getting insurance from the same company, but what some people are experiencing is a sudden change in the coverage that their plan gives them along with a higher cost, thus their plan, which they like, is not being kept the way they liked it.
    I don’t know how big a problem this is. Just anecdotally, based on people I know, it barely registers as a problem, but that’s because the people I know fall into three categories: Medicare/Medicaid, insurance through their job, or uninsured. I do know one person who had a single private plan for himself and who was told by his insurance company that they were changing his plan to one with higher coverage and cost.

91. My neighbor who experienced a change in his iinsurance and increase in cost is married to a former health insurance professional, I don’t know exactly what she did. Anyway she says that what’s happening is the insurance companies are changing what were essentially junk policies into policies that have more coverage, thus costing more. She says this is because the law requires coverage for people with preexisting conditions and other factors which increasing the number of ailing people covered, thus increasing payouts, which the insurance companies are passing along. She says the policies which are being changed typically have high copays, cover only relatively small part of services and had limited coverage. For example, her husband’s policy was basically coverage for disasters. IT was set up so he paid for everything short of a disaster, (He didn’t go to the doctor since he had to pay out of pocket for non-disastrous visits).
    So now he has insurance which will allow him to have routine doctor visits for the ordinary things, but it costs more.

92. IMO what’s true here is that there is a non-trivial population of people who are going to end up paying more than they want, for stuff they don’t want, under the ACA.
    That’s not a surprise, it was predictable when the law was written, and in fact was predicted by many folks when the law was passed.
    But there’s no value in trying to obscure or deny the fact that those people exist.
    Obama’s statement, taken at face value, didn’t make that clear, and in fact would seem to have been saying the opposite.
    So, not a good performance by the POTUS, in that case, and no value in trying to obscure or deny that.
    The population of folks in question are basically those who purchase health insurance, for themselves and their families, as individual policies rather than as part of a group. And, where the policies don’t meet the ACA standards for coverage. And, where their income is high enough that they won’t be eligible for sufficient (or any) public money to offset the additional cost.
    I don’t know how many folks that works out to, but it could reach to the low millions.
    Depending on where you sit, you either see that as an intolerable violation of their personal liberty, a great big giant PITA, or an acceptable trade-off that balances their interests against those of the population of people who will gain access to health insurance that they didn’t used to have access to.
    Which is another population that likely reaches into the millions.

93. I do know one person who had a single private plan for himself and who was told by his insurance company that they were changing his plan to one with higher coverage and cost.
    and there is talk that this is widespread and is due to insurance co’s unilaterally pushing people into more expensive plans, instead of telling them that they have options.

    It’s as though you get a letter from your car dealer saying, “That 2010 Toyota Corolla you’re leasing has been recalled. We can supply you with a Toyota Avalon for twice the price.” They’re not telling you that you can also get a 2013 Toyota Corolla for something like what you’re paying now.

94. oops. here’s the link to actual story on Drum’s site.

95. And there’s this:
    http://prospect.org/article/another-phony-obamacare-victim-story

96. Just as a general matter, we should keep in mind that what we’re seeing now may be described as labor pains for the ACA. What meaning both the current website problems and cancellations have in a year or two will depend on how successful things turn out to be over the next several months. If people who lost coverage get at least comparable coverage at comparable cost, and people are largely able to sign up for coverage through the exchanges before the mandate deadline, most people are going to forget or stop caring about this stuff before long.

97. or an acceptable trade-off that balances their interests against those of the population of people who will gain access to health insurance that they didn’t used to have access to.
    Or, just another correction to the free rider problem- they weren’t free-riding at the moment bc of their catastrophic insurance, so they were being as responsible as they could be in the current system. But the ones who did get chronic diseases would’ve found themselves priced out of the private individual market, and onto the Medicaid/public clinic/ER track.
    The only people who weren’t implicitly insured against long-term expensive illness by the public track are the ones on group plans (eg employer plans), and that’s assuming that they wouldnt lose those if they did get sick (eg if they got so sick that they couldn’t keep their job). And people with enough money that they are never going to end up on the public track.

98. For that matter, a slanted outlet with a distinct point of view could also take some pride in being honest about whatever the facts are here.
    I think part of it is cost-benefit. Digging out and analyzing facts is time-consuming and expensive, repeating your side’s factoid of the day is cheap. Especially when the occasional misstatement or intentional falsehood is accepted by most of the readers as par for the course (in my ideal world the second time a candidate or media source misrepresented something, they’d get shunned and temporarily or permanently ignored by most people).
    Funny thing though, afaict people keep trying to do this, or claiming to try to do this eg PolitiFact, and failing miserably. (PolitiFact drives me nuts- the writers can’t seem to tell the difference between opinions and facts, and their rating are insane- a statement consistent with some estimates but not others is “half-true”, as is an entirely misleading misrepresentation that happens to technically be true?)
    So there’s a market for looking like you’re cutting through the BS, but still not a market for actually doing so. 🙁

99. My faith has been shattered. Two days of comments, and nobody even mentioned the Economist???
    On the one hand, I read it most weeks, it’s one of the few traditional sources I still like (google “reader dailies” if you’ve got a kindle…). otoh, it’s not like they’re unbiased, they’ve just got different biases than our American conservatives. More palatible biases, to me, but still pretty obvious (eg for years they’ve been an unreadable morass of smears when it came to Latin American Socialists- not that I love Chavez, but the articles were just a mess and had to be skipped. Their bias about European politics just looks cute from here- awww, they’re fluffing Merkel again!).
    Sadly, Ive found their factual reporting to have slipped somewhat on the political front- they used to be pretty reliable, but in the last 5-10 years they’ve fallen to misrepresentation more often to make their case, and there are a lot more unsupported ‘facts’ used to make arguments about political personalities or programs. [Also, I think in the last decade Ive lost patience with their combined news-and-opinion style, but that’s a me thing].
    So do I trust the Economist to report ‘just the facts’ when those facts go against their (pro-free market, pro-UK Conservative, pro-business) philosophy? No I do not. They don’t distort much in US politics, but that’s because they’re ideologically in-between the two American parties and they’re far enough away to not get over-excited about it IMO.
    [Funny thing about international politics, I find in myself and often in others- if we’re on the left, we tend to identify with the ‘party of the left’ in other countries *even* when their national politics are so different from ours that the ‘right’ party is closer to our espoused positions. Theories: 1)it’s all about ‘team’ membership 2)secretly we’re more radical than we’re willing to say explicitly 3)we’re not prepped to resist arguments from those positions 4)we have a harder time taking seriously positions that wouldnt be taken seriously in our domestic politics.]

100. Since this thread was originally about what people turn to for information, I’ve been thinking about my pattern. It turns out I largely get information from sources that evaluate or debunk or critique corporate media sources, like the Prospect link I posted up thread.
     Which is good on several counts: I get more than one perspective on an issue in each article, I know I am reading something with a point of view and know what that PTO is, and, often, there is a lesson on how to evaluate journalistic writing which I can apply on my own for wider reading.

101. What kind of law says one thing, but allows unelected officials to rewrite that law?
     What kind of news source quotes part of a statement while leaving off a critical clause? What kind of readers uncritically quote that news source when it has repeatedly duped them with shenanigans such as these?
     [Anymore, when I see a quote that I want to use in an argument I google it first for context, unless it seems self-evidently consistent with the speaker’s known positions.]
     What kind of law allows the executive to pick and choose to whom the law applies? What kind of law can be suspended in whole or in part by the executive?
     If this were the first time in the history of America that the some part of the Executive Branch had to write specific regulations to meet legislative requirements but failed to meet the legislative deadline & therefore delayed the implementation, I would be more sympathetic. But this happens all the time.
     Consider Dodd-Frank- 3 years after it passed, many (2/3rds, according to USA Today) of its deadlines for regulation have been missed. What kind of law is Dodd-Frank? Slower than usual, so not quite par for the course, more like a bogey.
     I would also maybe be sympathetic if the Executive tried use this to game the system, endlessly delaying something that they didnt want to implement. That would, of course, make more sense if the ACA wasn’t Obama’s signature achievement, or if the Administration wasn’t setting a solid deadline. (If they keep punting on this after 2015, then Im all ears on that point, but we can hardly assume bad faith out of the gate here).
     In this case it seems relatively straightforward- the reporting regs weren’t even released until recently, and asking businesses to comply with those regs by Jan 1 isn’t reasonable. And iirc the Executive wants to revisit some of the regs to make them easier to work within. So they didn’t meet the statutory deadline, which would be entirely unremarkable if it couldn’t be spun into a shiny talking point-like object.

102. Or, just another correction to the free rider problem- they weren’t free-riding at the moment bc of their catastrophic insurance, so they were being as responsible as they could be in the current system. But the ones who did get chronic diseases would’ve found themselves priced out of the private individual market, and onto the Medicaid/public clinic/ER track.
     Sounds like a market opportunity to me – a very lost cost insurance policy against developing a chronic illness. But of course, the existence of Medicaid means that there is little incentive to buy something like that. As long as we are effectively offering a free emergency insurance, why should anybody take responsibility for themselves?
     So we institute a new program that tells people what they must buy, since getting elected confers absolute wisdom on how to solve matters of this kind.

103. a very lost [low?] cost insurance policy against developing a chronic illness
     how would such a thing work for the insurance company? chronic illnesses can be expensive, and small premiums from poor people isn’t likely to cover it.
     Medicaid exists because insurance wouldn’t cover these people.

104. Sounds like a market opportunity to me – a very lost cost insurance policy against developing a chronic illness.
     It would be, except at this point too many people are familiar with reccission etc. It may be a good business plan to take money from a bunch of people and pay out to the few who get chronic illnesses, but it’s an even better business plan to take that money and find a way to dump as many sick people as possible after they lose the disease lottery.
     Even if a company did this honestly for a while & developed a reputation for that honesty, Id be worried that some vulture capitalists would swoop in with a takeover and change the policy in the years or decades after Id become dependent on it. Or that they’d gradually morph into that sort of monster due to financial pressure. In order to depend on this I need it to stay stable for *decades*. Maybe they’ll just go out of business 20 years after I get my policy and 10 years after I get sick.
     Ideally, a contract would be a simple thing to enforce, but there are just too many things on the wrong side of the scale: a big corp with a lot of money and legal expertise draws up the forms, and they’re signed by a non-wealthy individual with minimal legal experience or advice, who’ll be trying to enforce that contract during a medical/financial crisis when they’re extremely vulnerable to bad settlements for a fraction of what they’re really owed just to get something today & not ten years from now.
     So we institute a new program that tells people what they must buy, since getting elected confers absolute wisdom on how to solve matters of this kind.
     Which you aren’t claiming to possess yourself? Or is it that the ‘free market’ is the assumed default, so we who advocate deviating from it must have some overwhelming arrogance, but those who advocate for keeping it don’t have to claim any particular wisdom?

105. how would such a thing work for the insurance company? chronic illnesses can be expensive, and small premiums from poor people isn’t likely to cover it.
     That’s a question for the actuaries, of course, but I expect that it should be fairly straightforward: you compute the cost of providing the care times the likelihood of needing to provide it and that’s how you determine the premium. If it is really impossible to charge a fair rate, then it must be unaffordable for Medicare as well.
     Ultimately, you run into an accountability problem. You can either tax people to provide for their irresponsible neighbors, thus providing an incentive for people to free-load, or you can allow people to suffer for their bad choices and have to rely on charity, thus providing an incentive for people to take responsibility for themselves. There is no free lunch.

106. You can either tax people to provide for their irresponsible neighbors, thus providing an incentive for people to free-load, or you can allow people to suffer for their bad choices and have to rely on charity, thus providing an incentive for people to take responsibility for themselves.
     Ah, the zero-sum morality play. That one never gets old.
     It surely can’t be that the goal is to make it easier for people to take responsiblity for themselves rather than harder, or that doing so benefits everyone in the long run.
     No, it’s better to let the “irresponsible” suffer, just so they can be properly incentivized. Not that it works, mind you, but it has the abstract appeal of rugged individualism juiced with moral superiority.
     Delicious.

107. What kind of news source quotes part of a statement while leaving off a critical clause?
     Two words: Suzanne Somers.
     Hey, she’s written 24 books on fitness and health. She must be an expert.
     Need I say more?
     What a clown show.
     Sounds like a market opportunity to me – a very lost cost insurance policy against developing a chronic illness.
     Here is a very low-cost insurance policy against developing chronic illness:
     Preventative care.
     Here’s what I want – a 100% market-driven approach to providing water for drinking, bathing, and cooking, to every home in the US.
     Who wants to sign up for that? Show of hands, please.
     The cult of the market is going to destroy this country.
     At our present rate of decay and destruction, I give it 50 years, max. More likely 30.

108. If it is really impossible to charge a fair rate, then it must be unaffordable for Medicare as well.
     “affordable” for a private organization means something quite different from what it means to a government.
     the US military, for example, spends $15,000 per second, and doesn’t turn a nickle of profit. affordable? no business could last with that kind of loss. but to most of the small-government “conservatives” i’ve heard from, we should be burning even more.
     but yeah, fnck the poor. we can’t afford them.

109. It would be, except at this point too many people are familiar with reccission etc. It may be a good business plan to take money from a bunch of people and pay out to the few who get chronic illnesses, but it’s an even better business plan to take that money and find a way to dump as many sick people as possible after they lose the disease lottery.
     Isn’t that why we have insurance regulations? If rescission is being abused (and I have doubt that it is), it should be practical to restrict it to material and intentional concealment of information.
     Which you aren’t claiming to possess yourself? Or is it that the ‘free market’ is the assumed default, so we who advocate deviating from it must have some overwhelming arrogance, but those who advocate for keeping it don’t have to claim any particular wisdom?
     I am not claiming any special wisdom; I am working from experience. The track record of free market in delivering goods and services at a fair price is much better than that of any government program (you need to count taxes in the price). And that is largely because the free market is self-correcting, which government programs are not. You just need the clout of the government to make sure that people uphold their contracts.
     It surely can’t be that the goal is to make it easier for people to take responsiblity for themselves rather than harder, or that doing so benefits everyone in the long run.
     That should absolutely be the goal. But having the government take responsibility for people seriously undermines it.
     No, it’s better to let the “irresponsible” suffer, just so they can be properly incentivized. Not that it works, mind you, but it has the abstract appeal of rugged individualism juiced with moral superiority.
     What is your basis for proclaiming that it doesn’t work?

110. You can either tax people to provide for their irresponsible neighbors, thus providing an incentive for people to free-load, or you can allow people to suffer for their bad choices and have to rely on charity, thus providing an incentive for people to take responsibility for themselves.
     Applying this to the many people who suffer from chronic diseases that weren’t primarily caused by behavior, am I to understand that eg getting cystic fibrosis is an irresponsible choice made by a free-loading child?
     I mean, I agree that taking on a chronic disease by choice is a dumb idea, and there are even some cases where we can agree that this happens. But so many chronic diseases are not ‘diseases of choice’ that this doesn’t even pretend to be a serious analysis.
     Fundamentally, this kind of rhetoric suggests that you’re still trying to apply generic free market dogma to the situation without even wondering whether it fits or not. Of course it fits! It’s the free market! It’s one-size-fits-all, even sick children.

111. I’d be a lot more concerned about taxing people to support irresponsible neighbors if this argument was ever used to cut the subsidies that go to oil companies and other profitable corporations.
     Do you support an increase in the minimum mage so our tax dollars don’t have to go for Food Stamps so Wlamart employees don’t starve?.

112. I am not claiming any special wisdom; I am working from experience. The track record of free market in delivering goods and services at a fair price is much better than that of any government program (you need to count taxes in the price). And that is largely because the free market is self-correcting, which government programs are not. You just need the clout of the government to make sure that people uphold their contracts.
     You can call that ‘experience’, but what it looks like to me is ‘dogma’. And yes, it had occurred to us folk who graduated from high school that we need to ‘count taxes in the price’.
     Im all for using the free market unless there’s a market failure. That is, where despite the generally good track record of the market in distributing goods and services doesn’t work to our satisfaction. Because my attitude towards free markets is “hey great tool” not “oh mighty invisible hand, bestow thy blessings upon this poor sick child by letting him die of a treatable disease as a lesson to others not to irresponsibly get cancer.”
     If rescission is being abused (and I have doubt that it is)
     Facts, who needs ’em, we got dogmas that fill that need and then some. Must I google this for you? Apparently I must.
     Many insurers even pay employee bonuses for meeting a cancellation quota and for the amount of money saved.
     Although WellPoint fiercely denied singling out breast cancer patients for scrutiny, it acknowledged using computer algorithms to search for a range of conditions that applicants would likely have known about at the time they applied. That seemed like a backhanded admission that it was indeed searching for excuses — the company would say legitimate reasons — to cancel coverage.
     “Health Net… admitted offering bonuses to employees for finding reasons to cancel policies, according to company documents released in court…. In a pending case, Blue Shield searched in vain for an inconsistency in the health records of the wife of a dairy farmer after she filed a claim for emergency gallbladder surgery, according to attorneys for the family. Turning to her husband’s questionnaire, the company discovered he had not mentioned his high cholesterol and dropped them both.
     Do you still have doubt? I can google all day.

113. There is no free lunch.
     Funny. As I recall back in the day when the Laffer Curve was taken seriously by people allegedly smart enough to know better, conservatives were arguing the exact opposite.

114. That’s a question for the actuaries, of course, but I expect that it should be fairly straightforward: you compute the cost of providing the care times the likelihood of needing to provide it and that’s how you determine the premium.
     There is a reason why there is no such thing as a level term (i.e., fixed premium) “whole health” policy on the market that has the attribute of an extremely low price if you are young and healthy.
     Think about it. Or contact your actuary for enlightenment.

115. Applying this to the many people who suffer from chronic diseases that weren’t primarily caused by behavior, am I to understand that eg getting cystic fibrosis is an irresponsible choice made by a free-loading child?
     No, the irresponsibility is not purchasing a policy to protect against chronic illness, if such policies are purchasable at a fair price. I had thought I’d made that clear. Apparently I was ambiguous.
     I’d be a lot more concerned about taxing people to support irresponsible neighbors if this argument was ever used to cut the subsidies that go to oil companies and other profitable corporations.
     If there are still special subsidies given to profitable companies, I agree. My understanding is that the deductions that the Democrats have been trying to eliminate are credit for taxes already paid to other countries for profits made overseas.
     Do you support an increase in the minimum mage so our tax dollars don’t have to go for Food Stamps so Wlamart employees don’t starve?.
     You are assuming that such a policy would lead to that result. I don’t. I believe it would have the result of putting more people out of work, and thus requiring more food stamps.
     Im all for using the free market unless there’s a market failure. That is, where despite the generally good track record of the market in distributing goods and services doesn’t work to our satisfaction.
     I definitely agree, assuming we define “market failure” in the same way. It is my belief that a prime responsibility of the government relative to the economy is protecting the integrity of the free market. That means combating false advertising and other deceptions, preventing monopolies, and so on.
     If rescission is being abused (and I have doubt that it is)
     Whoops. I apologize for the typo. That was supposed to say, “I have no doubt that it is.”
     Funny. As I recall back in the day when the Laffer Curve was taken seriously by people allegedly smart enough to know better, conservatives were arguing the exact opposite.
     And when have you heard me claim that? I am responsible for my own claims, not somebody else’s.
     There is a reason why there is no such thing as a level term (i.e., fixed premium) “whole health” policy on the market that has the attribute of an extremely low price if you are young and healthy.
     So explain the reason, if you know one.
     Parenthetically, I should note that earlier in this thread, somebody commented that conservatives are relatively rare, here. I would suggest that this kind of gang-challenging anybody who strays from the site dogma could explain why. After a while, it must get very tiring to have to answer multiple comments over and over again.

116. “Ultimately, you run into an accountability problem. You can either tax people to provide for their irresponsible neighbors, thus providing an incentive for people to free-load, or you can allow people to suffer for their bad choices and have to rely on charity, thus providing an incentive for people to take responsibility for themselves. There is no free lunch.”
     I’m sorry if I seem to be piling on by responding to this, Fuzzyface. The sentiment you expressed is one oft stated and broadly supported. I’m a liberal and I don’t want to subsidize people who are just lazy, either.
     My problem with this this sort of sentiment is it seems to show up most often as an excuse for not taking some kind of action that helps low income people, but never as a reason for withdrawing the considerable amount of tax money spent on corporations or wealthy individuals. I’m speaking here as a general observation, not as a specific response to you.
     And yet it seems to me that we as taxpayers spend a lot more money on underserving wealthy individuals or profitable businesses than we do on undeserving poor people, and it also seems to me that those politicians who reference undeserving poor are the same politicians who oppose actions which would clearly help people get out of poverty (such as low interest student loans or a raise in the minimum wage). Or affordable health insurance, for that matter, since a person who can keep up their health will be able to keep up their job, but a person with no insurance is at risk of becoming very seriously unwell over something that could have been caught early.
     So it’s just not that big a deal to me, this fear of the undeserving poor. I’m sure they exist, though not in great numbers. Most Food Stamp recipients, for example, are disabled, old, or under eighteen, not moochers at all. But there will be the undeserving in any system. So what? The hypothetical moochers just don’t suck up anywhere near as many of our dollars as Walmart (indirectly)does by underpaying their employees.Or the money spent on unnecessary pork barrel military projects. Or water projects for corporate farms. Or selling timber from National Forests are below market value. Or…and so on.
     I just can’t get excited about some hypothetical undeserving poor people getting some of my tax dollars when there’s a whole industry right here in the my vicinity that’s been living off our federal land subsidized by tax payers for about one hundred years.

117. And that is largely because the free market is self-correcting, which government programs are not.
     This is like listening to the Young Communists yammer away when I was back in university.
     Look, there are no ‘free markets’. The ‘free market’ is an abstraction invented by economists to help them reason about human behavior. The conditions for the economic ideal of a ‘free market’ don’t exist in the real world for anything other than the most rudimentary of commodities. Even there, they are rare.
     What conservatives want is not a ‘free market’, they want an unregulated market, which is not the same thing.
     The problem is that unregulated markets give us things that are highly undesirable from a social point of view. Not socialist, social.
     They give us volatile business cycles. Don’t believe me, look at the history of the US economy from, like, 1800 through about 1930.
     They give us concentration of wealth. They give us monopolies. They give us open warfare between capital and labor. Don’t believe me, look at the history of the US in the last couple of decades of the 19th C through the first couple of decades of the 20th.
     I am fine with leaving private commerce alone right up until the point that it creates results that are harmful. At that point, it is time for the public sector to intervene, in the interest of the broader public good.
     15% of the population with no health insurance is a PUBLIC problem.
     Widespread bankruptcies due to the high cost of medical care is a PUBLIC problem.
     Millions of people using the ER as their health care delivery mechanism is a PUBLIC problem.
     If your personal preferences run toward minimal government intervention, public action to address these things is going to rub you the wrong way.
     I’m sorry to tell you that that’s too freaking bad for you, because the rest of the country, and world, is going to do what it needs to do, with or without you.
     But don’t try this ‘the free markets will fix it’ bullsh*t on me, because they demonstrably WERE NOT GETTING IT DONE.
     That is why we are where we are.
     Enough of this crap.

118. So explain the reason, if you know one.
     Krugman here.
     Kenneth Arrow here.
     If you care to rebut what either of these two’s analysis, please do so. I don’t need an encyclopedia of facts and cites, but a relatively well structured argument would do (again, see Krugman on why ‘free markets’ won’t do the job with health care). Trotting out pablum* like “there is no free lunch” and “we need to incentivise the poor” (because we all of course know how much they enjoy being efffffing miserable) won’t cut it with most at this place.
     And you should not be surprised.
     The idea here is that you should relish a challenge, gang or otherwise subject to the group (there’s that terrible word) posting rules. That is why I actually do have some modicum of admiration for McKinny, Brett Bellmore, wj, and even, god help me, Slartibartfest….although I do my best to hide it. They do exhibit a bit of grit, I must say.
     Can you?
     *my favorite was the “self correctingness of free markets” which of course is totally undermined by the Great Depression, but whatever.

119. Laura wrote:
     And yet it seems to me that we as taxpayers spend a lot more money on underserving wealthy individuals or profitable businesses than we do on undeserving poor people, and it also seems to me that those politicians who reference undeserving poor are the same politicians who oppose actions which would clearly help people get out of poverty (such as low interest student loans or a raise in the minimum wage)
     OK, I can see why you have that impression. I hope I can help you understand why I disagree.
     Let’s take business taxes, to start. It is popular to denounce the idea of “tax breaks” for large businesses and label them as unfair “subsidies.” But business taxes are a more complex issue than most politicians are willing to admit.
     In the first place, the basic idea is that we tax profits, or some semblance of them: revenues less what we consider to be justifiable spending in order to gain those revenues. A very simple case might be a small business which pays rent and salaries and cost of raw materials (we’ll ignore things like equipment). Surely it only makes sense not to tax those expenditures? If we did, it could be very difficult for many businesses, many of whom have small profit margins, to stay in business at all.
     So, for example, if a store had $1 million in sales, paid 750,000 for the goods they were selling, $50,000 in rent and $100,000 on salaries, we only tax the $100,000 in profit, with the owner keeping what’s left. If we taxed the gross sales of $1 million, there would be no point in running the business at all.
     So the principal of deductions is fair. The question then is, what is a fair deduction? That can get complex. Tickets to a ballgame to woo a client are generally acceptable; the same tickets for the enjoyment of the owner are often not.
     The deductions that I keep hearing calls to eliminate pertain to breaks that other businesses get; in other words, treating certain oil companies differently from all other businesses, for no other reason that because they’re profitable. It’s the classic “picking winners and losers” thing that is so problematic, and would be taxing some portion of gross income.
     With regard to other things you mention, such as low interest student loans and minimum wages, the chief issue is not, “should we help people” but “will this actually help or just make things worse?” and those are topics that are worth many volumes of discussions.
     In another context, a man I respect taught that we should also assume that everybody is trying to do what is best; if we cannot see it, it is more likely that we simply don’t understand something than that they are evil or stupid or insane. People are a product of their experiences, and the range of different experiences that people have is vast. I try to remember this, but I know it is often hard when people push your buttons.

120. ” McKinny, Brett Bellmore, wj, and even, god help me, Slartibartfest”
     Not sure why you’d need God’s help with slarti. When people lose their tempers around here it is generally with Brett. And I didn’t even know wj was a conservative–for some reason had him/her pegged as a centrist.
     On the blog tendencies, I think it’s pretty standard for comments to end up being heavily slanted in one direction or another. ObiWi is much more civil to the minority group (here conservatives) than almost any other blog I’ve visited, though maybe I need to visit more (god no) but yes, conservatives will be mobbed, sometimes politely and sometimes not. When it gets too rough you sometimes find people on the liberal side pointing this out. Though perhaps never with Brett.

121. “When people lose their tempers around here it is generally with Brett.”
     Well, come to think of it, sometimes sapient and I have little tiffs. But that’s within the liberal tribe. Anyway, enough meta.

122. Fuzzy, thanks for responding, but I am not thinking about the tax protections you discussed. I am thinking about such things as selling timber at below market value from a National Forest, paying for Food Stamps so the children of employees of Walmart and Mcd’s don’t starve, subsidized flood insurance for upscale homes on shorelines, subsidies for immensely profitable corporations such as oil companies, contracts for unnecessary expenditures resulting from lobbying…Some dysfunctional person somewhere who hasn’t got the character to hold a job also hasn’t got the power to rip off the taxpayers like the Koch brothers can.
     Everyone wants tax dollars delivered to their own door. People who have wealth and power and businesses that have wealth and power are in a better position to get that money steered their way than some guy living in his mother’s basement because he he can’t find a job that pays over the minimum wage.
     So I just can’t get excited about the penny ante waste that goes to an undeserving poor person. Not when red state Congress people vote to cut Food Stamps while retaining farm subsidies for themselves.
     It just seems like a lack of perspective to me to focus on being tight about expenditures when the possible waste goes to a poor person, but let the systematized, entrenched gravy train of money that powerful interests groups have delivered to themselves go unremarked.
     I don’t really mind the money that goes to businesses and people I don’t like. I don’t expect my own wishes and values to be the determiner of how federal tax dollars are distributed. I’m just way passed tired of hypothetical undeserving poor people being the rationalization for opposing programs that fellow Americans–not undeserving people–need.
     I suppose partly why I feel so strongly about this is that I know so many poor people. And I don’t know a single one who wants to be poor or who wouldn’t improve their situation if they could. Being poor is a big hassle relentless hassle.
     I know a lady who chose to go a week without food to pay vet bill for her cat. I know a lady who hitchhikes to get to work because she can’t afford to repair her car. I know people who go to work sick because they can’t afford to take a day off. I get sick of poor people-bashing.

123. Not sure why you’d need God’s help with slarti.
     I must have overlooked the tongue-in-cheek key. If it’s not QWERTY I get lost.
     Facts. The conservative press is a never ending source of little factoids that are either irrelevant, out of context, misleading, mendaciously false, or just plain bullsh*t.
     So for all my liberal brethren somewhat pushed back on your heels with screaming headlines about policies getting terminated or prices going up, you might just check this.
     BENGAZI y’all!!!

