The conservative case for single payer health care. - Politics Forum.org | PoFo

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#14305467
We are having a major health care debate in the USA. I was strongly opposed the pre-Obamacare system as I am opposed to most aspects of Obamacare. It is incredibly complicated and albatross around the neck of business. Unfortunately one of the reasons it is so complex is because the right-wing essentially has taken single payer off the table and vowed massive resistance against it. Single payer, whatever its drawbacks may be, is still far simpler and more straight forward than the massive maze Obamacare has set up.

As I see it now the only people who benefit from American health care are those directly in the health care industry, especially hospital administrators and health industry executives, and the people independently wealthy enough to never have to worry about cost. The other 90% of us, insured or uninsured, are getting the short end of the stick. Even if you like your insurance, it is an objective fact that if you live in the USA no matter how good your insurance may be you are paying the highest prices for the lowest return. American health care is not the worst in the world in terms of quality, however in terms of cost effectiveness it is undoubtedly the worst, even below Ethiopia in the sense that Ethiopians get what they pay for on a dollar a day salary, whereas the USA would charge a hundred dollars for Ethiopian quality care by comparison if we are measuring on cost effectiveness, like we charge tens of thousands for what other developed nations get for mere thousands, and hundreds for what they get for tens.

Here are ten key conservative reasons to support single payer.

1. First, it is simpler than Obamacare.

Under single payer health services are funded out of general revenues, it would probably mean higher taxes in the short run but in the end it would all go to the same place, there would not be a massive myriad of regulations and subsidies. You pay taxes, you get health care.

2. There is always going to be rationing and paperwork anyway.

Economics is all about scarcity. There will always be rationing in health care. Currently America rations by taking some people out of the line completely through the uninsured. Finally, paperwork is going to be an aspect of every health system, in fact single payer systems have less than the American system due to their simplicity.

3. Government is accountable to the people, big health insurance companies are accountable to their shareholders.

There is a lot to hate about the government, but like it or not at the end of the day we still have the right to vote and change things in Washington. When you are dealing with a government health system you can petition Congress to change something you do not like. At the end of the day big health insurance companies are bottom line accountable to their shareholders, not consumers. Unless you can go out and purchase a huge number of shares, you ultimately cannot hold your health company accountable.

4. Government regulation of health care already exists and is not going away.

Some people say that a totally free market in medicine would reduce costs. It probably would, but politics is the art of the possible. The reality is that if we could go out and purchase any health treatment we want over the counter without FDA oversight and make licensing voluntary it would end up costing us a lot less. Some lives would be lost due to unlicensed medical personnel and addiction resulting from easier access to controlled drugs, however I believe that the number of people saved due to lower costs and access to drugs would outweigh the risks many times. I believe medical innovation would speed up. In the end though people would only focus on the horror story of how some kid got hooked on Miracle Drug X and killed himself, instead of the 10,000 people who were saved by the fact that government did not stifle it. Regulation would return. Were it politically possible to have true free market medicine I would support it, but it is not.

5. By holding costs down, it will save you more than enough to make up for any tax increase.

It is undeniable we may have to pay slightly higher taxes to pay for single payer in the short run, however under single payer there is a single negotiator for prices of drugs and medical equipment. It is a monopsony, the opposite of a monopoly. A monopoly has one seller and many buyers, thus it can extract a high price for purchases. Current health care is an oligopoly, which has a similar effect, as there are so few sellers as to make holding down prices unrealistic. However in the mirror image case one payer can command a lower price. In reality competition among insurance is actually a bad thing, since sellers can continue to jack up price by denying some services covered to some companies, and charge them what they want. In the end you spend a good chunk of your income on health care premiums anyway, and will do more so in years to come Obamacare or no Obamacare. In the end the reduction in what you pay will more than make up for any tax increase.

6. Ideologues are the main thing holding us back, and true conservatives ignore ideology.

Conservatism is by its nature a rejection of ideology, instead it is an attitude that rests on empiricism and responses to changing conditions, and generally holds a view of the world driven by reason and logic. In a nutshell, conservatives were always the cooler heads in the room, whereas liberals where pie in the sky idealists. Today the right has been hijacked by libertarian extremism. Note this is not ten reasons libertarians should support single payer, they never will b definition. It is about how libertarianism is not conservatism and never will be, "conservative ideologue" though repeated ad nausea in the media should be an oxymoron. Libertarians who hate any and all government by definition are holding us back from ideological reasons, appealing to a vague notion of freedom. However a more staid conservative approach is to recognize not all freedoms are equal. Thus the libertarian sees no differentiation between the freedom to use and abuse whatever recreational drugs one wishes and the importance of freedom of speech. Whether drug legalization is good or bad, the conservative recognizes that freedom of speech is a far more consequential freedom to defend than freedom of drug use. It is thus that the libertarian views restrictions on major medical corporations with billions of dollars as no different than the Soviets shuttering the shops of the kulaks, however the true conservative recognizes a huge difference. The conservative believes freedom is important, but freedom toward the ends of a decent society, whereas the libertarian embraces a nihilistic vision of freedom for freedom's sake. To the libertarian there is no moral difference between the liberty of Aristotle and the liberty of a massive health care company CEO or a drug abuser.

