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I'm Loyal to Nothing Except the Dream


#149

Agreed, it seems that health care should be a basic service. And I actually had hopes that President Trump might see it this way as well, he came out strong for example about negotiating with big pharma. But then today he met with them and has decided that regulation and taxes are more of an issue for them than the fact that many of the big pharma companies spend more on marketing in the US than they do on R&D. Ever wonder how much it costs to run all the TV ads, and pay those well paid sales reps who go doctor to doctor taking samples around and lobbying for them to carry their products? How much do the “vacation” seminars cost when they bring doctors to fun places in order to sell them on their products? I had a respected doctor in my family, who was head of a department and an industry specialty group. He never paid for a vacation, if anything he couldn’t go on all the trips he was offered by companies to nice places where they had a one hour seminar on their product and rest of the week was reserved to wining and dining them. I have no problem with non-necessity product companies doing this, if Apple wants to spend half their revenue on marketing, more power to them, first they have competition, and second their products are life or death for anyone event though many might think they are.

And I’m sure the capitalist would say that without a profit motive there would be not research into new treatments. And this may be true, but my point is we could directly pay for the R&D, and the output of that R&D as the treatments that are discovered, and still save a huge amount over what we pay now. One of the basic things that I think most people don’t understand is that for the most part scientist (and I’d venture even many people in the software industry) don’t do what they do just for the money. I love what I do, and while I’m extremely fortunate and happy that I get paid very well to do it, I’m pretty sure I’d still do it even if the compensation wasn’t as good, especially over sitting on my ass or doing a factory job. This is the disconnect between capitalist bean counters and scientists, the bean counters think money is the only motivation there is, because that is their primary motivation for everything. They can’t believe that some people do what they do because they like what they do, and as long as they are compensated well enough to live they will continue to do it. I know a lot of research scientists, and very few are highly money motivated, they are smart enough to know you don’t get rich as a researcher. Give them enough grant money to chase their passion and you typically have to make sure they don’t spend it all on the research and forget to buy food and pay their rent.


#150

Agreed, sorry I over generalized, my intent was convey we seem to have a pretty big population that have had some issues with health, in some cases due to “living hard and fast”, and others of course at no fault of them or anyone else. In the end I do think we need to recognize when people do have a choice and they choose one that may be detrimental to their health, in turn to the cost of it. But we can penalize those who the odds were against and they just flat came up short in the health area. I’ve been lucky to have good health so far, but I also recognize that it’s very possible for that to change at any time. It’s a bit of a reverse lottery, one you don’t want to win where you end up with health issues, which is why I think at least to me it’s reasonable in my mind that I pay a lot more out right now than I consume, and there is a good chance that I’ll never need it, but if I do it’s nice to know it might be there. But this is the same with any insurance. And while I don’t mind providing a bit of profit on my car insurance, or home insurance, I really don’t appreciate providing a nice profit margin on health insurance. For me I could if I chose to live without owning a house, or a car, but I don’t think I’d like to consider health care in the same way.


#151

The countries in Trump’s list were drawn up by the Obama administration in Feb 2016. So these particular complaints are based on a totally incorrect premise.


#152

It turns out that the existing healthcare system does just that already. We can recognize the difference between damaging lifestyle choices and freak health events as communities and come to one anothers’ aid that way, but forcing an entire nation to pay for frankly unhealthy choices is unethical.


#153

A mix of what I’d considered conservative and liberal views into a hybrid form. First you say government is too big, and inefficient, so they shouldn’t the in providing health care, a pretty conservative view. But then you say that it’s better if those can give “according to their ability to meet your need” which sounds a lot more like a liberal view of progressive taxation, those who can afford more should help out more. Except here it’s those who can donate more can do so.

So tell me what your considerations are that you feel universal health care is unworkable? I’ve been in the US my whole life, so really never was in a true universal system, except when I was in the military, there we had a pretty efficient health system that I participated in, fully run by the military, and I can’t complain one bit about the care I received. So based on that little bit of experience, and I’ll admit it’s been a few years since I experienced it, I’d say that if they could model after that we’d have a pretty good standard of care.

