Gas Bandit's Political Thread V: The Vampire Likes Bats

figmentPez

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Well, if we're still talking about heart transplant surgery here (which is, after all, what kicked off this whole latest tempest), it stands to reason that the surgery is taking place in a full blown hospital, yes?
I didn't specify any specific procedure, but no it doesn't stand to reason. There are cardiac care facilities, that specialize in cardiac care. A new one went up across the highway from me recently. It is a building specifically for cardiac procedures and recovery. Not all procedures are done in a hospital. Thus you'd get the rate for the cardiac care center, which would charge "fair market value" compared to other cardiac care centers. Hell, your new plan might well increase the number of such places, and start getting other branches to make their own facilities as well. New chances for hidden charges.

I could dispute it when I got the bill
And how would you do that, if they were in fact charging you roughly the same cost as everyone else? A price that no one needed to compete on because it wasn't something most people knew to factor in? And even if they knew, were unlikely to find anyone willing to cut a deal on anything but the base price. There's no magic way to set up a system as complicated as healthcare where all the pricing is upfront, transparent, and based on informed consumers choosing the best price. There are too many patients who need to be cared for who don't have a chance to comparison shop, too many cases where there is no comparable case to standardize price on, too many ethical concerns.

But I'm growing tired of trying to explain to you that every system is vulnerable to corruption. You seem to think that businesses can be forced to act in the public's best interest, and that somehow the government can force businesses to do this, but the government can't act on the government in the same way. It boggles my mind to think that you draw such a bizarre distinction. The fact that you think you can come up with a system that brings prices down to the point where everyone gets the care they need, while not explicitly funding care for the poor, is ridiculous.

I don't think your hypotheical system is any more flawed that hypothetical "single payer" systems. I just think it's ridiculous that you think your system has figured out all the angles, and that other systems are incapable of doing so. The only thing your system has going for it is something I've already pointed out, the way to keep capitalism in check is to force it to fail, and it's a lot easier to force that failure than it is to ensure a socialist type system's success. However, the more regulation you add to a capitalist starting point, the closer you get to other systems (not just socialism, but other philosophies as well), and the more you get into other systems, the more you're reliant on being able to succeed in order to avoid catastrophic failure. Arguably, the United States is much too far away from pure capitalism to aim for anything less than a successful implementation of it's goal, rather than relying on shooting down capitalists who get too powerful for the public's good.
 
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It's also very illegal in all 50 states (at least the off the clock/book overtime part).
Illegal doesn't stop companies from doing it, especially if they have the means to fight it in court.

Suits Say Wal-Mart Forces Workers to Toil Off the Clock

Wal-Mart Workers Win Wage Suit

It's clear that this is something that companies do if they can avoid repercussions from it. And it's clear exploitation.

There's also the on-going suits regarding Wal-mart refusing to make accommodations for pregnant workers.
 
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How would it have stabilized when the funding was a shell-game from the start?
Entire government is a shell game.

Ok, so, to repeat the question, Are you comforable with a panel of Trump appointees deciding who gets what end-of-life care vs palliative care vs being sent home with some aspirin?
The obvious answer is that with my current understanding of time there will be no Trump political appointees on whatever board oversees the program.

But a more nuanced point would be that I trust that political appointees that hate social security will send the checks out on time or that political appointees who hate Medicare will make sure that hospitals get paid. You build a strong institution and it'll weather the political appointees.

Well, I'm genuinely glad it worked out for your uncle and grandfather. There's been a lot of people who haven't been as fortunate. The mismanagement of the VA has been a rather prominent scandal over the past 4 years or so, with "rampant fraud, corruption, cover-ups, excessive and contradictory spending, inadequate care, a massive backlog of benefits claims, and a secretary position nobody can seem to hold down." It spurred full on criminal investigations by the FBI and congress. Hundreds of veterans died waiting for care. But naturally government bureaucrats covered for their own, and those who were deemed culpable were shuffled around to other positions or allowed to resign quietly instead of face criminal charges - and even that last part ended up only happening to 3 VA administrators.
Oh I'm not saying that there aren't problems with the VA. But I don't want to dismantle the ICBM portion of the nuclear triad just because they are all hopped up on meth and cheating on their readiness tests. I think the Navy needs some work because their ships keep on ramming other bigger ships because the sailors are too tired to think straight. Nor do I want to dismantle the military because they have a tendancy to murder reporters and MSF doctors and then cover up the fuck up. Nor do I think hospitals should be shut down for kicking out patients onto the streets when it's illegal for them to do so.

The VA needs reform no doubt about it. Maybe more than most government agencies. But I think it's still one of the best places for complicated cases to go in order to get them out of the system so that they aren't terribly distorting the healthcare market. The doctors are professional the infrastructure is there to deliver what is needed.
 
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I don’t remember if I already posted this, but one of my wife’s Internet friends keeps horses, and that friend posted some gingerbread-covered meme about how people who keep horses live longer, to which my wife replied that people who can afford to keep horses are also more likely to be able to afford healthcare.

—Patrick
Your wife is smart.
 