7. We have a religious moral imperative to do something about the uninsured, and charity is not adequate.

This next piece reflects in true conservatives, not libertarians. Conservatives of a moralistic bent recognize the importance of collective moral values, and one of those is the value of charity. If we are to be a Christian society then our primary concern must be living up to Jesus' ethic. When we get to the gates of Heaven I suspect St. Peter will be asking us what we did for the least among us, not what we did to keep taxes low and government small. In the end the whole "private charity will take care of it" thing is a cop-out. We already have lots of charity but it is not nearly enough to keep up with the massive demand for medical services.

8. The rest of the world is doing fine, including nations often touted by conservatives.

Conservatives often tout Greece as a reason to fear government programs, however there are lots of nations doing fine. The Greek debacle is complex and single payer will not make or break us. Canadians are doing fine with single payer. The UK, for all its flaws, is not a North Korean gulag yet that is what some on the far right will have you believe single payer will make us. The Nordic states are booming, as is Germany. More importantly Hong Kong, often touted by the right as the freest economy on Earth, has a national health service. Is Hong Kong a socialist hell hole. Meanwhile we spend more than all the rest of them, in combined public and private expenditures.

9. Around the world, conservatives are at ease with national health care.

In Britain conservatives vow to fight for the NHS. Even Margaret Thatcher herself was an ardent supporter of the NHS. In every European country the parties of the conservative persuasion have accepted the role of government in provision of health care and are at peace with it. Only in the USA of major industrialized nations is there a holdout. Why is this? I suspect it has to do with the fact that America is a large country and often ignores the rest of the world as a cultural matter. Finally I think special interests are too ingrained and what is often touted as a principled conservative stance is really just defending the special interests of big corporations to keep things exactly as it were. For however much the current system hurts the rest of us, a lot of people are making a lot of money on it. However if even conservatives are at peace with it elsewhere, from Canada to Europe to Israel to Japan, it may not be so bad.

10. The number one reason; it is competitiveness, stupid.

Government bungled health care by making the tax code in such a way that health care became seen as the employer's responsibility. As I explained before, government involvement in health care at some level is currently an accepted matter of life in the USA and an advancement to a truly free system is unlikely. Thus health care has become an albatross around the necks of American business. Finally, high health care costs are what Warren Buffett correctly described as a tapeworm eating away at the economic competitiveness of America. Everywhere in the world the government has lifted any responsibility for health care off the private sector, making it easier for businesses to compete. We may have lower taxes on average than the rest of the world, but we make up for it in health care costs. In the end American business is being saddled with this albatross. They may not like paying higher taxes, but may be receptive if it could mean removing concern about health care from their agenda. In the end it won't matter as businesses in other industrialized nations are competing at a higher tax level. An increase in marginal tax rates to fund health care in the USA will not make us less competitive on tax rates, since the USA is already a (comparatively) low tax nation.

Obviously libertarians will reject all this, but this is not aimed at people who confuse conservatism and libertarianism. Even if single payer health care were proven scientifically correct, I believe libertarians would still oppose it since their core principle is the minimum of government involvement, but conservatism's core principle is pragmatism.
#14305723
A rational and well-constructed argument. Unfortunately, rational arguments (at least in the US, and I suspect much of the remnants of the liberal West) are no longer applicable. Rational arguments presuppose a rational electorate, which doesn't exist. An electorate which gives us Senator Ted Cruz is not rational, and the House of Representatives would embarrass any self-respecting denizen of Bedlam.
#14306113
Ted Cruz claims his entire reason for opposing Obamacare is "freedom" which is silly. He also says his view on pre-existing conditions is that the market must be reformed, nothing more. Like it or not there are a lot of Republicans who would even like to throw those with pre-existing conditions under the bus because they weren't "personally responsible" enough to purchase insurance (discounting people born with diseases and those who can't afford it and fell into a coverage gap). The political wing of the GOP can't be for it because it is politically unpopular but there are a lot in the grassroots who agree with such a stance. I guess the scariest thing of all is not how radical the most radical elected Republicans are, but how much more radical their base is.

Quetz, what do you suggest be done? Is there anything? I think one of the downsides of technology is it allows us to live in our own ideological box.
#14306171
I wish I had something a little more optimistic to offer. As a practical matter, the two party system will continue to be held hostage by a radical minority within the GOP. No major changes are possible as long as this stalemate continues.

Voters in the US have traditionally voted neither their interests, nor a specific political ideology (at least not a coherent one). They vote their perceived identity. All politics is identity politics. In the past this was a source of stability and a bulwark against radicalism. As the perceived identity of America has splintered, so has its cohesion and political stability. If there's an obvious solution to this quandary, I haven't found it.
#14306193
I like the point you made about monopsony acting as a counter balance to monopoly. Currently pharmaceutical companies have monopoly pricing rights in the form of intellectual property rights granted by the state. These monopolies inflate prices and act as an insidious form of protectionism. The fact is that the USA already has socialism but the welfare state is serving the needs of the rich. The state funds a significant portion of R & D; socialising cost and risk, then anything useful that arises is handed over to corporations so that profits can be privatised.

I am not aware of any 'libertarian' politicians aggravating for reforms to IP. The Pirate Parties (who hold seats in various European parliamments) have proposed reforms.