124. Laura,
     I agree that people don’t want to be poor. And yet, as a country we’re not doing a great job at getting people out of poverty. The War on Poverty has been a failure to an extent, although if the goal were to War on Hunger, we’re doing that pretty well.
     And yes, there is a plenty of corruption in politics – but I don’t see any reason to assume that, for example, the Koch brothers are “rip[ing] off the taxpayers.” Do you have any specific examples?
     Food Stamps for Walmart and McDonald’s employees is an intriguing question, but I don’t know what you are saying – that we should be providing them? That we shouldn’t? A quick internet search suggests that 8-10% of Walmart employees receive food stamps, although a Daily Kos entry (cited in Salon) claimed, with no evidence that I can see, that it was 80%. Maybe it is also important to know what percentage of low-wage earners at both are supporting families, and what percentage are young folk either earning spending money or getting their start at entry-level jobs. It is far from clear to me that every single job must be seen as provider-level. I know that I worked a number of low wage jobs while in college – I’d have loved to have earned more, but I was mostly earning money to supplement what my parents were providing, not supporting a family.
     And I think you completely missed my explanation of tax deductions. They are not “subsidies.” They are simply, in the name of fairness, not taxing legitimate business expenses.
     I would also note, BTW, that an awful lot of people cannot find jobs, not because wealthy people are cheats, or mean, but because they don’t have any skills that are worth paying for – and foremost among those is the ability to show up on time and focus on a job.
     The owner of a job placement agency claims that he can find work for anybody who can show up on time, speak politely, and pass a drug test – and that fewer than half the applicants he sees can do that. And I keep hearing stories like that from employer after employer.
     Our national approach to dealing with poverty is providing money and services – but that doesn’t teach the needed skills and attitudes. There is a good correlation between been born to parents who are not married and winding up poor, and what incentives we provide nationally make such out-of-wedlock births more common. Of course poor people don’t want to be poor – but unlike most middle class folk, they also don’t know how to teach their children how to avoid poverty. Very often, the coping skills that you need to survive in poverty make getting out very hard – and assistance programs do nothing to break the cycle. Their children tend not to have very good role models, and any suggestion that doing the same things over and over again is not a good idea is met with cries of “racism” and “victim blaming.”
     So, no, I don’t think Food Stamps are the answer.
     Nor, for that matter, do I think low interest college loans do anything but drive up tuition costs and saddle students with massive debt that they can never repay. Many students are going to college when they failed to learn basic math and writing skills in high school – skills that would have been more valuable to them than the time spent in college taking oversubscribed and low-demand majors. There is a shortage of craftsmen like welders and machinists, in part because we are pushing people into college who would do better without it. College is not the answer for most people. Vocational/technical training would get most of them better jobs. We don’t insist that most students spend years in training camps, hoping for a very few highly paid spots as pro athletes. Not everybody has the ability even to strive for that. Why do we act as though college is for nearly everyone?
     I don’t know who you think is bashing poor people. I just think that we stop all of the demagogues who keep insisting that the right and only thing to do to help them is to give them money, and thereby keep them dependent on government largess forever.

125. Vocational/technical training would get most of them better jobs. We don’t insist that most students spend years in training camps, hoping for a very few highly paid spots as pro athletes. Not everybody has the ability even to strive for that. Why do we act as though college is for nearly everyone?
     I’m not sure how this is a problem with liberalism, but more of an attitude that any limitation on anyone’s choices in life are totally unacceptable. If I’m not mistaken, the conservative complaints that I hear is that liberals are somehow limiting choices. So welcome to our side, I guess…

126. I think at least part of the problem is that many employers these days require college education even for jobs where it is not needed or give precedence to those with college education over those without for those same jobs.
     That’s not merely for low level jobs. I know for example that pharmaceutical companies prefer to have their salepersons to have academic titles not because the job requires it but because it impresses customers. They would rather take someone with a PhD in Assyrology and no idea about chemistry than a chemistry graduate who ‘merely’ has a diploma. They get hired to sell stuff and titlke beats knowledge.

127. I’m not sure how this is a problem with liberalism, but more of an attitude that any limitation on anyone’s choices in life are totally unacceptable.
     I don’t recall saying that it was a problem with liberalism – not every problem is the fault of one political philosophy or another. And I am not saying that it has anything to do with limiting people’s choices. It’s a problem with social attitudes in general. When college degrees were rare, it was a clear benefit to get one. That’s no longer true, but it doesn’t stop people from thinking it still is – and that vo-tech training limits success.
     I think at least part of the problem is that many employers these days require college education even for jobs where it is not needed or give precedence to those with college education over those without for those same jobs.
     Very true – and I believe that a lot of that is the fallout from Griggs v. Duke Power (1971) which put serious limitations on the abilities of companies to use tests to determine hiring and promotion decisions. So, since they still wanted to filter based on IQ, a lot of companies chose to use college degrees, especially from prestigious colleges, as a proxy for intelligence.
     And that’s had some really perverse effects: if degrees are so critical, we want to make sure more people can get them, so we make it easier to borrow money for tuition (which raises tuition costs due to increased demand and lowered resistance to price increases). So universities have more money flowing in, which leads them to focus more on the business of attracting students, which leads to increased catering to students, which leads to pressure to give out better grades – which makes so many degrees poorer indicators of the very qualities that companies are seeking.
     Colleges are now much more focused on bestowing credentials than in educating. Prestige is all-important.

128. I don’t recall saying that it was a problem with liberalism –
     The comment seemed to be addressing Laura’s position and you seem to be taking issue with Obama’s push to provide college tuition, so I just wanted to point out that open market in education (which is quite different from most other countries) is driving that, and the government that is currently of a liberal bent has to deal with the situation. Something about governing requires you to deal with the problems you have, not the problems you want.
     Of course, if you want to do a rant about colleges, feel free, but don’t convince youself that you are addressing something that is problematic in a liberal view of the world, cause you aren’t.

129. And if you can wait until tomorrow, I’ll make the friday open thread “rage against the diploma”.

130. I’ll make the friday open thread “rage against the diploma”.
     Having trouble waiting until tomorrow to laugh! (Thank you lj.) That’s just what I was thinking as I read the last few comments.
     Although I’m all for vocational opportunities, college-bashing is something I just don’t get (except, of course, the financial hardship that it imposes, which is what the President wants to address). The idea that people might actually learn about stuff, even if they then choose to work in a trade, or as a laborer – I think that’s actually a good thing. I know that view is becoming less popular. Sorry – I’ll be quiet now until the open thread opens!

131. I’m beginning to think that “over-utilization” is an important concept in conservative thinking. Health care is over-utilized, higher education is over-utilized.
     So I repeat my question from the other thread: who gets to define “over-utilization”?
     –TP

132. Low interest loans and Pell grants do not drive tuition up. They just don’t. Lack of funding for education from state and federal government drives tuition up.
     Re: subsidizing the Koch brothershttp://thinkprogress.org/economy/2011/03/01/146847/charles-koch-welfare/–
     Granted it’s a liberal source. but facts are correct. The bias comes in the assumption that the situation is a bad thing, rather than a good one.
     My point is that oil companies are at this point engaged in an activity which is harmful to the rest of us, given the reality of global climate change, and that the companies are immensely profitable and the brothers themselves immensely wealthy so the idea that they need tax breaks to protect them from risk so that they can develop their business is ludicrous. In addition to protection from risk, they also receive subsidies for some of their businesses and receive pork barrel contracts, and, of course, tax deductions.
     I can understand deductions for a small business just starting that needs protection form risk. I can understand deductions for businesses engaged in something productive for the rest of us. Hell. I can even understand deductions just for the sake of deductions. But giving an oil company deductions is like giving deductions to a cocaine supplier only way worse. And that’s not even getting into the hypocrisy of a rightwinger demanding tax deductions as an indirect subsidy and demanding direct subsidies for his own business while also demanding that Food Stamps be cut on the grounds that the recipients are too dependent and while using the profits achieved in part because of the deductions and subsidies to engage in union busting, cuts in education funding, and other policies which will make it even harder for the Food Stamp recipient to get a living wage so as to not need Food Stamps any more.
     The Koch brothers are kind of a perfect storm of how utterly bassackwards rightwing values are. But they are not unique. There’s a whole list of farm state Republican Congresspeople who voted to cut Food Stamps while keeping farm subsidies for themselves and their donors.
     And of course the assumption that welfare recipients can end their dependency is questionable given that the vast majority of them are either elderly, disabled, or children. The Koch brothers can end their dependency, but a bed-ridden old lady can’t.
     So, once again, if there is a concern that some person out there is getting undeserved welfare, why not look at the Koch brothers who are getting tax deductions they don’t need as well as subsidies they don’t need that amount to millions and millions of dollars?
     Why not look at Republican farm state Congresspeople?
     Why not look at military contracts which are notoriously distorted by lobbyists?
     Why not look where the big money is going?
     Why worry about some imaginary able bodied Food Stamp recipient or recipient of subsidized insurance?
     As for Walmart, this is how it works: the business is enormously profitable and the owners is extraordinarily wealthy. The business model is to extract as much profit as possible for as little investment as possible, so wages are kept as low as possible. So one could say that’s their business model, their choice. Except that somewhere between 20 and 40 percent (I don’t know what the accurate figure is) of their employees are on Food Stamps to feed their kids. So the taxpayers are making up the difference between what the billionaire owner of a profitable company wants to pay her employees and what they need to live.
     That same owner uses her wealth to support politicians who want to cut those same Food Stamps. In fact cuts will be coming in just before the holiday season from Mrs. Walton’s political party.
     It’s the same political party that supports right to work for less laws and opposes union organizing, which is the only way Walmart workers will get a living wage.
     It’s the same political party that opposes an increase in the minimum wage, even though companies like Mc D’s can easily pay more and still be profitable. (In Australia McD’s workers make about the equivalent of our fifteen dollars an hour but the burgers cost the same as here).
     I think the dots need to be connected. If Mrs. Walton doesn’t want people to be dependent upon Food Stamps to feed their kids, then she should be less greedy and pay her employees more. If some taxpayer is concerned about paying for Food Stamps, maybe that taxpayer should invest energy in supporting unionizing so working people won’t need them.
     Bashing the poor is a staple of rightwing discourse, has been since Lee Atwater decided to use George Wallace’s racist slogans to turn the South Republican.
     If we were serious about ending dependency, we’d look at were the big money goes in terms of unneeded deductions, unneeded subsidies, and influence to gain unneeded contracts for things the taxpayers don’t need to purchase. And we would look to supporting those social mechanisms which provide a way for people to get work at a living wage such as union-organizing. And we would acknowledge that the people who are receiving Food Stamps are not going to get over being old or disabled, nor are they going to be sent out to work at a young age, and stop using the fear that someone somewhere is getting a Food Stamp they don’t need as a driver for policy.

133. someone at ObWi needs to implement a Like button, so i can Like Laura’s 8:59

134. The War on Poverty has been a failure to an extent
     Those policies created Medicare, Medicaid, and the food stamp program. The poverty rate plunged by a third in the decade after enactment. Poverty rates for senior citizens fell from 28% to 10% or so and have remained there. These programs are now deeply embedded in the social fabric, a fabric that is increasingly stressed by the inability of the private sector to generate well paying jobs in sufficient quantity.
     I think at least part of the problem is that many employers these days require college education even for jobs where it is not needed or give precedence to those with college education over those without for those same jobs
     You gotta’ sort them somehow, and a credential is a credential. So if you need the degree to get on a good career track, then there will be a demand for them. Studies still show those with college earn significantly more than those with only a high school education, although saddling them with incredible levels of debt tends to blunt the discounted value of the advantage.
     and I believe that a lot of that is the fallout from Griggs v. Duke Power (1971)
     Not true by any stretch of the imagination. The case revolved around the disparate impact of using IQ tests to determine job placement and promotion. It was a consciously adopted racist company policy implemented to advantage whites over blacks.
     As an aside: The minimum wage in the 60’s was nearly 40% of the average wage. Unemployment was something like 3-4%. The 1968 minimum wage in today’s dollars was nearly ten bucks an hour….yet whiner ‘entrepreneurs’ bemoan the fact that they can’t get qualified welders by offering a wage of $12/hr. It’s as if these folks don’t know how price signals work in the marketplace.
     Lastly, I join cleek in applauding Laura’s comment.

135. Lastly, I join cleek in applauding Laura’s comment.
     I’d like to applaud Laura’s comments in general. I have the “like button” urge regularly regarding her comments.

136. *my favorite was the “self correctingness of free markets” which of course is totally undermined by the Great Depression, but whatever.
     Oh, no, bobbyp, it doesn’t undermine the point all. It reinforces it. But it also reminds us how the market’s self-corrections need to be avoided like the plague, because, like the plague, they cause the needless deaths and suffering of untold millions. Markets do self-correct, often disastrously, in a very unstable way.

137. Oh, no, bobbyp, it doesn’t undermine the point all. It reinforces it.
     Refusing public intervention because ‘markets self-correct’ is like not boarding up your windows during a hurricane.
     Hurricanes are just the atmosphere, seeking equilibrium. What harm could possibly come of that?

138. The important thing is not to interfere or distort, whether you’re dealing with nature or the abstract idealization of the market in some number of economists’ heads. That would be bad.

139. HSH, Russell: Well yes. The free market assumption is that markets tend to move toward or self correct to ‘equilibrium’ where the most efficient allocation of resources is realized. Thus you get free market macro models that begin with “assume full employment” and go from there.
     The genius of Keynes’ insight was to demonstrate that at a macro level, the labor market can trend to a stable equilibrium that has significant involuntary unemployment–hence not efficient (In response you actually get some free market economists asserting that the observed unemployment is the result of workers’ expressed preference for more leisure time).
     So yes, self correcting markets can get into some very sticky wickets—and stay there.
     Thanks for the correction.

140. If there are still special subsidies given to profitable companies, I agree.
     If?
     The deductions that I keep hearing calls to eliminate pertain to breaks that other businesses get; in other words, treating certain oil companies differently from all other businesses, for no other reason that because they’re profitable.
     That would be a horse of a different color. There are quite a few loopholes in the tax code specific to certain industries. For the oil industry check these out. Drilling wells and searching for oil use different depreciation schedules that other assets, alowing for larger tax breaks when prices are high. Some investments are immediately deductible (rather than over the lifetime of the equipment, as is normal). Royalties (ie fees for the right to extract oil) from foreign governments are sometimes treated as ‘foreign taxes’ and create a tax break.
     Lowest estimates for total fossil fuel-targeted tax subisidies (second link) was around 10B/yr.
     Likewise, nuclear is targeted in 2012 with 58B worth of loan guarantees by the Feds. Plus the Nuclear Industry Indemnity Act capping liability from nuclear plants, with excess costs borne by the US Treasury, even in cases of gross negligence and willful misconduct, and punative damages are forbidden).
     On the one hand, I don’t necessarily agree that the government should have zero role in picking winners and losers. otoh, I think we can both agree that special subsidies for externality-creating businesses doesn’t make sense from either a liberal OR libertarian perspective.
     And while liberals will defend eg Social Security down to the last filibuster, we (at least, the grassroots) would be happy to get rid of the vast majority of these tax subsidies and loopholes. That conservatives don’t spend much time talking about this, or expressing a desire to do something about it (or, as above, questioning whether profitable corporations even get tax subsidies in the first place) is a curious thing to me. Paul Ryan says he is very eager to balance the budget, but not so eager that he’ll try to stop oil companies from counting overseas royalties as ‘foreign taxes’…
     This is very different from your view that we’re talking about some special tax liberals want to place on eg oil corps. There was some talk of a windfall profit tax a few years back, but that was never enacted & debates about that shouldn’t get too entangled with debates about tax subsidies in general IMO.
     

     Do you support an increase in the minimum mage so our tax dollars don’t have to go for Food Stamps so Wlamart employees don’t starve?.

     You are assuming that such a policy would lead to that result. I don’t. I believe it would have the result of putting more people out of work, and thus requiring more food stamps.
     Assuming, that is, based in the ample evidence that raising minimum wages (at the levels we’re talking about) doesn’t significantly affect employment. Better IMO than assuming, based on theory, that it does.
     Not gonna google it, been doing that too much.
     I definitely agree, assuming we define “market failure” in the same way. It is my belief that a prime responsibility of the government relative to the economy is protecting the integrity of the free market. That means combating false advertising and other deceptions, preventing monopolies, and so on.
     We don’t agree, because people stealing your stuff or committing fraud isn’t a market failure. A market failure is, well, take it away wikipedia: Market failures can be viewed as scenarios where individuals’ pursuit of pure self-interest leads to results that are not efficient – that can be improved upon from the societal point-of-view. Not the government *protecting* the free market, the idea behind market failure is that the market doesn’t always give the best results (unless your defition of “best” is “what the free market gives us”).
     This is why we call it “market failure”, not “market awesome”.

141. But giving an oil company deductions is like giving deductions to a cocaine supplier only way worse.
     What meaning are we imputing to the word *deductions* here?
     Does someone here have special expertise in oil and gas exploration, refining and distributing that permits statements like this to not only go unchallenged but to be seconded?
     Am I the only one here who drives a car that uses gas?
     Is this how the reality based, high information community makes policy decisions? By conflating Koch Brothers, but never George Soros, with the entire oil and gas industry and then comparing the total to cocaine dealers?
     Seriously?

142. MxTex, that’s a lot of questions.
     1)I think, “industry-specific deductions” as opposed to those applicable to all businesses, either explicitly set out for certain types of businesses or implicitly based on their activities (eg special depreciation schedules for oil well drilling equipment). aka “tax subsidies” or “loopholes”.
     2)I dont think I understand this question. Does someone have expertise that ‘seconds’ blog comments, or ‘unchallenges’ them?
     3)Very likely not.
     4a)No, because no one here is in a policy-making role.
     4b)That seems like quite an inadequate attempt at a summary. I might take Laura’s My point is that oil companies are at this point engaged in an activity which is harmful to the rest of us… that the companies are immensely profitable… so the idea that they need tax breaks to protect them from risk so that they can develop their business is ludicrous as closer to being a summary o her point, rather than taking a throwaway comparison to cocaine dealers as a summary of her point (and, writ large, the ‘liberal community’s method for making policy decisions’).

143. On the one hand, I don’t necessarily agree that the government should have zero role in picking winners and losers.
     The very idea of the government picking winners and losers, as it tends to be used, is a bit misleading, IMO. Even industry-specific subsidies, objectionable or not, don’t really pick winners and losers, unless there’s something going on I don’t know about (on this specific point – there are lots of things going on I don’t know about, generally). It would be one thing if Corporation A in industry X got to depreciate equipment Y in a more advantageous way than Corporation B in industry X did, but it doesn’t work that way, as far as I know.
     I’m reminded of the debate a few years ago over newly enacted federal requirements for lightbulb efficiency and some number of conservatives complaining about the government picking winners and losers, as though the government had a requirement that bulbs be made by GE, but not Westinghouse.
     It’s sort of like saying a foot race was fixed because the distance was set at 50 meters, and then the winner just happened to be the guy who ran the 50 meters in the shortest time. I mean, why 50 meters, after all?

144. The owner of a job placement agency claims that he can find work for anybody who can show up on time, speak politely, and pass a drug test – and that fewer than half the applicants he sees can do that. And I keep hearing stories like that from employer after employer.
     In the spirit of McTex, I answer with a series of questions?
     Do you spend a lot of time talking to employers? Enough that you feel it’s a representative sample?
     Is there any possibility that someone running a job placement agency might talk their business up by saying they can get a job for anyone qualified, and that those they cannot place are unplaceable by nature?
     If most of the people who are unemployed are unemployable, has this changed measurably since 2006 or so? Or were some of today’s unemployables employed at that time in defiance of the very meaning of the word?
     Is it possible that listening to and giving credence to just once side of a discussion gives you a good view of the entirety of the problem? That is, employers and employees are engaged in a form of competition over time for the fruits of their combined economic activity, does it seem wise to pick your favorite side of that competition and just believe what they say 100%?

145. The very idea of the government picking winners and losers, as it tends to be used, is a bit misleading, IMO. Even industry-specific subsidies, objectionable or not, don’t really pick winners and losers
     I was thinking at a larger scale than specific companies- eg subsidies for solar power, or urban enterprise zones. Maybe somewhat at odds with the way that piece of rhetoric is used by the right…
     More generally, point being that while I think some meddling in markets to deal with externalities etc is Ok, and libertarians think it isn’t, we should both agree that meddling in markets to *advantage* of externality-producing outcomes is hella-stupid- so why can’t we agree on that point and get something done?

146. By conflating Koch Brothers, but never George Soros…
     George Soros isn’t funding political forces that are endeavoring to undermine the social safety net. Part of Laura’s point was the hypocrisy of accepting government largess, in a very big way, while railing against others receiving it as a subsistence pittance. The rub, therein, lies.

147. It is my belief that a prime responsibility of the government relative to the economy is protecting the integrity of the free market.
     Can you please explain what you mean when you say ‘free market’?
     Is this the only prime responsibility that the government has relative to the economy?
     If not, what other prime responsibilities does it have relative to the economy?
     Thanks.

148. I don’t see why anybody argues that free markets don’t self-correct. Obviously they do.
     Of course, you may have to wait a decade or two for the correction. But that’s a nit, surely. 😉

149. the free market cannot fail. we can only fail the free market.

150. I don’t see why anybody argues that free markets don’t self-correct.
     I don’t think anyone is disputing that free markets, in the economic sense of efficient markets, self-correct.
     The issue I have is with what equilibrium looks like, when it arrives.

151. Am I the only one here who drives a car that uses gas?
     We all bike, walk, ride public transportation or use electric cars. Good lord, man, where have you been?

152. my car runs on smug and the vapors exuded from the evaporation of Freedom.

153. mine runs on the tiny drops of failed paternalism that I harvest from my bleeding heart.
     that, and my fred flintstone feet.

154. Russell:
     You’ve been asking various people to define free markets, or at least what they mean by free markets for the past few days. You deserve an answer, although I can’t speak for everybody, hopefully this gives a starting point.
     Free markets, if I can remember my macro (which I can’t):
     -Have an infinite number of buyers and sellers
     -No buyer or seller has enough market power to influence price
     -All agents are perfectly informed
     -There are no barriers to entry/exit
     -zero transaction costs
     -uniform goods
     -no economies of scale
     -rational, profit seeking agents
     There are probably some others…I’m not an economist. The most important point, and one which I believe you are trying to drive home, is that none of those aspects can ever be true in the real world. There is no ideal free market (I’ll call it IFM for short). But you can approximate them to varying degrees.
     So why do people care? In abstract, IFMs allow for spontaneous order, or the efficient allocation of resources (the invisible hand).
     So I believe (can’t speak for everybody) that if you can approximate an IFM well enough, it will efficiently allocate resources. The corollary to that is that worse approximations will be inefficient, costing the society as a whole.
     I, at least, start from a preference for “free markets” because I believe they have societal benefit, not because I view them as morally superior.
     None of this gets into the specifics of attempting to make a free market for health insurance and whether or not it is possible or better than the alternatives. Very deliberately. I just wanted to provide you a question to your repeated query.
     PS – And potentially give you something to rip into. If we can’t agree on terms and don’t know each other’s assumptions, discussions can be a little pointless. I wrote it kinda fast (so busy) but it’s a starting point.

155. Somehow, this comes to mind.

156. thompson, thanks for the thoughtful reply.
     my personal preference is for people’s activity, of whatever sort, to be left to them to sort out however they like.
     so, all other things being equal, i’m more than fine with not regulating people’s economic activity. i.e., a free market.
     what i find lacking in arguments that advocate for free markets is a lack of recognition that an *optimal* outcome, in economic terms, might not be a *desirable* outcome.
     an unregulated market in health care and / or health insurance might yield widespread access to all necessary goods and services, at prices affordable to everyone.
     yay!
     or, it might yield concierge medicine for folks who make a lot of money, and the ER for everyone else.
     no yay.
     free market solutions are presented as if they are inherently virtuous, merely because they are free market solutions. to a degree that approaches the tautological.
     i find that unconvincing.
     there are lots of things which i don’t think merit public action to make sure they are broadly available, regardless of wealth status. televisions, smart phones, restaurant dinners. if an unregulated market doesn’t deliver those to some statistical approximation of ‘everybody’, i don’t see the need to do anything about it at the public level.
     if you really want those things, figure out how to get them for yourself.
     health care IS NOT LIKE THOSE THINGS, because people who don’t have access to health care actually do suffer and die, needlessly, from things that are totally preventable, and often for not a whole lot of money.
     just more money than those folks happen to have.
     and aside from the obvious humanitarian aspect of it, there is an obvious public interest in not having people walking around sick and dying.
     so the fact that something is a ‘free market solution’ is, to me, beside the point.
     things work, or they don’t. if they don’t get the job done, the fact that they are ‘free market based’ is of no interest.
     that’s where i’m coming from with my skepticism about the free market and health care. i do not see that it’s an appropriate approach, partly because the conditions that are necessary for an efficient market don’t exist there and so it is prone to a million forms of distortion, and partly because recent evidence doesn’t argue for free market approaches yielding an outcome that is remotely desirable from a social point of view.
     if somebody wants to advance an argument that free market solutions actually WILL yield the desirable result, and that argument does not include assertions that (a) people who can’t afford insurance are stupid irresponsible layabouts, or (b) the existence of public support creates a moral hazard that causes people to spend all their leisure time getting MRIs and cosmetic surgery, that would be of interest.
     if your argument depends on beating poor people with the threat of terminal illness so they will get up off their sorry @sses and get a real job, i frankly think you’re kind of a @ss and i’m not interested in talking to you about anything, let alone something of this level of importance.
     and no thompson that last was not directed at you.

157. Free markets, if I can remember my macro (which I can’t)
     You mean “micro”, I think. Pedantic nit, I know.
     But maybe not. Macro-economics deals with things like taxation and the money supply, which enable The Free Market to exist. A large number of buyers and sellers can hardly trade efficiently with each other unless money exists and contracts can be enforced.
     Even macro does not deal with Life, which is different from and bigger than The Economy. Another trite observation, of course, but one often forgotten in “economic” discussions. We don’t live to serve The Economy. Do we?
     –TP

158. By conflating Koch Brothers, but never George Soros…
     George Soros isn’t funding political forces that are endeavoring to undermine the social safety net. Part of Laura’s point was the hypocrisy of accepting government largess, in a very big way, while railing against others receiving it as a subsistence pittance. The rub, therein, lies.
     Thank you! That’s my point! I’m not philosopically or ideologically opposed to the deductions and subsidies and so on.I’m opposed to the hypocrisy and selfishness of individuals and corporations who demand those for themselves but yammer on about OTHERS being dependent. Iam also opposed to the inaccuracy of those who blame the poor for high taxes and deficits when they simply don’t cost us as much money as the bennies for the wealthy and profitable which are built into the budget at the behest of the party that claims to support a free market and to want a balanced budget.

159. BTW I ran into a hilarious display of hypocrisy from the Koch bros when I was looking up the info about their special perks. Pickens, another billionaire, was angling for tax breaks for natural gas exploration and the Kochs opposed him on the grounds that the breaks he sought would interfere with the functioning of the free market and were corporate welfare. Of course they were right about that. But they want exactly the same kind of corporate welfare for themselves! They claimed their opposition was principled , but actually they just didn’t want tax breaks for a competitor.

160. And, of course the whole dependent on welfare theme is based on the assumption that the recipients could work at a living wage job if they wished. In other words its an invoking of Wallace’s niggers on welfare meme which was sanitized by Atwood into bums on welfare.
     But the people receiving Food Stamps are the old, the disabled and kids. What job should a bedridden old lady do> What work is there for a woman crippled with rheumatoid arthritis? How many hours a week and at what pay should elementary school kids work?

161. http://feedingamerica.org/how-we-fight-hunger/programs-and-services/public-assistance-programs/supplemental-nutrition-assistance-program/snap-myths-realities.aspx
     Compare that info to the timber industry which has been allowed to operate subsidized on a public resource for about one hundred years.

162. that’s where i’m coming from with my skepticism about the free market and health care . . . and partly because recent evidence doesn’t argue for free market approaches yielding an outcome that is remotely desirable from a social point of view.
     . . .lots of things which i don’t think merit public action to make sure they are broadly available, regardless of wealth status. televisions, smart phones, restaurant dinners . . .
     russell: At risk of being thought of as an @ss you don’t want to talk to, I’m going to respond and follow up on this line of thought.
     Maybe part of the difference in opinion is because of the perceived “free market” status of health care in America. Prior to Obamacare, it was not much there. Part of the “conservative” approach was to open up the market. Why not try to open up the market first? It would have been the least intrusive, most cost-effective way to increase coverage in America.
     Moving to the second point, I don’t have cable tv. I have a smartphone through my business. It is near necessity. My kids don’t get a smartphone until college. But in my work and in my volunteer life, I see those much less fortunate than myself with smartphones and Dish. I’m not poor. But I don’t have a lot of cash, either. Kids in college, that sort of thing.
     Is there anything inherently wrong with requiring the elimination of “wants” before we step in an provide healthcare at the cost of the taxpayers (or our grandchildren after China loans us the money)? Is there anything wrong with requiring adults to make adult decisions? You pointed out the issue with adult coverage, but it looks to me like kids are largely covered in America, right? I’m not opposed to providing for kids. I love kids! And I don’t dislike adults. But in my opinion, being a citizen of this country means you act like an adult when you get to that age. There is responsibility.
     I don’t think the disagreement can be reduced to conservatives thinking health care is like a cell phone. I know you and that isn’t really what you were implying. And it can’t be reduced to conservatives not caring about kids. Frankly, I’m conservative because solutions that take into account personal responsibility, IMHO, promote better kids and better adults. It promotes freedom for us all and more vapors for cleek’s car. It’s that simple.
     My heart goes out to those truly in need and, yes, I know the difference. I counsel with the poor quite often in my “free” time and I see it. I’m committed to helping those I deal with become self sufficient. I don’t see government dependency as good at all. People suffer inside when they are not self-sufficient. I’m somewhat open to the idea of taking health care off the table to, among other things, help the poor become self-sufficient (but please don’t tell my ex-liberal now freaking righter-than-right father-in-law), but I can’t see how to do it through the government without it becoming a complete debacle, prohibitively expensive or doing more harm that good.