GasBandit

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I didn't specify any specific procedure, but no it doesn't stand to reason. There are cardiac care facilities, that specialize in cardiac care. A new one went up across the highway from me recently. It is a building specifically for cardiac procedures and recovery. Not all procedures are done in a hospital. Thus you'd get the rate for the cardiac care center, which would charge "fair market value" compared to other cardiac care centers. Hell, your new plan might well increase the number of such places, and start getting other branches to make their own facilities as well. New chances for hidden charges.
Conversely, single payer solutions might shrink the number of such places, increase wait times for such procedures, and lower quality of care across the board. Heck, the ACA has already caused problems with doctors deciding this is a good time to get out, and fewer new med students are enrolling. The scuttlebutt seems to be we're already on our way to a doctor shortage.

And how would you do that, if they were in fact charging you roughly the same cost as everyone else? A price that no one needed to compete on because it wasn't something most people knew to factor in? And even if they knew, were unlikely to find anyone willing to cut a deal on anything but the base price. There's no magic way to set up a system as complicated as healthcare where all the pricing is upfront, transparent, and based on informed consumers choosing the best price. There are too many patients who need to be cared for who don't have a chance to comparison shop, too many cases where there is no comparable case to standardize price on, too many ethical concerns.
Well, the obvious answer is that you simply remove the distinction between the "specialist pricing" and the "hospital pricing." It doesn't matter if I get a Widget from Best Buy or WidgetsSpeciality Mom'n'pop, fair market value is the value set in the market, not by the specialist. Yes, there's no "magic way to solve everything," but there are common sense ways to make things better than they are. And there IS a magic way to ruin everything - and that's single payer.

But I'm growing tired of trying to explain to you that every system is vulnerable to corruption. You seem to think that businesses can be forced to act in the public's best interest, and that somehow the government can force businesses to do this, but the government can't act on the government in the same way. It boggles my mind to think that you draw such a bizarre distinction.
"We've investigated ourselves and have determined that we have done nothing wrong." Government has a terrible record in policing itself. And yes, business has a terrible record in policing itself. It's in everyone's best interest to keep the oversight separate from the action. What boggles my mind is why you think government has your best interests at heart any more than any business. The big difference is there are things that can be done to address a business acting in bad faith - when the government is the only game in town, and IT turns south, we're all gonna have a bad time.
I just think it's ridiculous that you think your system has figured out all the angles, and that other systems are incapable of doing so.
I never said I had "all the angles" figured out, I'm just pointing out it's possible to improve things through capitalism (with, yes, government oversight) - and that what we currently have is not that. There is no economic force on earth that can match a properly working marketplace, it's what made our nation hegemonic.

Illegal doesn't stop companies from doing it, especially if they have the means to fight it in court.

Suits Say Wal-Mart Forces Workers to Toil Off the Clock

Wal-Mart Workers Win Wage Suit

It's clear that this is something that companies do if they can avoid repercussions from it. And it's clear exploitation.

There's also the on-going suits regarding Wal-mart refusing to make accommodations for pregnant workers.
Wal-mart's an excellent example of what happens when a single entity becomes a monolithic force against competition. Now, imagine it was run by the government - so that there was absolutely no recourse for addressing the exact same concerns, short of armed revolution.

Entire government is a shell game.
Well, you'll not get argument from me on that. But how does that make the ACA not insolvent?

The obvious answer is that with my current understanding of time there will be no Trump political appointees on whatever board oversees the program.
It was more of a hypothetical meant to drive home the fact that governments are just as subject to corruption and malice as businesses, only with less options for redress. Call it what you will, trump supporters, appointees made by trump allies, whatever. When the only game in town becomes run by those who want to punish you politically, how comfortable does it make you? What about when, say, Trump decides that ICE needs to have a more active role in the medical procedure approval panels?

But a more nuanced point would be that I trust that political appointees that hate social security will send the checks out on time or that political appointees who hate Medicare will make sure that hospitals get paid. You build a strong institution and it'll weather the political appointees.
Wow. I sure don't. And if that "strong institution will weather the political appointees" thing was true, there wouldn't be so many ulcers being grown over Trump's SC nominees.

Oh I'm not saying that there aren't problems with the VA. But I don't want to dismantle the ICBM portion of the nuclear triad just because they are all hopped up on meth and cheating on their readiness tests. I think the Navy needs some work because their ships keep on ramming other bigger ships because the sailors are too tired to think straight. Nor do I want to dismantle the military because they have a tendancy to murder reporters and MSF doctors and then cover up the fuck up. Nor do I think hospitals should be shut down for kicking out patients onto the streets when it's illegal for them to do so.
Well, I can't speak to the things about the military, but at what point DOES it become appropriate to shut down a hospital for malfeasance? And is that easier to do with a private hospital, or a government hospital?
 
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What about when, say, Trump decides that ICE needs to have a more active role in the medical procedure approval panels?
Are you predicting that Trump will sign an executive order to authorize harvesting organs from asylum seekers?

. . . Oh crap. If @NSA has been watching this thread, we just gave Trump the idea.
 