Creatives become rent seekers;

[youtube]tk862BbjWx4[/youtube]
#14306749
Libertarian politicians seem to have a major obsessive focus on taxes and regulations impacting BIG business. For instance I am trying to start a house painting company but I live in one of ten states that requires a license to paint houses and one of four requiring education and exams, costing thousands of dollars at the outset, in fact you need a builder's license just to paint. I'm considering moving to a neighboring state. Republicans "took over" my state in 2010. Now I am the supposed entrepreneur they are trying to help, but at the end of the day my main concern is not taxes or Obamacare since I'm not making enough money to worry about high marginal tax rates and I actually view Obamacare as a benefit to a small entrepreneur, really businesses with over 50 employees who don't offer health insurance are the only ones who get hurt, and they are actually a minority among large companies. But Republicans are spending all their time worrying about something impacting people who whom complying is a drop in the bucket. At the end of the day I haven't seen a thing done to remove the licensing requirement, which was put in place by the previous governor, no doubt as a matter of protectionism lobbied for by established business. This is the sort of "red tape and regulations" stifling small business owners, little silly stuff like this, however once again not a single thing done to stop in. Meanwhile an obsession with repealing Obamacare. As a entrepreneur I have a hard time believing Republicans are standing up for my interests even though they say they are, because it seems like the only regulations they are focused on are the ones that only impact the people big enough to be able to afford compliance in the first place.
#14306995
I'm no fan of the Republicans. I'm definitely no fan of the Tea Party. One of the reasons I came to detest Conservatives was because they proposed first party health insurance mandates. Note the way some people erroneously try to equate first party insurance health mandates with third party car insurance mandates. The Health care mandate is a thoroughly good reason to shut down the government. It should be stopped.
#14307032
Hello, all,

Hi, nucklepunch;

We have a religious moral imperative to do something about the uninsured, and charity is not adequate.


I am keenly interested in this statement. As I don't consider my morality to be derived from Judeo-Christian religious values, but rather from earlier philosophical writings, I wonder how to convince those (conservatives or others) who are like myself; i.e.- not a Christian.

Hi, quetzalcoatl,

Voters in the US have traditionally voted neither their interests, nor a specific political ideology (at least not a coherent one). They vote their perceived identity. All politics is identity politics


It is interesting that you have noted this. I have noticed that my own views have become much more robust with the passing of time, and some of them have changed. I don't think that there is anything wrong with changing one's mind, for whatever reason. With so much polarization in politics these days, I feel as though people become 'rigid' in their views; it is as though changing one's mind, compromise or 'seeing things from a different perspective' is a 'sell-out', an example of waffling or even 'traitorous'. Nobody wants to feel like those things, ergo they cannot bend from whatever proposition they have decided to hold dear. An unfortunate development, in my opinion.

nucklepunch mentions

Libertarian politicians seem to have a major obsessive focus on taxes and regulations impacting BIG business.


I have noticed this as well, and it seems much to the detriment of small business people like yourself. It is interesting that you mention house painting specifically, as I have had several friends in that same line of work. I haven't checked, but I imagine that the states where I have known such individual entrepreneurs do not have the same regulations as your state (I have lived mostly in Alabama, a rather poor state).

Over the years, I have fallen more and more out of love with the libertarian platform because of these trends in new libertarian thought. Their 2012 platform was like nothing I remembered from twenty years ago.

horse
#14307033
Hi Rich,

Note the way some people erroneously try to equate first party insurance health mandates with third party car insurance mandates.


I would love it if you could give me quick lesson in the difference, including definitions of the above types of mandates. I've tried googling, but with the news articles and opinion pieces that come up at this moment in time, I haven't been able to clarify the ideas in my mind. Thank you!

horse
#14307067
Rich wrote:I'm no fan of the Republicans. I'm definitely no fan of the Tea Party. One of the reasons I came to detest Conservatives was because they proposed first party health insurance mandates. Note the way some people erroneously try to equate first party insurance health mandates with third party car insurance mandates. The Health care mandate is a thoroughly good reason to shut down the government. It should be stopped.


I disagree. Everyone should be contributing to the health care coverage pool. No one can "predict" when they will or will not have accidents and/or suffer a serious illness. I imagine anyone under 25 years old would be loath to buy health insurance because they never get sick and they think they are invincible (I fell into that category at one time), so why I should I buy health insurance.

And if said uninsured (and possibly poorly paid) 25 year old gets run over by a car for a two (2) week stay in the hospital, who gets the bill ? Everyone else who did pay premiums which were jacked up to cover the costs of the "deadbeats" in the health care system.

And for those with pre-existing conditions who cannot obtain catastrophic health care insurance; Guess what ? when something "catastrophic" happens to them, health insurance premiums go up.

In the case of health care, "mandating" that everyone contribute "responsibly" to the health care coverage pool makes "societal sense".
#14307079
Hi, Oscar,

Everyone should be contributing to the health care coverage pool. No one can "predict" when they will or will not have accidents and/or suffer a serious illness. I imagine anyone under 25 years old would be loath to buy health insurance because they never get sick and they think they are invincible (I fell into that category at one time), so why I should I buy health insurance.

And if said uninsured (and possibly poorly paid) 25 year old gets run over by a car for a two (2) week stay in the hospital, who gets the bill ?


I definitely agree with your take on healthy people and catastrophe. I was just such a person, a relatively healthy uninsured person who got into a car accident and needed emergency medical treatment. It was a single car accident, and so I was the responsible party for the medical bills incurred.

I would like to say, before anyone harps on me for being a deadbeat, that I did indeed pay off all of the medical bills I incurred, and I did so by negotiating with all of the providers that sent me bills. I was eventually able to do so by offering each provider with lump sums, as opposed to payment plans which went tens of months into the future (and into uncertainty of my ability to pay). It wasn't easy, but I was able to do so.