163. if I can remember my macro
     I thought this was like a computer macro, producing an output on demand, and thinking that thompson was good at the self-deprecation thing and was thinking of stealing the line.

164. Moving to the second point, I don’t have cable tv. I have a smartphone through my business. It is near necessity. My kids don’t get a smartphone until college. But in my work and in my volunteer life, I see those much less fortunate than myself with smartphones and Dish.
     I’m guessing you are in your 50’s? Figuring out a new smartphone is a really big pain? Not much that interests you on cable TV?
     Certainly, modern marketing has been able to change ‘wants’ into ‘needs’ and there is a certain amount of that. But the way a 20 year old student or young person uses a smartphone is, I think, so totally different from the way a 50 year old white collar worker does as to be virtually incomprehensible. Could my students stand to do less time on their phones and more time with real books. No doubt. But they are also finding short cuts, doing things differently and can, if we think about it, do the things I did 20 years ago a lot faster than I could do and get a lot further ahead than me in the same amount of time.
     I have no idea what the situation for cable TV and broadcast media is in the states. But I do know that if I am ignorant of basic trends, memes, what’s popular and what’s not in my cohort, I’m screwed. Fortunately, for us oldsters, we carry what is popular with us, and then can invoke it and know it will be understood. Living overseas in communities where there are not a lot of people from the same culture, it is much more obvious to me than it is to someone who is hanging out a group of like minded people from the same age cohort. I’m not sure I can describe how good it feels to experience the sensation of having someone who catches all your cultural references immediately, without explanation.
     It may be hard to comprehend, but just seeing the smartphone and the Dish from a distance does not give you full insight into how they are being used and why they might be of great importance to younger people. I realize that this is an assertion, but the idea that our parents faced the same situations as we do is pretty much a non starter, and so we should assume that the same is true for the distance between us and our kids. This is not to say that you are wrong to not get your kid a phone (my daughter is apparently the only kid in the entire JHS without a phone!) but she knows that we know that it can be a challenge and we try to make it up to her in other ways. With the second daughter, now in primary school, I don’t know what the hell we are going to do…

165. Russell:
     Thanks.
     “free market solutions are presented as if they are inherently virtuous, merely because they are free market solutions. to a degree that approaches the tautological. i find that unconvincing.”
     Part of the ‘why’ of my last comment was to separate from the “free-markets are virtuous b/c they are virtuous”. I think free-markets are *good* because they *work*. I understand the “they work” argument is still to be had, just trying to give you an impression of where I’m coming from.
     “(a) people who can’t afford insurance are stupid irresponsible layabouts, or (b) the existence of public support creates a moral hazard that causes people to spend all their leisure time getting MRIs and cosmetic surgery, that would be of interest.”
     If I *ever* make these arguments, please, feel free to yell at me, than disregard everything I said. I think it’s inhumane, especially considering the wealth of this nation, that people suffer and die for want of care. Where you and I disagree, perhaps, is how best to do that.
     I think America tends to have the worse of both worlds. Ineffective and hindering regulations that inhibit “free markets” coupled with sweetheart deals, revolving door lobbying and regulatory capture that inhibit “free markets.” I think healthcare is an example of this.
     I think we both agree, in healthcare, the market is broken. The market a regulated one, and has private and public components. I, a man that trusts free markets, sees improving the “free market” as a first path to try. We differ on that, and I certainly don’t think you’re crazy for it.
     Sorry, I know there is a lot to talk about on the “making free markets work” but I don’t have the time at the moment to give it justice and I don’t want to waste anybody’ time with poorly worded and unanswered posts.
     But I’m sure this topic isn’t going away anytime soon…

166. “You mean “micro”, I think. Pedantic nit, I know”
     I think I mean macro. We definitely discussed free markets in macro economics. But maybe that’s an indication of the quality of my econ education? 😛
     “We don’t live to serve The Economy. Do we?”
     No, Tony, I agree. The discussion remains how to best make the economy serve us.

167. “I thought this was like a computer macro, producing an output on demand, and thinking that thompson was good at the self-deprecation thing and was thinking of stealing the line.”
     Hah! If only I was so clever! Take the line…you came up with it.

168. bc: Why not try to open up the market first?
     It’s as if there was no medical care prior to Lyndon Baines Johnson? Surely you jest. We tried “full spectrum free market” health care from 1789 to 1965. It was an utter and abysmal failure. It proved to be socially and politically unacceptable. How many times should we revisit this failure?
     But let us try get more specific. Name just one ‘free market solution’ you would like to see implemented in the health care realm, and tell us why it is better and what we could reasonably expect to see if it was adopted.
     baby steps…..

169. Why not try to open up the market first?
     What does this mean?
     I.e., what do we do to “open up the markets”?
     And how does that increase the availability of health care to people who don’t have a lot of money?
     Regarding “wants”, I’m not really that interested in making people surrender non-essential stuff at the level of a smartphone before they can participate in things like Medicaid or Medicare – or for that matter, food stamps – for the same reason that I’m not that interested in making them surrender those things before they can have public assistance for stuff like water or electricity or a place to live.
     There are additional aspects to this also – having a phone is kind of like having an address, it’s damned hard to gain a toehold in the productive economy without either.
     But mostly I personally would file it under “don’t sweat the small stuff”. I feel the same way about stuff like spending food stamp money on ice cream or beer. I don’t care if somebody has a beer on me.
     If they blow it all on beer and don’t feed their kids, different story. But I’m just not that interested in stripping people of every single thing that isn’t absolutely essential before they can participate in public assistance.
     Just my opinion. It’s not a hill I’m all that interested in dying on, it just seems like it could become incredibly petty, in a hurry.
     I do recognize that kids, old folks, and the disabled have virtually universal coverage at some basic level through Medicaid. My comments on that topic and related topics involving @sses are mostly in response to comments made in another thread. Apologies for the bleed-over.
     If someone would like to explain what “opening the markets” means and how it would improve things, I’m all ears.
     I don’t really much care how it happens, I’m just interested in people being able to go the doctor.

170. this seems to be an expansive example of what the resident conservatives are suggesting:
     competition in the current market is currently ‘at the wrong level’; right now, the competition is between insurance plans, which means nobody bargains for service prices. but the competition ‘should’ be be at the procedural/diagnostic/service level. we should be shopping for bargain aneurism surgery and sales on heart transplants, instead of choosing an insurance plan to worry about paying for such things.
     and, this ideal competition needs to occur across state lines, nationally (though not internationally, it seems), … because.
     also, malpractice lawsuits are bad. somehow competition will make them better.
     how this help people who can’t afford the expensive services? beats me.

171. Assuming that “open up the markets” means to create a situation wherein people can choose between insurers, then how about this: subsidize people who can’t afford insurance so they can enter the market, and create exchanges so that people can get choices of insurance offered by different carriers. This would create a market of insurance that would exist along side the lack-of-market that is the result of insurance being tied to jobs or being unavailable due to lack of money.
     Yes, I know. I’m being snarky.

172. Maybe we need a futures market for healthcare, just to lube things up a bit. For a hundred bucks, I can buy a contract for a triple bypass in April 2041 at $15k. It’ll be just like oil or gold. We could come up with all sorts of crazy derivatives and options for speculators to bet on, you know, freely and without constraint. Who knows? We might end up with food trucks converted into mobile surgery centers where people can go get patched up on the cheap during their lunch breaks. “Do you ever go that guy on 23rd and Spruce? He takes out a mean gall stone for, like, 50 bucks. And the guy next to him has the best falafel.”

173. how this help people who can’t afford the expensive services?
     So which is it? Catastrophic insurance, insurance for all seasons, “basic access” insurance (or “basic” insurance) whatever that means, or what?
     Because I see references to everything.
     In fact the market can play a role and employing the reflexive progressive sneer anytime the market is mentioned isn’t really an answer.
     Does anyone know what they pay for a doctor visit? I don’t. I give my doc my insurance card. He doesn’t know either, BTW.
     What about MRI’s and all the other tests we have. Is there any competition? Does anyone have a choice?
     Yes, the prevalence of health insurance is the major driver behind this, but nothing in the new regime is likely to make any difference.

174. Yes, the prevalence of health insurance is the major driver behind this, but nothing in the new regime is likely to make any difference.
     Unless people getting insurance who couldn’t get it before is a difference.

175. In fact the market can play a role and employing the reflexive progressive sneer anytime the market is mentioned isn’t really an answer.
     It’s not anytime the market is mentioned. It’s when the market is mentioned as THE thing that’s going to fix all the problems. The market can play a role, always has, and still does.
     The government isn’t forcing people to go to medical school and making them work at set rates thereafter in a determined field in a specific place. Insurance companies can choose to be in the business or not. Medical technicians and nurses aren’t subject to a draft and prevented from being musicians or accountants. The ACA is not an absolute command and control regime that eliminates all market forces.
     But, on the other hand, letting the market do it all isn’t going to work.

176. What about MRI’s and all the other tests we have. Is there any competition?
     so, let’s say i have chest pains. i know i need to get to a doctor to see what’s up. i go to the doctor, he wants to get me into a hospital immediately.
     i say, “hey wait a minute doctor, you know i’m a frugal man. what tests will i need?”
     and he says “i don’t know, boy. your situation is out of my league.”
     which hospital do i choose?
     so, i decide to go to the closest one, because with all this additional stress, my chest is hurting even more.
     at the hospital, i ask what tests i’ll need, and what the prices are. the ER guy says “MRI, CT, Chem7, … i’ll be right back.”
     he returns with a list of prices, and i note that I can get that MRI cheaper at the hospital on the other side of town. i insist that i get the MRI done there. but, given the urgency, i would have to take an ambulance to get there, which would add $X0,000 to the cost. i weigh the options and decide against it.
     i ask if there’s a way to skip the MRI and maybe do an X-ray instead?
     the ER guy runs off to ask someone. but the doctors are all busy negotiating, dickering, and putting together treatment options for other penny-wise consumers, so it takes a while.
     and while i’m waiting, i die.
     saved a lot of money!
     In fact the market can play a role and employing the reflexive progressive sneer anytime the market is mentioned isn’t really an answer.
     people here have been asking, for days, for a “conservative” to demonstrate how the market is going to fix it all. none have done it yet.

177. In fact the market can play a role and employing the reflexive progressive sneer anytime the market is mentioned isn’t really an answer.
     It’s not anytime the market is mentioned. It’s when the market is mentioned as THE thing that’s going to fix all the problems.
     Precisely, and thank you HSH.
     People here and elsewhere are making arguments along the lines of:
     The ACA (or pick the public policy law or regulation of your choice) is bad because it interferes with the operation of the free market.
     Health care costs are high because the free market is not allowed to operate.
     Proposal XYZ is better because it’s market-based.
     To me, these kinds of responses are not really useful, because they’re tautological. Whether market dynamics are a good way to operate in the medical area is part of what we’re trying to figure out – asserting it as the best way to do things is, basically, a non-answer.
     My issue overall regarding the free market and health care stuff is two-fold:
     1. The benefits we would expect from market dynamics are likely not going to be available when it comes to health care, because the conditions for an efficient market (ably and accurately laid out by thompson, thanks thompson) don’t exist for that universe of goods and services. Or, they only exist for the most basic, commodity level stuff – band aids, aspirin, etc.
     If you want to say that hospitals, frex, should be required to charge no more for an aspirin than your local CVS, I will applaud you.
     If you want to claim that expecting a lay person to make a good, market-based analysis about whether they need open heart surgery, and who is going to give them the best bang for their surgical buck, I am not going to applaud you, because that’s an extraordinary level of expert information for a lay person to have.
     2. Even if we were able to structure the market for medical goods and services such that it could be made completely efficient, or even remotely efficient, that still does not ensure that the market in essential health care goods and services will reach equilibrium at anything like an acceptable level of access.
     A Pareto-efficient allocation of MRIs might result in them being available only in communities of 100,000 people or greater. It might result in joint or organ replacement only being available to people with a personal wealth of a million dollars or more. It might result in procedures costing more than $50K being totally unavailable to people older than 80 years old.
     Those are all outcomes that the pure application of market forces might give us, because the only criteria the market uses are marginal utility and efficiency.
     And, we, as human beings whose lives encompass a broader range of interests than just the economic, might want other outcomes.
     You will notice here that I am not sneering at the market, or downplaying the value of the market as an instrument for price-setting or allocation of resources.
     I am describing, IN TERMS OF THE MARKET ITSELF, reasons why market dynamics might not be the best instrument for deciding who has access to medical goods and services, and at what price.
     I would be interested in hearing the conservative response to that analysis.
     “Shut up hippie” is not a particularly useful conservative response.
     If somebody would like to explain to me why my analysis here is flawed, and why in fact I should trust market dynamics to produce an outcome that a reasonable person would find socially acceptable, I’d be delighted to hear it.
     Thanks.

178. another thing, he continued, at tedious length:
     what I think is going on with the conservative preference for the ‘free market’ is that many folks conflate ‘free market’ with personal freedom.
     I’m not sure that those things are the same. Or, at least not in anything like a useful or practical way.
     I could say that it violates my personal freedom to have to stop at a red light, or to build my house to code, or to leash my dog, or to not bury my household trash in a big lye-filled pit out in the back yard.
     And I would be correct. The fact that I cannot do those things interferes in some way with my personal autonomy.
     But the fact that I cannot do those things also allows me to live in a society with other people without having an undesirable impact on *their* lives. And, in fact, on *their* personal freedom.
     So, they can drive through a green light without living in fear of their lives, and they don’t have to worry about my house falling over or about dying in a fire if they come over for dinner, and they don’t have to worry about my dog biting their kids or killing their cat, and they don’t have to worry about living next to an open trash pit full of festering banana peels and hungry rats.
     Freedom, in a society of reasonable, mature, responsible adults, needs to expand beyond the concept of “You’re not the boss of me”, if it’s going to have any useful meaning.

179. The traditional sneering progressive formulation is of course the distinction between freedom to and freedom from.

180. Maybe part of the difference in opinion is because of the perceived “free market” status of health care in America. Prior to Obamacare, it was not much there. Part of the “conservative” approach was to open up the market. Why not try to open up the market first? It would have been the least intrusive, most cost-effective way to increase coverage in America.
     First, this smacks of the tired Communism-has-never-been-tried meme. There are no free markets in reality, so it’s always possible to say that the free market would work but *this* market wasn’t close enough to the ideal and *that’s* why it failed.
     Second, Id oppose this because we can trace some of the obvious failures of America’s healthcare market to market failures, and it becomes hard to see how to correct those market failures via the market. Eg afaict many people who bought catastrophic individual insurance in the past *thought* they would be covered against long-term illnesses (I did when I had some back in the day). Now it’s clear that should we have found a long-term condition, we likely would’ve been priced out of that plan or had our coverage retroactively invoked for not mentioning a pulled hamstring in high school.
     We could try to patch that with (market-obstructing) rules about when policies can be cancelled, compelling insurers to inform consumers about possible price changes, controlling price changes, etc. But that approach is tricky IMO, bc in the end we’re counting on restraining a large corporation with lobbyists and lawyers and plenty of chances to experiment on the best tactics, versus consumers who will probably only do this once in their lives, have zero individual legal clout, and will be undertaking this challenge simultaneously with a personal health crisis. That is, it’s a fight between a bear and a bunny, making sure the bunny is well-rested and hydrated or having him take some jujitsu classes isn’t going to help much IMO.
     Third, this needs specifics. What parts weren’t subject to the free market, and how do you plan to free them?
     I don’t see government dependency as good at all. People suffer inside when they are not self-sufficient.
     I dont know that I’ve seen anyone ‘suffering inside’ from going to the free clinic in town. I *have* seen them suffering on the *outside* though, because they couldn’t get decent medical care.
     Do people ‘suffer inside’ from getting their Social Security check? Or using Medicare? My folks are on Medicare, and if they’re ‘suffering inside’ they are doing a helluva job hiding the pain.
     Do the Koch brothers also ‘suffer inside’ from all of their corporate welfare checks? Are the guys on the board at Halliburton hurting because deep down they know their no-bid contracts came from lobbying and contacts rather than Real American Hard Work? Do the farmers getting drought relief suffer on the inside? People driving on interstate highways? etc.
     It’d be real Free Market if we listened to these people. You say that you counsel them- are they saying “Man, all this free healthcare is making me sad” or “Man, my knee has been killing me but the folks at the ER say it isn’t life threatening and the free clinic just gives me aspirin and a crutch”. Me, I hear more of the latter, but maybe we’re both hearing what we want to hear.

181. The traditional sneering progressive formulation is of course the distinction between freedom to and freedom from.
     One man’s “to” is another man’s “from”.

182. Refusing health insurance coverage to those with preexisting conditions, even trivial ones, is an example of the free market working.
     Large corporations which pay a large percentage of their workers minimum or near minimum wage and then counsel and encourage those same workers to seek Federal taxpayer help in the form of Food Stamps and Medicaid healthcare coverage is an example of the free market working.
     Permitting states to choose whether to set up their own healthcare exchanges under the ACA and/or to enlarge the pool of uninsured workers who could be covered under Medicaid (with monetary help upfront from the federal government), is an example of Federalism in practice.
     Looks like the free market is in fine fettle, if one means by the free market that millions of folks are free to have no choice.
     Looks like Federalism is working as well, if one means that some states may so choose to set up their ACA insurance exchanges, while some may not.
     NOTHING, as in “no thing” or “person” was stopping the health insurance industry from changing their free market practices to include those, including children, with preexisting conditions in their coverage, except the free market.
     NOTHING, as in no thing” or “person” was stopping the states from setting up their own credible health insurance schemes on their own before the ACA, or before Medicaid.
     For that matter, nothing was stopping the states from setting up their own credible social and medical insurance schemes before Social Security or Medicare.
     The private free market and the States had their chances since 1789 under the free market to tackle these problems on their own terms in a credible way.
     Few entities, if any, did so.
     I don’t blame the free market for any of this.
     I blame free market ideology.

183. It’s not anytime the market is mentioned. It’s when the market is mentioned as THE thing that’s going to fix all the problems.
     It’s like saying “WRENCH” over and over again when I ask how we’re going to fix the car. Yes, that’s a useful tool. How does it address the problems at hand? Unless we’re using the wrench like a crucifix to bless the car- which is a great deal what this feels like.
     So far, I think the only suggestions Ive heard are:
     -expose users to the costs of healthcare. Im not sure what that means; copays were supposed to make users aware of costs when utilizing services, but we’ve got those already & they haven’t changed things much (predictably, since presumably few users were utilizing healthcare *for fun* afaict). Exposing users to the *entirety* of the costs is called “uninsured”, a position that most users of healthcare strive vigorously to avoid. ie the free market says they don’t want that at all.
     -let insurers sell insurance in state X while complying with the regulations of state Y. That seems like a very bad idea:
     1)It will surely lead to a Delaware-like race to the bottom, whoever puts the fewest regulations and has the friendliest courts will get the insurers.
     2)Consumers will now have to be familiar with the state laws of many states in order to properly evaluate insurance (adding to the information disparity problem). Handling out-of-state lawsuits is likely to be more of a burden on them as well.
     3)Aside from allowing more rip-offs due to lax regulation and lax enforcement, I don’t see what the upside is supposed to be. If there’s some state where the pre-ACA system was working becase of their awesome free market regs, let us know what that was. Maybe we can even explicitly make those the federal regs rather than imposing them indirectly on the other states. (Or is the idea that this Ideal State Regulatory Regime won’t come into existence until we allow cross-border insurance sales?)

184. Do people ‘suffer inside’ from getting their Social Security check? Or using Medicare? My folks are on Medicare, and if they’re ‘suffering inside’ they are doing a helluva job hiding the pain.
     I know people for whom this is a problem. They see these poor souls suffering inside because they’re getting a Social Security check anonymously rather than having to go hat in hand and personally/publicly plead for charity, and this unnatural abomination forces them to keep their “dignity” when they should be selling it. This “dignity” then festers inside them, and becomes a cancerous lack of shame for their moral failure to be as self-sufficient as their humble neighbors. Tragic, really.
     One man’s “to” is another man’s “from”.
     Of course. But while this makes the traditional formulation a wee mite platitudinous (and hence as useful as any other platitude), it at least admits that the nature of freedom is contentious.

185. it at least admits that the nature of freedom is contentious.
     Yes, I recognize that and agree. It is and was a point worth making, my comment wasn’t intended to be dismissive.
     Thanks N. Vide!

186. I suffer grievously every time the rubber tires on my 1996 Toyota Tercel meet the Federal tarmac on I-70, and I silently mourn every time my plane is not hijacked and flown into a building, especially since i have to pay for my own drinks.
     I suffer for my Alzheimer’s-stricken mother for her unspeakable (literally, because she is in a state of unthinkableness) suffering at the hands of Social Security and Medicare forcing her dependence.
     As she spends down her own money (that’s why she saved it, though she would have preferred going out in a flash at less expense) on home caregivers (roughly $6000/month at the moment), I grieve inwardly for those who are preparing to suffer for her and themselves when her money runs out and she has to hand over her Social Security check and accept Medicaid to pay for her nursing home care.
     I remember my very Republican grandmother (as opposed to my nominally Republican grandmother) using her Social Security payments (actually, it was my grandfather’s) to defray a portion of her private nursing home expenses decades ago glowering darkly and nearly spitting on the carpet when Franklin D. Roosevelt’s name up.
     Or maybe she was annoyed by my shoulder-length hair at the time.
     Or maybe it was just that at 94 years of age, one has a look of painful suffering on their faces as a default expression.
     Hard to tell.

187. Just thinking that on the one hand, bc is saying that he thinks poor people would be better off if they were forced to take more responsibility for their lives- on the other hand, we’ve got several conservatives telling us that the free market ought to let people decide for themselves…
     Now, those are two different sets of people, and I think it’s unfair to ask one person to defend or justify another’s views. But they don’t seem compatible to me- if the poor people ought to be free to choose because they know what’s best for them, and they choose to take government benefits (that could be refused), then arguments that those benefits are harmful to them run contrary to the position that people ought to be free to choose what they want & that this will lead to optimal outcomes.
     [Or else Im just left with “free market is good”, ie poor people ought to be free to make choices that the free market provides because that adds value, but letting them pick a handout doesn’t add value because it makes them hurt inside because it’s not the free market anymore].

188. This comment was going to be a lot shorter, but apparently “shut up hippie” is not constructive. Another perfectly good phrase is sacrificed on the altar of “political correctness.”
     I want to apologize that I’m not being very responsive and trying to limit my posts to really targeted questions. I also want to reiterate that I speak for myself and not the “conservatives,” although I’m probably more “conservative” than most on the board.
     So what does “opening the market” mean to me? I think two things distort the market: Tax subsidies to employer based plans provide employer based plans an unfair competitive advantage over other sources of insurance (like individual plans). And two, I want to bring the hidden costs of uncompensated care into the open.
     I think tax-subsidized employer provided health insurance is a great inhibitor of the free market. It replaces tens, hundreds, or thousands of agents with a single bargainer. I think it gives employer-based insurance a competitive advantage over individual plans. I see no reason to give employer-based plans an advantage via tax law. There is an individual market, albeit weak, and I would rather the government encourage it through exchanges (which are one of the things I like about the ACA). Note, I don’t have a problem with a company OFFERING a health plan. I just don’t want it to be tax free.
     Emergency care mandate from the EMTALA. There are very few industries where the government forces the industry to provide services for free and I can’t think of a larger distortion of the free market. Uncompensated care is a hidden cost which gets passed onto other consumers. This report puts the cost at just under $1000/yr from every insured family in WA (http://media.spokesman.com/documents/2009/11/2232-UncompensatedCarereport_000.pdf). I feel we should allow hospitals to directly bill the government and remove the distortion from the market.
     So what’s my plan? (a) no tax subsidies (b) government directly pays for uncompensated care (c) institute exchanges (d) government subsidizes the poor so they can afford insurance (Brett’s ‘insurance stamps’)
     And I believe, perhaps wrongly, that this would allow for competition in the individual market and provide downward pressure on insurance prices.
     I also think there would need to be some regulation of insurers to deal with problems with rescission, pre-existing conditions, etc. I can get into them, but this is already way to long. So I’ll get into them another time.
     Regarding Laura’s snark at 8:21: I do realize that what I described is similar to what you described, and you were describing the ACA. And yet I don’t like the ACA. Am I insane, stupid, or both? You be the judge.
     I don’t like the ACA for several reasons.
     (1)I’m against the individual mandates on principle. I don’t like mandates. That doesn’t mean they aren’t sometimes required and I am willing to entertain the concept. I just would prefer to avoid it. Russell has repeatably provided a list, but one that I like to add is the draft. I can’t think of a harsher mandate issued by the government than to fight and die for it. Of course, drafts are (hopefully) infrequent and only in times of existential threat to the nation. Regarding the mandate to have insurance, I think most people, if they could afford it, would get insurance. I think the few that don’t are being irresponsible and I have no problem letting the government collect on any uncompensated care they require. I just think if insurance was accessible, it wouldn’t be much of a problem. If it was, I would be willing to entertain the concept.
     (2) I think cost control is very important. I think competition through individual market exchanges would be a good way to control costs. As I understand it, the ACA provides cost control in two ways. Regulators at the state and federal level prevent “unreasonable” premium increases and insurers are required to pay back premiums if they spend less than 85% on healthcare costs. (Please, correct me if I’m wrong. I tried to read the law but it was SO LONG, amirite?)
     Now, I’m a man who has a profound distrust of concentrations of power, government or corporate. I’m also a man who is bothered by the excessive and repeated collusion between government and private industry. Many examples of which Laura has provided on this thread. And I’m left asking myself, how long until the regulators are lobbied by the regulated? How long before that lobby is effective? If hospitals bill more, and the insurers can just turn around and say, “well, we did our best, but in order to stay in business we need a reasonable increase of 15%”, what will the regulators say? Especially after lobbying? What will the congress critter say when he’s out on the links with his good friend the lobbyist, who tells a tale of woe about how his company is going belly up without a “reasonable increase”.
     I could go on about my inherent mistrust of public/private relationships, and how convinced I am that insurance companies are going to be endlessly creative in skirting the law, but I’ve said far too much already.
     There is no ideal solution. I don’t think regulation is good for controlling cost (it’s easier to lobby a few regulators and congress critters than it is to lobby every potential customer). I do like the exchanges, but wish the ACA had gone further in encouraging the individual market. I would prefer to trust the combined self-interest of millions of individuals in seeking the best insurance at the best price among companies that are competing to provide the service.
     I apologize for the incredibly long post and I know I’ve left a lot out, but I’m trying to focus on bits and pieces at a time.

189. As an aside, this is pretty much why I’m not against a semi-independent government run health care plan, as long as it covers costs from premiums paid in. Bluntly, I don’t think the government is all that good at things, and I fully expect private insurers would be able to match and exceed the government option. Any for-profit company that can’t compete with the federal government doesn’t deserve a place at the table.
     It serves the additional role of keeping the insurers honest. If everyone can purchase insurance from a large, non-profit driven government corporation, private insurers have to at least match that to stay in business. I think other non-profits currently cover that role, but in my book, more competition is always good.

190. I feel we should allow hospitals to directly bill the government and remove the distortion from the market.
     i vote we simply do that for all health care! if single-payer works for poor people, old people, veterans, and the uninsured, let it work for all!

191. I think tax-subsidized employer provided health insurance is a great inhibitor of the free market. It replaces tens, hundreds, or thousands of agents with a single bargainer.
     I can see how it messes up the employment market (creating stickiness and privileging some jobs over others) and how it distorts health care v other goods, but I dont see how it messes up the insurance market per se. Really, having a good HR department to research plans ought to be a big advantage, plus they get the leverage of a bulk buyer. And they’re incentivized to offer me a suite of plans from which I find a satisfactory one, since that’s a signfificant part of my compensation.
     I could even see something like that evolving in an entirely free individual market- people often choose advisors who take a bit off of the top when making complex decisions, it wouldnt be far from that to have those advisors lump their clients together for market clout and develop some preferred provider relationships.
     So what’s my plan? (a) no tax subsidies (b) government directly pays for uncompensated care (c) institute exchanges (d) government subsidizes the poor so they can afford insurance (Brett’s ‘insurance stamps’)
     Im good with all of those, but I still see some problems that could linger:
     1)recission and other unfair practices- health insurance is tricky, particularly long-term stuff like chronic illness, because I only get to judge the quality of my good after Ive paid for it for years or even decades. So either consumers are hyper-informed (which is its own cost/burden), or there’s going to be some bad deals made (or good deals broken). I know the free market ideal is that all of this would be handled through the courts, but that just doesnt seem realistic to me.
     2)does the government set prices of uncompensated care and still mandate that people get treated? I dont mind that, but it does make me observe that preventative care for those users might be much, much cheaper than emergency care. Would it bother your free market principles to supply preventative care to that strata of society if it’s shown to be more cost-effective?
     I’m against the individual mandates on principle. I don’t like mandates. That doesn’t mean they aren’t sometimes required and I am willing to entertain the concept. I just would prefer to avoid it.
     What if we call it a tax to pay for healthcare, with an income cutoff, and a deduction for any money you pay for health insurance? That’s the same mechanism afaict, with different names for the moving parts.
     I could go on about my inherent mistrust of public/private relationships, and how convinced I am that insurance companies are going to be endlessly creative in skirting the law, but I’ve said far too much already.
     I also worry about regulatory capture. Yet I don’t think the answer to regulatory capture by industry is to kill regulatory power, any more than I think the solution to elephant poaching is to kill all the elephants. I think regulatory capture as a blanket rationale to avoid reulation at all is only convincing if you don’t think regulations are generally useful in the first place- at which point, you don’t need another rationale to want to not have them, right?
     I apologize for the incredibly long post
     I think I said it before, but if I didnt- it’s nice having you here, I hope you keep putting up long posts well into the future.