And I don’t disagree, people should be accountable for their choices, if it can be clearly shown to be causal. But in many cases unfortunately it’s pretty hard to determine if a condition is definitely from something someone has done, or just bad luck. Sure, if you are overweight you will probably have a higher chance of some forms of illness, but how do you determine if that was the root issue, or if it was just genetics, or luck? Do you say, “your chance of heart disease was 3x due to smoking, so we’ll only pay the 1/3 of a non-smoker”? Tough problem to solve in the end. I think the only way to really handle it is to incent people to not live unhealthy, tax rebate possibly if they do take care of themselves, i.e. gym memberships are tax deductible (if you actually use them…). My company provides us money for fitness, turns out that if it gets people to live healthier we save it on the back end on medical care costs. Last year I bought a rowing machine, company paid for it, I use it quite a bit, have rowed almost 1 million meters now in just under a year. And I can say without a doubt I’m definitely in better health than I was last year at this time. My annual physical (yes, we also pay for preventive care, so we can catch any issues early) was to the point my Dr. asked me what I had been doing he saw such a difference in last year. So it’s possible to get people, maybe not everyone, but a significant number to live a more healthy life. If nothing else as a capitalistic society we just need to put the incentives in the right place. Maybe we do the same for unwanted pregnancy, if a teen makes it to the age of 18 without getting pregnant, we give them a stipend of $10,000. Just a thought, but in my experience carrots are almost always better than sticks in changing unwanted behavior.


#154

Here’s a great example of free market economics at work in the healthcare industry from Reason.com http://reason.com/blog/2017/01/27/what-happens-when-doctors-only-take-cash
When government and insurance get in the way it distorts cost and quality. The place for insurance is for catastrophic situations. In the event someone needed hundreds of thousands of dollars of care coming up with $5-$10k would be managable with payments. This could be offset with tax free HSA’s. Save a little each month and then let the health industry compete for those dollars. I say this with experience as I write revenue cycle software for a major insurer. The ACA seemed like a great idea for my company because we would have forced customers. They were all for it until the economics failed and we decided to pull out after losing $500 million one year and forecast to lose even more the next. The free market works, universal healthcare does not. What about Canada you say? Read this https://www.city-journal.org/html/ugly-truth-about-canadian-health-care-13032.html


#155

That was definitely a huge problem. Both candidates were intensely disliked by a large number of voters. None of this, however, justifies betraying the fundamental principles America was founded on.

I would have preferred a ham sandwich over Trump. Trump is the worst president we’ve elected in the last 200 years. He’s dangerous. There’s a reason 50 retired military officers signed a letter saying that Trump was unfit for office.

Put party aside for a moment, and unlike Trump, think about what values actually make America great.

I’m not so sure about that. Clinton, as a candidate, had huge weaknesses and a lot of baggage, for sure – but we didn’t get to see Bernie’s weaknesses play out later as we did with Clinton. Calling it a sure thing is quite a stretch here. Hell, the polls said Clinton was a sure thing. But she wasn’t.

Yeah, the billionaire businessman is definitely gonna crack down on big businesses, right? This makes zero sense. Other points:

  • NAFTA is probably more of the same “we’re gonna bring back those old manufacturing jobs” narrative, which doesn’t seem likely at all to me. The robots and self driving trucks are coming, we need to adapt to that reality, not wall ourselves off in tariffs and trade restrictions to pretend the future doesn’t exist.
  • oil / gas is irrelevant, focus on incentivizing solar and other renewables. I don’t see any point in ripping apart our nature reserves when gas won’t even matter in 50 years… but our national parks and lands have to last forever.
  • term limits on Congress, would love to see this, but I think it has a 0% chance because the people voting for it will not benefit
  • five-year ban on lobbyists, I am fine with this but Citizens United is the real problem, not this.

I could go on… I’d say 80% of the stuff Trump has planned is either ridiculously shortsighted or outright harmful. The guy also has a very bad temperament for a leader and sets off so many red flags for me. Like I said, I vote on leadership most of all, and Trump is an awful leader. Capricious, vindictive, cruel, cronyism, nepotism, won’t ever admit he made a mistake, etc. I can go on. I mean just look at his portrait. Every other president in recent memory looks happy and proud, but Trump is angrily scowling.

I actually want politicians that try to reach a common consensus on decisions, rather than ramrodding through extreme plans with little forethought or discussion. Yes, this may result in slower progress overall, but that’s why the political system was designed by the framers with checks and balances to begin with. You’ll reach decisions that are acceptable to “most”.