From what I can gather, I think that I am the exception, rather than the rule, and most people would not be able to do so, were they in my situation (as opposed to my circumstances- i.e., unmarried with a very low rent and no children or car payments, yet a coincidentally great blue book value of the car and an insurance to pay it to me).

horse
#14308820
The reality is normal free market logic does not apply to health care. It is not like fire insurance, most of us will never use fire insurance but 95-99% of the public will use health insurance sooner or later. Finally, in insurance situations it makes sense to have everybody in a single pool, however there is a paradox. The more people in a single pool the better but if there is a small number of companies on a market system it leads to oligopoly where they can jack up consumers. Thus it makes sense to have government control it because government is accountable to the public. In the end I concluded that health care being too costly to pay out of pocket we are going to have our health insurance decisions in the hands of a massive flawed bureaucracy, c'est la vie, but in the end I would rather have that be a massive flawed bureaucracy that nonetheless has some accountability via the democratic process (the government) than a massive flawed bureaucracy only accountable for delivering profits for its shareholders. This was something a liberal argued with me when I was a more libertarian conservative and to me it is simply the second best argument for national health care I have ever seen (the first is that with DNA testing technology coming about, sooner or later insurance companies will be able to use it to deny coverage, arguably it will be too much of a horror story situation with people losing out because of their DNA that it will make the public clamor for national health care inevitable).

Now the right likes to point out that we once paid out of pocket for health care. Such made sense in the old days of primitive medical technology, but with today's high tech environment we should recognize times have changed. Arguably the uninsured have better access to health care than the wealthiest kings of 100 years ago or earlier, however that is no excuse to try to deny them access to the high tech treatments the rest of us have.

As for the religious argument somebody addressed, this list is addressed at US conservatives and their concerns. I don't necessarily think that religious reasons are good enough for policy but many American conservatives often claim we are a Biblically based society and to legislate otherwise is moral relativism. I am simply arguing that you can't have your cake and eat it too, it can't apply to the social realm but not to the economic realm. Indeed if the Christian right extended their logic far enough the Bible would have all for profit banks being shut down, an essentially far left position, I don't agree with it but once again you can't pick and choose if you claim the Bible should be the foundation of our political system.
#14309001
nucklepunche wrote:American health care is not the worst in the world in terms of quality, however in terms of cost effectiveness it is undoubtedly the worst, even below Ethiopia in the sense that Ethiopians get what they pay for on a dollar a day salary, whereas the USA would charge a hundred dollars for Ethiopian quality care by comparison if we are measuring on cost effectiveness, like we charge tens of thousands for what other developed nations get for mere thousands, and hundreds for what they get for tens.


It can be argued that all of that is a result of the health care system not being a free market. I don't think there's a single root cause, but I do think that the correlation between increased regulation in everything from drug development to insurance regulation, and increased costs, is not an illusion.

3. Government is accountable to the people, big health insurance companies are accountable to their shareholders.


Government is not accountable to the people. Government is a monopoly, and even when a politician is voted out of office, he's replaced by somebody just like him. There is no accountability to the voter at all, there's accountability to campaign contributors. Shareholders, if you will.

A private company on the other hand (without the guarantee of a government subsidy/bailout) is indeed accountable to customers. Now, health insurance is somewhat of a different case, in that it's a third-party to the health care transaction, and we all know when people are spending somebody else's money, they don't care about costs. So I agree that the current structure of the insurance industry is part of the problem with health care costs.

There is a lot to hate about the government, but like it or not at the end of the day we still have the right to vote and change things in Washington.


Except that no matter how one votes, things keep going in the same direction. The only thing a vote affects in this one-party-disguised-as-two-party system is the speed at which we're hurtling toward collapse.

When you are dealing with a government health system you can petition Congress to change something you do not like.


God forbid you're in a minority. And even then, you'll likely be waiting for the next election cycle, and then waiting a few more months (or years) for a bill to be written, debated, voted upon, and signed, and then an other few months for implementation, and then it's likely to be just as effed up in different ways.

With an insurance company (that is actually competing with other insurance companies), you can find one that better suits your needs.

Some people say that a totally free market in medicine would reduce costs. It probably would, but politics is the art of the possible. The reality is that if we could go out and purchase any health treatment we want over the counter without FDA oversight and make licensing voluntary it would end up costing us a lot less. Some lives would be lost due to unlicensed medical personnel and addiction resulting from easier access to controlled drugs, however I believe that the number of people saved due to lower costs and access to drugs would outweigh the risks many times. I believe medical innovation would speed up. In the end though people would only focus on the horror story of how some kid got hooked on Miracle Drug X and killed himself, instead of the 10,000 people who were saved by the fact that government did not stifle it. Regulation would return. Were it politically possible to have true free market medicine I would support it, but it is not.


I agree with all of that except the conclusion, that it's not politicaly possible. I believe it is, it's just not politically easy.

It is about how libertarianism is not conservatism and never will be, "conservative ideologue" though repeated ad nausea in the media should be an oxymoron. Libertarians who hate any and all government by definition are holding us back from ideological reasons, appealing to a vague notion of freedom.


I agree that libertarianism is not conservatism. I disagree that libertarians are "holding us back". They might be holding back non-libertarians from their non-libertarian desires, to which I say, "good".

Thus the libertarian sees no differentiation between the freedom to use and abuse whatever recreational drugs one wishes and the importance of freedom of speech. Whether drug legalization is good or bad, the conservative recognizes that freedom of speech is a far more consequential freedom to defend than freedom of drug use.