192. what i find lacking in arguments that advocate for free markets is a lack of recognition that an *optimal* outcome, in economic terms, might not be a *desirable* outcome.
     russell, few indeed are the people who will argue for free markets (or anything else) strictly on the basis of economic utility. Even those who argue that they should be applied to the poor don’t take the argument to its logical conclusion. Which, after all, would be that as soon as someone reachs the age where they can no longer support themselves, they should be dead. And that would include not allowing people to have a retirement, since retirement is not economically beneficial.
     So what it turns out to come down to is a belief that the working-age poor ought to be doing more to support themselves. And that they are not is entirely due to their not being willing to exert themselves. (Which may be a sincerely held belief. But few are those who would be willing to make it quite that explicitly.)
     The arguments for free markets around this really turn out to be about how to force (or at least provide incentives for) them to exert themselves appropriately. Which is an easy approach to take if you don’t happen to know anybody who is working extremely hard, but still not succeeding in making anything like a comfortable living. Not fo rlack of trying.

193. wj- Id be much more sympathetic to someone who said they wanted poor kids to get good healthcare, education from preschool through college, protection from eg lead and other development-altering pollutants, etc, and *then* said they were responsible for their position in life. Im not sure Id totally agree (kids and young adults often make bad decisions without thinking about consequences), but at least it would make sense to me to even the playing field as much as reasonably possible before starting the race.
     Saying that kids who grow up in bad neighborhoods or with bad parents ought to not have healthcare, ought to suck up lead paint or lead exhaust, ought to get schooling later than their peers and of a substandard quality, ought to be racially profiles by the police, ought to suffer whatever job etc discrimination private employers choose to engage in, and *then* they’re responsible for being behind- this just seems cruel.

194. thompson, thanks for the thoughtful reply. i’m with carleton, it was not at all too long, and i appreciate your contributions here.
     just wanted to also say that IMO your points about the employee tax subsidy and the unfunded nature of EMTALA are quite apt.
     i do have a question as to whether a market of all individuals will yield a better outcome than one oriented toward groups (as is typical in employer-provided coverage). it seems to me that the advantages of insurance products come from spreading risk, my sense — based on current practice — is that insurance products targeted toward individuals is going to shift risk back onto the insured in ways that will make “insurance” almost a product in name only.
     in other words, the products would be tailored so closely to the particulars of each individual that risks would not be spread at all, and folks who are inherently at higher risk due to genetics / occupation / age / etc. would still end up looking at bankruptcy etc in the event of any kind of significant medical event.
     my understanding is that something like three quarters of medical bankruptcies now are folks who have insurance of some kind.
     but even given all of that, there are ways to compose groups that don’t require employers to play.
     i don’t really share your lack of confidence in government in this case, IMO the public sector is actually really good at bean-counting and sheer mind-numbing bureaucratic administration, both of which are a large part of administering stuff like this. and, neither of which are skills to be dismissed as unimportant.
     they do a pretty good job with, frex, medicare, which almost everyone agrees (i think — right?) is a fairly efficiently run operation.
     net/net, thank you for the concrete and thoughtful suggestions. also, belatedly, to brett, whose thoughts early in the thread were equally specific and relevant, IMO.

195. Carlton:
     Points increased leverage in employer plans is well taken and a great point. But I don’t want to ban employers from offering plans. I just don’t think they should be subsidized. If, without the subsidy, they can still offer better than individual plans, good on them. They certainly have increased negotiating power. Why do we need to subsidize that specific method (employer-based) of coverage? If you’re right (and I think you sort of are), employers will be able to negotiate great rates, have plans that employees can and would want to opt into. But maybe another plan would better suit the employee’s needs and they would prefer to seek coverage individually or through another group, and I don’t see any reason to favor one method with tax subsidies.
     Those problems would linger, and I didn’t address them. But I am aware.
     (1) Bluntly, I think rescission should be illegal. Regulation, I know it’s shocking to hear me suggest it, but here we are. But really, if you’re offering insurance, rescission is just a form of rent-seeking, which I have little patience for.
     It leaves us with a problem of people waiting to get sick before getting insurance. Yeah, maybe, but insurance is a good idea and I think most people who can, will get it. If for no other reason that applying for insurance takes time you don’t have in emergencies. If cost is kept low, there is little reason not to get insurance.
     Those who can’t, should be subsidized. Those who can, and don’t, get free emergency care courtesy of the federal government, who can than use it’s reach to collect on them. If they were wealthy enough to afford it, welp, the IRS goes to town on them. If they weren’t, we foot the bill and give them a pamphlet on medicaid.
     The mandate is another way around the pre-existing condition problem. I just don’t think it would be required. If I had my druthers, I’d try it out this way and see if there was a substantial population trying to game the system. Maybe I’m naive, I just can’t see a large population that would live without insurance if it was affordable.
     (2) Yeah. I’m fine with that. Or have a random audit/fine system where providers have to justify their charges to the gov. Also, all for preventative care, which is why I think the poor should be subsidized so they can get insurance. No, it doesn’t bother me at all to subsidize those that can’t afford preventative care to be subsidized.
     “hat if we call it a tax to pay for healthcare, with an income cutoff, and a deduction for any money you pay for health insurance? That’s the same mechanism afaict, with different names for the moving parts.”
     Isn’t that what the SC said it was? A mandate by any method is not fine with me in general, although see my many statements of mandates being allowable if they are required. It’s not that I dislike “mandates” it’s that I dislike coercion. Governmental or otherwise. Of course, exceptions must be made, I just try to minimize them.
     “I also worry about regulatory capture. Yet I don’t think the answer to regulatory capture by industry is to kill regulatory power”
     I don’t want to kill all regulatory power. I just want regulatory capture to be part of the conversation. Too often, the discussion is presented as more/less regulation. Which is very much the wrong conversation to have. You need the RIGHT regulations. In my view, the US often has the worst of both worlds: a regulatory agency that’s in bed with the regulated and minimal power to actually inhibit anti-competitive or otherwise undesired behavior. Small, targeted regulations with substantial penalties are far better than broad powers with limited penalties. Penalty against rescission: targeted. An few regulators deciding what’s “reasonable”: a great target for corruption. And on that overbroad piece of soaring and vague rhetoric, I’ll close for now.
     “I think I said it before, but if I didn’t- it’s nice having you here, I hope you keep putting up long posts well into the future”
     I’m glad you feel that way. You’ll soon find it’s hard to shut me up. 🙂

196. Russell:
     Points well made. I mentioned rescission in my response to Carlton, I think you also need some regs on insurance policies in general. I can expand on it if you like, but I think some simple things like a shall-offer basic plan and limitations on how insurance companies can discriminate on pricing (age, geographic area, frex) should cover most of those problems while allowing insurance companies a lot of flexibility in how they run their business.
     “i don’t really share your lack of confidence in government in this case…they do a pretty good job with, frex, medicare, which almost everyone agrees (i think — right?) is a fairly efficiently run operation.”
     I do think medicare is a fairly efficient organization. But if healthcare costs continues to rise, even the most efficient organization will be struggling to provide care.
     Healthcare needs to be cheaper in this country, and I think large numbers of self-interested individuals is a good way of doing that. We can have an argument on single-payer as ANOTHER way of keeping costs down and discuss the pros and cons of that, but that’s a whole different can of worms. But right now, I don’t see the ACA providing cost control.
     Like I said before though, I’d be happy to be wrong.

197. But I don’t want to ban employers from offering plans. I just don’t think they should be subsidized.
     Im in agreement there. I don’t think it messes up the free market in healthcare in terms of making healthcare more expensive or making consumers less sensitive to price (which is what I thought you were saying), but I do think it messes up the employment market by making it somewhat more painful to switch jobs and much more painful/risky to strike out on one’s own. I once switched from a medium-sized company that was doing pretty well to a very small start-up, and one big consideration was that if they went under, we’d be out our insurance and how that could potentially play out very badly.
     I suspect and hope that the ACA will lead us in that direction; once the individual market is not entirely &$^#ed, it’ll be easier for people to accept ending the dumb employer-based system we wandered into by accident.
     Bluntly, I think rescission should be illegal. Regulation, I know it’s shocking to hear me suggest it, but here we are.
     I think that this is probably true for everyone here- either actual ducking of contractual obligations, or a mere misrepresentation of contractual obligations that means a consumer isn’t getting what they thought they were paying for. Both are not real free market (ie perfect info voluntary exchange of value) interactions.
     The question is, how do we stop it? I don’t favor a lawsuit-based approach, I see too many downsides (already gone into that in some detail). So we need something else- in general, a way of stopping insurance companies from trying to game the market into paying for something and then not receiving it by dumping people once they get chronically sick.
     [I also have concerns about very long-term issues bc companies come and go, and if Im betting my long-term care on company X being around to meet their end of the bargain if they aren’t, I lose. Like with FDIC-insured bank accounts, the ultimate backstop for these sorts of things *can be* the government to address that concern. Im sure there are other ways.].
     Those who can, and don’t, get free emergency care courtesy of the federal government, who can than use it’s reach to collect on them. If they were wealthy enough to afford it, welp, the IRS goes to town on them.
     I think you said this before, but I think it’s redundant- if you have some money and end up in the ER with massive bills and no insurnace, hospitals are *very good* at getting that money from you. Maybe not as well as the Feds, but pretty darn good. People getting treatment and then laughing all the way back to their McMansion is not the problem afaict.
     Isn’t that what the SC said it was? A mandate by any method is not fine with me in general, although see my many statements of mandates being allowable if they are required.
     I was just saying it’s like a new tax to fund the new system, with a new deduction that only applies to that tax. At which point, how is it more of a mandate than income taxes and targeted deductions? There is an element of using a tax to drive behavior, but that’s not exactly unique to the ACA, and Id argue that the behavior being encouraged makes more sense than most deductions.
     I don’t want to kill all regulatory power. I just want regulatory capture to be part of the conversation.
     You win! Whee! 🙂
     Seriously- yeah, me too. This sort of parallels what I was saying earlier about how liberals and free market conservatives ought to be able to team up on some low-hanging fruit: both dislike tax subsidies for externality-producing industries, and both are against regulatory capture.
     From where I sit, the reality is that free-market capitalism has very little actual pull in Washington, either on the Left or on the Right, and that therefore such an alliance is just a pipe dream created by talking to reasonable free market libertarians at the grassroots level.

198. thompson- are there any conservative blogs where you hang out in the comments section? I enjoy reading sources across the aisle, but I havent found anyplace where a reasonably civil conversation could be had….

199. “are there any conservative blogs where you hang out in the comments section? I enjoy reading sources across the aisle, but I havent found anyplace where a reasonably civil conversation could be had….”
     Why do you think I’m here? 😛 Seriously, though, the internet is sort of a cesspool when it comes to politics. Well, when it comes to anything. I haven’t found many blogs I like and I’ve only posted on this one.
     Civility is one of my goals. Maybe I’m naive, but I just keep thinking that people 90% agree 90% of the time…and we spend 100% of our energy arguing about the 10% we disagree on! I just keep hoping maybe if the tone was lowered back down from 11, we’d all be better off.

200. I just keep hoping maybe if the tone was lowered back down from 11, we’d all be better off.
     BULLSH!T!
     oops. i need to take off my Balloon Juice hat.
     i mean … yes!

201. I enjoy a good debate and so have enjoyed Fuzzy Face and Thompson, among others, too.
     I am puzzled by the belief that government will not do well at health care. Medicare is by far a better run insurance provider than any of the private companies. As I said earlier, I took a class in medical billing and Medicare was the one provider that didn’t deliberately try to stiff doctors on the payouts. Medicare also provides the service without wasting the consumer’s money on ridiculously over paid CEO’s, lobbyists, or advertising.

202. the internet is sort of a cesspool

     Agreed!

     I just keep hoping maybe if the tone was lowered back down from 11

     Sometimes adding one is just the ticket:

     After years of silence on the subject, Lockheed Martin’s Skunk Works has revealed exclusively to AW&ST details of long-running plans for what it describes as an affordable hypersonic intelligence, surveillance and reconnaissance (ISR) and strike platform that could enter development in demonstrator form as soon as 2018. Dubbed the SR-72, the twin-engine aircraft is designed for a Mach 6 cruise, around twice the speed of its forebear, and will have the optional capability to strike targets.

203. How do we stop rescission? We apply penalties to any company that engages in the practice and limit their ability to discriminate. If they wish to eliminate one of their insured, they must eliminate everyone that fits into that group (policy level, age, etc). If they want to increase prices to force people to drop, they increase prices on everyone in that group. Any company found deviating from their actuarial tables is fined and the penalties are paid to the injured insured.
     I think that’s the appropriate level of regulation to apply. There is an anti-competitive behavior (rescission), and we can apply regs to directly penalize that behavior.
     I honestly hadn’t thought too much about the companies going bankrupt or closing shop as a problem. I’ll have to think on it.
     “I think you said this before, but I think it’s redundant- if you have some money and end up in the ER with massive bills and no insurnace, hospitals are *very good* at getting that money from you. Maybe not as well as the Feds, but pretty darn good. People getting treatment and then laughing all the way back to their McMansion is not the problem afaict.”
     I agree, but I’ve had people tell me this, so I bring it up and dismiss it.
     Regarding taxes driving behavior. I agree the fine/tax thing is pretty much the same. I’m just against them in general. Again, not to say they aren’t sometimes necessary, I just try to avoid them. If costs were sufficiently low and appropriate subsidies, I think most people could afford insurance, and most people would purchase insurance, because accidents happen and it sucks to be on the hook for that. I think that’s a sufficient stick and don’t think we need another one in the fine/tax sense.
     I could be wrong, and it’s not a hill I’m going to die on (without the appropriate insurance) if that’s shown to be the case. But I’d avoid it if I can.
     “From where I sit, the reality is that free-market capitalism has very little actual pull in Washington, either on the Left or on the Right, and that therefore such an alliance is just a pipe dream created by talking to reasonable free market libertarians at the grassroots level.”
     I have no illusions about the environment in DC, trust me. And I agree that we should agree on things like subsidies, reg capture. I think there are a lot of noise machines running that prevent that kind of discussion…but I think its important to keep trying.

204. Thompson,
     1.) As pointed out by others, decoupling health insurance from employment is favored by most here. There is no logical link that I see that would necessarily infer ‘freer’ markets. Different markets yes, but freer? The current setup (like the mortgage interest deduction) is a subsidy that has distributional effects, not “allocation of economic freedom” effects.
     2.) Repeal of the EMTALA also does not mean ‘freer’ markets unless you believe ‘pony up or die’ is a good social policy when doing triage at the ER admitting dock. Certainly such a market would be ‘free’ in the classical micro sense, but it’s hard to argue that it would be Pareto optimal!
     The law results in a subsidy to those not insured. The effects are, yet again, distributional.
     For some totally unknown reason, conservatives yell for “freer” markets in healthcare that would favor certain groups: Doctors, insurance companies, HMO’s/hospitals, medical device manufacturers, and pharmaceutical companies. I rarely see a conservative voice raised in disgust at medical and drug patents, for example. I never see conservatives arguing for subjecting doctors to the income leveling forces of globalization (Milt Friedman was an exception) as they so strenuously do when it comes to steel or auto workers.
     Insofar as they do this, they remain consistent in their goal to use government to intervene in the marketplace and tilt the playing field toward “producers”, i.e. their constituency.
     Like eliminating deficit spending, the conservative cry for ‘free market healthcare’ rings hollow.

205. I think that’s the appropriate level of regulation to apply. There is an anti-competitive behavior (rescission), and we can apply regs to directly penalize that behavior.
     Rescission is not anti-competitive market behavior. It is classic free market behavior as developed and applied in contract law. In health care, this is underwriting against pre-existing conditions by other means, and it contributes to the classic death spiral that results in only the healthy being insured….a market failure.
     You do not repair market failures by making them ‘freer’ in any commonly understood application of micro economic theory.

206. thompson,
     Think how boring these threads would get if we stuck to talking about the 90% of stuff that 90% of us agree on:)
     In the spirit of keeping things interesting, I will challenge your statement that

     Healthcare needs to be cheaper in this country …

     which may or may not be one of those 90/90 beliefs. Specifically, I challenge the notion that it is somehow more important to make “health care” cheaper than to make food, rent, energy, education, or “defense” cheaper.
     First, a trite observation: you can’t spend less on everything you buy and still “grow the economy”. But let’s not get hung up on what you’d rather spend your money on.
     What I want to emphasize is this: your “cost” is somebody else’s income, and vice versa. If we can contrive a system that lets all of us pay less for “health care”, then somebody’s income has to go down. Well, whose? Doctors? Nurses? Insurance companies? Drug makers? Whose income do you want to reduce? No weaseling, please, or I might begin to think that you don’t really want to see cheaper “health care”.
     –TP

207. Repeal of the EMTALA also does not mean ‘freer’ markets unless you believe ‘pony up or die’ is a good social policy when doing triage at the ER admitting dock.
     If I’m not mistaken, what thompson was calling for was federal funding of EMTALA. I.e., if somebody shows up at the ER and can’t pay, Uncle gets the bill.
     At present, it’s an unfunded mandate, and the cost gets spread around to the rest of us in less transparent ways.

208. Thanks, Russell, you beat me to it.
     Yeah, bobbyp, I think EMTALA should be federally funded, rather than the cost being shuffled around. Regarding your point 1, I don’t see the reasoning behind preferring one form of acquiring insurance over another. Especially one which reduces the number of agents in the market. Infinite buyers and sellers being one of the hallmarks of ideal “free markets”, I’m pretty much saying more agents can lead to a better approximation of the ideal free market.
     As to the rest of that post: If you run into any of this no doubt very homogeneous group of conservatives, tell them I disagree with them. Thanks.
     “Rescission is not anti-competitive market behavior.”
     I disagree, but we’re deviating heavily into semantics. Are you more comfortable with “undesirable market behavior”? I don’t think it changes my point, so, if it gets us talking the same language, let’s go with that. It’s still something I’d like to avoid, because, you know, market failure.

209. Tony:
     Perhaps I haven’t been entirely clear? As I and others have mentioned, insurance companies can engage in rent seeking behavior, in which they accumulate wealth without providing any value to society.
     This is not economically beneficial, I’ve been told by many smart people, but honestly I’m at a loss to explain it rigorously, so if you don’t believe me, that’s fine, we can agree to disagree. If you’d like to change my mind about rent-seeking and why it’s NOT bad, knock yourself out, I’ll listen.
     To step back from the abstraction and go down to how it affects individuals: It really sucks when the things you need are to expensive. If you don’t get that, I don’t know if I can help you.
     Life sucks if your poor. It’s hard. I’d rather rent, food, and healthcare were cheap so at least people can get by, even if they can’t have all the toys of the richest country in the world. Unless you have a plan where we spend more money on healthcare and suddenly there’s no more poor people, I’m going to go with healthcare should be less expensive.
     As to who should earn less, I don’t really care. I honestly don’t. And the beauty of an approximately free market is that I don’t have to decide.
     Did that answer your question?

210. Agh! Another worry I’m coming off snarky. No snark intended, bobbyp and Tony, just rushing.

211. I can’t comment on LJ’s open thread. Does anyone else have this problem? It says page not found.

212. lj:
     sorry, but I 1) am under 50; 2) have a smartphone and have owned a droid, iphone and now the Nokia 1020 (love the pics). I have had Dish for significant periods and miss the History channel; wife misses HGTV. This isn’t about me being out of touch and that’s my point. I cut Dish because a chose to buy, among other things, health care and max out my HSA. Thank goodness I don’t smoke, drink and cannot drink coffee or I’d be cutting other things from the budget too.
     I have great kids. I’d probably let them have a smartphone but for the cost. But virtually EVERY kid at our rural, podunk high school, where upwards of 40% of the families are on more than basic assistance, has a smart phone.
     bobbyp: Selling insurance across state lines. That’s one. And equalizing the tax treatment of employer-provided health insurance and individually-purchased health insurance. There’s two.
     Interesting you brought up 1965. Take a look at health costs since 1965. Or better yet since, say, WWII. There is a good argument to be made that the rise in health care costs is largely due to: 1) health insurance at all (and specifically to the tax-free status of employer provided health care plans leading to the large growth in insurance) and 2) medicare driving even more into health insurance (and, of course, the observation by some that medical providers make up the discounted rates on the paying public). The third-party payor model, IMHO, encourages overuse at both ends. And it is inefficient. Catastrophic coverage, OTOH, coupled with out of pocket for most routine care, encourages the opposite. That’s why I favor the HSA method. It still has third party payor for “big” stuff, but discourages overuse prior to hitting the full deductible.
     Health care was an “abysmal failure” prior to 1965? Really? Do you mean coverage? Good thing I was born after that (barely)!
     And I’d throw in as additional ideas taking a look at why we have to provide the “latest and greatest” across the board. And make everyone have an Advanced Health Care Directive so we don’t end up providing unwanted, expensive end of life care. Some simple things like that.
     And since a lot of the higher cost in the US is provider pay, take a look at that, too. How is the immigration policy on physicians? I know nurses get in fairly easy. Looks like there isn’t enough competition.

213. …I think EMTALA should be federally funded, rather than the cost being shuffled around.
     but, but, but…THAT is just shuffling the costs around to the general taxpayer instead of policy holders…the VERY THING you say you are objecting to.
     In principle, I don’t object to ‘shuffling costs around’. That’s what politics does. However, advocating this public policy as part of a general scheme to make the health care market more “free” doesn’t strike me as making much sense.

214. Take a look at health costs since 1965.
     Well OK. Here you go.
     You will notice that all OECD countries are experiencing increasing levels of health care spending. You will also notice the sorry state of the level of spending incurred by our system vs. others that rely much less on “free markets”. The graph mocks the whole argument that ‘freer’ markets will reduce levels of healthcare spending. It would seem ‘more competition’ raises spending.
     As for the drivers of those costs, click to chart #3. You might want to revisit your hypothesis.
     More competition for doctors? I’m with you on that. Another policy would be to let US citizens participate in other countries’ health care plans. Now there’s competition.

215. Selling insurance across state lines.
     The case for that claim is weak. See the following links:
     Ezra Klein, liberal, on why it’s a bad idea>
     Wonkblog questions if even insurers like the idea
     Kaiser Foundation looks at the issue.

216. High deductible plans as panacea? I see it all the time in conservative circles. It’s not so easy. Catastrophic care polices come in many varieties, but they all have one thing in common: Higher risk.
     For many, that risk is simply not worth taking. And wonder of wonders, that’s THEIR choice.
     And what do we do with those who cannot meet their very high pie in the sky deductible? Send them back to the ER? Have the government pick up the tab? Let them die?
     Back to square one.

217. bobbyp:
     Comparisons are useful, but only to a point. Those other countries keep costs down by rationing. We ration too, but not to the same degree.
     And I don’t disagree with chart 3, but how does that do away with my hypothesis? Part of the equation is we are obsessed with the “latest and greatest.” If we froze what we provided via public health care to what was available ten years ago, I’ll bet the costs would go way down. Same with preventing really expensive end of life care when the person might not even want it.
     Body scanners might end up being great preventative care and ultimately save money. But cutting edge costs.
     That graph in no way mocks free markets, because there was no free market in health care in 1970. Partly “free,” yes. But again, you had a skewed tax incentive by then plus Medicare that put the vast majority of Americans on third-party pay. And when the care doesn’t come out of your own pocket, the rationale response it to accept or demand more care. It is much easier for physicians to prescribe more expensive treatments.

218. “but, but, but…THAT is just shuffling the costs around to the general taxpayer instead of policy holders…the VERY THING you say you are objecting to”
     I believe that is an overly narrow interpretation of what I said taken out of the larger context of the conversation. As to why I think that, I refer you to my previous, much longer posts.

219. “Dubbed the SR-72, the twin-engine aircraft is designed for a Mach 6 cruise, around twice the speed of its forebear, and will have the optional capability to strike targets.”
     About time. Maybe now we won’t need predators in theater in order to assassinate people. We can hit anywhere in the world in 3 hrs.
     Kidding aside, that’s impressive. I have a background in aeronautical engineering, and hypersonics was fascinating. Thermodynamics become extremely important as the fluid properties change dramatically across the surface. In some cases, continuum mechanics break down completely and you have to start dealing with discrete molecules of fluid rather than assuming a homogeneous mass. Keeping an aircraft stable at those speeds…well, I knew very smart people that were working on it, and it didn’t look easy.

220. Laura:
     Laura, sorry, I missed your comment in the page shift.
     “I am puzzled by the belief that government will not do well at health care. Medicare is by far a better run insurance provider than any of the private companies. As I said earlier, I took a class in medical billing and Medicare was the one provider that didn’t deliberately try to stiff doctors on the payouts.”
     That’s a fair point. It’s not that I think government agencies are inherently inefficient. Nor do I think the average government worker is a layabout suckling on the public teat because they are bad at useful skills. But there are some big caveats to that.
     Probably the biggest one is that they have to work in the confines of the law. And the law is written by a group of people (congress) that are lobbied extensively to write laws like medicare part D. Resulting in staggeringly stupid policy (http://www.familiesusa.org/assets/pdfs/no-bargain-medicare-drug.pdf). I fail to see it as anything other than a check from the public purse to pharmaceutical companies, with a little garnish of helping the elderly.
     Perhaps I’m cynical, but I think it will happen again and again. And I think the way to limit this, is by limiting what the government does. Give agencies powerful, but targeted, regulatory capacity. Again, I’m talking broad, general policy. I realize that there is no single answer for every type of problem, but that’s kind of where I start from.

221. I am puzzled by the belief that government will not do well at health care. Medicare is by far a better run insurance provider than any of the private companies. As I said earlier, I took a class in medical billing and Medicare was the one provider that didn’t deliberately try to stiff doctors on the payouts.
     I’m curious how much of Medicare’s “efficiency” is really picked up by those with insurance and not on medicare. My wife was medivaced out (she’s fine) recently. 76 miles. Total cost? $26k. Insurance picked up all but the $2k. Medicare pays about $5k. Medicaid, $2k. And my $26k? What is that paying for? Hmmm.

222. Selling insurance across state lines.
     The case for that claim is weak. See the following links:
     Honestly, bobbyp, if those links constitute argument against selling across state lines, the argument is incredibly weak. Klein’s comments are, frankly, pathetic. Most assume that selling across state lines would require a national standard, so the race to the bottom arguments are irrelevant. Same with the Kaiser article.
     Wonkblog isn’t quite as bad. But Wyoming? Yes, let’s use Wyoming (less population than Alaska!) as an example of why it won’t work. Setting up networks would be a problem initially. I don’t see that as a long-term problem. What I find funny is the closet anti-federalists among the liberals arguing against it. And their arguments don’t make sense in light of the ACA. I’m quite clear that promoting this idea goes against my constitutional ideals unless it is accomplished through state compacts.

223. sorry, but I 1) am under 50;
     Well, you are doing a very good imitation of an old man yelling at kids to get off the yard.
     I don’t know how the smartphone market works in the US, but here it is very difficult to get a ‘dumb’ phone starting up. There are also lots of plans for families. Perhaps everyone in your “podunk” high school is a “hopeless moron”, but if it is a fact that ‘40% of the families are on more than basic assistance’, that suggests that the problems are a lot bigger than some damn kids and their damn smartphones.
     As for the open thread, I re-posted it, so I hope it works.

224. We ration too, but not to the same degree.
     Is this true?
     Do other countries ration everything more than we do? Or just some things? Which things?
     Assuming there is a difference in rationing, does it have any effect on outcomes?
     Are the things that other countries ration more than we do available through other means? In other words, can you purchase insurance that is more generous on a private market? Or, for that matter, can just purchase the rationed thing directly if you like? If so, how does the all-in net cost compare to us?
     Long story short, I think this is an assertion that deserves to be unpacked a bit before it used to make a case for one approach or another.
     “You can have a generic but not the name brand” is rationing, frex, but I’m not sure it matters to anyone but the guy selling the name brand.
     In any case, I can surely tell you that many forms of rationing are in force here, whether you’re insured on the public dime or not.

225. I posted these on the other thread Russell, but it seems relevant here. It looks like we have more *rationing* here than in most other OECD nations:
     http://content.healthaffairs.org/content/25/3/819/T2.large.jpg
     http://www.oecd-ilibrary.org/sites/health_glance-2011-en/04/01/g4-01-01.html?contentType=&itemId=/content/chapter/health_glance-2011-29-en&containerItemId=/content/serial/19991312&accessItemIds=/content/book/health_glance-2011-en&mimeType=text/html

226. bc, the efficiency I was referring to was the efficiency in paying for what Medicare pays for, which is a lot, but not everything.
     Of course, every insurance plan has things it doesn’t pay for. However, with private insurance the consumer is paying for advertising, lobbying, and higher salaries at the top and, of course, a profit, as well as whatever the contracted coverage entails. And then there’s the problem of the private insurer playing games with the payouts. (And I know that ALL private insurers don’t do this. But it is a real problem). With Medicare, the relationship between the money that goes in and the service that comes out is much more direct.
     There’s lots of things governments don’t do well, there’s things that are done best locally, at state level, or nationally, and things best done by a business. Running an insurance program turns out to be something the federal government is doing pretty well.
     BTW, to revert to a point I was trying to make long ago (and this isn’t a direct response to bc or anyone in particular) the House is working on a dishonestly labeled Healthy Forests and Healthy Communities Act which is a wholesale rape and pillage assault on our National Forests on behalf of timber corporations. Guess which party supports using our National Forests as a WPA project for people who chose to live in rural areas of high unemployment and as a corporate welfare project? In this case it isn’t just the hypocrisy and selfishness that upsets me; it’s the damage to our already raped and pillaged public lands. This is an example of why I just do not believe that that there is any principled opposition to the concept of subsidized insurance for low income people in the minds of Republican politicians who vote for a bill like that one. Or at least not the principles claimed.