GasBandit

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And how is this any different than "We've investigated our biggest campaign donor, and determined that they have done nothing wrong."?
Well for one thing, your example happens much less than mine would, once there's literally nobody else to investigate, and no recourse when it does.
I mean... that's what I'M saying. But you (and BLOOMBERG for crying out loud) say "break up the monopolies" and you get likes. *I* say it and I get a never-ending parade of "It'll never work, Gas, you dummy"

Are you predicting that Trump will sign an executive order to authorize harvesting organs from asylum seekers?

. . . Oh crap. If @NSA has been watching this thread, we just gave Trump the idea.
Well, more along the lines of Trump would use the process of seeking health care as another vehicle to find and kick out brown people, but hey, your idea might happen too.
 

figmentPez

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Well for one thing, your example happens much less than mine would, once there's literally nobody else to investigate, and no recourse when it does.
You mean a system needs checks and balances to work? Holy shit. Why didn't someone think to make some of those when the country was started?

Why you think setting up business vs government as a check and balance system is possible, but that it's not possible to build checks and balances into government systems isn't. I get that far too few areas of the government have checks and balances, but that doesn't mean we can't implement them.
 

GasBandit

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You mean a system needs checks and balances to work? Holy shit. Why didn't someone think to make some of those when the country was started?

Why you think setting up business vs government as a check and balance system is possible, but that it's not possible to build checks and balances into government systems isn't. I get that far too few areas of the government have checks and balances, but that doesn't mean we can't implement them.
Because it's demonstrably become a foxes-guarding-henhouses situation, especially when one party starts to gain prevalence in all branches over the other. If we had ranked choice voting to scuttle the governmental duopoly, I might have fewer reservations. But as it is, government doesn't check itself. At all. It only seeks to grow its own power, forever.

There's nothing so permanent as a temporary government program. - Milton Friedman
 
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Ah, Milton Friedman, father of Reagonomics and other economic atrocities.

I also think it's funny that Gasbandit is arguing against ideas that are literally commonplace in most of the developed world by saying they wouldn't work, when they demonstrably do.
 

GasBandit

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Ah, Milton Friedman, father of Reagonomics and other economic atrocities.

I also think it's funny that Gasbandit is arguing against ideas that are literally commonplace in most of the developed world by saying they wouldn't work, when they demonstrably do.
Like I've said every time that's brought up - Most of the developed world has outsourced their defense budget to the US, so they can afford to overspend on the social end.
Most of the developed world has a fraction of our population, that lives in a land space a sliver of our size.
Canada's got a safety net in that when their hospitals get overwhelmed or they need an MRI in a hurry, they can hop over the St. Lawrence.
Britain's NHS has been running into walls for as long as it's been around, and is back to being overwhelmed again (and that's a new york times link)

I know, I know, it's never popular to campaign against santa claus sticking it to the rich, but somebody's gotta be the adult.
 
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Here's the thing. We have the resources to pay for it all. We do. We can cut military spending by a fraction, up taxes on the wealthy, stop funneling the creation of new wealth to the top via Friedman's supply side economics, and spend more efficiently. Like, literally paying tuition for every college age student in the US at a public college is cheaper than what we already spend on subsidizing student loans. Koch studies indicate that Medicare for all - which would reduce overhead for medical practices by not needing billing specialists - is cheaper than what we already spend on partial Medicare for some, $32 trillion over ten years to $48 trillion over ten years.

We're already paying for it, we just aren't getting what we paid for.

Society is build on people working together to make something better for everyone, rather than a bunch of individuals stockpiling in their bunkers.
 

GasBandit

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Like, literally paying tuition for every college age student in the US at a public college is cheaper than what we already spend on subsidizing student loans. Koch studies indicate that Medicare for all - which would reduce overhead for medical practices by not needing billing specialists - is cheaper than what we already spend on partial Medicare for some, $32 trillion over ten years to $48 trillion over ten years.
I'd really like to read your sources on those.

And I'm not saying that as a challenge. I genuinely want to read them.
 

Dave

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He's smart, he's progressive, he's young, & he's charismatic. Right now I think he's the dem's best shot at 2020.
 
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Conservatives will tag him for being inexperienced and for his past in a rock band. They'll paint him as some sort of crazy anarchist with no morality and not old enough to worry about "real America." Liberals, especially ones under 35, will complain about him being a straight white Christian male.

It would be a tough road to victory.
 
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I personally would like to see Sherrod Brown and Tammy Duckworth run as a ticket. Brown has strong support in a swing state, has good Rust Belt appeal, and a progressive record. Tammy Duckworth is tough as hell, has stood up to Trump & the GOP at every turn, and is a disabled veteran so she's got the service member appeal.
 

Dave

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I personally would like to see Sherrod Brown and Tammy Duckworth run as a ticket. Brown has strong support in a swing state, has good Rust Belt appeal, and a progressive record. Tammy Duckworth is tough as hell, has stood up to Trump & the GOP at every turn, and is a disabled veteran so she's got the service member appeal.
That's awesome as well.
 
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