I'm not sure this is true. Of course I agree that freedom of speech is "more consequential" than the freedom to ingest a substance. I think that libertarians don't find it desireable to rank varying degrees of freedom. Freedom of speech is freedom of thought. Freedom to ingest substances is freedom of ownership. When you start carving up freedom like that you've given up the principle that underlies both.

The conservative believes freedom is important, but freedom toward the ends of a decent society, whereas the libertarian embraces a nihilistic vision of freedom for freedom's sake.


Libertarians believe that freedom creates a decent society, and that restrictions on freedom (seemingly arbitrary restrictions, some of them) do the opposite. (I hope I don't have to explain that by "freedom" I don't mean the ability to go around hurting others.)

7. We have a religious moral imperative to do something about the uninsured, and charity is not adequate.


This really tends to get my goat, when conservatives (and especially liberals) fall back on a religious argument to justify something that Christianity doesn't teach: forcing your neighbors to be charitable.

When we get to the gates of Heaven I suspect St. Peter will be asking us what we did for the least among us, not what we did to keep taxes low and government small.


No, I'm sure he won't ask whether you were personally charitable, he'll just ask how much of your personal charitable responsibilty you forced onto everybody else by voting.

In the end the whole "private charity will take care of it" thing is a cop-out. We already have lots of charity but it is not nearly enough to keep up with the massive demand for medical services.


Except that you said yourself: without government regulations, medical services would be cheaper. It can also be argued that the existence of government welfare undermines personal charity ("I voted for higher taxes and more food stamps, so I don't really need to help anybody personally, I've done my part.")

8. The rest of the world is doing fine, including nations often touted by conservatives.[/b]


Not even America is doing fine in terms of government spending and debt, and that's before turning health insurance into a giant subsidized handout.

10. The number one reason; it is competitiveness, stupid.[/b]

Government bungled health care by making the tax code in such a way that health care became seen as the employer's responsibility.


Agreed.

As I explained before, government involvement in health care at some level is currently an accepted matter of life in the USA and an advancement to a truly free system is unlikely.


If we give up on it, it sure is.

I agree that one's health insurance shouldn't be tied to one's employer. But for the same reasons, neither should it be tied to one's government.

Obviously libertarians will reject all this, but this is not aimed at people who confuse conservatism and libertarianism. Even if single payer health care were proven scientifically correct, I believe libertarians would still oppose it since their core principle is the minimum of government involvement, but conservatism's core principle is pragmatism.


I think "conservatism" has changed dramatically in the United States. Originally "conservatives" opposed the income tax and Social Security. Now "conservatives" like say, "keep your government out of my Medicare". So it's my opinion that conservatism's core principles have eroded to the point that they are unrecognizable, a mish-mash of sometimes dichotomous talking points. I don't really consider pragmatism a principle anyway, but that's probably just me.
#14309028
Joe Liberty wrote:It can be argued that all of that is a result of the health care system not being a free market. I don't think there's a single root cause, but I do think that the correlation between increased regulation in everything from drug development to insurance regulation, and increased costs, is not an illusion.


Many other nation-states have even more regulated markets and yet they pay lower costs per capita for equivalent health of the populace. That seems to contradict the idea that more regulation must lead to higher consumer costs.

Government is not accountable to the people. Government is a monopoly, and even when a politician is voted out of office, he's replaced by somebody just like him. There is no accountability to the voter at all, there's accountability to campaign contributors. Shareholders, if you will.

A private company on the other hand (without the guarantee of a government subsidy/bailout) is indeed accountable to customers. Now, health insurance is somewhat of a different case, in that it's a third-party to the health care transaction, and we all know when people are spending somebody else's money, they don't care about costs. So I agree that the current structure of the insurance industry is part of the problem with health care costs.


The whole issue of accountability rests on the assumption that the consumer (or voter) has the required knowledge to effectively evaluate the provider of the good or service.

In terms of health care, the average consumer does not have the knowledge. The health care market is one where the suppliers have almost all the knowledge while the consumers have almost none. I cannot effectively evaluate treatments or complex insurance plans.

I agree with all of that except the conclusion, that it's not politicaly possible. I believe it is, it's just not politically easy.


Even if it was politically possible, I don't think it's economically possible.

I agree that libertarianism is not conservatism. I disagree that libertarians are "holding us back". They might be holding back non-libertarians from their non-libertarian desires, to which I say, "good".


There are people today who are dying or suffering today from things that are medically treatable. Some of these would not be doing so if they had access to public health care. If someone knew that these people existed, and they knew that their efforts to create a free market health care system was hampering the creation of a public health care system that would treat these dying and suffering people, they would then know that they are hampering someone's ability to get medical treatment.

This really tends to get my goat, when conservatives (and especially liberals) fall back on a religious argument to justify something that Christianity doesn't teach: forcing your neighbors to be charitable.


If I have to choose between the evil of forcing my neighbour to provide for the widow and the orphan, and the evil of letting the widow and the orphan die or suffer from medically treatable ailments, I will choose the former.

Not even America is doing fine in terms of government spending and debt, and that's before turning health insurance into a giant subsidized handout.


The rest of the world is doing fine, even though they have already turned "health insurance into a giant subsidized handout".

If we give up on it, it sure is.

I agree that one's health insurance shouldn't be tied to one's employer. But for the same reasons, neither should it be tied to one's government.