227. Saying that kids who grow up in bad neighborhoods or with bad parents ought to not have healthcare, ought to suck up lead paint or lead exhaust, ought to get schooling later than their peers and of a substandard quality, ought to be racially profiles by the police, ought to suffer whatever job etc discrimination private employers choose to engage in, and *then* they’re responsible for being behind- this just seems cruel.
     Carleton, I actually think it is pretty much like animal cruelty. That is, the people taking those kinds of positions basically don’t see the children involved (or their parents) as real people. And, therefore, not worthy of concern and care.
     They may be quite giving towards their friends and neighbors. But the poor are not really on their personal radar screens, except as a drain on their taxes and a blight on the landscape. (In that respect, more like animals that are noxious pests than animals that are pets.)
     The irony is that they frequently think of themselves as good Christians. Even though the founder of their religion would likely rank them with the elites that he denounced.

228. http://missoulian.com/news/local/house-bill-forces-forest-service-to-cut-percent-of-timberland/article_cd605468-2218-11e3-a563-0019bb2963f4.html
     Here’s a link. It really is a horrible bill. And it’s totally a welfare project for corporations and a WPA project for people in red states or red Congressional districts. This from the same party that doesn’t want to fund infrastructure, education, or health care.
     Why not tell the unemployed of a small town rural area in the West to just go get a job? Aren’t they harmed by dependency on the government? Shouldn’t we assume that they lack character, make bad choices and so on? Shouldn’t we blame the deficit on them?
     This kind of thing just enrages me. I actually have quite a bit of sympathy for the displaced timber industry employee that can’t sell the house in the small town and can’t find a job that pays a living wage either. I would not mind using my tax dollars to fund infrastructure repairs that would bring good paying jobs to those kinds of places, nor would I mind funding quality retraining programs. And I don’t mind making affordable health insurance available for them which would make it easier to live on what jobs are available in the vicinity.
     I mind very much all this shit about supposedly caring about making the poor be independent and saving them from dependency when all that really amounts to is a rationalization for screwing over people who are already having a hard time on behalf of the real clients of the Republican party, the 2% who don’t need help but demand it anyway since, apparently dependency doesn’t harm them. .

229. Klein’s comments are, frankly, pathetic.
     Heh. At long last we get to the nub of the conservative case. Well played, sir.

230. Laura:
     I live in one of those rural, Western towns formerly dependent on the abundant natural resource around them, the forest. It is ironic that you would mock the dependence on federal government, the same government that locked up the land for national forests killing jobs. Of course, the federal government passed bills that promised to replace the lost local tax revenue via a percentage off of the sales of timber off of the national forests. But as time went on, those sales became fewer and fewer until the funding was non-existent. The fight now is for school and road funding from the feds as Secure Rural Schools funding is threatened each and every year.
     Locally, environmentalists and loggers came together to talk about their differences and presented a unified front supporting certain timber sales. The Forest Service signed off. But time and again, injunctions prevented even the wisest timber plans. Instead, unable to thin forests to get them back to their more fire-resistant natural state, most of my county burned down. (the way we fight fires-well, that’s another story).
     Reminds me of Alaska. Few go to the Arctic National Wildlife Refuge, but believe locking up this northern Shangri la is the only solution. Only it’s not really a Shangri la. It just looks like it in the pictures of what isn’t exactly typical of the refuge. Where oil was discovered originally due to natural oil seeps, the area is almost as large as Wisconsin and the flies will drive you absolutely nuts in the summer and actually change the migration patterns of caribou. Those that visit come away changed. (I think the NYT Kristof was the one that visited in the early 2000s and, while not converted to drilling, certainly had his views altered although he didn’t necessarily support drilling).
     I’m not sure why the irony of San Francisco getting all its water from flooding Yosemite’s twin comes to mind here. . .
     Don’t get me wrong. I’m grateful for environmental laws that stopped acid rain and that made LA almost breathable. I really am. The pendulum has swung in some cases too far. That’s all I’m saying.
     Laura, you think Medicare is “efficient” because money comes in and out efficiently. You ignore the cost of collection on the money coming in. It takes .30 to collect $1.00 of revenue for the feds. Coming in is NOT efficient.
     lj: Angry old man? I’m on the school board and that hurts! I guess being fiscally conservative is now angry? I don’t care about kids having smart phones per se. Look at all the jobs it has brought to China! And I know the local plans and how much it costs to have two adults plus a kid or two on the plan.
     I’m not getting the “hopeless moron” comment. I didn’t say that.
     We are building dependency on the government in this country and it ain’t pretty. That doesn’t mean I don’t empathize and even try to help those in need. I don’t pretend to have all the solutions. I’m not knee-jerk opposed to all ideas liberal. I don’t think I’ve said anything that should qualify me as being angry and frankly, that seems to be (not here necessarily) something I hear too much from my liberal friends. “Deeply concerned” would be more accurate.
     Now I’m going to cut down a Western Red Cedar to start my fires this winter. Don’t worry, the forest service wants me to cut down dead snags as it helps fire prevention. And I have an EPA-approved 70+ efficient wood stove that probably beats most of your oil burners out there. I’m going local driving my 1997 GMC Pickup with 252K miles that, according to a total life study, is the more environmentally conscious than buying a new Prius so long as it continues to run well. And I’m not going far anyway.
     Thought you would want to know.

231. Sorry, bc, you are absolutely right, that was I am no one. Apologies for the conflation.
     However, if your figures are about people on assistance are correct, I stand by my observation that kids on smart phones is not what you should be worried about. At any rate, isn’t that what the free market is about? That people should spend their money on what they want and companies should figure that out?

232. I guess I have a couple of comments about the “smart phone” issue.
     First, I can understand in general why it might be annoying for somebody receiving public assistance to be walking around with spiffy consumer electronics. It’s a not-hard-to-understand human impulse.
     I don’t have a smart phone, I have a very very stupid phone indeed, and it’s piggybacked on my wife’s plan so I don’t even know what it costs. So I thought I would go see what a cheap smartphone might actually cost.
     I don’t know if this is typical, but it looks like you can get a phone for under $100. Voice and text plans, $30/mo, add web access and it’s $50/mo.
     So, not nothing, especially if you’re crying poor, but also not remotely comparable to the cost of, frex, health insurance.
     What I’d add is that having a phone number and an email address is increasingly necessary for even the most common and basic things now, and that’s true no matter what your income is.
     In other words, having a phone that you can use as a phone and for basic data services like text and email is less and less a “luxury good”.
     So, there’s all of that.
     Above and beyond that, IMO it’s problematic to base eligibility for public assistance on things like not owning anything above some “essential” baseline.
     What’s the baseline? Can you have a car? How new of a car?
     Can you own property? How much property?
     Can you go on a vacation? Can you travel to see family? How far can you travel? Can you fly, or do you have to take the bus?
     Can you have nice clothes? How nice? A leather coat, or only cloth? What if you buy your nice clothes at the thrift shop? Do you have to demonstrate that with a receipt, showing what you paid for it?
     It’s not hard to see this line of thought devolving into something that is intrusive far, far, far beyond the most feverish liberal nanny-state dream.
     There is also an aspect here of wanting to use public programs to coerce virtuous behavior of one kind or another. That’s not an unusual thing, or even a bad thing necessarily, but it opens another can of potentially very ugly worms.
     Whose idea of virtue?
     How do we monitor this, to make sure no non-virtuous behavior is going on?
     Are poor people receiving assistance with health insurance allowed to smoke?
     Can they drink? How much can they drink?
     Can they eat candy, or bacon?
     How many servings of vegetables must they eat each day in order to retain their eligiibility?
     Can they engage in risky behaviors like rock climbing, or riding motorcycles, or playing rugby?
     Can we require them to exercise?
     How much?
     What kind of exercise?
     And so on.
     To say that it’s a slippery slope is kind of a vast understatement.
     I don’t know why a lot of kids in bc’s kids’ school are (a) on some kind of public assistance and yet (b) have smart phones. I don’t know how smart the phones are, or whether they’re new or refurbs or a hand-me-down from a better-off cousin. I don’t know if they’re on an expensive no-data-limit plan with unlimited web access, or if they just do voice and text, or even just voice.
     Net/net, I’m not sure it’s relevant to whether they should be eligible, via their families, for things like TANF or SNAP or whatever it’s called now, or subsidies for health insurance.
     The other thing I have a question about is the focus on wanting people to bear the consequences for their own actions and choices.
     We live in an environment where millions of people have lost their jobs and have lost significant amounts of personal wealth THROUGH NO FAULT OF THEIR OWN.
     Note my capitals.
     We live in an environment where entire industries that used to provide a path to self-sufficiency and some level of economic security have vanished, and are not coming back in any of our lifetimes.
     We live in an environment where income for 80% of the folks who do have jobs have been flat for a generation.
     There are a lot of people in this country who work hard, do all the right things, and DON’T HAVE A LOT OF MONEY. Many of them DON’T HAVE ANY MONEY AT ALL to speak of.
     I’m talking about personal wealth, the kind of money that will let you send a kid to college, or weather a five-figure medical bill without being tossed into bankruptcy.
     So I’m not sure how many hoops we should expect people to jump through in order to prove how deserving they are. I’m not sure what we can assume about people’s intelligence, or level of effort, or good faith, or whatever virtuous quality you care to name, merely because they’re poor.
     A lot of people have been royally rogered over the last 5, and 10, and 30, years. A lot.
     It’s really not hard for me to imagine somebody having a phone, and still not having enough money to pay rent, or buy enough food to get through the whole month, or buy health insurance.
     It’s also not hard for me to imagine folks skimping on something else in order to have the phone, because pretty much everything nowadays runs on the assumption that everybody has a mobile. Certainly, on the assumption that everyone has a phone number and an email address, and has access to the web in one way or another.
     So, it’s hard for me to say to someone that they can’t have any help from me unless they give up their phone. It seems petty, and off-point, and most likely counter-productive.
     The issues we’re talking about are pretty big. Maybe we need to not focus on whether the crap sandwich poor folks are eating is big enough for them to deserve a hand.
     A lot of folks are having a hard time. I’m not sure what else they should be expected to go through in order to deserve help from the rest of us.
     My opinion only, of course.

233. Hopefully, some of the kids with smart phones will learn to be smart phone app’s programmers.

234. is ironic that you would mock the dependence on federal government, the same government that locked up the land for national forests killing jobs.”
     I think the ironic position is yours-if I am understanding you. You say the forests were “locked up”–ie, not open for timber industry activity. The use of the term “locked up” only makes sense if you believe that the timber industry was entitled to access, which is dependency.
     Why is the government obliged to use a public resource to create jobs and profits? And why isn’t that dependency? And how does one reconcile supporting one kind of dependency, which is longterm and costly, with treating the small number of able-bodied but lazy people that hypothetically exist as if they were a significant factor in our federal budget?
     BTW the way, I, too, live in a small Western timber town. One year the timber company handed out signs for its employees to post that said, “This family supported by timber dollars”. I drove around with a black marker and changed dozens of them to read, “This family supported by your tax dollars.”
     But note the subtext of the timber company’s message: us taxpayers and co-owners of the National Forest are supposed to think that the families are owed a lifestyle supported by the rest of us.
     And you know what? I wouldn’t mind supporting them if the timber companies behaved responsibly, but that isn’t the history. The timber companies have behaved responsibly only when forced to do so by regulation. The way I see it, the rest of us are doing them a favor by allowing them to operate in our forest and if they don’t want to abide by regulations, they should get the hell off our land.
     Which is more or less the same attitude I have about FoodStamps: I am happy to supply them to people who genuinely need them and less happy to supply them to someone who doesn’t.
     But, contrary to the popular myth, people don’t live on Food Stamps for generations and how many years have we been supporting the timber industry?
     So I don’t get why the fear of the undeserving poor looms so large in some people’s imaginations, when corporate welfare isn’t seen as a dependency and an imposition on the rest of us.

235. thompson: As to who should earn less, I don’t really care.
     If you really don’t care, then you should be OK with the “public option” that Obama gave up on because “conservatives” hated it. They hated it because, they said, it would bankrupt honest, hard-working, private-sector insurance companies. That would happen, they said, because The Government could charge people lower premiums, and force providers to accept lower prices, owing to its vast purchasing power. Meaning: the “public option” would CUT COSTS.
     For all I know, you would object to a “public option” on OTHER grounds. But then “cutting costs” would not really be your most important concern, would it?
     Alternatively, maybe you might deny that a “public option” would actually cut costs. But then I’d ask you to go argue with the people who opposed it because they claimed it WOULD.
     bc: If we froze what we provided via public health care to what was available ten years ago, I’ll bet the costs would go way down.
     Why stop at ten years ago? Why limit it to “public” health care?
     Suppose we gave The Free Market its head, and allowed it to offer you and your family Old Tyme Medical coverage. Premiums on a sliding scale, based on how recent (or ancient) the medical care it covered. You could probably buy a policy that stopped short of MRIs or arthroscopic surgery for a song. You could probably get a policy that stopped short of X-rays or antibiotics for peanuts. It would be your choice. Just for curiosity: what cut-off would YOU go for?
     –TP

236. Tony:
     If I run into someone that opposes a public option on the grounds that it cuts costs, I’d tell them I didn’t think much of their reason. Perhaps I’m just staggeringly lucky, but I’ve yet to meet someone who has made that argument. Maybe I just don’t watch as much Glenn Beck as you, I don’t know. Maybe you should be having that conversation with him?

237. Laura:
     “There’s lots of things governments don’t do well, there’s things that are done best locally, at state level, or nationally, and things best done by a business.”
     We pretty much agree here. No point, just like finding common ground.
     Regarding the timber thing, I’m not well versed on it and I’ll try to learn a little more. I’ve been holding off responding until I’ve had time to do reading…but I haven’t found it yet. If it’s as you describe, yeah, that’s the sort of thing that angers me as well. Resources owned by this nation should be maintained properly, and if sold, sold at a fair price.
     Of course, these kind of things also leave me with a deep mistrust of government…which is I think where we part ways. But it was a fun stroll with you while it lasted. 🙂

238. Russell:
     I want to second this:
     “It’s not hard to see this line of thought devolving into something that is intrusive far, far, far beyond the most feverish liberal nanny-state dream.”
     This is where I come down on it. I don’t think central authorities are good at determining what people (or markets) need. Leave it to them to decide. If they screw up there life, its on them. But lives get screwed a lot of different ways.
     I’ve known people with zero economic security. Some of them piss it away. Some of them were dealt a raw hand. Most were a combination of both.
     I’m not one to shed many tears if someone, through their own irresponsibility, ends up in a bad place, struggling to make ends meet. But I also know that being poor is trap that is almost impossible to get out of.
     Can’t fix your car because you don’t have money? How are you getting to work so you can get the money? Too bad, you’re fired.
     Need money because your kid broke their leg? If it could wait 4 days until your next paycheck, you’d be fine. But it can’t, so you get a payday loan. And interest takes a bite. Now you’re behind on your rent.
     It’s a cycle that you can’t really get out of unless you are hardworking, dedicated, optimistic, and damn lucky.
     But how do people get into this mess? Is it there fault? Was it out of their control? Did they need that soda? Should they really be eating at McDonalds?
     Those are questions I don’t want to ask. Because I can’t sit in judgement. For so many reasons, moral and practical. So we either let them rot or we don’t. If we want to provide them food or health assistance, then we provide them food and health assistance. And if they have an xbox, bully for them and I’m glad they bought from an american company.
     Regarding the phone thing, one of my family members does some work at a food bank. The homeless who come? All have phones. Maybe if they didn’t have phones they could afford rent, but I doubt it.

239. “Of course, these kind of things also leave me with a deep mistrust of government…which is I think where we part ways.”
     Not necessarily. The reason for the historic pattern of mismanagement of the National Forests is because governments can be subjected to undue influence from powerful forces. Managing a resource for multiple goals within the framework of the long term good is something I would not expect a government to be good at–because powerful interests focused on the short term benefits to themselves get too influential.
     Only the other hand I do think government does better at delivering services where the market and the profit motive don’t really apply. Public education, metal health services, National parks…

240. thompson: Maybe I just don’t watch as much Glenn Beck as you, I don’t know.
     Last time I (accidentally) tuned to Glenn Beck, it left a stain on my TV screen. And it sounds like you have no more use for the little twerp than I do. Good.
     Now: can you please be explicit? Did you, yourself, oppose the “public option”?
     If so, why?
     –TP

241. The homeless who come? All have phones.
     would it be better if they had land lines? or no phones at all?
     a basic phone plan is cheaper than a monthly bus pass, at least here in Boston. It’s about 2% of the cheapest bare-bones apartment rental around here, so no phone will DEFINITELY not get you into an apartment. it’s cheaper than groceries.
     it’s a freaking telephone. it’s not an exotic luxury good. it’s virtually impossible to navigate daily life in the current-day US without access to a phone.
     there are people who are homeless who have jobs, who have cars, who are raising kids. does that surprise you?
     housing is very expensive in a lot of markets. phones are pretty cheap. it should come as no surprise to anyone that there are homeless people and/or people who frequent food banks, who also have cell phones.
     I’m just not getting the obsession with mobile phones.

242. Lessee’ here…a decent 2-bdr. apartment goes for what in Boston? $1,600 a month for a family of 3-4? So obviously, the poor must put aside everything to make that nut…but you know what? They still come up short. If you’re making 16k a year, it’s simply not possible.
     According to our good conservative friends, these folks must therefore give up everyfnkinthing…even if doing so doesn’t get you there.
     This is perverse. It is evil.
     I have in-laws in the Yakima valley who are simply enraged that ‘mexicans’ are running around with government issued cell phones. Their tax dollars, theirs mind you, are paying for this ‘luxury’. The luxury of the cheap fruits vegetables they eat is conveniently forgotten.
     These are the same folks who cheered lustily when George W. Bush piled up a trillion or so of our tax dollars and lit it on fire to invade Iraq.
     I find lectures from them on public spending probity less than persuasive.

243. If there was such an item as a combination mobile phone/semi-automatic weapon, the uproar would die down, I expect.
     Maybe a smartphone/semi-automatic weapon/rice cooker.
     You’d have to be careful which end you talk into though.
     Not so for the person spotted buying boneless pork chops with food stamps. We can’t have that.
     There are no payphones to be had.
     Many homeless shelters boot single men and women out during the daylight hours. The line forms in the evening and maybe it doesn’t hurt to have a phone to call around regarding availability.
     Some of the homeless are veterans who need to call the VA to make their appointments and pick up prescriptions.
     Others have to check in with their parole and probation officers, or maybe their social workers, under pain of being forced into a home at the county jail.
     I’m sure the poor on public assistance who have shelter of their own also have computers and various tablets, at least for their kids, purchased with credit cards, as I’m sure their phones are too.
     Good luck looking for and applying for jobs, which is required if you are receiving unemployment compensation, without a phone or a computer.
     And speaking of unemployment compensation, good luck applying for it and checking in weekly without some sort of internet device.
     The office hours are sharply curtailed and if you are fool enough to show up in person every week, THAT will be your life — standing in line, probably to be turned away before you can complete your business.
     Budget cuts don’t you know. The government operates more and more online, just as businesses do.
     Must get those headcounts down so we have even more unemployed folks to bug about their phones and their foodstamps.
     As to kids having smartphones, surely this will allow them to keep abreast of technology for their future job plans. I expect the parents do without elsewhere to afford the things, though I’m not sure having one before a kid is say, 14, is a great idea generally.
     Many kids in poor families, especially single-parent families, are latch-key kids.
     Phones are security for the parents and the kids.
     Too, a smart phone is status for kids now. That sounds shallow, but think of the ONE THING you wanted as a kid that maybe your parents couldn’t afford but would find a way to procure for you.
     I wanted “Rubber Soul”. Today it’s a phone.
     They do without elsewhere.
     I’m sure many kids from poor families have chores or even off-the-record part time jobs too to help defray the expenses.
     Poor parents can be task masters too, even if they are on public assistance of one kind or another.
     I expect the games and music apps that come with phones actually save parents money because their kids can listen to lots of music for next to nothing and they don’t have to purchase video games.
     NETFLIX is a cheaper night out than the $8 matinee with the $7 popcorn and $6 canister of sugar water.
     Good luck communicating with more and more schools on grades and events without some sort of internet device.
     Having said all that, I hate cellphones and smartphones. I have a dumb one, though it has buttons and commands on it that seem smarter that I am.
     Watching others poke away at their smartphone keyboards makes me realize that the evolution of the opposable thumb has found its endgame.
     Sometimes I push the wrong button and I stare at the screen like a chimpanzee, trying to decipher exactly what it is this thing wants from me.
     A New Yorker cartoon not along ago depicted people walking every which way through a city square, each and every one of them with their heads-down and eyes glued to the screens of their smartphones in one hand, while each and every one the leash of their seeing-eye guide dog with the other, so they didn’t collide with other.
     I was watching a British detective series on Netflix the other night that was place in the 1960s and it’s amazing how they got along with very little in the way of communication devices.
     But they did.
     From my perspective, I see the convenience aspect of cellphones but I think the productivity aspect is over-rated. I expect it’s just one more thing to have one’s boss be on your case constantly or to have the employee constantly tethered and dependent to the employer.
     Hot air.
     Now get off my lawn and take your phones with you.

244. Say a homeless person gets his or her act together and can afford a place to rent.
     The landlord says: “Where can I reach you?”
     What’s the homeless person supposed to do, tell the landlord he’s only accepting messages via carrier pigeons or request a smoke signal with the details be sent up in the direction of the park where he sleeps?
     This has been a good thread by the way.
     bc is always a good read, as is fuzzy face, and thompson is a welcome addition.
     Nevertheless, what russell said.

245. Russell:
     Perhaps you missed my point. It was that cell phones are ubiquitous and cheap. So much so that people that have no home still have phones.

246. Apparently my unclear statement set off quite the firestorm. I apologize. Phones are cheap, get over it. Clear?

247. No problem, thompson.
     I’m ranting at all of those other people who don’t show up here, probably because they are in Congress cutting food stamps, and who have a problem with the homeless having a phone.
     I’d call them personally and yell at them, but then I’d go over my minutes.

248. “Now: can you please be explicit?”
     Tony, to be explicit, you didn’t ask me that to begin with. You presented me with a hypothetical argument I’m having with some position, not your own, that you described.
     I’m against the public option. Because I don’t think it will work. Medicare part D is an example why. I don’t disrespect people who do think it will work. I’m just far more cynical, I suppose.
     Explicit enough?

249. I’m just not getting the obsession with mobile phones.
     It’s the latest example of 2 minute hate in the conservative echo chamber. There actually is a federal program that subsidizes cell phones for the poor who qualify. Here is but one example of this hate.

250. I think my key statement was this:
     “Maybe if they didn’t have phones they could afford rent, but I doubt it.”
     Doubt being the operative word. I was gently (apparently too gently for everybody here) mocking the concept that someone was homeless because they chose a phone over rent.
     Oh well…sorry about that. I don’t post much online, don’t quite have a handle on how tone carries through.

251. Oh well…sorry about that. I don’t post much online, don’t quite have a handle on how tone carries through.
     Even disregarding Poe’s Law that is a very common problem even for frequent posters. Unless one knows each other very well (and sometimes even then) irony often is taken for a serious opinion and vice versa. Irony tags are so clumsy and there is no designated irony/sarcasm/snark font.

252. Perhaps you missed my point.
     I did, my bad. Sorry thompson!

253. I had relatives in the Wenatchee area who were obsessed by the fear that the undeserving poor were getting Food Stamps. They raised apples with the help of Bonneville Power. They lived in the part of the state where timber companies got subsidized access to public land and wheat farmers got help of various kinds. The biggest employer was government: state, local and federal. The discretionary money earned by those employees kept all of the other local businesses going. And yet the bitching was endless about taxes and it was always in the context of unnecessary wasteful big government programs and the legions of undeserving poor. Red part of the state, of course. Ironically, heavy on “Christians”. All living in an economy that wouldn’t exist if it weren’t for government programs. Which I guess they thought someone else should pay for.
     It isn’t the dependency that bugs me. It’s the hypocrisy and selfishness and dishonesty. Welfare is mostly a short term thing and relatively inexpensive in terms of the overall federal budget, and, while there is probably a cheater here and there, the great majority of recipients have genuine need for legitimate reasons.
     I don’t mind paying taxes to support Republican voters in red sates dependent upon government programs for their economic life. I do mind the voters living in such a dishonest and self-serving mythos.

254. Medicare part D is an example why.
     OK then. Why?

255. Russell: I really should have been more clear. I left my point as ‘self-evident’ in a thread arguing about that point. But it did lead to some great rhetoric. I give Count 5 stars. I especially like the flawless combine of homelessness, 1960s detective shows, and the burdens of being overlly connected into a single rant.

256. Thompson, it was bc, another (professed?) conservative who started the discussion about smartphones and that is who folks have been addressing, I think.

257. LJ:
     I’m aware. I wasn’t criticizing russell for talking about phones. I was remarking on my inability to indicate what side of the discussion I was on.
     I’m fairly certain russell directly quoted me, but misunderstood my (entirely unclear) point.
     The timing and the mention of the homeless, which I brought up, suggests to me that the other comments were also directed at least partially in my direction.
     I’m sorry if this got a little out of hand, I’m certainly not trying to disrupt the very same civil discussions I came here for.

258. Laura:
     Cheap and warranted matches my view on many of the safety net programs, as well. Deserving/undeserving I think are pretty meaningless at the bottom rungs. Not many people “deserve” that life, and I can’t imagine many people who are suited to make that judgment.
     I’m curious about your view on education being something the government does well. I personally have mixed views on this. I think the government does some things regarding education well, others not so much. What do you like/dislike about education?

259. bobbyp:
     I think Part D is an example of a heavily lobbied law that isn’t in the public’s interest. I think it’s a soft form of corruption that resulted in the government overpaying for drugs.
     I believe, perhaps cynically, that a single payer system would not be immune to such lobbying. Sooner or later, it would become another trough of money for lobbyists to feed at.

260. I’m fairly certain russell directly quoted me, but misunderstood
     yes, that’s correct.
     bc initially raised the phone issue, i mis-read thompson’s comment to be an additional post along the same lines.

261. thompson,
     You are quite right: Part D was so transparently a give-away to Big Pharma that the Republicans had to hold a 15-minute vote in the House open for 3 hours so that they could strong-arm (“lobby”, if you prefer) a number of Republican members into voting for it. Never mind that it passed by the sort of “mere” majority that conservatives (claim to) hold against the ACA. The point to note is that it was Republicans who lobbied for the giveaway to Big Pharma.
     So, okay, “Republican” does not equal “conservative”. But was the Republican opposition to allowing Medicare to negotiate prices a liberal position?
     A single-payer system would, as you say, “not be immune to such lobbying”. Doctors, hospitals, drug and device makers — all of them would be lobbying for a bigger cut of “health care spending”. And history shows that they would succeed, if Republicans were in power. The only recourse the electorate would have — the only way the general interest could prevail over the “special” interests — would be to vote Democrats into office. And to replace them with better Democrats, if the original crew proved too compliant to the lobbyists.
     Here in America, the ultimate “lobby” is the electorate. By all means, keep trying to convince people that they will be better off if they let private-sector insurance companies do their haggling for them against such special interests as doctors, hospitals, device makers and Big Pharma. But keep in mind that health insurance companies are a “special interest” too, and they are as likely to “capture” regulators as any of the others.
     –TP

262. what i never understand is why people think the government is prone to corruption inefficiency and incompetence, but the private sector never is.
     that does not match my experience of the world, at all.

263. What I like or dislike about education, Thompson, would require far more attention on your part than you would want to give! I’m a former special ed teacher.
     It isn’t that I don’t think the private sector can provide good schooling; some private schools are awesome. I just don’t see privatizing as being a miracle cure, and I do see really significant problems with the way privatizing is being done in various places. Ohio, for example, is a hotbed of corruption, and the South is full of crazy schools teaching a Medieval curriculum.
     One fundamental problem I see is this: the mistaken assumption that schools have the god-like power to affect positive outcomes and therefore are a failure if the students aren’t at grade level. The reality is that schools are, at most, one third of a partnership in affecting outcomes and far less influential than parents.
     Another mistaken assumption is that the outcome of an education should be grade level academic skills. That’s a snobbish attitude, really, since it assumes only one kind of success is valid. Not everyone is academically inclined. The person who becomes a successful hairdresser or car mechanic shouldn’t be an example of school failure just because he or she didn’t learn to read at twelfth grade level.
     I’m hyper-conscious of this because I taught the kids that got kicked out of other people’s classes. The ruthless, destructive assumption that there’s only one kind of success and one way to measure it doesn’t just destroy schools; kids get ground to a pulp too.
     But bottom line, since we’re all in this together, I do think that it is an essential function of government to provide an opportunity to learn what a person needs to know to be a functional citizen and to be successful at some legal occupation which matches the student’s talents and interests.