That said I wasn’t exactly a fan of Clinton. She was a politician’s politician. But again: I’d literally vote for a ham sandwich before I voted for Trump because I consider him not just unpalatable but dangerous to American democracy.

Nope.

Not according to Ruben Andersson, an anthropologist at the London School of Economics and Political Science and the author of a book titled “Illegality, Inc.: Clandestine migration and the business of bordering Europe.”

For one thing, Andersson said, walls tend to be built for domestic political reasons by governments that want to be seen to be doing something about migration. For another, it seems that where there’s a wall, there’s a way. In other words, people who want to cross a border badly enough will find creative ways to circumvent a wall – even if it means taking greater risks by crossing elsewhere.

“These fences are not solving anything,” Andersson said. “Numbers are not going down. People will find a way.”

You might as well take all that $25 billion and burn it. I say we should use that wall money to build bridges, roads, and other essential infrastructure that benefits Americans.

I agree with you 100% here @giorgiog and I will go this far – if Trump manages to make Medicare extend unconditionally to every person in America, as universal simple healthcare, I will go on record saying that I’ll vote for his re-election. And I promise I will, too. :us: That is so important that I’m willing to overlook everything else.

Seriously? Do you have children, Nathan? I apologize for asking, but please answer me: do you have children?

The current plan we’re using, with minor tweaks to continue doing the things that are effective, and dropping the things that are less effective. Our immigration policies are already working quite well, and growing goverment to add more bureaucracy isn’t a good idea.

Incorrect. It was written to provide a list of actions any American can take to make sure their voices are heard. Just refer to the bottom 1/3 of the post with the bullet points, and read them.

This is also incorrect, and the assumption here is quite telling. I’ll leave understanding that up to the reader.

We have some serious problems in America, and #1 among those is the huge (and growing) disparity between the rich and poor.

Please watch this.

I don’t think pointing out that a remembrance day holocaust statement from the white house that doesn’t mention Jews is in incredibly poor taste, particularly when the statements from previous administrations – one republican, one democrat – absolutely did. “All Lives Matter” is some bullshit.

This is not hard to understand. Vulnerable groups – houses on fire – need more help than I do as a rich white man.

I’d make the same argument anti-gun control proponents like to make – absolutely nothing about a US-mexico wall is going to stop any of that. It’ll just make America $25 billion poorer, with exactly the same number of illegal immigrants. Let’s spend that on infrastructure projects that matter, not performance art.

The point is that they explicitly left those countries. Likely to seek a better future, more rights and opportunities for their daughters and sons. We have freedom of religion in this country, and always have. Get used to it.

Well, if we can provide citations, links to reasonable sources, perhaps everyone can learn a bit about the issues and have a more nuanced position on their issues. That’s the goal, for me anyway…

Also thanks everyone for keeping it (mostly, cough David) civil here.


#156

“You can’t have an opinion on universal healthcare if you don’t have children / someone you love.”

That’s backwards thinking, Mr. Atwood. Mind what you’re saying, what you’re implying through those types of statements.

I would not say things like that if I wasn’t prepared to live by them.


#157

Fair enough, nothing is a sure thing until it plays itself out. Having said that, had it been Bernie vs Trump on the ticket, I would have voted for Bernie. That’s only a sample size of one obviously.

No offense, but how many democrats have cracked down on big business? Republicans? Sometimes trying something (or someone) different feels better than doing the same old shit expecting the different results. It may not wind up being better, but I felt no confidence things would get any better with Hillary. Neither candidate was likable, and from my point of view she had more political baggage than he did (for the obvious reason that he had never held office before.)

Citizens United is a large part of a huge systematic problem. Pay for play is alive and well and as long as the media keeps calling it lobbying, no one will be pressured into changing any of it.

You never actually answered his question about having children. But let’s presume you do at least have living parents. Assuming you graduated from college in 2012 that puts you around 25-26, and your parents are not yet likely old enough to be on Medicare, or to have serious health issues (of course I could be wrong, but based on your lack of sympathy and unrealistic ideas like fundraising for health, I assume your parents are in relatively good health.) Fast forward 10-20 years, your parents are retired and need long term care or a lengthy (3+ month) hospital stay - say goodbye to their life savings and say hello to a mountain of debt. My wife was a social worker at a nursing home - the cost for one month’s stay at that facility was between $6,000-8,000.