I assume you think it should be run by private insurers. Can we agree that there is no historical example of this ever working?
#14309182
It can be argued that all of that is a result of the health care system not being a free market. I don't think there's a single root cause, but I do think that the correlation between increased regulation in everything from drug development to insurance regulation, and increased costs, is not an illusion.


Red feather already addressed this so I'll move on, but once again it is a typical libertarian canard. The libertarians think the free market is magic. Replace the "free market" with "Jesus" in any libertarian pamphlet and you will hardly be able to recognize it was not intended to be religious in the first place.

Government is not accountable to the people. Government is a monopoly, and even when a politician is voted out of office, he's replaced by somebody just like him. There is no accountability to the voter at all, there's accountability to campaign contributors. Shareholders, if you will

A private company on the other hand (without the guarantee of a government subsidy/bailout) is indeed accountable to customers. Now, health insurance is somewhat of a different case, in that it's a third-party to the health care transaction, and we all know when people are spending somebody else's money, they don't care about costs. So I agree that the current structure of the insurance industry is part of the problem with health care costs.


As I believe I explained health care insurance is something that needs a bigger and bigger pool. There is no way a "mom and pop" insurance company can ever survive health care wise. The tendency will always be toward oligopoly, when you have that there is no accountability. Finally in the end we do have the right to vote, but we can't just purchase huge quantities of stock in health care. Also you seem to not understand that business doesn't exist to serve customers, but to make a profit for shareholders. You need customers to do that, but in an oligopoly it doesn't matter much how you treat them.

Except that no matter how one votes, things keep going in the same direction. The only thing a vote affects in this one-party-disguised-as-two-party system is the speed at which we're hurtling toward collapse.


I hate the two party system too, but in the end it is still possible to change things. If we all decided to we could elect 535 principled libertarians, or we could elect 535 communists. There isn't the popular will to do so but money and corruption aside the votes are still counted as they are.


God forbid you're in a minority. And even then, you'll likely be waiting for the next election cycle, and then waiting a few more months (or years) for a bill to be written, debated, voted upon, and signed, and then an other few months for implementation, and then it's likely to be just as effed up in different ways.

With an insurance company (that is actually competing with other insurance companies), you can find one that better suits your needs.


Except for those who have pre-existing conditions and genetic diseases. You can say that "it is like buying fire insurance after the house burned down" but in the end somebody cannot help it if it is in their DNA. With advances in genetic testing it will lead to more and more discrimination. Technology is eventually going to place the libertarian argument for personal responsibility up against a wall, because one can't honestly argue that somebody born with an uninsurable genetic defect was personally irresponsible. Also, please don't bring up the whole charity red herring. If charity were sufficient not one single American would ever go bankrupt due to medical costs. If we ever reach that point I will concede libertarians were right, but until then I don't buy that charity can help the uninsured.

I agree with all of that except the conclusion, that it's not politicaly possible. I believe it is, it's just not politically easy.




As of right now it is DOA. It is way outside the Overton Window. Libertarians don't live in any political reality once again. They are grasping at an unrealistic reality. It wouldn't be an issue if they weren't at least an intellectual influence on the Tea Party, who is in turn throwing the monkey wrench into everything. Truth is if the TP had never arrived I would probably still be a libertarian, since it would still be in the purely intellectual world but it took me seeing it in play to realize it was actually a destructive ideology.

I agree that libertarianism is not conservatism. I disagree that libertarians are "holding us back". They might be holding back non-libertarians from their non-libertarian desires, to which I say, "good".


At least you have some sense. Unfortunately a lot of people are calling themselves conservatives who really are not. Ted Cruz, Mike Lee and Rand Paul are unrecognizable to the Burke-Disraeli-Kirk school of conservatism. They would have called themselves liberals at that time. My argument is that the Republicans are not really conservatives, and are essentially "small l" liberals at this point. There really hasn't been a major conservative figure in a long time. Reagan was sort of at the border of influences, torn between conservatism and classical liberalism, whereas Eisenhower should be viewed as a sort of authentic conservative in the Burkean sense, in that he was a non-ideological pragmatist who believed in slow, gradual change and the importance of checks and balances between freedom and authority. To the best of my knowledge he never wore the conservative label on his sleeve and was not a very philosophical man, however he was conservative at least in temperment. Obama is more tempermentally conservative than most House Republicans, though I would not call him a conservative.

I'm not sure this is true. Of course I agree that freedom of speech is "more consequential" than the freedom to ingest a substance. I think that libertarians don't find it desireable to rank varying degrees of freedom. Freedom of speech is freedom of thought. Freedom to ingest substances is freedom of ownership. When you start carving up freedom like that you've given up the principle that underlies both.


A libertarian reveals finally in a candid moment the true moral relativism at the root of his ideology.

Libertarians believe that freedom creates a decent society, and that restrictions on freedom (seemingly arbitrary restrictions, some of them) do the opposite. (I hope I don't have to explain that by "freedom" I don't mean the ability to go around hurting others.)


Every restriction on freedom is not arbitrary. That is a straw man.

This really tends to get my goat, when conservatives (and especially liberals) fall back on a religious argument to justify something that Christianity doesn't teach: forcing your neighbors to be charitable.

No, I'm sure he won't ask whether you were personally charitable, he'll just ask how much of your personal charitable responsibilty you forced onto everybody else by voting.

This really tends to get my goat, when conservatives (and especially liberals) fall back on a religious argument to justify something that Christianity doesn't teach: forcing your neighbors to be charitable.