264. I just wanted to share this awesome rant:
     “Enough is enough,” says Jason R. Thigpen – formerly a Republican candidate seeking election to the U.S. House in North Carolina’s 3rd Congressional District. “After discussing it with my wife and family, I’ve decided to run as a Democrat rather than a Republican. I simply cannot stand with a Party where its most extreme element promote hate and division amongst people. Nothing about my platform has, nor will it change. The government shutdown was simply the straw that broke the camel’s back. I guess being an American just isn’t good enough anymore and I refuse to be part of an extremist movement in the GOP that only appears to thrive on fear and hate mongering of anyone and everyone who doesn’t walk their line. We’ve received some wonderful support by numerous leaders and members within the NC GOP, as the vast majority of Republicans are wonderful, hard-working people that don’t agree with those radical nut-jobs either but unfortunately the extremists in the party, with their ‘burn it all down’ philosophy, appear to be the ones turning out the majority of voters in the primaries and mid-term elections. And I want the people to know there is a choice.”
     And a bit more of his diatribe:
     Thigpen further explains, “I didn’t go to war to defend the liberties and freedoms of one Party, race, sex, or one income class of Americans. Whether white, black, Hispanic, Asian, man, woman, gay, lesbian, straight, rich, or poor – we fought together as equals, side-by-side for the benefit of every American in the same. So, to come home from serving our country and see North Carolina legislators using their super-majority status to gerrymander districts and pass a law to deliberately suppress and oppress the voting rights of Democrats but more specifically minorities and college students, is absolutely deplorable. This same group of spineless legislators piggybacked a motorcycle safety bill with legislation intentionally geared to shut down women’s health clinics because of their ‘right righteous’ beliefs on abortion, while then cutting funding to the programs which help feed and provide healthcare to the babies they invariably forced the same women to have. Sounds like the Christian thing to do, huh? These legislators, acting under the guise of the religious right and morality believe themselves to be the divine judge but according to the Bible, there is only one judge. They say they’re for a smaller government and individual rights while pushing legislation for more government intervention and regulation usurping our right to choose for ourselves. They take money away from the public school system so they can call it broken, only to give the money to their charter schools that are really private schools, just so our kids don’t go to the same school as theirs all the while giving some great speech trying to convince us it isn’t segregation. Right. But all along, they seemingly want you to believe that you have a choice – like ‘cake or death.’
     I copied it from the Washington Monthly, which has a link to the primary source.

265. I believe, perhaps cynically, that a single payer system would not be immune to such lobbying.
     That assertion alone kills single payer? You must be kidding. Our current ‘free market’ system is riddled with policies that are the direct result of ‘lobbying’: Part D prohibition of lobbying about drug prices; limited competition among doctors; the constrained supply of doctors; medical equipment patents; pharmaceutical drug patents; paying for medical services via the intermediation of a limited number of private for-profit insurance companies, fee for service delivery vs. fee for outcomes delivery; trade and immigration policies that close the door to available medical services at lower cost.
     Your implication is that somehow “free markets” would be less susceptible to “lobbying” which overlooks the fact that “free market” policies are themselves the result of ‘lobbying’ the government.
     Insofar as so-called free markets are themselves the result of social agreements on how to do things, the assertion you have made strikes me a self refuting.

266. “would require far more attention on your part than you would want to give”
     You’d be surprised.
     “I just don’t see privatizing as being a miracle cure, and I do see really significant problems with the way privatizing is being done in various places.”
     To be clear, I don’t think privatization is really the answer. Mostly because its to expensive. People can’t afford it. As I believe a person’s value isn’t determined by what tax bracket they are born into, I think schooling is a really important function of government.
     Also, as a general rule (I have lot’s of those): There is no such thing as a miracle cure.
     “Another mistaken assumption is that the outcome of an education should be grade level academic skills.”
     Couldn’t agree more. I think the obsession with metrics hurts in other ways too. I think you can have students that aren’t performing on their tests for whatever reason, and they just continuously get shuffled lower and lower, with the message always being: you couldn’t succeed.
     A real eye opening experience for me was tutoring to help pay for college. I was a TA/tutor (I think the title was “peer instructor” or some bs like that) in remedial pre-algebra class for a few semesters at a local CC. What struck me was how many of them had already given up. They were bad at math. They failed before and they would fail again. It saddens me to think that that’s probably what they had been told through high school. They got behind the curve and I doubt anybody was interested in helping them catch up. A lot of them were really bright too, given half a chance.
     Education is a problem I just don’t see easy solutions for. I’ve seen some pretty terrible public schools so I wouldn’t go as far to say the government has been a whiz-bang success…I just don’t see great options out there. I am a firm believer in education (not just math) being a route out of poverty, and a great equalizer of opportunity. Again, no miracle cures, but whether it’s shop, STEM, or the arts…education is important.

267. “what i never understand is why people think the government is prone to corruption inefficiency and incompetence, but the private sector never is.”
     Perhaps I should clarify my view, than. I think POWER is prone to corruption, regardless of the source. I think private industry can get strangleholds on markets, or cities, or what have you, and that does destroy people’s lives.
     I also think that overbroad government powers are prone to corruption. I think government dollars are frequently spent based on political favors rather than public needs. I think Laura’s done a good job pointing many examples out, I suppose I could dig up more if you want me to.
     I don’t fear inept government employees. Hell, I like my DMV. It’s collusion between the government and industry I worry about.

268. Well, I gave up on math. I don’t blame teachers–they tried. I am just not good at math. When I took the GRE’s to get into grad school I scored above ninety in two sections and thirty-three on the math section. I took remedial math in college, too. I just don’t have that kind of mind.
     I only have one regret about my lack of math ability: I wanted to major in biology, with the goal of becoming a wildlife biologist, but was unable to succeed in chemistry. I was also disheartened by the amount of math required in the intro to ecology class. Maybe I wouldn’t have made a good wildlife biologist after all. I got a degree in art instead, and I am successful. Math, as it turns out, isn’t important to my pursuit of happiness.

269. “The point to note is that it was Republicans who lobbied for the giveaway to Big Pharma.”
     You may be interested in political score-keeping. I am not. I don’t see the point and bluntly I think it’s toxic. You disagree, that’s fine, but I’m not going to engage with you about letting the wrong lizard win. I appreciate your understanding.
     Your answer is to simply elect better people. While that is no doubt a novel idea that no one has considered before, I guess I’m left with the concern that someday a worse person will be elected. Freedom requires constant vigilance, and all that, but time and time again through our history, we’ve elected people who are ineffective, corrupt, or both. I see little evidence that we can keep such people out of office.

270. bobbyp:
     That post is really meta for me. The “free market” lobbies for protections against “free market” forces, which are obligingly provided by the government? Was that the gist? If so, I think we pretty much agree.

271. I guess I’m left with the concern that someday a worse person will be elected.
     So am I. And I know HOW that can happen, because I’ve been keeping score since the days of Nixon.
     You are of course free to ignore history if it seems too much like “score-keeping” to you. Good luck with that.
     –TP

272. “Good luck with that.”
     Thanks!

273. what i never understand is why people think the government is prone to corruption inefficiency and incompetence, but the private sector never is.
     The thrill of taking orders from the son/daughter of the Founder is unmatched in its awesomeness of LIBERTY due especially to their bootstrapeage and the nonstop admonitions to the employees about ‘merit’…as these Galtian paragons have, for the most part, followed exactly in the footsteps of Horatio Alger by either being sired by or marrying into the wealth and power of those of whom it has been said, “Behind every great fortune is a great crime”.
     There can be no greater social virtue than being born to wealth and informing those not similarly bestowed to know their place.
     That our law genuflects to this wisdom should not come as a surprise.

274. The “free market” lobbies for protections against “free market” forces, which are obligingly provided by the government?
     the issue here is that ‘the free market’ doesn’t do anything. there is no person or organization, with any agency at all, known as ‘the free market’.
     ‘the free market’ is a term that is used to describe lots of people buying and selling goods and services. saying that ‘the free market’ does X Y or Z is like saying that ‘turbulence’, or ‘the weather’, or ‘brownian motion’ does X Y or Z.
     it’s a description of what a particular complex system does when left to its own devices. it has no agency, or intent, it’s just the result of a million individual micro-level actions and decisions by people who are not acting in anything like an organized fashion.
     whatever ‘organization’ exists there emerges spontaneously.
     that’s what the free market is. in principle, because it doesn’t exist in the wild.
     individual actors, acting in the context of a market that is more or less ‘free’ in the academic sense, will *always* do whatever they can to further their particular interest.
     if lobbying for regulations that favor their interests is possible, they will more than certainly do that.
     so no, the ‘free market’ doesn’t lobby for protection from market dynamics, individual actors do.
     Freedom requires constant vigilance
     that’s a nice sound bite, but in context i have no idea what it means.
     if the solution is not ‘to elect better people’ i’m not sure what’s left.
     fine, you’re eternally vigilant, but once your eternal vigilance spies a problem, what do you actually *do* about it?
     you can elect better people, or you can start shooting. historically, i think we’ve gotten better results from electing better people.
     YMMV.

275. I don’t think you could have a free market without government setting some ground rules. Otherwise you’d get Lord of the Flies followed by Monopoly.

276. Ugh. I give up. Russell, through no fault of your own, you missed my point.
     “Free market” was in quotes because I was responding to bobbyp’s post and I was trying to match his usage, which I understood to mean private industry.
     Everything else regarding that, yeah, pretty much. Industries will lobby the government, because it is in their best interest. All I was trying to get at was if that was his point, yeah, I agree. They will. If that wasn’t his point, than I don’t know if I agree or not.
     The second part deserves elaboration.
     Tony suggested “Elect better people.” I think that’s great and all, but I’m somewhat at a loss to you think people have been trying to do all these years. Elect bad people? Or just trying and sometimes failing to elect good people?
     If I knew we could reliably elect brilliant, honest, hard working politicians every time, this would be a very different conversation. Historically, we haven’t. I don’t think we ever will. Maybe we get lucky occasionally, but I don’t see any indication that we are trending towards a set of great politicians.
     You trimmed my quote a little from: “Freedom requires constant vigilance, and all that, but time and time again through our history, we’ve elected people who are ineffective, corrupt, or both.”
     My point, apparently poorly made, is that you can’t rely on always electing someone good. There is no amount of effort, or education, of insight that will get you good candidates every time. My point is there is NO SUCH THING as eternal vigilance. We, the voters, will fail. Maybe not this election, maybe not the next, but sometime. I’m sure you can think of current and former presidents/senators/representatives that you think were incompetent, dishonest, and/or corrupt. If you can’t, I’d ask you why our government shut down a few weeks ago.
     You asked what we do. We limit and balance their powers. Those concepts are entrenched in the constitution. We do our best to elect good people, but we have checks and balances and oversight and hearings and etc etc etc. If you don’t think our elected officials should have limited powers, we don’t have much to discuss (I don’t think you are saying that).
     “you can elect better people, or you can start shooting”
     Fantastic. I’m going to suggest a third path. It’s crazy, but I have some hope it will work. It’s that regardless of who gets elected, I can suck it up, realize that no single official can destroy the country, talk calmly and reasonably with people who disagree with me, and vote in the next election. And the one after that. And the one after that.
     I’m guessing that’s what you were actually suggesting.
     Russell, I’m not an anarchist. I don’t believe corporations have anything other than their interests at heart. I’m not advocating the violent overthrow of our government. I don’t think my comments thus far have suggested otherwise. Can you, perhaps, give me a small bit of latitude if I am not entirely clear when I’m responding to four different people?

277. Laura:
     I agree with your 10:58. If I ever led you to believe otherwise, I apologize. If that wasn’t direct at me, but simply an observation, I think it’s a good one.

278. Can you, perhaps, give me a small bit of latitude if I am not entirely clear when I’m responding to four different people?
     Irony is hard to read on the webs. It will take a little time for us all to dial in your tone.
     All of which is to say, sorry for not grokking, thanks for the reply spelling it all out, everybody’s got their own style and I’m sure over time we’ll get yours and you won’t have to spell everything out all the time.
     Glad to have you on board.

279. Math, as it turns out, isn’t important to my pursuit of happiness.
     It only seems that way to you because you are unable to calculate its importance, Laura.

280. Russell:
     I’m hard to grok, even in real life. I get that my tone needs to shift to be more explicit on the web. It’ll take me some time to adjust. I want to reiterate, I’m not feeling picked on and abused, but I do appreciate your (and everybody else’s) understanding as I do that.

281. Oh I don’t think you need to apologize! I kind of got lost about who said what, too. I often make a comment that is just sort of a general response and not a response to anyone in particula.r.

282. Ah, well, I misunderstood. But I do agree, there needs to be some framework for markets to exist in.
     Set a currency, at the very least, or I’d never be able to get medical care. I ate all my chickens.

283. The invisible hand strikes again.

284. TPM has confirmed two specific examples where companies contacted their customers prior to the marketplace’s Oct. 1 opening and pushed them to renew their health coverage at a higher price than they would pay through the marketplace. State regulators identified the schemes, but they weren’t necessarily able to stop them.
     It’s not yet clear how widespread this practice became in the months leading up to the marketplace’s opening — or how many Americans will end up paying more than they should be for health coverage.

     Sounds like a thorough special investigation. But stay tuned!

285. any is too many. and humana’s a big player.
     and yes, i will stay tuned.

286. Not being critical of you, russell; just of TPM’s reporting.
     Which is IMO more of a talking-points memo than it is news. Hence the name, I guess.

287. no worries slarti.

288. i trust that the good men and women of our honorable insurance companies would never do anything that would put increased profits ahead of the financial welfare of their valued customers.

289. bc initially raised the phone issue,
     and I’m almost sorry I mentioned phones. I’m not dying on the smart phone bridge. It was a real example but one of many (direct tv, booze, cigarettes, etc.) and thus also symbolic. So there. 😉
     It’s not hard to see this line of thought devolving into something that is intrusive far, far, far beyond the most feverish liberal nanny-state dream.
     Exactly. I never advocated using any sort of “smart phone” metric in actual life (or if I appeared to do so I take that back). Here is the short me: I’m ok with providing “health care” for those that cannot afford it. That means their marginal expenditures are for sustaining life. I put “health care” in quotes because I probably differ from many in terms of the scope of coverage. I’m not really ok with providing health coverage for those that can actually afford to purchase it themselves but buy other things that are not necessary to sustain life. I’m actually a bit more into the gray area of providing help, but philosophically that is basically where I am. Real world implementation can be a bugger. Just ask Sebelius.

290. Hills and bridges. Skimming back through the comments, it’s surprising how often people (frequently me) have refused to die on particular hills and bridges.
     No point, but martial metaphors keep coming up in political discussions.

291. Russell, regarding your “any is too many”.
     Why is “any too many” for corporations, but government corruption is fixable? I mean, I can give you examples of government failures, but you would likely jump on me if I said “ANY example of government failure is too many.” And you should. No system is perfect, it’s about getting the best result possible.
     And please don’t take this as snark, there are a lot of differences (you can’t vote for corporations except with your purchasing decisions, etc etc).
     I’m just curious why two examples (and I get there is more out there, two just surfaced) of corporate malfeasance are not allowable. But government dysfunction and corruption (e.g. shutdown, Iraq, part d, mineral rights, timber apparently) gets the response of elect better people or start shooting.
     Note, to be clear, I’m not saying corporate malfeasance should be allowed, encouraged, is actually for the benefit of society, or is in any way ‘ok’. But you asked previously (and I paraphrase, I can’t find the comment, so maybe I’m just misunderstanding) why people are skeptical of government competence/honesty but have faith in private competence/honesty. I guess I’m wondering why people have faith in either.
     Note, to be clear, that’s not to say I want the government to disappear. No pig’s head on a stick for me. Nor do I want it to be weak. A weak government gets you nothing except a tax bill and some make work. I just want it to be *limited* in scope because powers the government doesn’t have can’t be sold to the highest bidder.
     That’s not to say there isn’t A LOT of discussion to be had on what the right amount of limits are.
     Again, I hope this doesn’t come off as snarky or cute word play. Not my intent.

292. I’m not really ok with providing health coverage for those that can actually afford to purchase it themselves but buy other things that are not necessary to sustain life.
     One problem is that this whole statement resides in a grey area, insofar as it implies that “afford it” and “not necessary to sustain life” have (or can have) clear, fixed, unequivocal meanings.
     Another is that this really isn’t a useful sentiment in terms of public policy discussions unless you are advocating an extremely intrusive government. That, or workhouses.

293. Why is “any too many” for corporations, but government corruption is fixable?
     I think the difference is in “too many” versus “fixable.” If it weren’t too many, there wouldn’t be any need to fix anything.
     The question is, how do we fix what those insurance companies did?
     That said, the two “specific examples” were examples of schemes. To wit:

     After receiving the letter, which you can read here, some customers were badgered through phone calls to make a decision, Clark said. Of the 6,500 people who received a letter, 2,200 actually responded and gave the company their answer before they had a chance to look at what the Kentucky marketplace had to offer.

     We’re not talking about two people being misled. 6500 people were misled by just one insurance company in just one state. Why that bit of evidence wouldn’t be worth mentioning, short of an attempt to make an issue where there isn’t one, I don’t know. It suggests strongly to me that there is likely a wider problem that hasn’t been fully uncovered. Others, of course, may disagree, but I don’t know why they would.

294. On this:

     Sharon Clark, pictured, told TPM in an interview.

     Is it just my browser, or does Clark’s photo take up most of the screen right in the middle of the article? Does anyone else find that to be strange? I mean, does someone at TPM have a crush on her, or what?

295. I mean, I can give you examples of government failures, but you would likely jump on me if I said “ANY example of government failure is too many.” And you should. No system is perfect, it’s about getting the best result possible.
     I think there’s a difference of intent.
     If Humana was sending out letters in error, mistakenly or incompetently failing to inform their policy holders that they could make use of the exchanges, and in fact that the very policy they were being “continued” into was available on the exchange for less money and with the possibility of federal subsidy, I wouldn’t really have a problem, as long as they took some measures to rectify it.
     Trying to screw your customers out of money is not the same as screwing up.
     In other words, the insurance letter thing is not a failure, it’s a deliberate attempt to exploit incomplete information. If folks get screwed, it’s a success.
     If you’re talking government corruption, as opposed to incompetence or just general FUBAR-hood, I would also say any is too many. For the same reasons.

296. Ms. Clark is tastefully-sized in Firefox.
     and here’s the next para from the TPM article:

     But Clark’s office soon stepped in. They fined Humana $65,000 for the “misleading” information, and the 2,200 respondents were released from their obligation to Humana and freed to shop for insurance through the Obamacare marketplace starting Oct. 1.

     i’m losing faith in the trustworthiness of our insurance companies.

297. Ms. Clark is tastefully-sized in Firefox.
     On whatever (likely outdated) version of IE we use at work, the photo is 2/3 the width of my screen, and doesn’t even fit vertically, with zoom set at 100%. It’s like she’s in my office, trying to take half of my sandwich.

298. “Is it just my browser, or does Clark’s photo take up most of the screen right in the middle of the article?”
     The image is 735px × 1,000px, scaled to 150px × 204px. Apparently, your browser is forgoing the scaling.

299. Russell, thanks for the good answer. Intent is a really important component, I agree. And, again, to be clear, I wasn’t saying this company wasn’t deliberately screwing people over. They are, and that’s bad.
     “If you’re talking government corruption”
     Let’s just talk corruption. And I don’t want to unfairly pin you down to a definition you don’t like, but I’m using it in a general sense. Being influenced by direct or indirect gifts, having financial interests in laws/regulations that are under your authority, misuse of government funds, pardoning political allies, and the like.
     If that’s too broad a definition of corruption for you, perhaps you could suggest a different term?
     So do you think corruption doesn’t happen? Or if you think it does happen, what does “Any is too many” mean?
     For that matter, what does it mean with companies screwing people over?
     Not trying to pin you to your phrasing, just trying to understand the thoughts behind it.

300. “X does bad things.”
     “Oh yeah? What’s your evidence?”
     “Exhibit A and Exhibit B.”
     “Pshaw! those are just two anecdotes.”
     “They’re examples of a wider problem.”
     “Now you’re just generalizing!”
     How many times have we seen this form of debate, on-line and off? Note that I’m talking about FORM, not substance. It’s a silly form whether X is “insurance companies” or “welfare recipients”.
     But it’s an unavoidable form. Most of us would feel silly if we could NOT cite specific examples; few of us can resist the temptation to dismiss specific examples.
     Oh well: it would be a dull world if we had some sure-fire way to actually settle debates of ANY form.
     –TP

301. If that’s too broad a definition of corruption for you, perhaps you could suggest a different term?
     That’s a perfectly good definition. It’s fuzzy in the details, but not overly broad.
     So do you think corruption doesn’t happen?
     Would that that were so. In other words, no.
     Or if you think it does happen, what does “Any is too many” mean?
     Any is too many means exactly that. Those forms of corruption are not acceptable and shouldn’t exist.
     For that matter, what does it mean with companies screwing people over?
     Ditto.

302. Another is that this really isn’t a useful sentiment in terms of public policy discussions unless you are advocating an extremely intrusive government. That, or workhouses.
     And I respectfully disagree. I was (mostly) clarifying my position on cell phones.
     Here is how it is useful: In the quest for universal coverage, IMHO the nature of why people are uncovered is largely ignored. 20% are illegal aliens. 25% qualify for medicaid or S-CHIP but haven’t enrolled. Seems to me there are answers there.
     Over 40% have incomes 250% of FPL. Think $79k for a family of six or $29K for single. And, what, only about 30% remain uninsured for more than one year?
     I can work with those facts. Portability takes care of changing jobs and reduces the temporarily uninsured. Focusing on enrollment takes care of 25%. We can rationally discuss (yes, I said that!) the illegals and a more cost-effective way of paying for coverage that does not equal the ER.
     Here is an example of how you might define “affordable” and weed out those that can afford coverage and choose not to (one of the conclusions is that coverage is affordable to over 50% of the uninsured).
     Many want all to be covered whether some of the “all” don’t feel all that much like covering themselves. I don’t want to pay for coverage for those that don’t care enough to try to get it and/or can afford it.
     Bottom line: we didn’t need the ACA to solve the “problem” of lack of coverage. But that wasn’t the point of the ACA now, was it?

303. But that wasn’t the point of the ACA now, was it?
     i give up. what was the point of the ACA?

304. But that wasn’t the point of the ACA now, was it?
     Actually, I kinda thought it was.
     Did I miss the secret agenda?

305. It’s not hard to see this line of thought devolving into something that is intrusive far, far, far beyond the most feverish liberal nanny-state dream.
     Actually, I need to take this back.
     Bloomberg would probably go there.
     🙂

306. russell: lol.
     Not so secret agenda anymore, I’d say. Right now it looks like: failure, blame on markets, go single payor. Because if it was actually intended to succeed in living up to its name and the promises made by the big O, Houston, we have a problem.

307. bc: Right now it looks like: failure, blame on markets, go single payor.
     Yeah, that’s EXACTLY how Romneycare worked out here in MA.
     Actually, in the spirit of seeing deep, devious plots on the part of people one accuses of incompetence most of the time, I say bc is merely a secret advocate of the ACA who is merely pretending to be paranoid.
     –TP

308. Not so secret agenda anymore, I’d say. Right now it looks like: failure, blame on markets, go single payor. Because if it was actually intended to succeed in living up to its name and the promises made by the big O, Houston, we have a problem.
     I think you give Obama way too much credit. IMO control over what came out the other end of the legislative sausage grinder left Obama’s hands years ago.
     If I was going to fault him for something, it might be that he didn’t just chuck the whole thing when it became obvious what a Frankenstein’s monster the ACA was turning into.
     I don’t know if we’re going to be better off or not, when all is said and done.
     Net/net, I think that basically we are in Houston, we have a problem territory.
     I appreciate the NBER paper, and I agree that we shouldn’t (and I don’t want to) pay for folks who can pay their own way.
     That’s the point of the mandate, to get folks into the risk pool who would prefer to not bother, for whatever reason.
     That’s also the point of the requirement for policies to meet some baseline of coverage, because paying short money for very high deductible policies is another way to gamble that you’re not going to get really sick.
     From my point of view, folks who are not covered at all, or who have only minimal coverage, are shifting their medical risk to me, because when they end up at the ER, or end up not paying a multi-thousand-dollar bill because they go bankrupt, *I end up picking up the tab, one way or another*.
     There are humanitarian reasons for wanting to extend coverage to as close to everyone as possible, but they are far from the whole picture. I see my own self-interest in there as well.

309. Right now it looks like: failure, blame on markets, go single payor.
     If that were anything near true, then Republicans should be doing everything possible to make the program a success.
     So is the GOP dumb, or is this another aspect of the administration’s 11-thy dimensional chess? And I got the memo!

310. And I respectfully disagree. I was (mostly) clarifying my position on cell phones.
     Here is how it is useful: In the quest for universal coverage, IMHO the nature of why people are uncovered is largely ignored. 20% are illegal aliens. 25% qualify for medicaid or S-CHIP but haven’t enrolled. Seems to me there are answers there.
     There’s an awful lot of distance between what you’re advocating here, and the “mustn’t be spending money on things that are not necessary to sustain life” sentiment/criteria that I was calling largely useless.

311. “Those forms of corruption are not acceptable and shouldn’t exist.”
     Well, I agree they shouldn’t, of course, but they do. I don’t see any way of getting rid of corruption.
     Oversight, accountability, and limits are needed to control and minimize the effects of corruption. Just like regulations and laws are needed to prevent abuse of the weak by the strong.
     This is of course, all general and fuzzy. The devil is in the details of what limits and what laws.

312. “Right now it looks like: failure, blame on markets, go single payor”
     bc, if that was his plan, I don’t think it’s working. Obama’s approval ratings have dropped and while the rollout was a little bit of a fiasco, I haven’t heard a steady drumbeat of, ‘well, we should have gone single-payer!’
     Unless you think this is a long game where Clinton runs against Obamacare in 2016, I think the likely answer is: law-making is hard, DC is contentious, and the rollout of an online system which accesses multiple, varied, and typically ancient databases in real time is going to be bumpy.

313. That’s the point of the mandate, to get folks into the risk pool who would prefer to not bother, for whatever reason.
     russell:
     While I think you are right on the sausage analogy, there is no pretending he didn’t know they were making sausage, IMO.
     . . .because paying short money for very high deductible policies is another way to gamble
     I’m curious about this. When I last shopped for catastrophic plans, all I really saw were HSA plans (high deductible). Coverage was actually really, really good. And anything truly catastrophic ended up being a better deal (e.g. if you contracted cancer and needed over $2M in care, you actually had less out of pocket than the equivalent “full coverage” policy). Yes, you could add maternity or not. But other coverages were more or less(to my recollection) already there or unavailable (e.g. no choice). So were there in fact really bad plans out there that had a high penetration rate? I tend to doubt it because the plans have to be approved at the state level anyway.
     From my point of view, folks who are not covered at all, or who have only minimal coverage, are shifting their medical risk to me,
     I tend to think that way too. But the anecdotal evidence coming in doesn’t look that way to me under the ACA. We’ll see, I guess. But those in the middle to upper middle class appear to be bearing an even greater share of the “risk” than before. It looks more like pure income redistribution. Maybe that will change when the “penalties” kick in, but as soon as everyone figures out how to circumvent those . . .

314. But those in the middle to upper middle class appear to be bearing an even greater share of the “risk” than before.
     “Risk” or “cost”? You shifted back and forth there. It seems intuitively obvious that, projecting recent costs trends forward (you know, those “unsustainable” ones)those with any money are going to bear the brunt of those increased costs no matter what. And given past trends in income redistribution upward (aided and abetted by public policy) those folks will have all the financial resources anyway.
     Will their “share” be larger? Well, if the ACA succeeds in “bending the cost curve downward” they may not (relative to GNP).

315. A breakdown of the uninsured
     Disproportionately lower income. Disproportionately non-white. Working in industries that traditionally do not offer health care coverage as part of the wage package…..and yes, “illegals” (gasp!!!). No surprises here.
     Although I do admit it would be interesting to find these strange individuals with “high” incomes and no coverage. Anecdotally (this being an acceptable data base it would seem) I find this odd behavior concentrated amongst young white libertarian males in high tech jobs. Anecdotally speaking of course.

316. I’m curious about this.
     Sure, allow me to expand on it.
     If you have a policy with a $5K or $10K deductible, and you get sick, and you don’t have or have access to $5K or $10K of liquid cash, you go bankrupt.
     We’re not talking about small numbers of people.
     It looks more like pure income redistribution.
     I think it behooves us to be clear about what we mean when we say “pure income redistribution”. Especially that word “pure”.

317. Good old Ron Paul offers a less than helpful solution.
     Calhoun lives.

318. Conservatives often argue that they should be afforded the ‘freedom’ to purchase low cost catastrophic health insurance. However, this type of insurance is actually a form of adverse selection whereby the healthy get coverage and everybody else pays through the nose or goes without.
     In a large pool (say a tax advantaged plan in a large company) the healthy subsidize the ill. This is how health insurance works.
     Chiat offers up a good explanation here.

319. I don’t see anything wrong with income redistribution as an abstract principle. Like many other ideas, the goodness or badness depends on application.
     Seems to me the purest form, or simplest form, of income distribution is a graduated income tax, which is membership dues on a sliding scale–and that’s the fairest way to assess membership dues when membership is required.
     Like anything else, the devil is in the details. However, there’s a reason why every representative democracy has some forms of income redistribution going on: without income redistribution, democracies degenerate into oligarchy.