Are you going to take care of your father/mother if they develop Alzheimer’s Disease when their savings run out? Full-time? No of course, you can’t. How will you cope? You know who you’ll turn to? it’s not your little community, it’s that big organization you’ve been railing against throughout this thread.

Yep, he’s an asshole, one I wouldn’t want to be an adversary of. But if your interests and his align, I think you’d be quite happy that he were on your side. That was his pitch to the middle class. Enough people bit and here we are.

I’ll hold you to that promise…somehow…from across the other side of the nation.

I’m agreeing with you with a caveat… “Likely to seek a better future.” But you can’t be certain, so there is opportunity for fear and doubt. Would there be less violence in 2015/2016 in Europe had they not let waves of immigrants from Syria in? Who knows, but many people fear the worst and say we don’t want your refugees. As far as I’m concerned, it’s unlikely to affect me directly given my lack of proximity to likely targets (big cities.)


#158

I didn’t say that, nor do I mean that.

However, someone who would tell another human being that they should be forced to crowdsource medical funding for their sick child on Gofundme is deeply lacking in basic human empathy.

Remember Bannon explicitly said he wants to destroy everything. It is deeply cynical to walk in, break government, then say “see, I told you the system was broken.” Reform and improvement is needed, as it is at all times in American history, but that kind of nihilism isn’t accomplishing anything – and it can be harmful, as a lot of people depend on government for basic services.


#159

I don’t believe the President has the power to break everything (short of deploying nuclear weapons.) GW Bush had arguably smarter and at least equally sinister group of people surrounding him (Cheney and Rove come to mind.) He managed not to break everything. You may not have agreed with all of his policies, but we survived, made it through another president, survived…and I suspect the same outcome will occur in 4/8 years.


#160

Compare Bush’s first week in office with Trump’s first week. Radically different. And not in a good way. Lots of things are being broken.

I’m standing by my original production: when this is done, Trump will be considered among the three worst presidents in American history. If not the worst.

I would love to be wrong about that.


#161

Six months after Bush was elected he pushed through a huge tax cut which arguably put in a worse for at least 10 years (until they expired.)

One week is not a large enough sample size to judge Trump’s presidency, nor to compare it to GWB’s.

Compare the first 100 days EO’s across the last few presidents:

For me the jury’s still out. My impression is that many people just hate him and no matter what, they believe he’s going to ruin this nation because…feelings.


#162

I think you are being deliberately obtuse; point me to a single executive order as disruptive as Trump’s Muslim ban that any president has instituted in the first month of their presidency. And that was in the first week!


#163

Who has been disruptive? The protesters? they were nowhere to be found when Obama expanded the drone strike program which actually KILLED people in some of those countries in Trump’s EO:

According to the data, U.S. drone strikes in Pakistan, Yemen, Somalia, and Libya killed between 64 and 116 civilians during the two terms of the Obama administration — a fraction of even the most conservative estimates on drone-related killings catalogued by reporters and researchers over the same period. The government tally also reported 2,372 to 2,581 combatants killed in U.S. airstrikes from January 20, 2009, to December 31, 2015.

I’m having trouble figuring out how you can reconcile (ignore?) Obama’s actions versus Trump’s. You may not agree with his agenda/platform/party/etc, but you don’t actually know if it will turn out badly. So stop crying wolf.

Are you experiencing a case of nostalgia for “better” times under Bush or Obama? If memory serves me right, lots of people disliked Bush too.


#164

You and Andersson both claim that walls don’t work. Common sense and the CNN piece you quoted say that’s not true. Leaving aside the “land-grab” aspect of the Israeli wall, there is do doubt that it has been wildly effective. And it’s only barbed wire!

I watched that video. Didn’t learn anything new unfortunately. I’m well aware of wealth disparity in America. It’s a serious problem. A society needs a large middle class to be healthy. The Brazils of the world, with an enormous underclass and a rich elite, are so far gone that reforming their societies is probably intractable without an incredibly visionary leader and several generations of brilliant policies. I humbly submit that shipping jobs overseas and replacing middle class workers with illegal immigrant labour hurts the middle class and worsens wealth inequality. This is a huge topic, but I would like to propose a solution for a CEO earning 380 times the average worker. Especially since the takeovers of the 80s, it’s been made incredibly hard for people like Carl Icahn to take over companies and sack CEOs that are overpaying themselves. That needs to change. Steve Jobs, for example, deserved every cent he earned. He was probably underpaid. But the quality of the average American CEO of a publicly listed company is pretty terrible. No way are they worth 380 times the average worker. They need to be held accountable.