Leviticus 23:22 And when ye reap the harvest of your land, thou shalt not make clean riddance of the corners of thy field when thou reapest, neither shalt thou gather any gleaning of thy harvest: thou shalt leave them unto the poor, and to the stranger: I am the Lord your God.


Doesn't sound very voluntary to me. It kind of sounds like God is commanding them to give some of their wealth to the poor whether they like it or not. If you are an atheist this is not relevant, but as much as Christianity teaches that private charity comes first, that is not to say that Judaism and Christianity do not leave room for government mandated poor aid, as seen here. Obviously there wasn't much currency at the time and it was a barter based economy, but in today's context it is the equivalent of paying taxes to support social programs.

Except that you said yourself: without government regulations, medical services would be cheaper. It can also be argued that the existence of government welfare undermines personal charity ("I voted for higher taxes and more food stamps, so I don't really need to help anybody personally, I've done my part.")


I would argue it does to some extent as well. I do not support unlimited food stamps, in fact I think they have gotten too loose in giving people food stamps. A lot of people I see using them in front of me at the check out are obese. Hardly preventing hunger. We are fortunate that we live in a society where food is relatively cheap. I think its absurd to say that food is not widely available for a price anybody can afford, however health care is not. Endorsing one expansion of the welfare state does not automatically mean I support liberal largesse on every issue. Unlike libertarians I realize I don't have to sign on to 100% of everything any ideology teaches.

Not even America is doing fine in terms of government spending and debt, and that's before turning health insurance into a giant subsidized handout.


Actually things aren't really that bad, and we have cut spending a lot. We have long term problems with SS and Medicare decades out, but in the end the idea that we are spending ourselves into Greece is an oft touted idea that actually has no merit in truth. You might think we should spend less than we do, and we certainly should not spend more, however the debt is overblown. A national debt is not necessarily the problem when you have the full faith and credit of the largest economy on Earth. Unfortunately the extreme right is threatening to ruin that by not raising the debt ceiling. I just wish they would let Texas secede then they could all move there and have small government utopia. In fact if I were president I would kick Texas out of the union whether they wanted to or not. I think it would be enough to weaken the Tea Party within the rest of the country since Texas is 10% of the population and one of the most conservative states, and because Tea Party members would move there.

Government bungled health care by making the tax code in such a way that health care became seen as the employer's responsibility.

If we give up on it, it sure is.

I agree that one's health insurance shouldn't be tied to one's employer. But for the same reasons, neither should it be tied to one's government.


The reality is though there will never be political support. Essentially the options are either moving toward single payer or keeping the current bungled system. Where it between the bungled system and your system, I would actually swallow the pill of your system whatever the risks involved. However vulgar right-libertarians have more or less swallowed the pill that we already have free market health care and have set themselves up as defenders of the current system. I'm not counting Joe Liberty in this group, but mainly the sort of Fox News watching self-proclaimed "libertarians conservatives" you see at Tea Party rallies and in Congress.

I think "conservatism" has changed dramatically in the United States. Originally "conservatives" opposed the income tax and Social Security. Now "conservatives" like say, "keep your government out of my Medicare". So it's my opinion that conservatism's core principles have eroded to the point that they are unrecognizable, a mish-mash of sometimes dichotomous talking points. I don't really consider pragmatism a principle anyway, but that's probably just me.


Actually historically in Britain, where conservatisms roots lie, conservatism was originally opposed to both socialism and free market liberalism, viewing established institutions as the bulwark of society. There were always two definitions of conservatism in the USA, one similar to the British conservatism of Disraeli in an American context (like Russell Kirk) and the other a libertarian strand, William F. Buckley brought those two strands together in fusionism. In recent years the traditionalist strand has taken second place to libertarianism, and in the end oddly enough US libertarian conservatism came to influence Thatcher more than the earlier Tories of her own nation did. David Cameron by contrast is essentially a moderate social liberal in the Barack Obama mold, and isn't a conservative of either stripe in spite of what he says.
#14309748
nucklepunche wrote:Libertarian politicians seem to have a major obsessive focus on taxes and regulations impacting BIG business.

All businesses.

For instance I am trying to start a house painting company but I live in one of ten states that requires a license to paint houses and one of four requiring education and exams, costing thousands of dollars at the outset, in fact you need a builder's license just to paint. I'm considering moving to a neighboring state.

And was it a Democratic state legislature and governor who signed that requirement into law?

Republicans "took over" my state in 2010.

"Republican" is not a synonym for "Libertarian". I swear I am not making this up.

Now I am the supposed entrepreneur they are trying to help, but at the end of the day my main concern is not taxes or Obamacare since I'm not making enough money to worry about high marginal tax rates and I actually view Obamacare as a benefit to a small entrepreneur, really businesses with over 50 employees who don't offer health insurance are the only ones who get hurt, and they are actually a minority among large companies. But Republicans are spending all their time worrying about something impacting people who whom complying is a drop in the bucket.

Your state Republicans have no ability to repeal Obamacare. Are you saying all the time the members of your state's legislature spend "worrying" about Obamacare is preventing them from performing their duties as state legislators?

At the end of the day I haven't seen a thing done to remove the licensing requirement...

Is that the only piece of legislature the incoming state legislature should repeal? If so, then yes... it is a shame they didn't get right on it.

...which was put in place by the previous governor, no doubt as a matter of protectionism lobbied for by established business.

And was this previous governor a Republican?