320. …without income redistribution, democracies degenerate into oligarchy.
     Is that bad? 😉

321. I mean, I don’t want to eat the rich, but I would like to keep them from eating the rest of us.

322. …without income redistribution, democracies degenerate into oligarchy.
     Is that bad? 😉
     This is a question we should be able to answer, within a generation or so, from our own national experience.
     It seems like that shouldn’t be necessary, because we’ve been here before, but our memories are very short.

323. Dagnabbit, I’ll be the judge of purity around here, and the lot of you are pikers in that department!
     This is the point once a quarter or so in which I’m compelled, forced I say, to link to inflation-adjusted marginal tax rates during the Eisenhower Administration, particularly the years 1953 and 1954.
     Take a look, for once:
     http://taxfoundation.org/sites/taxfoundation.org/files/docs/fed_individual_rate_history_adjusted.pdf
     Conservative President Dwight D. Eisenhower, in an exercise of steadfast purity managed to push through a nominally Republican Senate and House a pure non-redistributionist marginal tax cut from 92% at the highest bracket clear down to 91%, with corresponding decreases on down the couple of dozens brackets to the low end.
     Growth, productivity, income equality, and national well-being, as you know, plummeted to zero (I kid) in what John Boehner remembers, in the midst of a crying jag, as the America he grew up in preserved in amber waves of grain alcohol, and Barack Obama has ruined the whole damned thing with his idea of purity, which seems to mean three or four marginal tax brackets with the highest bringing in something just north of 40%, depending on which side of the bed McKinneyTexas got up from this morning ;).
     Actually I think Boehner meant that Thurgood Marshall ruined the whole thing round about the same time, but the former is from Cincinnati, which in 1954 Werick Werickson would have moved to to get away from the liberal influences of Macon, Georgia.
     I spit on Americans’ conception of purity in 2013.
     We wouldn’t know purity if it bit us.
     hshd wrote:
     “I mean, I don’t want to eat the rich, but I would like to keep them from eating the rest of us.”
     Doctor Science has requested that we not make fun of Governor Christie and the bib he wears to work, so please ….

324. Here’s your pure redistribution.
     Way to go, red states.

325. inflation-adjusted marginal tax rates during the Eisenhower Administration, particularly the years 1953 and 1954

     I had no idea that marginal tax rates could be adjusted for inflation.
     Possibly you started off saying one thing, and then finished up with something else, and then maybe tacked on a third thing as an afterthought.
     Interestingly enough, tax revenues as a fraction of GDP doesn’t really change that much when you twist the upper-bracket rate up to 11. There’s a number of conclusions that one could draw from that, I imagine. My preference would be that a heightened incentive to avoid tax coupled with more latitude to cheat results in increased cheating, so that hardly anyone pays higher effective taxes. But there are likely other possibilities that I haven’t considered.

326. “I had no idea that marginal tax rates could be adjusted for inflation.”
     Yes, poorly phrased.
     The nominal dollar amounts (income) in the tables I linked to are adjusted to reflect 2013 dollars.
     Here are the nominal income amounts and corresponding marginal rates going back to 1913.
     http://taxfoundation.org/sites/taxfoundation.org/files/docs/fed_individual_rate_history_nominal.pdf

327. Interestingly enough, tax revenues as a fraction of GDP doesn’t really change that much when you twist the upper-bracket rate up to 11.
     This is an often repeated ‘nugget’ of so-called fiscal wisdom.
     Revenue fluctuates considerably with economic activity. Right now, taxes as a % of GNP are quite low compared to averages since 1950. Stagnant economic growth + low taxes = low revenues & big deficits
     One must also consider other sources of revenue, not just the income tax. Since 1950, estate, income, capital gains and corporate rates have been reduced while taxes tied to wages have gone up.
     See chart here for example.
     What we observe is an increasing component of spending for social services tied to wage taxes and the freeing of high earners from tax obligations. The balance consists of borrowing.
     And the kicker is this: Guess who holds most of those bonds? It’s not the Chinese.

328. In the spirit of the original post, I offer the following from Juan Williams at Fox News:
     http://www.foxnews.com/opinion/2013/11/05/insurance-cancelled-dont-blame-obama-or-aca-blame-america-insurance-companies/
     Let there be light!

329. Yes, but bobbyp, the insurance companies have been incentivized by Obamacare, don’t you know, or disincentivized, or desensitized, or stock optionized, or untelevised, they’ve been somehow mesmerized into behaving in ways that their mothers would highly disapprove of, but I am sure there will be an explanation forthcoming having something to do with Pavlovian saliva production and glandular capitalism or miniskirts made me do it or references to worldly philosophers for why none of this couldn’t be helped because the wallet was lying there and one is apt to cheat given the chance finders keepers lose their weepers ethic enshrined in the Constitution which doesn’t say in the bylaws we shouldn’t f8ck each other royally so why not go ahead have a bit on the side.

330. This is an often repeated ‘nugget’ of so-called fiscal wisdom.

     It’s not presented as wisdom; it’s presented as data.
     I assumed that most people were able to recognized the distinction.

     Revenue fluctuates considerably with economic activity. Right now, taxes as a % of GNP are quite low compared to averages since 1950. Stagnant economic growth + low taxes = low revenues & big deficits

     Yes, there’s that. But there’s also the fact that we experienced substantial growth in the late 1990s (just to make a point that is least likely to be disputed) and had MUCH lower upper-bracket rates, and revenues were still, as a fraction of GDP, comparable to those seen in in the mid 1950s.
     You could address that comparison, or you could continue with the appeal to ridicule. I’m good either way.
     The Reuters link refuses to load, by the way, so I can’t speak to it at all.

331. Right now, taxes as a % of GNP are quite low compared to averages since 1950.

     One must also consider other sources of revenue, not just the income tax. Since 1950, estate, income, capital gains and corporate rates have been reduced while taxes tied to wages have gone up.

     Income taxes as a percentage of total revenues are roughly the same now as they were back in the 1950s. Make of that what you will. I’m not as concerned about corporate taxation, because all of that eventually gets paid by the consumer.
     Yeah, I said that. Bare assertion. I don’t care whether you agree or not.
     I wasn’t aware that the OMB, for instance, tracked revenues, etc as a function of GNP.

332. It’s not presented as wisdom; it’s presented as data.
     My apologies. This line is often trotted out by those arguing against higher marginal income tax rates on the grounds that “it really doesn’t matter” and higher rates just mean more cheating (hey, wait, you did mention that. But of course turning dials “up to 11” was in no way meant to convey a normative position on the matter. Well then, OK. I’m fine with that.
     In fact, your bare assertion is correct. Income taxes as a % of GNP have been generally about 7-8%. As a % of federal revenue, they are generally about 40-45%.
     Whether you care or not….well, shoe, meet fit.

333. Slarti: …we experienced substantial growth in the late 1990s …
     How is THAT possible? Republicans TOLD us that Clinton’s tax hikes would DESTROY the economy, didn’t they?
     –TP

334. How is THAT possible?
     By lowering the cost of funds through the Fed, thus offsetting the effect of higher taxes. Clinton gets a lot of credit for an economy fueled by the dot-com boom (and eventual bust), accounting scandals that didn’t become apparent until after Clinton was out of office (the new governor of VA made a bunch of Enron-type money on such a deal), significantly reduced defense spending and the Federal Reserve’s monetary policy.
     That said, the economy can grow and can grow significantly with a marginal rate of 35-40% if the rate doesn’t kick in until, say, 500K in adjusted gross income, all other things being equal, which they are not.
     The private sector doesn’t trust a gov’t that uses, for example, its regulatory power to shut down, for all practical purposes, the coal industry. Or to eliminate whole lines of health insurance policies. You can argue, as I am sure most here will, that caol *needed* to be shut down and that those policies were really awful. Ok, so the progressive left takes it upon itself to decide who should be in business and who should not. Fine, go ahead and do that, but don’t say that doesn’t introduce an element of substantial uncertainty for ventures who might otherwise want to expand.
     Obama’s tax policy *alone* isn’t why the economy sucks pretty much as bad today as it did when he took office (how many times has Obama “pivoted” back to the economy?). No one knows what regulations his administration is going to roll out next. No one knows what this country is going to look like in five years, from a business point of view. And most of us outside the progressive tent believe that Obama would go a lot higher on taxes if he could get away with it.
     Dismiss this as you like. And tell me again that Obama didn’t lie selling ACA and didn’t lie two days ago when he denied lying in the first place. Progressives have their narratives just as the Tea Party does. You are right and they are wrong. And it isn’t just the Tea Party who is wrong, it is everyone who is not a progressive.

335. How is THAT possible?

     See also: bubble, dot-com.

336. The private sector doesn’t trust a gov’t that uses, for example, its regulatory power to shut down, for all practical purposes, the coal industry.

     WTF?
     http://www.eia.gov/coal/production/weekly/?src=Coal-f4

337. No one knows what regulations his administration is going to roll out next. No one knows what this country is going to look like in five years, from a business point of view.

     this is truly the strangest anti-Obama complaint out there. it assumes there has ever been a time when regulations and laws were guaranteed to be fixed, and that Obama somehow broke this idyllic state. as if every other President in the past 20 years hasn’t written as many regulations as Obama.
     and if “conservatives” are so fncking worried about uncertainty, maybe they should get their lackeys in the idiot caucus to stop sending the country into one economic crisis after another.
     frauds.

338. McKinney,
     Accounting scandals can boost economic growth? Amazing! How does that work?

339. I haven’t read all the thread, so apologies if someone has linked to this already, but Digby has a good post on one aspect of the ACA which can be legitimately criticized–there are people in areas of the country where the cost of living is high who are being forced to purchase health plans they can’t afford, and who won’t get subsidies because they are over the income limit (which,however, doesn’t mean that they are rolling in dough given where they live.)
     link
     I don’t know how one would fix this–maybe link the subsidy cutoff to the cost of living in a given area? Thereby making the law just a bit more complicated. (Another argument for single-payer, and yes, I know that isn’t politically possible.)

340. Obama’s tax policy *alone* isn’t why the economy sucks pretty much as bad today as it did when he took office
     Couldn’t agree more.
     No one knows what this country is going to look like in five years, from a business point of view.
     I’d extend this to a number of other points of view.
     The business climate is weird and full of risk for about a million reasons. I’d put the fear of arbitrary new federal regulations toward the bottom of the list.

341. The private sector doesn’t trust a gov’t that uses, for example, its regulatory power to shut down, for all practical purposes, the coal industry.
     And not for bloody freaking nothing, but trust as a basis for public life sort of needs to be a two-way street.
     When private actors can be trusted to do what’s best for all parties concerned without coercion, then we won’t need any regulations at all.

342. I’m just glad McKinney’s raising the issue of Glass-Steagall’s repeal, or so I’m inferring from the accounting scandals he mentions.
     It’s funny, it is, that financial deregulation is supposed to unleash productive investment. I was just listening to something on NPR this morning about the hype behind IPO “pops,” when the stock’s price quickly jumps by a significant percentage relative to the price initially offered, as thought that’s somehow great for the company going public – that their stock was grossly under-priced relative to market value so speculators on Wall Street could cash in by flipping the stock and the company could raise less investment capital to be used for actually producing stuff.
     Yippee! Markets! Feh…

343. Just wondering, Donald, why you’re being an Obama scold (with Digby) on the issue of the ACA.
     It’s true that a few (percentage-wise) people face higher premiums. Anytime anyone has to pay more of anything, they will complain.
     I’m not convinced by the fact that Digby lives in California, an expensive place to live. Digby chooses to live in California, which is expensive. Digby could cash in her house and move to a lot of other places and be much better off financially (but she wouldn’t have the view).
     In other words, cry me a river.

344. I’m not being an Obama scold, sapient–on the whole I think the ACA is a good thing, but it’s possible, you know, that it has some flaws. IIf so, it’s not a good idea to ignore them, IMO. Maybe they can be fixed. If it really is the case that the only way we can help tens of millions of poor people is by hurting a few million middle class people, then that’s the tradeoff and it’s better to help tens of millions than not to, but I see no reason to pretend that real people might not be hurt. If the problem is acknowledged, maybe there is a way to fix it.

345. McKinney: … the economy can grow and can grow significantly with a marginal rate of 35-40% if the rate doesn’t kick in until, say, 500K in adjusted gross income …
     Does this mean that a 50% marginal rate kicking in at $5M AGI, or 60% kicking in at $50M, would somehow stifle the economy?
     What I’m actually asking you, McKinney, is whether the “top” marginal tax rate HAS TO BE the one that kicks in at the AGI of an anaesthesiologist, rather than the AGI of a CEO, movie star, or major league shortstop.
     –TP

346. it’s possible, you know, that it has some flaws.
     It most certainly is possible (in fact, it’s a certitude) that it has some flaws. All legislation has some flaws.
     digby didn’t convince me that her particular story represented those flaws. She linked to her own speculative version of her own situation (circa June 1). She really didn’t present much of a case. She and her husband went uninsured for a period (a certain formula for bankruptcy in the event of an illness). Then she bought some crappy coverage because they could afford it. She didn’t talk about pre-existing conditions, or any other variables that the pre-ACA regime would have factored in.
     Instead, she talked about “Well, California is expensive.”
     Yes, and the weather is really nice! And if you happen to get a job there, you probably make more money than people who live in Alabama! Etc. Yes, the ACA has flaws. Not sure that those flaws were illustrated by digby (whose blog was really fun to read back in the day. There’s a reason why she doesn’t allow comments now.)

347. What I’m actually asking you, McKinney, is whether the “top” marginal tax rate HAS TO BE the one that kicks in at the AGI of an anaesthesiologist, rather than the AGI of a CEO, movie star, or major league shortstop.
     Fair question: I picked 500K as the bright line and I would apply it to everyone up to maybe 5mm and then I would max out at 50% for everyone beyond 5mm. I would tax cap gains at 20% but change the holding period from one to three years. Then, I would expect gov’t to live within its means.

348. Sapient, she linked to Josh Barro’s piece and was commenting on that, so if you’re interested in more than casual dismissal (and that seems to be your approach to anything that even remotely seems to reflect on Obama, which to my mind is utterly beside the point here), you’d read that. Barro says that there are likely to be several million “losers” from the ACA, typically people who make above the cutoff for subsidies, but who might find the increased cost burdensome. I’m not sure why you have to react so defensively to this.
     link to Barro
     As for digby, she continues to be worth reading. She supports Obama on some topics, criticizes him on others and when she had comments and I read them, they were dominated by people to her left being rude to her. So I’m not surprised she never brought them back.

349. Donald,
     NPR did a segment on this issue. One such “unlucky ducky” was a young single male 31 year old dentist making over $100k/yr. His new policy has coverage for things like prenatal care, etc., coverage he obviously does not need. However, to overcome adverse selection and increase the pool of insured, this is the kind of stuff that is necessary to make the ACA work.

350. Yes, but are all the unlucky duckies of that sort? In sapient’s words, I wouldn’t cry too many rivers over a single male making over 100K–the sort of people I’ve heard about are people who make considerably less, don’t qualify for subsidies, and are pretty tightly squeezed. Their concerns (assuming such people exist) shouldn’t be dismissed by lumping them in with affluent dentists.

351. Link to the NPR story bobbyp mentioned, FYI: http://www.npr.org/blogs/health/2013/11/07/243584170/how-the-affordable-care-act-pays-for-insurance-subsidies
     Of course, it provides only that one example, and no breakdown of the rest of individuals who are affected (which is likely impossible according to Donald’s link). So I don’t know if that anecdote really represents the people whose premiums are increasing. And by “I don’t know” I mean *I don’t know* because as far as I can tell there is no good data on it.
     The “unlucky ducky” seems a little dismissive. His premiums will double, which is probably somewhat of a hardship. It might be necessary to make it work, but it still kind of sucks for him, even if he’s more capable of handling it than the family of six living on 40K. That might not be how you intended it, if so, feel free to disregard.

352. Donald, this is the way Barro characterizes the “several million losers”:
     “The best I can do is say the ACA will create ‘several million losers.’ They’re a small slice of the population: in good health, relatively young, with moderate to high incomes, and not receiving health insurance through work. But they’re real and their losses are real.”
     But Barro focuses on their immediate financial loss, rather than the increased security of their insurance, the fact that, although they are “in good health” and “relatively young” now, they are sure to be in poor health and/or relatively old sometime in the future. In other words, their losses don’t have to be offset by other people’s gains. Their losses are offset by their own gains: more security now (in case they get sick), and the gain in health care benefits as they grow older.
     The one thing that’s a certainty is this: all of us are getting older, and almost all of us will get sick. A health care system that serves those eventualities is one that serves everyone, even those who are currently “in good health” and “relatively young.”

353. So far most of the cancellations have been in the individual market, which is about 5% of the population. Folks between 100% and 400% of federal poverty level are eligible for subsidies to help purchase insurance, so the effect on the individual market will likely be fairly small, at least as a percentage of the population.
     Less clear to me is how many of the small group plans are going to go away, and what the cost of their replacement will be. That’s (I think) a bigger piece of the market, and potentially affects more people.
     The other side of the coin is the ~50M people who were completely uninsured prior to the ACA, and the many millions more whose coverage was at best minimal.
     I appreciate that it’s a PITA for the dentist to have to pay for stuff that he won’t use. To me, it’s analogous to my paying taxes for public schools in my town, which my family does not use and whose benefit to me is at most indirect.
     What you make of all of this is obviously going to depend on whether you look at health care and/or health insurance as a pure commodity which should be left to the marketplace, or something in which there is a public interest.
     My best guess is that some low number of millions of people will end up paying more for health insurance, and in general that will be because their policy has to cover more. Sometimes the ‘more’ will be stuff that they will end up making use of, and sometimes it won’t.
     My best guess is that some large multiple of those millions will come out ahead, either by being able to get insurance AT ALL, or by getting more coverage for the dollar.
     And yes, it’s an expansion of the scope of federal regulation and oversight of the marketplace. And like most such expansions, it’s driven by the failure of other actors to address some palpable problem of national scale. As such, and given my general point of view, I’m fine with it.
     YMMV.

354. My best guess is that some low number of millions of people will end up paying more for health insurance, and in general that will be because their policy has to cover more. Sometimes the ‘more’ will be stuff that they will end up making use of, and sometimes it won’t.
     It might be worth keeping in mind that health care premiums have been going up since health insurance was invented, and that at least there now is, under the ACA, a relationship between the cost of premiums and the delivery of care. Only 20% of premiums can go to health insurance company administration and profits.
     So, yes, some people might be paying more than they were. What that means exactly (as compared to what they might have been paying if there had never been an ACA) is really very speculative.

355. Just a thought here on who’s lucky or not: You’re lucky if you pay for health insurance and you don’t have to use it (for anything other than having a baby). Being on the losing end financially is good on pretty much every other end.
     I’d like to shake the hand of the guy who’s saying, “Dammit, now that I have to pay for this insurance, I hope my spleen ruptures, and quick-like!”
     Not that it does or doesn’t mean anything with regard to the ACA’s policy merits…

356. Here is a fun doohickey if anyone wants to play around with population numbers.
     The amazing thing to me is that now, PRIOR to the ACA, 30% of the population is already insured on the public dime (Medicare + Medicaid + other, presumably including military).
     16% — 48.6M people — are not insured at all.

357. Sapient and others–I think I’ve said all I have to say on this (after this post, that is). I don’t know how many “unlucky duckies” there will be, and of that number I don’t know how many deserve sympathy and how many should just be dismissed. My only point is that we shouldn’t be too quick to assume that there aren’t some people who might actually suffer, in part because if there are, maybe the bill should be tweaked a bit. (Of course, whether that could be done with the Congress we have is a whole other issue.)

358. “I’d like to shake the hand of the guy who’s saying, “Dammit, now that I have to pay for this insurance, I hope my spleen ruptures, and quick-like!” ‘
     I just happened today to be watching this very old clip on a very young Woody Allen on Jack Paar. At about 1 minutes 15 seconds in, he explains the hospitalization insurance we yearn for:
     http://www.youtube.com/watch?v=in0X7vOYVjU
     A late aunt and uncle of mine spent the last years of their long lives (both made it into their 90’s) in an upscale retirement community with all of the amenities — fabulous food, recreation, hospital, morgue, hopefully in that order — and before they moved in, we were discussing the food and he said, yes it was quite sumptuous (and such large portions, he winced), but for what he was paying for the meal plan, he was going to choke down every bite if it killed him.
     He had a cell phone too, so I don’t know what all the complaining was about, 😉

359. Well, since this may be my last opportunity on this subject, let me say this:
     I don’t know how many “unlucky duckies” there will be, and of that number I don’t know how many deserve sympathy and how many should just be dismissed.
     Then maybe you should wait to come to the defense of the poor victim’s of Obama’s signature piece of legislation? In other words, quit piling on? Thanks!
     My only point is that we shouldn’t be too quick to assume that there aren’t some people who might actually suffer, in part because if there are, maybe the bill should be tweaked a bit.
     I have no doubt whatsoever that the law (bill, as you call it) should be tweaked a bit. In fact, it’s been my profession for much of my career to publish “tweaks” of bills.” In the United States, both in state and federal legislation, there are thousands and thousands of “tweaks” made to legislation each year. Legislation is partly wisdom, and partly trial and error. Until the law is implemented, when the Republicans are going ape-s#$( over the law, it’s not yet time to pile on.
     I don’t know how many “unlucky duckies” there will be, and of that number I don’t know how many deserve sympathy and how many should just be dismissed. My only point is that we shouldn’t be too quick to assume that there aren’t some people who might actually suffer, in part because if there are, maybe the bill should be tweaked a bit. (Of course, whether that could be done with the Congress we have is a whole other issue.)
     (Of course, whether that could be done with the Congress we have is a whole other issue.)
     Really?
     

360. Yes.

361. I think my italics error is fixed.

362. Gosh, I screw up my editorial stuff when I’m angry.

363. So my point, Donald, was:
     It’s a ridiculous and counterproductive exercise to take up the cause of the “victims” of Obamacare before it’s even implemented. Again, you’re making common cause with Republicans. Just stop it for a change.

364. “Again, you’re making common cause with Republicans. Just stop it for a change.”
     Dear sapient:
     No, he isn’t.
     Listen, I, of all people, understand your thinking here.
     But writing that Donald Johnson is making common cause with the Republicans is ridiculous.
     “Ridiculouth” is my province, so could you leave me to it?
     Ipso fatso, accusing Donald Johnson of making common cause with Republicans is like accusing an optometrist who points out to his patient that his health insurance doesn’t cover replacement eyeglasses of being a Pol Pot sympathizer in 1970 who turned in Cambodians for wearing eyeglasses because obviously the latter must be members of the urban, western-influenced intelligensia.
     Or, it’s like accusing Boston Red Sox World Series MVP David Ortiz of being an admirer of St. Louis Hall of Famer Stan Musial’s hitting prowess and therefore Ortiz must have really wanted to throw the Series to the Cardinals, despite hitting .650 or whatever he hit this Fall.
     One of the two. Maybe both, depending on how ridiculous you think I am, and whatever your guess, you will be low-balling.
     I understand. The scurvy Republicans in Congress and the 27% basest of the base do make one want to have the traitors amongst us shot at dawn as an example, but Donald Johnson?
     He’s one of our best snipers.

365. Thanks, Countme-in, for asking me to question my instincts, especially ridiculouthness, which obviously can be a problem.
     But do you really think it’s time to start finding theoretical “victims” of Obamacare, and wondering how we can tweak the ACA?
     I think that, unless you’re a Republican, it’s a bit early for that.

366. sapient, as an outsider, and one who probably has more sympathy for those who oppose the ACA than most here, I got to say:
     Nothing is more comforting to me than supporters of a law discussing it critically. I have concerns about the law and the massive structural changes it’s made to our healthcare system.
     And while I doubt how I feel is high on your list of concerns, it is comforting to me, at least, to hear discussion about the pros and cons of a bill by people who nominally support it. Because it suggests to me, perhaps wrongly, that those people are interested in solutions more than political victories.
     The law is structured such that the healthy subsidized the unhealthy. The single people subsidize the families. You can say it’s better for the nation overall, you can argue about the importance of bringing in the uninsured. You can even argue that most of the those single healthy people are going to get sick and have families or what not. Those are all great arguments.
     Not a great argument, at least in my mind? It’s “Obama’s signature piece of legislation” so “quit piling on”

367. I didn’t expect, thompson, that as someone who opposes the ACA, you would want to “quit piling on.” So continue to do so, if you want to.
     I’m glad it’s comforting to you that people who support healthcare reform are talking about it. Love to provide comfort. Maybe the people who, from the get-go, have opposed ACA can offer some substantive amendments to the law, while preserving its strengths. Have there been any such attempts? No, obviously not.
     We heard, originally: “repeal and replace!!!” but no actual bills to replace were forthcoming.
     Now you’re saying “Tweak!” (Are you saying that? I don’t note any immediate suggestions for a tweak.)
     Honestly, it’s the ACA or what we had before, which is this: when people are so sick that insurance companies have to pay a lot to cover their care, their insurance is cancelled, and they can go bankrupt.
     Fighting against the ACA now, or insisting on “tweaking” it (since the Republican House would never “tweak” it) is a vote for the status quo ante: bankruptcy for millions when there’s a health care catastrophe. I would suggest that good people wait until the effects of the law play out for a few months before registering their complaints. This, despite the fact that foes of the law aren’t “comforted” by the failure of its advocates to help derail it for awhile.

368. http://www.ewg.org/research/forbes-fat-cats-collect-taxpayer-funded-farm-subsidies
     A list of billionaires who receive farm subsidies.
     Just mentioning this to reinforce the point I tried to make about who the real moochers are, and where the real money is going.

369. Thanks, Donald, for supporting people who insisted that Obama “bow.”
     12 Years a Slave.
     But, of course, you’re a good man.

370. Again, you’re making common cause with Republicans. Just stop it for a change.
     No sapient, you should stop it.
     There are issues with the law as it stands. People are entitled to discuss them without catching a load of crap about it. It is, in fact, *useful* to discuss them.
     DJ is not even discussing tweaks to the law, he’s simply pointing out that some people are likely to be disadvantaged by the ACA.
     That’s such an obvious thing to say that it should not even be controversial, it would be virtually impossible to pass a law that did anything of use that didn’t result in a disadvantage to somebody.
     You’re acting like the freaking liberal though police, it would be nice if you’d knock it off.
     You won’t, I’m just pointing out that it would be nice.

371. DJ is not even discussing tweaks to the law
     Because that would actually be constructive. What would those tweaks be?
     Thank you very much for offering amendments, russell.

372. Which, to my point, is this:
     Writing legislation is extremely difficult. There is no question whatsoever that the ACA is a huge law that should be tried, should be amended, should be made better, over the years.
     Trying to identify the poor “victims” before anyone really knows what’s what, and before their real actuarial advantages, and disadvantages, are truly assessed, is a political attack on the law itself, and a vote in favor of the previous regime.
     Sure (and as I mentioned, something I know something about) there are about the zillion-and-a-half legislative amendments that are made to existing law every year. That’s what legislatures do. Laws are never perfect. Tweak away.
     This isn’t the time to do that, especially when tweaks won’t happen with the Republican Congress.
     Do you never think, russell, that there’s a time to solidly support someone who stands for something (generally) that you believe in?

373. Russell, in case our exchange disguised this article:
     Yes, sure. We can all call the New York Times out for talking about how Obama had to “bow” to Chuck Todd. But, please. Does this not give you the ultimate creeps?
     I find it horrifying, and I’m angry at anyone who furthers this crap.

374. There is no question whatsoever that the ACA is a huge law that should be tried, should be amended, should be made better, over the years.
     Great, we’re in agreement.
     Trying to identify the poor “victims” before anyone really knows what’s what, and before their real actuarial advantages, and disadvantages, are truly assessed, is a political attack on the law itself, and a vote in favor of the previous regime.
     No, it’s not.
     At least at the level that is being done here, by Donald Johnson, it is part of the process of understanding what the strengths and weaknesses of the law are.
     It’s a sufficiently complex law, and it’s being implemented in a sufficiently complex environment, that it’s worth noting those things as they come to attention.
     And as a matter purely of my own opinion and experience, no argument is ever well served by refusing to concede things that are actually so.

375. Does this not give you the ultimate creeps?
     No, it doesn’t give me the creeps at all.

376. that are actually so
     What is actually so? There is very little evidence here of what is so.
     And it’s interesting that you omit the major issue, which is the way Barack Obama is being treated in the process, as if he were a political figure in the Reconstruction. “Bowing” to Chuck Todd.
     Oh, wait, and I forgot to ask again: where are your suggested amendments to the ACA? So far, we’ve discussed theoretical “victims” and we don’t actually know what their situations, choices, futures or anything are. You’re so discerning! And such a responsible citizen! What is the last law you scrutinized with such anticipatory concern?
     Just suggest something, russell, rather than waxing on about how you should have the right to dissent.

377. I’m glad to know that the concept of Barack Obama “bowing” to Chuck Todd, and apologizing isn’t creepy to russell. Let that fact be stated very loudly.

378. I’m a little surprised to see how my final comment on this subject was interpreted. I thought it was banal, obvious, and not anything sapient would disagree with and I actually came on to point out what I’d seen on Chris Hayes, that Obama had very sensibly said that maybe some people were hurt and he’d do his best to fix the situation. Good for him. That’s how a President should react. I liked and respected his reaction. I come here and find that I was siding with slaveowners. Interesting.
     I’d be angry, maybe, but this is so ridiculous it’s not worth the bother.