I just think you’re making something out of nothing here. Holocaust remembrance is incredibly important, but again, I was very surprised that the all statements are so short, and that they basically don’t go into any detail about groups and numbers, to make it more real, and impress how horrific it was for the Jews especially and everyone else who died. I can’t see how you’re reading hidden meanings and references to Black Lives Matter and All Lives Matter into this. It seems a little… disjointed.

Again, you say walls don’t work. The Israeli wall, the Great Wall of China, and Hadrian’s wall prove that they do. Perhaps you think that Netanyahu, Qin Shi Huang, and Hadrian just wanted to look busy?

Of course they want a better future. Of course they want more opportunities for their families. Of course they want to come to America. But they will bring with them beliefs and values that are completely at odds with your own (especially your own) and the vast majority of American citizens. They will bring with them the beliefs and values of the cultures they came from. If the bulk of the citizens of the 10 countries, all Muslim, that kill homosexuals like Joel don’t have a problem with that law, what on Earth makes you think that the only ones who want to come to America will be the ones who disagree with it? Consider that the more of those sorts of people you let in, the less they have to integrate, as they can stay in their own communities. Yes, America has always had freedom of religion, more or less. But it has never had large numbers of Muslims with incredibly (relative to your values) regressive social attitudes either. Your argument would be valid if all the Muslims who end up in America and other Western countries magically shake off their regressive values and ideas and integrate. But that’s not going to happen. Obviously.


#165

Speaking about Belgium:

About 25 years ago was the infamous “Black Sunday”. All of a sudden a right-wing party (Vlaams Blok, later called Vlaams Belang) made a big gain. They would achieve further gains the next few elections. It wasn’t like people all of a sudden became racist. But rather a growing group of people felt like the other parties blatantly ignored their concerns. By now, a less extreme right-wing party, N-VA, scooped up most of those “against” votes.

Maybe our proportional system, and the resulting larger amount of big parties makes our voting system a bit more resilient to extremism, but evidently it doesn’t prevent this kind of surprising election outcomes.


#166

Nice article, so it seems we need to get insurance companies out of the way of pricing. Agreed, so now if we do that how do patients get the money to pay for their health care? If you work for an insurance company then you understand the basics of insurance, you are paying for the ability to get more if you really need it, but that means that many other people need to pay in more than they will ever get back. It’s the nature of insurance, and a way to pool risk across a group. I don’t see how if you went to cash you’d have a populace able to pay for their health care. Not saying we shouldn’t be able to, but I just don’t see it happening.

As for the article on the Canadian system, it sound like they’ve as well as many other countries are having some challenges. Many of them seem to be around lack of staff, especially doctors. That is one thing I can say when I was in the military, the hospitals I went to weren’t under staffed, and I never had to wait long for treatment. I could call in the morning and get in to see the flight surgeon’s office that afternoon in about 95% of the cases. The next day if it was too late in the day and not critical. So maybe the difference is getting more people into medical care? It seems we have a limited number of medical schools, all at capacity and a growing population needing more care then ever. Maybe we need to open more schools, and help qualified students get the money to go to medical school? If you want to go with standard supply and demand economics, it seems we have a supply problem. So let’s start to fix that, while we look at some of the other issues. Maybe the government needs to bootstrap a few new medical schools, maybe a lot of medical schools?


#167

Maybe we just need an H-1B program for doctors :slight_smile:


#168

One thing to consider, a wall across the southern border of the US is an entirely different beast than the little border fence that Israel has. Fences don’t scale well, make them long enough and it’s extremely hard to maintain and ensure that they aren’t having holes put in them, or being climbed over every day. Sure you can make sure that doesn’t happen, but that isn’t free either, so how much do you spend on protecting the border. At some point you’d be better off handing out checks at the border to send prospective illegals home to Mexico a little richer, it would cost less (I’m being sarcastic here, but at times I wonder how much we could have paid every person in the Middle East with the Trillions we’ve spent there now protecting our right to cheap oil, which is essentially what the middle east is, our place to ensure oil, nothing more, nothing less. If there were no oil there, it wouldn’t be in the “interests of America”)