This is the sort of "red tape and regulations" stifling small business owners, little silly stuff like this, however once again not a single thing done to stop in. Meanwhile an obsession with repealing Obamacare.

Please list the actions your state legislators are taking to repeal Obamacare.

As a entrepreneur I have a hard time believing Republicans are standing up for my interests even though they say they are, because it seems like the only regulations they are focused on are the ones that only impact the people big enough to be able to afford compliance in the first place.

How many other regulations has your state legislature repealed since taking office? How many were repealed by their predecessors?


Phred
#14310403
In this case a Democratic Governor passed the requirement, which is bad. What I am saying is that there is a middle ground. I feel like both sides go too far too often, but I am saying that Republicans need to focus on issues like this that really do stifle entrepreneurs instead of obsessing over Obamacare and 4% tax increases and threatening to lead us to default. I hate Democrats too, I am a conservative of the traditionalist, Burkean sense and I seek to pull the GOP back to those roots and away from absolutist libertarianism. I don't care about the Democrats because I will always disagree with them, what I am focused on is restoring the party of Lincoln and Eisenhower and doing everything I can to take it away from the Ted Cruz wing.
#14311080
nucklepunche wrote:I don't care about the Democrats because I will always disagree with them, what I am focused on is restoring the party of Lincoln and Eisenhower and doing everything I can to take it away from the Ted Cruz wing.

What evidence can you present that Ted Cruz favors restrictions on entrepreneurs who want to paint houses for a living?


Phred
#14311094
I don't think Ted Cruz does, in fact I am sure he would be on my side on this one as everybody except the heads of building trade unions would most likely. What I am arguing is that this used to be the sorts of ridiculous things that riled up Republicans and still does, since it is a direct attack by the state on the small entrepreneur. What I am saying is that in the past Republicans were always the party of small business owners, and generally supported those interests more or less.

Today however the focus has changed. They focus on Obamacare and claim it will stifle entrepreneurs, but I don't see how it will. I don't agree with a lot of it like the employer mandate which is terrible and I want to see it repealed, that being said I don't see how it stifles a small business person in my situation. It certainly stifles a lot of low wage big businesses and that's bad because a lot of workers may lose hours in retail and food. But once again it is absurd to say Obamacare stifles small entrepreneurs. I guess I just see today's GOP as more concerned about the interests of big insurance than about somebody like me.

What I am saying is that I want a moderate conservative Republican Party with a big tent. I want a party that embraces common sense policies. At one time most of Obamacare was a Republican idea, except the employer mandate, but now it has become totally opposed to it. Reagan raised taxes as much as he cut them. The bottom line is that today's GOP is the most ideological it has ever been. You can't deny that there are more purity tests in the GOP than there have been in the past, and on the Democratic side.

What I want to see is pragmatic conservatism, and I feel like Ted Cruz' style is to burn down the whole house if you do not get your way. In the end Cruz doesn't really care about conservatism because he would be moderating otherwise. He knows he's in a safe seat in Texas so he can get away with this and it helps him bring in money. What is absent is what Cruz is doing to win swing voters in Ohio, Pennsylvania, Florida, and Virginia. I don't see him doing anything but working to alienate those people from the GOP forever by making the GOP a more "pure" brand appealing to only the hardest of the hardliners. You might like 150 proof moonshine but there's a reason that Bud Light sells more, because it is palatable to more people. Ted Cruz and the Tea Party are sort of making it so the 150 proof stuff is the only thing coming out the GOP.

Politics, ultimately like it or not comes down to winning elections. Otherwise it's just armchair theorizing at the end of the day. The core base of the GOP is white people over 50 focused on rural and suburban areas. These tend to be the most hardline conservatives around, but they are dying out more and more each cycle whereas Millenials and minorities are making up more and more each time. Unless you get young people and minorities to vote Republican they are doomed, and people like Ted Cruz focus on extracting maximum loyalty (and above all dollars) from old white people. Millenials voted for Obama overwhelmingly both times, and will make up one third of the electorate next time. Republicans can't afford to lose 60-70% of one third of the electorate and expect to win.

I know it gets repeated ad nauseam in he media but it is the bitter truth whether you like it or not. Obama would have lost in 2012 if the demographics were the same as in 2004. Statistically 60% of elderly people vote Republican, and around two thirds of Millenials vote Democratic.

Let's say you have a state that is very close. Let's say you have a million Democrats and a million Republicans. Let's say 50,000 elderly voters die between 2012 and 2016. Statistically about 30,000 were Republicans, 20,000 were Democrats. You then have 980k Democrats and 970k Republicans. Already Democrats have an advantage. Then let's say you have 100,000 young people turning 18 as population growth is a bit higher. Statistically about 66,000 of them will go Democratic, only 34,000 go Republican. Then Democrats have 1.46 M and Republicans have 1.04 M, so Democrats are getting an advantage every time. That's sort of a microcosm of what is happening in the nation. You don't see it now but every election cycle it will get stronger.
#14317523
Why DON'T we have a single payer USG system of Health care?

1. Health Health insurance companies would be relegated to bidding only on the paperwork requirements (as medicare is now handled).

2. There would perhaps be NO NEED for AARP Medi-gap Policy and the additional handling.

3. Tighter controls can be exercised because of standardization and HELP curtail looting.

Obamacare is the 1st step 1n the direction of a single payer system.

Don't forget the forty thieves were also unhappy that Ali Baba heard the password and spoiled use of their lair. :-)

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