379. To get back on topic of this post I’m having trouble finding what the fox has to say of this “science” http://www.salon.com/2013/11/07/can_science_explain_tea_party_rage/

380. Donald, in all fairness, I piled on a little. By mentioning that it gives me comfort, as someone you doesn’t like the law, to see supporters discuss it critically. I know, that was probably harsh bordering on ridiculous.
     But to respond directly to sapient:
     “We heard, originally: “repeal and replace!!!” but no actual bills to replace were forthcoming.
     Now you’re saying “Tweak!” (Are you saying that? I don’t note any immediate suggestions for a tweak.)”
     Sapient, I’ve suggested numerous things throughout this thread about how to fix healthcare in this country. I’ve said the things I don’t like, and the things I do like about the law. I’ve engaged (semi?)-constructively about the pros and cons of the law. I could repeat them all, but that would be a waste of everybody’s time. Or at least my time. But probably everybody else’s as well.
     If you want to engage me on what I said, please do. I’d love to discuss it.
     “Fighting against the ACA now, or insisting on “tweaking” it (since the Republican House would never “tweak” it) is a vote for the status quo ”
     Or maybe its a vote to fix the status quo. Maybe its a vote to engage in reasonably debate with people who disagree with the law. Maybe its a vote to improve it. The point where we can not constructively engage with each other is a sad one indeed. What saddens me the most is that you are practically admitting problems with the law, and yet you *refuse to discuss them*.
     “This, despite the fact that foes of the law aren’t “comforted” by the failure of its advocates to help derail it for awhile.”
     Does my comfort really deserve scare quotes? Seriously, does it bother you that I enjoy debate and to know people you disagree with me are willing to take a hard look at their positions?
     To be clear, and I’ve stated this many times: I *am not* rooting for failure. I want this country to succeed. With the ACA or without. Yeah, I think we have a better shot without, but that’s what debates and elections are for. And, as an opponent of the law, I can say without doubt, that Donald was not trying to derail the law. Or if he was, he was being woefully ineffective.
     What shocks me constantly about politics is that its not even pretend tribalism. It’s in your face, unabashed, if *we* don’t win, *they* will.
     I’m probably optimistic and hippy-dippy about this, but its really hard to mock sincere, honest people. Even when they’re wrong. Especially when they are willing to engage with you about it.
     Sapient, I’d really like to hear what you like and don’t like about the law. What you think the tough choices were. What could be improved.
     You are, of course, free to ignore me.

381. Thompson, I didn’t have any objection to what you said. My only point is that supporters of the law should listen to (some of) the critics and not react defensively if some of the criticisms turn out to be valid. It was an utterly banal point, and arguably not quite as evil as, say, kidnapping a free black man and selling him into slavery. But that might be a notion we could debate–is criticism of the ACA, no matter how mild, the most evil thing to happen in America since the days of slavery? Ben Carson thinks the ACA is as bad as slavery and sapient thinks my comments in this thread are as bad as slavery. It’s very confusing.
     As for solutions, I don’t have any to offer. Don’t know enough. I have some naive notions, but hesitate to offer them since if I type anything else it might constitute another crime against humanity. Can’t have that.

382. Donald,
     That is an utterly banal point, except for politics. You see, if “we” lose, “they” win. Actually, I’m probably a “they” in this case, although I don’t really know if I’m comfortable with that.
     I will say, however: Slavery? People died. Were slaughtered. And that was just getting to the country where they were sold into forced labor. And then were killed sometimes just because.
     I’m not gifted in rhetoric and I can’t begin to express the horror that the slave trade was. I’m glad I wasn’t alive to see it.
     The ACA? It’s a law. Passed in a democracy, even if contentious. Where people can vote, regardless of race and gender. And yeah, opportunities aren’t what they should be, but this is still a pretty good place to live. I can’t equate any of this to slavery. It’s just hyperbole.

383. Again, you’re making common cause with Republicans. Just stop it for a change.

     Evidently Donald is objectively pro-Republican, which also makes him objectively pro-terrorism.

384. Thanks, Donald, for supporting people who insisted that Obama “bow.

     Methinks you are being deliberately and overly literal, here, in order to attempt to bludgeon Donald into shutting up.
     You’re really a lot less subtle than you might think.

385. Just suggest something, russell, rather than waxing on about how you should have the right to dissent.
     I suggest you give it a rest.
     Oh, about the ACA? I suggest the WH be candid about the possible downsides of the law. Which, it seems, they have begun to do, and good for them.
     In any case, this is rapidly turning into another stupid pissing match about how many kittens are going to die if anyone says anything that can remotely be seen as critical of Obama, so I’m bowing out.

386. I think we need a new thread! Something new to talk about.
     The Western Black Rhino has been declared extinct.

387. Poached to the end

388. Oh, Mr. Todd! Mr. Todd! Dean Baker would like a word with you.

389. Yeah, bobbyp. If your insurance company goes out of business, that’s Obama’s fault, too, I guess.
     Dare I say, on a blog no less, that I think the law should be looked at and changed if it appears that changing it (in what way, I couldn’t say yet! sorry!) is the best thing for American citizens, BUT! the cancellations are acts of insurance companies, not ACA requirements.
     So I think one can acknowledge a consequence of the ACA, without blaming the president for lying about what the ACA required, while considering how to improve on the situation… you know, hypothetically, and not too soon, of course, especially in a blog comment, where the ramifications are dire in nature and historic in scope.

390. Aw, Laura, that’s sad.
     I never understood rhino poaching. Are there that many people with loads of money that are stupid enough to think powdered rhino horn makes you super-virile or whatever?
     I guess the answer is yes. It’s just always an answer I didn’t want to believe.
     There’s hope for the rest, though, if you support conservation efforts.
     Or maybe just start a fake rhino powder business. I doubt the recipients can tell one source of keratin from another, and there are a lot of nail clippings in the world.

391. via Eschaton, here are some links to a guy who has suggestions to improve the ACA:
     Shorter read:
     http://virtuallyspeaking.us/blog/2013/10/30/the-problem-with-the-ppaca
     Much longer listen:
     http://www.blogtalkradio.com/virtuallyspeaking/2013/11/08/stuart-zechman-virtually-speaking-with-jay-ackroyd
     I’ve read the first and I’ve no opinion at the moment. I’m saving the second for free time.
     From the looks of it, the conversation about improving the ACA is off and running, which will make sapient angry.
     These particular links look like they will make everyone angry, too.

392. But maybe we should have an open thread on something else, like health insurance for the animal kingdom, the latter of which is not really a kingdom, but a princely state nuked by the human kingdom.
     In addition to extinct rhinos, we have Captain Ahab of Moby Dick pulling Ben Braddock of “The Graduate” aside and suggesting a career path, by which I mean our plastic fetish is wiping out whales.
     If our dogs and cats and goldfish were consuming great sheets of plastic and gagging o death, we’d be on the march.
     First, the dreadful reality:
     http://www.realnews24.com/gray-whale-dies-bringing-us-a-message-with-stomach-full-of-plastic-trash/
     And second, my allusion to “The Graduate”:
     http://www.youtube.com/watch?v=PSxihhBzCjk
     “Ben, Ben, I want to say one word to you. Just one word.
     Yes, Captain Ahab,somehow i thought it would be two words, but I’ll take a guess: ‘Ishmael’?
     No, Ben …… plastics.

393. I’ve read the first and I’ve no opinion at the moment.
     I did like the one comment, which boiled down to something along the lines of, “The real liberal solution is single-payer, not more Rube Goldberg.”

394. but, until the liberal pony Utopia arrives, the ACA will have to do.
     maybe people could try not letting the good be the enemy of their fantasies.

395. but, until the liberal pony Utopia arrives, the ACA will have to do.
     I agree. But that article goes on about how ideologically screwed up the Obama administration and a large segment of the Democratic party are, and how someone has to fight the real liberal fight, and so on, as though what the author’s proposing isn’t just a somewhat better “market-based” solution. He’s the one who positioned himself as the true, steadfast liberal champion, rather than someone who was trying to be practical – even if in a good way.
     It’s just kind of funny.

396. thompson: Sapient, I’d really like to hear what you like and don’t like about the law. What you think the tough choices were. What could be improved.
     What I like about the law is pretty simple: Number One: It passed. Number Two: Now people can get health insurance, even if they’re sick, which will prevent a lot of bankruptcies. People aren’t stuck at hideous jobs for fear of becoming uninsured: if they have a small savings, they can start their own business.
     Like a lot of people here, I’d prefer single payer, or at least a public option, paid for by a progressive tax system. That’s not possible in our country right now, and I don’t see how we can make sharing the burden of healthcare more equitable than subsidizing low-income people, and providing everybody else with somewhat standardized coverage options.
     As to flaws, obviously, the IT people need to work on the website.
     Although you, thompson, have some thoughts about regulatory regimes prohibiting insurance companies from rescinding contracts, etc., that didn’t happen (despite many, many years of dissatisfaction with the health care system), largely because insurance companies would not have stayed in business insuring the sick, without healthy people contributing premiums in large numbers. There aren’t that many “private” solutions where the math adds up to allow sick people to be insured, and insurance companies to stay in business.
     But actually, I was bored to death with the early part of this thread, re-litigating the pros and cons of the ACA, so sorry if I missed your other points. We have worked hard for decades to get what we have, and Republicans (the champions of the free market) never offered us any solution.
     It’s time to see how the ACA works for a few years. Its problems can be fixed after people know what the law’s effects actually are. But, so far, a lot of the “victim” sob-stories have been anti-ACA propaganda. Let’s find out what’s real.

397. From here:

     On Thursday, for example, the conservative group Americans for Prosperity launched a $1 million ad campaign targeting four House members, including two Democrats who voted for the health-care law. One ad criticizes Rep. Ann Kirkpatrick (D-Ariz.) for helping make the law a reality. “Now Arizonans are losing the health-care plans they love,” the narrator says. “The doctors they love. And millions remain uninsured.”

     I didn’t know so much love was a stake, or that Americans for Prosperity was such a sensitive bunch. It’s kind of sweet, really. Almost kitten-like.

398. This might go in the ‘Centrist Media’ group but still can’t find what does the Fox say.
     http://www.culturalcognition.net/projects/second-national-risk-culture-study.html

399. “It’s time to see how the ACA works for a few years. Its problems can be fixed after people know what the law’s effects actually are. But, so far, a lot of the “victim” sob-stories have been anti-ACA propaganda. Let’s find out what’s real.”
     That’s reasonable, and in line with what sources like Josh Barro are saying. And with Digby, who in her latest piece takes a potshot at a rich former MSNBC commentator whining about his increased insurance cost.

400. Sapient, I appreciate the response. I note #1 on you list is “it passed”
     To touch on your point:
     ” largely because insurance companies would not have stayed in business insuring the sick, without healthy people contributing premiums in large numbers”
     People said that constantly. I don’t know how true that is. I doubt there is a large number of financially stable people out there that would willingly go without insurance, even if they are healthy. Yeah, I think it should be their choice, but it’s not a choice I expect an appreciable number of people to make. And these aren’t companies that are really suffering:
     http://money.cnn.com/magazines/fortune/fortune500/2010/industries/223/index.html
     I think they have some wiggle room in their profit margins without enforcing that people buy insurance.
     But maybe I’m wrong, I never found great numbers on it. Just vague, people wouldn’t buy insurance and the companies will go belly up claims.
     “Its problems can be fixed after people know what the law’s effects actually are.”
     This bothers me. Why can’t we discuss continuously and fix the problems as they arise? Shutting down discussion because we don’t know yet just feeds into a narrative that the republicans used during the passage of the bill: It’s to big and complex, nobody even understands what the law does.

401. That’s reasonable, and in line with what sources like Josh Barro are saying. And with Digby, who in her latest piece takes a potshot at a rich former MSNBC commentator whining about his increased insurance cost.
     Thanks for calling me reasonable! 🙂
     A quick look at Hullabaloo shows that Digby wrote a subsequent post, and I’m not sure that it is correct regarding the “sacrifices” of people in the individual market versus group health plans. When she talks about people being “covered by their employers,” it’s not necessarily true that employers pay for the entire cost of coverage (although, traditionally, being part of an employer’s group plan made it less likely to be cancelled in the event of an illness).
     Normally group plans require shared premium cost, between the company and the insured. In fact, some companies may sponsor a group plan, but the employees actually pay for the premiums. Not sure whether premium costs for groups are set only within the group, or are set based on a wider population, but I think the latter.
     That’s why a comment section is always helpful to a blog – if the blogger makes erroneous factual assumptions, they need to be called out.

402. maybe I’m wrong, I never found great numbers on it. Just vague, people wouldn’t buy insurance and the companies will go belly up claims.
     But it could easily have been tried, and now it’s moot.
     And, as to keeping a discussion going about alternatives to the ACA, be my guest. I won’t be joining in that one, because I don’t find insurance law all that fascinating, and I’m satisfied with seeing how the current law plays out, especially since the “problems” (except for the mechanical ones) seem largely to be made up.

403. People said that constantly. I don’t know how true that is.
     The reason there is a mandate in the ACA is that the insurance companies demanded it as the price for dropping recission, and for shall-issue.
     I’ll also point out that the practice of recission, refusal to insure pre-existing conditions, and the efflorescence of high-deductible catastrophic coverage plans, all came about in an environment where a number of high-risk demographics – the very poor, everyone over 65, people with a variety of very expensive chronic illnesses, and everyone in the military – were *already* out of the private market.
     The argument that the insurance companies couldn’t make enough $$$$ without the mandate is one that was primarily being made by the insurance companies themselves.
     People “say it constantly” because the evidence points that way.
     I doubt there is a large number of financially stable people out there that would willingly go without insurance, even if they are healthy.
     “financially stable” is doing a lot of work in this statement.
     People buying their own insurance are often looking at a low-five-figure price tag. That’s a lot of money. For “a lot of money”, read “second mortgage”.
     At that price point, “willingly” can translate to “I’d prefer to eat and heat my apartment in the winter”.

404. Your point about rescission suggests to me it wasn’t employed because it was the only way they could be profitable. I think they did it because they could and were rent-seeking. If that’s the case, I don’t necessarily see the need to match an end to rescission with an individual mandate.
     “The argument that the insurance companies couldn’t make enough $$$$ without the mandate is one that was primarily being made by the insurance companies themselves.”
     Who I, of course, trust implicitly to let us know when they’ve made enough money?
     “People “say it constantly” because the evidence points that way.”
     Which evidence? I never could find much, but I was probably looking in the wrong places. If you could point me to the analysis, I’d appreciate it.
     “”financially stable” is doing a lot of work in this statement.”
     Fair enough. But we’ve discussed how to make healthcare affordable (so people wouldn’t have to make Insurance vs rent/food choices) in this thread and I don’t see much point in revisiting it.
     More than 80% of the US population has coverage. Around 40% of the current uninsured don’t fall under the mandate (http://kff.org/health-reform/perspective/the-individual-mandate-how-sweeping/). Leaving around 10% of the population compelled by the mandate. Unless that 10% is an essential component to insurance company’s books, we’re left with the concept of people pulling out of the market without the mandate.
     What I was getting at is this abiding belief that without a mandate in the presence of regulations on denying coverage, people would pull themselves out of the insurance pools.
     It honestly always struck me as a little farfetched. Like the terrorist anchor-babies thing. I could see the security hole people were talking about, but it just seems like a ridiculously narrow case. The mandate seemed more like a political gesture to the insurance companies so they wouldn’t dump money into opposing the law, rather than an actual structural necessity of the law.
     This isn’t a bridge or other geographical object I’m willing to die on, I just always balked at the assumption that the insurance system would collapse without the mandate. It seems counter-factual to my experience…most people I’ve met, even below the poverty line, value health insurance pretty highly. I never could find data one way or the other, and again, if you could point me towards that data, I’d appreciate it.

405. I don’t necessarily see the need to match an end to rescission with an individual mandate.
     Neither do I. However, our opinions on the matter were not requested.
     Who I, of course, trust implicitly to let us know when they’ve made enough money?
     Again, our opinions on the matter were not of interest.
     I couldn’t agree more that a private insurance company *ought to* be able to make enough money without the mandate, or recission, or shall-issue.
     But it is not my decision.
     The reason there’s a mandate is because the private insurers insisted on it as a quid pro quo for dropping recission, and for accepting shall-issue. They asserted that they wouldn’t be able to make enough money without forcing healthy folks into the pool.
     That’s the basis for folks saying that they wouldn’t make enough money otherwise.
     Because *they said* they wouldn’t make enough money otherwise.
     Was that true? I don’t know.
     Do they really need to make as much money as they do make? I doubt it, but it ain’t up to me.
     The feds could have tried the approach of *telling* them that they would drop recission, and accept shall-issue, without the mandate, but since they did not, I assume they needed the buy-in to get the ACA passed.
     In other words:
     The mandate seemed more like a political gesture to the insurance companies so they wouldn’t dump money into opposing the law, rather than an actual structural necessity of the law.
     Yes, that’s probably right.
     And in the real-world context in which passing laws occurs, the distinction between *things that are necessary to get the law passed* and *things that are structurally essential to the law* is sort of academic.
     Don’t mean to be dismissive of your point, because it’s valid, however it’s more or less made moot by the situation.
     If the private insurers say that the money they could make without the mandate was not enough, then that sort of has to stand as the reality. Because nobody else is in a position to tell them how much is enough for them to make.

406. I don’t necessarily see the need to match an end to rescission with an individual mandate.
     Neither do I.
     Yes. It strikes me that this is only one part of the mosaic that comprised this complex ‘bargain’. As I understand it, the government is providing the health insurance industry a bigger pool (via mandates and premium subsidies) of more paying customers. As a general rule, private for-profit enterprises tend to really like this.
     In return the industry agreed to an end to rescission, shall-issue, caps, 80% of revenues* going to cover claims, expanded policy coverage, exchanges, etc.
     Thus, in principle, effectively capping their max. profit @ 20% which is both unrealistic (cf admin costs & CEO salaries) and ‘plenty’, but I digress. So we kinda’ are telling them how much is enough.

407. And in the real-world context in which passing laws occurs, the distinction between *things that are necessary to get the law passed* and *things that are structurally essential to the law* is sort of academic.
     Thank you, russell. Sadly, the real world is where we live.

408. So we kinda’ are telling them how much is enough.
     Yes, fair enough, we are telling them ‘how much’ in terms of what percentage of their total revenue has to go toward services for the insured.
     Thank you, russell. Sadly, the real world is where we live.
     You’re welcome, and yes, for good or ill, it surely is.

409. Was anybody else amused by the “libertarian” saying ‘couldn’t we be a little harder on the corporations’ while the “liberals” are saying ‘it’s what they say, so oh well’? Paraphrasing of course.
     “is sort of academic.”
     Well, I guess I am an academic. These things keep me up at night.
     “Sadly, the real world is where we live.”
     The real world is where we live but I like to talk about things in real terms. An example of which is the exchange we just had…the distinction between and *political reality* and *economic reality*.
     I probably object to those kind of interest group/government negotiations and political settlements more than average. I’ll cop to that. But I do recognize democracy is messy and there are going to be compromises to bring people to the table. I just like when those compromises are described as political settlements rather than as it’s the only way to make the system work.
     Because I try not to demonize people for the compromises and tough choices they make. I think discussion of those political realities is far too often missing from the public discourse, replaced with apologists fervently arguing that every aspect of a bill, or a politician, is above reproach.
     That was my point, made long and circuitous. I’ll stop beating the dead horse (or perhaps dead magical unicorn doctor) now, except to say I appreciate the candor of both russell and sapient in replying to me.

410. I probably object to those kind of interest group/government negotiations and political settlements more than average.
     It’s a big country. Lots of different people want different things. Interest group negotiations and political settlements are the way we sort it out.

411. With blogs like this around I don’t even need website anymore. I can just visit here and see all the latest happenings in the world.

412. i agree with website. i think.

413. As I understand it, the government is providing the health insurance industry a bigger pool (via mandates and premium subsidies) of more paying customers. As a general rule, private for-profit enterprises tend to really like this.
     Which, of course, proves that the ACA was designed to run insurance companies into the ground so that we would have to go to a single-payer system.

414. Oh, the mandate was just a lure to draw the insurance companies into the trap. Blinded by the new customer base and the expected profits they would jump right in it and realize too late that they signed their own death warrants because it subjects them to rules that will by design ruin them. All part of the longterm plan to turn the US into an islamo-atheist commie-fascist hellhole.

415. “Blinded by the new customer base and the expected profits they would jump right in it and realize too late that they signed their own death warrants because it subjects them to rules that will by design ruin them.”
     You could be right…
     

416. “You could be right…”
     Curiously enough, the link features quotes (and pictures!) of Rep. Gohmert, of terrorist anchor baby fame.

417. Charles, did you manage to find insurance on the exchange yet, because I worry?
     I read your link, and while I’m sympathetic to making changes in the ACA, an article that quote Louie Gohmert right off the bat seems a disincentive to continued reading, but I persevered.
     Next up, this:
     “In a sense, it legalizes fraud,” said Wesley J. Smith, a senior fellow at the Discovery Institute of Human Exceptionalism and a frequent critic of the Affordable Care Act. “It legalizes putting your burdens on the insurance companies’ shoulders and never paying your premiums. The government wants people to be irresponsible and apparently they want the whole system to descend into chaos.”
     Mr Smith (he should have left this ridiculous language to a lesser fellow at the Institute) must not have a particularly elevated view of “Human Exceptionalism” if he believes so many of us are prone to committing this type of fraud, nor can he be serious with “apparently they (the government) want the whole system to descend into chaos.”
     The word “Apparently” died like a third-world underfed, repeatedly-lashed pony trying to pull that gangbang of an overloaded sentence.
     Not that I don’t think the language cited in the ACA should be looked at.
     On the other hand, I can understand some folks with little in the way of resources stiffing the medical community on medical care, just as I can understand shoplifting to feed one’s children, despite whatever carrots and sticks the Discovery Institute of Human Exceptionalism brandishes in its gauntlet of incentives and disincentives through which we must run naked to achieve the aforesaid exceptionalism.
     After all, the way the system works now is that folks show up uninsured at the emergency room for all manner of medical care and the hospitals give it to them (fine by me) on my insurance nickel, despite these folks having to give up their extravagant cellphones because the bill collectors unsuccessfully or successfully harass them into homelessness.
     Plus, we are fed rhyming couplets by the usual suspects that the Government (hereafter referred as they) should be run more like the private sector, so a little emulation of the Book of the Month Club (buy ten books no obligation for the next dozen), the Record of the Month Club (buy six records, no obligation), Andrew Sullivan’s website (read so many posts free and then that’s it without full subscription) etc seems in order.
     Maybe doctors could offer one course of chemo gratis, as a tease, until they have people hooked, since medical care is just like every other commodity product.

418. One way to defraud the ACA system was put in on insistence of Republicans. If I understand it correctly, the government is bereft of legal means to collect the fee, if people should not buy insurance as the law requires because a refusal to pay it cannot be prosecuted or the money taken from the refusee’s assets.

419. You could be right…
     You can’t be serious. Wesley J. Smith, fellow at the Discovery Institute of Human Exceptionalism? Really? A propagandist for anti-Darwinist “irreducible complexity”? That Wesley?
     The man is a crackpot. I’d sooner take seriously OTC stock tips from George Gilder.
     And Hartmut: Shhh

420. In support of sapient’s point, I’m reminded of the programmer’s dictum “premature optimization is the root of all evil.” Meaning the places you think will be the worst issues hardly ever are, and you can waste a lot of time and energy making relatively small improvements in the overall outcomes.

421. I keep seeing the complaint that Obamacare is a transfer of resources from the fit and healthy to the un- including a few people in this thread. Laura (I think it was) argued that in a democracy it was ever thus. I’d go further and say that’s basically what a society is. I can’t think of a single social organization, from the family on out, that can’t on some level be accurately described as a transfer from fit, healthy working age adults to those more in need.

422. I find the “transfer of resources from the fit” argument, so often
     dominating the discussion, extremely galling. It ignores the basic
     principle of insurance, which is to spread risk.
     In any system of insurance, people who do not suffer losses subsidize
     those who do. That is the whole idea.
     Now with health care, there are some risk factors that are to some
     extent under personal control, such as cigarette smoking, obesity, or
     participation in extreme sports, for example. Also true, there will
     always be people who game the system, no matter what system there is.
     Do we really want to draw a moral line and say to someone, you are not
     worthy of health care because of your own actions and inability to
     afford it? There are examples of that attitude in the “let them die”
     response from the 2012 Republican debates, or Scrooge’s “are there no
     prisons?”, but since I prefer humor, let me point instead to this.

423. In support of sapient’s point, I’m reminded of the programmer’s dictum “premature optimization is the root of all evil.”
     Contra this, I can’t think of any modern SE paradigm that calls for bug reports to be ignored, and I think that’s more the issue here than outright optimization. It might be premature to debug, redesign, or refactor ACA, but it’s not too early to note possible problems.

424. The program got passed with KNOWN problems but it was not feasible at the time to remove them before passage. At least some got put into it by its enemies in the game of slowdown. The choice was to pass something or nothing. If it is possible to get rid of some of these before too many people trip over them, that seems legitimate to me. Taking spanners out of the works is different from redesigning the engine before the first test.

425. The choice was to pass something or nothing.
     This. Thanks, Hartmut.

426. there are some risk factors that are to some
     extent under personal control, such as cigarette smoking, obesity, or
     participation in extreme sports, for example. Also true, there will
     always be people who game the system, no matter what system there is.
     And the more we know about things like addiction, obesity, and other “risk factors,” the more complicated we know that those issues are.
     Medicine is about compassion and care, not mechanics.

427. The choice was to pass something or nothing.
     This. Thanks, Hartmut.

     That. It’s one thing to tell us we have to hold our noses and shut our mouths to make sure something can get passed, but it’s quite another to tell us we need to keep our mouths shut once it’s passed – and implemented – until.. when, exactly? The ACA is hardly Tinkerbell, so I don’t think we really need scolded for stopping clapping.

428. Nombrilisme Vide, exactly.
     Now the problem is how to improve it without risking losing everything again. And some conservadems are, as it seems, already trying to work on the latter.

429. One way to defraud the ACA system was put in on insistence of Republicans.
     Really? Was this when the Dems sat down with the Repubs and let the Repubs suggest changes, etc to ACA? Can you give me a date on that?

430. Here you go McKinneyTexas http://www.whitehouse.gov/health-care-meeting/republican-ideas

431. then again it does look like most of their ideas were met with rejection. http://rsc.scalise.house.gov/uploadedfiles/gop_amendments_submitted_to_hr_4872–8.31.10.pdf

432. Only 197 amendments were passed in the end
     36 from Democrats
     161 from Republicans.

433. This seems like a pretty thorough legislative history of the ACA.

434. 161 from Republicans.
     Well, this obviously cannot be true. Republicans assert this monstrosity was passed in the dead of night as porters (aka “union thugs”) secretly carted 2,000-11,000 pages (reports vary)of coded incentive destroying regulations into Nancy Pelosi’s office the night before the coup (aka “up or down vote”). How could there be amendments, much less GOP ones? Doesn’t that imply they had read the damned thing?

435. bobbyp, actually no. I think most amendments need no knowledge at all of the content of the bill they get added too. Far more common are amendments of these types
     A) money gets redirected to benefit the amender’s district in exchange for a Yes vote
     B) poison pills like adding something outrageous to the bill, so anyone voting ‘Yes’ can later be attacked for it

436. A) OK
     B) Yes. However, contra your hypothesis, 161 of the GOP amendments were incorporated into the bill (assumes Jeff’s numbers above are correct)…and it is quite hard to believe the Democrat storm troopers under the iron fist of Nancy Pelosi would let poison pill amendments anywhere near Washington, D.C., much less onto the floor of the House of Representatives.
     🙂

437. Sarah Palin, on what the Republicans should do to replace Obamacare:
     “The plan is to allow those things that had been proposed over many years to reform a health-care system in America that certainly does need more help so that there’s more competition, there’s less tort reform threat, there’s less trajectory of the cost increases, and those plans have been proposed over and over again. And what thwarts those plans? It’s the far left. It’s President Obama and his supporters who will not allow the Republicans to usher in free market, patient-centered, doctor-patient relationship links to reform health care.”
     The scary thing is that her position–an incoherent and mindless repetition of rightwing buzz words–isn’t different in substance from what Republicans in Congress have offered as an alternative. I think that mindless buzz words is all they have.

438. bobbyp, it was not meant as specifically addressing the ACA but as a general observation. I doubt that many congresscritters actually read the ACA. As usual they left that to their staffers (at best). What I wanted to say is that there is no inherent contradiction between offering amendments and not having read the bill. Iirc quite a number of proposed amendments tried to ‘add’ something that was already addressed in the bill. Additionally many bills deliberately contain shark-bait intended to draw neutralizing amendments while keeping the actually valued stuff untouched (because the sharks gather round the decoys). Imo the Democrats made the grave mistake to cut up real stuff (like the public option) for bait instead of using fakes only put in for that. purpose.

439. Well, I think the Administration came out yesterday and said mental illness should be covered by medical insurance, so there may be help for Governor Edwinia Norton from Alaska.
     Or maybe it’s just one of them, whatchamacallit, speech impediments, there Ralphie.
     Whatever the problem is, think of her as Presidential material.
     Think of the State of the Union addresses if President McCain had the big one and was on life support at Bethesda.

440. http://missoulian.com/news/national/scientists-oppose-logging-bills-in-congress/article_5ac01ac3-1994-5296-aaf0-418227c1c1cc.html
     The effect of the corporate welfare being pushed by the Republicans in Congress on our National Forests, the same folks who argue against Obamacare on the grounds that it makes people dependent..

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